Objective To examine the hemodynamic changes and oxygen metabolism during off-pump coronary artery bypass grafting (OPCABG) .Methods Twenty patients (18 male, 2 female) aged (60?8)yr, weighing (71?9)kg undergoing OPCABG were studied. The patients were premedicated with diazepam 10 mg PO 2h before operation and morphine 10 mg and scopolamine 0.3 mg im 30 min before operation. Anesthesia was induced with midazolam 0.1-0.2 mg?kg-1, fentanyl 5-10 ug?kg-1 and vecuronium 0.12-0.15 mg?kg-1 and maintained with 0.5%-2% isoflurane inhalation, fentanyl 10-20 ug?kg-1 and intermittent iv boluses of vecuronium and in some patients propofol infusion. Radial artery was cannulated. Swan-Ganz catheter was placed via internal jugular vein into pulmonary artery. Hemodynamic parameters including MAP, HR, cardiac index (CI), stroke volume (SV), MPAP, PCWP, SVR, left ventricle stroke work index (LVSWI) and RVSWI; oxygen metabolism including oxygen delivery (DO2) , oxygen consumption (VO2) and oxygen extraction ratio (ERO2); regional cerebral oxygen saturation (rSCO2) and arterial blood lactate level (ABL) were measured and recorded before skin incision (A), when pericardium was incised before operation on the heart (B), during operation on the heart (C), 10 min after operation on the heart (D) and at the end of surgery (E) . Results During surgical manipulation on the heart (C) MAP, SV and CI decreased while CVP and HR increased, but the decrease in CI and SV was not significant. During manipulation on the heart(C) DO2 decreased whereas ERO2 increased, but there was no significant change in VO2. After manipulation on the heart (D) DO2 and ERO2 returned to the pre-manipulation level. Arterial blood lactate concentration increased at E. Conclusion OPCABG can be performed uneventfully under our general anesthetic regimen. During operation while the beating heart is being manipulated MAP tends to decrease while CVP and HR increase. The changes are of short duration and do not result in any serious consequeaces.

OBJECTIVE: To investigate the clinical efficacy of self-made 32P applicator for treating different kinds of keloid. others were treated with surgical excision combined with self-made 32P applicator. The 32P applicator was shaped according to the size and shape of the diseased region and the application time was calculated according to the dose rate and the decay correction. 4.0-5.0 Gy was applied in every diseased region in each of the four days (one course), and 4-6 courses in total was required, with 4 weeks of intervals following each course. For children, dose was reduced to 4 Gy or less once a day in every diseased region. Patients in the operation combined with application group were performed keloids excision first. Then 32P applicators were applied to the wound without any exudation in the same way as above. RESULTS: Of all the 39 patients (lesion thickness≤0.3 cm, 32P applicator therapy only), 32 ones was cured (82.1%), with the total effective rate of 98%. For patients with lesion thickness > 0.3 cm, the total effective rate of 32P applicator therapy and surgical excision combined with self-made 32P applicator were 55.6% and 93.3% respectively, and the difference was ofsignificance (P < 0.01 ). Among these patients, those with disease course less than 9 months had the effective rates of 25.0% and75.0% corresponding to 32P applicator therapy only and surgical excision combined with self-made 32p applicator respectively.For those with long course of disease, the effective rates were 13% and 77% respectively. A total of 26 patients experienced local buming and slight pain during the 32P applicator treatment, and all the symptoms were relieved by using calamine lotion; 5 patients and 2 patients expedencad grade Ⅰ and Ⅱ radio dermatitis respectively, which were relieved by using Mupirocin Ointment. No radio dermatitis of grade Ⅲ or above occurred to any patient. In addition, pigmentation or color changing occurred at local skins of cured patients.CONCLUSION: 32P applicator therapy is safe and effective for treating keloid. For patients with short disease course and lesion thickness ≤0.3 cm, 32P applicator therapy only is enough. Otherwise, patients are suggested to use 32P applicator after operation.

Child, Preschool ; Diarrhea, Infantile ; therapy ; Female ; Humans ; Infant ; Moxibustion

A high Streptolydigin-producing strain Streptomyces lydicus AS 4.2501-L8 with genetic stability was obtained from the original strain S. lydicus AS 4.2501-P28 by mutagenesis with UV and acridine orange, followed by resistance selection. Its yield of Streptolydigin was 177.0 ?g/mL, 96.2% higher than the original strain.

Humans ; Accidents, Traffic ; Colon, Sigmoid ; Forensic Medicine ; Autopsy ; Abdominal Injuries ; Thoracic Injuries ; Rupture

OBJECTIVE Zn-doped CuO nanocomposites (nZn-CuO NPs) are novel nanoparticles synthesized by sonochemical method.This study aimed to further investigate the antitumor effects and mechanism of nZn-CuO NPs, as well as the exact mechanism of reactive oxygen species (ROS) on nZn-CuO NPs-induced death using N-acetylcysteine (NAC). METHODS The antitumor effects of nZn-CuO NPs were evaluated by MTS assay and orthotopic transplantation tumor model in nude mice. The effects of nZn-CuO NPs with or without NAC on ROS production, DNA damage, apoptosis, mitochondrial damage, autophagy, lysosome impairment, and ER and Golgi stress were determined. Also,western blot was used to detect apoptosis and autophagy related proteins,as well as NF-κB pathway related proteins. RESULTS nZn-CuO NPs significantly inhibit tumor growth both in vitro and in vivo. nZn-CuO NPs were able to cause cytotoxicity, ROS production, DAN damage mitochondrial damage, apoptosis, and autophagy, and NAC can attenuate them. Further studies showed that nZn-CuO NPs induced changes of apoptosis, autophagy and NF-κB pathway related proteins, and NAC can restore them. CONCLUSION Overall, our data demonstrated that nZn-CuO NPs could inhibit tumor growth both in vitro and in vivo by ROS-dependent regulation of apoptosis and autophagy, which might be cross-linked by NF-κB pathways.

Brain Diseases ; diagnosis ; Child, Preschool ; Epilepsy ; diagnosis ; Female ; Fever ; Humans ; Infant ; Male ; Skin ; pathology ; Tomography, X-Ray Computed ; Tuberous Sclerosis ; diagnosis

Professor LI Zhi-dao's acupuncture technique at muscle belly and its clinical experiences for the treatment of arthralgia are introduced. From aspects of TCM, anatomical physiology and sports biomechanics, the theory basis of this technique is explained, while its method is elaborated in details from acupoint selection and manipulation combined with classic medical cases. The acupuncture technique at muscle belly is applied at the muscles which already have pathological changes, avoiding re-stimulation on the pain area. It provides new thinking methods and references for acupuncture to treat arthralgia.
Acupuncture Points ; Acupuncture Therapy ; methods ; Adult ; Aged ; Arthralgia ; therapy ; Female ; Humans ; Male ; Middle Aged

Objective To discuss the safety and efficacy of using ExoSealTM vascular closure device to obtain rapid hemostasis of puncture site in interventional procedure via retrograde femoral artery access.Methods The clinical data of 124 patients,who were admitted to authors' hospital during the period from March 2016 to April 2016 to receive interventional procedure via retrograde femoral artery access,were retrospectively analyzed.During the performance of intervention,ExoSealTM vascular closure device (ExoSealTM group,n=52) or manual compression (MC group,n=72) was employed to make femoral artery puncture point hemostasis.The time spent for hemostasis,the manual compression time,the limb immobilization time,the amount of blood loss during compression process,and the procedure-related complications were recorded and the results were compared between the two groups.Results Technical success rate in ExoSealTM group was 98.1％(51/52).In ExoSealTM group and MC group,the time spent for hemostasis was (0.28±0.08) min and (5.83±1.46) min respectively,the manual compression time was (2.65 ±0.57) min and (7.70± 1.88) min respectively,the limb immobilization time was (2.72±0.43) h and (6.15±0.69) h respectively;all the differences between the two groups were statistically significant (P＜0.01).In ExoSealTM group subcutaneous hemotoma occurred in one patient,while in MC group subcutaneous hemotoma occurred in 3 patients and pseudoaneurysm in one patient;the complication rates were 1.92％ (1/52) and 5.56％ (4/72) respectively,but the difference was not statistically significant (P＞0.05).In MC group the amount of blood loss during compression process was (1.11±0.86) ml,which was remarkably less than (7.83±2.08) ml in ExoSealTM group,the difference between the two groups was statistically significant (P＜0.01).Conclusion For hemostasis of puncture site in interventional management via retrograde femoral artery access,the use of ExoSealTM vascular closure device is safe and effective.

Objective To compaire the physical characteristics of semen morphology before and after semen coagulation-liquefaction under microscope and understand the significance of these characteristics for the determination of semen liquefaction.Methods Semens were placed in sperm counting chamber immediately after collection.The morphological changes of the seminal gelatinous substance during liquefaction were observed under microscope and analyzed.Results Morphological changes during semen liquefaction can be clearly observed.Among 32 samples of semen,forward sperm progression and motility were (30.3?12.4)% and (45.0?14.9)%,(44.9?12.7)% and (59.0?15.3)%,before and after the liquefaction,respectively.The differences were statistically significant (t=-1.130,5.023,P0.05).Conclusions Microscopic observation of the seminal gelatinous substance is a simple and feasible method for objective measurement of sperm liquefaction.These findings suggest it may provide pathological significance on semen liquefaction abnormality in infertility clinic.