1.Application of graft eversion anastomosis technique in aortic surgery
Chinese Journal of Thoracic and Cardiovascular Surgery 2021;37(3):188-192
Due to the emergence of various treatment methods for aortic diseases, the treatment methods of anastomosis have become diversified.The anastomosis of the graft distal eversion partly inserted into the aorta or graft inversion wholely inserted into the aorta increase the joint area between them, and it obviously reduces the impact of tidal blood flow and the lateral force on the anastomosis.Therefore, it has the outstanding advantages of reducing the risk of hemorrhage after anastomosis, simplifying the intraoperative suture operation and easy treatment of anastomotic hemorrhage.Similar techniques with different names are often used in the surgical treatment of aortic lesions and have achieved good anastomosis.In this paper, the concept is uniformly referred to as " Graft Eversion Anastomosis Technique" , and its application evolution in aortic surgery is systematically expounded, so as to further deepen the understanding of the technology.
2.EFFECT OF ZINC SULFATE AND ZINC METHIONINE ON GROWTH AND THEIR MECHANISM IN MICE
Zepeng YU ; Guowei LE ; Yonghui SHI
Acta Nutrimenta Sinica 2004;0(06):-
Objective: To investigate the effect of zinc sulfate and zinc methionine on growth and their possible regulating mechanism in mice. Method: Ninety male KM mice were randomly divided into three groups. The control group was fed on basal diet containing zinc of 11. 67 mg/kg 10d. The ZnSO4 group and Zn-Met group were fed on the diets supplemented with ZnSO4 or Zn-Met at 30 mg/kg(on the basis of Zn) for 10 d. Initial and final body weight,serum zinc concentration, growth hormone (GH),the levels of growth hormone receptor (GHR) and insulin like growth factor 1 (IGF-1) mRNA were determined. Results: Both ZnSO4 and Zn-Met enhanced body weight and serum zinc concentration of mice,Zn-Met more effectively than ZnSO4 for body weight . Both forms of zinc had no effect on GH and the expression of GHR mRNA , but both up-regulated the expression of IGF-1 mRNA. As compared to ZnSO4, Zn-Met enhanced the level of IGF-1 mRNA significantly. Conclusion: Both ZnSO4 and Zn-Met had no effect on GH and the expression of GHR Mrna,but enhanced the expression of IGF-1 mRNA. Zn-Met enhanced the body weight gain and up-regulated IGF-1 mRNA expression more effectively than ZnSO4.
3.Intravascular ultrasound assisted endovascular therapy for renal artery stenosis
Guifang TAN ; Zepeng SHI ; Zhigang LIU ; Shen LI ; Chunyu YU ; Meng ZHANG ; Yi ZHANG ; Rong XING ; Chunmei ZHANG ; Yong QIAN
Chinese Journal of Interventional Imaging and Therapy 2024;21(11):654-658
Objective To observe the value of intravascular ultrasound(IVUS)for assisting endovascular therapy for renal artery stenosis(RAS).Methods Thirty patients with RAS who underwent endovascular therapy were retrospectively analyzed.Parameters of renal artery and plaques in RAS segment measured with CT angiography(CTA)and IVUS before treatment were compared.Bland-Altman diagram was performed to evaluate the consistency of lumen cross-sectional stenosis rate and plaque eccentricity index between CTA and IVUS.The stent parameters measured with IVUS were recorded immediately after implantation of balloon-expandable covered stents.Results Before treatment,the minimum lumen diameter,lumen cross-sectional stenosis rate and stenotic segment length of IVUS were all larger,while maximum lumen diameter and lumen eccentricity index of IVUS were both smaller than those of CTA(all P<0.05).No significant difference of plaque eccentricity index,plaque type nor stenosis distal remodeling was found between CTA and IVUS(all P>0.05).The average difference between IVUS and CTA for evaluating lumen cross-sectional stenosis rate and plaque eccentricity index was-0.020(-0.096,0.050)and-0.020(-0.130,0.091),respectively.The consistency of IVUS and CTA for evaluating plaque eccentricity index was better than that of lumen cross-sectional stenosis rate.The stent symmetry,stent eccentricity index,stent expansion coefficient and stenosis coverage rate immediately after implantation measured with IVUS was(82.69±14.61)%,(1.54±9.16)%,(99.81±10.70)%and 100%,respectively.Among 30 cases,2 cases(2/30,6.67%)underwent postdilation since poor stent apposition.Conclusion IVUS could assist evaluating lumen and plaque parameters of stenotic renal arteries,guiding stent release and real-timely monitoring the effect of endovascular therapy.
4.Short-term effects of extended adventitial inversion with graft eversion anastomosis technique in the root treatment of acute type A aortic dissection
Xuezhi HE ; Feng GAO ; Yang GAO ; Lei SHI ; Xijing ZHUANG ; Wei LIU ; Wenjun WANG ; Zepeng SHI
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2022;29(03):371-376
Objective To evaluate the short-term therapeutic effect of extended adventitial inversion with graft eversion anastomosis technique in the root treatment of acute type A aortic dissection (ATAAD). Methods From November 2019 to July 2020, 28 patients with ATAAD were treated by extended adventitial inversion with graft eversion anastomosis technique in the Department of Cardiovascular Surgery, Dalian Municipal Central Hospital, including 19 males and 9 females, aged 60.11±11.11 years. The intima of the ascending aorta was trimed to 5 mm above the sinotubular junction. The adventitia of the ascending aorta was longitudinally cut to the reserved intima margin along the junction of the three aortic valves. The extended adventitial inversion was sutured continuously, no coronary sinus was sutured over the aortic annulus, and the left and right coronary sinus was sutured above the coronary ostium. The anastomotic graft was everted and inserted into the aortic lumen, and the everted graft was continuously sutured at the level of sinotubular junction which was 5 mm away from the edge of graft. Results There was no intraoperative death, intractable root hemorrhage, residual root false lumen, root dilatation, anastomotic hematoma or other complications. There was no recurrence of the pain in the back of all patients, and the results of the CT angiography were not significantly changed. In 22 patients with no regurgitation, only 1 (4.55%) patient had a mild regurgitation. In 6 patients with mild aortic regurgitation, the disappearance rate of regurgitation was 50.0% (3/6). Conclusion The treatment of extended adventitial inversion with graft eversion anastomosis technique in the root treatment of aortic dissection eliminates the residual dissection at the root. The anastomotic hemorrhage is prevented, the root structure of aortic dissection is reconstructed and strengthened, the root function is restored, and the possible expansion of the root is prevented. The short-term results are satisfactory.