Objective To evaluate the technique of coronary bypass grafting and its early result in 286 consecutive patients.Methods Two hundred and eighty-six patients from June 2002 to December 2005 underwent coronary artery bypass grafting.The average unmber of grafts was 3.3.Two hundred and eighty-three patients had left internal mammary artery bypassed to the left anterior descending branch.Other grafts were from saphenous veins.Results All patiens were clinical recovery.Respirator assisted within 0～28 hours(average 10).Conclusion Coronary artery bypass can be safely done with low mortality excellent surgical results even in patients with multi-vessel coronary artery disease.

Objective To study the role of the oxidative stress in the development of wound healing and observe the effect of the antioxidant PTD-SOD on damage and inflammation reaction after mechanical wound. Methods In this experiment,acute wound healing model by removal the whole layer dorsal skin of the mice was prepared,SOD(3 000 U and 6 000 U)and the fusion protein PTD-SOD with different concentrations(1 000 U,3 000 U,6 000 U and 10 000 U)were used to deal with the wounds continuously for 13 days.The mice were divided into different concentration SOD treatment group and PTD-SOD treatment group,model control group,physiological saline treatment group and compound iodine solution control group.The wound healing situation and healing percentage of the fight and left skin wounds of each mouse in every group was recorded every day.At day 14 after wound,the wound healing skin of each group was removed and some were used to make 10%tissues homogenate for detecting the activities of superoxide dismutase(SOD),catalase(CAT),glutathione peroxidase(GSH-Px)and contents of malondialdehyde(MDA)and hydroxyproline(Hyp);in the meantime,the other removed skin were fixed in 10% formalin for observing the histopathological changes of the tissues. Results Compared with the model control group,the physiological saline treatment group and the compound iodine solution control group,the skin wound healing percentage was significantly(P<0.05 or P<0.01)improved,with increase of the activities of SOD,CAT,GSH-Px and contents of Hyp (P<0.05 or P<0.01)and decrease of MDA(P<0.05 or P<0.01) in the SOD groups or PTD-SOD groups (except for 10 000 U PTD-SOD group).When compared with the physiological saline treatment group or the compound iodine solution treatment group,the effect was similar to the model control group.In comparison to the SOD groups,under the same dosage and environment condition,the PTD-SOD groups were much better than SOD groups with regard to promoting skin wound healing percentage,increasing activities of antioxidases and contents of Hyp,decreasing contents of MDA.Among the PTD-SOD groups,the effect of high dosage 10 000 U on promoting skin wound healing was declined. Conclusions The oxidative stress may playan important role in the development of wound healing.Proper application of treatment with antioxidants is a alternative strategy in the early stage of wound.PTD-SOD is able to prevent the oxidative stress damage,inhibit inflammatory infiltration and promote skin wound healing efficiently.

Objective To explore the clinical significance of retrograde access for the interventional treatment of lower extremity arterial occlusive diseases when the occluded segment of lower extremity artery could not be reached through antegrade access.Methods Twenty-seven cases (male 17,female 10; age range 32-89 years ) were retrospectively investigated, including 18 with lower limb arteriosclerosis obliterans,7 with diabetic foot and 2 with thromboangiitis obliterans.According to the Fontaine staging,6 cases were classified as Fontaine Ⅱ,11were classified as Fontaine Ⅲ and 10 were classified as Fontaine Ⅳ.All cases underwent endovascular operation through antegrade access first with an attempt to cross the occlusive segment,but in vain.So retrograde access was tried via puncture of pedis dorsalis or posterior tibial artery or exposure of lateral branches of posterior tibial artery,peroneal artery or dorsal artery by open surgery,which followed by Percutaneous transluminal angiography and (or) stenting.Results The operation through retrograde access was successful in all cases with obvious improvement of ischemic symptoms.Hematoma at the puncture site occurred in 3 patients,and paresthesia of toes occurred in 1after dorsalis pedis arteriotomy.No severe perioperative complication occurred.The average ankle brachial index increased from 0.37 ± 0.11preoperatively to 0.85 ± 0.12 postoperatively.Conclusions Retrograde access could be used as an alternative strategy in lower extremity arterial occlusive diseases when the occluded segment could not reach through antegrade access.

Objective To evaluate the value of carotid artery bruit in predicting carotid stenosis in patients with cerebral arterial thrombosis. Methods Two hundred cerebral arterial thrombosis patients were divided into bruit group and no bruit group according to carotid artery auscultation,with 100 cases in each group. The patients with cardiac murmur, vein sound and thyroid noise were excluded from bruit group. The examination of carotid artery auscultation (transcranial Doppler sonography ) was managed in all the patients,and digital subtraction angiography (DSA) about aortic arch and the whole brain were perfomed. The carotid stenosis rate, site, degree were compared and the relationship between carotid bruit grade and carotid stenosis degree were evaluated. Results The carotid stenosis rate in bruit group [67% (67/100)] was higher than that in no bruit group [29%(29/100)](P＜ 0.01 ). There was significant difference in the carotid stenosis site and degree between two groups (P ＜0.05). Carotid bruit were significantly associated with stenosis near carotid bifurcation or serious stenosis (P ＜ 0.05). The carotid bruit grade was positively related with the carotid stenosis degree (P ＜ 0.05 ). Conclusions Carotid bruit is associated with site and degree of carotid stenosis. Carotid bruit is valuable in screening for carotid stenosis in patients with cerebral arterial thrombosis.

Objective To explore the radical surgery for tetralogy of Fallot combined with right pulmonary artery stenosis.Methods Thirteen cases with tetralogy of Fallot combined with right pulmonary artery stenosis accepted radical surgery,among them 7 cases who-had a long right pulmonary artery stenosis accepted aortic transaction for radical surgery of tetralogy of Fallot;5 cases who had the entrance stenosis of the right pulmonary artery accepted right pulmonary artery patch expansion for radical surgery of tetralogy of Fallot;One case who had the distortion and stenosis after pulmonary shunt accepted the radical surgery for tetralogy of Fallot after seperation and expansion.Results There were no operation-related deaths,post-operative low cardic output and perfusion lung occurred for all the cases.Ten cases had grade 1 cardiac function and 3 cases had grade 2,respectively.Conclusion Right pulmonary artery stenosis increased the risks during the radical surgery for tetralogy of Fallot,but it is still the primary operation choice.

Objective To investigate the blood-saving effect of tranexamic acid in patients undergoing Stanford type A aortic dissection surgery.Methods Fifty-six patients of both sexes with acute Stanford type A aortic dissection, aged 34-58 yr, weighing 62-84 kg, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ , with their left ventricular ejection fraction ＞ 40％, undergoing emergency surgery, were randomly divided into 2 groups: control group (group C, n=26) and tranexamic acid group (group TA, n=30).Tranexamic acid was infused as a bolus of 10 mg/kg over 30 min before skin incision followed by an infusion of 10 mg · kg-1 · h-1 throughout the surgery in group TA.The equal volume of normal saline was given instead in group C.The total volume of drainage at 24 h after operation, the postoperative requirement of allogeneic red blood cells, fresh frozen plasma and platelets, and re-thoracotomy for bleeding were recorded.The postoperative mechanical ventilation time, duration of intensive care unit stay, and complications after operation were also recorded.Results Compared with group C, the total volume of drainage at 24 h after operation, and the requirement of allogeneic red blood cells, fresh frozen plasma and platelets were significantly reduced, the incidence of rethoracotomy for bleeding was decreased, the postoperative mechanical ventilation time, and duration of intensive care unit stay were shortened, and the incidence of postoperative acute lung injury and transient neurological dysfunction were decreased in group TA.Conclusion Tranexamic acid has blood-saving effect and can reduce postoperative bleeding and allogeneic blood transfusion in patients undergoing Stanford type A aortic dissection surgery.

Objective To analyze the mortality in people aged 70 years and over who had undergone aortic valve replacement (AVR) for aortic stenosis.Methods The clinical data of 246consecutive cases aged 70 years and over,who had received AVR,were retrospectively analyzed.The 144 cases (58.5 % ) had hypertension,42 cases ( 17.1 %) had atrial fibrillation,27 cases ( 11.0 % )were obeses,and 18 cases (7.3%) had undergone previous heart surgery.Results The 29 cases (11.8%) were dead within 30 days after operation.Among them,15 cases (8.8%) were with isolated AVR and the other 14 cases (18.7%) were with an associate procedure,the difference was significant (P ＜ 0.05).The rate of postoperative complication was 24 .4%.The commoncomplications were:48 cases (19.5%) with low cardiac output,24 cases (9.8%) with renal dysfunction,52 cases (21.1% ) with prolonged ventilatory support and 12 cases (4.9%) with sepsis.In the Poisson regression analysis,the main predictors of mortality were low cardiac output,renal failure,sepsis and associate procedure.The main predictors of morbidity were CBP time ＞ 120 min,atrial fibrillation and chronic obstructive pulmonary disease.Conclusions The balance between the benefits and risks of the surgery should be well evaluated before deciding to perform AVR.

The delivery of bioactive macromolecular substances into cells provides an efficient approach to changing cellular conditions, and is thus of enormously potential therapeutic significance. It has also been an extremely difficult approach due the the impediment and protective nature of cell membrance until the protein transduction domain's (PTD's) capability to ferry macromolecule across cell membrance was discovered. PTD's efficient transductive function has rendered an exciting promise to the clinical treatment of diseases, therapeutic proteins drug development, and basic medical and applied research. The technology has been successfully applied to deliver a variety of substances into cells or tissue organs, and its superior application values have been explicitly demonstrated.
Cell Membrane Permeability ; physiology ; Drug Delivery Systems ; methods ; Genetic Therapy ; Humans ; Protein Sorting Signals ; Protein Transport ; physiology

Aminopeptidase H (APH) is an universally distributed aminoendopeptidase in the tissue of many organism. However, it is hard to investigate its mechanism underlying the catalysis and the function in cell. In this paper, the full DNA sequence of this enzyme was cloned from chicken liver, then subcloned to the vector pET22 b(+). The recombined vector was transformed into E. coli Rosetta(DE3), and the APH gene was expressed by the induction of IPTG. It was found the recombinant protein exhibited same mo lecular weight as authentic APH on SDS-PAGE analysis; the expression level increased with induction time and approached maximum of 94.7 mg/L till 6 hours, which contained 16.7% of the total protein. Moreover, this recombinant protein showed similar prop erties of subunit composition, thermal stability and optimum pH with native APH, based on the enzymatic assay, purification and analysis of enzymological properties. Therefore, it is confirmed that APH was expressed in this prokaryote system with a high-level of 1636 u/L aminopeptidase activity. These results would help to elucidate the catalysis mechanism and biological function of APH by providing enough material.
Aminopeptidases ; biosynthesis ; genetics ; Animals ; Chickens ; Endopeptidases ; biosynthesis ; genetics ; Enzyme Stability ; Escherichia coli ; genetics ; metabolism ; Recombinant Proteins ; biosynthesis ; genetics ; isolation & purification

OBJECTIVE: To study the effects of long term use of beclomethasone dipropionate (BDP) nasal spray on bone density with perennial allergic rhinitis (AR) in adults. METHOD: A 5-year randomized study was conducted on the effects of BDP nasal spray on serum calcium, phosphorus, alkaline phosphatase, and bone density determined before and after the treatment in 36 adult patients with perennial AR. 20-45 years of age, were randomly divided into 3 groups. That is group A (nasal spray 1 - <3 year), group B (nasal spray BDP 3 - <5 year) and group C (nasal spray BDP > or =5 year). The data were analyzed by paired t test. RESULT: The perennial AR were followed up for more than > or =1 year, > or =3 year and > or =5 year to observe the influences of nasal spray BDP. There were no significant difference between the data examined before and after the treatment (P > 0.05). Bone development is not influenced by nasal spray BDP < or =400 microg/d within 5 years. CONCLUSION Long term use of BDP nasal spray in adult patients does not lead to osteoporosis if the lowest effective steroid dose is given.
Adult ; Alkaline Phosphatase ; blood ; Beclomethasone ; administration & dosage ; adverse effects ; therapeutic use ; Bone Density ; drug effects ; Calcium ; blood ; Female ; Humans ; Male ; Middle Aged ; Phosphorus ; blood ; Rhinitis, Allergic, Perennial ; drug therapy ; metabolism ; physiopathology ; Young Adult