The host protein SAMHD1 has been identified as the first mammalian deoxynucleoside triphosphate triphosphohydrolase (dNTPase), which blocks the infection of HIV-1 in non-cycling immune cells.SAMHD1 protein is highly expressed in human myeloid-lineage cells and resting CD4+T lymphocytes, which restricts HIV-1 replication by hydrolyzing the cellular dNTPs, thus inhibiting reverse transcription and viral complementary DNA ( cDNA) synthesis. Recent studies have revealed that SAMHD 1 plays an important role in virus whole life by promoting HIV -1 genome recombination, degenerating viral genome RNA and restricting virus transmission between cells .In this review, these progress on SAMHD1 research are summarized and the mechanisms by which SAMHD 1 mediates retroviral restriction are analyzed .

Objective To determine the efficacy of coronary artery bypass grafting (CABG) in children with coronary obstructive disease subsequent to Kawasaki disease. Methods Between Feb 2005 and Sep 2009, 6 children with ischemic heart disease due to Kawasaki disease comprised the study group. The age of patients at operation was ranged from 6 to 12 years with a mean of ( 8.0 ± 2.3 ) years. The preoperative EF was ranged from 0.33 to 0.71 with a mean of 0.57 ± 0.15. There was one case with moderate mitral valve regurgitation. Results All patients survived the procedures. The mean number of bypass graft was 2.0 ±0.6,with 4 internal thoracic arteries and 7 radial arteries. Mitral valve repair was employed in 1 case. The cardisc function ( NYHA and EF) was significantly improved postoperatively. Postoperative CTA showed no graft disease in all cases. Conclusion CABG using the arterial grafts can provide attractive mid-term results in patients with obstructive coronary arteries associated with Kawasaki disease.

Objective The aim of this study is to review the experience of using non-transplantation procedure treating ischemic heart disease. Methods Between Jan of 2000 and Jan of 2008, 74 patients with ischemic heart disease comprised the study group, including 66 males and 8 females. The age of the group ranged from 36-79 years, mean 63.3 ±9.28years. The patients underwent non-transplantation procedure according to the preoperative tests. To evaluate the aimed vessels and the survival myocardial viability, coronary angiography, echocardiography, radioisotope scanning and dobutamine-stress echo-test were used. The cardiac function data were analyzed before and after operation. Results Seventy-one cases underwent coronary artery bypass [mean (3.26 ± 1.14) grafts/case], containing 54 arterial grafts and 177 veinuos grafts. The mechanical assistance was applied in 51 cases including 1ABP 50 cases(67.6% ), IABP and ECMO 1 case(1.4%). Postoperative complication contained re-thoracotomy for bleeding 1 case ( 1.4% ), wound infection 3 cases (4.1%), renal dysfunction 3 cases(4.1%), low cardiac output 11 cases(14.9 %). The in-hospital mortality was 10.8% ( 8 cases ). The follow-up time ranged from 17 to 107 months, mean (47.47±24.51 ) months. The follow-up mortality rate was 3.0%. The re-hospitalization for cardiovascular events taken place in 6 cases(9.1% ). The cardiac function improved postoperatively. EF increased from preoperative 0.33 to postoperative 0.47. The diameter of the left ventricular decreased markedly. The left ventricular end-systolic diamension decreased from preoperative 47.6 mm to postoperative 43.4 mm. Conclusion Selected patients with ischemic heart disease, potentially eligible for transplantation, can be managed by the non-transplantation surgery. In those patients post-operative quality of life is satisfactory, with comparable survival and low risk of re-hospitalization.

Objective To evaluate the clinical application and midterm result of mitral valve repair with multiple techniques for patients with complex mitral valve regurgitation. Methods From January, 2000 to July, 2006, 34 patients with complex mitral regurgitation, including 24 males and 10 females, aged 23 - 65 years [ average (42.8 ± 11.7) years ], comprised the study group. The data of the cardiac function (NYHA/EF), the diameter of left ventricular, left atria and the degree of mitral regurgitation were analyzed before and after operation. Results There was no mortality or major morbidity or reoporatien. Patients were followed up from 1 to 54 months [ average (31.2 ± 19.4) months]. The degree of mitral valve regurgitation decreased significantly after operation. The mean degree of pre-operatien mitral regurgitation was 3.62 ± 0.49, and follow-up degree was 1.18 ± 0.99 ( P ＜ 0.05) respectively.The diameters of left ventricular and left atria reduced. The postoperative cardiac function improved apparently. EF increased from 0.55 ± 0.11 preoperatively to 0.57 ± 0.10 postoperatively ( P = 0.06). Conclusion The comprehensive application of multiple techniques in repairing complex mitral valve regurgitation may be effective, and with a satisfying midterm results.

Objective:To investigate the door-to-balloon (D2B) time and its influencing factors for Percutaneous Coronary Intervention (PCI) in patients with acute ST-segment elevation myocardial infarction (STEMI).Methods:180 cases of patients with STEMI in our hospital from January 2014 to April 2016 were selected.PCI therapy were operated on all patients after their consent.The pre-hospital delay time and D2B time of the patients were recorded.The related information of the patients,including demographic data,clinical factors,background of the disease and psychological factors,were investigated by the questionnaire survey.The patients were divided into short D2B group (D2B time≤ 126 min,n=96) and long D2B group (D2B time＞126 min,n=84).Univariate and multivariate logistic regression methods were used to analyze the influencing factors of D2B time.Results:The median D2B time of all the patients was 126 min,and only 26.7％ of patients' D2B time controlled within 90 min.Univariate analysis showed that differences of sudden attack,pay attention to symptoms,someone was present when attack,symptoms progress was fast,in hospital during holiday,no symptom in CCU,outpatient treatment,transfered by emergency medical service system (EMSS),time in CCU (6 am-10 pm),angina before infarction and pre-hospital delay time between the two groups were statistically significant (P＜0.05).Multivariate logistic regression analysis showed that in hospital during holiday,outpatient service,no symptom in CCU,pay attention to symptoms,use of transfered by EMSS,time in CCU (6am-10pm) are the factors affecting the time of D2B (OR=2.62,2.04,1.59,0.52,0.28,0.61 P＜0.05).Conclusion:The D2B time of most patients with STEMI can not reach the guidelines.The factors of patients,doctors,accepting mechanism of hospital are all related with D2B time.

Objective To evaluate the effects of different methods of administration on clinical pharmacodynamics of cisatracurium during liver transplantation.Methods Twenty-four ASA physical status Ⅲ patients of both sexes,aged 18-63 yr,weighing 60-88 kg,with body mass index of 20-30 kg/m2,scheduled for elective liver transplantation,were randomly divided into 2 groups (n =12 each):continuous infusion group (group C) and intermittent bolus injection group (group Ⅰ).The total intravenous anesthesia was used during surgery.When T1 recovered to 10％ of control height after induction of anesthesia,continuous infusion of cisatracurium was started with an initial rate of 1.5 μg· kg-1 · min-1,and the infusion rate was manually adjusted to maintain T1 at about 10％ in group C,and intermittent iv boluses of cisatracurium 0.03 mg/kg were given to maintain T1 ≤ 10％ in group Ⅰ.The use of muscle relaxants was stopped immediately after peritoneum closure.The consumption of cisatracurium per minute,time for T1 to recover from 10％ to 25％,recovery index and time for recovery of spontaneous breathing after surgery were recorded.Results Compared with group Ⅰ,the consumption of cisatracurium per minute was significantly reduced and the time for recovery of spontaneous breathing after surgery was shortened (P ＜ 0.05),and no significant changes were found in the time for T1 to recover from 10％ to 25％ and recovery index in group C (P ＞ 0.05).Conclusion Compared with intermittent bolus injection,continuous infusion of cisatracurium during liver transplantation is helpful in improving the clinical potency of the muscle relaxant and in reducing the occurrence of complications during anesthesia recovery period.

Objective To investigate the efficacy of esomeprazole (Esomeprazole) and flupentixol and melitracen (Deanxit) in treatment of non-erosive gastroesophageal reflux disease (NERD) with depression and anxiety.Methods The diagnosis of NERD was based on the results of esorneprazole scale (reflux diagnostic ques- tionnaires,RDQ) and endoscopy,the degree and frequency of symptoms were graded and scored.Hamilton de- pression scale was used to evaluate depression and anxiety status.Sixty-three patients were randomly divided into group A (esomeprazole 20 mg qd),B (Deanxit 1 tab qd),C (esomeprazole 20 mg qd and Deanxit 1 tab qd) with each group 21 patients,and treated for four weeks.The efficacy was evaluated by the symptom scores.Results There were some effects of esomeprazole or Deanxit alone on the improvement of symptoms of NERD.Although the effect of Deanxit was not as good as esomeprazole,there was not difference for relieving heartburn and sub- sternal pain between two groups in time point of each week after treatment (P＞0.05).esomeprazole was better for relieving acid regurgitation than Deanxit (P＜0.01).Combined treatment of esomeprazole with Deanxit was better and faster for relieving the symptoms of NERD than esomeprazole or Deanxit alone (relieving rate 81% in group C,23.8% in group A and 14.3% in group B,P＜0.01).The total efficacy rate of group C (100%) was higher than that of group A (80.9%) or group B (61.9%,P＜0.01),but there were not difference of relieving rate and total efficacy rate between group A and B (P＞0.05).Conclusions There was better efficacy of com- bined treatment of esomeprazole and low-dose Deanxit in treating NERD with depression and anxiety.These re- sults suggest that depression and anxiety have some effects on the pathogenesis and progress of NERD.

Objective Wegener's granulomatosis is a rare multisystem vasculitis of unknown aetiology. The clinical features of the disease,the treatment and long-term follow-up is observed in this study.Methods Eleven WG patients were from Rheumatology Department of Guangdong Province People's Hospital between 1999—2005.Data were obtained retrospectively.The patients' clinical manifestation and laboratory results were studied.Results All patients had upper and lower respiratory tracts involvement.The upper respiratory tract(nose,sinus,throat,trachea,and middle ear)-(E)lung(L),and kidneys(K)were the most commonly in- volved organs.The majority of patient received i.v.puls methylprednisolone 0.5 g/d?3 d,followed by oral pred- nisone 1 mg.kg~(-1).d~(-1)and i.v.pulses of cyclophosphamide 750 mg/m~2.The long-term outcome was good. Conclusion Wegner's granulomatosis is a systemic vasculitis occurring in patients with histopathologic mani- festation of necrotizing vasculitis with granuloma formation.Corticosteroid and immunosuppressive treatment may achieve good outcome.

ObjectiveTo explore the relationship between the weight-bearing of affected side and the functional mobility in stroke patients.Methods36 hemiparetic stroke patients participated in this study. They were asked to measure the ration of the weight-bearing of affected side on the undisturbed and maximum situations, as well as the time for Timed "Up and Go" Test (TUGT) and Sit-to-Stand Test. The correlation between the ration of the weight-bearing of affected side on maximum situations and the time for the TUGT and Sit-to-Stand Test were analysed statistically with Spearman's correlation in those stroke patients whose ration of the weight-bearing of affected side on undisturbed situations was less than 50%.ResultsThere were correlation between the ration of the weight-baring of affected side on maximum situations and the time for the TUGT (r=-0.605, P<0.01) and the time for the Sit-to-Stand Test (r=-0.456, P<0.05).ConclusionA good relationship exists between the weight-bearing of affected side and the functional mobility in stroke patients.

Objective To investigate the diagnosis and treatment methods of traumatic renal infarction.Methods A retrospective analysis was performed on 6 cases of traumatic renal infarction treated between September 2008 and February 2013.There were 5 males and 1 female,at age of 5-65 years (average,36.2 years).Causes of injury included vehicle collisions in 4 cases and high falls in 2.Out of 6 cases,segmental renal infarction was identified in 2 and total infarction in 4.According to American Association for the surgery of trauma renal trauma grading system,2 cases were classified to grade Ⅳ and 4 to grade Ⅴ.Results Three cases were managed conservatively,which showed segmental infarction in 1 case and total infarction in 2.Three cases underwent surgical exploration,followed by partial nephrectomy in 1 case,left kidney removal plus partial pancreectomy in 1 and right kidney removal in 1.There were no major complications intraoperatively or postoperatively and no cases received blood transfusion.Period of follow-up was 3-34 months.In conservative management,there were no renal atrophies in segmental renal infarction cases and some degree of atrophies in total renal infarction cases,but none presented with arterial hypertension.Conclusions Enhanced CT is the preferred diagnostic tool for evaluation of traumatic renal infarction.Conservative therapy is the optimal option for most cases,but nephrectomy is reserved for cases of infection or renal hypertension.