Objective To evaluate the diagnostic value of 128-slice spiral CT angiography( MSCTA)for bypass grafts in patients after coronary artery bypass grafting(CABG).Methods One hundred and thirty-three bypass grafts (44 IMA grafts,89 saphenous veins grafts) of 46 patients after CABAG operation for 12 to 76 months were examined by MSCTA.Then the coronary angiography(CAG) was performed on those patients 3 - 10 days after MSCTA examination.The MSCTA results were compared with the angiography results.Results Among the 133 bypass grafts,MACTA examination showed that 17 grafts were occluded and 20 grafts were severe restenosis( restenosis degree ＞ 50％ ).There was also 17 occluded grafts showed in CAG examination as in MSCTA results.But 21 restenosis ( restenosis degree ＞ 50％ ) bypass grafts were identified by CAG.Compared with the CAG results,there was 1 false positive and 2 false negative in the MSCTA results.The overall sensitivity and specificity of MSCTA on evaluating the bypass grafts were 94.7％ and 98.9％.The positive predictive value and the negative predictive value were 97.3％ and 97.9％,respectively.Conclusion As a noninvasive examination,128-slice spiral CT could accurately identify and evaluate the bypass grafts lesions after CABG.

Objective To analyze the reasons of perioperative hypoxia in Stanford A aortic dissection,and summarize its management strategies.Methods From Dec.2005 to Jul.2011,sixty four patients underwent surgery for acute type A aortic dissection,of which 9 cases were with chronic dissection and 55 cases with emergent ones.Preoperative oxygen fraction ratio( PaO2/FiO2 )in 51 cases was lower than 200 mm Hg.All of them underwent the surgery with the help of deep hypothermia cardiac arrest technique.Results Three cases died.Thirty-three cases could not live without ventilation during the first 72 h because of continuous hypoxia ( PaO2/FiO2 ＜ 200 mm Hg).One case underwent tracheotomy and auxiliary ventilation for 9 days.The rest were live without ventilation after auxiliary ventilator for 72 - 120 hrs.The data showed that postoperative hypoxia was related to preoperative hypoxia (oxygen fraction ratio ＜ 200 mm Hg),BMI,acute onset,hypothermia cardiac arrest time,and transfusion more than 3000 ml ( P ＜ 0.05 ).Conclusion Great attention should be paid to the perioperative hypoxia-related factors in Stanford A dissection,which will be helpful to improve prognosis.

Objective To explore the clinical value of the liquid based cytology test in the sputum/pleural fluid cytology diagnosis.Methods Collect the liquid based cytology test over the past year the sputun/pleural fluid specimen test results with the traditional detection methods of detection results,to compare the differences in the positive rate and other indicators.Results Two by detection of sputum/pleural fluid specimens of 225/136 cases,76/82 cases positive results of the liquid based cytology test; traditional technology for the 41/42 cases; data,P ＜ 0.05,statistically significant differences.Conclusion The liquid based cytology test in the sputum/pleural fluid cytology diagnosis is more superior to traditional methods,under conditions permitting,should be widely applied.

To observe the preventive effect of polydatin on diabetic myocardial hypertrophy in mice and discuss its and mechanism. The diabetic model was induced with low dose STZ (40 mg x kg(-1) x d(-1) x 5 d, ip) for five days in mice. The myocardial hypertrophy was determined by hypertrophy indexes (LVHI, left ventricular/right ventricle and septum), left ventricular/body weight (LV/BW), the histological examination and the mRNA expression of atrial natriuretic factor(ANF). The fast blood glucose(FBG), serum insulin and plasma hemoglobin A1c ( HbA1c) levels were detected, and then HOMA insulin resistance index ( HOMA. IR) was calculated. The mRNA and protein expressions were measured by qRT-PCR and western blotting, respectively. According to the results, the FBG of the model group exceeded 11.1 mmol x L(-1), with notable decrease in BW and significant increase in insulin, HbA1c and HOME. IR, suggesting the successful establishment and stability of the diabetic model. The increases in LVHI, LV/BW, cell surface and ANF mRNA indicated a myocardial hypertrophy in diabetic mice. Meanwhile, the model group showed decrease in mRNA and protein expressions of PPARβ and significant increase in NF-κB p65, COX-2 and iNOS expressions. After the preventation with PD (50, 100 mg x kg(-1) x d(-1)), diabetic mice showed increase in BW, reduction in the levels of FBG, insulin and HbA1 c, relief in insulin resistance and significant recovery in hypertrophy indexes, indicating PD has the protective effect in diabetic myocardial hypertrophy. Meanwhile, PD up-regulated the expression of PPARβ, inhibited the expressions of NF-κB p65, COX-2 and iNOS, demonstrating that PD's protective effect may be related to the activation of PPARβ and the inhibition of NF-κB, COX-2 and iNOS signaling pathways.
Animals ; Diabetes Mellitus, Experimental ; complications ; Diabetic Cardiomyopathies ; drug therapy ; genetics ; metabolism ; Drugs, Chinese Herbal ; administration & dosage ; Glucosides ; administration & dosage ; Humans ; Hypertrophy ; drug therapy ; genetics ; metabolism ; Insulin ; metabolism ; Male ; Mice ; NF-kappa B ; genetics ; metabolism ; Signal Transduction ; Stilbenes ; administration & dosage

Objective: To observe the therapeutic effects of needle warming moxibustion for chronic diarrhea. Methods: Two-hundred cases with chronic diarrhea were divided randomly into a treatment group and a control group. 100 cases in the treatment group were treated with needle warming moxibustion on specific acupoints. 100 cases in the control group were treated by oral administration of Smecta. Results: The therapeutic results showed cure in 52 cases, remarkable effect in 34 cases, improvement in 14 cases and the total effective rate in 100.0% in the treatment group, and cure in 5 cases, remarkable effect in 23 cases, improvement in 33 cases, failure in 39 cases and the total effective rate in 61.0% in the control group. The comparison of the total effective rate between the two groups was statistically significant (P<0.05). Conclusion: The needle warming moxibustion on specific acupoints is better than oral administration of Smecta in the therapeutic effects.

Objective To regard the implication of viruses particularly herpes in pemphigus vulgaris,and assess and compare the level of immunoglobulin G (IgG) antibodies against herpes simplex virus types 1 and 2 (HSV1 and HSV2),cytomegalovirus (CMV) and Epstein-Barr virus (EBV) in patients with pemphigus vulgarisand healthy people.Methods In this study,23 patients with pemphigus vulgaris and 26 healthy individuals comprised the experimental and control groups,respectively.Serum samples were taken from both groups;the levels of IgG antibodies against HSV1,HSV2,CMV and EBV were measured using ELISA.Results Immunoglobulin G titer was higher for all four viruses in the patient group in comparison to the control group.This difference was significant for anti-EBV,anti-CMV and anti-HSV2 (t=2.16,P＜0.05;t =4.76,P＜ 0.01;t=3.75,P＜0.01),respectively,but not significant for anti-HSV1 (t=0.52,P＞0.05).Conclusion Viruses including EBV,CMV,and HSV2 probably play a role in the pathogenesis of pemphigus in addition to the effects of genetics,toxins and other predisposing factors.In this study,no statistically significant relationship was observed between HSV1 and pemphigus vulgaris.More studies must be done in this regard.

Objective:To establish and improve the quality standard for Lanqiao Jiedu oral liquid. Methods:A TLC was used for the qualitative identification of Forsythiae Fructus, Sophorae Tonkinensis Radix Et Rhizoma and Anemarrhenae Rhizoma. An HPLC was used for the qualitative identification of Isatidis Radix. Forsythin in Forsythiae Fructus was quantitatively identified by HPLC. Results:Forsythiae Fructus, Sophorae Tonkinensis Radix Et Rhizoma and Anemarrhenae Rhizoma showed clear spots and there was no interfer-ence from the negative control. The HPLC further confirmed Isatidis Radix was ( R, S)- epigoitrin. Quantitative study of forsythin re-vealed good specificity without interference from the negative control. Conclusion: The study provides an improved quality standard with high specificity and reproducibility, which can be applied in the quality control of Lanqiao Jiedu oral liquid.

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.