Objective: Based on nationwide cardiovascular surgery registry database, to analyze the current status and future development of minimally invasive cardiovascular surgery (MICS) in China.
Methods: There were 45 institutions from 19 provinces nationwide involved in Chinese cardiovascular surgery technique registry study. A total of 16480 adult patients with cardiovascular surgery from 2010-09 to 2012-03 were divided into 2 groups, Conventional surgery group, n=14503 and MICS group, n=1977. The basic clinical conditions were analyzed and compared between 2 groups in order to explore the current status and future development of MICS in China.
Results: Compared with Conventional surgery group, the patients in MICS group had the younger age, better and stable pre-operative condition. In MICS group, compared with 4 other common procedures, the patients who received hybrid procedure had obviously shorter cardiopulmonary bypass (CPB) time, aortic occlusion time, ventilator using time, ICU and in-hospital stay time, meanwhile decreased post-operative drainage volume;except for Robotic surgery, it required less red blood cells and plasma at during and post-operative time, all P<0.01. There were 12 (0.6%) in-hospital death in MICS group, the total complication rate was at 4%.
Conclusion: MICS are widely used in China, its short-term safety and efifcacy are conifrmed. Upon cardiovascular disease spectrum changing, the MICS procedures will be adjusted accordingly.

Objective: To compare the long term prognosis between revascularization (REV) and medical therapy (MP) in patients with three-vessel disease (3VD) with or without left main (LM) lesion.
Methods: A total of 4,875 consecutive patients with elective coronary angiography (CAG) diagnosed 3VD with or without LM lesion treated in our hospital from 2007-01 to 2008-12 were retrospectively studied. The patients were divided into 2 groups: MT group,n=705 (14.5%) and REV group,n=4170 (85.5%). The all cause mortality and the rate of revascularization during follow-up period were compared between 2 groups by inverse-probability-weighting approach with propensity score.
Results: There were 3962/4875 (81.3%) patients with simple 3VD (right, left anterior descending and left circumlfex coronary arteries) and 913 (18.7%) with 3VD+LM lesion. The in-hospital mortality was similar between 2 groups (OR=0.7, 95% CI 0.3-1.4,P=0.30). With the longest 2-year follow-up study, the adjusted all cause mortality and the rate of revascularization in MT group were both higher than those in REV group (HR=8.3, 95% CI 6.7-11.1,P<0.001) and (HR=1.4, 95% CI 1.1-1.6,P<0.001). No matter the patients with simple 3VD or 3VD+LM lesion, compared with REV group, MT group had the higher all cause mortality, for 3VD+LM lesion (HR=10.4, 95% CI 7.1-15.4,P<0.001) and for simple 3VD (HR=7.1, 95% CI 5.3-10.0,P<0.001).
Conclusion: In real world, the long term prognosis by revascularization treatment was superior to medical treatment in patients with either simple 3 vessel coronary disease or 3 vessel combining LM disease.

Objective:To investigate the predicting value of European system for cardiac operative risk evaluation ( EuroSCORE ) and sino system for coronary operative risk evaluation ( SinoSCORE ) in early quality of life of patients after coronary artery bypass surgery (CABG).Methods:A total of 218 consecu-tive patients who underwent CABG from March 2010 to January 2013 were evaluated with both systems before operation .Health related quality of life ( QoL) was estimated by using 36-item short form health survey ( SF-36) preoperatively and postoperatively in order to evaluate the predicting value of the two sys -tems in early post-operative QoL.Calibration was evaluated by Hosmer-l,emeshow goodness-of-fit test. Discrimination was tested by determining the area under the receiver operating characteristic ( ROC ) curve .Results:There was no significant difference between the accumulation of the EuroSCORE and SinoSCORE in the all patients (t=-0.904, P=0.368), When using Wilcoxon test on life quality in the preoperative and postoperative patients respectively ,the data showed that the quality of life improved significantly in various dimensions of the postoperative patients (Z=-2.886, P<0.001).Except for bodily pain (BP) and mental health (MH), statistically significant correlation was found between the preoperative risk evaluation scores and the postoperative QoL scores (r:-0.203 to -0.493, P<0.05). Logistic regression analyses indicated that both the scores emerged as the independent predictor for a relatively worse QoL ( OR>1 , P<0 .05 ) .Furthermore , the EuroSCORE predicted the outcome with a higher OR.For SinoSCORE the Hosmer-Lemeshow test was significant (P=0.628) and the area under ROC curve was 0.754.For the EuroSCORE the Hosmer-Lemeshow test was significant (P=0.538) and the area under ROC curve was 0.854.Conclusion:Both EuroSCORE and SinoSCORE could be viewed as a predictor for several aspects of postoperative QoL , while EuroSCORE might have a greater predicting value.

Objective Explore the reversibility and potential molecular mechanisms of pulmonary hypertension in pa-tients with complete transposition of the great arteries (cTGA) combined with ventricular septal defect (VSD) in comparison with those with simple VSD. Methods Twenty-four patients with pulmonary hypertension (mean pulmonary arterial pressure was greater than 30 mmHg) were enrolled in our study, in which 10 patients suffered from cTGA with VSD, and the rest 14 pa-tients suffered from simple VSD. Lung specimens were taken from the right middle lobe of lung before cardiopulmonary bypass. The extent of pulmonary hypertension was then graded according to the Heath-Edwards classification. ELISA was used to exam-ine the expression of eNOS, iNOS, ET-1, ET-AR, ET-BR, MMP-2, MMP-9 and TIMP in all the specimens. Results No statistically significant differences in age, height, weight, the size of VSD, and the pulmonary artery pressure before operation were found between the groups. The level of hemoglobin, aortic and pulmonary arterial oxygen saturation, and the reduction value of pulmonary arterial pressure after surgery were significantly higher in the cTGA patients than that in the simple VSD pa-tients (P < 0.05). All patients had grade 0 - Ⅱ Heath-Edwards changes in their lung biopsy samples. The expression of eNOS and MMP-2 was significantly lower in the TGA group than that in the simple VSD group [eNOS: (280.13 ± 101.92) ng/mg vs. (488.41±249.6) ng/mg, P<0.05; MMP-2:(31.68±15.36)ng/mg vs. (69.28±49.12)ng/mg, P<0.05]. There were no statistically significant differences between the two groups regarding the expression of iNOS, ET-1, ET-AR, ET-BR,MMP-9 or TIMP. Conclusion The imbalance of the NOS/ET system and the MMP/TIMP system involves in the development of pulmonary hypertension in patients with TGA combined with VCD. In patients with cTGA, the high oxygenation state in pul-monary circulation may decrease the expression of MMP2 and eNOS, and may affect the progress of pulmonary hypertension to a certain extent.

Abstract: Objective　To analyze the detection of SARS‑CoV‑2 in household environment and public place environment of Huangpu District, and describe the feature of SARS‑CoV‑2 contamination in the environment exposure to the infected cases, so as to support the control strategies such as disinfection and health communication. Methods　The results of RT-PCR test for the environmental samples exposure to the cases infected by SARS‑CoV‑2 during February 1 to March 31 2022 in Huangpu District of Shanghai were collected as the research data. Pearson χ2 was used to test the significance of the differences between positive rates of SARS‑CoV‑2 contamination. Results　From February 1 to March 31, household environment samples had a higher positive rate (6.47%, 234/3 618) of SARS‑CoV‑2 contamination while the public place samples had a lower one (1.22%, 47/3 582) in Huangpu District of Shanghai (χ2=141.908, P<0.01). Among the household buildings, the lane houses of old style representing poorer living condition had the highest positive rates (8.31%, 96/1 155) of SARS‑CoV‑2 contamination while the apartments representing better living condition had the lowest (3.59%, 22/612) (F=5.25，P<0.05). Among the samples from household environment, samples regarding sewerage had the highest positive rates (13.30%,58/436) of SARS‑CoV‑2 contamination, while samples regarding the tool of cooking and sweeping had the lowest (3.10%,17/548) (F=9.84，P<0.01). Among the samples from public place environment, samples regarding entertainment tools had the highest positive rates (13.33%, 2/15) of SARS‑CoV‑2 contamination, while samples regarding the tool of cooking and sweeping had the lowest (0.62%, 4/646) (F=4.22，P<0.01). Conclusion　In the environment exposure to the SARS‑CoV‑2 infected cases, the disinfection, ventilation and cleaning should be intensified strictly. SARS‑CoV‑2's surviving in sewage environment should be evaluation dynamically. More health communication should be pushed to people of poorer living condition.

OBJECTIVETo observe the expression of P-selectin (Ps), intercellular adhesion molecule-1 (ICAM-1) and nuclear factor-kappa B (NF-kappaB) in lung tissues of acute lung injury (ALI) rat model induced by oleic acid (OA) and to explore the protective effects of melatonin (MT) in lung tissues in rats.

METHODSAll rats were randomly divided into four groups: control group, OA group, MT + OA group and SB203580 + OA group. Rat model of ALI was established by intravenous injection of oleic acid (OA). Lung coefficient was measured, lung tissues were imbedded by paraffin to observe morphological changes and the expression of Ps, ICAM-1 and NF-kappaB in lung tissues by means of immunohistochemistry staining.

RESULTSCompared with control group, the lung coefficient increased significantly in OA group (P < 0.05). Alveolar septum thickened significantly in OA group, there had many infiltrated inflammatory cells and collapsed alveoli of lung; positive expression of Ps, ICAM-1 and NF-kappaB were very obvious (P < 0.05); the administration of MT and SB203580 mitigated above changes significantly (P < 0.05).

CONCLUSIONMT possesses obviously protective effect on lung tissues during ALI, its protective mechanism might be related to the inhibition of the expression of Ps, ICAM-1 and NF-kappaB.

Acute Lung Injury ; chemically induced ; physiopathology ; prevention & control ; Animals ; Down-Regulation ; drug effects ; Intercellular Adhesion Molecule-1 ; metabolism ; Male ; Melatonin ; pharmacology ; therapeutic use ; NF-kappa B ; metabolism ; Oleic Acid ; adverse effects ; P-Selectin ; metabolism ; Protective Agents ; pharmacology ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo evaluate the effectiveness of endoscopic variceal ligation (EVL) in patients with different grades of liver function.

METHODSMELD scores were determined for 156 patients before their EVL operations. After the EVL these patients were followed-up and their survival rates were analyzed.

RESULTSFifty percent of the patients whose MELDs were less than or equal to 7 survived longer than 45 months after the EVL; in those with MELDs between 7 and 9, 50% of the patients survived 47.34 months; however, the figure for those whose MELD were more than 9 survived only 24.89 months. In the first two groups, 50% of the patient' survival duration was significantly longer than that of the third group. The difference was statistically significant.

CONCLUSIONEVL becomes an effective clinical way to treat hemorrhage of esophagus varicose veins. The survival rate for this procedure is directly correlated with the liver function of the patient before the EVL.

Adult ; Aged ; Esophageal and Gastric Varices ; surgery ; Female ; Humans ; Liver Diseases ; diagnosis ; physiopathology ; surgery ; Male ; Middle Aged ; Prognosis ; Treatment Outcome ; Young Adult

Objective To study the overweight and obesity situation among Mongolian ethnic children and adolescents in the last 25 years and to provide a basis on related prevention and control measures.Methods A cross-sectional study was used,with 18 366 aged 7 to 18 Mongolian ethnic children and adolescents involved.Surveys on their physical health,in 1985,2000 and 2010 were carried out.Comparison on the mean of BMI and the prevalence rates of overweight and obesity in different years,genders,location of residence (urban or rural) was also made.Results Over the past 25 years,among the aged 7 to 18 Mongolian ethnic children and adolescents,the overall trend on their means of BMI was increasing.The prevalence rates of overweight and obesity in Mongolian ethnic children and adolescents were 2.1％,0.5％ in 1985,and 6.3％,2.4％ in 2000,with an increase of 2 to 4 times during the last 15 years.The prevalence rates of overweight and obesity were substantially increasing in the year 2010,to have reached 9.1％ and 6.6％,which were 4 to 12 times of the figures in 1985.The detection rates of overweight and obesity in urban boys were 1.2％,0 in 1985,7.9％,3.4％ in 2000 and 11.0％,11.8％ in 2010.However,the rate of obesity in the rural boys were 0.6％ and 0.6％ in 1985,2.8％,2.1％ in 2000 and 9.0％,3.4％ in 2010.In 1985 the rates of overweight and obesity in urban girls were 1.8％,0.3％,8.1％,4.3％ in 2000 and 9.4％,8.4％ in 2010.However,among the rural girls,the prevalence rates of overweight and obesity prevalence was 8.8％,2.2％ in 1985,4.5％,0.9％,in 2000 and 10.2％,4.5％ in 2010.The rates of overweight and obesity among groups in different years showed significant differences (P＜0.05).Conclusion Over the past 25 years,the prevalence rates on overweight and obesity increased significantly in Mongolian ethnic children and adolescents,and continued to rise,which called for reasonable and effective measures to be taken to prevent and control the occurrence of the problem.

AIM:To study the regulation of human chromosome 1 open reading frame 109(c1orf109)gene by transcription factor Myc-associated zinc-finger protein(MAZ)in vitro.METHODS:In vitro study,electrophoretic mobili-ty shift assay was performed to screen the binding sites of MAZ in the promoter region of c1orf109 gene.The HeLa cells were co-transfected with the enhanced green fluorescent protein reporter vector driven by c1orf109 promoter,and MAZ and transcription factor specificity protein 1(Sp1)expression plasmids.After 24 h,the transcriptional expression of c1orf109 gene in the co-transfected cells was determined by confocal scanning microscopy and flow cytometry.RESULTS:The c1orf109 promoter could bind to MAZ ,and shared the binding sites with Sp 1.MAZ and Sp1 both inhibited the transcrip-tional expression of c1orf109 gene and the inhibition effect of Sp1 was greater than MAZ(P<0.05).CONCLUSION:Both MAZ and Sp1 regulate the expression of c1orf109 gene in physiological and pathological conditions ,and this regulation is redundancy with the same direction.The existence of redundancy transcriptional regulation manner of this gene suggests that precise regulation of c1orf109 gene is vital important for cell biological processing.

OBJECTIVETo explore the effects of brain-derived neurotrophic factor (BDNF) pretreatment on beta amyloid protein (Abeta) induced impairment of in vivo hippocampal long-term potentiation (LTP) in the CA1 region of rats.

METHODSThirty-six adult male SD rats were randomly divided into six groups (n = 6): control, Abeta25-35, BDNF, (0.02 microg, 0.1 microg, 0.5 microg) BDNF + Abeta25-35. A self-made hippocampal local drug delivery catheter and a parallel bound stimulating/recording electrode were used to deliver drugs/stimulation and record field excitatory post-synaptic potentials (fEPSPs) in the hippocampal CA1 region of rats. High-frequency stimulation (HFS) was used to induce in vivo LTP.

RESULTS(1) Abeta25-35 (2 nmol) injection into CA1 region of rats did not affect the baseline fEPSPs, but inhibited the HFS-induced LTP significantly (P < 0.01). (2) Hippocampal CA1 injection of BDNF (0.1 microg) alone did not affect the baseline fEPSPs and HFS-induced LTP. (3) Compared with Abeta25-35 alone group, the averaged amplitude of LTP in BDNF (0.1 microg and 0.5 microg) plus Abeta25-35 groups significantly increased at 0 min, 30 min, and 60 min after HFS (P < 0.01), indicating that pretreatment with BDNF effectively protected against the Abeta,25-35 induced depression of LTP in a dose-dependent manner.

CONCLUSIONIntrahippocampal injection of BDNF can protect against the Abeta25-35-induced LTP impairment, suggesting that the up-regulation of BDNF in the brain could maintain the normal hippocampal synaptic plasticity and may contribute to the improvement of learning and memory in Alzheimer's (AD) disease patients.

Amyloid beta-Peptides ; antagonists & inhibitors ; Animals ; Brain-Derived Neurotrophic Factor ; pharmacology ; CA1 Region, Hippocampal ; drug effects ; physiology ; Excitatory Postsynaptic Potentials ; physiology ; Long-Term Potentiation ; physiology ; Male ; Peptide Fragments ; antagonists & inhibitors ; Rats ; Rats, Sprague-Dawley