Objective: The experiment was designed to evaluate the in vitro creation of tissue engineered heart valve leaflets. Methods: Aortic artery was harvested from 6 hybrid young pigs. The endothelial and myofibroblast cells were isolated and cultured to get enough cells for seeding. The myofibroblast and endothelial cells were seeded on the scaffolds sequentially. The cellular scaffolds were cultured 28 days and sent for scanning electron microscopy (SEM), histological and hydroxyproline examination. Results: SEM showed that a large amount of cells attached on the scaffolds. The cell had covered a large area of scaffold with a lot of matrix synthesized. The HE stain showed large amount of cells growing on the scaffolds and some cells were found in the central part of scaffolds. Gomori stain showed that there was elastin synthesized on the scaffolds. Hydroxyproline content is (10.93?2.89) ?g/g (scaffolds). Conclusion: With vascular cell, it is possible to seed them onto biodegradable scaffolds and create a viable tissue-engineered heart valve leaflets in vitro.

Objective: To study the long-term effects of mitral valve replacement with bioprostheses in rheumatic heart valve disease. Methods: 166 patients with rheumatic heart valve disease underwent isolated mitral valve replacement from Jan.1978 to Dec.1985. 79 Patients were male and 87 female. Patients' age ranged from 11 to 53 years[mean (29.4?9.9) years]. The patients were classified into two groups: group 1(age

Objective To summarize the experience of radical treatment of tetralogy of fallot in adults.Method Between Nov. 1985 and May 2005,115 patients over 18 years of age with tetralogy of fallot underwent total surgical correction.Longitudinal or oblique right ventriculotomy was used to ensure complete release right ventricular outflow obstruction and complete ventricular septal defect closure.Transannular patches were used in 74 patients,right ventricular outflow tract(RVOT) patches in 37 cases,primary closure of right ventricle in 5 cases,respectively.One patient had separate pulmonary main artery and RVOT enlargement.Results Seven patients had residual septal defect and 3 cases suffered from residual RVOT obstruction.Severe cardiac output syndrome occurred in 10 patients and 6 patients died early postoperatively with the mortality rate of 5.22%.Conclusion By careful surgical management,the treatment of total correction in adult patients may result in good effectiveness.

OBJECTIVETo summarize the clinical characteristics, surgical management and postoperative complications in patients with congenital bicuspid aortic valve (CBAV) over 50 years of age.

METHODSFrom January 2009 to September 2011, 73 CBAV patients aged 51-76 years (mean 61.8∓0.73 years) were treated in our center. Except for 1 patient who underwent Bentall surgery and another having Wheat surgery, all the patients received aortic valve replacement (AVR), including 7 with double (mitral and aortic) valve replacement (DVR), 6 with mitral valvular plasty, 11 with tricuspid valvular plasty, 8 with coronary artery bypass graft implantation, 1 with aortic-left ventricular tunnel repair, 1 with atrial maze ablation, and 1 with left atrial thrombosis removal.

RESULTSTwo patients died after the surgery, with a perioperative mortality rate of 2.7%. The cardiopulmonary bypass time was 78-217 min (mean 131.9 ∓6.0 min) with an aortic blocking time of 56-158 min (mean 88.2 ∓4.8 min) and total postoperative ICU time of 23.0-647.4 h (mean 97.9∓10.5 h). The postoperative complications included low heart output syndrome in 5 cases, bleeding in 4 cases, wound debridement in 4 cases, and hemodialysis due to acute renal failure in 1 case. The left ventricular end diastolic diameter reduced significantly after the surgery (52.6∓1.7 vs 43.2∓1.0, P=0.001). No significant changes were detected in the left ventricular ejection fraction (62.3∓2.5 vs 65.5∓1.3, P=0.257).

CONCLUSIONThorough preoperative examination, preoperative risk factor assessment, timely perioperative interventions, careful evaluation of patients' tolerance of surgery, and prevention of surgical complications are essential to decrease the perioperative mortality in elderly patients with CBAV.

Aged ; Aortic Valve ; abnormalities ; surgery ; Coronary Artery Bypass ; Female ; Heart Valve Diseases ; mortality ; surgery ; Heart Valve Prosthesis Implantation ; methods ; Humans ; Male ; Middle Aged ; Mitral Valve ; surgery ; Postoperative Complications ; prevention & control ; Retrospective Studies

OBJECTIVETo summarize the experience with surgical correction of tetralogy of Fallot in adults over 40 years of age.

METHODSFrom November 1985 to July 2008, 9 male and 11 female patients aged 41-53 years (mean 46.3±3.5 years) underwent total surgical correction for tetralogy of Fallot. Twelve patients had preoperative NYHA class III cardiac function. The common comorbidities included infective endocarditis, cerebral abscess, cerebral infarction, renal dysfunction, and tricuspid insufficiency. Surgical corrections were carried out at the anatomical or physiological level.

RESULTSNineteen patients received right ventriculotomy to relieve right ventricular outflow obstruction and for ventricular septal defect closure, and 1 patient had Fontan operation. Two patients died after the surgery for heart failure and ventricular fibrillation. The average cardiopulmonary bypass time, aortic clamp time, and postoperative ventilation time was 142.9±36.3 min, 89.9±25.1 min, and 72.0±17.5 h, respectively. Postoperative low cardiac output syndrome occurred in 5 cases, septic shock in 1 case, secondary renal failure in 1 case, and bleeding in 2 cases. Echocardiography showed a significant postoperative reduction of the mean right ventricular outflow tract velocity from 4.29±1.36 m/s to 2.13±0.83 m/s (P<0.01); the right ventricular longitudinal dimension exhibited no significant changes postoperatively (57.1±6.7 mm vs 55.1±7.0 mm, P=0.65).

CONCLUSIONSSurgical correction of the tetralogy of Fallot in patients over 40 years is highly risky and requires appropriate management of cardiac failure, careful myocardial protection, and thorough intracardiac lesion correction to decrease surgical complications.

Adult ; Female ; Humans ; Male ; Middle Aged ; Tetralogy of Fallot ; surgery ; Treatment Outcome

Objective To survey the prevalence of greenhouse farmer's lung and related risk factors in part of rural areas of Liaoning Province.Methods Using uniform scheme,procedures and questionnaire,a survey for 5420 farmers(2660 men and 2760 women)with complete data who work inside greenhouses was performed in Shenyang,Xinmin,Chaoyang,and Jinzhou between August 2006 and June 2009.Pulmonary function tests was performed for every active farmer.Results Greenhouse farmer's lung was diagnosed in 308 cases,205 men(66.55%,205/308)and 103 women(33.44%,103/308),a prevalence of 5.7%(308/5420).The prevalence rate of greenhouse farmer's lung in males was significantly higher than that in females(?2=39.93,P0.05).In the 308 cases,the number of patiernts presented with fever chill,cough/sputum,chest tightness/shortness of breath were 180(58.44%),192(62.34%),160(51.95%)respectively,and the number of crepitations,radiological changes,spirometry abnormalities and serum IgE antibodies(+)was 164(53.25%),153(49.68%),147(47.73%)and 136(44.16%)at the time of the study.62.34%(192/308)of patients with greenhouse farmer's lung were mild and 38.66%(116/308)were severe.Conclusion The total prevalence rate of greenhouse farmer's lung in part of rural areas of Liaoning Province was 5.7% and multiple risk factors were associated with the disease.

Osteoporotic vertebral compression fracture (OVCF) can lead to lower back pain and may be even accompanied by scoliosis, neurological dysfunction and other complications, which will affect the daily activities and life quality of patients. Vertebral augmentation is an effective treatment method for OVCF, but it cannot correct unbalance of bone metabolism or improve the osteoporotic status, causing complications like lower back pain, limited spinal activities and vertebral refracture. The post-operative systematic and standardized rehabilitation treatments can improve curative effect and therapeutic efficacy of anti-osteoporosis, reduce risk of vertebral refracture, increase patient compliance and improve quality of life. Since there still lack relevant clinical treatment guidelines for postoperative rehabilitation treatments following vertebral augmentation for OVCF, the current treatments are varied with uneven therapeutic effect. In order to standardize the postoperative rehabilitation treatment, the Spine Trauma Group of the Orthopedic Branch of Chinese Medical Doctor Association organized relevant experts to refer to relevant literature and develop the "Guideline for postoperative rehabilitation treatment following vertebral augmentation for osteoporotic vertebral compression fracture (2022 version)" based on the clinical guidelines published by the American Academy of Orthopedic Surgeons (AAOS) as well as on the principles of scientificity, practicality and advancement. The guideline provided evidence-based recommendations on 10 important issues related to postoperative rehabilitation treatments of OVCF.

The application of robots in thoracic surgery is mainly based on the da Vinci general surgery robot. With the popularization of artificial intelligence (AI) application scenarios, the combination of AI and robots is more closely, and there is a strong clinical demand and huge application space for the development of specialized disease-specific robotic systems for thoracic surgery. This article aims to systematically describe the history of the rise of specialized surgical robots and the status of the localization of surgical robots in China, propose the concept of applying AI to the research and development of integrated specialized disease-specific robots in thoracic surgery, and clarify the ethics and prospects that intelligent specialized disease-specific surgical robots will face.

Adult ; Humans ; Retrospective Studies ; Pneumonia ; Community-Acquired Infections/epidemiology* ; Hospitalization

Objective To analyze the short- and mid-term outcomes of patients undergoing reconstruction of intervalvular fibrous body (IVFB) via double valve replacement (Commando procedure) or aortic valve replacement and mitral valve repair (Hemi-Commando procedure). Methods The patients who underwent Commando or Hemi-Commando procedure between September 2014 and September 2022 in Guangdong Provincial People’s Hospital were collected. The perioperative and follow-up data were reviewed and analyzed for the assessment of short- and mid-term outcomes. Results Eleven patients received Commando procedure (a Commando group), including 4 males and 7 females with a median age of 61 (33, 68) years; 7 patients received Hemi-Commando procedure (a Hemi-Commando group), including 5 males and 2 females with a median age of 50 (36, 58) years. Two patients died in the postoperative 30 days (1 patient in the Commando group and 2 patients in the Hemi-commando group). Low cardiac output syndrome complicated with multiple organ dysfunction syndrome was the main cause of death. Fifteen patients were discharged and followed up for 13 (6, 42) months, with a survival rate of 100%. The rates of free from recurrent endocarditis or re-operation were both 100%. Conclusion Commando and Hemi-Commando procedures are effective strategies for IVFB reconstruction, and can achieve excellent mid-term outcomes if patients survive from the frailest period of early postoperative stage.