Objective: This study was designed to determine the expression of IFN-γ mRNA in heart allograft and its correlation to postoperative, cell infiltrating and allograft survival time. Methods: The heterotopic rat heart transplantation model was established with a simplified method, and the allografts and isografts were harvested at 1, 3,5,7,9 and 11 postoperative days. After the total RNA was prepared, the standard primer and target primer were amplified in the same tube, the average ratio of the target products pixel volume to primer's was calculated and a coordinates chart was made. Results: The expression level of IFN-γ mRNA in heart allograft was elevated and its peak was on the fifth postoperative day, and prior to the heart death has a positive correlation with cell infiltrating. Conclusion: IFN-γ may play on important role in postoperative rejection.

Objective To investigate the feasibility of aortic and mitral valves replacement under video-assisted thoracoscope.Methods The subjects included 16 dogs(Experimental Group) and a clinical volunteer(Clinical Group).The procedure was performed under extracorporeal circulation with femoral artery and vein intubation.An incision 4~5 cm in length and two 1.5 cm ports were made in the right chest wall.The superior and inferior vena cava were cross-clamped by a self-made clamp and the myocardium was protected by cold cardioplegic coronary perfusion.Artificial mechanical aortic and mitral valves were intermittently sutured.Results In the Experimental Group: the time of extracorporeal circulation was 104~196 min(143.2?46.5 min) and the ascending aorta cross-clamped time was 58~128 min(82.4?26.1 min).Autopsy findings showed satisfactory valve suture fixation,without thread loosing or paravalvular rupture.In the Clinical Group: the time of extracorporeal circulation was 157 min,the ascending aorta cross-clamped time was 112 min,the time of mechanical ventilation was 10 h,and the drainage volume,150 ml.The patient was discharged from hospital on the 10 postoperative day.Follow-up observations for 9 months found no paravalvular leakage or other complications.Echocardiography showed normal prosthetic valve movement.Conclusions Video-assisted thoracoscopic aortic and mitral valves replacement is technically feasible.

Objective To summarize the experience of mitral valve replacement (MVR) using video-assisted thoracoscope. Methods 28 cases of MVR were performed through three right anterior ports under thoracoscopy using femorofemoral extracorporeal circulation. The aorta was cross-clamped and the myocardium was protected by coronary perfusion with cold cardioplegic. 33 patients underwent routine open approach MVR as control group. Results There was no death and no morbidity directly related to this approach. Comparing with control group, time of extracorporeal circulation was 82～146 (96?38)min vs. 80～132(92?31)min, cross-clamped 37～76(47?18)min vs. 34～72(45?13)min and ventilation time were 8.6～14.8(10.2?3.1)h vs. 8.3～15.9(11.3?3.4)h . The volume of drainage was 50～230 (72?28)ml in VATS group while 70～460(108?4.2)ml in control group((P

Objective To explore the feasibility of off-pump coronary artery bypass grafting (OPCAB) in the treatment of severe coronary atherosclerotic heart disease. Methods Clinical data of 37 cases of severe coronary heart disease from January to December, 2002, were retrospectively reviewed. All operations were conducted under general anesthesia by midline sternotomy. The left internal mammary artery (LIMA) and the great saphenous vein (SV) were divided for grafting. Then we stabilified the local myocardium and exposed the diseased coronary arteries. Following the insertion of an intracoronary shunt, the LIMA was anastomosed to the left anterior descending artery (LAD). Afterwards, the SV was proximally anastomosed to the aorta, and then, to the coronary artery. Results All the operations were completed by beating heart revascularization. The number of bypass grafting was 3 2?0 5 (range, 1～6). Except 1 patient died on the 10th postoperative day, no severe complications, such as peri-operative myocardial infarction, respiratory failure, renal insufficiency or cerebrovascular accident, took place in the remaining 36 patients. Conclusions In the context of skillful procedure techniques and strict peri-operative management, OPCAB in the treatment of severe coronary atherosclerotic heart disease is feasible.

Objective: To explore the feasibility of observing hemodynamics on ischemia/reperfusion(I/R) rat heart model in vivo by studying the changes of hemodynamics,myocardial zymogram and electrocardiogram. Methods: Twenty SD rats were randomly divided into 2 groups(n=10)(IR group and control group).The left anterior descending coronary artery was ligated or left untouched,a catheter was put into the left ventricle to trace the pressure change index and peak pressure of left ventricle,and to record ST segment changes of ECG.At the end of experiment,the levels of myocardial zymogram were determined.The results of two groups were compared. Results: Compared with control group,IR group showed reduced dp/dt max,declined LVSP,raised ST segment in ECG,and elevated myocardium zymogram. Conclusion: Our I/R rat heart model in vivo is feasible and stable to explore the cardiac hemodynamics.

Objective　To summarize the treatment of 7 cases of severe coronary artery disease with CO2 laser transmyocardial revascularization(TMLR).　Methods　The mean preoperative angina class (Canadian Cardiovascular Society, CCS), number of diseased coronary arteries were 3.6±0.7 and 2.8±0.6 respectively. All the patients underwent left anterolateral thoracotomy through the fifth intercostal space under general anesthesia, the left ventricule was exposed and then TMLR was performed. The mean channels in TMLR was 32.5. 　Results　The symptoms of angina disappeared during the first postoperative month, with no relapse reported in the first follow-up year. There was significant difference in the angina class (P＜0.05), ejection fraction also increased. The ischemia region of the heart decreased through the single photon emission computed tomographic(SPECT) test.　Conclusion TMLR can relieve angina and improve life quality of patients with severe coronary artery disease. It can accelerate the recovery of dormant myocardium and enhance the contractility.

Objective To investigate the role of tissue factor in the occurrence and development of co agulation in acute vascular rejection of heart xenotransplantation. Methods An animal model for acute vascular rejection of heart xenotransplantation was es tablished by using rat as recipient and guinea pig as donor. The xenografts were removed at 4, 8, 12, 16, and 24 h after the operation for fibrin sedimentation by immunohistochemical technique to evaluate coagulation. Meanwhile, the express ion of tissue factor mRNA was detected at different time points by RT-PCR. Hear ts of normal guinea pigs were used as controls. Results Immunohistochemical examination showed that coagu lation developed at the 8 h when interstitial fibrin deposition and fibrinous th rombus appeared and aggravated with time. High expression of guinea pig tissue factor mRNA appeared at 4 h after the transplantation and then steadily d eclined and totally terminated at the 16 h. The expression of rat tissue factor mRNA appeared 16 h post operation and then kept steadily enhanced. Conclusions The tissue factor acts as an important role in the acute vascular rejection of h eart xenotransplantation. The high expression of donor tissue factor mRNA might be related to the trigger of coagulation and the high expression of the receptor ’s tissue factor may be related to the further development of coagulation.

Objective To investigate the high risk factors for severe complications after cardiopulmonary bypass cardiac surgery of patients aged 70 years and over. Methods 204 consecutive patients aged 70 years and over undergoing cardiopulmonary bypass cardiac surgery in our department were investigated.The patients′ characteristics,perioperative outcomes and the high risk factors for severe complications after surgery were analyzed.Results The overall mortality was 6.4%(13 of 204).A total of 40 cases with severe complications,including early death after surgery,were recorded.It was significantly higher than that in patients aged

Objectives:To investigate the effect of TP 5 on the immune function and infection rate in patients undergoing cardiopulmonary bypass(CPB) operation. Methods:Ninety four patients were divided into two groups to observe the effect of TP 5 on the immune function and infection rate. Results:The immunological parameters in the TP 5 group was better than the control group, and postoperative infection was prevented. Conclusions:TP 5 can improve patients' cell mediated immunity and reduce infection rate.