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.

Objective To compare the clinical effects of endoscopic saphenous vein harvesting and traditional surgical management in coronary artery bypass grafting(CABG).Methods Between march 2007 to June 2008,215 patients underwent CABG.Among them,87 patients underwent endoscopic saphenous vein harvesting.At the same time,128 cases were managed by traditional ways.Results The cases were foUowed up for 1-17 months.Endoscopic great saphenous vein harvesting was superior to traditional management in the healing of wound infection,relief of pain,improvement of edema and skin feeling(P＜0.05).Conclusion Endoscope saphenous vein harvesting is an efficient technique for CABG which is characterized by less trauma and fewer wound complications,and will not influcence the function of vein as well.On the other hand,the satisfaction is improved.

AIM: Niflumic acid (NFA) is known as a kind of inhibitor of calcium-activated chloride channel. The inhibition and mechanism of NFA on the proliferation of airway smooth muscle cells (ASMCs) were investigated. METHODS: Using [ 3H]-TdR incorporation method, we examined the effect of NFA (at concentration of 10 and 50 ?mol/L) on the proliferation of primarily ASMCs from BALB/c mouse. With confocal laser scanning microscope the [Ca 2+ ]i in ASMCs exposed to histamine was observed, and the opposed effects of NFA and nifedipine on histamine were also checked. Finally the effect of NFA on expression of MAPK in ASMCs was examined by indirect immunofluorescent assay. RESULTS: Compared with control group, the proliferation of NFA group was reduced markedly with dependent concentration. Histamine significantly improved the [Ca 2+ ]i in ASMCs, but NFA and nifedipine showed the inhibition on the effect of histamine. NFA reduced the level of MAPK expression in ASMCs. CONCLUSION: It is demonstrated that NFA inhibits the proliferation of ASMCs by reducing [Ca 2+ ]i and the expression level of MAPK. [

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

Objective To assess the relationship between serum uric acid (SUA)and metabolic syndrome and coronary artery disease(CAD).Methods 232 untreated subjects with essential hypertension were divided into two groups(CAD and no CAD)by coronary angiography.All subjects were free of myocardial infarction,cardiomyopathy,valvular disease, atrial fibrillation,aortic dissection,and renal disease.Results Compared to no CAD group,age,diabetes,triglycerides and SUA in CAD group were higher.There was a significant association between SUA and the severity of CAD (P=0. 015).However,after adjustment for concomitant risk factors of cardiovascular disease,SUA was not an independent risk factor of CAD(P=0.151).In sex-specific analysis,there was a trend of SUA to be an independent risk factor of CAD in women(P=0.062),but it was no statistic significance.The highest quartile level of $UA tended to be associated with increased risk for CAD,but it was not statistically significant either(OR=2.52,P=0.075).SUA was closely associated with metabolic syndrome and diabetes in woman.Conclusion In untreated patients with essential hyperteusion,SUA was associated with metabolic syndrome and the severity of CAD,but it is not an independent risk factor of CAD,the raised SUA may be only a marker of insulin resistance.

Diagnosis, Differential ; Humans ; Infant ; Male ; Neuroectodermal Tumors, Primitive ; pathology ; Orbital Neoplasms ; pathology

Objective To describe the treatment experience of post-operative complications after total arch replacement for acute type A aortic dissection in 34 cases.Methods The subjects were 34 consecutive patients (Twenty-eight males and 6 females,age 34.0 -60.0 yrs) who received total arch replacement for acute Stanford type A aortic dissection from Jan.2005 to Oct.2010 in our hospital.The duration from the onset of the symptoms to the hospitalization ranged from 4 - 18 hrs.Pre-operative 2-D Echo revealed aortic valve regurgitation in 8 patients and mitral valve regurgitation in 1 patient.Results Three patients died after operation ( mortality 8.8％ ).Severe complications included acute kidney injury in 13 cases,respiratory dysfunction in 12 cases,paraplegia in 1 case,mental disorder in 10 cases and excessive post-operative bleeding in 2 cases.Conclusion The incidence of the complications after total arch replacement is still high and severe.Intensive care should be stressed peri-operatively and early diagnosis and treatment for post-operative complications are important procedures.

Objective To evaluate the clinical significance of the change of serum matrix metalloproteinases (MMP)-1,-2,-3 and -9 in acute and chronic aortic diseases and acute myocardial ischemia.Methods The blood serum levels of MMP-1,-2,-3 and -9 were detected in 30 patients with acute aortic dissection,19 patients with chronic aortic dissection,19 patients with aortic aneurysm and in 12 patients with acute myocardial ischemia,as well as in 16 healthy individuals who served as the control group.Serum MMP levels were measured by using an ELISA technique.Results There were significantly higher levels of MMP-3 in patients with acute myocardial ischemia as compared to acute aortic dissection ( [19.10 ± 3.11 ] μg/L vs [11.89 ± 1.31 ] μg/L,P =0.02).Significantly lower levels of MMP-1 were found in healthy controls compared to the groups of patients ( [1.30 ± 0.56 ] μg/L vs [2.99 ± 0.78 ] μg/L in acute aortic dissection,P =0.03,[3.12 ±0.78] μg/L in chronic dissection,P =0.02,[3.01 ± 1.01 ] μg/L in thoracic aortic aneurysm,P =0.03 and [5.01 ± 0.98 ] μg/L in acute myocardial ischemia,P =0.01 ).Higher levels of M MP-1 and MMP-3 were detected on males.There was a positive correlation between MMP-1 and increasing age ( r =0.38,P ＜ 0.05 ).In patients operated for acute type A aortic dissection,the levels of MMP-1,MMP-3 and MMP-9 increased immediately after surgery,while the levels of MMP-2 decreased.Twenty-four hours after surgery levels of MMP-1,-2 and -9 were almost equal to the preoperative ones( P ＞ 0.05 ).Conclusion Measurement of serum MMP levels in thoracic aortic disease and acute myocardial ischemia is a simple and relatively rapid laboratory test that could be used as a biochemical indicator of aortic disease or acute myocardial ischemia,when evaluated in combination with imaging techniques.

Objective To describe the follow-up data of 34 patients receiving total arch replacement with an open stent graft for acute type Ⅰ aortic dissection.Methods The subjects were 34 consecutive patients with type Ⅰ acute aortic dissection ( Twenty-eight males and 6 females,aged 34.0 - 46.0 yrs) who received total arch replacement with an open stent graft in our hospital from Jan.2005 to Oct.2010.Thirty of the 34 patients were followed up for 2 - 70 months.CT scanning was performed at the 3 and 12 months and then yearly after operation to detect the thrombus formation,absorption of thrombus,and obliteration of the false lumen after its exclusion by the stent graft.Results Three patients died peri-operatively with the mortality of 8.8％.One patient died during the follow-up period.Obliteration was recognized in all the patients at the distal side of the stent graft during the follow-up period.The false lumen remained in 10 patients at the distal part of descending aorta,but the diameter of the false lumen was not enlarged.Conclusion In patients with acute type Ⅰ aortic dissection,it is relative safe to perform extensive primary repair of the thoracic aorta by stent grafting.This method may enhance the obliteration of the false lumen and reduce the possibility for further operations to manage a residual false lumen.

Objective To evaluate the results of rotary self-locking intramedullary nail (RSIN) for treating long tubular bone fracture of extremities, and discuss the current problems. Methods One hundred and twenty-two patients with long tubular bone fracture of extremities,including 59 femoral fractures,57 tibial fractures and 6 humeral fractures,who had been treated by RSIN were retrospectively investigated. Results All of the patients achieved clin-ical healing,with an average time of 24 weeks. Nobody was found to appear maluniun,infection and the break of inter-nal fixture. Internal fixations were removed after the fracture healing,with an average time of 14 months. It was diffi-cult to remove the internal fixations in 5 cases, and one case refractured after removing the internal fixations. Conclu-sion RSIN has the advantages such as easy operation,less trauma,no pendulum effect,early motion after operation and so on, except the characters of general interlocking intramedullary nail such as anti-rotation, anti-crispition and anti-displacement.