Objective To evaluate the impact of the off -pump coronary artery bypass (OPCAB) on left ventricular(LV) function with transesophageal echocardiography(TEE). Methods Blood flow velocities of pulmonary vein (PV) and mitral valve (MV) were performed in 21 patients with coronary heart disease and myocardial infarction two weeks pre-OPCAB, and the left ventricular SV, CO and LVEF were measured by biplane Simpson′s method, the data were compared with the results observed one month post-OPCAB. Results The peak flow velocities of PV had significant difference between pre- and post-OPCAB(P

Objective To realize the construction and expression of human dsFv genes to rabies virus. Methods The genes of dsFv VH and VL were amplified by PCR-based point mutagenesis strategy. Then the genes were cloned into plasmid pET-22b (+). E. coli BL21(DE3) was transformed with the recombinant expression plasmid and the protein was induced in Luris-Bertani medium by addition of IPTG. The inclusion body proteins of VH and VL were denaturalized by GuHCl, and then re-naturalized in refolding solution to form dsFv fragments. Afterwards, we evaluated the antigen-binding activity of the dsFv and its stability as compared with its originative scFv. Results The fragment genes of dsFv to rabies virus were constructed successfully by PCR-based point mutagenesis strategy. Sequence analysis proved that cysteines were introduced into the position 44 aa of VH and position 100 aa of VL. The dsFv VH and VL genes were expressed in PET22b(+)/BL21(DE3). The VH and VL protein folded into the active dsFv antibody fragments which showed specific binding capability to rabies virus. Conclusion We succeeded in achieving the stabilization of the human scFv to rabies virus and obtaining the active human dsFv antibody fragments. This established a solid basis for further study of the biological activaty and clinical application of dsFv to rabies virus.

Objective To assess the changes of left ventricular function after off-pump coronary artery bypass (OPCAB) using Tei index. Methods Fourty-six patients of coronary artery disease, who had accepted OPCAB, were enrolled. Left ventricular ejection fraction(LVEF), E/A ratio at mitrial orifice(E/A), E deceleration time(EDT), isovolumic relaxation time(IVRT), ratio of systolic wave to diastolic wave of pulmonary vein flow(S/D) and Tei index were measured by transthoracic echocardiography before, immediate, 1 week, 1 month, 3 months and 6 months after OPCAB. Results Tei index decreased gradually as time went on after OPCAB and the differences were significant between different times(P

Objective To investigate the relapse factors and its control strategy for peptic ulcer patients .Methods A total of 160 cases of peptic ulcer patients who visited our hospital from Jan 2011 to Aug 2013 was retrospectively analyzed .The recurred pa-tients were assigned as the experimental group , and the others as the control group .The relapse factors for peptic ulcer were observed . Results Among 160 peptic ulcers , there were 46 cases with recurrence with a relapse rate of 28.8%.Single factor logistic regression analysis showed that smoking, drinking, the spring and autumn season, h.pylori (Hp) infection, non-steroid anti-inflammatory drugs (NSAIDs), mental factor, and male were the risk factors for recurrence of peptic ulcer .Further multivariable logistic regression analy-sis showed that smoking, drinking, mental factors, history taking NSAIDs, and Hp infection were also the risk factors for recurrence of peptic ulcer .Conclusions Smoking and alcoholism history , meatal factors , history of taking NSAIDs , and Hp infection were the in-dependent risk factors of recurrence of peptic ulcer , intervention of these risk factor might reduce ulcer recurrence .

Objective To summarize the experiences in clinical diagnosis and surgical treatment of chest cancers invading the superior vena cava (SVC). Method Retrospective study of 12 cases with chest cancers invading the SVC, SVC and innominate vein were reconstructed with prosthesis in 3 cases, the side wall of the SVC was excised and repaired in 9 cases. Results Complete resection was performed in 10cases,2 cases had incomplete resection. There was no death associated with operation in these patients. All patients were followed up for 1 - 7 years after operation,and 3 cases were lost to follow up,5 of remaining 9cases were dead because of relapse and metastasis, their median survival time was 8 months,other 4 cases lived, their median survival time was 42 months. Conclusions Patients with chest cancers invading the SVC should have surgical treatment of not only tumor resection but also the vessel reconstruction,the prognosis would be better than without surgical treatment. These patients have a high quality of life and live with long-term survival.

Objective To evaluate the methods of standard patient (SP)combined with case-based learning (CBL ) in humanistic quality cultivation for interns in the department of thoracic surgery. Methods Medical interns in the department of thoracic surgery were divided randomly into experimental(n=30)and control group(n=30)respectively. In experimental group,SP combined with CBL was used while in control group traditional teaching was used. At the end of the study,teaching effect was assessed by the final examination and questionnaires and the data were processed by t test andX2 test. P<0.05 signifies statistical differences. Results There was no significant difference in test scores between the two groups (P>0.05). Scores of history-taking,medical check-up,paper writing quality in the final examination in experimental group were significantly higher than those in control group(P<0.01). Satisfaction degrees of doctor-patient communication,responsibility and service attitude in experimental group were better than those of control group(X2=16.484,10.335,20.376,32.851,P<0.01). Conclusions SP combined with CBL teaching method can stimulate the students' interests in thoracic surgery practice,improve the doctor-patient relationship and strengthen the ability of human-istic concern. It is a better clinical thoracic practice teaching method and it is beneficial to cultivating medical students with humanistic concern.

OBJECTIVE:The effects of Astragulus injection on cardiac function in myocardial infarction convalescents were observed.METHODS:42 cases were randomly divided into two groups(therapeutic group and control group).21 cases in therapeutic group were treated with routine treatment and 21 cases in control group were treated with Astragulus injection on the basis of routine treatment for three weeks.The ejection fraction(EF),early diastolic peak velocity of blood flow(E),late diastolic peak velocity of blood flow(A) and A/E of all patients were measured with pulse ultrasonic Doppler cardiography before and after the treatment.RESULTS:After the treatment,the EF,E and A/E were improved (P

Objective To investigate the effect of Shanzha Xiaozhi Capslue on stability of atherosclerosis plaques in patient with metabolic syndrome (MS) and carotid atherosclerosis (CAS). Methods Totally 106 patients with MS and CAS were randomly divided into 2 groups with 55 cases in the treatment group and 51 cases in the control group. The control group improved the way of life and control of relevant risk factors, while the treatment group was treated with Shanzha Xiaozhi Capslue additionally for 6 months. The occurrence of major adverse cardiovascular and cerebrovascular events of the two groups was compared. The intima-media thickness, plaques grade of carotid artery and the changes of Hs-CRP, Hcy, insulin resistance were measured before and after the treatment. Results After treatment, the occurrence of major adverse cardiovascular and cerebrovascular events in the treatment group reduced significantly compared with the control group (P=0.047). The intima-media thickness and plaques grade of carotid artery in the treatment group decreased significantly compared with the control group (P<0.05), and the serum levels of Hs-CRP, Hcy, insulin resistance were decreased significantly compared with the control group (P<0.01). Conclusion Shanzha Xiaozhi Capslue can decrease the intima-media thickness and plaques score of carotid artery, stabilize atherosclerotic plaque, thus reduce the occurrence of major adverse cardiovascular and cerebrovascular events of patients with MS and CAS.

Objective To investigate the effect of Shanzha Xiaozhi capslue on intima-media thickness(IMT) and plaques score of carotid artery in patients with non-acute phase coronary heart disease and traditional Chinese medicine(TCM)syndrome of phlegm and blood stasis. Methods A prospective study was conducted to carry out a research on 102 patients with non-acute phase coronary heart disease and TCM syndrome of phlegm and blood stasis. They were randomly divided into two groups:a control group(50 cases)treated with conventional western medicine alone and a observation group(52 cases)which was treated by both conventional western medicine and Shanzha Xiaozhi capslue(the main TCM ingredients:Shanzha,Dahuang)0.7 g,3 times a day,the therapeutic course being 6 months in both groups. The cardiocerebral vascular incidences of the two groups were observed,in the mean time,the carotid artery IMT and plagues score were registered,the scores of phlegm stagnation syndrome and blood-stasis syndrome were measured,adverse reaction was observed and compared in both groups before and after treatment. Results After treatment,the occurrence of major adverse acute cardiovascular and cerebrovascular events in observation group were reduced significantly compared with those in the control group(5.77%vs. 20.00%,P<0.05). The IMT and plaques score of carotid artery and the scores of phlegm stagnation syndrome and blood-stasis syndrome were all decreased obviously compared to those before treatment,and the effect was more remarkable in the treatment group〔IMT of carotid artery(mm):0.80±0.13 vs. 0.95±0.12,the plaques score:1.35±0.65 vs. 1.75±0.88, phlegm syndrome score:20.98±6.42 vs. 35.55±9.22,blood-stasis syndrome score:23.23±5.12 vs. 28.95±6.38, P<0.05 or P<0.01〕. Abdominal pain appeared in 2 patients of observation group without other adverse reactions. Conclusion Shanzha Xiaozhi capsule can stabilize atherosclerotic plaque and reduce the occurrence of acute adverse cardiocerebral vascular events in patients with non-acute phase coronary heart disease and phlegm and blood stasis syndrome possibly by removing phlegm and blood stasis to decrease the IMT and plaques score of carotid artery.

[Objective] To summarize image manifestations in intestinal tuberculosis (ITB) examined by multi-slice computed tomography enteroclysis (MSCT) and evaluate the diagnostic value of MSCTE in ITB,[Methods] The imaging findings were retrospectively analyzed in 15 cases of ITB that were confirmed by endoscopy or postoperative pathologic examination,including the location,number,shape,edge,surrounding tissue alterations of ITB and other associated changes in the peritoneum,mesentery and solid abdominal organs,and compared with endoscopy and pathology.[Results] In 15 patients,ileocecum was involved in 13 cases (87％),4 cases (27％) showed multi-segmental symmetric intestinal mural thickening,9 patients (60％) showed solid masses,1 case (7％) showed multi-segmental symmetric intestinal mural thickening and solid masses,1 case (7％) showed homogenous enhanced masses and perforation,12 cases (86％) showed enlarged lymph nodes (LNs) with rim enhancement,and 2 cases (13％) showed the comb sign of enhanced mesenteric vessels.Based on enhancement pattern of MSCTE,ITB was divided into three types:homogenous enhancement type (n=5);target sign type (n=2);caseous necrosis type (n=2).[Conclusion] The imaging features of ITB are diverse.MSCTE can clearly display the shape of intestinal mucosa,the alterations of intestinal wall and the relationship between lesion and adjacent tissues,which provides valuable information for the clinic diagnosis of ITB.