Objective:To investigate the impact of " staging" hybrid coronary artery revascularization (HCR) on the short-and long-term efficacy of patients with multiple coronary artery lesions.Methods:A retrospective case-control study was conducted. Eighty patients with multiple coronary artery lesions admitted to the Baoding Second Central Hospital from January 2017 to October 2018 were selected and divided into two groups according to different surgical methods. Forty patients were treated with " staging" HCR and were designated as the HCR group, and 40 patients were treated with off-pump coronary artery bypass grafting (OPCAB) and were designated as the OPCAB group. The perioperative related indicators and perioperative serious complications were compared between the two groups. The serum myocardial injury marker levels were detected preoperatively and 48 hours postoperatively, including heart-type fatty acid binding protein (H-FABP) and troponin I (cTnI). All subjects were followed up for at least 3 years to calculate the incidence of major adverse cardiovascular and cerebrovascular events (MACCE).Results:The bypass surgery time, mechanical ventilation time, ICU stay time, and total hospital stay time in the HCR group were all less than those in the OPCAB group (all P<0.05), and the incision length in the HCR group was shorter than that in the OPCAB group ( P<0.05). The intraoperative bleeding volume, postoperative 24-hour drainage volume, red blood cell transfusion volume, and plasma transfusion volume in the HCR group were all less than those in the OPCAB group (all P<0.05). Forty-eight hours after surgery, the serum H-FABP and cTnI levels in both groups were significantly higher than those preoperatively (all P<0.05), but the increase was more significant in the OPCAB group (all P<0.05). The perioperative serious complication rate in the HCR group was 2.50%(1/40), which was significantly lower than that in the OPCAB group [20.00%(8/40)] ( P<0.05). During the 3-year follow-up after surgery, the MACCE incidence in the HCR group was 12.50%(5/40), and that in the OPCAB group was 22.50%(9/40). There was no significant difference in the long-term MACCE incidence between the two groups ( P>0.05). Conclusions:" Staging" HCR treatment for multiple coronary artery lesions can achieve ideal surgical results. Compared with OPCAB, its short-term efficacy is more significant, and long-term efficacy is equivalent.

（正）Luketich 等[1]2000 年首次报道了胸腹腔镜联合食管癌微创手术（minimally invasive esophagectomy， MIE）病例。随着近 10 多年的发展，食管癌微创外科已经进入一个技术成熟的阶段，能使广大食管癌患者受益。2009 年美国国立综合癌症网络（NCCN）临床指南[2]已将 MIE 列为标准食管癌术式之一。

Objective: To compare the efficacies of the two techniques of "micro-hemostasis and micro-cutting" with straight bipolar electrocoagulation forceps and traditional clamp-ligation for hemostasia in thyroid surgery. Methods: A total of 228 patients who underwent surgical treatment for thyroid neoplasms in our hospital between January 2015 and December 2018 were retrospectively analyzed, including 50 males and 178 females, aged 23-68 years old. Of those, 150 cases as electric knife group received traditional thyroid surgery between January 2015 and December 2018 and 78 cases as bipolar electrocoagulation group received thyroid surgery by using the technique of bipolar electrocoagulation with meticulous anatomy between January 2018 and December 2018. The total operation time, single operation time, intraoperative hemorrhage, postoperative drainage volume on the first day, postoperative hoarseness and hypocalcemia were compared between the two groups. SPSS 16.0 was used to analyze the data. Results: The total operation time and intraoperative hemorrhage in the bipolar electrocoagulation group were significantly lower than those in the electric knife group ((59.33±18.29)min vs (77.21±25.39)min, (14.83±9.22)ml vs (36.86±11.80)ml, all P<0.01). The single operation time of the bipolar electrocoagulation group was shorter than that of the electric knife group((10.25±6.16) min vs (20.34±7.24)min, (16.25±7.15)min vs (35.68±8.25)min, (12.12±5.25)min vs (20.68±7.26)min, t value was 3.948,16.262,8.238, all P<0.01).There was no significant difference between the two groups in postoperative drainage volume on the first day (P>0.05) and the incidence of postoperative hoarseness (P>0.05), while the incidence of hypocalcemia in the bipolar electrocoagulation group(10.26%) was lower than that in the electric knife group(21.33%,χ²=4.353, P<0.05). Conclusions The fine dissection for thyroid operation can be achieved by using straight bipolar electrocoagulation tweezers. The use of "micro-hemostasis" and "micro-cutting" technique with bipolar electrocoagulation tweezers can greatly reduce intraoperative bleeding, operation time and postoperative complication.

Objective To investigate the mechanisms of paeoniflorin in protection of retinal ischemia injury.Methods Fifty-four male specefic pathogen free (SPF) degree Wistar rats were randomly divided into normal control group,model control group and paeoniflorin group.Retinal ischemia injury was induced by raising the intraocular pressure of right eyes of rats to 110 mmHg for 30 minutes.The rats of paeoniflorin group were administrated through intraperitoneal injection of 5 mg/kg paeoniflorin each day for 14 days.OCT and electroretinogram (ERG) were performed to detect the thickness of retinal nerve fiber layer+retinal ganglion cell layer+inner plexiform layer (NGI)and electrophysiological changes of retina,respectively.Retrograde labelling of retinal ganglion cells (RGCs) was used to evaluate the survival number of RGCs.Western blot analysis was used to detect NLRP3,apoptosis-associated speck-like protein containing a caspase activation and recruitment domain (ASC),cleaved caspase 1 (c-caspase 1),IL-18,and IL-1β expression.The use and care of animals complied with the statement of the Association for Research in Vision and Ophthalmology (ARVO) and Regulations for the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission.Results The thickness of retinal NGI in model control group was (58.2 ± 1.7) μm,which was significantly lower than (84.8 ± 1.9) μm in normal control group and (71.1 ±2.4) μm in paeoniflorin group (both at P＜0.05).The amplitudes of A and B waves in paeoniflorin group and normal control group were significantly higher than those in model control group (both at P＜0.05).The number of RGC in model control group was significantly lower than that in paeoniflorin group and normal control group (both at P＜0.05).The relative expressions of NLRP3,ASC,c-caspase 1,IL-18 and IL-1β in model control group were significantly higher than those in normal control group and paeoniflorin group (all at P＜0.05).Conclusions The paeoniflorin can prevent retinal ischemia induced injury of the retina through NLRP3 inflammasomes pathway,which provides a new treatment strategy for clinical therapy.

Objective To investigate the mechanisms of paeoniflorin in protection of retinal ischemia injury. Methods Fifty.four male specefic pathogen free ( SPF) degree Wistar rats were randomly divided into normal control group,model control group and paeoniflorin group. Retinal ischemia injury was induced by raising the intraocular pressure of right eyes of rats to 110 mmHg for 30 minutes. The rats of paeoniflorin group were administrated through intraperitoneal injection of 5 mg/kg paeoniflorin each day for 14 days. OCT and electroretinogram ( ERG ) were performed to detect the thickness of retinal nerve fiber layer+retinal ganglion cell layer+inner plexiform layer ( NGI) and electrophysiological changes of retina, respectively. Retrograde labelling of retinal ganglion cells ( RGCs ) was used to evaluate the survival number of RGCs. Western blot analysis was used to detect NLRP3,apoptosis.associated speck.like protein containing a caspase activation and recruitment domain (ASC),cleaved caspase 1 (c.caspase 1), IL.18,and IL.1β expression. The use and care of animals complied with the statement of the Association for Research in Vision and Ophthalmology ( ARVO ) and Regulations for the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission. Results The thickness of retinal NGI in model control group was ( 58. 2 ± 1. 7)μm, which was significantly lower than ( 84. 8 ± 1. 9)μm in normal control group and(71. 1±2. 4)μm in paeoniflorin group (both at P<0. 05). The amplitudes of A and B waves in paeoniflorin group and normal control group were significantly higher than those in model control group ( both at P<0. 05 ) . The number of RGC in model control group was significantly lower than that in paeoniflorin group and normal control group ( both at P<0. 05). The relative expressions of NLRP3,ASC,c.caspase 1,IL.18 and IL.1β in model control group were significantly higher than those in normal control group and paeoniflorin group (all at P<0. 05). Conclusions The paeoniflorin can prevent retinal ischemia induced injury of the retina through NLRP3 inflammasomes pathway,which provides a new treatment strategy for clinical therapy.

[Abstract] Objective: To investigate the expression and clinical significance of lncRNAANRIL in glioma tissues. Methods: 129 cases of glioma tissues and 25 cases of normal brain tissues as control were collected from patients treated in Sichuan Provincial People’ s Hospital from January 01, 2012 to December 30, 2016. Real-time quantitative PCR was used to detect the mRNA expression of lncRNAANRIL; and the relationship between lncRNAANRIL expression and sensitivity of patients to temozolomide as well as the clinical prognosis of glioma patients were analyzed. Results: Compared with control group, the expression of lncRNAANRIL in 129 cases of glioma tissues was significantly increased ([8.730±0.336] vs [1.090±0.137], t=9.957, P<0.01). The expression of lncRNAANRIL in WHO Ⅰ-Ⅱ grade patients was significantly lower than that of patients at grade Ⅲ-Ⅳ ([4.198±0.260] vs [10.550±0.291], t=13.03, P< 0.01). lncRNA ANRIL expression was significantly correlated with WHO stage，the sensitivity to temozolomide（TMZ）and survival status（all P<0.05）, but not associated with gender, age, KPS score and tumor size (all P>0.05). Moreover, Kaplan-Meier analysis demonstrated that decreased lncRNAANRIL expression contributed to significantly longer overall survival ([29.17±0.64] vs [13.54±0.74] months, P<0.01) and recurrence-free survival time ([9.08±0.56] vs [15.88±0.83] months, P<0.01). Univariate and multivariate analysis also indicated that lncRNAANRIL expression, WHO stage and chemosensitivity could be independent prognostic markers for glioma (P<0.05). Conclusion: Higher pathological grade of glioma patients indicates higher lncRNA ANRIL expression and shorter survival time. lncRNAANRIL is involved in the occurrence and development of glioma, and can be used as a molecular marker for the diagnosis and prognosis of glioma.

Objective To summarize the experience of diagnosis and treatment of occult spontaneous pneumothorax in young adults.Methods To review and summarize the imaging data and treatment process of 22 cases of occult spontaneous pneumothorax.Results Surgical treatment was performed in 22 patients.Among them,VATS operation in 18 cases,VATMoperation in 4 cases.Operation difficulty was severe adhesion free existed in the apex of lung and pleural top.22 patients with the successful completion of the operation,no major bleeding during the operation,no open chest surgery.1 -3 years follow -up without recurrence.Conclusion Surgical treatment is the first choice for occult spontaneous pneumothorax in young adults.Often due to severe adhesion of the chest,surgery is difficult,the surgeon should be fully prepared before surgery.Patients with good prognosis,due to the difficulty of early diagnosis,clinicians should pay attention to.

Objective To investigate the effects of advanced oxidation protein products (AOPP) in type 2 diabetic ocular muscles palsy (DOMP). Methods 58 DOMP patients and 50 type 2 diabetes patients were included in the research. Hemoglobin A1c (HbA1c), blood glucose (FPG), fasting insulin (FINS) and triglycerides (TG), total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL) were measured and recorded. Homeostasis model assessment was performed to evaluate the status of insulin resistance (HOMA-IR), basal insulin secretion (HOMA-β) and the insulin sensitivity index (ISI). Serum AOPP was measured by enzyme linked immunosorbent assay. Unconditional logistic regression model was used to evaluate the influencing factors of DOMP. Results The DOMP group showed higher levels of plasma AOPP, TG, LDL, FPG, FINS, HbA1c and HOMA-IR, but lower levels of HDL, HOMA-β and ISI than those of the T2DM group. Unconditional logistic regression analysis revealed that AOPP was an independent risk factors for DOMP (OR =3.01, P = 0.002). Conclusion AOPP may be involved in the pathogenesis of DOMP. AOPP could be a useful indicator for monitoring the development of DOMP and for evaluating its severity.

Highly conjugated linear molecular wires are one of the basic elements for constructing molecular electronic devices. Among these conjugated compounds, ferrocene-terminated compounds as well as their derivatives have been widely studied because of their ideal electrochemical activity. Based on these, a new ferrocene-terminated phenylethynyaniline ( Fc-NH2 ) was synthesized by Sonogashira cross coupling reaction. The structure of the target compound was identified by infrared ( IR) , nuclear magnetic resonance ( NMR) , mass spectra ( MS) and cyclic voltammetry ( CV) . Combined the graphene-chitosan ( GH-CS) and Fc-NH2 , a new composite of GH-CS/Fc-NH2 was prepared and then used for immobilization of Cytc to prepare the GH-CS/Fc-NH2/Cytc/GCE. It was found from the CV result that a pair of peaks near-0. 2 V appeared which can be attributed to Cytc. The GH-CS/Fc-NH2/Cytc modified GCE showed good catalysis towards NaNO2 , and good linear relationship was found in the range of 1 ×10-7-1. 5 ×10-4 mol/L,and the determination limit was bellow 4×10-8 mol/L. Therefore, cytochrome c (Cytc) can be immobilized on the GH-CS/Fc-NH2 and the direct electron transfer can be realized between the electrode and solution and shows good prospect for detection of NaNO2 .

Objective:To explore the roles of contact allergens and photoallergens in the treatment of several inflammatory skin diseases by retrospectively analyzing the photopatch testing results of 560 patients from the Dermatology Department during January 2014 and December 2014 .Methods:A total of 560 patients undergoting photopatch testing were collected .The positive rates of photoallergic contact dermatitis(PACD) ,as well as those of allergic contact dermatitis(ACD) among the 20 types of allergens were compared by evaluating the photopatch testing results based on criteria from the International Contact Dermatitis Research Group (ICDRG) .Results:Among the 560 patients ,there were 378 cases (65 .17% ) with PACD positive , 342 cases (58 .97% ) with ACD positive ,and 62 cases (10 .69% ) with both PACD‐ and ACD‐positive .The most common allergens among PACD‐positive patients were chlorpromazine (56 .81% ) ,thiomersal (12 .19% ) ,and formaldehyde (7 .89% ) , whereas the most common allergens among ACD‐positive patients were formaldehyde (22 .04% ) , potassium dichromate (21 .14% ) , and chlorpromazine (14 .70% ) . Furthermore , the most common allergens among PACD‐ and ACD‐ positive patients were chlorpromazine (6 .27% ) ,thiomersal (2 .33% ) ,and nickel sulfate (1 .61% ) .Conclusions:Photoallergens and contact allergens may be related to the pathogenesis of inflammatory skin diseases such as chronic actinic dermatitis ,facial dermatitis ,and eczema .