5) receiving cardiopulmonary coronary artery bypass grafting(CCAB) during the same period was reviewed as control group(CCAB Group).The preoperative risk factors,operation parameters,and postoperative outcomes between the two groups were compared for statistical analysis.Results The EuroSCORE value of the OPCAB Group and the CCAB Group was 9.0?2.6 and 8.3?2.1,respectively(t=2.016,P=0.045). The number of grafts in the OPCAB Group was less than that in the CCAB Group(3.2?0.9 vs 3.8?0.9;t=-4.267,P=0.000).The postoperative levels of creatine kinase(CK) and creatine kinase myocardial band(CK-MB) were significantly lower in the OPCAB Group [570(61～8246) U/L and 20(1～282) U/L] than the CCAB Group [870(246～8155) U/L and 55(12～300) U/L](Z=-3.648 and-5.767,P=0.000).The blood transfusion in the OPCAB Group was significantly less than that in the CCAB Group(775?693 ml vs 1088?712 ml;t=-2.887,P=0.004).There was no statistical difference in postoperative complications between the two groups.The mortality is 3.5%(4/113) in the OPCAB Group and 6.6%(5/76) in the CCAB Group,without statistical difference(?2=0.925,P=0.336).Conclusions OPCAB is safe and effective in high risk patients.Different operation methods should be used for patients with different risks.

Objective To study the facial nerve canal (FNC) abnormalities of the congenital external auditory canal (EAC) atresia by MSCT curved planar reformation (CPR).Methods 15 cases(17 ears) of congenital EAC atresia were scanned by MSCT. Post-processing images were completed by Philips Mx8000 workstation.Results In 17 ears, there were 2 ears with stenosis of EAC, 2 ears with membranous atresia of EAC and 13 ears with bony atresia of EAC.There were 1 ear with congenital cholesteatoma, 3 ears with malformation of tympanum, 7 ears with malformation of the ossicular chain and 1ear with malformation of inner ear. In 17 ears with abnormalities of FNC, included 11 ears with the shortness of FNC general length, 5 ears with the anomalous course of FNC, 9 ears with the displacement of FNC, 1 ear with the narrowing of FNC and 1 ear with the branch of FNC.Conclusion MSCT CPR of FNC, combined with HRCT axial scan, can clearly show the FNC abnormalities of the congenital EAC atresia and provide valuable information for surgery.

Objective Using curved planar reformation(CPR)to delineate the ossicular chain(OC)in one image and evaluate its clinical application. Methods HRCT of temporal bone was performed in 122 cases(165 ears).The CPR of OC was then performed.The main parameters were as follow:collimation 0.5mm,pitch 0.875,reformation interval 0.2～0.3mm,reformation matrix 1024?1024.Results (1)CPR of normal OC were performed on 80 ears,the three ossicles and its joints could be showed on one image clearly.(2)Clincal application(72cases):in 39 cases of temporal bone trauma,OCs were normal in 21 cases and abnormal in 18 cases.Subluxation or dislocation of malleoincudal joint(MIJ)(5,5) and incudostapedial joint(ISJ)(5,6),dislocation of MIJ and ISJ with rotation of incus(1 case),fracture of manubrium of malleus(1 case) were found respectively.In 16 cases of external auditory canal dysplasia(EACD),the most commonly associated type of OC deformity was absence of manubrium of malleus(10 cases)。Absence of OC associated with coarctation of middle ear cavity(3 cases) and fusion of the malleus and incus associated with absence of long process of incus represented in 1 case.Congenital ossicular anomalies without associated EACD were found in 2 cases.The long processes of the incus of both side were absent in 1 case.Incudostapedial disconnection was demonstrated in 1 case due to improper development of the long process of the incus.In 15 cases of chronic otitis media(COM),6 cases were complicated cholesteatoma.Destruction of OC was demonstrated in 6 cases.Conclusion CPR of OC with multislice spiral CT is an effective method in the diagnosis of conductive hearing loss.

Objective To explore the high-resolution CT manifestation of chronic otitis media with cholesteatoma. Methods clinical and high-resolution CT manifestation of 31 cases of chronic otitis media with cholesteatoma were analyzed. All the cases were confirmed by operation and pathology. Results High-resolution CT can accurately show the signs of soft-tissue occupancy and bony-erosion of cholestcatoma in middle ear which originate from various sites and of various sizes.confirmed by operation, accuracy were as high as 93.5%-100% . Conclusion high-resolution CT is extremely accurate in diagnosis of chronic otitis media with cholesteatoma.

Objective To explore the applied value of multi-slice spiral CT(MSCT) scan in the traumatic facial palsy.Methods 41 cases of traumatic facial palsy were scanned using MSCT,the MPR of interseted region of temporal bone and curved planar reconstruction(CPR) images were performed on Philips Mx8000 MSCT work station.The types,locations and course of the temporal bone fracture and the involving features of the external auditory canal,middle ear,inner ear were observed.Results 39 cases of the 41 patients had temporal fracture in different location.34 cases were longitudinal fracture,2 were transverse fracture and 2 were mixed fracture.The facial nerve canals were involved in 21 cases.Conclusion MSCT and the reformation images can help to study the facial nerve canal in the traumatic patients.It is important to use the MPR and CPR in the traumatic facial palsy.

Objective To evaluate the appropriate timing of coronary artery bypass grafting(CABG) with acute myocardial in- farction(AMI) and to discuss the influence of postoperative mortality on 30 days.Methods 233 patients after CABG were divided into 2 groups,AM/group and unstable angina (UA) group.There were 176 males (75.4%) and 57 females (24.5%).The mean age was (65.6?9.2) years(range 34～86 years).The mean grafts were 3.46?0.89.The complex risk elements between the 2 groups were analyzed to evaluate the independent risk element of death.Results Internal mammary arteries were used in 137 patients (58.8%).The postoperative mortality rate was 4.3 % (10/233).The operative mortality rates(OMR) were closely related to the in- creasing time intervals between AMI and CABG,for less than 3 days was 14.6% (6/41 cases),for 4 to 10 days was 2.7 % (1/37) and for 11 to 30 days was 0.The OMR of AMI less than 3 days has significant difference (P=0.033) comparing with that of unstable an- gina pectoris [2.3% (3/130) ].Conclusion Proper timing of CABG should be done in 3 days after AMI.

Objective To study MR imaging features of transient bone marrow edema syndrome of the hip so as to improve its diagnosis and differential diagnosis.Methods MR images of transient bone marrow edema syndrome of the hip in 13 patients were retrospectively analyzed in combination with literature review.Results The bilateral hips were affected in 4 patients.The single hip was affected in 9 patients,left hip in 6 and right hip in 3.The MR images demonstrated low signal intensity in all 13 patients on T1WI,and normal signal intensity in 2 patients,moderate or high signal intensity in 11 patients on T2WI,and high signal on T2 fat suppressed or STIR images in all 13 patients.The bone marrow edema pattern involved the femoral head and neck in 13 hips,the femoral head and neck and the intertrochanteric region in 4 hips.A small joint effusion was observed in 8 hips on T2WI.The configuration of femoral heads were normal.Conclusion Correct judgement of MRI manifestations of transient bone marrow edema syndrome of the hip can improve its diagnosis and differential diagnosis.

AIM: To observe the influence of gold nanoparticles combined with Endostar (AuNPs-Endostar) on the melanoma lung metastasis of mice and the underlying mechanism.METHODS: C57BL/6 mice (n=24) were selected for constructing the model of spontaneous lung metastasis of melanoma B16-F10 cells.Subsequently, the mice were randomly divided into Endostar group, AuNPs group, AuNPs-Endostar group and model group.After the formation of melanoma, the mice in each group were injected with different drugs through tail vein for 0.1 mL daily.After 9 d, the mice were narcotized for cutting the tumors in situ.After the operation, they were raised for 2 weeks before killed for obtaining the lung tissues to observe the situation of the metastasis.HE staining was utilized for observing the necrosis status of the tumors in situ, while immunostaining was applied for testing the expression of CD31, carbonic anhydrase-IX (CA-IX), vimentin and zonula occludens-1 (ZO-1) in the tumors.RESULTS: Compared with model group, the pulmonary metastasis in the groups with medical treatment was obviously reduced.In AuNPs-Endostar group, the metastasis inhibition rate was the highest, and the tumor necrosis was also decreased obviously, with the significant reduction of CD31, CA-IX and vimentin expression in the tumors and significant increase in ZO-1 expression.CONCLUSION: Compared with using Endostar or AuNPs alone, the combination of AuNPs with Endostar significantly improves the curative effect of inhibiting the pulmonary metastasis of melanoma in the mice.The mechanism may be related to reducing the tumor angiogenesis, norma-lizing the blood vessels and improving tumor hypoxia, thus inhibiting the tumor epithelial-mesenchymal transition, increasing the tight junctions between tumor cells and decreasing the invasiveness.

Objective To measure the dimention and area of the cerebellar vermis and determine the effects of age and sex on the size of the cerebellar vermis in healthy adults.Methods We estimated the dimention and area of the cerebellar vermis in 360 healthy volunteers,20～87 years old.Results We found a significant reduction in the anterior-posterior dimention and the superior-inferior dimention after 60 years old.The anterior lobule area and the total area of the cerebellar vermis were larger in male than that in female.However,the analysis of age trends in the verian lobules revealed differential age related declines.Conclusion The dimention and area of cerebellar vermis reduced with aging after 60 years old.The area of the anterior vermis is larger in men than that in women.

Objective To measure the dimension and area of the brainstem on MR images in healthy adults and to study the relationship between age, sex and the size of the brainstem.Methods The dimensions and areas of the brainstem in 360 healthy volunteers on midsagittal MR images were measured. There were 180 males and 180 females, ranged in age from 20～87 years old. Results The average antero-posterior(AP) distances and areas of the midbrain were the largest at the 20～29 years old, and decreased slightly over 60 years. The average AP distance, vertical distance and area of the frontal pontine and pontine were no significant difference between different age groups, but there were significant difference in sex. The average upper diameter and area of the medulla oblongata were significant difference in partial age groups, and there was difference in sex (?