Objective To investigate the predictive value of epicardial adipose tissue(EAT) thickness for the recurrence of atrial fibrillation (RAF) after concomitant valve replacement and bipolar radiofrequency ablation.Methods From January 2012 to May 2014,156 patients with permanent atrial fibrillation and organic valvular diseases underwent concomitant valve replacement and successful bipolar radiofrequency ablation in the First People's Hospital of Shangqiu.After 1 year of follow-up,the recurrence of AF was analyzed and the correlation factors were analyzed statistically.Results All patients completed a regular follow-up.During a 12-month follow-up period,RAF was observed in 39 patients (25.0％).Echocardiography-derived regional EAT thickness was significantly greater in RAF patients than that in non-RAF patients((6.9±0.6) mm vs.(5.5±0.7) mm,t=4.649,P＜0.05).The EAT thickness strongly correlated with patients age,body mass index,Ratio of left atrial diameter,mitral diastolic blood flow velocity and early diastolic velocity of mitral annulus,low density lipoprotein-cholesterol and thyroglobulin (r =0.62,0.57,0.68,0.59,0.73,0.76;P ＜ 0.05).Cox multivariable analysis showed that,duration of AF history (95％CI:1.01-1.15,P =0.040),left atrial diameter (95％CI:1.07-1.24,P =0.021) and EAT thickness (95％CI:1.05-1.79,P =0.009) were independent predictors of RAF.Conclusion Echocardiography-derived regional EAT thickness combined with left atrial diameter may serve as effective parameters in identifying patients at the highest risk for RAF.

Objective To review the outcome of coronary artery bypass graft (CABG) using left internal thoracic artery grafts in the patients aged over 70 years old.Methods Two hundred and eighty-eight patients aged over 70 years old from January 2009 to January 2014 who underwent CABG were selected.All of the patients were divided into two groups on base of the graft:control group:only saphenous vein graft was used in 138 cases; observation group:the left internal thoracic artery to the left anterior descending artery was used in 150 cases,which also included total arterial grafting,facilitated by the use of the radial artery,right gastroepiploic artery was operated in 7 cases,beside these artery grafts,saphenous vein graft was used to anastomosis with other vessels.Results Operative mortality was 2.9％ (4/138) in control group and 2.0％ (3/150) in observation group,and there was no significance (P ＞ 0.05).The volume of blood drainage was larger in observation group [(796.2 ± 382.4) ml] than that in control group [(512.8 ± 387.5) ml],and there was significant difference (P ＜ 0.05).At the same time,there was no significant difference in the incidence rate of second thoractomy,malignant arrhythmia,stroke,poor wound healing,and usage of intraaortic balloon counterpulsation between two groups (P ＞ 0.05).Conclusion It does not increase the mortality and incidence of serious complications using the left internal thoracic artery to the left anterior descending artery in the patients aged over 70 years old during CABG.

Liver metastasis is one of the main causes of treatment failure in colorectal cancer, and the key to improve the efficacy of treatment is to adopt precision therapy. Oligometastatic classification clearly defines the treatment methods and goals for distinguish-ing liver metastases, as well as promotes nonsurgical methods for local treatments. In addition to RAS oncogene, other biomarkers with prognostic and therapeutic predictive values urgently need to be identified. Precision therapy encompasses the entire course of optimal treatment in colorectal liver metastases (CRLM) including the following:optimization of therapy sequence for initial resectable liver metastases, treatment predictive value of KRAS oncogene for liver resection, selection of sensitive subgroups for conversion ther-apy, application of the optimal follow-up strategy, and formulation of individual comprehensive treatment regimens. This review focus-es on the recent progress of precision treatment for CRLM.

AIM: To investigate the differentiation of human mesenchymal stem cells (MSCs) into neuron-like cells induced by the supernatant of rat C6 glloma cells. METHODS: The heparin anticoagulant human bone marrow sampling was performed and human MSCs were separated flom human bone marrow using Percoll gradient method, followed by trypsinization and passage culture. When the MSCs at 4-6 passages reached a confluence of 90%, they were inoculated into a 24-well culture plate at a density of 2×103 per well. Cells were then divided into induction group and control group. In the induction group, C6 glioma cells were induced by the complete culture medium supplemented with 50% C6 glloma ceils supernatant (L-DMEM containing 0.1 fetal bovine serum), and half of the culture medium as replenished every 2 days. In the control group, cells were cultured in the complete culture medium. Both groups were treated 3 days and the expression of neuron-specific marker was monitored with S-P immunocytochemical stain. RESULTS: After an induction period of 24 hours, the differentiated MSCs showed typical neuron-like appearance, while the controlled cells exhibited no obvious alters. After 3 days of the induction, the neuron specific enola,se-positive rate of the cells in the induction was significantly higher than that in the control group (P < 0.01). The neurofilament protein-positive rate of cells in the induction group was (44.2±2.4)%, and the control group cells did not express neurofilament protein. Typical glial astrocyte marker glial fibrillary acidic protein was negatively expressed in both groups. CONCLUSION: Differentiation of MSCs into neuron-like cells can be induced by the supematant of rat C6 glioma cells in vitro.

Objective To investigate physical activity in patients with type 2 diabetes mellitus and to analyze its influencing factors,in order to provide references for the prevention and control of disease.Methods A total of 469 cases of patients with type 2 diabetes mellitus were enrolled in this study.The basic information,such as gender,age and so on,and situation of physical activity,including work,housework,transportation and entertainment,were surveyed via questionnaire.Results The total amount of physical activity of patients with type 2 diabetes mellitus in this survey was (1 581.59±743.65)MET-min per week,were mainly contributed from entertainment and housework which was (940.83 ± 547.06) and (407.20 ± 226.63)MET-min per week respectively.The amount of physical activity of patients in different age,occupation,duration of illness and BMI,and patients with or without other chronic diseases were significantly different (P＜0.05).Under 45 years old,being on-the-job,with other chronic disease were risk factors for lack of physical activity in patients with type 2 diabetes mellitus (P＜0.05),while aged 45-＜60 years old,light or normal weight was the protection factors of sufficient physical activity in patients with type 2 diabetes mellitus (P＜0.05).Condusion The overall physical activity of patients with type 2 diabetes mellitus is on the medium level,and its main types are entertainment and housework.Patients under 45 years old,being on-the-job,with other chronic diseases have higher risk of lacking physical activity.

length of the spine.

With statistics and anatomic description, the extensor and flexor thigh muscles in francois leaf monkey were studied. Using stepwise regression, the origins and insertions' of the muscles, showing significant correlationship with the femur (E), are only the distance from the most anterior point of origin of the m. sartorius to the acetabular fossa (A) (r=0.68, t=3.33, P

Objective To investigate the role of Chinese traditional medicine-Tianlongchuankeling in modulation of the transdifferentiation of sub-epithelial fibroblasts into myofibroblasts induced by rhTGF-?1,and the involved mechanism of the signal transduction.Methods Human primary bronchial sub-epithelial fibroblasts(HPBFs)were incubated with either Tianlongchuankeling or its main components of Qingtiankui,Danfuzi and Faxia respectively before being treated with rhTGF-?1(10 ?g/L)for different time.Total protein of cells were collected at different timelapse(10min,30min respectively).Phosphorylated MAPKs for p38,ERK1/2,phosphorylated smad2 and the expression of ?-SMA were detected by using Western blotting.Total RNA was extracted at 20 h and 72 h and subjected to RT-PCR for evaluation of the expression of ?-SMA gene.Results The induction of ?-SMA in HPBFs by TGF-?1 was down-regulated significantly in the cells treated with Tianlongchuankeling or Danfuzi.The phosphorylation of ERK1/2 under TGF-?1 stimulation was inhibited significantly in Tianlongchuankeling and Danfuzi group.No difference of the level in phosphorylation of p-38 and smad2 was found among groups.Conclusion Tianlongchuankeling has the capability to suppress the induction of ?-SMA by TGF-?1 through down-regulation of the phosphorylation of ERK1/2,thereby preventing the transdifferentiation of sub-epithelial fibroblasts into myofibroblasts,which may be responsible for the treatment of airway hyperresponsiveness in asthma.Danfuzi,one of main components of Tianlongchuankeling,may make a major contribution to this process.

Objective To investigate the effect of tetramethylpyrazine injection on serum ion and β2-GPI/ox-LDL in patients with IgA nephropathy.Methods 58 IgA nephropathy patients were randomly divided into two gorups with 29 cases in each group.The control group were treated by benazepril and conventional treatment of dipyridamole, the experiment group were treated on the basis of the control group with tetramethylpyrazine injection.10 days of 1 courses, 2 courses of treatment.The serum ion,β2-GPI/ox-LDL and renal function related indexes were tested.Results Compared with before treatment, the serum inorganic phosphorus,β2-GPI/ox-LDL, Scr, BUN, CysC levels and 24 h urinary protein quantitation were lower( P<0.05), the blood calcium level were higher(P<0.05).Compared with the control group, the serum inorganic phosphorus,β2-GPI/ox-LDL, Scr, BUN, CysC levels and 24 h urinary protein quantitation were lower(P<0.05), the blood calcium level were higher(P<0.05), the clinical effect were higher (P<0.05).Conclusion Tetramethylpyrazine injection can effectively decrease the serum phosphorus, β2-GPI/ox-LDL, SCR, BUN, CysC levels and urinary protein amount of patients with IgA nephropathy, elevate blood calcium levels, significantly improve renal function and with less adverse reactions.