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 investigate the preventive effect of the artificial nerve canal on irritating neuralgia after neurilemmoma resection.Methods Thirty patients diagnosed as neurilemmoma were divided into artificial nerve group and control group at randomly.There were 15 patients in each group.The nerves in artificial nerve group were enclosed using the artificial nerve besides neurilemmoma resection.The nerves in control group only had neurilemmoma resection.All patients were assessed with VAS for the degree of irritating neuralgia at 3 time points after operation.Calculate the incidence of irritating neuralgia and analyze the data using statistical methods.Results In control group,the VAS scores were 7.5,5.1,2.8,and the incidences of irritating neuralgia were 80％,67％,40％,respectively.In artificial nerve group,the VAS scores were 3.2,1.5,0,and the incidences of irritating neuralgia were 33％,13％,0.The VAS scores and the incidences of irritating neuralgia of two groups had significant difference by statistical analysis (P ＜ 0.05).Conclusion The artificial nerve canal can relieve the degree and decrease the incidence of irritating neuralgia after neurilemmoma resection,which is a useful method to prevent irritating neuralgia in clinic.

Spinal fractures are a big challenge to orthopedists.Thoracolumbar Injury Classification and Severity Score (TLICS),a newly developed evaluation system for thoracolumbar fractures,has proved to be valid and reliable in the last decade.However,there have still been many problems in the clinical application of TLICS in China.We discussed nine issues about the clinical application of TLICS in this article,hoping to promote better understanding and application of TLICS in Chinese spinal surgeons in their daily practice.

Objective To observe whether the intravenously transplanted homologous bone marrow mesenchymal stem cells (MSCs) can migrate to the impaired pancreas tissue in the rats with acute necrotizing pancreatitis (ANP). Methods MSCs were isolated from bone marrow of male Sprague-Dawley (SD) rats and adhered to the culture plate in vitro. Female rats were divided randomly into 3 groups:normal transplantation group, ANP transplantation group, ANP group with 10 rats in each group. ANP was induced by intraperitoneal injections with L-arginine. Both transplantation group received MSCs infusion through tail vein. 72 h later, the rats were sacrificed, the pancreas, heart, liver and kidney tissues were harvested, and the morphological changes were examined and scored, the characteristics of migration of MSCs to pancreas were detected with the expression of sry gene of Y chromosome by using chromogenic in situ hybridization (CISH). Results Rapid proliferation occurred in isolated MSCs after culture for 3 ～ 5 days and colonies were formed. After 3 generations, CD29 + CD44 + CD45-cells accounted for over 95% of all the cells. There ware massive tissue necrosis, inflammatory cells infiltration in the pancreas of ANP group, the pathological score was 10.31 ±0. 85, which were significantly higher than that in ANP transplantation group (7.30 ±0.79, P ＜ 0.05). Sry gene could be detected in the pancreas, heart, liver and kidney tissues. In addition, scattered distributed sry positive cells were observed in the normally transplanted pancreatic tissue, lots of sry positive cells were observed in the ANP transplanted pancreatic tissue, and they were located in the most injured areas.Conclusions The inflammatory pancreatic tissue has the ability of recruiting MSCs in vivo, which can alleviate local inflammation.

Objective To investigate the effectiveness of ilioischial plating through modified Stoppa and iliac fossa approaches for complex acetabular fractures. Methods A consecutive series of 40 patients with complex acetabular fracture were treated operatively from January 2014 to February 2015. Of them, 20 were treated through modified Stoppa plus iliac fossa approaches as an experimental group ( including 12 males and 8 females with a mean age of 46. 8 ± 10. 3 years ) . The anterior column was stabilized with a recon-struction plate for the iliac wing along the iliopectineal line to the pubis in all cases. The posterior column was fixed with a newly developed ilioischial plate running from the ilium to the ischial ramus. The other 20 patients ( 10 males and 10 females with a mean age of 45. 6 ± 11. 7 years ) served as a control group, treated with a reconstruction plate for the conventional posterior column fixation through the Kocher-Langenbeck approach. The 2 groups were compared in terms of operative time, intraoperative blood loss, reduction and functional recovery of the hip. Results The 40 patients obtained an average follow-up of 18 months ( from 8 to 24 months ) . The experimental group reported significantly shorter operation time ( 2. 1 ± 0. 7 hours ) and signifi-cantly less intraoperative bleeding ( 320. 8 ± 100. 4 mL ) than the control group ( 2. 9 ± 0. 6 hours and 621. 6 ± 118. 7 mL, respectively ) ( P <0. 05 ) . According to modified Matta's criteria for reduction, the experimental group had 15 excellent, 3 good, one fair and one poor cases ( giving an excellent to good rate of 90％) while the control group had 17 excellent, one good, one fair and one poor cases ( giving an excellent to good rate of 90％) . According to the modified Merle d'Aubigné and Postel scoring for the functional recovery of the af-fected hip at the final follow-ups, the experimental group had 14 excellent, 3 good, 2 fair and one poor cases ( giving an excellent to good rate of 85％) while the control group had 12 excellent, 4 good, 3 fair and one poor cases (giving an excellent to good rate of 80％). There were no significant differences between the 2 groups in the above comparisons ( P> 0. 05 ) . There were no significant differences in the MOS item short form health survey score and postoperative complication rate between the experimental group and the control group. Conclu-sion Ilioischial plating through modified Stoppa and iliac fossa approaches has advantages of reliable fixa-tion, limited invasion, less intraoperative blood loss and fewer complications for complex acetabular fractures.

Objective To observe the effects of hyperbaric oxygen (HBO) on learning and memory ability and on the level of myelin basic protein (MBP) in the brain tissue of rats with delayed neurological sequelae (DNS) after acute carbon monoxide poisoning (COP).Methods Forty-eight male SD rats had their cognitive performance assessed with the Morris water maze.After basic training with the Morris water maze and screening,the rats were randomly divided intoanormalcontrol (NC) group (n=11),a COP group (n=17) and an HBO group (n=17).Pure CO gas was injected intraperitoneally to establish acute COP in the latter two groups.The NC group received a similar injection of air.The HBO group was given HBO therapy.The rats in each group were tested for changes in their learning and memory abilities using the Morris water maze.On the 21 st day after the treatment,paraffin tissue sections of the rats' brains were subjected to immunohistochemical (IHC) examination and Western blotting (WB) was used to detect any expression of MBP in the brain tissue.Results After 21 days,morbidity among the COP group was 64.3％,while it was 26.7％ in the HBO group,a significant difference.The average maze escape latency in the COP group was significantly longer than in the HBO group.IHC staining and Western blotting showed that MBP in the hippocampal tissue of the COP group was significantly lower than that in the HBO group.In gray scale comparisons of the rats' brain tissue,that from the NC group was significantly better than that from the COP and HBO groups,but that from the HBO group was significantly better than that from the COP group.Conclusion HBO can effectively reduce DNS after acute COP,mitigate the severity of DNS,reduce demyelination of brain tissue and thus play an important role in protecting brain cells.

Objective To analyze the clinical characteristics and recent curative effect of mantle cell lymphoma (MCL) after conventional treatment.Methods Clinical data of 15 MCL patients admitted in the Affiliated Hospital of Academy of Military Medical Sciences between August 2004 and October 2013 were retrospectively analyzed.Results The median age of those patients was 59 and the male to female ratio was 1.5∶1.Fourteen(93%)cases were in Ann-Arbor stages Ⅲ -Ⅳ, 15 cases (100%)primarily with lymph node involvement,7 cases (47%)with bone marrow involvement,4 cases (27%)with gastrointestinal involvement,and 3 cases (20%)with orbit involvement.Less than 40% expression of Ki-67 was observed in 9 cases (60%),while 6 cases were with more than 40% (40%).One case was blastic variant.First-line therapy was CHOP-like regimens,which were combined with rituximab in 8 of the 15 cases.In this study,the median survival time was 12 months (3 -64),and the overal response rate was 80%after induction chemotherapy.The current survival of 7 /9 cases with less than 40% expression of Ki-67 was 8 -64 months,2 /6 cases with more than 40% expression of Ki-67 was 8 and 9 months,respectively.Conclusion MCL mostly occurs in older males.Extranodal invasion is common in MCL as an aggressive tumor.The efficacy of traditional chemotherapy is currently limited.Blastic variant or high expression of Ki-67 is an adverse prognostic indicator.

Objective To research the jugular foramen,internal auditory pore (IAP)and the turning point between its components by imageological methods and to provide theoretical basis for retrosigmoid approach in the operation of acoustic neurinoma.Methods The skulls of 100 volunteers were scanned to get the final result with thin-section computed tomographic image. High-resolution spiral CT multiplane reformation was used to reform images that were parallel to the Frankfort horizontal plane to measure the distance between the turning point of retrosigmoid (A),the edge of jugular foramen(B)and the lower edge of the internal auditory canal(C)(denoted AC,AB,BC) and the shortest distance from the jugular foramen to AC.The angles between AC,AB and sagittal axis(α,β) were measured.Results The distance of AC was (44.94 ± 3.84)mm,the distance of AB was (43.68 ± 4.56)mm.The distance of BC was (6.15 ±2.04)mm,and the shortest distance between jugular foramen and AC was (5.21±0.23)mm.The angleαwas measured as (39.50±4.74)°,and the angleβwas measured as (46.35± 5.51)°.Conclusion The research measure the distance and angle between entry points and landmarks of retrosigmoid approach and the safe distance.

OBJECTIVETo establish an ELISA approach to study the interaction of polysaccharides with cytokine in vitro.

METHODSThe heparin BSA complexes (HBC) were synthesized with a chemistry method and separated using a 1 X 90 cm column of Separose 4B. After identification of the complex via SDS-PAGE,the wells of ELISA plates were coated with HBC and the interaction of HBC with interferon-gamma (IFN-gamma) was detected. The effects of heparin, low molecular weight heparin (LMW heparin), chondroitin sulfate (CS), hyaluronic acid (HA) and carrageenans on the binding of HBC to IFN-gamma were tested in this system.

RESULTHuman recombinant IFN-gamma bound to heparin in a concentration dependent manner, the binding of IFN-gamma to HBC was detected at the concentration of 0.25 ng, and saturated at around 2 ng. Free heparin, LMW heparin, CS,HA and carrageenans competed for the binding of IFN-gamma to HBC with significant different ability. The IC(50)concentrations of heparin and LMW heparin were 2.40 microg/ml and 18.60 microg/ml respectively.

CONCLUSIONIFN-gamma is a cytokine with high binding affinity to heparin and carrageenans family but poor to CS-A and CS-C. ELISA is a simple, sensitive approach to detect the interaction of polysaccharides with cytokine in vitro.

Enzyme-Linked Immunosorbent Assay ; methods ; Heparin ; metabolism ; Interferon-gamma ; metabolism ; Polysaccharides ; metabolism ; Serum Albumin, Bovine ; metabolism

Objective To investigate the effect of silencing E6-associated protein(E6AP)on the level of p53 protein in human papilloma virus(HPV)negative cervical cancer cells(C33A cells).Methods The siRNA sequence silencing E6AP(siE6AP)and silencing control disordered siRNA sequence(siControl)were transfected into C33A cells with the mediation of LipofectamineTM2000 transfection reagent respectively.The silencing effect of siRNA on E6AP and the expression of p53and cleaved-caspase-3 proteins were detected by Western blot.Results The levels of E6AP protein in C33A cells of siE6AP group were significantly lower(t =-4.597,P<0.05),while the levels of p53 and cleaved-caspase-3 proteins were significantly higher than those of siControl group(t = 4.533 and 7.099 respectively,each P<0.05).Conclusion Silencing of E6AP significantly increased the expression of p53 protein in C33A cells,indicating that silencing of E6AP may restore the activity and function of p53 protein in C33A cells.