Objective To explore the feasibility of off-pump coronary artery bypass grafting (OPCAB) in the treatment of severe coronary atherosclerotic heart disease. Methods Clinical data of 37 cases of severe coronary heart disease from January to December, 2002, were retrospectively reviewed. All operations were conducted under general anesthesia by midline sternotomy. The left internal mammary artery (LIMA) and the great saphenous vein (SV) were divided for grafting. Then we stabilified the local myocardium and exposed the diseased coronary arteries. Following the insertion of an intracoronary shunt, the LIMA was anastomosed to the left anterior descending artery (LAD). Afterwards, the SV was proximally anastomosed to the aorta, and then, to the coronary artery. Results All the operations were completed by beating heart revascularization. The number of bypass grafting was 3 2?0 5 (range, 1～6). Except 1 patient died on the 10th postoperative day, no severe complications, such as peri-operative myocardial infarction, respiratory failure, renal insufficiency or cerebrovascular accident, took place in the remaining 36 patients. Conclusions In the context of skillful procedure techniques and strict peri-operative management, OPCAB in the treatment of severe coronary atherosclerotic heart disease is feasible.

Child ; Epidermal Cyst ; Humans ; Keratoderma, Palmoplantar ; Nails, Malformed ; Skin Diseases ; Syndrome

Amino Acid Metabolism, Inborn Errors ; pathology ; Child, Preschool ; Humans ; Male ; Twins

Air ; analysis ; Air Pollutants, Occupational ; analysis ; Chromatography, Gas ; methods ; Styrenes ; analysis ; Workplace

Objective To develope both qualitative and quantitative analytic method of the four urinary markers,i.e.lactate,uracil,orotate and hippurate,from ornithine transcarbamylase deficiency(OTCD) by Gas Chromatography-Mass Spectrometry(GC-MS).Methods Urea in urine samples was decomposed with urease,and heptadecanoiate was added as internal standard,then protein was denatured with ethanol and removed by centrifugation.After evaporation,the residue was derivatized trimethylsilylly by BSTFA/TMCS,and analyzed by GC-MS.ResultsThe markers can be separated in total ion current profiles,with indentifications confirmed by mass spectra.The significantly elevated levels of lactate,uracil and orotate in urine from OTCD patient were droped to normal or subnormal levels,together with large amount of hippurate excretion in the urine,after clinical therapeutic measures,including introduction of benzoic acid,were performed.Conclusion GC-MS analysis of the urinary markers is a valuable tool for the diagnosis and evaluation of the therapeutic outcome of OTCD.

Objective This study was conducted to describe job stressors of nurses employed in military hospitals and relationship between job stressors and demography characters.Method 296 employed nurses were investigated by nurse job stressor questionnaires.Result Professional and career issues were the most frequently encountered job stressor among employed nurses,the other stressors in descending order were workload and time pressure,patient care and interaction,resource and environmental problems,management issues.Job stressors of nurses could be influenced by their age,job title,et al.Conclusion The finding suggest that effective stress management strategies should be relieve job stress.

Adult ; Ear Canal ; Foreign Bodies ; Humans ; Male ; Mandibular Condyle

AIM: To determine the contents of tetrandrine and fangchinoline in Qingshenjianfei Tablets by RP-HPLC. METHODS:In this method Zorbax C 18 column was used, and methanol—0.3%diethylamine (75∶25) as a mobile phase , the detection wavelength was at 242 nm. RESULTS:The recovery of tetrandrine was 103.65% and RSD was 1.59% .The recovery of fangchinoline was 97.11% and RSD was 1.91% (n=6). CONCLUSION: This method is simple,quick,reproducible and can be used for the quantitative analysis。

Child ; Child, Preschool ; Female ; Gene Expression Regulation, Neoplastic ; Humans ; Infant ; Male ; Wilms Tumor ; genetics ; metabolism ; Wnt Proteins ; genetics ; metabolism ; beta Catenin ; genetics ; metabolism

Background A main cause of visual impairment in proliferative diabetic retinopathy (PDR) is vitreous hemorrhage and retinal detachment due to contraction of fibrovascular membrane.To explore the pathogenic mechanism of fibrovascular membrane is a new target for the prevention and management of PDR.Objective This study was to determine the change in expression of vascular endothelial growth factor (VEGF),connective tissue growth factor(CTGF) and pigment epithelium derived factor(PEDF) in the proliferative membranes of patients with PDR after intravitreal injection of avastin,an anti-VEGF agent.Methods This study was approved by the Medical Ethic Committee of Tianjin Medical College,and written informed consent was obtained from each patient before enrollment.A prospective randomized-controlled study was designed.Twenty-six eyes of 24 patients with PDR scheduled for surgery were enrolled from January to June,2008 in Tianjin Medical College Eye Hospital.The patients were randomized into the simple vitrectomy group and avastin injection combined with vitrectomy group,with matched gender,age and disease duration.1.25 mg (0.05 ml) of avastin was intravitreally injected prior to surgery,and vitrectomy was performed 10 days after injection in the avastin injection combined with vitrectomy group,and only vitrectomy was given in the simple vitrectomy group.Preretinal membrane was collected during the surgery.Expression of VEGF,CTGF and PEDF in the preretinal membranes was assayed by immunochemistry.Results VEGF,CTGF and PEDF were expressed in the cytoplasm.The rate of VEGF expression in the preretinal membranes was 30.77％ in the avastin injection combined with vitrectomy group,showing a significant reduction in comparison with the simple vitrectomy group(100.00％)(U =4.000,P＜0.01).The rate of expression CTGF was remarkable elevated in the avastin injection combined with vitrectomy group compared with the simple vitrectomy group (92.31％ vs.62.54％)(U=7.500,P=0.048).However,no significant difference was found in the expression rate of PEDF between the two groups(100.00％ vs.92.31％) (U =65.500,P =0.299).Conclusions The results suggest that intravitreal injection of anti-VEGF drugs resulted in the decrease of VEGF expression and increased CTGF expression in proliferative membranes from patients with PDR.