Objective To analyse the clinical features and outcomes of myocardial bridge treated by coronary artery bypass grafting (CABG). Methods The hospitalization and follow-up data of patients with myocardial bridge treated between March 1999 and March 2009 were collected. The symptoms, examinations, diagnosis, treatment and follow-up findings were retrospectively analysed, the clinical features and outcomes were analysed, and discussion was performed after literature review. Results Twenty-six patients with myocardial bridge were hospitalized, all of whom were confirmed by coronary angiography. All patients experienced symptoms of myocardial ischemia such as angina, which could not be relieved by medication. Electrocardiography was characterized by depressed ST, flat or inversed T wave. All patients received CABG (off-pump operation in 15 patients and on-pump operation in 11 patients). No surgery-related death or complications occurred. Patients were followed up for (3.5 ±2.0) years, and symptom of myocardial ischemia was relieved in all. Angina took place in 5 patients, and was eased by medication. Electrocardiographic reexaminations revealed that ST was normal in 22 patients, and flat ST was improved in the other 4 patients after operation. Conclusion Myocardial bridge is one of the congenital coronary artery malformations, and was mainly diagnosed through coronary arteriography examination. CABG is one of the best choices for the treatment of myocardial bridge with severe myocardial ischemia. Angina after operation in some patients may be related to the vascular spasm, as well as the blood flow competition between own vessels and grafts.

ObjectiveTo evaluate the value of inferior petrosal sinus sampling (IPSS) in the diagnosis of adreno-corticotropic hormone ( ACTH ) dependent Cushing syndrome ( CS ) with unknown origin. MethodsIPSS was carried out for the diagnosis of 16 cases with ACTH dependent CS who had not been identified after a series of dexamethasone suppression tests and radiological examinations. The ratio of inferior petrosal sinus/peripheral ACTH was assayed.The sensitivity and specificity of diagnosis of the Cushing disease were estimated. ResultsThe inferior petrosal sinus/peripheral ACTH ratio was over 2. 0 in 13 cases. Twelve cases underwent surgery with pathological diagnosis of pituitary ACTH adenoma, 1 patient relieved after γ knife treatment. The ratio was ＜ 2.0 in 3 cases including 2 pulmonary carcinoid and one pituitary ACTH adenoma. The sensitivity and specify of IPSS for the diagnosis of Cushing disease were 13/14and 2/2 respectively.ConclusionIPSS was a safe technique with high sensitivity, specify and infrequent complications in the diagnosis of ACTH dependent Cushing disease.It had great clinical value in the differential diagnosis of ACTH dependent Cushing disease with unknown origin.

Objective To compare the outcomes of off-pump versus on-pump CABG.Methods From 2002 to 2008,CABG was performed in 105 patients aged 80 years and over,including 45 without cardiopulmonary bypass (CPB) or off-pump (OP) CABG (OPCAB) and 60 with CPB (onpump CABG).The outcomes were compared between two groups.Results The mean ICU stay was (37.1±30.3) h in OPCAB group and (60.6±58.2) h in on-pump CABG group (P＜0.01).Average ventilator-assisted time was (10.8±9.7) h for OPCAB group versus (22.3±35.7) h for onpump CABG group (P＜0.01).Postoperative atrial fibrillation occurred in 31.1％ of OPCABG patients and 41.7 ％ of on-pump CABG patients (P＜0.01).The mortality rate was 5.0％ in OPCABG group versus 8.3％ in on-pump CABG group (P＜0.05).Conclusions OPCABG is a safe and efficient method of myocardial revascularization in the elderly patients with lower morbidity and complications.

Objective:To observe the effect of tuina manipulations on blood pressure and its variability in hypertension patients. Methods:Forty hypertension patients were randomized into an observation group and a medication group, 20 cases in each group. The observation group was intervened by tuina manipulations of kidney-tonifying blood-circulating and collaterals- unblocking in addition to regular medication, while the medication group was by the same medication. The 24-hour blood pressure monitoring was performed before intervention and after 3-month intervention. The blood pressure and its variability were observed and compared. Results:There were no significant differences in comparing the blood pressure and blood pressure variability between the two groups before intervention (P>0.05); after 3-month intervention, the blood pressure and its variability were significantly improved in both groups (P<0.05); the improvements in the observation group were more significant than those in the control group (P<0.05). Conclusion:Tuina manipulations of kidney-tonifying blood-circulating and collaterals-unblocking plus medication can produce a better effect than regular medication in promoting blood pressure and its variability, and this method is worth applying in clinic as it’s easy-to-operate and has no adverse effect.

Objective To confirm the immunomodulatory effect of ursolic acid on normal and immunosuppressive mice caused by cyclophosphamide.Methods We assayed the function of T lymphocyte transformation with MTT test,examined the function of B lymphocyte with hemolysis spectrophotography,determined the function of non-specific immunity with phagocytosis of macrophages,and measured the content changes of Th_(1) cytokine IL-2 and Th_(2) cytokine IL-6 in serum with ELISA.Results Ursolic acid had a suppressant effect on the function of humoral immunity and enhanced cell-mediated immune response at the low dosage but presented opposite effect at the high dosage in normal mice.Ursolic acid significantly improved immune function on immunosuppressive mice caused by cyclophosphamide(P

OBJECTIVETo discuss the clinical effects and superiority of applying external fixation and bone transport to treat osteomyelitis and bone defect of femoral bone.

METHODSFrom August 2008 to December 2013,16 patients with osteomyelitis and bone defect of femoral bone were treated including 11 males and 5 females with an average age of 42 years old ranging from 13 to 62 years old. The average course of disease was 18 months ranging from 2 months to 4.5 years, and the average length of bone defect was 7.8 cm ranging from 4.5 to 15 cm. The bone defect of all cases were treated by external fixation and bone transport, the bone transport began at 1 week after operation, 1 mm per day and 4 times per day.

RESULTSAll patients were followed up for 10 to 36 months (means 22.5 months). One patient did not cooperate with treatment leads to the failure, then took the amputation. The remaining 15 cases of osteomyelitis were under control, including 12 cases of bone transport achieved one stage bone union, 3 cases achieved bone union via bone graft from iliac bone. The bone union time was 5 to 13 months(means 7.9 months). Thirteen patients almost obtained the same length of two lower extremities,2 patients had shortening of 1.5 to 2 cm. The time of moving the external fixation was from 6 to 16 months (means 9.3 months).

CONCLUSIONApplication of external fixation and bone transport is an effective method in treating the osteomyelitis and bone defect that can control the infection, eradicate wounds, and be the equalization of limb length.

Adolescent ; Adult ; Bone Transplantation ; External Fixators ; Female ; Femur ; surgery ; Humans ; Male ; Middle Aged ; Osteomyelitis ; surgery

Objective:To observe the clinical efficacy of Yi Jin Jing (Sinew-transforming Qigong Exercises) for primary osteoporosis in the elderly.Methods:Eighty old patients with primary osteoporosis were randomized into a Yi Jin Jing group and a medication group,40 cases in each group.The Yi Jin Jing group was intervened by Yi Jin Jing (Sinew-transforming Qigong Exercises) training,while the medication group was intervened by oral administration of alendronate sodium tablet.Prior to and after 6-month intervention,the bone mineral density (BMD) of the proximal femur,visual analog scale (VAS) and activities of daily living (ADL) were estimated.Results:There were no significant differences in the BMD of the proximal femur,and VAS and ADL scores between the two groups before the intervention (P＞0.05).After 6-month intervention,the above items all improved significantly in both groups (both P＜0.01);the improvements in VAS and ADL scores in Yi Jin Jing group were more significant than those in the medication group (P＜0.01),while the between-group difference in the BMD of the proximal femur was statistically insignificant (P＞0.05).Conclusion:Practice of Yi Jin Jing (Sinew-transforming Qigong Exercises) can effectively ameliorate the BMD in the elderly with primary osteoporosis,and it can reduce the pain and improve ADL,with a better general effect compared to oral administration of alendronate sodium tablet.

Objective To determine the correlation between the expression of interleukin 8 (IL 8) and vascularity in human gastric carcinoma speciemens,and to provide a possible new clinical way for anti angiogenesis of tumor . Methods IL 8 mRNA expression was examined with reverse transcription polymerase chain reaction (RT PCR).IL 8 protein secretion level and its specific expression were determined by enzyme linked immunosorbent assay (ELISA).The number of blood vessels in the gastric carcinoma was determined by antibody against factor Ⅷ associated antigen and immunohistochemical analysis. Results Most of the tumors (26/29,89.7%) and metastatic lymph nodes (17/20,85%) expressed IL 8 at higher levels than that in corresponding normal mucosa of resection end of stomach and negative metastatic lymph node.The expression of IL 8 protein and IL 8 mRNA were at the same level.The level of IL 8 mRNA in the gastric carcinoma tissue correlated strongly and positively with vascularization (P= 0.001).Conclusions There is a positive correlation between IL 8 mRNA expression and the vascularity of gastric carcinoma.IL 8 produced by tumor cells may up regulate the microvascularization in the gastric cancer, and enhance the growth,spreading and lymph node metastasis in human gastric carcinoma.So decreasing the IL 8 expression might inhibit the microvascularization,growth and metastasis of gastric cancer.

Objectives To search for the pathogenesis of vaseular endothelial injury and its clinical significance.Methods 36 patients with acute lower respiratory trect infection(ALRI)and 30 healthy controls were envolved. Circulating endothelial cells (CEC)and nitric oxide (NO) levels were tested.Results Circulating nitrite/nitra levels,the stable metabolic products of NO,were found to be significantly higher in the patients with ALRI (44.6?22.6umol/L) than that in the controls (24.5?14.1umoI /L, P

Objective To establish a stable and reliable model of brain death in swine, and to provide a more stable model for investigating pathomorphology in brain tissue and for studying transplantation immunology during brain death. Methods Base on the classic methodology of increasing epidural intracranial pressure, Codman intracranial pressure moni-toring probes were implanted in landrace pigs invasively. According to the relationship between ICP and MAP, brain death models were established by increasing intracranial pressure slowly and intermittently, with real-time monitoring of the intra-cranial pressure. Results Among twelve experimental landrace pigs, one died from anesthetic accident, while the rest elev-en were successfully established as brain death models. With effective respiratory and circulatory support, those brain death models can be maintained for (31.3 ± 4.7) h. Brain death model establishement is a stable and reliable process demonstrated by transcranial Doppler, EEG, ECG, mean arterial blood pressure and other monitoring methods. After brain death is con-firmed, animal models can be maintained for a long time. Conclusion Our methodology of inducing brain death model un-der ICP monitoring is stable and easy to be standardized. It can also provide a more stable model for studying brain tissue pathomorphology and transplantation immunology.