The minimally invasive approach is the direction of cardiac surgery.With the development of telemanipulation and computer technology,the minimally robotic surgery has become reality.As the one of the most minimally invasive cardiac surgery,the robotic surgical system provides cardiac surgeons with less invasive manner and dexterity manipulation.Robotic cardiac surgery is an evolutionary process and has resulted in a substantial increased attention to surgeons and patients.This review is to introduce the recent clinical application of robotic technology in cardiac surgery.

Objective To investigate the effect of non-restrictive external stent on both cell proliferation of rabbit vein grafts and prevention from hyperplasia of the grafts' neointima. Methods 36 New Zealand white rabbits were randomly divided into two groups, each animal was subjected to a reversed autologous venous graft between external jugular vein and common carotid artery. In stenting group (group S), the vein grafts were surrounded by a 6 mm in diameter non-restrictive stent, and in non-stenting group (group NS), there is no stent to support the vein grafts. The grafts were harvested 1 week (1W), 2 weeks (2W) and 4 weeks (4W) after surgery, respectively. The sections were stained with hematoxylin and eosin stain, ?-smooth muscle actin (?-SMA) and proliferating cell nuclear antigen (PCNA) immunocytochemistry stain. PCNA index was calculated in intima, media and adventitia, respectively. Results (1) HE staining: From 1W to 4W, the hyperplasia of intima and media appeared gradually in both group S and group NS, nevertheless such hyperplasia in group S was lessintense than in group NS. (2) ?-SMA staining: Almost all cells in media were positive, but few cells were positive in intima of both groups at 1W; the thickness of intima of both groups increased gradually, and almost all cells except endothelial cells were positive in intima in both groups, though the thickness of intima of group S was smaller than in group NS at 2W and 4W. (3) PCNA index: the index of intima in both two groups peaked at 2W, and the index of intima in group S was less than in group NS at 2W and 4W, P

0.05; at 14 d,28 d, the thickness and area of the intiam in group S were smaller than those in group NS,P

Objective To study the changes in protease and cytokines,and to evaluate the protective effect of ulinastatin on ischemia-reperfusion lung injury in rabbits.Methods Thirty New Zealand rabbits were randomly divided into three groups(n=10): control group,traumatic hemorrhagic shock group(shock group) and ulinastatin-treated group.Blood samples were taken at four time points: pre-shock,post-shock,as well as 2h and 4h after blood volume repleshment.The serum levels of TNF-? and IL-8 were measured.4h after blood volume repleshment,the rabbits were sacrificed.The activity of myeloperoxidase(MPO) in lung tissue and neutrophil elastase(NE) in bronchoalveolar lavage fluid(BALF) were determined.Results In control group,the serum concentrations of TNF-? and IL-8 showed no obvious changes during the experiment.While in shock group and ulinastatin-treated group,the serum concentrations of TNF-? and IL-8 increased significantly in the duration of experiment compared with the values before shock(P

0.05). While the significant differences existed between postoperative hypoxemia group and non-hypoxemia group (P

0.05). The levels of PT, APTT, TT were longer and INR was higher and FB, PTA were lower in two groups at the end of operation than at the preoperative day (P0.05). CCABG group was higher than OPCABG group in Allogeneic blood transfusion (P

Objective To analyze the hemodynamic changes during coronary artery bypass grafting with or without cardiopulmonary bypass.Methods Thirty patients undergone coronary artery bypass grafting from January to June,2006 were retrospectively analyzed.Among them,12 patients were operated on with cardiopulmonary bypass(CCABG)and 18 without cardiopulmonary bypass(OPCAB).The stabilizator(type Octops III)was used to fix target vessels in OPCAB group.In CCBAG group,the extracorporeal circulation was used routinely,and internal mammary artery and saphenous vein were used to anastomose with target branches of coronary artery.The hemodynamic changes at different time points during and after operation were monitored,and the relevant parameters were also recorded.Results The anaesthesia time,intraoperative blood loss and fluid input,and ventilating time after operation in CCABG group were significantly higher than those in OPCAB group,and the postoperative haematocrit(HCT)was significantly lower in CCABG group than that in OPCAB group(P

Studies were carried out on the incidence of SCE and chromosomal aberrations in primary cultured cells of mouse embryo exposed to ~(60)Co-? rays and/or treated with chemical carcinogen——benzopyrene.Result shows in the cultured cells exposed to ~(60)Co-? rays at 50 rads, as compared wtih controls there was no statistically significant change in the frequencies of the appearance of both SCE and chromosomal aberrations, In the cells, however, exposed at 300 rads, the frequencies of SCE and chromosomal aberrations were about 1.3 and 24 times higher than that in the unirradiated controls respectively. In the cultured cells treated with 0.05?g of benzopyrene per millilitre of culture medium, the frequency of SCE were increased by about 1.8 times of that of the control group, while the change of chromosomal aberrations had no statistical significance.From the above results, it was suggested that SCE was proved to be a sensitive indicator for evaluating the effects of chemical carcinogens. There is a remarkable difference existing between the frequencies of SCE and chromosomal aberrations induced by ionizing radiation and chemical carcinogens. The difference seems to have a certain relation to their differences in carcinogenic mechanism and effects on carcinogenesis.It was noted that there are some advantages to utilize primary cultured cells of mouse embryo as target cells.

Objective: The study was to analyze hemodynamic changes of blood flow of left internal mammary artery (LIMA) in off-pump coronary bypass surgery (OPCAB). Methods: From January 2002 to August 2002, a total of 65 patients received intraoperative hemodynamic assessment of their bypass grafts by transit-time flowmeter(TTFM) during OPCAB. All operations and flow measurements were performed by the same surgeon (GCQ). The mean age of patients was (64.3?0.94) years(range 47 to 75 years), There were 50 men and 15 women. One-vessel disease was in 7 patients, two-vessel disease in 26, three-vessel disease in 32, and left main stem disease (isolated or associated) in 22. Left anterior descending artery (LAD) was routinely bypassed with LIMA. The blood flow of LIMA was measured immediately after completion of the anastomosis to LAD (early phase) and before sternum closure (late phase) using transit-time flowmeter. Results: The mean flow significantly decreased from (29.91?3.32) ml/min in early phase to (25.12?2.56) ml/min, P

0.05). Accordingly, statistics shows that the mean value of PI is 2.56?2.35. Conclusion: The referential range of PI for Chinese CABG patients is 2.56?2.35.