Objective To study the early clinical outcome of patients undergone minimally invasive direct coronary bypass(MIDCAB) surgery,and the mid-term patency of left internal mammary artery(LIMA)-left anterior descending(LAD) anastomosis.Methods From Jannuary 2007 to May 2014,47 cases underwent MIDCAB surgery in our department,with 35 males and 12 females,aged 48-76 years,with the average of (62.9 ± 8.1) years old.Types of LAD lesions were as followed:1 case was ostial total obstruction,28 severe stenosis at proximal segment,10 long and severe stenosis,3 calcified lesion with severe stenosis,5 myocardial bridge.All patients had symptomatic angina,typical myocardial ischemia could be detected by electrocardiogram for all patients with myocardial bridge.Comorbidities included:hypertension 38 cases,27 diabetes mellitus,3 COPD and 3 chronic kidney disease.Results All surgery went well without transfer to mid-sternotomy.LIMA harvest time was 38-53 minutes,mean LIMA flow rate was(22 ± 6) ml/min after anastomosis.Surgery duration was 117-143 minutes,blood loss was less than 100 ml for each operation.No blood transfusion was required.Tracheal intubation time was 4-16 hours,ICU stay time was 22-45 hours,hospital stay time was 6-10 days.There was no peri-operative death,either no myocardial infarction or cerebral vessel accident.During follow-up,all LIMA-LAD appeared to be patent by coronary CT angiography.Conclusion High patency rate of LIMA-LAD anastomosis could also be obtained during MIDCAB surgery.It was reserved as a safe and effective surgery for well-selected patients.

Objective: To describe the distribution of plasma vitamin B12 concentration in Chinese adults aged 35 to 64 years.Methods:Cross-sectional analysis was empolyed.Plasma vitamin B12 concentration was measured in 2 459 adults sampled from the representative urban and rural areas in the South and North of China.Results:Adjusted plasma vitamin B12 concentration was significantly higher (260 pmol/L) in the Southerners than in the Northerners (189 pmol/L).There were different patterns of seasonal changes of plasma vitamin B12 concentration between South and North.Plasma vitamin B12 concenration was higher during the summer and autumn (269 pmol/L)than during the winter and spring (252 pmol/L) in the South.However,the concentration was lower during the summer and autumn (177 pmol/L) than during the winter and spring (200 pmol/L) in the North.Women tended to have higher plasma vitamin B12 concentration than men.There were 5.5 percent of the participants whose plasma vitamin B12 concentration was lower than 110 mol/L.Conclusion:Significant regional and gender differences in plasma vitamin B12 concentration were observed in Chinese adults.The seasonal changes between the South and North were different.

Objective: To describe the differences of plasma folate concentration and prevalence of folate deficiency in genders and ages in Chinese adults aged 35 to 64 years. Methods: By cross-sectional analysis, plasma folate concentration was measured in 2 545 adults including men and women by microbiological assay. Results: (1) Men tended to have lower plasma folate concentration and higher prevalence of folate deficiency(9.70 nmol/L, 31.0%) than did women(14.2 nmol/L, 12.5%, P=0.001). (2) Men in South have significantly higher plasma folate concentration and lower prevalence of folate deficiency than in North. The difference of plasma folate concentration was not evident between urban and rural area, but evident in North between in winter and spring. There were no significant differences of prevalence of folate deficiency for men between urban and rural areas in both regions. For women, the differences of plasma folate concentration in areas were significant, which were higher in South and urban, and lower in North and rural areas. (3) Plasma folate concentration increased with age in Southern men. A similar trend for others was not significant. Conclusion: Men have lower plasma folate concentration and higher prevalence of plasma folate deficiency than do women. The distribution of plasma folate concentrations in urban and rural areas seems different between men and women.

Objective To summarize the experience of hybrid repair performed in high risk patients with dissection involving the aortic arch.Methods From Sep.2007 to Mar.2015,hybrid repair was performed in 33 high risk patients with dissection involving the aortic arch including acute (n =8),subacute (n =15),or chronic (n =10) cases.Descripitive statistics were computed for continuous and categorical variables.Results There were 22 male and 11 female patients with a mean age of(69 ± 10) years,and ASA Physical Status Ⅲ-Ⅳ.Simultaneous (n =27) and staged (n =5,mean interval 5.0 ± 1.3 days)endovascular repair were performed via femoral artery.The technical success rate was 100％.The average hospital stay was (16 ±6) days.One case died of cerebral infraction.There were two with strokes,one with pneumonia and two with renal failure as complications.Median follow-up was 47 months (3-66 months).There were four deaths with two were related to aortic artery.Endoleak was found in 3 during follow-up.One type Ⅰ endoleak was cured after remedy hybrid repair.Conclusions Hybrid repair performed in patients at high risk with dissection involving the aortic arch is less invasive with favorable medium and long-term outcomes.

ObjectiveTo explore the role of ERK1/2 in the expression of the type-1 plasminogen activator inhibitor(PAI-1) induced by parathonnone (PTH) in human renal tubular epithelial cell line HK-2 cells.MethodsVarious concentrentions of PTH and manifold durations were applied in the test.The expression of PAI-1 mRNA and protein in HK-2 cells was measured by RT-PCR and Western blotting,respectively.Besides,ERK1/2 protein was detected by Western blotting before the ERK1/2 inhibitor incubated with the HK-2 cells or after.Results The expression of PAI-1mRNA and protein was gradually up-regulatad along with the increasing concentrations of PTH(10-12-10-10 mol/L).The maximum level of PAI-1 mRNA and protein was detected in 10-10 mol/L PTH and was 4.01 and 3.81 times of control group.Otherwise,the decreased expression of PAI-1 was found while the concentrations of PTH were beyond 10-10 mol/L.The levels of PAI-1 mRNA and protein were increased in pace withtime from 12 to 72 hour,in time-dependent manner,which was 4.06 (12 h) and 4.03 (72 h) times of 0 hour group.The levels of ERK1/2 and PAI-1 were ascended after 10-10 mol/L PTH incubated with the HK-2 cells (all P＜0.01).Howerver,both of them decended after cells were pretreated by the ERK1/2 inhibitor (all P＜0.01),but were still higher than those of control group(all P＜0.05).ConclusionERK1/2 kinase system partly participates in the regulation of PAI-1 induced by PTH in HK-2 cells.

OBJECTIVETo explore potency material bases of Xuebijing (XBJ) formula, and to analyze its effects at the molecular network level.

METHODSTotally 16 sepsis-related targets were selected and classified into three categories such as inflammation, immune, and coagulation referring to biological roles. Then molecular database of chemical compositions in XBJ formula were constructed to explore mutual actions with inflammation, immune, and coagulation targets.

RESULTSDanshen root and safflower, with more effector molecules with immune and coagulation targets, have extensive anticoagulation and anti-inflammation effects. The former 10 molecules with better mutual actions with sepsis targets were sequenced as tryptophane, danshensu, gallic acid, salvianolic acid D, protocatechuic acid, salvianolic acid A, danshensu C, vanillic acid, rosmarinic acid, phenylalanine. There existed two phenomena in XBJ formula as follows. One component had stronger actions with multi-targets, for example, danshensu had actions with 13 targets. Meanwhile, different components acted on the same target protein, for example, 8 molecules acted with MD-2.

CONCLUSIONXBJ formula had certain potential synergistic effects with sepsis targets, which could provide certain referential roles for findina new type anti-septic drugs.

Caffeic Acids ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; therapeutic use ; Gallic Acid ; Hydroxybenzoates ; Inflammation ; Lactates ; Sepsis ; drug therapy

OBJECTIVETo investigate the clinical effects and operative options for the treatment of Forestier disease.

METHODSFrom June 2005 to May 2012, 8 patients with progressive dysphagia due to Forestier disease were treated through anterior approach, their clinical data were retrospective analyzed. There were 6 males and 2 females, aged from 65 to 83 years old with an average of 73 years. Among the patients, osteophytes removal was performed in 3 cases, osteophytes removal with discectomy and fusion was performed in 2 cases, osteophytes removal with corpectomy and fusion was performed in 3 cases. According to Bazaz dysphagia score to assess the improvement of the patients' symptoms before and after operation.

RESULTSAll patients were followed up from 12 to 40 months with the mean of 18.5 months. Seven cases were asymptomatic and 1 case had mild symptom in the last follow-up. Radiographs showed the space enlargement between vertebral body and trachea.

CONCLUSIONIt is effective to treat patients with progressive dysphagia due to Forestier disease through surgical method. And the operative options depend on the stability of cervical spine and the neurological symptoms of the patients.

Aged ; Aged, 80 and over ; Female ; Humans ; Hyperostosis, Diffuse Idiopathic Skeletal ; diagnosis ; etiology ; surgery ; Male

Objective To explore the feasibility of imaging and treatment of cervical cancer xenograft model using 131I mediated by hNIS gene transfection. Methods The cervical cancer xenograft models were established with Hela-NIS( +) cells and Hela cells, respectively. Five Hela-NIS( +) xenograft models and five Hela xenograft models were dynamically imaged at 0.5, 1, 2, 4, 8, 16 and 20 h postinjection of 131I(7.4 MBq). Five Hela-NIS( +) xenograft models were imaged at 0. 5,1,2,4,8,16, 20 and 25 h postinjection of 99TcmO4-(11.1 MBq). Twenty Hela-NIS( +) cervical cancer xenograft models were randomly divided into four groups: Three 131I treating groups and one control group. The therapeutic effects of 131I at threelevels (74,111,148 MBq) were investigated following intraperitoneal injection. Results Hela-NIS( +)human cervical cancer xenografts were established successfully in nude mice. The Hela-NIS( +) xenografts significantly accumulated radioactivity after intraperitoneal injection of 131I, and the radioactivity was persistently present until 20 h postinjection, but Hela xenografts had no radioactive accumulation. The T/B value of the Hela-NIS( +) xenografts reached 17.34 at 8 h postinjection. The imaging with 99TcmO4- showed that the radioactivity was persistently present in Hela-NIS( +) xenografts for almost 25 h. The Hela-NIS( +)xenografts shrinked after 131I treatment. The inhibition ratios of tumor growth in 111 MBq and 148 MBq groups were both significantly higher than that of 74 MBq group (t: 2.74-5.75, P ＜0.05). Conclusions Hela-NIS( +) cervical cancer xenografts in nude mice could persistently accumulate 131I and 99TcmO4- and could be treated successfully with 131 I. 131 I treatment mediated by hNIS gene transfection could be a promising cancer treatment method.

Objective To investigate the guidance value of TOI classification in treating traumatic T-type atlantoaxial dislocation (ADD).Methods A retrospective case series study was made on 32 cases of traumatic TOI T-type ADD treated between January 2012 and December 2015.There were 19 males and 13 females,aged (38.4 ± 14.7) years.Fifteen cases of T1-type underwent external fixation or internal fixation without fusion,while 17 cases of T2-type underwent internal fixation with fusion.Symon-Lavender clinical standard,Japanese orthopedic association score (JOA),visual analogue scale (VAS),atlas-dens interval (ADI) and space available for the cord (SAC) were used to evaluate the therapeutic effect.Results Patients were followed up for 6-54 months (mean,32.4 months).At final follow-up,ADI was decreased to (2.3 ± 1.4) mm from preoperative (5.6 ± 1.6) mm,but SAC was increased to (15.4 ± 1.9) mm from preoperative (12.0 ± 2.9) mm(P ＜ 0.01).At final follow-up,cervical axial rotation range of motion was 102°-154° in T1-type cases and 57°-93° in T2-type cases.Range of motion for atlantoaxial joint was preserved in T1-type cases,but lost in T2-type cases.According to the Symon-Lavender clinical standard,there were 14 cases of mild disability,nine moderate disability,eight severe disability and one extremely severe disability before operation;there were 21 cases of mild disability,nine moderate disability and two severe disability at last follow-up.Significant difference was observed in the grades according to the Symon-Lavender clinical standard before operation and at last follow-up (P ＜0.05).At last follow-up,JOA score was increased to (14.6 ± 2.9) points from preoperative (9.9± 3.2) points,and VAS was decreased to (2.7 ± 1.3)points from preoperative (6.0 ± 1.6)points (P ＜ 0.01).Conclusions By using TOI classification,reconstruction of stability and improved neurological function can be achieved in treatment of traumatic T-type atlantoaxial dislocation.Non-fusion treatment of T1-type atlantoaxial dislocation can preserve range of motion for atlantoaxial joint.

Objective To investigate whether the gene polymorphisms of cytochrome P450(CYP) 2E1 are associated with the risk of anti-tuberculosis drug induced hepatotoxity (ADIH).Methods In this case control study, 339 patients who matched the diagnosis criteria of tuberculosis were included. The gcneral healthy status and liver biochemical parameters were checked in all these patients. Polymerase chain reaction-restriction fragment length polymorphism (PCR RFLP) technique was used to determine CYP 2Et polymorphisms. The statistic analysis were performed by using both univariate and multivariate Logistic regression analysis. Results The allele frequencies of CYP 2E1 7632T/A, 1019C/T and 1259G/C in 103 tuberculosis patients of ADIH group were 17.5%, 26.2%and 27.2 % respectively, while those in 236 tuberculosis patients of control group were 29.7 % ,39.4 %and 40.7%, respectively (x2 =5.539, P＜0.05; x2 =5.458, P＜0.05; x2 =5.628, P＜0.05). The results of univariate analysis demonstrated that the risk of concurrent ADIH was significantly higher in patients with wild genotypes of CYP 2E1-7632T/A, CYP 2E1-1259G/C, CYP 2E1-1019C/T than in patients with other genotypes. After adjusted for sex, occupation and alcohol consumption status, the results of multivariate Logistic regression analysis also showed that wild genotypes of CYP 2E1-7632T/A, CYP 2El-1259G/C, CYP 2E1-1019C/T were significantly associated with higher risk of ADIH. The results of interaction analysis indicated that the wild genotypes of CYP 2E1-7632T/A and CYP 2E1-1259G/C or CYP 2E1-1019C/T had synergetic effects on the development of ADIH.Conclusions The risk of concurrent ADIH is significantly higher in patients with wild genotypes of CYP 2E1-7632T/A, CYP 2E1-1259G/C, CYP 2E1-1019C/T compared to patients with othergenotypes. Wild genotypes of CYP 2E1-7632T/A and CYP 2E1-1259G/C or CYP 2El-1019C/T have synergetic effects on the development of ADIH.