Objective To evaluate the effect of off-pump coronary endarterectomy (CE) plus off-pump coronary artery bypass grafting (off-pump CABG) on patients with chronic total occlusion (CTO) combined with diffuse distal atherosclerosis. Methods From October 2006 to August 2009,65 CTO patients with 176 angiographically confirmed vascular stenosis or occlusive lesions, 70 of which were complete occlusion, underwent off-pump CABG. During the operation, diffuse intimal thickening distal to occlusive lesion was found, and blood flow of the bridges was unfavorable.Results Therefore endarterectomy was performed, followed by CABG. The blood flow in the bridges were 2-10 ml/min versus 14-37 ml/min before versus after endarterectomy. Pulsatility index (PI) was 5.1-15.6 versus less than 5 before versus after endarterectomy. Left ventricular ejection fraction was also improved significantly [before operation: (0.47±0.12)%, after operation: (0. 52±0.15)%, t=2.17, P＜0.05]. Peri-operative myocardial infarction occurred in 2 cases, but without significant cardiac homodynamic changes. And 23 patients underwent coronary angiography to evaluate graft patency 3-18 months after operation, all of them had favorable blood flow. Conclusions It is feasible to perform off-pump CABG plus coronary endarterectomy for patients of chronic coronary total occlusion combined with diffuse distal atherosclerosis. This treatment is safe and effective.

A novel amplifier system was proposed for low-noise recording of pico-ampere current in nanopore experiment (<100 pA). As an example, the amplifier system was applied in α-hemolysin based nanopore detection of DNA-PEG-DNA conjugate to record the signals of translocation and bumping events in buffer solution (1 mol/L KCl, 10 mmol/L Tris--HCl, 1 mmol/L EDTA and pH=8. 0). The amplified current signal was filtered by a 3 kHz Bessel filter and sampled by a 100 kHz analog-digital convertor. As a result, the presented amplifier system could lower the noise in recording the current. The current blockages (<10 pA) of single molecules with low amplitude were recovered due to the high signal-to-noise ratio.

Objective To explore the contrast perilymphatic MRI characteristics of inner ears with sudden hearing loss with vertigo.Methods Forty three patients with sudden hearing loss with vertigo and 35 patients with unilateral tinnitus diagnosed by the department of Otolaryngology-Head and Neck Surgery were retrospectively included.Forty eight ears (38 ears with unilateral sudden hearing loss and 10 ears in 5 cases with bilateral sudden hearing loss) were regarded as sudden hearing loss group,35 asymptomatic ears (the opposite ears of the unilateral tinnitus ears) as control group.Thirty eight opposite ears of the 38 unilateral sudden hearing loss ears and 35 ears of the control group showed normal in the pure tone audiometry exam.One hundred and twenty one ears (48 hearing loss ears,38 opposite ears of the 38 unilateral sudden hearing loss ears and the 35 control group's ears) underwent contrast perilymphatic MR exams,0.4 to 0.5 ml gadolinium hydrate diluted with saline was injected through the tympanic membrane,twenty four hours later,three-dimensional fluid attenuated inversion recovery (3D-FLAIR) sequence was performed using a 3.0 T MRI scanner.After the contrast perilymphatic MR exam,success in the exam was judged through the raw image.The signal intensity ratio (SIR) of cochlea basal turn and homolateral brain stem was quantitatively calculated.The SIR difference of 48 ears with sudden hearing loss and 35 asymptomatic ears in control group was analyzed by t test.The SIR difference of the 38 unilateral sudden hearing loss ears and the contralateral asymptomatic ears was also analyzed.The presence of endolymphatic hydrops was judged.Results The contrast perilymphatic MRI of 121 inner ears with intratympanic gadolinium injection were all successful.Endolymphatic hydrops were observed in 12 sudden hearing loss ears with the occurrence rate of 25％(12/48).The SIR of basal turn and homolateral brain stem of the sudden hearing loss ears (2.062±0.907) were lower than the SIR of the control groups' asymptomatic ears (2.703± 0.640) with significant difference between them (t=3.619,P=0.001),the SIR of basal turn and homolateral brain stem of the unilateral sudden hearing loss ears (1.941 ±0.860) were also lower than the SIR of the contralateral asymptomatic ears (2.411±0.670) with statistical difference between them (t =3.270,P=0.002).Conclusions Endolymphatic hydrops were observed in sudden hearing loss with vertigo.The SIR of the cochlea in sudden hearing loss ears were lower than that of the asymptomatic ears,indicating the abnormal permeability of the round window membrane.

OBJECTIVE: To investigate the role of endoplasmic reticulum stress (ERS) in lipopolysaccharide (LPS)-induced hepatocyte apoptosis. METHODS: Cells of the rat hepatocyte line BRL were cultured. The hepatocytes were treated with LPS, ERS inducer thapsigargin (TG), and ERS inhibitor 4-phenylbutyric acid (4-PBA), respectively or in their different combination. The cell viability was measured by MTT assay. The cyto-nuclear morphological changes of apoptosis cells were detected by the fluorescent dye Hoechst 33258. The apoptosis rate was assessed by flow cytometry with Annexin V-FITC/PI double-staining. Expressions of GRP78 as ERS marker protein, CHOP, caspase-12 and cleaved-caspase-3 as ERS related protein were detected by Western blotting. RESULTS: LPS could cause a decrease in cell viability and an increase in apoptosis rate in a dose- and time-dependent manner. The expression of GRP78, CHOP, caspase-12 and cleaved-caspase-3 proteins were significantly increased with LPS treatment. TG led to a marked decrease in cell viability and an increase in apoptosis rate, which aggravated the hepatocyte injury induced by LPS; whereas 4-PBA alleviated LPS-induced apoptosis. CONCLUSION ERS mediates LPS-induced hepatocyte injuries, indicating that ERS may play a vital role in the pathogenesis of LPS-induced hepatocyte injuries.
Animals ; Apoptosis ; Caspase 3 ; Cell Survival ; Endoplasmic Reticulum Chaperone BiP ; Endoplasmic Reticulum Stress ; Heat-Shock Proteins ; Hepatocytes ; Lipopolysaccharides ; Phenylbutyrates ; Rats

Objective To use diagnosis related group (DRGs ) for the first time in overall evaluation of inpatient service performance evaluation of major diagnostic category (MDC)for all the Beijing municipal hospitals,and recommend how to strengthen Beijing municipal hospitals system in diagnosis and treatment ability of main diseases and improve inpateint service performance.Methods BJ-DRGs burster software was used to analyze the first page information of the medical records of cases discharged from all the Beijing municipal hospitals between 2012 and 2014 to determine the weight of each DRG,and based on such weight the related indicators of such hospitals and central hospitals in 2012, 2013,2014 were compared and analyzed.Results Improvements were found in such indices as diagnosis and treatment difficulty of 50% MDC,time efficiency of 81.8% MDC,cost efficiency of 77.3% MDC, and general capacity of 54.5% MDC for all Beijing municipal hospitals.In addition,the municipal hospitals were found superior to the central hospitals in such indices as cost efficiency of 68.2% MDC, and time efficiency of 59.1% MDC.On the other hand however,they were found inferior to the central hospitals in such indices as diagnosis and treatment difficulty of 72.7% MDC,and the comprehensive ability index of the two systems were found equivalent.Another finding was that there was no obvious improvement of the coverage of disease types at major tertiary hospitals in Beijing for the past three years.Municipal hospitals of greater contribution of MDC weight were highly consistent with the hospitals assigned with national key projects of disciplinary developments. Conclusion The comprehensive evaluation results of inpatient service performance of main diseases at Beijing’s municipal hospitals based on DRGs system,showed that the Beijing’s hospital authority had played an important role in improving inpatient service performance especially in reducing the burden of patients,improving the service efficiency through increasing government investment,optimizing service organization and implementation of performance management.But it also suggested that measures such as collectivize construction and management should be taken to improve municipal hospitals’linical specialty ability, improve the MDC diagnosis and treatment difficulty,and resume their functions of tertiary hospitals.

Background and purpose: The incidence and mortality of lung cancer ranked first in China. This study aimed to describe lung cancer survival in Shanghai, and provide background information for cancer prevention and treatment evaluation. Methods: Data of lung cancer cases diagnosed during 2002-2006, follow-up information and death report were collected from Shanghai Cancer Registry. Life table method and Ederer Ⅱ were used to calculate observed survival (OS) and relative survival (RS) respectively. Related demographic characteristics and status were also analyzed to present the survival situations of the lung cancer survivors in Shanghai. Results: In this study, 41802 lung cancer cases were included in analysis. The 5-year OS and RS for lung cancer were 13.75% and 20.23% respectively, and median survival time was 318 days. Survival rate was higher among females than males, with the 5-year OS of 15.49% and 13.00% respectively. The 5-year OS was higher among suburban residents (14.25%) than urban residents (13.23%). Survival rates decreased with increasing age and advanced stage. Patients aged 0-34 had a 5-year OS of 38.21%, while patients aged above 75 had a 5-year OS of 5.48%. Patients diagnosed with stage Ⅰ had a 5-year OS of 55.47%, while patients diagnosed with stage Ⅳ had a 5-year OS of 5.27%. Survival of lung cancer patients differed by tumor histological subtype. The 5-year OS of squamous lung cancer (24.40%) was higher than other histological types, followed by adenocarcinoma (22.26%), large cell (20.27%) and small cell lung cancer (12.22%). From 1972-1976 to 2002-2006, the 5-year OS of urban male patients increased from 6.8% to 12.4%, and 5-year OS of urban female patients increased from 7.3% to 14.9%. Analysis of RS gave the similar results. Conclusion: During the past 30 years, survival rate of lung cancer patients in Shanghai improved steadily, and the survival condition is above average among different countries and areas. However, survival rate of lung cancer is still low compared with other types of cancer. Future focus should be placed on the control of tobacco smoking, early detection by low-dose helical computed tomography and targeted therapy to further improve lung cancer survival.

OBJECTIVE: To investigate effects of antioxidant stress protein heme oxygenase-1 (HO-1) on lipopolysaccharide (LPS)-induced endoplasmic reticulum stress (ERS) of rat hepatocytes. METHODS: The BRL cells (rat hepatocyte cell line) were cultured. The hepatocytes were treated with LPS, LPS+HO-1 siRNA, HO-1 siRNA and PBS solution, respectively. The cell viability was measured by trypan blue exclusion test. The apoptosis cells were detected by the fluorescent dye Hoechst 33258. Expressions of GRP78, CHOP, caspase-12 and HO-1 were detected by Western blotting. RESULTS: LPS caused an increase of HO-1 protein expression of rat hepatocytes in a dose-dependent and time-dependent manner, a up-regulation of GRP78, CHOP and caspase-12, a decrease in cell viability, and an increase in apoptosis rate of hepatocytes. Pretreatment of HO-1 siRNA inhibited the up-regulation of LPS-induced HO-1, however, aggravated ERS and cellular injury. CONCLUSION HO-1 inhibites ERS-mediated cellular injury of rat hepatocytes induced by LPS.
Animals ; Apoptosis/physiology* ; Endoplasmic Reticulum/metabolism* ; Endoplasmic Reticulum Stress/physiology* ; Heme Oxygenase-1/pharmacology* ; Hepatocytes/metabolism* ; Lipopolysaccharides/pharmacology* ; Rats

OBJECTIVE: To explore the role of hydrogen sulfide (H2S) in acute liver injury induced by crushing hind limbs of rats. METHODS: The rats were randomly divided into the following groups: control, crushing, H2S donor sodium hydrosulfide (NaHS) + crushing, H2S inhibitor propargylglycine (PAG) + crushing group. The acute liver injury model was established by 'crushing the hind limbs of rats with standard weight. Rats were sacrificed at 30 min and 120 min after the crush. The activities of serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were measured by colorimetric method, and the content of H2S in plasma and the contents of malondialdehyde (MDA), protein carbonyl, glutathione (GSH) in the liver and the activity of H2S generating enzyme (cystathionine y-lyase, CSE) were determined by chemical method. The expression of CSE mRNA in liver was detected by RT-PCR. RESULTS: For crush injury group, the levels of AST and ALT in serum, MDA and protein carbonyl in liver increased. The levels of GSH, CSE, CSE mRNA in liver and H2S in serum decreased. The administration of NaHS before limbs crush could attenuate the changes of liver injury, but the pre-treatment with PAG could exacerbate the changes. CONCLUSION The decrease of H2S production could involve in mediating the acute liver injury induced by traumatic stress in rats.
Alanine Transaminase/blood* ; Alkynes/pharmacology* ; Animals ; Aspartate Aminotransferases/blood* ; Cystathionine gamma-Lyase/metabolism* ; Glutathione/metabolism* ; Glycine/pharmacology* ; Hydrogen Sulfide/pharmacology* ; Liver/injuries* ; Malondialdehyde/metabolism* ; Protein Carbonylation ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Sulfides/pharmacology*

Objective · To evaluate the effect of phacoemulsification combining with intraocular lens (IOL) implantation in cataract patients with Fuchs endothelial corneal dystrophy (FECD) and high myopia. Methods · Five patients (9 eyes) diagnosed with FECD and high myopia were collected retrospectively at Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine from January 2015 to February 2016. All the 9 eyes underwent phacoemulsification combining with IOL implantation. Visual acuity, intraocular pressure, corneal endothelial cell density (CD) and central corneal thickness (CCT) were evaluated. Paired t-test was performed to evaluate the differences. Results · 88.89% (8/9) of the vision of the patients was improved, the best corrected visual acuity improved at least 2 lines. The intraocular pressure had no statistically significant difference before and after the operation (t=-1.066, P=0.318). The preoperative and postoperative CDs were (2184.25±196.44) cells/mm2 and (1910.0±83.41) cells/mm2 (t=2.876,P=0.064). The preoperative and postoperative CCTs were (546.83±33.74) μm and (566.67±24.66) μm (t=1.971, P=0.106). The loss rate for endothelial cells was (12.10±7.84)%. Only one patient was observed corneal edema and the CD could not be determined, so he underwent penetrating keratoplasty.Conclusion · Phacoemulsification combining with IOL implantation is safe and effective for patients with FECD and high myopia. Preoperative evaluation of corneal endothelium is necessary. Some measures should be taken into consideration to reduce the loss of endothelial cells during in surgery.

BACKGROUNDNosocomial infection caused by methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) could lead to increased morbidity and mortality. In 2006, VRE nosocomial spread became a reality in our hospital since the first VRE nosocomial infection in 2003. Little is known about the prevalence of coexistence with VRE and MRSA in the patients. The primary objective of the study was to identify the molecular characteristics of epidemic MRSA clones in our hospital and the prevalence of the coexistence with MRSA and VRE in same patients during the 2-year period, 2006 - 2007.

METHODSThe clinical features, laboratory test results, and therapeutic outcomes of 129 cases who isolated MRSA collected from January 2006 to December 2007 were retrospectively analyzed. Polymerase chain reaction (PCR) was used to determine mecA-femB type and staphylococcal cassette chromosome mec (SCCmec) type. All the participants were screened for clinical and microbiological data to identify the coexistence of VRE strains with MRSA.

RESULTSOne hundred and twenty-nine MRSA isolates were included in the study: 71 (55%) from the intensive care unit, 35 (27.2%) from the surgical wards and 23 (17.8%) from the medical wards. The most frequent source of isolation of MRSA was sputum (76.7%). From seven patients we isolated MRSA and VRE (E. faecium) simultaneously during their inpatient stay. One hundred and twenty-seven (127/129, 98.4%) MRSA isolates harboured SCCmec type III, only 2 MRSA strains contained SCCmec type II. All of the 129 MRSA isolates remained sensitive to vancomycin, teicoplanin and linezolid. Higher sensitivity rates were noted for chloramphenicol 99.2% (128/129). Only 20.2% (26/129) of the MRSA isolates were sensitive to rifampin. All isolates presented resistance to multiple antimicrobial agents with high minimum inhibitory concentrations (MICs), including: beta-lactams (penicillin, oxacillin, cefoxitin, and cefazolin), tetracycline, erythromycin, gentamicin, and quinolones (ciprofloxacin, levofloxacin, and moxifloxacin).

CONCLUSIONSThe predominant MRSA clone at Beijing Chaoyang Hospital from 2006 to 2007 had the type III SCCmec element. All of the MRSA isolates were multiresistant to antimicrobial agents. Emergence of coexistence of MRSA and VRE in the same patient was not rare. Physicians should pay more attention to infections resulting from MRSA and VRE. Aggressive infection control measures should be taken to prevent the transmission of the multidrug resistance organism.

Adult ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents ; pharmacology ; China ; Chromosomes, Bacterial ; genetics ; Enterococcus ; drug effects ; genetics ; physiology ; Gram-Positive Bacterial Infections ; epidemiology ; Hospitals ; statistics & numerical data ; Humans ; Male ; Methicillin-Resistant Staphylococcus aureus ; drug effects ; genetics ; physiology ; Microbial Sensitivity Tests ; Middle Aged ; Polymerase Chain Reaction ; Prevalence ; Staphylococcal Infections ; epidemiology ; Vancomycin Resistance