Objective To explore the value of endoscopic mini-incision greater saphenous vein harvesting for coronary artery bypass operation. Methods A total of 411 patients scheduled for coronary artery bypass operation were given either endoscopic vein harvesting(EVH Group,n=136) or open vein harvesting(OVH Group,n=275),based on patient's willingness.The operation outcomes and incision complications were compared between the two groups. Results The incidence of various incision complications was significantly lower in the EVH Group(18.4%,25/136) than in the OVH Group(36.7%,101/275)(?~2=14.406,P=0.000).As compared with the OVH Group,the EVH Group had lower incidences of edema(1.5% vs 35.3%;?~2=56.861,P=0.000),paraesthesia(7.4% vs 33.8%;?~2=33.937,P=0.000),hematoma(16.2% vs 27.3%;?~2=6.214,P=0.013),and incisional liquefaction(0.7% vs 8.7%;?~2=10.174,P=0.001) of the lower extemity.The total operation time were 226.3?28.5 min in the EVH Group and 224.7?19.2 min in the OVH Group,without significant difference between the two groups(t=0.673,P=0.502).Early graft failure happened in 1 case in each of the groups,without significant difference between the two groups(?~2=0.000,P=1.000).The numbers of distal coronary anastomoses were 3.6?0.8 in the EVH Group and 3.3?1.0 in the OVH Group,with significant difference(t=3.049,P=0.002). Conclusions Endoscopic greater saphenous vein harvesting can significantly reduce the morbidity associated with incision complications,whereas does not prolong the operative time,increase the incidence of early graft failure,and decrease the number of distal coronary anastomoses.

Objective To investigate the changes of plasma cortisol and adrenocorticotrophic hormone(ACTH)levels in prema-ture neonates with the infectious diseases.Methods Ninety premature neonates in the neonatal department of our hospital were di-vided into the control group(30 cases),mild infection group(30 cases)and severe infection group(30 cases).The radioimmunoassay was adopted to detect the serum cortisol and ACTH levels on 1,3,7 d after birth in all subjects and the corresponding comparison was conducted.Results The cortisol levels on 1,3,7 d in the mild infection group were (193.04 ±39.48),(151.12 ±35.62 ), (128.37±27.47)ng/mL respectively,the level on 1 d was higher than that on 3,7 d (P <0.05),and the 3 d was higher than that on 7 d (P <0.05).The cortisol level on 1,3,7 d in the severe infection group were (99.43±50.17),(96.52 ±44.69),(131.13 ± 42.73)ng/mL respectively,and the level on 1,3 d was significantly lower than that on 7 d (P <0.05).Conclusion The relative ad-renocortical insufficiency exists in premature neonates with the early stage of severe infection and is manifested by the decline of plasma cortisol level,which could recover to the normal level on 7 d,but the plasma ACTH level has no relation with infection.

Objective:To analyze the risk factors of non-alcoholic fatty liver disease (NAFLD) among elderly residents in the community.Methods:A total of 1 894 patients aged 60-75 years with NAFLD visiting general practice clinic from March 2016 to March 2018 were enrolled in the study; 1 894 age and sex-matched subjects without NAFLD served as the control group. The data of gender, age, smoking status,body mass index (BMI), waist circumference, blood pressure, blood biochemistry,past medical history and other clinical and laboratory testing were collected in the two groups. Multivariate logistic regression analysis was performed to explore the related risk factors of NAFLD.Results:The BMI [(27±3) kg/m 2vs.(24±3) kg/m 2, t=-26.139], waist circumference [(89±8) cm vs.(82±8) cm, t=-24.398], heart rate [(75±11) bpm vs. (74±11) bpm, t=-2.370], and diastolic blood pressure [(87±10) mmHg vs. (85±10) mmHg(1 mmHg=0.133 kPa), t=7.898] in the NAFLD group were significantly higher than those in the control group(all P<0.05). The levels of fasting blood glucose (FBG) [(5.9±2.0)mmol/L vs. (5.3±1.5) mmol/L, t=10.438], glycated hemoglobin (HbA1c) [(6.2±1.2)% vs. (5.9±0.9)%, t=11.654], alanine aminotransferase (ALT)[(24±16) mmol/L vs. (18±15) mmol/L, t=11.915], aspartate aminotransferase (AST) [(23±11) mmol/L vs.(22±13) mmol/L, t=4.300], blood uric acid (UA) [(342±84) mmol/L vs. (307±80) mmol/L, t=13.189], total cholesterol (TC) [(5.3±1.1) mmol/L vs. (5.1±1.0) mmol/L, t=6.073], triglycerides (TG)[1.71(1.29,2.35) mmol/L vs. 1.17 (0.91,1.57) mmol/L, Z=37.261], and low-density lipoprotein cholesterol (LDL-C)[(3.4±0.9) mmol/L vs. (3.2±0.9) mmol/L, t=6.984] in NAFLD group were significantly higher than those in the control group (all P<0.01); and the levels of blood creatinine (Cr) [(70±17) mmol/L vs. (71±18) mmol/L, t=-2.712] and high-density lipoprotein cholesterol (HDL-C) [(1.3±0.3) mmol/L vs. (1.5±0.4) mmol/L, t==-16.726] in NAFLD group were significantly lower than those in the control group (all P<0.01). The proportion of people with hypertension [53.8% (1 019/1 894) vs. 43.4% (822/1 894)], type 2 diabetes [16.7%(317/1 894) vs. 11.3%(214/1 894)], metabolic syndrome [48.3% (915/1 894) vs. 18.0% (341/1 894)] in NAFLD group was significantly higher than that in the control group (χ 2=41.013, 23.237, 392.446, P<0.01). Logistic regression analyses revealed 13 independent risk factors of NAFLD, including 60-75 years-old female ( OR=2.348, 95 %CI: 1.917-2.876, P<0.01), high BMI ( OR=1.143, 95 %CI: 1.099-1.189, P<0.01), elevated TG ( OR=1.894, 95 %CI: 1.716-2.090, P<0.01), LDL-C ( OR=3.066, 95 %CI: 2.359-3.983, P<0.01) and HbA1c ( OR=1.276, 95 %CI: 1.175-1.386, P<0.01). Conclusion:The factors associated with NAFLD are complicated; and corresponding measures targeting the risk factors should be taken to reduce the occurrence and development of NAFLD among elderly people in the community.

Objective To investigate the interference and associated mechanism of hnman tissue kallikrein (HK) gene on renal interstitial fibrosis in rats with 5/6 nephrectomy. Methods Human kallikrein cDNA was packed in a recombinant adeno-associated virus(rAAV)-based plasmid vector. The rAAV-HK was produced by transfection in 293 cells. Twenty-four male Wistsr rats were divided into sham operation and operation groups. The rats with 5/6 nephrectomy were randomly divided into simple operation, control and experiment groups. The rats in experiment group received single dose rAAV-HK via the tail vein with 1×1011 pfu. Before nephrectomy and every month after surgery until the rats were sacrificed, the caudal arterial pressure was measured using tail cuff blood pressure determinator. Three months after HK gene delivery, the rats were sacrificed. The expression of HK in rats was assessed by RT-PCR, Western blot and enzyme-linked immunosorbent assay (ELISA). The pathological changes of renal interstitium were evaluated by Masson stainning, and the distribution of bradykinin B2 receptor (BKB2R) and angiotensin Ⅱ typel receptor (ATIR) was examined by immunohistochemistry. The expressions of BKB2R, AT1R, p-MAPK protein in renal tissue were detected by Western blot. Results Three months after HK gene delivery, the systolic blood pressure of experiment group was significantly decreased compared with the control group [(163±13) nun Hg vs (217±16) mm Hg, P<0.01](1 mm Hg=0.133 kPa). Compared with sham rats, the rats in simple operation group and control group had much more renal interstitial collagen deposition and more serious fibrosis performance, but renal interstitial collagen deposition and fibrosis were significantly ameliorated in the rats of experiment group. In addition, the tubulointerstitial injury index of HK transgenic rats was significantly lower than that of the rats in control group (1.33±0.73 vs 3.01±0.62, P<0.01). Up-regnlating expression of bradykinn B2 receptor protein and down-regulating expression of AT1 receptor and p-MAPK protein were found in renal tissues of experimental group after three months (P<0.05). Conclusion HK gene delivery significantly alleviates renal interstitial fibrosis in rats with 5/6 nephrectomy through regulating the expression of bradykinin B2 receptor, AT1 receptor and p-MAPK in renal tissue.

Objective To explore the application of hydrogen proton magnetic resonance spectroscopy (1H-MRS) in the diagnosis of peripheral tumor cell infiltration of gliomas. Methods Forty patients with glioma were examined by 1H-MRS preoperation, and were divided into low grade glioma group (n=20) and high grade glioma group (n=20) according to postoperative pathological diagnosis. Tumor resection with peripheral tissues marked previously was carried out under the guidance of neuronavigator system. All the pathological sections were divided into positive group and negative group according to the presence or absence of tumor cells, and the differences in pathological findings of peripheral regions (region 1, 2 and 3) and 1H-MRS values were analyzed in these two groups. Results No infiltration was found in the peripheral regions of low grade glioma group except for one case in peripheral region 1, while infiltration was found in all peripheral regions of high grade glioma group. There was no significant difference in 1H-MRS values between positive group (n=24) and negative group (n=36) in patients with high grade glioma (P>0.05). Conclusion 1H-MRS enjoys some advantages over routine radiological examinations in the diagnosis of peripheral tumor cell infiltration of gliomas. Total removal can be expected when combined with neuronavigator system, while there is room for improvement for relevant techniques.

Objective: To analyze the relationship between the serum levels of low density lipoprotein cholesterol (LDL-C) and achilles tendon thickness (ATT).
Methods: We studied 154 patients with high serum level of LDL-C (LDL-C≥3.37 mmol/L) from 2014-03 to 2015-03, the patients were at (18-75) years of age. According to《Guidelines on Prevention and Treatment of Blood Lipid Abnormality in Chinese Adults 2007》, the patients were divided into 2 groups:Borderline high LDL-C (3.3-4.12 mmol/L) group n=50 and High LDL-C (≥4.14 mmol/L) group, n=104;in addition, there was a Normal control group (LDL-C<3.37 mmol/L), n=51. ATT values were measured by standard digital radiography and the results were compared among 3 groups;the relationship between serum levels of LDL-C and ATT was studied.
Results: ATT levels in High LDL-C group (9.42 ± 3.63) mm was higher than Borderline high group (8.24±1.73) mm and Normal control group (6.05±0.28)mm, all P<0.05. The liner correlation coefifcient of serum level of LDL-C and the mean ATT was (r=0.346, P<0.001).
Conclusion: Our preliminary research showed that the higher serum level of LDL-C associated with thicker ATT, they had positive correlation. This phenomenon should be further conifrmed by large sample and multi-center investigation.

Objective To investigate the level of depression and coping style in primary liver cancer after transcatheter artery chemoembolization, (TACE). Methods 110 liver cancer patients after TACE were investigated by the self-rating depression scale and medical coping modes questionnaire(MCMQ). Results 53.6% of liver cancer patients after TACE were suffered from depression, the scores of them were higher than that of domestic norm (t =9. 827 ,P ＜0. 01 ). The scores of confrontation coping were lower than that of norm( t = -5.284, P ＜ 0. 01 ); and avoidance dimension was higher than norm(t =4. 743 ,P ＜0. 01 ); A significant positive relationship was found between depression and resignation of coping style ( r = 0. 523, P ＜ 0. 01 ). Conclusions Liver cancer patients after TACE were prone to show depression and its level was correlated with coping style.

OBJECTIVETo study the impact of organized stroke ward on the therapeutic effect in stroke patients.

METHODSA total of 2637 patients with acute stroke were randomly assigned to organized stroke ward or the general ward for treatment, and the rates of mortality, nonrecovery, improvement, and recovery were compared between the two groups.

RESULTSThe rates of mortality, nonrecovery, improvement, and recovery in 5 years were 2.00%, 0.90%, 74.94% and 22.16% respectively in the organized stroke ward group, as compared to 3.26%, 1.02%, 74.01% and 21.71% in the general ward group, respectively. The mortality rate was significantly lower in organized stroke ward (P<0.05), but no significant difference was found in the rates of nonrecovery, improvement, or recovery between the two groups (P>0.05).

CONCLUSIONAdmission of the stroke patients in organized stroke ward for treatment can be associated with lowered mortality rate.

Female ; Hospital Units ; standards ; Humans ; Intensive Care Units ; Male ; Outcome Assessment (Health Care) ; Patient Care Team ; organization & administration ; Stroke ; mortality ; therapy ; Stroke Rehabilitation ; Survival Rate ; Treatment Outcome

OBJECTIVETo investigate the influence of aqueous extract of Aralia echinocaulis Hand.-Mazz on the expression of fracture healing-ralated factor receptors.

METHODSSingle factor model was set up in SD rat. Selecting 14 and 28 days in the experiment. Immunohistochemistry was employed to determine the expression of Fibroblast growth factor receptor 2 (FGFR2), Fms-like tyrosine kinase (Flt-1) and Fetal licer kinase (Flk-1) at 14 and 28 days after model establishing.

RESULTSThe expression of Flt-1 and Flk-1 at 14 days (the latter was more remarkable) were obviously promoted in High dose group of aqueous extract of Aralia echinocaulis Hand.-Mazz, and higher than that in normal group and model group. The expression of FGFR2 in the high dose group of Aralia echinocaulis Hand -Mazz was also promoted visibility, close to that in the compare group (traditional Chinese medicine), but higher than than in the model group. There was no significant difference among them. At 28 days, the expression of FGFR2, Flt-1 and Flk-1 in all groups decreased except normal group, and got higher expression in model groups than each control groups.

CONCLUSIONAqueous extract of Aralia echinocaulis Hand.-Mazz can promote angiogenesis in fracture healing, improve the activity and aggregation of fibroblasts, osteoblasts and chondrocytes. It also helps to quicken ossification in the cartilage and promote fracture healing.

Animals ; Aralia ; chemistry ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; therapeutic use ; Female ; Fibroblast Growth Factors ; metabolism ; Immunohistochemistry ; Rats ; Rats, Sprague-Dawley ; Vascular Endothelial Growth Factor A ; metabolism ; Wound Healing ; drug effects