BACKGROUND:Althoughpolyurethane possesses excelent biocompatibility, its inherent inertness leads to its weak interactions with cels. So, its modification is necessary. OBJECTIVE:To prepare the polyurethane/polyhedral oligomeric silsesquioxane nanocomposite fibers with controlable morphology. METHODS:The polyhedral oligomeric silsesquioxane was dispersed in a certain concentration of polyurethane solution to prepare the polyurethane/polyhedral oligomeric silsesquioxane nanocomposite fibers using electrospinning method. Meanwhile, the effects of mass of polyurethane and oligomeric silsesquioxane, spinning voltage and spinning advance velocity on composite fiber morphology were analyzed. The optimum preparing conditions were filtrated. The stability of oligomeric silsesquioxane in polyurethane was determined. The morphology and composition of fibers were analyzed by scanning electron microscopy, infrared spectroscopy, X-ray photoelectron spectroscopy. RESULTS AND CONCLUSION: Oligomeric silsesquioxane stably existed in polyurethane. Polyurethane/polyhedral oligomeric silsesquioxane nanocomposite fibers were the most uniform when the mass fraction of polyurethane in composite fibers accounted for 20%, the mass ratio of polyurethane and oligomeric silsesquioxane was 10: 1, spinning voltage was 15 kV and spinning advance velocity was 0.5 mL/h. Compared with the pure polyurethane, the O/C ratio of polyurethane/polyhedral oligomeric silsesquioxane nanocomposites increased significantly.

Objective To study the clinical advantages of modified incision for PDA interruption under video-assisted thoracoscopy. Methods Sixty patients suffering PDA were operated on by the modified incision technique through the left subaxillary 3rd interspace 2.0cm-2.5cm mini-incision as manipulation incision and the front axillary line of the same interspace 0.4cm-1.0cm thoracoscope incision the operative difficulty required surgical time surgical field exposure,complications,postoperative pain and,cosmetic and surgical results were compared with those of the conventional PDA operation. Results The operation on the 60 cases were all successful.Actual intra-thoracic operation duration was (20.39?9.63)min.Due to the minor surgical trauma,the patients were able to ambulate two days after the surgery.Only eleven patients needed analgesia after the operation.Heart murmur completely disappeared postoperatively.No complications occurred.Postoperative echocardiogram showed no residual or recurrent shunt ,even in three years follow-up. Conclusions The modified incision for PDA interruption with the video-assisted thoracoscopy causes minim surgical trauma and is a safe and simplified surgical technique.

Objective To study the alteration of hepatocyte growth factor and c-met in the lungs of rats with pulmonary arterial hypertension and its possible underlying mechanisms.Methods Left pneumonectomy plus monocrotaline injection was used for rat PAH model.Rats were executed after measurement of their pulmonary arterial pressure at 1,2, 3 and 4 weeks after MCT injection.Then the right lung and heart were harvested for further analyses.Expression of HGF and c-met was determined by RT-PCR and Western blot.Expression of eNOS and caspase-3 was analyzed immunohistochemically and intrapulmonary TGF-β and ET-1 was analyzed with ELISA.Results Compared with the normal controls, manifestations of right heart hypertrophy and failure, well-elevated pulmonary arterial pressure were observed 28 days after left lung resection and MCT injection.Pulmonary vascular remodeling (i.e., pulmonary fibrosis, hyperplasia of pulmonary arterial endothelial cells and vascular smooth muscle cells in tunica media, as well as decease of vascular density) was observed.Intrapulmonary HGF expression decreased in a time-dependent manner at both mRNA and protein levels 4 weeks after MCT injection, while c-met stayed unchanged.Immunohistochemically, expression of eNOS was reduced and caspase-3 strengthened.On the contrary, ET-1 and TGF-β were obviously up-regulated(P ＜ 0.01).Conclusion Intrapulmonary HGF expression was obviously downregulated in PAH rats, accompanying with reduction of NO and increase of ET-1 and TGF-β expression, while c-met still unchanged.

Myocardial infarction and other cardiovascular diseases are one of the main causes of human death.Myocardial infarction leads to a reduction in the number of regional myocardial cells,cardiac decompensation,myocardial fibrosis,and heart failure.At present,the main treatment methods of myocardial infarction include drug therapy,coronary stent implantation,coronary artery bypass grafting and heart transplantation.However,these methods have limitations.In particular,irreversible heart failure cause by myocardial fibrosis and ventricular remodeling is difficult to treat.Cell transplantation therapy can repair necrotic myocardium,which may provide a potential for myocardial regeneration.However,the survival rate of transplanted cells is low,which affects the effect of transplantation.The review focuses on the development of cell transplantation therapy in recent years and the factors that improve the survival rate of transplanted cells.

Objective: To analyze the mid long term results of prosthetic valves replacement. Methods: 2?141 patients underwent prosthetic valve replacement from 1978 to 2001, and 1?681 patients were followed up by completion of 78.5%, cumulate of 8?021.1 patient years and averages of 4.77 patient years each. The data were analyzed by multi factor regression and T test. Results: 92 patients died after operation. The 5 year and 10 year survival rates were (92.3?2.2)% and (90.1?2.7)%, respectively. The main complications were thromboembolism, valve mechanical malfunction, peri prosthetic leak, hemolysis and SBE. The heart function (NYHA) was significantly improved after valve replacement. Conclusion: The mid long term results of prosthetic valve replacement are rather satisfactory with low mortality and morbidity. Subvalvular structure preservation and tricuspid annuloplasty contribute can greatly improved heart function. Satisfactory myocardial protection during CPB is the key of successful operation.

This study sought to assess the effect of SspA on the formation of Staphylococcus aureus biofilm extending over the surfaces of Cardiovascular Biomaterial Dacron. SspA was extracted from the surface of staphylococcus aureus biofilm, purified, and then used to influence the adhesion of Staphylococcus aureus and the formation of Staphylococcus aureus biofilm on Dacron biomaterial surfaces. The formation of the Staphylococcus aureus biofilm on cardiovascular biomaterial Dacron surfaces under gradient SspA concentrations was evaluated by confocal laser microscopy. The result revealed that SspA inhibited the formation of Staphylococcus aureus biofilms on cardiovascular biomaterials surfaces effectively, and it was dose dependent. This study indicates that SspA is effective for preventing biomaterial centered infection and this method is conducive to clinical applications.
Bacterial Adhesion ; Biocompatible Materials ; chemistry ; Biofilms ; growth & development ; Polyethylene Terephthalates ; Prosthesis-Related Infections ; microbiology ; Serine Endopeptidases ; pharmacology ; Staphylococcus aureus ; pathogenicity ; physiology

Objective we assessed our institutional outcomes of hybrid treatment for aortic arch disease with supra-aortic debranching and endovascular stent graft repair.Methods From March 2016 to November 2016,6 patients underwent Hybrid total aortic arch repair:1 had aortic arch pseudoaneurysm;1 had type Ⅲ aortic dissection;4 had aortic arch aneurysm because of hypotension,of whom 1 with aneurysm prerupture and 1 with Aortic intramural hematoma.Supra-aortic vessels were involved and high-risk for traditional operations in all patients.Bifurcated artificial vessels were used,main vessel was end-to-side anastomosed with ascending aorta.Branching vessel were end-to-end anastomosed with right innominate artery and left subclavian artery,end-to-side anastomosed with left common carotid artery.Then,stent graft was implanted into ascending aorta and aortic arch.All patients were followed postoperatively,with regularly contrast computed tomography angiogram (CTA) and echocardiography(discharge,three months,six months,and yearly).Results Hybrid procedure with supra-aortic debranching and endovascular stent graft repair were completed in all patients,technical success rate was 100％.There were no perioperative obvious morbidity and mortality,follow-up period were 2-9 months.1 patients had stroke during follow-up period,condition improved after treatment.Supra-aortic vessels were patency and there were no endoleak in all patients.There were no recurrent aortic disease during follow-up period.Conclusion Hybrid aortic arch replacement can be performed with good postoperative and early results in high-risk patients for traditional open repair.

Objective Assessment of fenestration in the aortic arch disease .Methods 13 patients with aortic arch dis-ease underwent fenestration operation to reconstruct affiliated vessels , aortic arch aneurysm in 5 patients, aortic anch ulcer in 4, Ⅲ type aortic dissection in 3 and Ⅰ type leakage after aortic stent graft in 1 patient.All patieuts were divided into 2 groups.8 patients in pre-fenestration group, 5 patients in in-situ fenestration group.Only left subclavian artery was rebuilded in 9 patients, both left carotid common artery and left subclavian artery were rebuilded in 3 patients, all three affiliated vessels of arch were rebuilded in 1 patient.Results Branch vessels of aortic arch were successfully rebuilded in all 13 patients.There were no endoleak, stenosis of branch vessels, graft diaplacement or deaths peri-operative period.During follow-up, no postop-erative complications occurred and all target vessels remained patent .No fenestration related endoleaks were observed.Conclu-sion Fenestration may be a viable alternative for patients with aortic arch disease .

Objective To explore a more minimally invasive and economical treatment for atrial septal defect (ASD) through comparing the efficacy and safety in percutaneous transcatheter closure of atrial septal defect procedure,guided by transthoracic echocardiography(TTE) and transesophageal echocardiography(TEE).Methods From March 2014 to September 2017,197 patients with ASD who were feasible to treated with percutaneous transcatheter closure procedure evaluated by preoperative ~ were recruited.TTE showed ASD belonged to secundum(central type) with a maximal diameter range from 2 mm to 35mm,including 82 cases of the ASD without aortic rim.There were 106 patients(47males and 59 females including 37 ASD without aortic rim) with a mean age of 14.2 years(6 months-59 years) old and a mean body weight of 29.5(8.5-64.0)kg were performed percutaneous transcatheter closure of ASD guided by TEE under general anesthesia and endotracheal intubation,and 91 patients(41males and 50 females with 45 ASD without aortic rim inside) with a mean age of 13.8 years(9 months-65 years) old and a mean body weight of 30.4 (9.5-61.0)kg were treated with the percutaneous transcatheter procedure guided by TTE when patients in waking state of local anesthesia(general anesthesia were adopted in patients under 12 years old without intubation).The size of the occluder was selected on the basis of the maximal diameter plus 2-6mm.All 197 cases intraoperation and postoperation data were collected,including complications 、operation time 、operation room stay time and total cost.Results 1 patients in 106 cases of the the TEE group were transferred to small incision on the chest performing transthoracic transcatheter closure of ASD because the difficult stuck of the occluder.3 patients in TEE group transferred to repair under cardiopulmonary bypass(CPB) via small incision on the chest because the difficult stuck of the occluder even in using transthoracic transcatheter closure way.86 patiens in TTE group successfully treated with percutaneous transcatheter closure,and there were 5 failed cases including 2 patients who transferred to TEE guided because of the poor imaging of TTE,another 2 cases treated with transthoracic transcatheter closure of ASD because the difficult stuck of the occluder,and 1 patient performed ASD repair procedure under CPB via small incision on the chest because of the huge ASD without aortic rim and difficult stuck of the occluder.All the 197 patients were cured and discharge from hospital,and there were no complications.There was no significant difference in age,weight,and maximum diameter of ASD between TEE group and TTE group (P ＞ 0.05).Follow-ups were conducted by TTE at month 3 post-operation,and all 197 cases performed no residual shunt of ASD,there were no difference between 2 group.The stay time in the operation room was(68.2 ± 17.3) min in group TEE and (34.7 ± 16.8) min in group TTE,there was obviously shortened the stay time in operation room(P ＜0.01).The total cost of the TTE group was(24.2 ± 2.1) thousand yuan,and the group TEE was(29.3 ± 1.4) thousand yuan,and the cost was significantly reduced in TTE group (P ＜ 0.01).Conclusion The treatment of percutaneous transcatheter closure of ASD guided by TTE is effective and safe,and the feature of more non-invasive and socioeconomic benefits show a broad application prospect.

Objective    To compare video-assisted thoracic surgical technique (VATS) and conventional surgical technique (CSM) in mitral valve replacement (MVR). Methods    We retrospectively analyzed clinical data of 93 patients in our hospital with mitral valve replacement between January 2010 and January 2015. The patients were divided into two groups including a VATS group and a CSM group.There were 43 patients with 25 males and 18 females at age of 57.43±5.65 years in the VATS group, and 50 patients with 27 males and 23 females at age of 56.40±6.32 years in the CSM group.The clinical outcomes of the two groups were compared. Results    There was no mortality. Echocardiography was normal in both groups during 1-year follow-up. There was no significant difference between the two groups in the operative time, aortic clamping time, cardiopulmonary bypass (CPB) time, or ventilation time. As compared with the CSM group, the patients in the VATS group had a significantly lower complication rate, shorter chest incision length (5.23±1.36 cm vs. 18.21±3.89 cm), less blood transfusion (1.75±0.25 U vs. 3.15±1.50 U), less chest drainage (202.34±12.12 ml vs. 412.32±21.56 ml) and lower pain score (1.26±0.86 vs. 3.01±1.13), shorter time of postoperative hospital stay (8.20±2.36 d vs. 12.10±3.26 d). Conclusion    MVR under VATS is not only technically feasible, but also with excellent clinical results.