Overexpression of sirtuin 1 attenuates calcium oxalate-induced kidney injury by promoting macrophage polarization.

Sirtuin 1 (SIRT1) protein is involved in macrophage differentiation, while NOTCH signaling affects inflammation and macrophage polarization. Inflammation and macrophage infiltration are typical processes that accompany kidney stone formation. However, the role and mechanism of SIRT1 in renal tubular epithelial cell injury caused by calcium oxalate (CaOx) deposition and the relationship between SIRT1 and the NOTCH signaling pathway in this urological disorder are unclear. This study investigated whether SIRT1 promotes macrophage polarization to inhibit CaOx crystal deposition and reduce renal tubular epithelial cell injury. Public single-cell sequencing data, RT-qPCR, immunostaining approaches, and Western blotting showed decreased SIRT1 expression in macrophages treated with CaOx or exposed to kidney stones. Macrophages overexpressing SIRT1 differentiated towards the anti-inflammatory M2 phenotype, significantly inhibiting apoptosis and alleviating injury in the kidneys of mice with hyperoxaluria. Conversely, decreased SIRT1 expression in CaOx-treated macrophages triggered Notch signaling pathway activation, promoting macrophage polarization towards the pro-inflammatory M1 phenotype. Our results suggest that SIRT1 promotes macrophage polarization towards the M2 phenotype by repressing the NOTCH signaling pathway, which reduces CaOx crystal deposition, apoptosis, and damage in the kidney. Therefore, we propose SIRT1 as a potential target for preventing disease progression in patients with kidney stones.

[Long-term effects of permanent pacemaker implantation on tricuspid valve regurgitation].

OBJECTIVE: To explore the long-term effects of permanent pacemaker implantation (PPI) on tricuspid valve regurgitation (TR) in Chinese patients so as to determine the incidence and related factors, evaluate its effects on heart structure and function and ascertain the exact mechanism of TR after PPI. METHODS: A total of 430 patients undergoing permanent pacemaker replacement at our hospital between January 2000 and June 2011 were recruited. The patients with isolated atrial lead implantation procedures, significant heart valve disease or chronic obstructive pulmonary disease were excluded. The data of 108 patients who had Doppler echocardiograms performed before the first pacemaker implantation procedure and this pacemaker replacement procedure were obtained and retrospectively analyzed. According to the post-implant grade of TR, the patients were divided into two groups: normal tricuspid (n = 79) and abnormal tricuspid (n = 29). Their clinical characteristics and echocardiographic data between two groups were analyzed and compared. RESULTS: The mean follow-up time (from the first pacemaker implantation) was (13 ± 6) years (range: 4 - 34). Among 108 patients with initially normal tricuspid post-implant, 29 patients (26.9%) developed significant TR during the follow-up. In comparison to those in normal tricuspid group, the patients in abnormal tricuspid group had a longer time from the first pacemaker implantation ((16 ± 7) vs (12 ± 5) years, P = 0.003), more transtricuspid leads (1.31 ± 0.66 vs 1.10 ± 0.30, P = 0.026), larger right atrial size ((38 ± 7) vs (35 ± 4) mm, P = 0.028) and higher prevalence of mild TR and mitral valve regurgitation (MR) pre-implantation (TR: 21% vs 4%, P = 0.015, MR: 28% vs 5%, P = 0.003). The size of right atrium, right ventricle and left atrium in abnormal tricuspid group were more than those in normal tricuspid group. The prevalence of significant MR post-implantation in abnormal tricuspid group was higher than that in normal tricuspid group. The ejection fraction in abnormal tricuspid group was lower than that in normal tricuspid group during the follow-up. CONCLUSIONS: Abnormal TR after PPI during a long-term follow-up is quite common. The related factors include the time interval from the first pacemaker implantation, number of transtricuspid lead, right atrial size, mild TR and MR pre-implantation.

[Acute kidney injury early after cardiac surgery with cardiopulmonary bypass: clinical analysis].

OBJECTIVE: To explore the occurrence of acute kidney injury (AKI) in early stage after cardiac surgery under cardiopulmonary bypass (CPB) and discuss the perioperative risk factors and its impact on clinical outcome. METHODS: Retrospective analysis was performed among 1472 adult patients undergoing cardiac surgery with CPB between January 2008 and April 2011. The postoperative occurrence of AKI following cardiac surgery was stratified according to the RIFLE criteria. And the perioperative risk factors of AKI and its impact on clinical outcome were analyzed. RESULTS: AKI occurred in 437 patients (29.7%) within 72 hours postoperation. Of these, 292 (19.8%) fulfilled AKI-Risk, 110 (7.5%) AKI-Injury and 35 (2.4%) AKI-Failure. Logistic regression analysis showed that age, hypertension, chronic renal insufficiency, reoperation, aortic surgery, CPB duration, intraoperative transfused erythrocyte volume and perioperative use of intra-aortic balloon pump were independent risk factors for AKI. A postoperative elevation of AKI level was associated with a prolonged duration of mechanical ventilation, intensive care unit stay, postoperative hospital stay, delayed extubation, extubation failure and death. Receiver operator characteristic (ROC) curve showed that AKI classification was a postoperative predictor of delayed extubation, extubation failure and death. CONCLUSION: As a common complication after cardiac surgery, AKI is associated with many perioperative risk factors. And the AKI classification is predicator of delayed extubation, extubation failure and death.

[Impact of prior percutaneous coronary intervention on outcome of coronary artery bypass graft surgery].

OBJECTIVE: To determine the impact of prior percutaneous coronary intervention (PCI) on outcome of coronary artery bypass graft (CABG) surgery. METHODS: Perioperative data were collected from 1306 patients undergoing CABG from January 2002 to November 2010, including 117 patients with prior PCI and 1 189 patients without prior PCI. Among 117 patients with prior PCI, 99 patients had a single PCI procedure and 18 had multiple PCI procedures. The surgical outcomes including in-hospital mortality and major adverse cardiac events were compared between two groups. RESULTS: Patients with prior PCI were younger, less likely to have triple vessel and left main stem disease, and less recent myocardial infarction. Interval time between PCI and CABG was (13.39 ± 13.81) months. There were no significant difference in in-hospital mortality (1.7% compared with 0.5 % P=0.156) and major adverse cardiac events (including postoperative myocardial infarction, stroke, and in-hospital death,2.6% compared with 1.1% P=0.167) between two groups. CONCLUSION: There was no association between prior PCI and isolated CABG. Good outcomes can be obtained in the group of patients undergoing CABG who have had previous PCI.

[Early and midterm outcomes of coronary artery bypass grafting in octogenarians].

OBJECTIVE: To investigate the early and midterm postoperative outcomes and analyze risk factors of coronary artery bypass grafting (CABG) in octogenarians. METHODS: Clinical data of 38 patients aged 80 years or greater receiving isolated coronary artery bypass grafting from September 2001 to November 2010 were reviewed. There were 33 male and 5 female patients, aging from 80 to 87 years with a mean of (82.6 ± 1.2) years. Twelve patients underwent conventional (on-pump) CABG and 26 patients underwent off-pump CABG. The number of bypass grafts was 1 to 5 (mean 2.5 ± 1.1). Left internal mammary artery was used in 37 (97.3%) patients. RESULTS: The perioperative mortality was 2.6% (1/38). Postoperative complications included stroke (4 cases), respiratory infection (1 case). The atrial arrhythmias occurred in 25 patients. Intensive care unit and hospital length of stay lasted (3.8 ± 1.4) days and (15 ± 6) days, respectively. Totally 38 patients were followed up for 4 to 70 months. Six patients died during the follow-up period. The 92.6% patients recovered without any cardiac events. CONCLUSIONS: Isolated CABG can be performed safely with acceptable postoperative morbidity and mortality in octogenarians. Appropriate surgical strategy and intensive perioperative treatment must be enhanced in octogenarians who underwent CABG.

[The empirical study on paracrine communication of bone marrow mesenchymal stem cells].

OBJECTIVE: To study the influence of (60)Co gamma exposure on paracrine effect of marrow mesenchymal stem cells (MSC). To evaluate the function and construction after early stage of acute myocardial infarction (AMI) by injection of supernatant liquid. To discuss the mechanism of prarcrine communication initially. METHODS: MSC were radiated by (60)Co gamma with different dosage. The culture solution was collected peri-irradiation. The changes of Vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), Interleuki-1beta (IL-1beta) in supernatant liquid were checked by ELISA. Using a rat model of AMI, the supernatant liquid and control medium were injected intramyocardially and intraperitoneally according to the project. After 4 weeks, the cardiac dimension and functions were assessed, the microvessel density were detected. RESULTS: Three cytokines decreased significantly after irradiation, with the increasing in dosage of irradiation, the secretory volume of cytokines decreased greatly. When compared with the control group (group A 6.6 +/- 0.6) and medium group (group C 5.7 +/- 0.7), the microvessel density in supernatant liquid group (group B 10.8 +/- 2.9) increased obviously, contributing to improvement in cardiac function and dimension. (Left ventricular internal dimension in diastolic (LVDd) postoperation: A 8.1 mm +/- 1.5 mm, B 7.0 mm +/- 1.5 mm, C 7.7 mm +/- 1.1 mm; Eject fraction (EF) postoperation: A 43.8% +/- 8.9%, B 51.5% +/- 7.8%, C 45.6% +/- 8.1%. CONCLUSIONS: (60)Co gamma radiation exposure can degrade MSC' ability of paracrine communication. The paracrine effect which should take important role in improving the cardiac function after AMI. The mechanism of prarcrine is complex, neovascularization is the important link.

[Clinical analyses of cardiovascular operations in patients with severe dilated left ventricle].

OBJECTIVE: To explore the perioperative features of surgical treatment in valvular patients with severe dilated left ventricle and investigate the structural changes of left ventricle and its correlation with cardiac functions. METHODS: A total of 126 patients with severe dilated left ventricle underwent mitral valve and/or aortic valve operation from January 2003 to December 2008, including mitral valve replacement (MVR) (n = 27), mitral valvuloplasty (MVP) (n = 13), aortic valve replacement (AVR) (n = 51), AVR+MVR (n = 25) and AVR + MVP (n = 10). There were 79 males and 47 females with a mean age of (52 ± 13) years old. The mean pathological course was (18 ± 12) years. The pathological changes were mainly of aortic and/or mitral incompetence. The concomitant procedures included Bentall procedure (n = 6), coronary artery bypass grafting (n = 3), tricuspid valvuloplasty (n = 58) and left atrial folding (n = 62). RESULTS: The perioperative mortality was 3.17% (4/126). Two died of multiple organ failure (MOF) secondarily to severe low-output syndrome while another 2 died of sudden ventricular fibrillation. Forty-six (36.5%) patients suffered from ventricular arrhythmia during the earlier postoperative period and they required a venous injection of lidocaine and/or amiodarone. Fourteen (11.1%) patients suffered from severe low-output syndrome. Among them, 4 patients were resuscitated with an intra-aortic balloon pump for another 4 - 6 days. And 26 (20.6%) cases were complicated with multiple organ failure. The echocardiographic examinations showed that left ventricular dimensions decreased significantly at Days 7 - 14 postoperatively and progressively at Months 6 - 12 postoperatively. Left ventricular end-diastolic diameter (LVEDD) was (77 ± 6) mm preoperatively and (63 ± 12) mm (Days 7 - 14), (58 ± 10) mm (Months 6 - 12) postoperatively (P < 0.01). The contractile function of left ventricle temporarily decreased during the early postoperative stage and improved gradually afterwards. But it was not restored to normal range even until 6 - 12 m post-operation. Ejection fraction was 49% ± 12% preoperatively and 42% ± 9% (Days 7 - 14), 51% ± 7% (Months 6 - 12) postoperatively (P < 0.01). Left ventricular fraction shortness was 28% ± 7% preoperatively and 25% ± 4% (Days 7 - 14), 29% ± 5% (Months 6 - 12) postoperatively (P < 0.05). CONCLUSION: For the patients with severe dilated left ventricle, cardiovascular operation can achieve an excellent outcome through a rigorous perioperative regiment. The prevention and treatment of postoperative ventricular arrhythmia should be emphasized. The dimension of left ventricle decreases progressively during the early postoperative period. There is a postoperative decline of cardiac functions.

[Analysis on the risk factors of intracardial thrombus after prosthetic valve replacement: a 1-year follow-up study].

OBJECTIVE: To analysis the risk factors predicting intracardial thrombus after prosthetic valve replacement. METHODS: The clinical data of 29 cases from January 2005 to April 2009 with intracardial thrombus after prosthetic valve replacement during a 1-year follow-up was retrospectively analyzed. There were 11 male and 18 female, aged from 12 to 70 years with a mean of 48 years. The risk factors of intracardial thrombus were examined by univariate and multivariate analysis. RESULTS: Univariate analysis found that bioprosthetic valve replacement, anticoagulation using aspirin, valve replacement at mitral position, atrial fibrillation, preoperative and postoperative internal diameter of left atrium, postoperative fibrinogen were predict factors of intracardial thrombus after prosthetic valve replacement (P < 0.05). Logistic regression analysis showed valve replacement at mitral position (OR = 9.815, P < 0.05), atrial fibrillation (OR = 5.267, P < 0.05), preoperative internal diameter of left atrium (OR = 4.529, P < 0.05) were significant risk factors of intracardial thrombus after prosthetic valve replacement. CONCLUSIONS: Valve replacement at mitral position, atrial fibrillation, and preoperative internal diameter of left atrium are the correlated risk factors of intracardial thrombus after prosthetic valve replacement. Anticoagulation after prosthetic valve (especially bioprosthetic valve) replacement should be standardized to prevent intracardial thrombus formation.

[The empirical study in transplantation of bone marrow mesenchymal stem cells for acute myocardial infarction].

OBJECTIVE: To study the effect of (60)Co gamma ray on proliferation and differentiation potency of MSC. To evaluate the function of heart after early stage of acute myocardial infarction (AMI) in rats by transplantation of MSC. METHODS: Irradiated MSC was cultured with the method of adherent culture, the ability of its proliferation was detected by Methyl thiazolyl tetrazolium (MTT) shade selection test. The express of Cardiac troponin T (C-TNT) and beta-myosin heavy chain (beta-MHC) in MSC were detected by Reverse transcriptase-polymerase chain reaction (RT-PCR), which was induced by 5-azacytidine. Using a rat model of AMI, irradiated and unirradiated MSC were transplanted into myocardium after infarction. At 4 weeks, the cardiac dimension and functions were assessed by echocardiography and hemodynamics, the microvessel density were detected after VIII factor immunohistochemistry stain. RESULTS: The ability of proliferation in 4Gy group was depressed. C-TNT and beta-MHC expressed somewhat in unirradiated group. When compared with the control group (6.6 +/- 0.6), the microvessel density in both transplanted groups (12.7 +/- 2.2, 11.5 +/- 2.1) increased, contributing to improvement in cardiac function and dimension. CONCLUSION: MSC with or without differentiation potency can improve cardiac function equally at the early stage of AMI.

[Structural and functional changes of postoperative small left ventricle patients].

OBJECTIVE: To explore the perioperative features of surgical treatment in valvular patients with small left ventricle, and investigate the postoperative early structural changes of left ventricle and its correlation with cardiac function. METHODS: A total of 51 patients with small left ventricle underwent mitral valve replacement from January 2003 to August 2008. There were 7 males and 44 females with mean age of (48 +/- 5) years old. The mean pathologic course was (18 +/- 9) years old. The concomitant procedures included aortic valve replacement in 6 cases, coronary artery bypass grafting in 1 case, tricuspid valvular plasty in 48 cases, left atrial thrombi scavenging in 36 cases, and left atrium folding in 42 cases. RESULTS: The perioperative mortality was 3.9% (2/51). Fourteen patients (27.5%) suffered from severe low-output syndrome in the earlier period postoperatively. Among them, 5 patients needed secondary cardiopulmonary bypass (CPB) to assist circulation, with the result of 1 patient died of weaning off CPB unsuccessfully, 1 patient revived with intra-aortic balloon pump assisted for another 2 d after termination of CPB and another 1 patient died of multiple organ failure (MOF) 10 d later. Eleven cases complicated with MOF. Five patients complicated with ventricular arrhythmia. The echocardiographic examinations showed that the left ventricular dimensions didn't expand significantly postoperatively at 7 to 14 d postoperatively. Left ventricular end-diastolic diameter (LVEDD) was (36.5 +/- 3.2) mm preoperatively and (38.6 +/- 5.3) mm postoperatively (P > 0.05). Preoperative LVEDD index (LVEDDI) was (45.9 +/- 3.8) ml/m(2) and postoperative LVEDDI was (48.2 +/- 7.4) ml/m(2) (P > 0.05). The contract function of left ventricle was improved postoperatively but with no statistical significance. Ejection fraction was 48.6% +/- 6.7% preoperatively and 52.8% +/- 8.3% postoperatively. Left ventricular fraction shortness was 25.5% +/- 3.3% preoperatively and 27.1% +/- 1.3% postoperatively. CONCLUSIONS: For the patients with small left ventricle usually, the postoperative emphases should be put on the management of low output syndrome. The decreased dimension of left ventricle doesn't expand in the early period after valvular operation.

Etiology of 305 cases of refractory hematospermia and therapeutic options by emerging endoscopic technology.

To investigate the surgical outcomes of vesiculoscopy on refractory hematospermia and ejaculatory duct obstruction (EDO), the clinical data (including pelvic magnetic resonance imaging (MRI) examinations and the long-term effects of endoscopic treatment) from 305 patients were analyzed. Four main etiologic groups were found on MRI. We found that 62.0% (189/305) of patients showed abnormal signal intensity in MRI investigations in the seminal vesicle (SV) area. Cystic lesions were observed in 36.7% (112/305) of the patients. The third sign was dilatation or enlargement of unilateral or bilateral SV, which were observed in 32.1% (98/305) of the patients. The fourth sign was stone formation in SV or in an adjacent cyst, which was present in 8.5% (26/305) of the patients. The transurethral endoscopy or seminal vesiculoscopy and the related procedures, including fenestration in prostatic utricle (PU), irrigation, lithotripsy, stone removal, biopsy, electroexcision, fulguration, or transurethral resection/incision of the ejaculatory duct (TURED/TUIED), chosen according to the different situations of individual patients were successfully performed in 296 patients. Fenestrations in PU+ seminal vesiculoscopy were performed in 66.6% (197/296) of cases. Seminal vesiculoscopy via the pathological opening in PU was performed in 10.8% (32/296) of cases. TURED/TUIED + seminal vesiculoscopy was performed in 12.8% (38/296) of cases, and seminal vesiculoscopy by the natural orifices of the ejaculatory duct (ED) was performed in 2.4% (7/296) of cases. Electroexcision and fulguration to the abnormal blood vessels or cavernous hemangioma at posterior urethra were performed in 7.4% (22/296) of cases. Two hundred and seventy-one patients were followed up for 6-72 months. The hematospermia of all the patients disappeared within 2-6 weeks, and 93.0% of the patients showed no further hematospermia during follow-up. No obvious postoperative complications were observed. The transurethral seminal vesiculoscopy technique and related procedures are safe and effective approaches for refractory hematospermia and EDO.

[Effect of non-restrictive external stent on the expression of platelet-derived growth factor in vein grafts of rabbits].

OBJECTIVE: To investigate the potential mechanism of non-restrictive external stent in preventing re-stenosis of vein grafts. METHODS: Thirty-six rabbits underwent reversed bypass grafting of autologous external jugular vein into common carotid artery and then were randomly divided into two equal groups, stenting group (Group S), with an external stent 6 mm in diameter (Dacron vascular prosthesis) surrounding the vein graft, and control group (Group NS) , without stenting. The vein grafts were harvested 7, 14, and 28 days after the operation respectively. Immunocytochemistry was used to detect the platelet-derived growth factor B (PDGF-B) positive cells. The mRNA expression of PDGF-B was detected with RT-PCR. RESULTS: The PDGF-B positive cell percentages in the intima of Group S 7 and 14 days later were both significantly lower than those of Group NS (15.2% +/- 3.6% vs 21.6% +/- 4.6%, and 6.5% +/- 2.6% vs 12.5% +/- 4.4%, both P < 0.05) . The PDGF-B positive cell percentages in media 7, 14 and 28 days later of Group S were all significantly lower than those of Group NS (13.8% +/- 4.6% vs 25.4% +/- 6.2%, 21.3% +/- 4.4% vs 35.7% +/- 7.3%, and 7.2% +/- 3.2% vs 19.2% +/- 5.4%, all P < 0.01). The PDGF-B positive cell percentage in adventitia peaked 28 days later in Group S and 14 days later in Group NS, and the PDGF-B positive cell percentage in adventitia 28 days later of Group S was significantly higher than that of Group NS (42.5% +/- 8.6% vs 31.9% +/- 4.6%, P < 0.01). RT-PCR analysis revealed that PDGF-B amplification products (457 bp) appeared in both group S and NS from 7 to 28 days, and the PDGF-B mRNA expression levels 7, 14, and 28 days later of Group S were all significantly lower than those of Group NS (31.2% +/- 6.5% vs 45.4% +/- 8.4%, P < 0.05; 42.3% +/- 6.2% vs 65.2% +/- 11.5%, P < 0.01; and 21.3% +/- 5.6% vs 36.2% +/- 9.4%, P < 0.01). CONCLUSION: Non-restrictive external stenting can inhibit the synthesis of PDGF and change its distribution, which may be one of the mechanisms of external stent in preventing re-stenosis of vein grafts.

[The use of recombinant activated factor VII for blood loss after cardiovascular surgery].

OBJECTIVE: To describe the early experiences with rFVIIa in the management of bleeding after cardiovascular surgery. METHODS: From May 2006 through December 2007, 16 patients received rFVIIa during or after surgery despite conventional medical therapy and transfusion of blood products. There were 15 male patients and 1 female patients, aged from 36 to 77 years old with a mean of 52 years old. The surgical procedures include aortic procedures for 8 cases, valve replacement for 6 cases, pulmonary thromboendarterectomy for 1 case and atrial septal defect repair for 1 case. The data of these patients were reviewed and the safety and efficacy of rFVIIa after cardiovascular surgery were evaluated. RESULTS: rFVIIa was administered as a first dose of 27.6 to 54.5 microg/kg with a mean of 40.2 microg/kg. Six patients achieved hemostasis after the first dose. Nine patients received a second administration within 30 min, with a cumulative dose of 59.3 to 90.9 microg/kg, a mean of 80.3 microg/kg. Eight patients achieved hemostasis and 1 patient went to exploration. One patient received four doses of rFVIIa with a cumulative dose of 203.4 microg/kg and the bleeding stopped. Mean amount of chest drain loss and the amount of red blood cell, fresh frozen plasma, cryoprecipitate, and platelet transfusions decreased significantly after rFVIIa administration. The total amount of chest drain losses, transfusions of red blood cell and cryoprecipitate within 12 h postoperatively was positively correlated with the time from the end of bypass to administration of rFVIIa. No thromboembolic complications and other adverse reactions were noted. CONCLUSIONS: The use of rFVIIa is associated with reduced blood loss, rapid improvement of coagulation variables, and decreased need for blood products. rFVIIa is safe and efficacious in the management of refractory postcardiotomy bleeding.

[Diagnostic study on the coronary artery bypass grafts lesions using 64 multi-slice computed tomography angiography].

OBJECTIVE: To evaluate the diagnostic accuracy in the assessment of coronary artery bypass grafts using 64 multi-slice computed tomography angiography (64-MSCTA) technology. METHODS: There were 228 patients post coronary artery bypass grafting (CABG) underwent 64-MSCTA from July 2005 to April 2007. Thirty-one patients with 82 bypass grafts performed coronary angiography (CAG) because of angina or grafts lesion showed by 64-MSCTA. RESULTS: All bypass grafts could be visualized by 64-MSCTA. Thirteen bypass graft occlusions and fourteen significant stenosis were detected by 64-MSCTA and confirmed by CAG. One venous grafts distal anastomosis was missed and another one was miss diagnosed as stenosis. One false negative and one false positive CT-finding resulted in a sensitivity of 93.3%, a specificity of 98.1%, a positive predictive value of 93.3%, a negative predictive value of 98.1% and an accuracy of 97.1% for grafts stenosis. As to the grafts lesion, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy for grafts occlusion were 96.4%, 98.1%, 96.4%, 98.1% and 97.6%, respectively. CONCLUSION: 64-MSCTA demonstrates high diagnostic accuracy in the assessment of graft patency and suitable for the follow-up of patients post CABG.

Expression Status of PIWIL1 as a Prognostic Marker of Colorectal Cancer.

The PIWI-like protein 1 (PIWIL1) plays a crucial role in stem cell proliferation, embryogenesis, growth, and development, as well as differentiation and maturation in multiple organisms. The relationships between PIWIL1 expression and clinicopathological features of colorectal cancer (CRC) patients were analyzed by us. Survival analysis was performed using the Kaplan-Meier method and Cox's proportional hazards model. The high expression rate of PIWIL1 in the cancer tissue was obviously higher than that in the corresponding adjacent tissue. The expression of PIWIL1 was closely related to the tumor differentiation degree, infiltration depth, lymphovascular invasion, lymph node metastasis, and TNM stage. The Kaplan-Meier survival model suggested that the survival time of CRC patients in the high PIWIL1 expression group was notably lower than that in the low PIWIL1 expression group. High PIWIL1 expression suggests a poor prognosis for CRC patients, and PIWIL1 can serve as an important molecular marker for predicting the prognosis of CRC patients.

[Mean flow of saphenous vein graft and its influencing factors in patients performed coronary artery bypass grafting].

OBJECTIVE: To analyze the mean blood flow of saphenous vein (SV) graft and it's influencing factors in off-pump coronary artery bypass grafting by using transit-time flowmeter (TTFM). METHODS: Three hundred and twenty-six patients were studied. After all anastomoses were completed, and hemo-dynamic status was stable, TTFM was utilized to measure and record the SV flow wave, pulsatility index (PI), value of mean flow, diastolic and systolic peak flow, vascular resistance, insufficiency ratio and mean blood pressure. The standard conditions of good graft status to define the normal mean flow included good diastolic augmentation of blood wave, PI less than 5, intraoperative and postoperative no significant change in electrocardiogram, and smoothly postoperative recovery. RESULTS: Total mean flow calculated from that of all patients was (39 +/- 23) ml/min (10-153 ml/min). Majority mean value (60.1%, 196/326) was in the range of 20-50 ml/min. Statistics showed that mean flow was significantly related to vascular resistance and diastolic peak flow and PI rather than the other factors (r was -0.95, 0.77 and -0.51 respectively). CONCLUSIONS: For the patients, over 15 ml/min mean flow of SV graft is acceptable, and over 35 ml/min is satisfactory. The diastolic peak flow and vascular resistance are two important factors influencing mean flow.

[Effect of A Novel Emodin Derivative on Chronic Myelogenous Leukemia K562 Cells and Imatinib-resistant K562/G01 Cells].

OBJECTIVE: To explore the effect of a novel emodin derivative E19 on proliferation inhibition and apoptosis induction of human chronic myelogenous leukemia (CML) cell line K562 and imatinib-resistant CML cell line (K562/G01), and to clarify the involved mechanisms. METHODS: MTT and colony formation test were used to detect the cell proliferation. Apoptotic induction effects were examined by DAPI staining method and DNA ladder assay. Western blot was performed to detect the changes of P210(Bcr-Abl) protein. RESULTS: The emodin derivative E19 could efficiently inhibit proliferation and induce apoptosis in K562 and K562/G01 cells. IC50 of K562 cells and IC50 of K562/G01 cells were (1.20 ± 0.19) µmol/L and (1.22 ± 0.16) µmol/L, respectively. DNA fragmentation in K562 cells and K562/G01 cells confirmed that the E19 induced apoptosis in dose-dependent manner. Western blot showed that emodin derivative inhibited phosphorylation of P210 protein in K562 cells and K562/G01 cells and down-regulated the expression level of P210 in dose- and time-dependent manners. CONCLUSION: The emodin derivative E19 can efficiently inhibit growth and induce apoptosis of K562 cells and K562/G01 cells, while the inhibition of phosphorylation of P210 protein and down-regulation of P210 protein expression may be involved in these processes.

[A comparative study on grafts' blood flow after on-pump and off-pump coronary artery bypass surgeries].

OBJECTIVE: To compare the grafts' blood flow after on-pump and off-pump coronary artery bypass graftings. METHODS: Five hundred and forty-seven cases were studied, including four hundred and three cases undergoing off-pump coronary artery bypass (OPCAB, off-pump group) and one hundred and forty-four cases undergoing on-pump coronary artery bypass (CCABG, on-pump group). In all cases left internal mammary artery (LIMA) was routinely anastomosed to left anterior descending artery (LAD), and saphenous vein (SV) to the other target vessels in sequential mode when there were more than two anastomoses. After all anastomoses were completed and hemodynamic status was stable, transit time flow-meter was utilized to measure and record the grafts' flow wave, pulsatility index (PI), value of mean flow, diastolic and systolic peak flow, vascular resistance, insufficiency ratio and mean blood pressure. RESULTS: PI, insufficiency ratio and diastolic peak flow of LIMA in off-pump group were 2.7 +/- 1.8, (2.2 +/- 4.3)%, (46.8 +/- 2.7) ml/min respectively; those in on-pump group were 2.8 +/- 2.0, (3.4 +/- 3.1)% and (52.8 +/- 3.7) ml/min respectively. And those of SV in off-pump group were 2.8 +/- 0.1, (1.8 +/- 0.3)% and (85.8 +/- 3.2) ml/min respectively and those in on-pump group were 2.6 +/- 0.2, (1.3 +/- 0.2)% and (93.9 +/- 5.6) ml/min respectively. For both LIMA and SV grafts' blood flow there was no significant difference in PI, insufficiency ratio, diastolic peak flow and mean blood pressure in both groups (P > 0.05). The mean flow and systolic peak flow in off-pump group were significantly less than those in on-pump, while the vascular resistance in off-pump group was significantly greater than that in on-pump group (P < 0.01). CONCLUSION: There is no significant difference in grafts' patency between OPCAB and CCABG.

[Clinical analysis of 1018 cases of coronary artery bypass grafting].

OBJECTIVE: To analyze retrospectively 1018 patients who underwent coronary artery bypass grafting surgery (CABG) in order to summarize surgical techniques and clinical outcome. METHODS: From 1997 through 2004, data of same surgeon for 508 patients who underwent conventional coronary artery bypass surgery on pump (CCABG) and 510 patients who underwent off-pump CABG (OPCAB) were collected and analyzed retrospectively. Eight hundred and fifty-two patients had unstable angina, 582 patients were over 60 years old (57.2%) and 784 patients had concomitant diseases including valve lesion, hypertension, diabetes, myocardial infarction, left ventricular aneurysm with septal defect, stroke, chronic obstructive pulmonary diseases, renal failure and cancer. A hundred and fifty-six patients had left main stem (LIMS) stenosis and 671 patients, triple-vessel disease. RESULTS: Total mortality was 0.39% (4-case death) and morbidity, 1.6% (sternal dehiscence, stroke and mediastinitis). The grafts per patient with CCABG and OPCAB were 3.3 +/- 0.6 vs. 2.5 +/- 0.4. Left internal mammary artery use was 93.8% of the patients, 29 patients were implanted intra-aortic balloon pump intraoperatively. Follow-up was 4 months to 7 years. CONCLUSIONS: Scientific surgical strategies, excellent surgical techniques and improvement of cardiac anesthesia and cardiopulmonary bypass make the mortality and morbidity decrease significantly, CABG surgery is safe and effective in patients with coronary artery disease.

Transurethral endoscopic treatment of seminal vesicle cysts (report of seven cases).

OBJECTIVE: Seminal vesicle cysts are a rare disorder of the male reproductive system. The goal of this report was to summarize the radiological manifestations and transurethral endoscopic treatment of large seminal vesicle cysts. MATERIALS AND METHODS: The clinical data of seven cases of giant seminal vesicle cysts, including their symptoms, radiological images, transurethral endoscopic treatment, and postoperative follow-up, were retrospectively reviewed. RESULTS: Computerized tomography and magnetic resonance imaging (MRI) demonstrated the cysts behind the bladder, above the prostate, and away from the midline. The lesions ranged in size from 8.26 cm × 7.98 cm × 4.85 cm to 9.27 cm × 8.95 cm × 8.15 cm. Two cases were associated with ipsilateral renal and ureteral agenesis and were classified as congenital malformations. The other five cases were simple seminal vesicle cysts thought to be secondary to acquired ejaculatory duct obstruction. All seven cases were successfully treated using transurethral endoscopic unroofing with cautery of the mucosa. All the seminal vesicle cysts were confirmed by pathologic examination. No malignant disease was found. All preoperative symptoms resolved after surgery. No complications were observed. No patient developed abnormalities of erection, ejaculation, or orgasm. No bladder or rectal injuries were noted. The seminal vesicle cysts were significantly decreased in size or absent 3-6 months after treatment. CONCLUSION: MRI best characterized seminal vesical cysts and their cause. Transurethral unroofing with cautery of the mucosa is an extension of well-accepted cystoscopic techniques. It is safe, easy to perform, and effective. It is the preferred method for the treatment of large seminal vesicle cysts.