Objective To review our experiences of diagnostic methods and surgical treatment of the left superior vena cava (LSVC) draining into the left atrium.Methods Nineteen patients with LSVC draining into the left atrium were diagnosed and treated surgically from February 1998 to January 2012.All the cases were combined with other congenital heart diseases including patent ductus arteriosus,ventricular septal defect,atrial septal defect,single atrium,triatriatum,partial endocardial cushion defect,anomalous pulmonary venous drainage,right ventricle outflow stenosis,pulmonary valve stenosis,tetralogy of Fallot,double outlet right ventricle,complete endocardial cushion defect,tricuspid atresia.The patients were diagnosed through different methods including echocartiographic examination,cardiac catheterization,computer tomography,and explored during the operation,even postoperatively.All were treated surgically with four techniques including simple ligation to the LSVC,including ligation during a redo procedure; intra atrial rerouting to drainage the flow from the LSVC to the right atrium,atrial septum reconstruction to make the outlet of the LSVC lying in the right side of the patched atrial septal,and bidirectional Glenn shunt to get a physiological result.Results No mortality postoperatively.All the cases were uneventful postoperatively.And the main postoperative course was related only to the main diagnosis of congenital heart disease,not to the left superior vena cava draining into the left atrium.The echo examination result was satisfied before the discharge.The early and long term follow-up(1-11 years) results are excellent,no arrhythmia,no cardiac deficits after echo examination,including stenosis obstruction and residual shunt.No death.Conclusion The diagnostic methods of the LSVC draining into the left atrium are difficult,the only way to make the diagnosis clearly enough before the operation is depending on improving of more and more comprehending to this rare cardiac anomaly,by the pediatric cardiologists,the sinologist,the intensive care unit,and the pediatric cardiae surgeons.The choice of different surgical treatment is depending on the diagnosis and the findings during the operations,and the results are excellent after a suitable choice made.

Obiective To investigate the association between single nucleotide polymorphisms (SNPs) of ER β gene and susceptibility of breast cancer in Uygur women in Xinjiang.Methods A case-control study was designed to explore the genotypes of Rsa Ⅰ (G/A) of ER β gene,detected by PCR-restriction fragment length polymorphism (PCR-RFLP) assay,in 112 breast cancer cases of Uygur women and 139 medical health cases of Uygur women.The association between SNPs of ER β gene and risk of breast cancer in Uygur women was analyzed by unconditional Logistic regression model.Results The frequencies of genotypes of Rsa Ⅰ (G/A) of ER β gene in cancer group and control group were 83.0 ％ and 17.0 ％,73.4 ％ and 26.6 ％,respectively.Rsa Ⅰ (G/A) locus allele frequency were 91.5 ％ and 8.5 ％,86.7 ％ and 13.3 ％,respectively.There were no statistically differences between the cancer cases and control cases (x2 =3.335,P =0.068.x2 =2.917,P =0.088).Presence of estrogen exposure history of two groups for genotypes distribution were 74.2 ％ and 25.8 ％,86.4 ％ and 13.6 ％,respectively.Any family history of cancer in the two groups for the genotypes distribution were 100 ％ and 0,72.8 ％ and 27.2 ％ respectively.There were statistically significant difference between two groups (P =0.046,P =0.001).Compared with wild-type genotype GG,the GA type with estrogen exposure and without a family history of cancer showed a lower incidence of breast cancer in Uygur women (OR =0.385,95 ％ CI 0.148-0.999.OR =0.285,95 ％ CI 0.134-0.605).Conclusions ER β gene SNP is associated with breast cancer of estrogen exposure and no family history of cancer factors.GA genotype may be a protective factor for Uygur women with breast cancer.

Objective To summarize the clinical experience of successful intervention in single chronic coronary actery total ocdusion (CTO) lesions by the transradial.Methods A retrospective analysis was conducted in 103 patients with single CTO lesions who got intervention treatment by the radial artery.Results ( 1 ) Of the 103 cases,57 cases had unstable angina,12 cases had stable angina,and 34 cases chronic myocardial infarction.Lesions' block time was ≤ 6 months in 83 cases,and ＞ 6 months in 20 cases.(2)The path vessels of the 103 patients have no severe tortuosity and anatomical structure variation.Fifty-one cases occurred left anterior descending occlusion,25 cases occurred left circumflex branches occlusion,and 27 cases occurred right coronary artery occlusion.Furthermore,24 cases had chronic complete occlusion,and 79 cases had chronic functional block.The side branches did not block in 91 cases,no lesions(bridge) collateral formation occurred in 87 cases,lesions length was less than 15 mm in 67 cases,and tapered lesions was observed in 81 cases.( 3 ) Final intervention rate via Judkins,XB,EBU guide catheter was 37.86％,30.10％ and 29.13％ respectively.(4)the PILOT successfully through the lesions for the series wire guided was 64.08％.(5) 1.25 mm diameter series with a balloon through the first lesions and successful expanding was observed in 57 cases (55.34％),and 1.5 mm diameter series with a balloon occurred in 38 cases(36.89％ ).Conclusion Intervention treatment by the radial of single CTO lesions is feasible for experienced performers.The successful intervention depends on path vessels unimpeded,target vessels with characteristic pathological features and reasonable choice of instruments.

There is a great diversity for cellulolytic microbes in nature and the strategies they use to digest cellulose. In addition to the cultured cellulolytic microbes, there are still a great number of microbes being not readily culturable in natural environments, which may represent great potential for identifying novel cellulases and their encoding genes. The rise of metagenomics and metaproteomics provides essential technologic tools to dig up these resources and significant progress has been made so far. This review gives an insight into some relative results that have arisen from the meta-genomic or proteomic analysis of definitive uncultured microbe communities. Their potential role in elucidating the process and mechanisms of cellulose degradation in natural environment from the point of "community system microbiology" is also discussed.
Bacteria ; enzymology ; genetics ; Cellulases ; genetics ; metabolism ; Cellulose ; metabolism ; Cloning, Molecular ; Environmental Microbiology ; Genome, Bacterial ; Metagenomics

BACKGROUNDThe prevalence of lung cancer in the elder increases gradually recently, and lung cancer has become the main cause of cancer-related death. The aim of this study is to analyse the operative indication, complication, perioperative management and surgical measures, results and specificity for lung cancer in the elderly patients.

METHODSOne hundred and thirty-seven elderly patients with lung can-cer, aged from 70 to 83 years old with mean age of 74 were analysed. Of the 137 cases, 13 patients were in the stage I, 76 in stage II, 48 in stage III. Surgical procedures included pneumonectomy for 4 patients, lobectomy for 122 patients, segmentectomy and wedge resection for 7 patients, sleeve lobectomy for 19 patients, bronchoplastic procedure and pulmonary artery reconstruction for 2 patients. Video-assisted thoracic surgery was performed in 13 cases for segmentectomy and wedge excision

RESULTSThere was no operative death. The resection rate was 97.1%, and postoperative complication rate was 29.9%. The follow-up rate was 88.3% . The 1-, 2-, 3-year survival rate was 62%, 35%, 28% respectively.

CONCLUSIONSElderly patients with lung cancer can obtain good therapeutic results and prognosis undergoing surgical therapy, but the operative indications will be limited. Exquisite surgical technique and application of respirator after operation may expand the operative indications.

Objective To explore the effect of sucralfate on cytokines in rats with paraquat (PQ) poisoning. Methods Seventy-two healthy male Sprague-Dawley (SD) rats were randomly divided into PQ model group, sodium bicarbonate intervention group (SB group) and sucralfate suspension gel group (LTL group), with 24 rats in each group. The rat model of PQ poisoning was reproduced by one-time intragastric administration of PQ solution 25 mg/kg. The rats in SB group and LTL group were intragastricly administrated with 5 mL·kg-1·d-1of 100 g/L sodium bicarbonate or 200 g/L sucralfate at 2 hours after exposing to PQ, and the rats in PQ model group were given the same amount of sterile saline. The abdominal aortic blood of rats was collected at 1, 3, 6, and 10 days after PQ poisoning, and the levels of serum tumor necrosis factor-α (TNF-α), interleukin-10 (IL-10) and transforming growth factor-β1 (TGF-β1) were determined by enzyme-linked immunosorbent assay (ELISA). The left lung tissue was harvested, and lung wet/dry weight (W/D) ratio was assessed. Results With prolonged exposure, lung W/D ratios in all the groups were increased gradually, reached the peak at 10 days, but in the SB group and LTL group, the amplitude of increase was obviously reduced, the ratios were significantly decreased at 6 days and 10 days as compared with those in PQ model group (SB group vs. PQ model group: 4.99±0.79 vs. 6.98±0.86 at 6 days, 5.61±0.36 vs. 7.36±0.95 at 10 days; LTL group vs. PQ model group: 4.61±0.24 vs. 6.98±0.86 at 6 days, 4.24±0.20 vs. 7.36±0.95 at 10 days, all P < 0.05), but there was no significant difference between SB group and LTL group (all P > 0.05). After PQ poisoning, the levels of TNF-α, IL-10 and TGF-β1 were elevated, and reached the peak at 3 days and then decreased gradually. Compared with the PQ model group, serum TNF-α, IL-10 and TGF-β1 levels in SB group and LTL group were decreased significantly [SB group vs. PQ model group: 3-day TNF-α (ng/L) was 147.6±12.3 vs. 168.2±11.3, 3-day IL-10 (ng/L) was 65.4±3.2 vs. 115.1±9.2, 3-day TGF-β1 (ng/L) was 356.3±50.3 vs. 415.6±68.3; LTL group vs. PQ model group: 3-day TNF-α (ng/L) was 82.2±7.4 vs. 168.2±11.3, 3-day IL-10 (ng/L) was 44.4±5.2 vs.115.1±9.2, 3-day TGF-β1 (ng/L) was 296.3±40.2 vs. 415.6±68.3, all P < 0.05], especially in LTL group (all P < 0.05). Conclusion Early gastrointestinal lavage with sucralfate could effectively reduce the inflammatory exudation in lung tissue after PQ poisoning, and inhibit the cytokine secretion.

Objective To observe the effects of three doses of dexmedetomidine hydrochloride on stress and myalgia in patients before conventional modified electroconvulsive therapy (MECT).Methods Seventy-nine patients scheduled for the first time of MECT with schizophrenia,depression or mania patients,38 males and 41 females,aged 18-65 years,ASA physical status Ⅰ or Ⅱ,were randomly divided into four groups.The patients received intravenous drip infusion of dexmedetomidine 0.4 μg/kg (group D1,n=20),0.7μg/kg (group D2,n=19),1.0 μg/kg (group D3,n=20) and saline 20 ml (group N,n =20) within 10 min before conventional MECT treatment.The mean arterial pressure (MAP) and heart rate (HR) were recorded before anesthesia (T0),drug pump (dexmedetomidine or saline) after 10 min (T1),30 s after MECT shock (T2) and 5 min after MECT shock (T3);the blood glucose and the concentration of serum cortisol (Cor) were recorded at T0 and T2;visual analogue scores (VAS) 30 min after electric shock (T1) and 6 h after shock (T5),the recovery time,recovery time of spontaneous breathing were also recorded.Results Compared with group N,the concentration of Cor and MAP at T2 were decreased significantly,the HR was increased significantly in groups D1-D3;the blood glucose at T2 were decreased significantly in groups D2,D3 (P＜0.05).The degree in group D3 was larger than that in group D2,and the degree in group D2 was larger than that in group D1 (P＜0.05).Compared with group N,the VAS score at T5 were decreased significantly in groups D1-D3;the recovery time was prolonged significantly in groups D2,D3.The degree in group D3 was larger than that in group D2,and the degree in group D2 was larger than that in group D1 (P＜0.05).The spontaneous breathing recovery time had no difference in three groups.Conclusion Dexmedetomidine pretreatment before modified electroconvulsive therapy can dose-dependently reduce stress response and treatment related myalgia and prolong the recovery time.

Objective To grasp the general situation of patent application and authorization of 77 medical and health institutions in Zhejaing,to provide reference and basis for promoting the patent application and conversion.Methods Patent data were searched through Bai Teng net patent database,and SPSS 19.0 was used for statistical analysis.Results The total number of patent application showed a trend of generally rise.There were 1430 valid invention patents in total,among which 264 were invention patents and 1166 utility model patents.The total number of patens as well as invention patents were positive correlated to province GDP GDP and doctors per thousand population (r=0.824,0.812,0.784,0.771 respectively,P＜0.001).The rate of collaborative patent application was 6.28％,and there was a significant difference (α=0.05/3,P＜0.001) in the collaborative patent applications around Hangzhou,provincial and other cities medical and health institutions.Conclusions The total number of patents in 77 medical and health institutions in Zhejaing has reached a certain scale,and the number of patents increase with the economic development and the number of doctors per thousand population.The effective patents present in concentrating in regions,and the proportion of invention patents was low.