Clinical and laboratory results of 270 children with infectious mononucleosis / 中华实用儿科临床杂志

Objective:To summarize the clinical and laboratory characteristics of infectious mononucleosis (IM) in children.Methods:Clinical features and laboratory results of 270 cases with IM admitted to the Department of Pediatrics in Strategic Support Force Medical Center of People′s Liberation Army from January 2012 to December 2020 were retrospectively analyzed. χ2 test was used for comparison between groups. Results:IM mainly occurred in children aged 5 months to 18 years old in autumn and spring.The highest incidence rate (105 cases, 38.9%) was 3-<6 years old (preschoolers). There were 253 cases (93.7%) with fever, 266 cases (98.5%) with adenopharyngitis, 196 cases (72.6%) with tonsil pseudomembrane or exudation, 248 cases (91.9%) with cervical lymphadenopathy, 92 cases (34.1%) with eyelid edema, 202 cases (74.8%) with nasal obstruction, 124 cases (45.9%) with nasal obstruction and snoring, 24 cases (8.9%) with rash, and 112 cases (41.5%) with splenomegaly.A total of 225 cases (83.3%) presented with typical triplets of IM (fever, adenopharyngitis and cervical lymphadenopathy). Sixty-two IM patients were complicated with pulmonary infections and 3 cases with diarrhea.The main co-infection pathogens in children with IM were Mycoplasma pneumonia (MP) (79 cases, 29.3%), influenza A or B virus (34 cases, 12.6%), Streptococcus pneumonia (SP) (18 cases, 6.7%), adenovirus (22 cases, 8.1%) and cytomegalovirus (3 cases, 1.11%). A total of 46 cases (17.0%) had multiple infections.Laboratory test results suggested that absolute lymphocyte count ≥5.0×10 9/L was found in 199 cases (73.7%), and abnormal lymphocyte ratio >0.10 was found in 225 cases (83.3%). Some children had elevated transaminase levels.Epstein-Barr virus capsid antigen-immunoglobulin M (EBV-VCA-IgM) was positive in 249 cases (92.2%), Epstein-Barr virus capsid antigen-immunoglobulin G (EBV-VCA-IgG) was positive in 238 cases (88.1%), and Epstein-Barr virus nuclear antigen-immunoglobulin G (EBV-NA-IgG) was negative in all cases.EBV-VCA-IgG showed low affinity in all cases (<40%). EBV DNA tests of peripheral blood plasma were carried in 153 cases, of which 118 cases (77.1%) were positive. Conclusions:EBV related IM mainly attacks preschoolers.Most patients are presented with typical triplets of IM.Eyelid edema, nasal obstruction, snoring, splenomegaly and elevated transaminase levels are prevalent in IM children.Most cases have a favorable prognosis.

Effects of interpregnancy interval on pregnancy outcomes of subsequent pregnancy: a multicenter retrospective study / 中华妇产科杂志

Objective:To explore the effects of interpregnancy interval (IPI) on pregnancy outcomes of subsequent pregnancy.Methods:A multicenter retrospective study was conducted in 21 hospitals in China. Information of age, height, pre-pregnancy weight, IPI, history of diseases, complications of pregnancy, gestational age of delivery, delivery mode, and pregnancy outcomes of the participants were collected by consulting medical records of pregnant women who had two consecutive deliveries in the same hospital during 2011 to 2018. The participants were divided into 4 groups according to IPI:<18 months, 18-23 months, 24-59 months and ≥60 months. According to the WHO′s recommendation, with the IPI of 24-59 months group as a reference, to the effects of IPI on pregnancy outcomes of subsequent pregnancy were analyzed. Stratified analysis was further carried out based on age, history of gestational diabetes mellitus (GDM), macrosomia, and premature delivery, to explore the differences in the effects of IPI on pregnancy outcomes among women with different characteristics.Results:A total of 8 026 women were included in this study. There were 423, 623, 5 512 and 1 468 participants in <18 months group, 18-23 months group, 24-59 months group and ≥60 months group, respectively. (1) The age, pre-pregnancy body mass index (BMI), history of cesarean section, GDM, gestational hypertension and cesarean section delivery rate of <18 months group, 18-23 months group, 24-59 months group and ≥60 months group were gradually increased, and the differences were statistically significant ( P<0.05). (2) After adjusting for potential confounding factors, compared with women in the IPI of 24-59 months group, the risk of premature delivery, premature rupture of membranes, and oligohydramnios were increased by 42% ( OR=1.42, 95% CI: 1.07-1.88, P=0.015), 46% ( OR=1.46, 95% CI: 1.13-1.88, P=0.004), and 64% ( OR=1.64, 95% CI: 1.13-2.38, P=0.009) respectively for women in the IPI≥60 months group. No effects of IPI on other pregnancy outcomes were found in this study ( P>0.05). (3) After stratified by age and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months would significantly increase the risk of oligohydramnios for women with advanced age ( OR=2.87, 95% CI: 1.41-5.83, P=0.004); and <18 months could increase the risk of premature rupture of membranes for women under the age of 35 ( OR=1.59, 95% CI: 1.04-2.43, P=0.032). Both the risk of premature rupture of membranes ( OR=1.58, 95% CI: 1.18-2.13, P=0.002) and premature delivery ( OR=1.52, 95% CI: 1.07-2.17, P=0.020) were significantly increased in the IPI≥60 months group. After stratified by history of GDM and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months would lead to an increased risk of postpartum hemorrhage for women with a history of GDM ( OR=5.34, 95% CI: 1.45-19.70, P=0.012) and an increased risk of premature rupture of membranes for women without a history of GDM ( OR=1.44, 95% CI: 1.10-1.90, P=0.009). After stratified by history of macrosomia and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months could increase the proportion of cesarean section for women with a history of macrosomia ( OR=4.11, 95% CI: 1.18-14.27, P=0.026) and the risk of premature rupture of membranes for women without a history of macrosomia ( OR=1.46, 95% CI: 1.12-1.89, P=0.005). After stratified by history of premature delivery and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months would significantly increase the risk of premature rupture of membranes for women without a history of premature delivery ( OR=1.47, 95% CI: 1.13-1.92, P=0.004). Conclusions:Both IPI≥60 months and <18 months would increase the risk of adverse pregnancy outcomes in the subsequent pregnancy. Healthcare education and consultation should be conducted for women of reproductive age to maintain an appropriate IPI when they plan to pregnant again, to reduce the risk of adverse pregnancy outcomes in the subsequent pregnancy.

Research progress in rehabilitation of cardiac exercise after percutaneous coronary intervention / 中国医师杂志

Coronary heart disease is the leading cause of death in the United States and many developed countries. Percutaneous coronary intervention (PCI) is an important means to treat coronary heart disease. However, PCI can not eliminate the risk factors of coronary heart disease. As an important auxiliary means of PCI, cardiac rehabilitation can significantly slow down the progress of atherosclerosis, reduce cardiovascular events, improve patients′ exercise tolerance and the quality of life of patients. It have been developing vigorously in developed countries and achieved remarkable results. This paper will review the effects of cardiac exercise rehabilitation and the research on cardiac exercise rehabilitation in different clinical stages.

Research progress of environmental hygiene management in patients′ surroundings / 中华医院管理杂志

Hospitals today are confronted with new challenges in environmental hygiene management. Based on recent literatures and norms at home and abroad, this review analyzed such challenges and defects found in the environmental hygiene management of hospitals in China. The problems include but are not limited to the following: incomplete environmental management system and norms, insufficient staffing and funding support, lack of HR management mechanism in terms of employment, training, appraisal and reward/penalty, as well as poor hygiene awareness of hospital environmental services staff. In view of these problems in the hospitals, the authors provide specific countermeasures as follows: establishing new environmental hygiene management models, improving management mechanisms, creating positive and normalized cultural atmosphere for environmental infection control, and applying informatization to upgrade environmental hygiene quality. These measures are expected to serve as references for improving surrounding hygiene of patients.

Safety evaluation of early exercise out of bed in patients with partial hepatectomy / 中国实用护理杂志

Objective@#To confirm early (6 hours) exercise in patients with partial hepatectomy is safe and feasible.@*Methods@#The control group included 211 patients who qualified for partial liver resection before the accelerated rehabilitation surgery (ERAS), 218 patients with partial hepatectomy who met the entry criteria after the implementation of ERAS were taken as test group, get out of bed 24 hours after routine mission in control group, activity of 6 hours after operation in ERAS group. To observe the time of getting out of bed and the incidence of postoperative complications in 2 groups.@*Results@#Comparison with control group, early exercise time of patients in ERAS group after surgery. The incidence of postoperative complications decreased was 14.3% (31/218) while 34.6%(73/211) of the control group. The difference was statistically significant (χ2=299.3, 18.270, P < 0.01). And did not increase the risk of falls, incision pain, postoperative bleeding.@*Conclusion@#Liver partial resection is safe and effective for patients with 6 hours post-operative exercise, worth clinical application.

Long-term efficacy of a second generation biodegradable polymer sirolimus-eluting stent (EXCEL2) in treating patients with de novo coronary artery diseases / 中华心血管病杂志

Objective@#To evaluate the long-term efficacy of a second generation biodegradable polymer sirolimus-eluting stent (EXCEL2) in treating patients with de novo coronary artery diseases.@*Methods@#CREDIT Ⅱ trial was a prospective, multicenter, randomized, controlled study, conducted at 15 Chinese cardiac centres from November 2013 to December 2014. In this analysis, eligible patients for coronary stenting (n=419) were randomized to receive either the EXCEL2 stent (n=208) or the EXCEL stent (n=211). The primary endpoint was target lesion failure (TLF) at 3 years after PCI defined as a composite endpoints of cardiac death, target vessel myocardial infarction (TVMI), or clinically indicated target lesion revascularization (CI-TLR). Secondary endpoints included patient-oriented composite endpoint (PoCE) including all-cause death, all MI, or any revascularization at 3 years and independent components, and stent thrombosis according to Academic Research Consortium′s (ARC) definition.@*Results@#Among 419 enrolled patients, 413 (98.6%) patients completed 3-year clinical follow-up. Compared with the EXCEL group, 3-year TLF (5.4%(11/204) vs. 11.5% (24/209), P=0.025) and PoCE (9.8% (20/204) vs. 20.1% (42/209), P=0.003) were significantly lower in the EXCEL2 group. The cumulative event rate of CI-TLR (2.0% (4/204) vs. 5.7% (12/209), P=0.042) and any revascularization (4.9% (10/204) vs. 14.4% (30/209), P=0.001) were statistically lower in the EXCEL2 group than in the EXCEL group. There were no significant difference between two groups in terms of all-cause death and all MI. Rates of stent thrombosis were low without significant difference between the two groups (EXCEL2 vs. EXCEL, 1.0% (2/204) vs. 2.9% (6/209), P=0.285).@*Conclusion@#3-year clinical follow-up results demonstrate that EXCEL2 stents are effective and safe in treating CAD patients with de novo coronary lesions.

Safety evaluation of early exercise out of bed in patients with partial hepatectomy / 中国实用护理杂志

Objective To confirm early (6 hours) exercise in patients with partial hepatectomy is safe and feasible. Methods The control group included 211 patients who qualified for partial liver resection before the accelerated rehabilitation surgery (ERAS), 218 patients with partial hepatectomy who met the entry criteria after the implementation of ERAS were taken as test group, get out of bed 24 hours after routine mission in control group, activity of 6 hours after operation in ERAS group. To observe the time of getting out of bed and the incidence of postoperative complications in 2 groups. Results Comparison with control group, early exercise time of patients in ERAS group after surgery. The incidence of postoperative complications decreased was 14.3% (31/218) while 34.6%(73/211) of the control group. The difference was statistically significant ( χ2=299.3, 18.270, P<0.01). And did not increase the risk of falls, incision pain, postoperative bleeding. Conclusion Liver partial resection is safe and effective for patients with 6 hours post-operative exercise, worth clinical application.

Protective effects of rosiglitazone on hepatic ischemia reperfusion injury in rats / 中南大学学报(医学版)

To explore the protective effect of rosiglitazone (RGZ) on hepatic ischemia reperfusion injury (HIRI) and the underlying mechanisms.
 Methods: A rat model of ischemia-reperfusion injury was established by clamping the left and middle lobe of liver with noninvasive vascular clamp. A total of 30 Sprague-Dawley rats were randomly divided into a sham group, an HIRI group, and a RGZ group (10 rats in each group). Two hours after reperfusion, serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activities, lactate dehydrogenase (LDH) level, malondialdehyde (MDA) content and catalase (CAT), glutathione peroxidase (GPx) and superoxide dismutase (SOD) activities were examined. HE staining was used to observe liver pathological morphology. The liver peroxisome proliferators-activated receptor γ (PPAR-γ), p-PPAR-γ, nuclear factor related factor 2 (Nrf-2), antioxidant response element (ARE), heme oxygenase 1 (HO-1) and quinone oxidoreductase-1 (NQO-1) were detected by Western blot.
 Results: Compared with the HIRI group, the levels of ALT, AST, LDH and MDA in the RGZ group were significantly decreased (all P0.05).
 Conclusion: PPAR-γ agonist RGZ can attenuate HIRI, which may be related to activating Nrf2/ARE signaling pathway and enhancement of antioxidant ability.

Analysis of audiological characteristics and genetic background in patients with nonsyndromic deafness and mitochondrial DNA 1555A>G mutation / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To analyze the audiological features and genetic background of patients carrying mitochondrial DNA(mtDNA) 1555A>G mutation and factors which may influence the extent of nonsyndromic hearing loss associated with the mutation.</p><p><b>METHODS</b>A literature search was carried out on databases including PubMed, CNKI, Wanfang, and VIP. Combined with author's data, the clinical features of the patients, in particular audiological characteristics, were summarized.</p><p><b>RESULTS</b>A total of 857 effective cases were collected and analyzed. A significantly correlation was identified between history of aminoglycosides exposure and extent of hearing loss, in addition with a negative correlation between the age of onset and extent of hearing-impairment. Drug exposure was corelated with the age of onset but independent to the loss of high-frequency hearing loss. Heteroplasmies had a reverse correlation with the degree of hearing loss. Among the haplotypes of mitochondrial DNA, haplotype D was the most common one, while haplotype B had the highest penetrance.</p><p><b>CONCLUSION</b>Nonsyndromic hearing loss associated with mitochondrial DNA 1555A>G mutation is influenced by factors such as aminoglycosides exposure, age, proportion of mutation, and haplotype of the mitochondrial DNA. Analysis of clinical cases is critical for identifying individuals carrying deafness susceptibility mutations and is the first step for early diagnosis.</p>

Analysis of clinical effect of different approaches for clipping anterior circulation aneurysms / 重庆医学

Objective To compare the treatment effect of surgically clipping anterior circulation aneurysms by lateral supraorbital approach and supraorbital keyhole approach for guiding the selection of surgical approach for anterior circulation aneurysms.Methods The clinical data of 80 patients diagnosed as anterior circulation aneurysms due to spontaneous subarachnoid hemorrhage from January 2011 to January 2016 were retrospectively analyzed,including the operation time,craniotomy time,cranial closure time,estimated intraoperative blood loss,HCT change before and after surgery,early ambulation time,postoperative hospitalization days,GCS scores at admission and discharge,GOS scores at discharge were compared between the two groups and the literatures were reviewed.Results The operation time and craniotomy time of the lateral supraorbital approach were less than those of the supraorbital keyhole approach,and the differences between the two groups were statistically significant (P＜0.05);the cranial closure time,estimated intraoperative blood loss,HCT change before and after surgery,early ambulation time,postoperative hospitalization days,GCS scores at admission and discharge and GOS scores at discharge had no statistical differences between the two groups (P＞0.05).Conclusion The lateral supraorbital approach has the advantages of shorter operation time and craniotomy time,providing a better surgical field during operation,less intraoperative traction and less postoperative complications,and can serve as an alternative scheme for the supraorbital keyhole approach in clipping anterior circulation aneurysms.

Cost-benefit analysis of different surgical methods in patients with trigeminal neuralgia / 重庆医学

Objective To analyze the cost-benefit ratio of primary trigeminal neuralgia patients with bad drug control and never accepted the surgical treatment through surgery [including microvascular decompression (MVD) ,percutaneous radiofrequency rhizotomy (RFR) ,stereotactic radiotherapy (SRS)] .Methods A total of 89 patients with primary trigeminal neuralgia who under-went surgical treatment for the first time from 2005 to 2013 were enrolled in this study ,including 27 patients with MVD ,23 patients with RFR and 39 patients with SRS .Evaluation criteria (effect factors) include facial pain (excellent :no pain and no drug treat-ment ;good :no pain but medication ;worse:less than 50% of patients with pain ;worse:more than 50% of patients with facial pain or need to undergo secondary surgery ) ,numbness ,cost and .Results The mean age of the patients treated with MVD was (50 .4 ± 14 .3)years old ,RFR was(73 .2 ± 13 .6) years old SRS was (72 .6 ± 11 .8) years old ,MVD group was younger than RFR and SRS group(P<0 .05);The average total cost of each surgical approach as follows :MVD was 50274 yuan ,RFR was 4539 yuan ,SRS was 38512 yuan (P<0 .05);The postoperative facial numbness proportion of MVD was 1 .1% ,RFR was 52 .2% and SRS was 28 .2% (P<0 .05);The ratio of patients who needed recurrent surgery in two years was MVD 26 .0% ,RFR 73 .9% and SRS 30 .7% (P<0 .05);The mean remission rate of MVD was 1 .6 years ,the RFR was 2 .1 years ,and the SRS was 1 .0 year(P<0 .05);The cost-benefit ratio of MVD was 31618 yuan ,RFR was 1982 yuan ,SRS was 39297 yuan(P<0 .05) .Conclusion The cost-ben-efit ratio of the three surgical from low to high were RFR ,MVD ,SRS ,which means the unit cost of RFR gain the highest ,followed by M VD and SRS .

Analysis of clinical effect of different approaches for clipping anterior circulation aneurysms / 重庆医学

Objective To compare the treatment effect of surgically clipping anterior circulation aneurysms by lateral supraorbital approach and supraorbital keyhole approach for guiding the selection of surgical approach for anterior circulation aneurysms.Methods The clinical data of 80 patients diagnosed as anterior circulation aneurysms due to spontaneous subarachnoid hemorrhage from January 2011 to January 2016 were retrospectively analyzed,including the operation time,craniotomy time,cranial closure time,estimated intraoperative blood loss,HCT change before and after surgery,early ambulation time,postoperative hospitalization days,GCS scores at admission and discharge,GOS scores at discharge were compared between the two groups and the literatures were reviewed.Results The operation time and craniotomy time of the lateral supraorbital approach were less than those of the supraorbital keyhole approach,and the differences between the two groups were statistically significant (P＜0.05);the cranial closure time,estimated intraoperative blood loss,HCT change before and after surgery,early ambulation time,postoperative hospitalization days,GCS scores at admission and discharge and GOS scores at discharge had no statistical differences between the two groups (P＞0.05).Conclusion The lateral supraorbital approach has the advantages of shorter operation time and craniotomy time,providing a better surgical field during operation,less intraoperative traction and less postoperative complications,and can serve as an alternative scheme for the supraorbital keyhole approach in clipping anterior circulation aneurysms.

Clinical characteristics of coronary chronic total occlusion in patients without myocardial ;infarction / 中国介入心脏病学杂志

Objective To analyze the clinical, imaging and interventional data of patients with chronic total occlusion (CTO) lesions without myocardial infarction (MI) and to summarize the clinical and imaging characteristics of these patients. Methods The data of 2651 patients with CTO verified by coronary angiography between January 1995 and December 2014 were analyzed retrospectively. Results There were 1466 CTO patients (55. 3%) without MI (the control group) and 1185 CTO patients (44. 7%) with MI ( the MI group). The age, percentage of female patients, unstable angina, hypertention, mean triglyceride levels, left ventricular ejection fraction ( LVEF) were lower in the MI group than in the control group ( all P﹤0. 05). The rates of heart failure and serum creatinine levels were higher in the MI group than the control group (both P﹤0. 05). The rate of multi-vessel disease was higher in the control group than in the MI group (81. 4% vs. 76. 5%, P﹤0. 05). According to the target CTO vessel location, patients in the control group had lower rates of CTO in LAD (36. 2% vs. 40. 7%, P=0. 007) and higher rates of CTO in LCX (17. 0%vs. 12. 7%, P﹤0. 001). Patients in the control group without MI had better collateral circulation than that in the control group (32. 7% vs. 27. 0%, P﹤0. 001). There were no differences in success rate of PCI and complete revascularization between the two groups. Conclusions The present study showed that the CTO patients without MI were associated with better collateral development compared with the CTO patients with MI. Age, gender, unstable angina encouraging ischemic preconditioning and hypertension may be beneficial by facilitating collateral development through endogenous cardioprotective mechanisms.

Safety and feasibility of transradial approach for intervention therapy after coronary artery bypass graft / 中国介入心脏病学杂志

Objective To compare safety and feasibility using radial versus femoral access during cardiac catheterization of patients who had previously undergone coronary artery bypass graft ( CABG) surgery. Methods We retrospectively evaluated 116 consecutive patients who underwent graft intervention via the transradial (TRA group, n = 46) or transfemoral approach (TFA group, n = 70), and observed the baseline clinical characteristics, angiography characteristics and complications between the 2 groups. Results The baseline clinical characteristics between the 2 groups were similar ( all P > 0. 05) . No significant difference was observed in angiography characteristics and procedural parameters including operation time, radiation exposure and puncture time between the 2 groups (all P > 0. 05). There was no significant difference in major adverse cardiac events during hospitalization. PCI to graft vessels were all successful and procedural success rates were similar between the 2 groups (P = 0. 669). Vascular access site complications were significantly lower ( P = 0. 03) in the TRA group. No access site complication was recorded in the TRA group. 7 cases (10. 0% ) with complications were recorded in the TFA group including 1 case of major bleeding (1. 4% ), 3 cases of minor bleeding (4. 3% ), 2 cases of local hematorna (2. 9% ) and 1 case of A-V fistula formation. Conclusions In contrast to the transfemoral route, the rate of major vascular complications was negligible using the transradial approach.

Diabetes with mucormycosis：Two cases report / 中国糖尿病杂志

[Summary] This article reviewed the clinical features in two diabetes cases complicated with nasal‐brain mucormycosis by pathology and pulmonary mucormycosis. In one patient with diabetes combined with pulmonary mucormycosis ,manifestations of chest pain and hemoptysis ,the right upper lung biopsy tip morphology was consistent with Mucor ,successfully cured with amphotericin and operation treatment. The other patient with diabetes‐complicated nasal mucormycosis with headache and nasal cavity clump , showed black caseous matter ,finally hemiplegia. A nasal cavity tumor was proved by pathological examination. After treatment with fluconazole and operation ,the patientdied. Mucormycosisis rare and may be secondary to diabetes and hypoimmunity disease. It needs rapid diagnosis and treatment.

Combined intervention treatment of descending thoracic aortic dissection with coronary heart disease / 中国介入心脏病学杂志

Objective To evaluate the effectiveness of combination technique in treating descending thoracic aortic dissection with coronary heart disease by endovascular graft exclusion (EVGE) and percutaneous coronary intervention(PCI). Methods From April, 2002 to October, 2013, a total of 40 in-hospital patients with descending thoracic aortic dissection and coronary heart disease who underwent EVGE and PCI were analyzed for outcomes. All patients were performed EVGE before they underwent PCI in 3~7days of time. Long-term treatment were observed. Results For dissection tears, 40 trunk tectorial membrane stents were used. The rate of success of EVGE implantation was 100%. No paraplegia, death and other complications. 59 stents were placed to 54 target vessels of 40 patients. The success rate of PCI procedure was 100%and no severe complication occurred. All patients were followed up for average 56±31 months. The rate of followed up was 92.5%(37/40). During follow-up, 3 patients died including two patients died of cerebral hemorrhage and one case of malignant tumor. The major adverse cardiac events (MACE) rate was 6.9% in the 29 cases of patients who underwent EVGE and PCI during the clinical follow-up. Conclusions It is safe and feasible that treating descending thoracic aortic dissection with coronary heart disease by combination technique of EVGE and PCI.

The use of a pedicled umbilical vein graft to repair the defect in the bile duct in Mirizzi's syndrome: a study of 35 patients / 中华肝胆外科杂志

ObjectiveTo review our experience in the use of a pedicled umbilical vein graft in the repair of the defect in the bile duct in Mirizzi's syndrome. MethodsThis is a retrospective study on the use of a pedicled umbilical vein graft to repair the defect in the bile duct in 35 patients with Mi rizzi's syndrome. These patients suffered for Mirizzi's syndrome type Ⅱ in 19 patients, type Ⅲ in 15 patients, and type Ⅳ in 1 patient. ResultsThere was no peri-operative death. Five patients developed postoperative biliary leak which healed spontaneously after drainage of the bile collection. All patients had been followed up for at least 6 months, and 27 patients had been followed up for 3 years.There was no biliary complication. ConclusionsBile duct reconstruction with a pedicled umbilical vein graft is simple. It is a good procedure to repair the defect in the bile duct in Mirizzi's syndrome.

Effectiveness of drug eluting stents in patients with small coronary artery lesions / 中国实用内科杂志

Objective To assess the safety and effectiveness of the drug eluting stents(DES,including Cypher and TAXUS stent)in treating patients with single- and multi-vessel de novo lesions located in small native coronary arteries with comparison of bare metal stent(BMS).Methods From December 2002 to May 2005,coronary stenting procedures were performed in 407 patients with small coronary artery lesions consecutively(among whom 150 patients with multi-vessel small coronary lesion).There were 214 patients(63 patients with multi-vessel)in BMS group,140 patients(46 patients with multi-vessel)in Cypher group and 132 patients(41 patients with multi-vessel)in TAXUS group.The results of in-hospital and 6-month clinical follow-up were analysed among the 3 groups.Results There were no differences in lesion characteristic,success rate of percutanous coronary intervention(PCI),in-hospital major adverse cardiac events(MACE)and in-stent minimal lumen diameter after PCI among 3 groups.However,angiographic restenosis occurred significantly less in two DES groups than in BMS group(4.9%in Cypher group and 7.5%in TAXUS group vs 29.2% in BMS group,P

Polyclonal antibody production and expression of CREG protein in human vascular smooth muscle cells / 老年心脏病学杂志（英文版）

Objectives The cellular repressor of E1A-activated genes (CREG), a novel gene, was recently found to play a role in inhibiting cell growth and promoting cell differentiation. The purpose of this study was to obtain antibody against CREG protein and to study the expression of CREG protein in human internal thoracic artery cells (HITASY) which express different patterns of differentiation markers after serum withdrawal. Methods The open reading frame of CREG gene sequence was amplified by PCR and cloned into the pGEX-4T-1 vector. Glutathione-S-transferase (GST)-CREG fusion protein was expressed in E. Coli BL21 and purified from inclusion bodies by Sephacryl S-200 chromatography. Rabbits were immunized with the purified GST-CREG protein. Western blot examined with immunohistochemistry staining and the protein expression level was analyzed by Western blot in HITASY cells after serum removal. Results It was confirmed by using endonuclease digesting and DNA sequencing that the PCR product of CREG was correctly inserted into the vector. The GST-CREG protein was purified with gel filtration chromatography. Polyclonal antibody against GST-CREG was obtained from rabbits. CREG protein immunohistochemistry staining displayed a perinuclear distribution in the cytoplasm of HITASY cells. Results from Western blot suggested that comparing with the untreated cells upregulation of CREG polyclonal antibody against CREG was comfirmed. Using this antibody, the changes of CREG protein expression was observed in the process of phenotypic modulation of HITASY cells. These results provide basic understanding on the relationship of CREG gene with the cell phenotypic conversion.

Retrovirus-mediated cellular repressor of E1A-stimulated genes inhibits neointima formation in the rat carotid artery after balloon injury / 中国病理生理杂志

AIM: To evaluate the effects of over-expression of cellular repressor of E1A-stimulated genes(CREG) mediated by retrovirus on neointima formation in injured rat carotid.METHODS: The pluronic F127 containing pLNCX/CREG or pLNCX/GFP retroviral vectors was placed around the injured rat carotid.The neointima,media areas and the intima to media ratio were calculated.Expressions of CREG,SM ?-actin and Ki-67 were detected.RESULTS: The GFP expression was observed at day 2 in pLNCX/GFP groups.The expression of exogenous CREG was also significantly increased in arteries at day 2 after pLNCX-CREG infection.Over-expression of CREG significantly suppressed neointima formation,attenuated the expression of Ki-67 and up-regulated SM ?-actin expression.CONCLUSION: Over-expression of CREG inhibits VSMCs proliferation and promotes VSMCs differentiation after vascular injury.It suggests that modulation of CREG expression or activity may be a viable approach to treat neointimal restenosis after percutaneous coronary intervention.