Objective To retrospectively review clinical results of combined coronary artery bypass grafting (CABG) and other heart surgical procedures.Methods Combined CABG and other heart surgical procedures have been done in 134 consecutive cases (male 114, female 20), aged from 48 to 76 years with a mean of 61.7. Coronary angiograph showed that all patients have coronary stenosis with left main involved in 20 cases, and 41 cases have diffused coronary artery disease. 56 patients have post myocardial infarction left ventrical aneurysms, and 42 patients have valve dysfunction which need surgical correction. Left ventricular ejection fraction (EF) were equal to or lower than 45% in 63 patients and in 13 patients EF is less than 30%. All the patients received combined CABG under the support of cardiopulmonary bypass (CPB) and other heart surgical procedures (Transmyocardial laser revascularization in 36, valve procedures in 42, and left ventricle aneurysm resection or plasty in 56 patients simultaneously). Results The mean number of grafts was 2.46 per patient. Intra-aortic balloon pump was required in 6 cases for 11 to 54 hours Postoperative. 3 patients died postoperatively with mortality rate 2.2% (two from low cardiac output syndrome, and one from multiple organs failure). 131 patients recovered and discharged.Conclusion Combined CABG and other heart surgical procedures in more demanding than CABG along but can be done with acceptable morbidity and mortality if good surgical plan can be designed and all the heart abnormalities can be corrected simultaneously.

BACKGROUND:Muscle transposition is a conventional method to treat muscle tissue defects,but it results in damage to another piece of muscle.For this reason,we designed this study to search for a method to in situ repair muscle tissue defects.OBJECTIVE:To investigate the conditions for in vitro induced differentiation of rat bone marrow mesenchymal stem calls(BMSCs)into skeletal muscle cells.METHODS:Following isolation and culture,passage 3 BMSCs were induced to differentiate in vitro by a combination of5-azacytidine,myogenic differentiation factor,transforming growth factor β1,and insulin like growth factor.At 9 days after induction,cells were harvested and identified by immunohistochemistry.RESULTS AND CONCLUSION:Primary cultured BMSCs exhibited an adherent,colony-like growth.After 5-7 days,multi-synaptic calls,thin and fiat polygonal cells,polygonal cells,and triangle-shaped cells were observed.After 12 days,calls confluenced and covered the whole bottom of culture flask,with slightly altered morphology of BMSCs.After 5-azacytidine induction,some calls died and grew slowly.After 7 days,cells markedly grew and soma was gradually enlarged,presenting with an oval,spindle-shaped,or irregular appearance.After 14 days,spindle-shaped calls become more.After 18-22 days,myotubes were increased in number and enlarged in volume,and myotube nucleuses were also increased.The newly formed myotubes and spindle-shaped fibroblasts were distributed in parallel interval.The immunohistochemistry of BMSCs revealed that cells were positive for CD44,with dark brown granules in the cytoplasm,especially around the nucleus,but they were negative for CD34.The immunohistochemistry of induced BMSCs demonstrated that calls were positive for desmin and skeletal muscle myosins.These findings indicate that myogenic differentiation factors and 5-azacytidine could induce the oriented differentiation of BMSCs into skeletal cells,with the presence of positive expression of desmin and skeletal muscle myosins.

Objective:To study the effect of totally endoscopic surgery and Miccoli surgery for papillary thyroid microcarcinoma. Methods Totally 64 patients with papillary thyroid microcarcinoma from April 2013 to April 2014 in our hospital were divided into the ob-servation group and the control group according to a random number table.And the intraoperative and postoperative situation of the two groups were compared.Results The number of lymph node dissection,postoperative hospital stay,hospital costs of the two groups had no sig-nificant difference (P >0.05).The blood loss,operative time,drainage time,amount of drainage,incision length,time of postoperative recov-ery of the observation group were significantly less than those of the control group with statistical significance (P <0.05).But the cosmetic score of observation group after operation was lower than that of the control group,and there was a significant difference (P <0.05).Postop-erative pain grade of the observation group was better than the control group with statistical significance (P <0.05).The complication rate of control group was significantly higher than the observation group (P <0.05).Conclusion Miccoli surgery for papillary thyroid microcarci-noma has more advantages compared with totally endoscopic surgery in terms of blood loss,operative time,drainage time,amount of drainage, incision length,time of postoperative recovery,and degree of pain.Moreover,it has a lower complication rate and high security,which should be the first choice in clinic surgery.

Objective To investigate the clinical effect of proximal femoral nail anti-rotation (PFNA) on femoral intertrochanteric fracture in the elderly.Methods Eighty-seven elderly patients from June 2007 to March 2012,who had femoral intertrochanter fracture and received treatment of PFNA,were enrolled in this study.Patients were comprised by forty seven people with stable fracture and forty people with unstable fracture.Results They were all followed up from 4.5months to 14 months,with the average time of 7.2 months.No death were found in hospital.The operation time was 25 min in average.During operation,losing blood was 80 ml.Ambulation time was 5.5 d,and the fracture healing time was 22 weeks in average.However,there were significant differences in intraoperative resetpostoperative position of the blade between the stable and unstable fracture patients (P＜0.01).Conclusions PFNA is one of the effective methods in the treatment of intertrochanter fracture,and it has shorter operation time,less losing blood,earlier ambulation,and hardly has complications.

Objective To investigate the difference of clinical efficiency and safety in obsessive-compulsive disorders (OCD) treatment with escitalopram or paroxetine.Methods A total of 156 OCD patients were randomly divided into escitalopram group (ESC group) and paroxetine group (PAR group).Yale-Brown Obsessive Compulsive Scale (Y-BOCS),Hamilton Depression Scale (HAMD) and Treatment Emergent Symptom Scale (TESS)were used to evaluate the clinical efficiency and safety before and after1,2,4,6,8 weeks treatment.Results The cure rate(21.79％ vs 17.95％) and effective rate(70.51％ vs 71.79％) had no statistically difference between ESC group and PAR group,and incidence of side effect had no significant difference between two groups(x2 =1.99,P＞0.05).Compared with the group before treatment,HAMD scores were significantly decreased from the first weekend in ESC group,but in PAR group HAMD scores did not decrease until the second weekend,and the differences were also significant(P＜0.05).Conclusion Escitalopram is a safety,effective and well-tolerated drug in the treatment of obsessive-compulsive disorder.

Objective To design a new animal model for end-to-side anastomosis of peripheral nerves and analyze the efficiency. Methods The experiment involved 28 Wistar rats,of which the left legs were set as experimental group and the right ones as control group based on mode of nerve anastomosis.In experimental group,the tibial nerves were cut off for anastomosis of the proximal end of the tibial nerves with the distolateral side of the common peroneal nerve.While in control group,the common peroneal nerves were cut off to anostmose the distal end of the peroneal nerve with the distolateral side of the tibial nerves.Electrophysiological examination was done three months later to observe and compare wave amplitude,latent period and maximal wave amplitude at set stimulus volume in both groups and compare the fiber number at distal and proximal ends of the common peroneal nerves. Results There was no significant statistical difference in regard of amplitude,latent period and maximal wave amplitude in both groups.However,the fiber number at distal end of the stoma was much more than that at proximal end in the experimental group,with statistical difference(P

BACKGROUND: Several studies have demonstrated that sphingosine-l-phosphate(S1P)can induce the differentiation of adipose-derived stem cells differentiation into smooth muscle cells.Whether S1P,rather than 5-azacytidine,can be used as an inducer of mesenchymal stem cells differentiation into cardiomyocytes remains unclear.OBJECTIVE: To investigate the possibility that S1P promotes human umbilical cord mesenchymal stem cells(HUMSCs)differentiation into cardiomyocytes in the presence of different culture media.METHODS: HUMSCs were cultured with cardiomyocyte conditional medium(CMCM)and/or SIP media.At 1,5,and 10 days of culture,morphological changes of HUMSCs were observed.After culture for 10 days,the induced cells were confirmed by immunocytochemical analysis and patch clamp in terms of cell phenotype and function.RESULTS AND CONCLUSION: During the induction,some cells gradually enlarged,elongated,connected with adjacent cells,and formed myotube-like structures,and some cells congregated into cell clusters in the CMCM and CMCM+S1P groups.In the CMCM+S1P group,cells exhibited special perpendicular terrace-shaped,intercalated disc-like arrangement.Immunohistochemistry results revealed that some cells strongly express specific antibodies against sarcomeric myosin andα-actinin in the CMCM and CMCM+S1P groups.These findings suggest that HUMSCs can be induced to differentiate into cardiomyocytes.Through the use of patch clamp technique,a rapid ascending,but without plateau phase,action potential,a voltage dependent inward current,and a voltage dependent outward current were recorded in some cells from the CMCM+S1P group.These findings indicate that S1P plays a key role in promoting cardiomyogenic differentiation of HUMSCs and functional integration.

ObjectiveTo study the therapeutic effects of cerebellar fastigial nucleus electrical stimulation (FNS) on motor and depression symptoms and monoamine neurotransmitters in the spinal cord fluid of patients with Parkinson's disease (PD).Methods65 patients with idiopathic Parkinson's disease following depression were divided into stimulation group (FNS+Madopar, n=35) and control group (Madopar, n=30). The stimulation group took Modopar, and treated with FNS, 30 miniutes once a day for 30 days. The control group took Modopar only. Madopar dose has no change during the treatment. The patients were evaluated by Webster Parkinson's Disease Evaluation Form, and Hamilton Depression Scale (HAMD) before and after FNS treatment. The loading of monoamine neurotransmitters was measured by high performance liquid chromatography-electrochemical process.ResultsAfter the treatment, the stimulation group improved in clinical feature and depression, scored significantly lower on Webster and HAMD than the control group(P<0.05); the loading of 5-hydroxytryptamine(5-HT) in spinal cord fluid increased; however noradrenalin and dopamine had no different. But there was no significant change in the symptoms and the loading of monoamine neurotransmitters in the control group.ConclusionFNS is efficient to relieve the motor and depression symptoms of PD, which possible mechamism might be central neuroprotection and the release of 5-HT by FNS induction.

Objective To assess the relationship between type 2 diabetes and the risk of kidney cancer. Methods PubMed, Medline, CNKI and VIP were used to identify studies which regarded the relationship between type 2 diabetes and risk of kidney cancer up to July 2014. The relative risks (RRs) and the corresponding 95% confidence interals (CIs) were used to estimate the association between type 2 diabetes and the risk of kidney cancer through software STATA. Results 8 studies were included in this analysis. Compared to the popula-tion without type 2 diabetes, there was an increased risk of kidney cancer in the type 2 diabetes patients, the pooled RR (95%CI) was 1. 55 (1. 24,1. 92),P<0. 05. Conclusion Our meta-analysis suggestes that type 2 diabetes can increase the risk of kidney cancer.

Objective To evaluate the biocompatibility of ZSM-5 zeolite and provide an experimental basis for developing the first-aid hemostatic agent.Methods According to Chinese evaluation standards on medical devices and biological tests,the cytotoxicity in vitro,hemolysis test,acute toxicity of system,pyrogen test,intracutaneous stimulation,sensitization and micronucleus test were studied in ZSM-5 zeolite.In order to find out the side-effect of the zeolite granules' remains left in the wounds to body,muscle implantation test was studied.Results There were no obvious cytotoxity,hemolysis reaction.Acute tocicity,pyrogen reaction,intraeutaneous stimulation,sensitization and potential mutagenesis in themicronucleus test were observed.Their results were a11 consistent with the Chinese biological evaluation of medical devices.Obvious inflammatory reaction was observed when ZSM-5 zeolite was implanted in muscle for 12 weeks.Conclusion The ZSM-5 zeo1ite has reliable biocompatibility.But zeolite can cause inflammatory reaction when it is remained in the wound surface for long term.