Despite the fact that the patency rate of saphenous vein graft(SVG) is less than those of arterial grafts,SVG is fully appreciated by cardiac surgeons and remains the most widely-used conduit for coronary artery bypass grafting(CABG).Recently,thanks to the growing understanding of the pathogenesis of vein graft failure(VGF),the emergence of new drugs and the improvement of surgical techniques,the patency rate of SVG has been well improved.This article reviews the history and the current understanding of SVG,the pathogenesis of VGF,the clinical strategies that may improve the patency rate and the research prospects in this filed.

AIM: To investigate the effects of low-dose paclitaxel on the morphology of bladder after partial bladder outlet obstruction ( BOO) in rats.METHODS:Healthy female Sprague-Dawley rats ( n=30) were randomly di-vided into sham operation group, BOO group and low-dose paclitaxel group.The rats in BOO group and low-dose paclitaxel group received operation to establish an obstruction model, while the rats in sham group underwent sham operation.After operation, the rats in low-dose paclitaxel group received intraperitoneal injection of paclitaxel at a dose of 0.3 mg/kg twice a week for 4 weeks.At the same time, the animals in sham group and BOO group received the same volume of saline by in-traperitoneal injection.Four weeks after operation, each rat was sedated and the bladder was weighted.Histological chan-ges of the bladder were observed by HE staining.Collagen deposition in the bladder tissue was observed by Masson stai-ning, and the fibrosis area was measured.The ultrastructure of the detrusor was studied by transmission electron microsco-py.RESULTS:Compared with sham operation group, a significant increase in bladder weight (0.376 g ±0.052 g vs 0.112 g ±0.014 g, P<0.05), the muscle hypertrophy, and a decrease in the percentage of collagen area [collagen/(col-lagen+muscle), 29.66%±2.69%vs 38.94%±3.67%, P<0.05] was observed in BOO group.Under electron micro-scope, intracellular connection had more gap junction and desmosomes than intermediate junction.The cell gap widened with a large amount of collagen fiber.Compared with BOO group, low-dose paclitaxel group decreased bladder weight (0.215 g ±0.025 g vs 0.376 g ±0.052 g, P<0.05) and improved the muscle hypertrophy.The percentage of the colla-gen area was also decreased (19.94%±1.90% vs 29.66%±2.69%, P<0.05).The detrusor microstructure showed that the intermediate junction was characterized by a predominance among the intracellular connections, and the intercellu-lar space contained less collagen fibers in low-dose paclitaxel group.CONCLUSION:Low-dose paclitaxel may ameliorate the morphological damage of the bladder and recover bladder function in the rats with BOO by slowing down the process of bladder fibrosis.

Objective To study angiography characteristics of myocardial infarction complicated with type 2 diabetes mellitus(DM). Methods A total of 389 cases confirmed by coronary angiography were divided into two groups according to the status if they had combined with DM(166 patients) or not(223 patients). Results The DM patients suffered more from hypertension than without DM patients(P

Objective: To investigate the incidence density of adult sleep disorders (SD) in Yinzhou District, Ningbo City, Zhejiang Province from 2017 to 2023, so as to provide insights into formulating the control measures of SD. Methods: The electronic health records of permanent residents aged 18 years and over in Yinzhou District from 2017 to 2023 were collected through the Yinzhou Regional Health Information Platform. New cases of SD were diagnosed for the first time a year after establishing health records. The incidence density was estimated using Poisson distribution. The temporal, population and regional distribution characteristics of new cases of SD were analyzed using a descriptively epidemiological method. Results: From 2017 to 2023, there were 1 255 129 permanent residents aged 18 years and over in Yinzhou District, with a total observed person-time of 6 292 884 person-years and a median of 5.67 (interquartile range, 3.74) person-years. There were 165 490 new cases of SD, including 67 095 males (40.54%) and 98 385 females (59.46%). The incidence density of SD in Yinzhou District from 2017 to 2023 was 26.30/1 000 person-years, with no significant trend observed (P>0.05). The incidence density of SD was higher in females than in males (29.63/1 000 person-years vs. 22.57/1 000 person-years, P<0.05). The highest incidence density of SD was observed in individuals aged 70 to <80 years (63.30/1 000 person-years), and the lowest was in individuals aged 18 to <30 years (7.24/1 000 person-years). The incidence density of SD in individuals aged 30 years and over was higher than that in individuals aged 18 to <30 years (all P<0.05). The incidence density of SD was 32.03/1 000 person-years in individuals with junior high school education or below, which was higher than individuals with senior high school/technical secondary school education (25.93/1 000 person-years) and college degree and above (18.87/1 000 person-years, all P<0.05). Dongliu Street, Dongjiao Street, and Baihe Street had relatively higher incidence densities of SD, at 45.11/1 000 person-years, 42.87/1 000 person-years and 40.16/1 000 person-years, respectively. Conclusions From 2017 to 2023, there was no significant trend in the incidence density of SD in Yinzhou District. Higher incidence density were observed in females, the elderly, and individuals living in central urban areas.

AIM: To investigate whether homocysteine (Hcy) has influences on endothelial progenitor cell (EPCs) number and activity from peripheral blood. METHODS: Total mononuclear cells (MNCs) were plated on fibronectin-coated culture dishes and cultured for 7 days, and then attached cells were stimulated with Hcy or vehicle control for 6 h, 12 h, 24 h and 48 h. The adhesion, proliferation, migration and in vitro vasculogenesis activity of EPCs were assayed, respectively. RESULTS: Incubation of isolated human MNCs with Hcy dose and time-dependently decreased the number of EPCs with maximum at 200 (?mol/L) for 24 hours (35.7?6.7 vs 62.5?10.6, P

Objective To detect time-dependent change of neuritin expression in brain tissues after traumatic brain injury and discuss the effect of neuritin after brain damage occurred. Methods Forty-two rats were divided into normal group, control and experimental group. According to the postoperative time divided into 6 subgroups, including 6 hours group, 12 hours group, 24 hours group, 3 days group, 7 days group and 14 days group. Immunohistochemical and western-blot were used to detected the protein expression levels of neuritin. Results The immunohistochemical staining indicated that the positive expression of neuritin was strong in the cytomembrane and cytoplasms of the neurons, with a higher intensity, 6 hours after the operation. 12 hours after the operation last to the seventh day, the neurons with the strongest positive expression, is significantly higher than control group and normal group, significant decrease on the fourteenth day. The result of western-blot indicated that the level of neuritin protein sharply increased at 6 hours, reached the peak on 24 hours and after lasted to the seventh day, significantly higher than control group and normal group (P < 0.01), significant decrease on the fourteenth day (P < 0.05). Conclusion Up-regulation of neuritin in cerebral contusion tissues may play an important role after traumatic brain injury.

BACKGROUND:Schwann cells are important celllines in the process of repairing peripheral nerve injury, and human amniotic homogenate supernatant is shown to secrete a variety of cytokines, which could promote the proliferation of Schwann cells.
OBJECTIVE:To investigate the effect of different concentrations of human amniotic homogenate supernatant on the proliferation of rat Schwann cell96.
METHODS:Schwann cell96 was cultured with high-glucose DMEM containing 20%fetal bovine serum, and the second generation of Schwann cell96 was applied for experiments. The cultured cells were divided into five groups according to different volume fractions of human amniotic homogenate supernatant (0%, 10%, 15%, 20%, 25%) in the medium.
RESULTS AND CONCLUSION:The total protein concentration of human amniotic homogenate supernatant was 675μg/mL, in which the concentration of epidermal growth factor, basic fibroblast growth factor and vascular endothelial growth factor were respectively (470.625±2.546), (4.121±0.026) and (0.172±0.002) ng/L. At 1-7 days, the cellproliferation rate of the 10%and 15%concentration groups was greater than that in 20%and 25%concentration groups (P<0.05);10%and 15%concentrations promoted cellproliferation, while 20%and 25%concentrations inhibited cellproliferation. There were no significant difference in the viability of Schwann cell96 between the control group and the experimental group (P>0.05). Low concentrations (10%, 15%) of human amniotic homogenate supernatant promote the proliferation of Schwann cell96, while high concentrations (20%, 25%) of human amniotic homogenate supernatant inhibit cellproliferation.

Objective: To investigate the rationale for appropriate diagnostic methods and treatment protocols for unexpected gallbladder carcinoma(UGC). Methods: The clinical and pathological data of 45 patients with UGC admitted at Department of General Surgery, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine,from January 2008 to December 2017 were retrospectively collected and analyzed.There were 11 males(28.9%) and 34 females(71.1%),aged 68 years(range:27 to 68 years).And there were 20 cases who aged above 70 years. Twenty-four cases were diagnosed preoperatively as cholecystolithiasis plus chronic cholecystitis.Ten cases were diagnosed preoperatively as cholecystolithiasis plus actue cholecystitis.Six cases were diagnosed preoperatively as cholecystolithiasis plus choledocholith.Six cases were admitted because of gallbladder polyp and 1 case was admitted because of gallbladder adenomyomatosis. Results: Thirty-four patients with UGC received radical surgery.Among them,11 patients experienced postoperative complication and no posterative mortality occoured during hospital stay.Thirteen patients were diagnosed with T1b UGC, the harvested lymph node of Nx, N0, N1 and N2 was 2, 9, 1 and 1, respectively.In addition, 2 cases were identified to have local-regional tumor recurrence during our rescue radical surgery.The median overall survival time of the patients who did not receive radical surgery was 7 months(range:2-56 months).Nevertheless,the median overall survival time for patients diagnosed with T1, T2 and T3 tumors who received radical surgery, was 41 months(range: 19-82 months), 33.5 months(range: 31-36 months) and 17 months(range: 7-46 months), respectively. Conclusions For patients with UGC, rescue radical surgery can achieve a better survival time.Furhtermore, our experience proved that rescue radical surgery for UGC is safe and feasible.Therefore,rescue radical surgery should be performed in patients with diagnose with UGC especially those T1b patients.

The selection of conduit has always been one of the most perennially debated topic in the field of coronary artery bypass grafting (CABG) . Arterial grafts have demonstrated excellent biological characteristics and long-term patency in CABG. Clinical observations and randomized clinical trials over the past two decades have shown that the internal thoracic artery is the gold standard graft. Multi-arterial and total-arterial CABG significantly improves patients′ long-term survival, but there are technical challenges and concerns of sternal complication. Currently multi-arterial and total-arterial CABG are strongly advocated and increasingly applied worldwide. Several guidelines have been published and updated, as well as Chinese expert consensus. Coronary surgery in China is paving anupper stage of quality improvement. Arterial coronary artery bypass grafting should be carried out more broadly in China as evidence accumulation and excellent long-term clinical results.

The selection of conduit has always been one of the most perennially debated topic in the field of coronary artery bypass grafting (CABG) . Arterial grafts have demonstrated excellent biological characteristics and long-term patency in CABG. Clinical observations and randomized clinical trials over the past two decades have shown that the internal thoracic artery is the gold standard graft. Multi-arterial and total-arterial CABG significantly improves patients′ long-term survival, but there are technical challenges and concerns of sternal complication. Currently multi-arterial and total-arterial CABG are strongly advocated and increasingly applied worldwide. Several guidelines have been published and updated, as well as Chinese expert consensus. Coronary surgery in China is paving anupper stage of quality improvement. Arterial coronary artery bypass grafting should be carried out more broadly in China as evidence accumulation and excellent long-term clinical results.