Cardiomyopathies ; etiology ; Humans ; Polymyositis ; complications

According to the principle of immunomagnetic separation, a novel high-efficient immunomagnetic isolator termed as CMSI 100 for the purification of human CD34 + hematopoietic cells was designed and successfully developed. To do this , neodymium iron boron having magnetic properties superior to any other permanent magnet materials was selected as the key parts of CMSI 100 isolator. The core of the magnet assembly was constructed by sandwiching mild steel bars between 4 pieces of magnet bars of neodymium iron boron. Each piece of magnet bars must be limited to the specifications of 3.5cm?2.0cm?0.3cm so that 2 700 gauss magnetic attractive force could be exerted at the magnet surface. Otherwise magnetic field above the surface of the magnet assembly is either very stronger or weaker, both of which are not beneficial to the enrichment of CD34 + hematopoietic cells. With CMSI 100 immunomagnetic isolator, more than 90% purity and over 95% viability of CD34 + hematopoietic cells could be obtained. These data indicate that CMSI 100 immunomagnetic isolator is as good as the internationally used Isolex TM 50 made by Baxter Company in USA.

OBJECTIVETo evaluate the effect of aorta-iliac bypass total thoracoabdominal aorta aneurysm repair to spinal cord function.

METHODSThis was a prospective study. From June 2014 to April 2015, 31 patients underwent total thoracoabdominal aorta aneurysm repair were treated with aorta-iliac bypass technique. There were 23 male and 8 female patients with a mean age of (36±12) years. A 4-branched tetrafurcate graft was used. The aorta-iliac bypass was established, then distal descending aorta was perfused in a retrograde fashion via bypass graft. Thoracic and abdominal aorta were replaced in a staged fashion. Evoked potentials (EP) monitoring was adopted to assess the spinal cord ischemia throughout the procedure. The intraoperative evoked potentials results, clinical outcomes and follow-up results of this technique were evaluated.

RESULTSThe EP wave disappeared after proximal descending aorta clamped and gradually recovered after the patent segmental arteries reattached. Motor evoked potentials disappeared for (56±18) minutes, somatosensory evoked potentials disappeared for (50±19) minutes. The EP wave was restored to normal at the end of operation in all cases. The somatosensory evoked potentials remained unchanged in 2 cases (false negative). One case died after operation. There were acute kidney dysfunction in 3 cases, and pulmonary haemorrhage in 1 case. No spinal cord injure occurred. The median follow-up after operation was 8 months (ranging from 1 to 11 months). There was no delayed neurologic deficit or relative death.

CONCLUSIONSThere is a transient function loss of spinal cord during the aorta-iliac bypass total thoracoabdominal aorta aneurysm repair. But the process is reversible. The technique of the aorta-iliac bypass is practicable.

Adult ; Aorta, Abdominal ; surgery ; Aortic Aneurysm, Abdominal ; surgery ; Aortic Aneurysm, Thoracic ; surgery ; Evoked Potentials, Motor ; Evoked Potentials, Somatosensory ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies ; Spinal Cord ; physiopathology ; Vascular Surgical Procedures ; adverse effects

Acute Stanford type A aortic dissection with important branches involved is more complex, could lead to organ malperfusion syndrome even organ failure. The understanding of pathological anatomy, classification, staging, and the pathophysiological change has increasingly mature, but not complete. In addition, the treatment strategy for complex lesions is diversified, some questions may not reach consensus. Fully understanding of the anatomical and pathophysiology is very important for surgeons to choose reasonable treatment strategy. As the rapid development of the basic research, imaging techniques and the concept of surgery procedures, the manage technique of Stanfrod type A dissection and branch vessels at the same time is getting seriously, the related issues also need further discussions.