Objective To analyze the mid- and long-term results after coronary artery bypass graft surgery (CABG), to evaluate the accuracy of multi-detector CT coronary angiography (MDCT) on the graft patency status and to compare the patency for different grafts. Methods One hundred and one cases underwent CABG from June 1992 to March 2008 were followed up by searching the database of MDCT (42 cases) and selective coronary angiography (SCA, 59 cases). The mean following up period was (66.79 ±44.27) months. Three hundreds and 10 grafts including 115 arterial and 195 venous were analyzed.A comparison of the patency rate between the arterial and venous grafts was also carried out. At the mean time, 2 groups were divided according to the paft lesions( patency of not). Uunivariate analysis and Logistic regression analysis were made for statistics. Results At the follow-up of (53.93 ± 36.80) months, the patent rate of LIMA, RA, SV and CV examined by MDCT was 94.7%, 92.0%, 85.9% and 60.0%, respectively. The patent rate for MDCT patients with angina was 83.5%, and 95.2% for angina-free group ( P = 0.046). At the follow-up of (75.95 ±47.09) months, the patent rate of LIMA, RA, SV and CV examined by SCA was 87.1%, 81.0%, 53.6% and 57. 1%, respectively. In SCA patients the patent rate was 62.0% for angina group and 100% for angina-free group ( P = 0.025 ). According to logistic regression analysis, only the postoperative period was statistically related to the graft lesion. Conclusion MDCT could find out the occlusions and obvious stenoses of the grafts after CABG. It might be served as a noninvasive method to evaluate the grafts patency postoperatively. The mid- and long-term patency of arterial grafts is better than venous grafts. Graft lesion is an important factor leading to postoperative recurrent angina pectoris. The severity of the graft lesion has a close relation to the lenth of postoperative period.

Objective To investigate effects of acute normovolemic hemodilution(ANH) used in on-pump coronary artery bypass graft(CABG) surgery.Methods 60 patients had received CABG surgery under cardiopulmonary bypass,of which 30 patients using ANH techniques and 30 patients using no ANH techniques.A series of index were observed and compared between the two groups after operation.Results All patients had been revascularized completely with stable surgical procedure,no serious complications,no operative mortality.Oxygen supplying was balanced with demanding,without tissue hypoxia.Indicators of myocardial protective effect,coagulation,kidney function,degree of systemic inflammatory reaction and postoperative drainage volume were not significantly different between the two groups(P ＞ 0.05).Allogeneic blood transfusion volume of the study group was significantly lower than that of the control group [(1.1 ± 0.8) U vs.(2.3 ± 1.1) U,P ＜ 0.05].Condusion The ANH technique used in CABG operation on appropriate patient is feasible and safe,with satisfactory clinical result.

Objective To investigate effects of acute normovolemic hemodilution (ANH) used in coronary artery bypass graft (CABG) surgery in elderly patients.Methods 60 elderly patients (aged ≥65 years) received CABG surgery under cardiopulmonary bypass,of which 30 patients using ANH techniques and 30 patients without ANH techniques.Results All patients were revascularized completely with stable surgical procedure,no serious complications and no operative mortality were found.Oxygen supplying was balanced with demanding,without tissue hypoxia.Indicators of the myocardial protective effect,coagulation,liver function,kidney function,glucose metabolism,negative nitrogen balance,and postoperative drainage volume were not significantly different between the two groups (P＞0.05).Allogeneic blood transfusion volume was significantly lower in study group than in control group[(0.9±0.9)U vs.(2.5±1.2)U,t=2.704,P＜0.01].Conclusions The ANH technique used in CABG operation in appropriate elderly patient is feasible and safe,with satisfactory clinical results.

Objective To investigate the changes of hemodynamics,cardiac troponin T(cTNT) and CK-MB zymogram perioperatively in elderly patients receiving off-pump versus on-pump coronary artery bypass grafting (CABG).Methods Totally 40 elderly patients (age＞65 years) undergoing surgical revascularization in our hospital were reviewed.20 patients were received off-pump coronary artery bypass grafting (group A),20 patients received on-pump surgery (group B).The cardiac output index (CI) and systemic vascular resistance index (SVRI) of each patient were recorded at the time of preoperative (T1),surgery completion (T2) and first day after surgery (T3).cTNT and CKMB of all patients were detected perioperatively.Results The level of CI was increased after operation,whereas CI of group A in T2 was significantly higher than that of group B [(3.92±0.43) L· min-1 · m-2 & (3.81±0.52)L · min 1 · m-2,t=2.036,P＜0.05).SVRI was decreased after operation,there was no difference between the two groups during the same time (P＞0.05).The levels of cTNT and CK-MB were within normal range before operation,whereas enhanced immediately after operation and returned to normal within the 7th day.The level of CK-MB in group B after operation was higher than that in group A [(11.8±4.4)tμg/L vs.(8.4±4.3)μg/L,t=2.214,P＜0.05) ；The level of cTNT in group B at 1st day after operation was increaesd compared with that in group A [(0.23±0.12)μg/L vs.(0.l1±0.09)μg/L],t=2.189,P＜0.05).Conclusions Both off-pump and on-pump CABG could improve the cardiac output and get approving myocardial protection effects in elderly patients,the effect of off-pump CABG might be superior to that of onpump CABG comparatively.

0. 05). Creatinine clearance improved significantly in group C from a mean value of (90?23)ml/min preoperatively to (139?46)ml/min during operation (P

Objective To observe the Th17 and regulatory T cells(Tr) equilibrium state as well as their changes of tuberculosis patients in six-month's anti-Tuberculosis treatment.Methods Select thirty-two tuberculosis patients received anti-Tuberculosis treatment while thirty-two healthy volunteers as controls.Flow cytometry was used to analyze Th17 and Tr cells in venous blood at the time of pre-therapy,3th,6th month.Results The ratio of Th17 cells in CD4 cells in tuberculosis patients and volunteers were (1.10±0.39)％,(2.50±1.03) ％,(3.90±1.34) ％,(4.50±1.52)％,respectively; the ratio of Tr cells were (9.17±3.26)％,(6.85±2.73)％,(5.46±1.69)％,(4.35±0.86)％,respectively.Conclusion Tuberculosis could make Th17 cells and Tr cells lost their balance,but the immune equilibrium state may gradually recover after anti-tuberculosis.The change of the amount of immune cells was likely to be the reference indexes to observe the progress of tuberculosis and the treatment effect of anti-tuberculosis.

Objective Analysis of hybrid cardiac and non-cardiac operations.Methods 11 patients received hybrid operations during 2000 ～2016 in our hospital were summarized, meanwhile another 11 patients undergoing only cardiac sur-gery served as controls.The level of CK-MB, TNI and visual analogue pain scores were recorded.The hospitalization expenses and postoperative hospital time were compared between the two groups .Results There was no death during hospitalization . There were no serious complications such as wound infection, delayed wound healing, postoperative bleeding requiring re-thora-cotomy and hemostasis, malignant arrhythmia, cerebral infarction and so on.Longer operation time[(358 ±79)min vs.(224 ±56)min, P<0.01], more allogeneic red blood cells transfusion[(3.2 ±1.6)U/case vs.(1.1 ±0.8)U/case, P<0.05] and more plasma transfusion[(515 ±234)ml/case vs.(284 ±92)ml/case, P<0.01]in hybrid operation group than those in the control group.There was no significant difference about CK-MB and TNI between two groups perioperatively(P>0.05). The wound pain was mild after cardiac surgery , and the wound pain was moderate after hybrid operation , which had little effect on rehabilitation exercises such as cough.4 days longer of postoperative hospital stay and 23 thousand yuan of hospitalization cost in hybrid operation group than those in the control group.One patient diagnosed of unstable angina pectoris and sigmoid colon cancer with intestinal obstruction was failed to resection of the tumor after received pericardial stripping and coronary ar-tery bypass surgery.The patient died three weeks after surgery due to intestinal obstruction and cachexia .The remaining 10 pa-tients were underwent successful surgery, cured and left hospital.No serious cardiovascular events, tumor recurrence and me-tastasis were found as followed up for 6-20 months.Conclusion Our practices show that hybrid cardiac and non-cardiac op-erations can be done safely and effectively.

How Th2 immunity develops in vivo remains obscure. Basophils have been considered key innate cells producing IL-4, a cytokine essential for Th2 immunity. Increasing evidence suggests that basophils are dispensable for the initiation of Th2 immunity. In this study, we revisited the role of basophils in Th2 immune responses induced by various types of adjuvants. Mice deficient in IL-3 or IL-3 receptor, in which basophil lymph node recruitment is completely abolished, fully developed wild type level Th2 CD4 T cell responses in response to parasite antigen or papain immunization. Similar finding was also observed in mice where basophils are inducibly ablated. Interestingly, IL-4-derived from non-T cells appeared to be critical for the generation of IL-4-producing CD4 T cells. Other Th2 promoting factors including IL-25 and thymic stromal lymphopoietin (TSLP) were dispensable. Therefore, our results suggest that IL-3- and basophil-independent in vivo Th2 immunity develops with the help of non-T cell-derived IL-4, offering an additional mechanism by which Th2 type immune responses arise in vivo.
Animals ; Basophils ; Immunization ; Interleukin-3 ; Interleukin-4* ; Lymph Nodes ; Mice ; Papain ; Parasites ; Receptors, Interleukin-3 ; T-Lymphocytes

OBJECTIVETo investigate the gene frequencies and mutation patterns of alpha thalassemia (alpha-thal) and beta thalassemia (beta-thal) in Liuzhou city of Guangxi Zhuang Autonomous Region.

METHODSCluster sampling was used. A total of 1 028 of umbilical blood samples were collected for a prevalence study of alpha-thal and a total of 1 312 healthy young people when receiving pre-marriage consultation were recruited for a beta-thal prevalence survey. Individuals live in city or town area of Liuzhou. A complete blood count as well as hemoglobin electrophoresis analysis were done in all of samples for phenotyping of alpha and beta-thals. Those with Hb Bart's for alpha-thal indicator and those with both microcytosis (MCV < 85 fl) and elevated levels of Hb A(2) (>/=4.0%) for beta-thal were further studied by DNA analysis. PCR-based methodologies were used to characterize the mutation contributions of alpha and beta-thals. All the subjects were tested for the state of carrying beta-thala alleles for evaluating the situation of the compound heterozygotes of alpha-thal with beta-thal.

RESULTSOf 1 028 random samples of umbilical blood screened, 112 of subjects were defined to be the gene carriers of alpha-thal. The alpha-thal carrier rate was as high as 11.19% including 3 compound heterozygotes. Five well-known types of alpha-thal alleles were detected with gene contributions of 37.4% (--(SEA) deletion), 31.3% (-alpha(3.7) deletion), 17.4% (-alpha(4.2) deletion), 12.1% (alpha(CS)alpha mutation), and 0.9% (alpha(QS)alpha mutation), successively. Of the 1 312 adult specimens studied, 89 with beta-thal including 14 of the compound higher Hb F subjects were detected. All of the 89 phenotypic beta-thal carriers had the mutations in the beta-globin gene, making the overall prevalence 6.78%. The commonly seen three mutations, beta CD41 - 42 (-CTTT) frameshift, beta CD17 (T-A) nonsense mutation and beta-28 (A-G) promoter variation were accounted for 90% of the beta-thal alleles in Liuzhou. Of these beta-thal subjects, 16 (accounting for 18%) were found to be the compound heterozygosity for a beta-thal and an alpha-thal with 9 different types of gene defects with a detection rate 1.22%.

CONCLUSIONData from ecidation of alpha and beta-thal gene frequencies and mutation spectrum in Liuzhou city was useful for genetic counselling and prenatal diagnosis of this disease.

Adult ; China ; epidemiology ; Female ; Gene Frequency ; Genetic Counseling ; Humans ; Male ; Prevalence ; alpha-Thalassemia ; epidemiology ; genetics ; beta-Thalassemia ; epidemiology ; genetics

OBJECTIVETo develop an allele-specific PCR (AS-PCR)/restriction fragment length polymorphism (RFLP) assay for CYP1B1 gene haplotypes predisposing to primary congenital glaucoma (PCG).

METHODSTwenty Chinese PCG patients and 20 healthy controls were recruited. Peripheral blood sample was subjected to direct sequencing for common single nucleotide polymorphisms (SNPs) of the CYP1B1 gene. Based on the results, CYP1B1 gene haplotypes were constructed by PCR-RFLP and AS-PCR combined with RFLP.

RESULTSFour SNPs loci were identified by sequencing, which included rs10012 G>C (S1 in exon 2), rs1056827 T/G (S2 in exon 2), rs1056836 C/G (S3 in exon 3) and rs1056837T>C (S4 in exon 3). The distribution of such loci showed different characteristics between the two groups. 50% of the PCG patients had rs10012 G>C and rs1056827 T>G, while 25% of PCG patients had rs1056836 C>G and rs1056837T>C. As for the controls, 25% had rs10012 G>C and rs1056827 T>G, 10% had rs1056836 C>G and rs1056837T>C. None of the SNP loci has presented alone. PCR-RFLP was carried out to confirm the results of SNPs typing, but could not confirm the linkage between the SNP loci. By contrast, AS-PCR combined with RFLP has achieved specific amplification for rs10012 G>C and thorough differentiation of 1056827 T>G polymorphism. Similar results have been obtained by the same method for rs1056836 C>G and rs1056837T>C typing and linkage disequilibrium analysis.

CONCLUSIONThe AS-PCR/RFLP assay has successfully constructed the haplotypes of the CYP1B1 gene. For its accuracy, efficiency and specificity, the method may be used for constructing haplotypes for hereditary disease studies.

Adult ; Aged ; Alleles ; Base Sequence ; Cytochrome P-450 CYP1B1 ; genetics ; Female ; Gene Frequency ; Genetic Predisposition to Disease ; genetics ; Genotype ; Glaucoma ; congenital ; genetics ; Haplotypes ; Humans ; Linkage Disequilibrium ; Male ; Middle Aged ; Polymerase Chain Reaction ; methods ; Polymorphism, Restriction Fragment Length ; Polymorphism, Single Nucleotide ; Reproducibility of Results ; Sequence Analysis, DNA ; methods