Objective To elucidate the clinical implication of early ST segment changes after PCI for IRA for acute ST segments elevation myocardial infarction.Methods From Jan.2001 to Dec.2001,216 patients with AMI after successful angiographical primary PCI Who were admitted to Beijing Chaoyang Hospital were retrospectively analysed.Forty-one patients with index of ST segment elevation≥50%and 50 randomised patients from 175 patients with index of ST segment elevation

Objective To This paper is to probe the clinical implication of left ventricular function for angiographic no reflow phenomenon after primary percutaneous coronary intervention(PCI). Methods Cilnical and angiographic data of 497 patients after primary PCI were retrospectively analysed between January 1999 and October 2002. Angiographic no reflow phenomenon defined as substantial coronary antergrade flow ≤ TIMI 2 class without mechnical obstruction of embolism, thrombus, dissection and spasm in influence of normal flow after PCI, but, normal flow defined as TIMI 3 class. 58 patients were with angiographic no reflow phenomenon, 60 patients randomized from 439 with coronary antergrade flow TIMIⅢ after primary PCI were normal flow group, with random count table of excel. Results Enzyme value、Killip class、number of Q waves on electrocardiogam and WMS are significance in two groups with the angiographic no reflow phenomenon and with the normal flow( P

Objective:To introduce a new style of platysma myocutaneous flap and to evaluate its application value in the restoration of oral-maxiofacial defects.Methods:Platysma myocutaneous flap with apron incision was used for the restoration of oral-maxiofacial defects after oral lesion ablation in 15 cases from January,2014 to September,2015.The platysma muocutaneous flap was harvested with a U shaped apron incision.The skin above the flap pedicle was preserved.The platysma pedicle was widened to ensure the flap survival.All the patients were followed up form 4 to 33 months.Results:Of the 15 platysma myocutaneous flaps,12 survived completely and 3 had partial flap necrosis.The total survival rate of the flaps at the recipient site of buccal mucosa,tongue and alveolar was 8/9,1/3 and 3/3 respectively.Additionally,there were 2 cases of disturbed wound healing in the neck.Except for 1 case of carcinoma of gingiva which had apparent cervical scar and 1 case of tongue carcinoma which had limited tongue mobility,the other cases showed a satisfactory recovery of oral-maxillofacial contour and fucnction.Conclusion:Compared with the traditional platysma myocutaneous flap,the platysma myocutaneous flap with apron incision can provide a larger skin paddle,and is suitable for the restoration of small and medium sized buccal mucosa and alveloar defects,but not for tongue defect.

Objective:To explore influence of nasal continuous positive airway pressure (nCPAP)on maximal oxygen uptake (V · O2 max )etc.in patients with chronic congestive heart failure (CHF)complicated moderate-to-severe ob-structive sleep apnea-hypopnea syndrome (OSAHS)and explore its significance.Methods:A total of 83 CHF com-plicated moderate-to-severe OSAHS patients were selected and randomly divided into routine treatment group (n=40)and nCPAP group (n = 43).Both groups were treated for six months.Left ventricular ejection fraction (LVEF),apnea hyponea index (AHI)and V · O2 max were measured and compared between two groups before and af-ter treatment.Results:Compared with routine treatment group after six-month treatment,there was significant re-duction in AHI [(27.5±6.2)vs.(6.8±1.2)],and significant rise in LVEF [(0.45±0.07)vs.(0.48±0.05)]and · V O2 max [(16.5±3.5)ml·kg-1 ·min-1 vs.(19.2±3.4)ml·kg-1 ·min-1 ]in nCPAP group,P <0.05 all.Con-· clusion:The nCPAP can improve ventilation function,heart function and V O2 max in patients with CHF complicated moderate-to-severe OSAHS,who have received basic medication.

Objective To investigate the clinical features of malignant conversion of oral submucous fibrosis (OSF) and the application value of polyflaps perforator flaps in its surgical treatment.Methodis Ten patients who suffered from malignant conversion of OSF underwent simultaneous multiple defects reconstruction using polyflaps perforator flaps after radical tumor resection from August 2012 to October 2014.The fibrous bands leading to severe trismus near the pterygomandibular ligament as well as other intraoral lesions with malignant tendency were also resected besides from the known carcinoma.Patients with synchronous multiple primary cancers underwent radical resection and neck dissection of all other malignant lesions.The flaps were cut and tailored between adjacent perforators according to the amount and size of defects,forming several independent paddles for each defect reconstruction.Results Twenty-two defects were formed in 10 patients with malignant conversion of OSF.All of them were repaired with polyflaps anterolateral thigh (ALT) perforator flaps,including 8 cases of bipaddled ALT flaps and 2 cases of tripaddled ALT flaps.The total size of the flaps ranges from 3 cm ～ 8 cm × 6 cm ～ 24 cm,and the pedicle length ranges from 5 ～ 12 (9.7 ± 2.1)cm.Thirty-five perforator vessels were dissected,and each paddle included 1.6 perforators on average.All flaps survived after transplantation,and only 1 patient had infection of the neck incision.Post-operative adjuvant radio-chemotherapy was applied in 2 patients.All patients showed satisfactory accepting-site morphology with good speech function and swallowing recovery,and their trismus was improved during 6 to 30 (11.6 ± 3.7) months.One patient died from lung metastasis 10 months after the surgery while local recurrent or metastasis did not occur in others.The donor sites were closed primarily without skin-grafting,leaving no obvious surgical donor-site complications.Conclusions Polyflaps perforator flaps can reconstruct multiple and sizable complicate defects,increase month opening by one stage operation.They are worth being applied in surgical treatment of malignant conversion of OSF.

Metagenomic cosmid libraries containing 1.26 x 10(5) clones, covering about 4.8 x 10(6) kb metagenomic DNA of uncultured microorganisms from the contents of buffalo rumens were constructed, and 118 independent clones expressing beta-glucosidase activity were isolated from the libraries. Screening of these clones showed that eight clones expressed relatively higher beta-glucosidase activity at pH 5.0 and 37 degrees C. One out of the eight clones was subcloned. Sequencing analysis showed that an open reading frame (ORF) of 2223 bp, termed umcel3G, potentially encodes a beta-glucosidase. The encoded product shared highest homology with a beta-glucosidase from Bacillus sp. at 60% identity and 73% similarity. The umcel3G was over-expressed in Escherichia coli and the size of the translated product Umcel3G on SDS-PAGE was in agreement with the predicted molecular mass. Zymogram analysis showed that Umcel3G exhibited beta-glucosidase activity, confirming that this ORF encodes a beta-glucosidase. The Umcel3G, purified with Ni-NTA column, exhibited optimal activity at pH 6.0-6.5 and 45 degrees C. Certain ions such as Ca2+, Zn2+ had significant positive effect on the activity of Umcel3G. However, some ions such as Fe3+, Cu2+ gave significant inhibitory effect on the enzyme. The Ni-NTA purified recombinant beta-glucosidase Umcel3G had a specific activity of 22.8 IU/mg at pH4.5, 35 degrees C and at the presence of 5 mmol/L Ca2+, indicating that this enzyme has potential applications in the fermentative production of ethanol by simultaneous saccharification and cofermentation (SSCF) of lignocelluloses.
Animals ; Bacteria ; enzymology ; genetics ; Buffaloes ; Cloning, Molecular ; Escherichia coli ; genetics ; metabolism ; Open Reading Frames ; genetics ; Recombinant Proteins ; biosynthesis ; genetics ; isolation & purification ; metabolism ; Rumen ; microbiology ; beta-Glucosidase ; biosynthesis ; genetics ; isolation & purification

Objective To investigate the clinical application and safety of DSA-guided infusion port implantation via internal jugular vein,subclavian vein and axillary vein.Methods A total of 827 patients with malignant tumors,who underwent DSA-guided intravenous infusion port implantation at the Jiangyin Municipal People's Hospital of China between March 28,2016 and June 28,2018,were enrolled in this study.According to the used approach in the port implantation,the patients were divided into internal jugular vein group(group A,n=125),subclavian vein group(group B,n=87),and axillary vein group(group C,n=615).The success rate of puncturing and the incidence of complications were compared between each other among the three groups.Results The success rates of the DSA-guided first-time puncturing in group A,B and C were 98.40％(123/125),94.25％(82/87),and 97.89％(602/615)respectively,the difference was statistically significant(P＜0.05);the success rate of puncturing in group B was lower than that in group C,and among the other groups there was no statistically significant difference(P＞0.05).All patients were followed up for a mean period of(15.56±2.91)months(range of 3-26 months).The overall incidence of postoperative early complications was 3.75％,which in group A was 4.00％(5/125),in group B was 9.20％(8/87),and in group C was 2.93％(18/615),and the incidence of complications in group B was obviously higher than that in group C(P＜0.0167).There was no statistically significant difference in the incidence of various complications between each other among the three groups(P＞0.05).The overall incidence of postoperative long-term complications was 4.72％(39/827),which in group A was 4.80％,in group B was 14.95％,and in group C was 3.25％,and the incidence of complications in group B was strikingly higher than that in group A and group C,the difference was statistically significant(P＜0.05).Comparison of groups for the rates of various complications showed that the incidence of catheter fracture in group B was higher than that in group C,and the clipping syndrome occurred only in group B,the difference was statistically significant(P＜0.0167).There was no significant difference in the incidence of other complications between each other among the three groups(P＞0.05).The abnormal port-taking rate was 1.45％,including 3 patients in group A,7 patients in group B,and 2 patients in group C.The postoperative abnormal port-taking rate in group B was the highest(8.05％),which was significantly different from that in group C(P＜0.0167).Conclusion For intravenous infusion port implantation,axillary vein approach is clinically safe,comfortable,minimally-invasive and highly-efficient method,it is superior to internal jugular vein approach and subclavian vein approach in effectively reducing the incidence of complications and improving the postoperative abnormal port-taking rate of patients.Therefore,this technique can be regarded as a first choice in clinical practice.(J Intervent Radiol,2023,32:1212-1216)

Objective To observe the day and night nonlinear indexes in patients with coronary heart disease(CHD)of excess syndrome,deficiency syndrome and syndrome of intermingled deficiency and ex-cess (mingled syndrome),so as to explore the nonlinear characteristics existed objectively in TCM syn-dromes.Methods Based on the TCMprinciples of syndrome differentiation,243 patients were divided into excess syndrome group(excess group,n =44),mingled syndrome group(mingled group,n =148) and deficiency syndrome group(deficiency group,n =51).Three nonlinear indexes of complexity,mean value of correlation dimension and mean value of approximate entropy were calculated based on the data picked up from 24 h dynamic electrocardiogram(Holter)at the six time intervals:0∶00 to 1∶00,4∶00 to 5∶00,8∶00 to 9∶00,12∶00 to 13∶00,16∶00 to 17∶00 and 20∶00 to 21∶00.Results The values of the three nonlinear indexes had a feature in common:the highest in excess group and the lowest in deficiency group.Conclusion The differences of three nonlinear indexes among the syndromes of excess and defi-ciency presented the differences of the nonlinear characteristics and the functional status of autonomic nerves.

Background and objectiveSerum carcinoembryonic antigen (CEA) and the soluble fragment of cyto-keratin 19 (CYFAR21-1) are important tumor markers (TMs) in the preoperative examination of patients with non-small cell lung cancer (NSCLC). However, the prognostic role of these markers in NSCLC patients remains controversial. hTe aim of the study was to investigate the clinical signiifcance of serum CEA variances and CYFAR21-1 levels for the prognosis of NSCLC patients following surgery.MethodshTis retrospective study investigated the clinical records and follow-up sessions of 175 patients with NSCLC who accepted surgery and adjuvant chemotherapy. Patients were subdivided into groups based on serum CEA and CYFAR21-1 levels. Survival analysis was conducted usingKaplan-Meier method for each group. hTe prognostic fac-tor was evaluated usingCox proportional hazards model.Results hTe overall survival (OS) of patients with high preopera-tive CEA or CYFAR21-1 levels was lower than that of patients with normal preoperative CEA or CYFAR21-1 levels. hTe OS displayed a signiifcant difference (P=0.001) between groups with high and normal preoperative CYFAR21-1. Compared with groups exhibiting normal preoperative and postoperative levels of CEA or CYFAR21-1, the OS was shorter for groups with high preoperative and postoperative levels of CEA or CYFAR21-1. hTe difference of the paired groups was signiifcant (P<0.05). Compared with the groups with normal preoperative and postoperative levels of CEA and CYFAR21-1, the OS was lower for the groups with high preoperative and postoperative levels of CEA and CYFAR21-1, which indicated a signiifcant difference (P<0.001). hTe CEACYFAR211 (HHHH), CEACYFAR211 (NNHH), CYFAR21-1 (HH), CEA (HH), and male genderwere identiifed as independent prognostic factors (P<0.05).ConclusionhTis study suggested that the prognosis of NSCLC patients was not signiifcantly satisfactory if preoperative and postoperative level of serum CEA or CYFAR21-1 was higher than standard value, especially if the preoperative and postoperative levels of CYFAR21-1 and CEA were higher than the standard values. hTe measurement of preoperative and postoperative levels of CYFAR21-1 and CEA proved helpful for the prognosis of patients with NSCLC.

Objective: To summarize the clinical anatomical features and surgical technique of the submental artery perforator flap (SMAPF), and to evaluate the outcome and value of the flap for oral cavity reconstruction after cancer ablation. Methods: A total of 56 patients with oral cancer were included in this study. The modified SMAPF excluded the anterior belly of the digastric muscle and submental fatty tissue. The primary sites of malignancy were buccal mucosa (n=24), tongue (n=21), mandibular gingiva (n=6), mouth floor (n=3), soft palate (n=2). Results: The flap size varied from 3 cm×5 cm to 5 cm×12 cm. Four flaps presented mild venous congestion, which was salvaged with conservative measures such as acupuncture and blood letting. Overall flap survival rate was 100%. The SMAPF with septocutaneous perforator was used in 49 cases and with musculocutaneous perforator in seven cases. External jugular vein and internal jugular vein provides venous drainage were applied in half cases respectively. All the patients showed a good recovery of tongue mobility and mouth opening with a follow-up of 3-41 months. Local recurrence was detected in one patient 4 months after operation. Conclusions The SMAPF is a reliable flap for oral cavity reconstruction with outstanding functional and aesthetic outcomes.