Objective To investigate the learning curve of minimally invasive direct coronary artery bypass ( MIDCAB) via left anterior small thoracotomy. Methods We retrospectively reviewed results of a consecutive series of 80 patients underwent MIDCAB via left anterior small thoracotomy performed by a single surgeon.The patients were divided into 4 groups ( group A, B, C, D, n=20 in each group) according to the sequence of the operation.The left internal mammary artery ( LIMA) harvesting time, anastomosis time, total operative time, the drainage volume of the first day postoperation, mechanical ventilation time, hospital stays postoperation, in-hospital morbidity and mortality were compared.The learning curve was assessed by means of regression analysis with logarithmic curve fitting. Results The basic clinical characters were similar in all groups before the operation.The operations were accomplished successfully in all the 80 cases.No intraoperative conversion to sternotomy, death, or perioperative myocardial infarction happened.The LIMA-harvesting time in the group B, C, and D was significantly shorter than that in the group A [(53.7 ±19.2) min, (50.2 ±17.7) min, and (43.2 ±10.3) min vs.(77.0 ±30.0) min, P =0.001, 0.000, and 0.000].There was no difference between group B and C, B and D, C and D in the LIMA-harvesting time (P>0.05).The total operative time in the group B, C, and D was significantly shorter than in the group A [ (128.7 ±21.7) min, (129.0 ±33.3) min, and (112.2 ±14.5) min vs. (165.2 ±41.8) min, all P=0.000], without difference between the group B and C, B and D, C and D (P>0.05).The learning curve models were obtained: LIMA-harvesting time ( min) =113.77 -16.869 × ln ( operation number); total operative time (min)=220.281 -25.276 ×ln (operation number). Conclusion MIDCAB via left anterior small thoracotomy is safe and effective, with a learning curve of approximately 20 cases.

Objective To compare the graft function of 2 methods of kidney harvesting,the modified method of combined liver and kidney procurement and rapid en bloc kidney procurement. Methods The clinical data of 220 cadaveric renal transplantation recipients were collected(12 months follow-up),174 cases from en bloc kidney procurement and 46 from combined liver and kidney procurement.The average harvesting time,the incidence of renal vein injury,1 year kidney survival and incidence of acute rejection were compared between the two methods.Results In average harvesting time and incidence of renal vein injury,the en bloc kidney procurement were better than the method of combined liver and kidney procurement.However,the method of combined liver and kidney procurement was better than the en bloc kidney procurement in 1 year kidney survival,1 year incidence of acute rejection and average warm ischemia time.There was no difference in 1 year survival of patients and 24 h,1 week and 1 year graft function after transplantation. Conclusion Although the method of combined liver and kidney procurement is better than the en bloc kidney procurement in 1 year kidney survival and 1 year incidence of acute rejection,there is no difference between the 2 methods in 1 year survival of patients and graft function after transplantation.

Air ; analysis ; Air Pollutants, Occupational ; analysis ; Formates ; analysis ; Gas Chromatography-Mass Spectrometry ; methods ; Humans ; Occupational Exposure ; analysis ; Workplace

Objective] To amplify,clone and express of a gene encoding hexose transporter of Plasmodium falcipuram(PfHT1) from Southern China isolate FCC1/HN for studing the immune of recombinant which protective from malaria parasite infection. [Methods] Cultivation of P.falciparum isolate FCC1/HN in vitro; extraction of genomic DNA from FCC1/HN using the alkali specific cleavage method; PCR amplification of PfHT1 and cloning into eukaryotic expression vector, pEGFPN3. The recombinant was introduced into mammalian cells, HEPG2 by using liposome\|mediated transfection. [Results] The gene encoding PfHT1 was specifically amplified from the genomic DNA of P.falciparum isolate FCC1/HN. The size of amplified fragment was 1 516 base pair. The eukaryotic expression recombinant, pN3\|HT1 , was constructed and expressed steadily in the hepatocarcinoma cell lines, HEPG2. [Conclusion] The gene encoding PfHT1 was successfully amplified and cloned. The pN3\|HT1/HEPG2 cell line was built for expressing fusion protein of GFP\|HT1.

Objective To study the changes of umbilical blood lactate,pH, blood sugar(BS),bilirubin, electrolyte, osmotic pressure (OP) in the newboms with fetal distress.Methods Thirty-five newborns with fetal distress (distress group) and 40 healthy new-borns (control group) were studied. Distress group were divided into distress group Ⅰ and distress group Ⅱ respectively, based on without or with neonatal asphyxia. Concentration of umbilical blood lactate was determined with enzyme method, pH, BS,serum total bilirubin (BIL), serum electrolyte (Na+ ,K+ ,Ca2+ ) and OP were analyzed respectively. Results 1. The difference of incidence of newborn asphyxia between distress groups (29.03%) and control group (2.50%) was statistically significant. 2. Compared with the controls and distress group Ⅰ, the umbilical blood lactate concentration significantly increased in distress group Ⅱ (P 0.05).The incidence of hyperglycemia was significantly elevated in distress groups than that in the control group. 4. Lactate concentration in distress I and distress fl group showed negative correlation with pH. Conclusion The concentration of umbilical blood lactate can provide the proof for diagnosis and prognosis of fetal distress.

Objective To explore the changes of cytokine levels and their roles in morbidity of autoimmune thyroid disease(AITD) in children.Methods The serum concentrations of interleukin-4(IL-4),interleukin-6(IL-6),tumor necrosis factor-?(TNF-?),interferon-? (IFN-?) were determined with enzyme linked immunosorbent assay (ELISA) among 30 patients with Graves′ disease (GD) and 20 patients with Hashimotos thyroiditis(HT) and 30 children without AITD subjects.Results The serum levels of IL-4 and IL-6 in patients with GD were higher than those of subjects (Pa

Objective To study the level of serum IL-10 in renal allgraft recipients with stable renal function,acute rejection,infection and chronic allgraft nephropathy(CAN),and to study the level of serum IL-10 in stable renal function recipients with different postoperative time,different dosage of CsA,different rejective frequency in order to find out the value of IL-10 in the follow-up of out-patients. Methods IL-10 were detected randomly by ELISA technique in 127 renal allgraft recipients during the follow-up,and 20 healthy volunteers were enrolled as controls.Results Level of serum IL-10 in stable renal function group was significantly higher than that in rejection group,CAN group and control group(P

Objective To study the quick triage assessment system for emergency nurse, establish evaluation model and method, select indicators and contents, guide triage nurses to be accurate, fast, convenient and practical, and also to optimize the use of emergency medical resources. Methods Screening the target population to conduct the research, collecting main indicators and features covered with main symptom and characteristics of severe critical emergency patients, selecting manifestation form of triage assessment system. Results The selected indicators and contents were demonstrated by a table-based form, and the quick triage assessment form for emergency nurse was established to instruct triage work. Conclusions This established quick triage assessment form is simple, intuitive and can improve the quality of emergency triage work. It possesses feasibility, practicality and achieves the optimal medical services with the limited emergency medical resources, which shows both social and economic effect.

ObjectiveObserve the efficacy, toxicity and the effection of telomerase activity of allicin combined with paclitaxel plus cisplatin and 5-Fu(TFP)chemotherapy for patients with advanced gastric carcinoma.MethodsFifty-four patients with advanced gastric carcinoma were randomly divided into two groups. A group was treated with allicin and TFP, B group was only treated with TFP. The chemotherapy was paclitaxel (135 mg/m2, dl, 8) plus cisplatin (75 mg/m2, d2-4) followed by 5-Fu (500 mg/m2 d1-5). Allicin was used in 60 days(3 times every day,once 20 mg).Telomerase activity was performed by enzyme-linked immunosorbent assay. ResultsThe total efficiency rate was 40.7 ％ (11/27) in A group and 33.3 ％ (9/27) in B group.There was no statistical difference between the two groups(~ = 0.079,P =0.779).There was significant difference in nausea and vomit (P =0.043), and the incidence of A group was 77.8 ％ (21/27) which was lower than that of B group[92.6 ％(25/27)].There was statistical difference in telomerase activity between the two groups(P =0.000).ConclusionAllicin could reduce the toxicity of chemotherapy and inhibit the telomerase activity in advanced gastric carcinoma.

ObjectiveTo evaluate the efficacy of preoperative oral pregabalin for attenuating postoperative pain after laparoscopic cholecystectomy.MethodsIn this prospective,randomized controlled double-blind study,sixty ASA Ⅰ or Ⅱ patients aged 19-72 yr weighing 46-86 kg undergoing laparoscopic cholecystectomy were randomly divided into 2 groups ( n =30 each):control group (group C) received placebo,and pregabalin group (group P) received oral pregabalin 150 mg 1 h before surgery.Anesthesia was induced with propofol,fentanyl and rocuronium and maintained with sevoflurane inhalation and intermittent iv boluses of fentanyl and rocuronium.The patients were intubated and mechanically ventilated.BIS value was maintained at 40-50 during operation.Static and dynamic VAS score,Ramsay score and consumption of morphine were recorded at 6,12,and 24 h after surgery.Side-effects including nausea,vomiting,headache and dizziness were also recorded.ResultsStatic and dynamic VAS scores and morphine consumption were significantly lower during the first 24 h after surgery while Ramsay scores were higher at 6 h after operation in group P than in group C.There was no significant difference in the incidence of side-effects between the 2 groups.No over-sedation occurred in group P.ConclusionPreoperative oral pregabalin 150 mg is safe and effective in reducing postoperative pain after laparoscopic cholecystectomy.