Objective To compare the clinical effect of off-pump coronary artery bypass grafting (eft-pump CABG)and on-pump coronary artery bypass grafting(on-pump CABG).Methods The clinical dates of 152 cases with coronary artery bypass grafting(off-pump CABG group 85 cases,on-pump CABG group 67 cases)were received from June 2005 to December 2008,the preoperative dates,postoperative mortality and the rate of complication were compared between two groups.Results The preoperative dates of two groups were no significant difference(P>0.05);2 cases(2.35%)were died in off-pump CABG group and 13 cases(15.29%)had complications in off-pump CABG group;9 cases(13.43%)were died in on-pump CABG group and 25 cases(37.31%)had complications in on-pump CABG group.The mortality and the rate of complication in off-pump CABG group was significantly less than that in on-pump CABG group.it was significant difference(P<0.01).Conclusion Off-pump CABG is safe therapy of mieosurgieal operation.

OBJECTIVETo compare therapeutic effects of clavicular hook-plate fixation and modified Weaver-Dunn surgery combined with clavicular hook-plate fixation in treating Tossy type III acromioclavicular joint dislocation.

METHODSForty-one patients with Tossy type III acromioclavicular dislocation treated by operation were retrospectively analysis from January 2012 to January 2014. The patients were divided into clavicular hook-plate fixation group (group A) and modified Weaver-Dunn surgery combined with clavicular hook-plate fixation (group B) according to surgical procedures. In group A, there were 15 males and 6 females aged from 17 to 51 years old with an average of (31.60 ± 12.58) years old, preoperative Constant-Murley score was 40.25 ± 9.80, and treated with clavicular hook-plate fixation. In group B, there were 13 males and 7 females aged from 18 to 48 years old with an average of (29.40 ± 11.27) years old, preoperative Constant-Murley score was 41.45 ± 8.81, and treated with modified Weaver-Dunn surgery combined with clavicular hook-plate fixation. Operative time, blood loss, imaging changes before and after operation, postoperative complications were compared; Constant-Murley score at 3, 6 and 12 months after operation were evaluated.

RESULTSIn group A, operative time was 40.50 ± 24.36) min, blood loss was (75.30 ± 30.36) ml; In group B, operative time was (60.10 ± 23.55) min, blood loss was (100.70 ± 40.12) ml. Twenty-one patients in group A were followed-up from 12 to 18 months with an average of (14.8 ± 3.1) months; 20 patients in group B were followed-up from 12 to 14 months with an average of (13.6 ± 1.5) months. There were no significant differences in operative time, blood loss and follow-up time between two groups. Complications were in six patients of group A and 3 patients of group B, and there were no significant meaning between two groups. At 6 months after operation, Constant-Murley score in group A was 88.85 ± 4.23, 92.15 ± 3.82 in group B; and had significant meaning between two groups (t = -2.56, P = 0.022 < 0.05). While there were no differences in Constant-Murley score in other times.

CONCLUSIONBoth of clavicular hook-plate fixation and modified Weaver-Dunn surgery combined with clavicular hook-plate fixation are effective operative methods for the treatment of Tossy type III acromioclavicular dislocation. Clavicular hook-plate fixation has advantage of less trauma, while modified Weaver-Dunn surgery combined with clavicular hook-plate fixation could reconstruct coracoclavicular ligament more stronger, clavicular hook plate could take out earlier, also improve shoulder joint function earlier.

Acromioclavicular Joint ; injuries ; Adolescent ; Adult ; Bone Plates ; Case-Control Studies ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Shoulder Dislocation ; surgery

Objective To investigate the inhibitory effect of dexamethasone on residual Lewis lung cancer cells in mice after palliative surgery.Methods The model of residual Lewis lung cancer cells in C57BL mice after palliative surgery were established,then accordance with the random number table,18 mice were randomly divided into 3 groups with 6 animals in each group:the normal saline group,cisplatin group,and dexamethasone group.After operation,the subcutaneous tumor nodules of each mouse were measured on days 4-10 using vernier calipers (accuracy of 0.l mm).The expressions of hypoxia induction factor-1α (HIF-1 α) and mean vascular density (MVD) in the normal saline group,cisplatin group and dexamethasone group were assessed by paraffin immunohistochemical assay.The expressions of HIF-1α,VEGF and PCNA mRNA and protein in the three groups were assessed by real-time quantitative PCR and Western blotting.Results Tumor growth curve showed that the tumor volume in cisplatin group (200.34 ± 20.94) mm3 and in dexamethasone group (436.58 ± 37.94)mm3 were obviously decreased compared with the normal saline group (1 398.81 ± 192.85) mm3,with statistically significant differences (t =-1201.75,P ＜ 0.001;t =-921.52,P ＜ 0.001).As Paraffin immunohistochemical assay showed,in cisplatin group and dexamethasone group,the expressions of HIF-1 α(2.67 ± 0.43,1.67 ± 0.43) and MVD counts (17.01 ± 3.24,9.89 ± 2.25) were decreased significantly compared with the normal saline (4.21 ± 0.35,29.75 ± 5.64),with statistically significant differences (t =-1.55,P＜0.001;t=-1.83,P＜0.001;t=-12.68,P＜0.001;t=-18.35,P＜0.001).The results of real-time quantitative PCR showed that the expressions of HIF-1α (0.56 ±0.11),VEGF (0.61 ±0.18) and PCNA mRNA (0.38 ± 0.07) in dexamethasone group were obviously reduced compared with the normal saline group (1.21 ±0.13,1.13 ± 0.26,1.06 ± 0.08),with statistically significant differences (t =-0.55,P ＜ 0.001;t=-0.62,P＜0.001;t=-0.69,P＜0.001).The expressions of HIF-1α (0.31 ±0.12),VEGF (0.30 ± 0.13) and PCNA mRNA (0.18 ± 0.06) in cisplatin group were also obviously reduced compared with the normal saline group,with statistically significant differences (t =-0.73,P ＜ 0.001;t =-0.76,P ＜ 0.001;t =-0.81,P ＜ 0.001).The results of Western blotting showed that the expressions of HIF-1α (85.98 ± 20.86),VEGF (173.28 ± 30.98) and PCNA protein (228.96 ± 22.97) in dexamethasone group were decreased significantly compared with the normal saline group (198.98 ± 29.89,378.98 ± 28.98,357.98 ± 35.98),with statistically significant differences (t =98.78,P ＜ 0.001;t =85.68,P ＜ 0.001;t =120.86,P ＜ 0.001).The expressions of HIF-1 α (65.78 ± 18.62),VEGF (109.43 ± 19.86) and PCNA protein (176.86 ± 22.76) in cisplatin group were decreased significantly compared with the normal saline group,with statistically significant differences (t =132.86,P ＜ 0.001;t =108.68,P ＜ 0.001;t =154.74,P ＜ 0.001).Conclusion Dexamethasone can effectively inhibit the growth and angiogenesis of the residual Lewis lung carcinoma after palliative surgery in mice,and may also provide a new method of postoperative adjuvant therapy for patients,especially who received palliative surgery.

Objective To investigate the effects of different doses of alcohol on the synthesis of testosterone and the expression of androgen binding protein(ABP)mRNA in rat testis.Methods Forty male Wistar rats were randomly divided into 4 groups(10 rats each group)and received either distilled water(control group)or alcohol(alcohol-fed groups)for 5 months.Alcohol was administered by garage with a single daily dose : 5 g/kg(large dose group),2.5 g/kg(middle dose group)and 0.5 g/kg(small dose group).Testosterone content was measured by ELISA.mRNA levels of peripheral-type benzodiazepine receptors(PBR),PPARct and ABP were assayed by RT-PCR.Results Compared with control group:(1)ethanol feeding with daily doses of 5 g/kg,2.5 g/kg and 0.5 g/kg significantly decreased testosterone levels by 31.13%(P0.05)respectively,indicating that ethanol might impair testosterone synthesis;(2) mRNA levels of PBR were decreased in all three ethanol-treated groups(all P

Human gut microbiota plays a key role in the development of obesity. Intestinal flora can regulate energy absorption and nutrition metabolism, increasing the energy harvesting from diet. Alteration of gut flora produces excessive lipopolysaccharide, which, when absorbed into the blood, can induce inflammatory reactions and promote the high-fat diet-associated obesity and metabolic syndrome. Intestinal flora increase visceral fat deposition by lowering the expression of Fiaf in intestinal mucosa. Different immune status also affects the intestinal flora.The gut microbiota is hypothesized to be an environmental factor that contributes to obesity; by interacting with factors such as host and diet, it adjusts the energy metabolism. Antibiotics or probiotics may alter the composition of intestinal microflora and improve the metabolic syndrome, and thus provides new treatment options.
Animals ; Diet, High-Fat ; Gastrointestinal Tract ; microbiology ; Humans ; Inflammation ; etiology ; Mice ; Obesity ; microbiology ; therapy ; Probiotics ; therapeutic use

This study evaluated the clinical effect of impaction bone graft and distal press-fit fixation for the reconstruction of severe femoral bone defect in revision total hip arthroplasty. A total of 234 patients (involving 236 hips) with Paprosky III and IV femoral bone defects were treated with the revision total hip arthroplasty from June 1998 to Aug. 2006. Impaction bone graft technique was used for 112 hips, with allogeneic freeze-dried bone as bone graft and SPII as prosthesis. With 124 hips, modular distal press-fit fixation and tapered femoral stem (MP stem) were employed. After the operation, the subjects were followed up on regular basis and results were assessed by using the Harris Hip Score (HHS) and 12-item Short Form Health Survey (SF-12). Radiolucence, subsidence and loosening were observed and complications, including infection, fracture, dislocation etc. were recorded. A 6-14-year follow-up showed that prostheses failed, due to infection, in 4 patients of impaction bone graft group and that 6 patients in the press-fit fixation group experienced prosthesis failure, with the survival rates for the two techniques being 96.43% and 95.16%, respectively. One-way ANOVA showed that prosthesis survival was significantly associated with surgery-related complications (P<0.05) and was not related to the type of the bone defects (P>0.05). The rate of complications bore significant association with the type of bone defects in the two groups (P<0.05). Our study showed that the two revision methods could achieve satisfactory mid-term and long-term results for the reconstruction of severe bone defects. It is of great significance for attaining high prosthesis survival rate to select suitable operation on the basis of the type of bone defect. Careful operative manipulation and post-operative rehabilitation aimed at reducing complications are also important.

Bacillus are well known antibiotic producers. In this study,dozens of Bacillus strains from different sources were screened. Among them,a strain with strong antifungal activity was found. With 16S rDNA test and Biolog assay,this strain was identified to be Bacillus amyloliquefaciens. The fermentation conditions were optimized in small conical flasks. After ammonium sulfate salting out,dialysis,freezing vacuum dehydration,the crude protein extracts were obtained. The thermal stability,pH stability,protease stability,ion stability and antifungal spectrum of this protein were studied further. Scanning electronic microscope was also used to explore the antifungal mechanism.

OBJECTIVETo evaluate the short-term and long-term curative effect of microvascular decompression sensory root of trigeminal nerve combing (MVD + SRTNC) by post-sigmoid approach as well as the complications in these operations.

METHODSThe data from 138 idiopathic trigeminal neuralgia (TN) patients treated with MVD + STRNC that followed up 33 months to 58 months was analyzed.

RESULTSImmediate relief from pain occurred in 136 patients (98.6%). On Kaplan-Meier analysis, cumulative proportion effectiveness at the end of 25 months decreased to 91.4%, and 85.8% from 49 months to 58 months. There were cases of 63.83% and 19.15% with slight and midrange hypoesthesia after surgery but majority recovered at the end of 3-58 months (P < 0.01). No serious hypoesthesia occurred. The complications including leakage of cerebrospinal fluid, herpes and headache caused by high intracranial pressure, were observed in 4 cases (2.90%), 36 cases (26.09%) and 3 cases (2.17%), respectively. Two cases (1.43%) died of cerebral hemorrhage.

CONCLUSIONSThe proposed surgical strategy of standard MVD plus sensory root of trigeminal nerve combing was a good strategy option for TN, but It was important for surgeons to think highly of the risks of the surgery.

Adult ; Aged ; Aged, 80 and over ; Decompression, Surgical ; Female ; Humans ; Male ; Microcirculation ; Middle Aged ; Treatment Outcome ; Trigeminal Nerve ; blood supply ; surgery ; Trigeminal Neuralgia ; surgery ; Young Adult

OBJECTIVETo evaluate the efficacy of treatment with allogeneic peripheral blood stem cell transplantation for benzene-induced severe aplastic anemia.

METHODSHLA-compatible sibling (pregnancy) allogeneic peripheral blood stem cell transplantation (Allo-PBSCT) was successfully performed for a patient with severe aplastic anemia caused by benzene poisoning. 9.41 x 10(8) nucleated cells/kg, 12.49 x 10(6) CD(34) positive cells/kg and CFU-GM 8.2 x 10(5)/kg were infused. The patient was treated with cyclophosphamide (120 mg/kg), total body radiation (8 Gy) and anti-lymphocyte globulin (60 mg/kg) before transplantation. Donor buffy coat cells (9.02 x 10(8) nucleated cells/kg, 10.62 x 10(6) CD(34) positive cells/kg, 6.3 x 10(5) CFU-GM/kg) were infused again on day 18 after transplantation to prevent from graft failure. Graft versus host disease prophylaxis consisted of both methotrexate and cyclosporin A.

RESULTSThe lowest ANC was 0, the lowest platelet was 3 x 10(9)/L after transplantation. The patient achieved an ANC of greater than 0.5 x 10(9)/L from 21st day, and the platelet of greater than 50 x 10(9)/L from 28th day after transplantation. Grade I cGVHD was found the fourth month after grafting. Examination of recipient's bone marrow cells showed a normal 46, XX (presumably marrow donor) karyotype. Blood group changed from B to O.

CONCLUSIONThis is the first case reported in China showing a successful treatment of benzene-induced severe aplastic anemia with allo-PBSCT. Allo-PBSCT may be an effective remedy for this kind of patients.

Adult ; Anemia, Aplastic ; chemically induced ; therapy ; Benzene ; poisoning ; Humans ; Male ; Occupational Diseases ; chemically induced ; therapy ; Peripheral Blood Stem Cell Transplantation ; Transplantation, Homologous ; Treatment Outcome

PURPOSETo compare the clinical effects of long vs. short intramedullary nails in the treatment of intertrochanteric fractures in old patients more than 65 years old.

METHODSA retrospective analysis of 178 cases of intertrochanteric fractures of the femur (AO type A1 and A2) in the elderly was conducted from January 2008 to December 2013. There were 85 males (47.8%) and 93 females (52.2%) with the age of 65e89 (70.2±10.8) years. The patients were treated by closed reduction and long or short intramedullary nail (Gamma 3) fixation. The length of short nail was 180 mm and that for long nail was 320e360 mm. The general data of patients, operation time, intraoperative blood loss, length of hospital stay, preoperative hemoglobin level, blood transfusion rate, postoperative periprosthetic fractures, infections, complications, etc were carefully recorded.

RESULTSThere were 76 cases (42.7%) in the long intramedullary nail group and 102 cases (57.3%) in the short nail group. All the cases were followed up for 12e48 (21.3±6.8) months, during which there were 21 deaths (11.8%), mean (13.8±6.9) months after operation. The intraoperative blood loss was (90.7±50.6) ml in short nail group, greatly less than that in long nail group (127.8±85.9) ml (p=0.004). The short nail group also had a significantly shorter operation time (43.5 min±12.3 min vs. 58.5 min±20.3 min, p=0.002) and lower rate of postoperative transfusion (42.3% vs. 56.7%, p=0.041). But the length of hospital stay showed no big differences. After operation, in each group there was 1 case of periprosthetic fracture with a total incidence of 1.1%, 1.3% in long nail group and 0.9% in short nail group. At the end of the follow-up, all patients achieved bony union. The average healing time of the long nail group was (6.5±3.1) months, and the short nail group was (6.8±3.7) months, revealing no significant differences (p=0.09). Postoperative complications showed no great differences either.

CONCLUSIONBoth the intramedullary long and short nail fixation has a good clinical effect in treating intertrochanteric femur fractures in the elderly. They showed no significant difference in terms of therapeutic effect, hospital stay and postoperative complications. The incidence of periprosthetic fractures treated by either length of nails was low. But short intramedullary nailing can obviously decrease the intraoperative blood loss, operation time and postoperative blood transfusion.

Aged ; Aged, 80 and over ; Blood Loss, Surgical ; statistics & numerical data ; Blood Transfusion ; statistics & numerical data ; Female ; Fracture Fixation, Intramedullary ; instrumentation ; Hip Fractures ; surgery ; Humans ; Length of Stay ; statistics & numerical data ; Male ; Operative Time ; Postoperative Complications ; epidemiology ; Recovery of Function ; Retrospective Studies ; Treatment Outcome