ObjectiveTo investigate the influence of carotid artery stenosis on the incidence of neurological complication in patients undergoing off-pump coronary artery bypass grafting.MethodsWe prospectively analyzed 176 consecutive patients ≥60 years old undergoing selective off-pump coronary artery bypass grafting (from June 2010 to July 2011 ).Carotid duplex ultrasound screening was used to determine the presence and severity of carotid artery before surgery. Neurological complications 7 days after surgery were compared between the patients with ( ≥75％ ) and without severe carotid artery stenosis ( ＜ 70％ ).Multivariate analysis was used to determine the predictor of severe carotid artery disease.ResultsSixteen patients (9.1％ ) were found to have severe carotid artery stenosis before surgery. Thirty-seven patients (20.8％ ) had single or multiple neurological complications:1 (0.6％ ) had stroke; 12 (6.7％) had hypoxic-metabolic encephalopathy; 21 ( 11.8％ ) had cognitive dysfunction; 3 ( 1.7％ ) had depression.When compared with the counterparts,patients with severe carotid artery stenosis had a higher rate of neurological complications (43.8％ vs 18.8％ ; P =0.044).In multivariate analysis,significant predictive factor for severe carotid artery stenosis was prior stroke ( OR:4.04 ; 95％ CI 1.22-13.37 ).Conclusion Severe carotid artery stenosis alone is a risk factor for neurological complication after off-pump coronary artery bypass grafting and prior stroke is a predictor for sever carotid artery disease.

Objective To evaluate the nutrition status and the prognosis of acute stroke patients with hy-pothyroidism during hospitalization. Methods The clinical data of 28 acute stroke patients with hypothyroidism (study group) and 28 stroke patients with normal thyroid function (control group) were retrospectively analyzed.Results After (10±4) days of hospitalization, hemoglobin and serum albumin levels in study group significantlydecreased ( P < 0. 05 ). The requirement of calories and protein, incidence of pulmonary infections, alimentarytract hemorrhage and diarrhea, and hospital stays were significantly higher in study group than in control group (P < 0. 05 ). Conclusion The nutrition status is poor in acute stroke patients with hypothyroidism, who were more easier to be suffered from clinical complications and worse prognosis.

Objective Research the effect of anti-inflammatory and anti-oxidation drugs on acute stroke patients. Methods 128 patients with acute ischemic stroke are divided into two groups- combined treatment group (71) and control (57). Test serum biomarkers and evaluate neurological function and living ability before and after therapy, compare between groups and intra-group. To observe the effects of combined therapy on serum biomarkers and prognosis in acute stage. Results ( 1 ) MMP-9 of combined treatment group (3.23 ±0. 99) ng/L is higher than control (2. 82 ± 4. 21 )ng/L before therapy (P ＜0. 05). (2) The level of pre-treatment ox-LDL-Ab in combined treatment group ( 0. 08 ± 0. 01 ) U/ml higher than posttreatment (0. 07 ±0. 01 ) U/ml (P ＜ 0. 05 ). The level of pre-treatment NIHSS in control group (5.76 ±6.61) score higher than post-treatment (4.22 ±5.45) score,P＜0.05. Conclusion Combined treatment can degrade serum MMP-9 and ox-LDL in acute ischemic stroke patients, but it can't obviously improve the earlier prognosis.

AIM : To explore the effects of ASODN targeting survivin on apoptosis in HL 60 cells. METHODS : The cell proliferation was tested by MTT assay, the cell morphological transformation was observed by inverted microscope, the cell apoptosis index was examined by TUNEL, the cell apoptosis rate was precisely detected by flow cytometry, and the expression of survivin mRNA was detected by reverse transcriptase PCR. RESULTS : 5-20 ?mol?L -1 of survivin ASODN showed obviously inhibitory effect on the cell proliferation of HL 60 cells, and the inhibitory effect correlated with time and dosage. The cell apoptosis rate and the expression inhibitory rate of survivin gene in ASODN groups were obviously higher than that in the control group. Effects of antisense oligonucleotide targeting survivin on apoptosis in HL 60 cells$$$$ QI Shi mei, BI Fu yong Department of Biochemistry, Wannan Medical College, Wuhu 241001, Anhui, China ABSTRACT AIM : To explore the effects of ASODN targeting survivin on apoptosis in HL 60 cells. METHODS : The cell proliferation was tested by MTT assay, the cell morphological transformation was observed by inverted microscope, the cell apoptosis index was examined by TUNEL, the cell apoptosis rate was precisely detected by flow cytometry, and the expression of survivin mRNA was detected by reverse transcriptase PCR. RESULTS : 5-20 ?mol?L -1 of survivin ASODN showed obviously inhibitory effect on the cell proliferation of HL 60 cells, and the inhibitory effect correlated with time and dosage. The cell apoptosis rate and the expression inhibitory rate of survivin gene in ASODN groups were obviously higher than that in the control group. [WTHZ CONCLUSION : ASODN targeting survivin can effectively inhibit the expression of survivin mRNA and induce the cell apoptosis, and it indicates that survivin plays an important role in maintaining the proliferation of tumor cells.

Embolic stroke of undetermined source ( ESUS ) refers to non-lacunar brain infarcts without definite proximal arterialstenosis or major cardioembolic sources.Paroxysmal atrial fibrillation may be the most important cause of ESUS, thus anticoagulation may be more effective than antiplatelet therapy for secondary stroke prevention to this group of patients.This paper reviews the latest progress on the definition, epidemiology, diagnostic approach, relation to atrial fibrillation and management of ESUS.

Objective To investigate the clinical features of stroke in young adults with infective endocarditis (IE).Methods This is a retrospective analysis of clinical data of young patients (aged between 18 and 44 years) diagnosed with IE in Beijing Anzhen Hospital affiliated to Capital Medical University from January 2003 to March 2013.Results Three hundred IE patients (209 male and 91 female) were enrolled with mean age of (31.8 ± 7.8) years old.Fourteen of them were prosthetic valve endocarditis.All of the cases were found vegetations.The vegetations were mainly distributed in the mitral valve and/or aortic valve (262/300 patients).Congenital heart disease and rheumatic valvular disease were most frequently background diseases.Thirty-five cases (11.7％) were complicated with stroke.Among them,21 cases were with cerebral infarction (including 7 subjects with hemorrhagic transformation),9 cases with cerebral hemorrhage,3 cases with subarachnoid hemorrhage,and 2 with reasons unknown.Within the 21 cerebral infarction cases,the infarction sites were mainly distributed in internal carotid artery system with 5 cases involving bilateral internal carotid artery systems and 2 vertebro-basilar artery systems.As to the cerebral hemorrhage,lobar were the bleeding sites in all cases,and mainly distributed in internal carotid artery system.The proportions of left-sided endocarditis and rheumatic valvular disease were significantly higher in patients with stroke than those without [100.0％ (35/35) vs 86.4％ (229/265),P =0.02;22.8％ (8/35) vs 6.4％ (17/265),P =0.001,respectively].Regression analysis showed that the OR of the rheumatic valvular disease for stroke in young IE patients was 4.950 (95％ CI 1.626-15.072),and the OR of stroke for death was 8.387 (95％ CI 1.997-35.225),respectively.Conclusions Stroke is common in young patients with IE.Cerebral infarction often involves multiple vascular systems,and is prone to hemorrhagic transformation.Intracerebral hemorrhage often occurs in lobar.Rheumatic valvular disease might be a risk factor for stroke in young patients with IE,which is an independent risk factor for death of these patients.

Objective To analyze the risk factors and clinical features of stroke following off-pump coronary artery bypass grafting in patients with prior stroke. Methods From January 2006 to July 2009, the clinical information of 437 patients undergoing OPCABC in Anzhen Hospital was collected. The patients were divided into stroke group and non-stroke group according to whether stroke occurred after operation. Preoperative and operative variants were evaluated by univariate and multivariate logistic stepwise regression analysis. Results 32 of 437 patients (7.3% ) suffered from stroke after OPCABG, 32 cases were cerebral infarction and no case was cerebral hemorrhage. There were more patients whose left ventricular ejection fraction ≤0. 50 in stroke group than that in non-stroke group (12 of 32, 37.5% versus 69 of 405, 17.0% , P = 0. 004), more patients had atrial fibrillation after operation in stroke group than that in non-stroke group (9 of 32, 28. 1% versus 27 of 405,6.7% , P ＜ 0.001), more patients had hypotension after operation in stroke group than that in non-stroke group (13 of 32,40.6% versus 42 of 405, 10. 4% ; P ＜ 0. 001), more patients had ventilatory time and ICU time after operation in stroke group than that in non-stroke group(9 of 32, 28.1% versus 49 of 405, 12.1% , P =0.021; 14of 32,43.8% versus 97 of 405, 24.0% , P = 0.013), and patients in stroke group took longer to stay in hospital than that in non-stroke group (29.0 ±15. 8 versus 22. 9 ± 10. 4, P = 0. 002 ). Logistic stepwise regression analysis showed that left ventricular ejection fraction SS0.50(OR=2.837, 95%CI: 1.238-6.498), atrial fibrillation after operation( OR =3. 065, 95% CI: 1.157-8.118) and hypotension after operation (OR =4.209, 95%CI: 1.805 -9. 813) were independent risk factors of stroke following offpump coronary artery bypass grafting in patients with prior stroke. Conclusion This data suggest that left ventricular ejection fraction ≤0. 50, atrial fibrillation and hypotension after operation are risk factors for stroke following off-pump coronary artery bypass grafting in patients with prior stroke. These patients with stroke after operation took longer to extubate and stay in ICU and hospital.

BACKGROUND: As a biochemical marker of cytoplasm, the increased activity of creatine kinase (CK) in human spermatozoa is correlated with both the residual cytoplasma and the ratio of sperm with abnormal func tion. It is a marker of mature sperm and associated with the potential of in semination. OBJECTIVE: To investigate the differences of CK activity in sperm and the relative contents of sperm CK-MM and CK-BB isoenzymes between normal fertile males and infertile males, and evaluate its significance in clinical diagnosis of male infertility. DESIGN: Case-control observation. SETTING: Laboratory of Biochemistry, Family Planning Research Insti tute of Sichuan Province. PARTICIPANTS: Ninety-four male infertile patients between January 1999 and October 2000 were selected from the Department of Family Planning Sciences of Sichuan Province, who had no aspermatism with their wives proved to be fertile. The average age of subjects were 31 years. Eighty subjects with the sperm count ＞ 2×1010 L-1 were taken as normal sperm group and 14 subjects with the sperm counts ＜ 2×1010 L-1 were considered as oligospermia group. Semen obtained from 27 healthy males who were normal in routine examinations and with children was taken as the healthy control group.METHODS: Semen sample collected by masturbation after abstinence of 3 to 5 days was incubated at 37 ℃ for liquefication and routinely analyzed.Total activity of CK in sperm was determined by using a kinetic spectrophotometry and the relative contents of CK isozyme was determined by agarose gel electrophoresis followed by density scanning of CK isozyme.MAIN OUTCOME MEASURES: Sperm counts, percentages of viability and motility of sperm, total CK activity and the relative contents of CK-MM and CK-BB isozyme in spermatozoa.RESULTS: A total of 94 enrolled patients and 27 normal controls were involved in the analysis of results. ①Sperm counts, percentage of viability and motility in oligospermia group ( Ⅱ + Ⅲ, WHO method) were obviously lower than those in the healthy control group, and those in the normal sperm group, except the sperm counts, were remarkably lower than the healthy control group [the sperm counts in healthy control group, normal sperm group and oligospermia group was (6.05 ±0.81 )×1010 L-1, (7.76±1.37)×1010 L-1 and (1.46±0.19)×1010 L-1 respectively (P ＜ 0.01). The survival rate in healthy control group, normal sperm group and oligospermia group was 85.1%,56.8% and 58.2%, P ＜ 0.01, and the sperm motility was 62.9% ,34.6% and 29.5% respectively, P ＜ 0.01].②Total activity of sperm CK in oligospermia group was significantly higher than the healthy control group [respectively (9.000±6.117) and (1.933 ±0.943) kat/108 sperm,P＜ 0.05],although that in the normal sperm group (2.800±0.862) kat/108 sperm was a little higher than the healthy control group, while there were no significant difference between the two groups (P ＞ 0.05).③The relative contents of sperm CK-MM isozyme in the normal sperm group and oligospermia group were obviously decreased (that in the healthy control group, normal sperm group and oligospermia group was 30.5%, 19.0% and 18.0% respectively,P ＜ 0.05), which implied a remarkable difference in sperm differentiation between healthy control group and the latter two groups.CONCLUSION: The determination of sperm CK is meaningful for the diagnosis and pathogenesis of oligospermia. More work should be done on the distribution of sperm CK-MM isozyme in different infertile population as well as its importance in the diagnosis of infertility.

Objective To explore the eorrelafion factors of health promotion lifestyle of the elderly los-ing their land and sea estate. Methods Using the health value scale, health promotion lifestyle profile and the general conditions scale to investigate the health value, health promotion lifestyle and general conditions of 85 old people losing their land and sea estate in Dalian development area. Results There was no correlation between health value and health promotion lifestyle of the eldly, age, education degree, number of children and previous employment were rehted with the health promotion lifestyle. Conclusions There was distance be-tween their thought and actual health behavior of the elderly, community management personnels and med-ical workers should strengthen the concrete intervention in lifestyle, not simply relying on propaganda of the importance of health.