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 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 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: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 provide the new idea for clinical pharmacists providing pharmaceutical care in oncology depart-ment. METHODS:Applying the principles and methods of clinical pathway,the pharmaceutical care of anti-tumor drugs could be divided into before medication,during medication,after medication and patient education,according to the sequence of taking med-icine. On the basis of evidence-based medicine,the care contents of each unit were established,and the pharmaceutical care path-way (PCP) was formed. During chemotherapy duration for a breast cancer metastasis patient with liver function injury,clinical pharmacists conducted pharmaceutical care for drug pretreatment,ADR monitoring and disposal,patient education,as well as put forward the proposal of drug treatment as supplementing calcium,adjusting the dose of epirubicin and paclitaxel targeting on PCP of zoledronic acid,epirubicin and paclitaxel. RESULTS:Physicians adopted the pharmacist’s recommendations. The patient suf-fered from joint and muscle pain during chemotherapy,and the symptom was relieved after symptomatic treatment by celecoxib;chest and back discomfort was relieved significantly after chemotherapy,and the disease condition kept stable. The patient was dis-charged from the hospital. CONCLUSIONS:PCP focus on the time,content and countermeasures of pharmaceutical care,the pro-gram and treatment results of pharmaceutical care,and promote standardization,formalization,simplification and procedure of pharmaceutical care. Clinical pharmacists conduct individualized pharmaceutical care rapidly targeting on PCP so as to deepen the communication of clinical pharmacists with physicians,nurses and patients,and promote the development of pharmaceutical care smoothly.

Objective To investigate the clinical efficacy of acupuncture at Huatuo jiaji points plus point Shixuan bloodletting in treating cervical spondylotic radiculopathy.Methods One hundred patients with cervical spondylotic radiculopathy were randomly allocated to treatment and control groups, 50 cases each. The treatment group received acupuncture at Huatuo jiaji points plus point Shixuan bloodletting and the control group, acupuncture at Huatuo jiaji points alone. Plasma viscosity was measured in the two groups before and after treatment. The clinical therapeutic effects were compared between the two groups.Results There was a statistically significant pre-/post-treatment difference in plasma viscosity in the two groups (P<0.05). There was a statistically significant post-treatment difference in plasma viscosity between the treatment and control groups (P<0.05). The total efficacy rate was 94.0% in the treatment group and 84.0% in the control group; there was a statistically significant difference between the two groups (P<0.05).Conclusion Acupuncture at Huatuo jiaji points plus point Shixuan bloodletting is an effective way to treat cervical spondylotic radiculopathy.

Objective To observe the effects ofYiqi Shuxin Pills on the coronary flow reserve (CFR) of patients with acute coronary syndrome (ACS) in the coronary angiography (CAG); To discuss its relevant mechanism of action.Methods Totally 101 patients with ACS were divided into control group (49 cases) and treatment group (52 cases). Patients in the treatment group were treated with western therapy andYiqi Shuxin Pills, while patients in the control group were treated with western therapy only. After treated for 6 months, CAG was reviewed to compare the CFR in both groups before and after the treatment. The blood-stasis syndrome and qi-deficiency syndrome scores and the level of NO, ET-1, hs-CRP, sVCAM-1, P-selectin in blood of both groups before and after the treatment were observed.Results The blood-stasis syndrome and qi-deficiency syndrome scores in the treatment group were significantly lower than those in the control group (P<0.01); The levels of ET-1, hs-CRP, sVCAM-1, P-selectin were obviously reduced and NO obviously increased in treatment group than those of control group (P<0.05). The CFR in the treatment group was significantly better than that of control group, with statistical significance (P<0.05). ConclusionYiqi Shuxin Pills can improve the state of blood-stasis syndrome and qi-deficiency syndrome, improve vascular endothelial function, relieve inflammatory reaction, lower the expression of platelet, stabilize atherosclerotic plaque of coronary artery, and then improve the CFR of ACS patients in CAG.