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 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.

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.

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 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.

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.

OBJECTIVETo summarize the method and experience of cardiopulmonary bypass (CPB) with vacuum-assisted venous drainage technology (VAVD) in the minimally invasive cardiac surgery (MICS).

METHODS35 cases of patients undergoing MICS were achieved femoral arterial cannula and femoral venous cannula. During the course of the CPB, we used the VAVD technology. At the same time, we selected 35 cases as control group.The time of the CPB, mechanical ventilation and ICU, and the amount of the urine, blood products, and chest drainage were recorded.

RESULTSThe time of mechanical ventilation and ICU staying, the volume of the blood products and the volume drainage within 48 h postoperatively in the MICS group were significantly shorter and less than that in control group (P < 0.05).

CONCLUSIONThe use of VAVD in the MICS can increase the vena cava drainage effectively, and ensure the surgery safe and successful.

Adolescent ; Adult ; Aged ; Cardiac Surgical Procedures ; methods ; Drainage ; methods ; Female ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods ; Vacuum ; Veins ; Young Adult

Objective To investigate the diagnosis and therapy of primary maligmant tumors of the heart. Methods Clinical data of 21 patients with malignant cardiac tumors admitted to our department from June 1980 to May 2008 was analyzed and the references were reviewed. Results All patients received operations. Pathological classification of the tumors was made by histological examinations. Radical resections for 10 eases and partial resections for 5 eases were performed. The other 6 patients received only thoracotomy and cardiac exploration. Three eases were lost during follow up. Three survivors received radical resections are still alive now 2-15 months after the surgery, while all the other patients died within 4 years after the operation due to malignant tumor recurrence and (or) metastasis. Conclusion Echocardiography, CT, 3D-CT, MRI, coronary CT and angiocardiography are helpful for the diagnosis of the malignant cardiac tumors and the selection of operations. Histological examination is necessary for the final diagnosis. Early diagnosis, radical resection and post-operative radiotherapy and chemo therapy may provide a better result.