Objective To develop a new rabbit model of myocardial infarction and assess left ventricular function and the survival rates.Methods A total of 30 adult rabbits were equally and randomly assigned into improved（n =15）and traditional model groups（n =15）.The rabbits were not intubated and ventilated in improved model group.A thoracotomy was performed along the left sternum by small nick with rib and pleura cavity integrity.The left anterodecendant arteries（LAD）of adult rabbits were ligated to establish animal models of my-ocardial infarction by a 60-min occlusion of the LAD,followed by reperfusion.In another group,rabbits were intubated and ventilated with rib abscised during thoracotomy inversely.Echocardiographic assessment was performed 3 weeks after myocardial infarction and survival rates were analyzed.Results Echocardiography showed that there was a sizable reduction in systolic and diastolic function in both groups with cardiac function significantly decreased 3 weeks later.Compared with traditional model group,improved method significantly increased the survival rate of rabbit model with myocardial ischemia.Conclusion This improved method is applicable to make an animal model of my-ocardial ischemia in rabbit.We established a simple,rapid,and effective method to mimick myocardial infarction in rabbit.

Objective To evaluate the effectiveness of mild hypothermia and the intra-aortic balloon pump (IABP) in postcardiac surgical patients with severe heart failure. Methods Twelve patients took combination therapy of IABP and mild hypothermia after cardiac surgery, which did not improve the low cardiac output with massive doses of catecholamine, were included in this study. The values of cardiac index (CI), mixed venous oxygen saturation (SvO2), urine volume and creati-nine (Cr) were measured before and after treatment. Results After combination therapy of IABP and mild hypothermia, the value of CI was improved obviously [L/(min·m2):2.4±0.5 vs 1.6±0.2], the value of SvO2 increased (0.65±0.07 vs 0.52±0.05 ), urine output increased obviously [mL/(kg·h):2.9±1.9 vs 1.2±0.9 ] and the value of Cr decreased obviously (mmol/L:95±10 vs 282±25 ). Conclusion The combination therapy of mild hypothermia and IABP is an effective and simple procedure for the postcardiac surgical patients with severe heart failure.

Objective To study the feasibility and clinical experience of off-pump multivessel coronary artery bypass grafting (OPCAB) for patients with acute myocardial infarction (AMI). Methods Sixty-one patients with AMI were treated surgically. The mean age of was (64.7?7.2) years. The last attack angina pectoris unreliable with use of Nitro-Glycerine, and the levels of CK-MB documented (3.5?1.8) times and TnI were (10.9?4.1) times higher than the normal. OPCAB was performed in sixty-one patients and in two patients, converted to cardiopulmonary bypass. All patients were followed up from twelve months to twenty-four months. Results The mean interval between the onset of AMI and the accomplishment of OPCAB was (115.8?15.1) hours ,and the number of distal anastomosis was (3.4?0.7)/pt. The mortality rate was 3.28%. During the period of follow-up, all patients were asymptomatic and the results of echocardiography showed the function of ventricles improved. Conclusion Off-pump technique applying to multivessel coronary artery disease with AMI yielded satisfied clinical outcome. The morbidity and mortality of OPCAB is substantially lower maybe due to avoiding the adverse effects of CPB.

BACKGROUND:Bone marrow mesenchymal stem cells(BMSCs) have the potential to differentiate into various cells and growth factor plays a key role in cell engraftment, survival, and differentiation.OBJECTIVE:To observe the effects of hepatocyte growth factor(HGF) and insulin-like growth factor(IGF) combined with stem cell transplantation on cardiac function in rabbits after myocardial infarction.DESIGN, TIME AND SETTING:The randomized controlled animal study was performed at the Animal Experimental Center, China Medical University from November 2006 to March 2008.MATERIALS:A total of 28 healthy adult rabbits, of both genders, weighing 2.0-2.5 kg were used in this study.METHODS:Rabbit BMSCs were cultured in vitro.The left anterodecendant arteries(LAD) of adult rabbits were ligated to establish animal models of myocardial infarction by a 60-min occlusion of the LAD, followed by reperfusion.A total of 28 adult rabbits were equally and randomly assigned into 4 groups.In the combination group, rabbit models were injected with 8 ?L DMEM, supplemented with 5?1011/L BMSCs 40 ?L, 150 ?g/L HGF and 200 ?g/L IGF-1 at 3 days following model induction.In the stem cell group, rabbit models were infused with 5?1011/L BMSCs 40 ?L.In the growth factor group, rabbit models were injected with 8 ?L DMEM containing 150 ?g/L HGF and 200 ?g/L IGF-1.In the control group, rabbit models were treated with the same volume of DMEM.Three dimensional(3D) full volume image of the left ventricle was measured by IE33 model ultraphonic apparatus with 3D detecting head.MAIN OUTCOME MEASURES:The following parameters were measured:results of BMSC fluorescent labeling, end diastolic dimension, end systolic volume and ejection fraction of the left ventricle in each group at 6 weeks following model induction.RESULTS:A total of 28 adult rabbits were included in the final analysis.BMSCs adhered, with various morphology.Following 1 week, adhered cells gradually formed cell colony, with the presence of spindle-shape.At 2 weeks, about 80%-90% cells were confluent.Under a fluorescence microscope, DAPI-positive cells were found in the combination and stem cell groups.Positive cells were scattered in the rabbit myocardium, and surrounding the scar, along cardiac muscle fiber direction.Compared with the control and growth factor groups, cardiac function was significantly improved in the combination and stem cell groups(P

Objective To investigate the effect and significance of early coronary artery bypass grafting (CABG) on the expression level of nerve-related factor at infracted border zone (IBZ) in dogs with acute myocardial infarction (AMI).Methods The anterior descending coronary artery of all thirty dogs randomly assigned into experimental group(n =22) and control group(n =8)were ligated into MI model.The experimental group included those undergoing CABG 1(n =6),2 week(n =4),4 week(n =6)and 6 week (n =6) after MI,and control group(n =2) was established for every experimental group.We detected the local expression level of nerve-related factor such as GAP43 mRNA,NGF mRNA and SYN mRNA at normal myocardium and infracted border zone myocavdium by means of RT-PCR through thoracotomy at eight weeks after surgery.Results Four dogs of every experimental group and all dogs of control group survived to the end of the study.The local expression level of GAP43 mRNA,NGF mRNA and SYN mRNA in control groups was significantly higher than that in normal and experimental groups (P ＜0.01 ).The local expression level of GAP43 mRNA,NGF mRNA and SYN mRNA in 4 and 6 weeks bypass groups was significantly higher than that in normal and 1,2 weeks bypass groups (P ＜0.05).There was no statistically significant the expression level of SYN mRNA among all experimental groups (P ＞ 0.05 ).Conclusions Early CABG surgery for AMI in dogs could lessen the expression level of nerve-related factor and the sympathetic remodelling at IBZ.Especially CABG surgery two weeks after MI could lessen the sympathetic maximacily.

Objective To observe the effects of rehabilitation intervention on the quality of life (QOL) of patients after coronary artery bypass grafting. Methods Fifty-eight hospital patients in need of coronary artery by-pass grafting (CABG) were randomly assigned to a cardiac rehabilitation group ( rehab ; n = 31 ) or a routine care group (control; n = 27 ). In the rehab group, patients received progressively increasing movement and appropriate psychological intervention. Changes in the medical outcome study short form (SF-36) scores and 6 min walk dis-tances (6MWDs)as well as the length of post-operative stays in hospital were observed in both groups. Results Compared with the control group, patients in the rehab group scored significantly higher on the SF-36. Their physical functioning, general health, vitality, role-emotion and mental health scores improved significantly, their final 6MWDs were longer, and they had significantly shorter average hospital stays after the operation. Conclusions Rehabilita-tion training can improve QOL for patients after coronary artery bypass grafting.

The effects of Panax notoginsen saponins ( PNGS ) on myocar- dial ischemia and reperfusion injury in conscious rabbit were studied with observation of changes in electrocardiogram (ECG), the activities of creatine phosphokinase ( CPK ) and lactate dehydrogen-ase ( LD ) and the size of ischemic area. 50 mg/kg and 100 mg/kg PNGS significantly decreased the activities of CPK and LD, and the abnormal changes of ECG during ischemic and reperfusion periods. Also, PNGS significantly reduced the size of myocardial ischemic area. These results suggest that PNGS have the protective effects on myocardial ischemia and reperfusion injury.

Objective To observe the effects of rehabilitation on the quality of life and capacity of aerobic exercise in patients after coronary artery bypass graft. Methods 58 patients after coronary artery bypass graft were divided into rehabilitation group (n=31) and control group (n=27). Patients in the control group received routine drug treatment out of hospital, while the rehabilitation group was guided regularly for rehabilitation. All patients were surveyed with the MOS item short form health survey (SF-36) and 6 min walking test on the 15th and the 90th day after operation. Results Compared with the control group，the scores of all the items of SF-36 in rehabilitation group improved (P<0.01) except in body pain. The result of 6MWT was also higher in rehabilitation group than in controls(P<0.01). Conclusion Rehabilitation can improve capacity of aerobic exercise and the quality of life of patients after coronary artery bypass grafting.

BACKGROUND; As the bridge vessel, radial artery is easy to occur spasm and injury of endometrium, and the abnormal proliferation of endometrium, re-vasospasm, etc. appear at early period postoperatively, which can affect the operative outcomes.OBJECTIVE: To compare the effects of nitroglycenn (NTG), verapamil (VP), paraverine (PA), and the mixture of NTG and VP on relaxing spasm of radial artery in human being.DESIGN: A randomized controlled trial.SETTING: Department of Cardiosurgery, General Hospital of Shenyang Military Area Command of Chinese PLA.PARTICIPANTS: Thirty patients who underwent coronary artery bypass graft (CABG) with autologous radial artery, were selected from the Department of Cardiosurgery, General Hospital of Shenyang Military Area Command of Chinese PLA from September to November in 2006, including 18 males and 12 females, 48-74 years of age. Informed consents were obtained from all the patients or their relatives preoperatively.METHODS:① The samples of human radial artery in CABG were collected, and totally 95 vascular rings were used in this study. The rings were divided into five groups: NTG group, VP group, PA group, VP+NTG group and control group.There two parts of the experiment, vasospasm relaxation test and vasospasm prevention test. The vascular rings in the control group were only immersed in the Krebs- Ringer solution without any drug. ② Drugs: NTG was purchased from Solo Pak Laboratories (Franklin Park, IL), PA from Eli Lilly & Co., (Indianapolis, IN), VP and others from Sigma (St.Louis, MO). ③ Thirty vascular rings were used in the vasospasm relaxation test, and the method of bath chamber was applied. Deoxyepinephrine (terminal concentration of 1 ×10-3 mol/L) was added to stimulate the contraction and spasm of the vascular rings, then four vasodilatators were added, the concentrations of VP and NTG were 30 μmol/L, and that of PA was 0.1%. Relaxation rate=(resting tension after stimulation-initial resting tension)/initial resting tension× 100%. ④ The other 60 vascular rings were used in the vasospasm prevention test. Firstly, the rings were immersed in the four solutions of vasodilatators of corresponding concentrations and Krebs- Ringer solution respectively for 30 minutes. After pretreatment, the vascular rings were randomly divided intc normothermia group (n =30) and cryopreservation group (n =30). In the cryopreservation group, the vascular rings were put into the Krebs-Ringer buffer solution at 4 ℃, and kept in refrigerator at 4 ℃ for 24 hours. The spasms of radial artery were observed.MAIN OUTCOME MEASURES: Changes of resting tension (degree of contraction and relaxation rate of dilatation) of vascular rings before and after administration.RESULTS: ① Effect on the dilatation of spastic radial artery: The radial artery was completely within 11 minutes in all the VP+NTG group, VP group, NTG group and PA group. But in the first 3 minutes, the dilating effects of VP+NTG and NTG were obviously better than the other two groups. The dilatation curves showed that the dilating ability in order was VP+NTG ＞ NTG ＞ VP ＞ PA. ② Effect of pretreatment of radial artery on antispasm: In the normothermia group, the contractility of the vascular ring produced by 1 ×10-3 mol/L deoxyepinephrine was close between the VP+NTG group and VP group [(0.47±0.06), (0.49±0.08) g, P ＞ 0.05], which were obviously different from those in the NTG group and PA group [(0.81±0.22), (0.87±0.26) g, P ＜ 0.05]. After cryopreservation for 24 hours, the contractility in the VP+NTG group was not obviously different from that in the VP group [(0.86±0.11), (0.90±0.13) g, P ＞ 0.05], and obviously lower than those in the NTG group, PA group and control group [(4.82±0.87), (5.00±0.53), (5.10±0.67) g, P ＜ 0.01], whereas those in the NTG group and PA group were close to that in the control group (P ＞ 0.05).CONCLUSION: The drugs can prevent and relax the spasm of radial artery to different extents, whereas considering from preventing spasm and the time-effect of treatment, the mixture of VP and NTG seems to be more proper as the preparation solution for the treatment of radial artery in CABG.

Objective To investigate the impact of diabetes on coronary artery bypass grafting (CABG)in peroperative patients. Methods Clinical data of 692 CABG patients were collected retrospectively from Sep. 2006 to Jul. 2010. The CABG patients were divided into diabetic group (n = 276) and nondiabetic group (n = 416) according to with the status of diabetes or not before operation. Blood glucose was dynamicaly monitored and treated with insulin to control blood glucose in perioperativeperiod. The postoperative effect,perioperative complication and inhospital case fatality and their relationship with diabetes were analyzed using univariate analysis. Results No significant differences were found regarding the incision complications (5. 8%vs. 4. 3 % , P > 0. 05). The volume of blood transfusion was (890. 7 ± 520. 6) ml in the diabetes group, which was not significantly different from that of (825. 2 ±518. 4)mlin the non-diabetes group (P>0. 05). No significant difference was found on cardiac arrhythmia (13.0% vs. 13. 5%),renal function insufficient (5. 1% vs. 2.4%)and case fatality (2. 9% and 1. 9%) between the diabetes and non-diabetes group (Ps >0. 05). In the diabetes group and non-diabetes group, the duration of IABP (3.7 ± 1. 6) d vs (3.5 ± 1.6)d, use of ventilator (2. 6 ± 1.9)d vs. (2. 4±1.5)d were not sigfnificantly different (Ps >0.05). The length of hospital stay and cost were (22. 0 ±8. 8)d and (8. 11 ±2. 40) thousand RMB in the diabetes group, which were significantly higher than that of (20. 6 ±7. 6)d and (7. 63 ±2. 20) thousand RMB in the non-diabeties group (t =2. 22 and 2. 71 ,Ps <0.05) . Conclusion There are no significant differences in the operative case fatality and complications between patients with diabetes and without nondiabetes. However,diabetes increases hospital stay and expense.