Objective The risk for coronary artery bypass surgery is reported to be increased with age and associated with diabetes. We examined the outcomes of coronary artery bypass grafting (CABG) in patients with diabetes who were older than 70 years of age and evaluate the effect of diabetes on CABG in those patients. Methods From March 2000 to March 2008, the data of 649 patients older than 70 years of age were collected retrospectively and divided into diabetic group or non-diabetic group based on pre-operative diagnosis. The blood glucose level of patients was maintained between 7.0 mmol/L ( 126mg/dl) and 10.0 mmoL/L ( 180 mg/dl) porioporatively. Stats 7.0 was used for statistical analysis. The t test and χ~2 test were used to determine the differences in the numerical variables and categorical variables respectively. Results No statistical differences were observed between the two groups in the baseline variables, such as age [ ( 74.78±3.67 ) years for diabetic group vs. ( 75.00±3.65 ) years for non-diabetic group, P = 0. 4877 ], female patients ( 34.76% vs. 29.22%, P =0. 1663 ), ejection fraction [ ( 57.02±10. 10 ) % vs. ( 58.49±10. 39 ) %, P = 0. 1004 ) ], myocardial infarction history (26.20% vs. 28.35%, P =0. 5795), though there were more left main diseases in the diabetic group (52.41% vs.26.41%, diabetic vs. non-diabetic, P = 0. 0000 ). The overall in-hospital mortality was 6.32% (8.02% in the diabetic group vs. 5.63% in the non-diabetic group, P = 0. 2571 ). The main causes of death were sudden respiratory and cardiac arrest,low cardiac output syndrome ( LCOS), malignant arrhythmia, respiratory failure, renal failure, central nervous system compli-cations, and multiple organ failure. Major post-operative complications were bleeding, atrial fibrillation, plural effusion and pulmonary infection. Post-operative variables, such as EF (0.59±0. 13 in the diabetic group vs. 0. 61±0.15 in the non-dia-betie group, P =0. 1807), re-revascularization due to bleeding (2. 14% vs. 4.76%, P = 0. 1232), blood transfusion (89.84% vs. 84.63%, P = 0.0820) and the administration of vasoactive agent (21.93% vs. 27.71%, P= 0. 1286),were found no significant difference between the two groups. Conclusion Conclusions The early outcomes of CABG in aged patients are acceptable. The surgical consequences in diabetic patients may be similar to those in non-diabetic patients.

In the present study, the specifically knockdown models of P-gp or MRP2 were constructed by using a series of chemically synthesized small interfering RNA (siRNA) in vitro. The expression of P-gp and MRP2 was measured by real-time PCR and Western blot, and the function was evaluated by applying P-gp and MRP2 substrate, rhodamine and methotrexate. The results showed that MRP2 siRNA-3 or P-gp siRNA-2 significantly decreased the mRNA expression of MRP2 or P-gp, the inhibition ratio was 68% or 84%; MRP2 siRNA-3 or P-gp siRNA-2 at a dose of 80 nmol x L(-1) significantly reduced the protein expression of MRP2 or P-gp at 48 h after treatment, the inhibition ratio was 62% or 70%. Meanwhile, other transporters were not influenced by siRNA. When pretreatment with MRP2 siRNA-3 or P-gp siRNA-2, the efflux of methotrexate or rhodamine decreased significantly and the intra-cellular concentration increased. The results suggested that chemically synthesized siRNA could significantly inhibit the expression and function of MRP2 and P-gp, and the model of RNAi in vitro could be used to evaluate the role of efflux transporters in transportation of drugs.
ATP-Binding Cassette, Sub-Family B, Member 1 ; genetics ; Gene Knockdown Techniques ; Multidrug Resistance-Associated Proteins ; genetics ; RNA Interference ; RNA, Small Interfering ; Real-Time Polymerase Chain Reaction

OBJECTIVETo evaluate the clinical characteristics and short-term outcomes of neonatal asymmetric crying facies (ACF), in order to improve recognition of the disease.

METHODSThe clinical data of 11 infants with ACF between January 2010 and February 2012 were retrospectively studied. Physical and neurological development were followed up at correct gestational age 44 weeks and 3 months.

RESULTSOf the 11 infants with ACF, 4 had ipsilateral ear malformation, 2 had congenital heart disease and 1 had syndactyly and polydactyly. Of the 11 infants, 8 were male and 3 were female. Eight infants presented with lesions on the left side and 3 presented with lesions on the right. The fathers were aged over 35 in 8 cases and the mothers were over 30 in 7 cases. Eight mothers had a history of at least 3 pregnancies and 2 infants were born to mothers with diabetes mellitus. Physical index was below P10 in 1 case and 2 cases showed a low NBNA score and mild abnormal GMs (poor repertoire PR) during the writhing period at correct gestational age 44 weeks. Physical index was between P10-P90 and GM assessment during the fidgety period showed normal movements in all infants at correct gestational age 3 months, but they still had ACF.

CONCLUSIONSACF is associated with a high rate of other congenital malformations. The short-term outcomes of ACF infants are satisfactory, but long-term follow-up and interdisciplinary cooperation are necessary to improve prognosis.

Crying ; Facial Paralysis ; physiopathology ; Female ; Follow-Up Studies ; Humans ; Infant, Newborn ; Male ; Retrospective Studies

Objective To evaluate the safety of the da Vinci Si surgical system in thyroid surgery and to accumulate operation experience .Methods The da Vinci Si surgical system consists of a surgeon's console, a patient-side robotic cart, and high-definition 3D vision system.The robot arm tips were introduced via a single axillary incision or small chest wall ports and attached to the arms of the robot .The surgeon , sitting at the con-sole, manipulated the EndoWrist instruments and endoscope view that transfer the surgeon 's movements to the arm tips.The so called EndoWrist'technology offers seven degrees of movements ( up, down, left, right, twist, et al) , thus exceeding the capacity of a surgeon's hand in open surgery .The da Vinci Si surgical system was used to perform thyroidectomy in two small pigs .The animals were intubated and kept anesthetized with halothane .Re-sults Four surgical procedures were done using the da Vinci Si system from beginning to the end , including 2 thyroidectomies and 2 thymectomies .No conversions to open or laparoscopic procedure was used .The procedure length was 61 minutes and 50 minutes, respectively.Conclusions Robotic thyroidectomy can be performed safe-ly by the experienced surgeons after short-term da Vinci Si surgical system training .The learning curve for robotic thyroidectomy is shorter .

BACKGROUNDSeasonal influenza epidemic occurs every year in Guangzhou, which can affect all age groups. Young children are the most susceptible targets. Parents can decide whether to vaccinate their children or not based on their own consideration in China. The aim of this study was to identify factors that are important for parental decisions on vaccinating their children against seasonal influenza based on a modified health belief model (HBM).

METHODSA cross-sectional study was conducted in Guangzhou, China. A total of 335 parents who had at least on child aged between 6 months and 3 years were recruited from women and children's hospital in Guangzhou, China. Each eligible subject was invited for a face-to-face interview based on a standardized questionnaire.

RESULTSUptake of seasonal influenza within the preceding 12 months among the target children who aged between 6 months and 36 months was 47.7%. Around 62.4% parents indicated as being "likely/very likely" to take their children for seasonal influenza vaccination in the next 12 months. The hierarchical logistic regression model showed that children's age (odds ratio [OR] =2.59, 95% confidence interval [CI]: 1.44-4.68), social norm (OR = 2.08, 95% CI: 1.06-4.06) and perceived control (OR = 2.96, 95% CI: 1.60-5.50) were significantly and positively associated with children's vaccination uptake within the preceding 12 months; children with a history of taking seasonal influenza vaccine (OR = 2.50, 95% CI: 1.31-4.76), perceived children's health status (OR = 3.36, 95% CI: 1.68-6.74), worry/anxious about their children influenza infection (OR = 2.31, 95% CI: 1.19-4.48) and perceived control (OR = 3.21, 95% CI: 1.65-6.22) were positively association with parental intention to vaccinate their children in the future 12 months. However, anticipated more regret about taking children for the vaccination was associated with less likely to vaccinate children within the preceding 12 months (OR = 0.21, 95% CI: 0.08-0.52).

CONCLUSIONSThe modified HBM provided a good theoretical basic for understanding factors associated with parents' decisions on their children's vaccination against seasonal influenza.

Child, Preschool ; China ; Cross-Sectional Studies ; Female ; Humans ; Infant ; Infant, Newborn ; Influenza Vaccines ; therapeutic use ; Influenza, Human ; immunology ; prevention & control ; Male

Objective To explore the metabolic abnormality in patients with first-episode schizophrenia and effect of atpical antipsychotics olanzapine on them.Methods Thirty patients with first-episode schizophrenia,admitted to our hospital from February 2010 to February 2011,and 40healthy controls were chosen in our study; patient group was given oral olanzapine for 4 week.The height,weight,waistline and hipline were measured before and after treatment,and the total cholesterol (TC),triglyceride(TG),high-density lipoprotein(HDL),low-density lipoprotein(LDL),apolipoprotein AI(aPOAI),apolipoprotein B100(aPOB100),lipoprotein a(LPa),fasting blood-glucose,fasting insulin and C peptide levels were detected before and after treatment; and the insulin resistance(IR)index,waist hip ratio(WHR)and body mass index(BMI)were calculated before and after treatment; metabolic index were compared between patients and controls,and patients before and after the treatment.Results The HDL and aPOA1 levels in patient group were significantly lower,and the WHR,IR index,fasting insulin and C peptide levels were obviously higher as compared with those in the controls(P＜0.05).The BMI,waist circumference,WHR,the IR index,the insulin,TC,TG,LDL and aPOB100 levels after treatment were significantly increased as compared with those before treatment(P＜0.05).Conclusion There may be some inborn metabolic abnormality factors in patients with first-episode schizophrenia; the high incidence of metabolic abnormality in patients with schizophrenia may be the result of combined action from antipsychotics and inherit susceptibility.

OBJECTIVETo isolate and characterize human rheumatoid arthritis (RA) fibroblast-like synoviocytes (FLSs).

METHODSThe synovial membrane tissues were obtained from 4 RA patients, 1 chondroma patient and 1 healthy subject and FLS were isolated by means of tissue culture. The cell morphology was observed by phase-contrast microscope and the cell surface markers were detected by flow cytometry.

RESULTSThe FLSs were successfully cultured from the synovial membrane tissues with good cell homogeneity after the third passage. The FLSs of the 3rd to 7th passages were stable and proliferated actively, followed by slow proliferation and aging since the 8th passage. Flow cytometry showed that the 4th-passage FLSs from the RA patients contained 99.04% CD90(+) cells, 2.73% CD3(+) cells, 0.29% CD3(-)CD19(+) cells, 2.81% CD3(-)CD16(+)CD56(+) cells, 5.89% CD14(+) cells, and 54.17% CD55(+) cells. The presence of interleukin-1 receptor type I (IL-1RI, 158.63-/+20.32 pg/ml) and IL-1beta (4.67-/+0.82 pg/ml) were detected in the cell culture supernatant of the 4th-passage FLSs from the RA patients by enzyme-linked immunosorbent assay ELISA.

CONCLUSIONFLSs from RA patients can be effectively culture by means of tissue culture, and the cultured FLSs show high expressions of CD90, IL-1RI and IL-1beta.

Adult ; Aged ; Arthritis, Rheumatoid ; pathology ; Cell Proliferation ; Cell Separation ; Cells, Cultured ; Female ; Fibroblasts ; pathology ; Humans ; Interleukin-1beta ; metabolism ; Male ; Middle Aged ; Receptors, Interleukin-1 Type I ; metabolism ; Synovial Membrane ; cytology ; pathology ; Thy-1 Antigens ; metabolism

STUDY DESIGN: We performed an ex vivo study to observe cell morphology and viability of human nucleus pulposus (NP) chondrocytes isolated from degenerated intervertebral discs (IVD). PURPOSE: To better understand the biological behavior of NP chondrocytes in monolayer cultures. OVERVIEW OF LITERATURE: Biological repair of IVDs by cell-based therapy has been shown to be feasible in clinical trials. As one of the most promising transplanting seeds, how the isolated NP chondrocytes behavior ex vivo has not been fully understood. METHODS: Human NP chondrocytes were harvested from 20 degenerated IVDs and cultured in monolayers. Histological and immunochemistry staining was used to detect cell morphology change. Cell viability was studied by analyzing cell cycle distribution and apoptotic rate in the primary and subculuted cells. RESULTS: The round or polygonal primary NP chondrocytes had an average adherence time of 7 days and took nearly 31 days to reach 95% confluence. The spindle-shaped P1 NP chondrocytes increased growth kinetics and took about 12 hours to adhere and 6.6 days to get 95% confluent. Immunochemistry staining of collagen II was positive in the cell cytoplasm. Nearly 90% of the confluent NP chondrocytes stayed in G1 phase while 16% underwent apoptosis. No significant difference of the collagen II expression, cell cycle distribution or the apoptosis indices were detected between the primary and subcultured NP chondrocytes. CONCLUSIONS: Human NP chondrocytes undergo significant morphological change in monolayer cultures. Cell cycle distribution pattern and apoptosis index of the cutured NP chondrocytes potentially influence their clinical transplantation or laboratory use.
Apoptosis ; Cell Cycle ; Cell Survival ; Chondrocytes ; Collagen ; Cytoplasm ; G1 Phase ; Humans ; Immunochemistry ; Intervertebral Disc ; Kinetics ; Seeds ; Transplants

OBJECTIVETo study the expression of COX-2 and pregnancy associate plasma protein A (PAPP-A) in coronary arteries and their relationship with acute coronary syndrome.

METHODSTwenty-one autopsy cases with acute coronary syndrome encountered during the period from 2002 to 2007 were enrolled into the study. Another 21 autopsy cases without evidence of acute coronary syndrome were used as the controls. The right and left coronary arteries of each group were dissected, embedded and processed as paraffin sections. Immunohistochemical study for CD68 and alpha-actin was performed to highlight the presence of macrophages and smooth muscle cells, respectively. The expression of COX-2 and PAPP-A was evaluated.

RESULTSIn the acute coronary syndrome group, COX-2 was localized mainly in the cytoplasm of endothelial cells, macrophages and smooth muscle cells. COX-2 expression in the cytoplasm of smooth muscle cells (28.60%) was significantly higher than that in the control group (4.76%, chi(2) = 14.13, P< 0.05). There was a positive correlation on COX-2 and PAPP-A expression in smooth muscle cells of the media layer of coronary arteries in acute coronary syndrome group (r = 0.88, P < 0.05). The expression of PAPP-A in smooth muscle cells of the media layer in coronary arteries not associated with plaque formation, was higher than that when there were atherosclerotic plaques (chi(2) = 10.36, P < 0.05).

CONCLUSIONIn coronary arteries, COX-2 and PAPP-A play certain roles in the pathogenesis of acute coronary syndrome.

Acute Coronary Syndrome ; metabolism ; pathology ; Adult ; Aged ; Autopsy ; Coronary Vessels ; metabolism ; pathology ; Cyclooxygenase 2 ; metabolism ; Female ; Humans ; Middle Aged ; Myocytes, Smooth Muscle ; metabolism ; Plaque, Atherosclerotic ; metabolism ; Pregnancy ; Pregnancy-Associated Plasma Protein-A ; metabolism ; Young Adult

OBJECTIVETo investigate the effect of postauricular tube flap for repairing traumatic partial helical defect.

METHODSThe tube flaps were designed according to the site and size of helical defects. The length of tube flaps was 1.2 - 1.5 times as the length of the defects. The length-to-width ratio of tube flap was 3 - 4:1. The procedures required three stages for completion: (1) fabrication of tube flap; (2) 2 - 3 weeks later, division of one pedicle and insetting the flap; (3) 2 - 3 weeks later, complete division of pedicle and repairing the defects.

RESULTSFrom January 1998 to June 2006, 47 cases of traumatic partial helical defects were treated with postauricular tube flaps. All the tube flaps survived completely with no vascular disturbance, infection or necrosis. The patients were followed up for 2 months to five years with satisfactory results.

CONCLUSIONSPostauricular tube flap is a reliable and simple procedure for traumatic partial helical defects with good cosmetic result and less donor site morbidity.

Adolescent ; Adult ; Ear Auricle ; injuries ; surgery ; Female ; Humans ; Male ; Mastoid ; surgery ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; methods ; Surgical Flaps ; Young Adult