ObjectiveTo observe the effects of lung resection surgery on left heart hemodynamics in elderly patients, and explore its correlation with postoperative arrhythmia.Methods The 16 elderly patients (age≥75 years) receiving lung resection surgery were selected. At the same time, 21 patients (age＜60 years) were selected as controls. The hemodynamic parameters of each patient were recorded at the time of preoperative (T1), surgery completion (T2) and first day after surgery (T3). For patients with arrhythmia during three days after operation, the parameters would be recorded before and after arrhythmia. Results There were no significant changes in heart rate (HR), mean arterial pressure (MAP), cardiac output (CO), cardiac stroke volume ( SV),acceleration index (ACI), systemic vascular resistance (SVR) at T2 and T3 compared with T1 for both the two groups (P＞0. 05). Only the central venous pressure (CVP) increased at T2 compared with that at T1 [elderly group: (7.58±0.45) cm H2O vs. (5.92±0. 51) cm H2O, t=2.641, P＜0.01; control group: (7.49±0.34) cm H2O vs. (6.23±0.47) cm H2O, t=1.982, P＜0.05], while the CVP recovered to the preoperative level at T3. The incidence of arrhythmia was significantly higher in elderly group than in control group (31.3% vs. 14.3%, x2 = 4.26, P＜0.05), but there were no significant changes in the parameters before and after arrhythmia compared with those before surgery (P ＞ 0. 05 ).Conclusions The effects of pulmonary resection surgery on left heart hemodynamics in elderly patients can be avoided through full assessment preoperatively, heart-lung protection intraoperatively, as well as the correctly and timely clinical treatment and intensive care postoperatively. Pulmonary resection surgery has no effect on left heart hemodynamics even for patients with postoperative arrhythmia.

ObjectiveTo explore the role of activation and expression of absent in melanoma 2 (AIM2) in pathogenesis of hepatitis B virus (HBV) associated glomerulonephritis (HBV-GN).MethodsFifty-four patients with HBV-GN were recruited into the investigational group,and 25 patients with chronic glomerulonephritis (CGN) and 6 patients with chronic hepatitis B (CHB) were included as negative control group and positive control group,respectively.Immunohistochemistry was used to detect AIM2,Caspase-1 and interleukin (IL)-1β expressions in both kidney tissues from the investigational group and negative control group and liver tissues from positive control group.The differences between groups were compared by chi-square test,and the correlation analysis was conducted by Spearman correlation test.ResultsThe positive expression rates of AIM2 in 54 patients of HBV-GN group and 25 of CGN group were 81.4 ％ and 4.0％,respectively (x2 =38.746,P＜ 0.01).AIM2 was found to be expressed in all 6 CHB patients.In HBV-GN group,the expression of AIM2 was positively correlated with Caspase-1 (rs =0.444,P＜0.01),and the expression of IL-1β was also positively correlated with Caspase-1 (rs =0.515,P＜0.01 ).In HBV-GN group,the expression of AIM2 in patients with HBV DNA≥1 ×105 copy/mL was significantly higher than that in those with HBV DNA＜1 × 105 copy/mL (x2 =6.097,P＜0.05).ConclusionThe activation of AIM2 may play a role in the pathogenesis of HBV-GN through Caspase-1 activation and inflammatory factor IL-1β release.

Objective To study the pre-existing intimal hyperplasia and the expression of nuclear factor-κB (NF-κB) and vascular cell adhesion molecule 1 (VCAM-1) in great saphenous vein(GSV) among the patients with diabetes mellitus undergoing coronary artery bypass grafting(CABG).Methods Segments of GSV were collected from 20 patients with diabetes mellitus and 22 patients without diabetes mellitus undergoing CABG.Morphometric analysis was performed after hematoxylin-eosin (HE) staining and Masson staining by microscopic computer analysis.Immunohistochemistry staining was used to examine the expression of NF-κB and VCAM-1 in intima.Results Pre-existing intimal hyperplasia was more common and server in GSV of the patients with diabetes mellitus.The expression of NF-κB and VCAM-1 were significantly higher in intima of GSV in patients with diabetes mellitus than patients without diabetes mellitus.The expression of VCAM-1 was positively related to NFκB in intima of GSV.Conclusion The pre-existing intimal hyperplasia and the expression of NF-κB and VCAM-1 were more common and server in GSV of the patients with diabetes mellitus than patients without diabetes mellitus.This can partially explain the poor prognosis of patients with diabetes mellitus after CABG.

Objective To investigate the effect of Beraprost Sodium and atorvastatin in the treatment of TIA combined carotid plaques. Method 60 cases in our hospital with TIA and carotid artery plaques were randomly divided into observation group and control group, 30 cases in each group. The observation group was received beraprost natriuretic peptide and atorvastatin calcium therapy, the control group was treated with atorvastatin calcium. 12 months later,two groups were compared with carotid plaque area change and coagulation conditions. Results Carotid plaque area in observed group was significantly less than the control group (P<0.05). The differences of platelet agglutination test(PAgT), fibrinogen(Fg) , hypersensieive 3 C-reaction protein, total cholesterol(TC), high density lipoprotein cholesterol (HDL), low density lipoprotein cholesterol (LDL), TIA recurrence rate and incidence of ischemic stroke between two groups after treatment were statistically significant (P<0.05). Conclusion Beraprost Sodium and atorvastatin has a good effect in reducing carotid plaques area, adjusting blood fat and preventing TIA and ischemic stroke, It is worthy to clinical popularization and application.

Objective: To explore the distribution characteristic of syndromes and the rule of the differentiation of symptoms and signs of functional dyspepsia(FD).Methods: We investigated and analyzed the 565 cases of FD by the epidemiological ascertainment methods,and had the second differentiation of symptoms and signs by "cold,heat,deficiency,exc ess" on the basis of the traditional method,then established the database and had a statistical analysis by SPSS.Results: Based on the differentiation of symptoms and signs of "cold,heat,deficiency,excess",FD could be mainly classified as asthenia cold syndrome-insufficiency(or deficiency-cold) of the spleen and stomach,excess-heat syndrome dampness-heat of spleen and stomach,deficiency-excess complicated syndrome spleen-deficiency and qi stagnation,and cold-heat complicated syndrome.Conclusion: It is a brief,clear and also feasible method for the differentiation of symptoms and signs of FD with the class of "cold,heat,deficiency,excess".

Objective: To investigate the protective effects of different storage solutions on the ultrastructure and integrity of rabbit endothelial cells, and their effects on endothelin 1 secretion. Methods: Femoral artery segments were harvested from 16 adult rabbits, which were then stored separately in four different storage solutions. The solutions was: (1) verapamil nitroglycerin solution (VG); (2) heparinized papaverine autologous blood (PB); (3) papaverine solution (PS); (4) Ringer's solution (Ringer). The ultrastructure of the endothelial cells,the covering percentage of endothelium monolayer and the level of endothelin 1 secretion were evaluated. Results: The covering percentage of endothelium monolayer was significantly higher in VG [(69?10)%] and PB[(71?9)%] compared with that in Ringer [(55?11)%] (P0.05). The endothelial ultrastructure was more seriously damaged in PS than that in VG and in PB through TEM. The level of endothelin 1 secreting was similar significantly increased only in PB [(116.781?22.387) pg/ml] compared with that in Ringer (P

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.

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 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.

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