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.

Objective To study the expression and value of CXCR1 and CXCR2 on neutrophils, CD14~+ monocytes and CD3~+ T lymphocytes of peripberol blood of ankylosing spondylitis(AS)patients and to investigate the correlation between CXCR1,CXCR2 and disease activity.Methods A case control study was designed and enrolled 30 active AS,30 active rheumatoid arthritis(RA)and 30 healthy controls.The levels of CXCR1 and CXCR2 expression on neutrophils,CD3~+ T cells and CD14~+ monocytes of peripheral blood of the patients and healthy controls enrolled were measured and analyzed by flow cytometry by measuring the mean fluorescence intensity(MFI)channel.The correlations between the level of CXCR1 and CXCR2 anti disease activity or functional index of AS such as BASDAI,BASF1,ESR and CRP were analyzed.Results The MFI of CXCR1 expression on CD3~+ T lymphocytes of peripheral blood was significantly higher in AS patients (41?24)than that in RA patients(18?10)and healthy controls(19?7)(P

Child ; Humans ; Sleep Wake Disorders ; diagnosis ; etiology ; Tourette Syndrome ; complications

The new intein-mediated PHB purify protein system is a high expression, automatic cutting, for purification, low-cost protein purification system,it is conducive to large-scale protein purification.Choose human antibacterial peptide LL-37 as the purification objects,which is poison to prokaryotic cell.We construct intein-mediated PHB purified human antimicrobial peptide LL-37 system through genetic engineering technology and use this system to purify LL-37. The results show that this system can highly express LL-37 fusion protein and purifiy the product as same size with expectations.

Objective To study the effects of nuclear factor-?B(NF-?B)decoy oligodeoxynucleotide(ODN)on the preeclamptic umbilical serum induced expression of precollagen Ⅰ,Ⅲ mRNA and tumor necrosis factor-?(TNF-?)in cultured human umbilical artery smooth muscle cells (HUASMC).Methods Primary cultured HUASMC of normal pregnancy were divided into four groups: group A(HUASMC were incubated with umbilical serum of normal pregnancy);group B(HUASMC were incubated with umbilical serum of preeclampsia);group C(HUASMC were transfected with NF-?B cis decoy ODN 48 h before incubation with umbilical serum of preeclampsia);group D(HUASMC were transfected with NF-?B scramble ODN 24 h before incubation with umbilical serum of preeclampsia).NF-?B cis decoy ODN and NF-?B scramble ODN were transfected with cationic lipofectamine to the latter two groups,respectively.The proliferation of human umbilical artery smooth muscle cells was evaluated by methyl thiazolyl tetrazolium and the apoptosis was analyzed by flow cytometry.The expression levels of precollagen Ⅰ,Ⅲ mRNA were detected by RT-PCR,the expression levels of TNF-? were detected by western blot.Results(1)The proliferation of group B(0.19?0.02)and group D(0.18?0.03)was significantly increased as compared with those of group A(0.11?0.02)and group C(0.14?20.02)(P0.05).(5)The expression of TNF-? of group B(0.74?0.11),group C(0.36?0.09)and group D(0.79?0.12)were significantly higher than that of group A(0.15?0.03)(P0.05).Conclusions NF-?B cis decoy ODN could down-regulate the proliferation,as well as the expression levels of precollagen and TNF-? of HUASMC induced by umbilical serum of preeclampsia.NF-?B may play an important role in the pathogenesis of placental artery abnormalities in preeclampsia.

Objective:To explore the predictive value of relevant hemodynemics indexes on cardiac shock prognosis by PiCCO technology.
Methods:A total of 54 consecutive patients with cardiac shock treated in our hospital from 2012-01 to 2013-05 were studied. The patients’ general information with hempdynemics indexes as cardiac index (CI), extra vascular lung water index (EVWI), general ejection fraction (GEF), general end diastolic index (GEDI), systolic vascular resistance index (SVRI) were monitored by PiCCO technology at before and 48 hours after treatment. Based on 28 days surviving condition, the patients were divided into 2 groups:Survival group, n=28 and Death group, n=26. The levels of above indexes were compared between 2 groups and their predictive values on cardiac shock prognosis were calculated by ROC curve analysis.
Results:Compared with Death group, Survival group presented much higher CI, GEF and much lower EVWI, SVRI at before and 48 hours after treatment, P<0.05-0.01, while GEDI was similar between 2 groups, P>0.05. With 48 hours treatment, the ROC analysis showed AUCEVWI=0.846 with cut-off point at 7.5ml/kg, AUCCI=0.884 with cut-off point at 3.46 L/(min·m2) and AUCGEF=0.853 with cut-off point at 16.5%;the sensitivity and speciifcity of EVWI, CI, GEF were 79.2%and 81.0%, 82.8%and 83.0%, 74.1%and 88.7%respectively. Multivariate Logistic regression analysis indicated that CI and EVWI were the independent predictors for cardiac shock prognosis.
Conclusion:PiCCO monitoring technology may guide the balance of relevant hempdynemics indexes in patients with cardiac shock. With 48 hours treatment, the levels of CI and EVWI had predictive value for cardiac shock prognosis.

Objective To investigate the distribution of HLA-B27 subtypes in ankylosing spondylitis(AS) patients of Chinese Han population by using the updated HLA-B27 typing data. Methods One hundred AS subjects were randomly selected from spondyloarthritis patients data bank of the third affiliated hospital of Sun Yat-sen university. All subjects were independent individuals, and the duplicated samples in the same family were excluded. Salt fraction method was used to prepare genome DNA. Luminex liquid array combining PCR-SSOP was used to perform the low resolution HLA-B genotyping. PCR-SSP was applied to perform the high resolution HLA-B27 typing for HLA-B27 positive subjects. Results Ninety-eight independent AS patients were recruited randomily, of which, 93 were HLA-B27 positive, with positive rate 94.9%, and covered 96% patients with family history of AS. Three subtypes were detected in this population including B * 2704 (n=76, 81.7%), B * 2705 (n=12, 12.9%) and B * 2715 (n=5, 5.4%). Compared with the two reports about HLA-B27 subtype distribution in healthy HLA-B27 positive Han population there was no significant difference between AS patients and healthy controls. But no B * 2715 case was found in those two reports of healthy population. Three reports (including 1 report in Chinese) could found about B * 2715 subtype, but all positive cases were oriental people. Furthermore, all B * 2715 positive patients were AS patients. Conclusion B * 2704 is the predominant subtype ,in AS patients of Chinese Han population, and followed by B * 2705. We found five cases with positive B * 2715, a considerable rare allele. This may suggest association between B * 2715 and AS.

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 investigate the value of inflammatory biomarkers such as procalcitonin (PCT),C-reactive protein (CRP),and endotoxin in early diagnosis of bacteriemia patients infected with gram-negative bacteria.Methods A cohort of 79 bacteriemia patients infected with gram-negative bacteria admitted from February 2011 to May 2013 were enrolled for retrospective study.Collected data for analysis included gender,age,disease severity (APACHE Ⅱ score),bacterial isolates from blood culture and other general information.The inflammatory biomarkers such as white blood cell (WBC),neutrophils (NEU),Creactive protein (CRP),procalcitonin (PCT),and endotoxin were assayed within 6 hours after admission.SPSS version 16.0 software was used for statistical analysis.The test of normality was used for analysis of continuous variables,t-test for inter-group comparison and non-parametric statistics for non-normal distribution variables.The AUC of ROC was calculated for determining the sensitivity and specificity of biomarkers for diagnosis of bacteriemia.Results (1) Statistically positive correlations were found among serum PCT,CRP,and endotoxin levels (PCT/CRP =0.916,PCT/endotoxin =0.496,Endotoxin/CRP =0.387),and between those and APACHE Ⅱ score were (PCT/APACHE Ⅱ =0.505,Endotoxin/APACHE Ⅱ =0.467,CRP/APACHE Ⅱ =0.278),respectively,in bacteriemia patients infected with gram-negative bacteria.(2) The receiver operating characteristic (ROC) curve indicated that AUC PCT =0.715 (sen 64.6％,spe 80.7％),AUC CRP =0.666 (sen 67.7％,spe 78.6％),AUC endotoxin =0.771 (sen 78.8％,spe 81.8％) in gram-negative bacteria bloodstream infection patients.(3) The AUC PCT =0.865 (sen 86.2％,spe 77.5％),AUC CRP =0.733 (sen 72.4％,spe 75.0％),AUCendotoxin =0.618 (sen 70.7％,spe 67.5％) in bacteriemia patients infected with gram-negative bacteria in severe sepsis and septic shock group.Conclusions The plasma PCT,CRP,and endotoxin have early predictive value in bacteriemia patients infected with Gram-negative bacteria.In sepsis stage,the level of serum endotoxin has the most significant value for diagnosis.In severe sepsis and septic shock stages,the PCT is the most value for diagnosis of bacteriemia.All biomarkers are positively correlated with severity of the disease.

Objective To investigate the medical assistance to inpatients from low-income families for solving their difficulties in seeing doctors and affordability.Methods Random sampling was made to five ongoing medical assistance projects in the hospital for statistics and analysis of the data so collected.Results Medical expenses of such inpatients are beyond their affordability.Despite the coverage of their basic medical insurance,the reimbursement rate is too low to alleviate their financial burden.Conclusion A“4-party payment”model is recommended,combining the government support for basic medical insurance,social welfare assistance,philanthropic assistance and that paid by the inpatients.This model is expected to effectively alleviate the financial burden of such inpatients.