Objective To study the effect of pulmonary artery perfusion with the modified low-potassium dextran(LPD) solution on cardiopulmonary bypass(CPB)-induced systemic inflammatory response. Methods 30 patients undergoing mitral valve replacement were randomly divided into control group (n=15) and lung perfusion group (n=15). The patients in the lung perfusion group were perfused with the modified LPD solution by pulmonary artery during CPB. The patients in the control group underwent the routine procedure of mitral valve replacement. The plasma concentrations of TNF-? and IL-8 were measured before and 0 h, 6 h after surgery by ABC-ELISA. Results The plasma levels of TNF-? and IL-8 significantly increased after surgery in both groups. The plasma levels of TNF-? and IL-8 were significantly lower(P

Objectives To review the experience of surgical treatment of univentricule.Methods 26 patients with univentricule underwent surgical treatment were retrospectively analyzed. There were 17 cases of total cavopulmonary connection, 8 cases of bi-directional Glenn shunt and one case of pulmonary artery banding.Results Followed-up for 6～30 monthes(mean 11 months) showed 4 early postoperative death,there was mortality of 15 4%,no advanced death.Conclusions The result of this study suggests that surgical outcome is related to the selection of proper surgical indicators,perioperative management and complete correction of cardiac deformity.

Objective To examine the effect of all-trans-retinoic acid (atRA) on proliferation and apoptosis rates of smooth muscle cells in healing vein bypass grafts.Methods Autogenous vein graft model was established in 40 rats by transplanting the internal branch of the jugular vein to the carotid by end-to-end anastomosis.Animals were divided at random into two groups:atRA group and control group.The animals received atRA(10mg?kg -1 ?d -1 ) or same dosage vehicle(corn oil) from 4 days preoperation to 10 days postoperation.Animals were sacrificed and the grafted veins were harvested at 7,14 days,respectively after the operation .The grafted veins were then processed for staining and measurements.Hyperplasia,smooth muscle cell proliferation were detected by pathological and immunohistochemical methods.All the data were analyzed by a computerized system.The presence of apoptotic smooth muscle cells was demonstrated by terminal deoxynucleotidyl transferase biotin nick end-labeling (TUNEL) method.Results There was a significant decrease in the average intimal thickness at 7,14 days in the atRA group.Immunohistochemical analysis of proliferating cell nuclear antigen (PCNA) indicated decreased positive cells in the atRA group, compared with the control group at 1 or 2 weeks after the operation. Apoptosis of smooth muscle cells was higher in the atRA group than in the control group at 1 week or 14d postoperation.Conclusions These preliminary results demonstrated that atRA (10mg/kg/d) inhibits smooth muscle cell proliferation and induces smooth muscle cell apoptosis in rats.

Objectives To determine the changes of right ventricular hemodynamic in the early phase after lung resection and non-lung resection thoracotomy by Doppler echocardiography and to investigate the correlation with preoperative lung function.Methods 55 patients who underwent thoracotomy were divided into two groups. In group A: 15 patients underwent non-lung resection thoracotomy; in group B: 40 patients underwent lung resection. The group B were subdivided into group B1 (n=23) and group B2 (n=17), acording to the preoperative lung function results: Artery blood gas analysis were measured and right ventricular hemodynamic indices were calculated by Doppler echocardiography before and after operation,respectively.Results Right ventricular ejection fraction (RVEF) and artery oxygen pressure(PaO 2) significantly decreased (P

Objective To review the experience of costal cartilageplasty and sternal elevation on pectus excavatum (PE) children. Methods A transverse anterior wedge osteotomy of the sternum is made at the level of maximal depression. The posterior table of the sternum is gently fractured without displacement and then elevated to the desired position. Tight sutures are placed through the anterior table across the osteotomy with stainless-steel wire. The deformed costal cartilages are partially resected subperichondrially and plasty is performed. Between Jan 1994 and Oct 2003, 57 patients who underwent costal cartilageplasty and sternum elevation operation were followed-up. Results With the exception of one patient, all children had normal thoracic contour. The preoperative symptoms improved markedly. Conclusion The costal cartilageplasty and sternum elevation may yield satisfactory results.

Objective To investigate the effect of autologous bone marrow mononuclear cells (BM-MNCs) implantation on neovascularization in rat model of hind limb ischemia, and explore its mechanism. Methods Rat BM-MNCs were isolated from tibia and femur using density gradient centrifugation. A rat model of ischemic hind limb was made by the ligation of the right femoral artery and its branches in imbred Wistar rats. BM-MNCs were injected into 7 points of the ischemic muscles (20?l/point). The levels of VEGF, bFGF and IL-1? in the ischemic musles at the third, 7th and 14th days after ligation were measured by ELISA. Micro-vessel density (MVD) in the ischemic mulsles was evaluated at the second and 4th weeks after ligation. Results The levels of bFGF and IL-1? in the implantation group were significantly higher than those in the control group. The MVD of ischemic mulsles in the implantation group was also significantly higher than that in the control group at the second and 4th weeks after treatment. Conclusion The implantation of autologous BM-MNCs could induce neovascularization in a rat ischemic hind limb, and bFGF and IL-1? secreted by BM-MNCs might play a role in the neovascularization.

BACKGROUND: Chronic rejection limits the long-term success of cardiac transplantation and the underlying causes of the disease are unknown. Connective tissue growth factor (CTGF) is considered as a mitogenic and chemotactic factor for fibroblasts and is associated with cell proliferation and collagen synthesis.OBJECTIVE: To evaluate the role and significance of expression of CTGF in rat chronic rejection heart aliografta.DESIGN, TIME AND SETTING: A randomized controlled animal experiment was performed at the Laboratory Animal Center of the Second Xiangya Hospital between April and August 2007.MATERIALS: Twenty Wistar rats serving as donors and twenty Sprague-Dawely (SD) rats serving as recipients were included. An additional 10 Wistar rats were included as controls.METHODS: After intra-abdominal heterotopic heart transplantations, rats received cyclosporine A, mycophenolate, and methylprednisolone immunosuppression. Ten recipient rats were anesthetized and sacrificed for heart harvesting at 2 and 8 weeks postoperation, respectively.MAIN OUTCOME MEASURES: Coronary vessel density, fibrosis grade, and intimal occlusion were observed by hematoxylin-cosin staining and Van Gieson staining. Myocardial fibrosis was semi-quantitatively scored. CTGF expression was detected by immunohistochemistry. The associations between CTGF expression and allograft fibrosis and CAV formation were analyzed.RESULTS: Allografts harvested at 8-week post-surgery showed more obvious coronary intimal proliferation, fibrosis and higher CTGF expression compared with the 2-week allografts and the controls (P < 0.05-0.01 ) while the cardiac artery density was lower than the control group (P < 0.05). However, the control group in our study showed negligible CTGF expression. There were strong negative correlations between the gray value of CTGF protein expression and cardiac fibrosis and coronary intimal occlusion (r = -0.734, -0.713, P < 0.01), demonstrating that CTGF protein expression was positively correlated with cardiac fibrosis and coronary intimal occlusion.CONCLUSION: CTGF is expressed in cardiac myocyte with CAV. The increased expression of CTGF in the cardiac allograft is associated with CAV development and fibrosis formation and is involved in the pathogenesis of cbronic heart rejection

Objective To detect the expression of connective tissue growth factor (CTGF) in acute heart allograft rejection in rats and to investigate the relationship between CTGF expression and cardiac allograft fibrosis. Methods Sixteen Wister rats served as donors and another 16 Sprague-Dawely (SD) rats served as recipients. Intra-abdominal heterotopic heart transplantation was performed. All rats received 10 mg/(kg·d) cyclosporine,40 mg/(kg·d)CellCept, and 3 mg/(kg·d)methylprednisolone immunosuppression after the surgery. Ten allografts were harvested 2 weeks postoperation while 10 normal Wister rats served as controls. The paraffin sections of harvested heart specimens were stained with hematoxylin and eosin (HE),and van Gieson(VG) for the examination of morphological changes to observe the lumen loss of myocardial coronary arteries and myocardial fibrosis. The expression of CTGF was studied by immunnohistochemical method and was measured semi quantitatively. The correlation between the CTGF expression and allograft fibrosis was studied. Results The allografts showed a typical symbol of acute rejection with excessive granulocyte infiltration around the vessel wall and myocardial interstice. There were also intimal proliferation and obvious fibrosis in the acute group and the differences between the acute and control group were significant (P<0.05). The expression of CTGF protein was mainly located around the vascular and myocardial lesions in the acute group while the control group showed no CTGF expression. The gray scale value of CTGF was (AR vs NH: 103.52±6.42 vs. 182.61±8.72,P<0.05). Strong negative correlations were found between the gray scale value and fibrosis formation(r=-0.734,P<0.01). Conclusion CTGF was overexpressed in acute allograft rejection rat hearts and might be involved in the pathogenesis of transplanted heart fibrosis.

OBJECTIVE: To evaluate the efficiency of video-assisted thoracoscopic surgery for primary palm hyperhidrosis by T4 sympathicotomy plus bypass fiber resection, and to describe our experience regarding the prevention of related postoperative complications. METHODS: Clinical data for 32 cases of primary palmar hyperhidrosis in patients who underwent bilateral video-assisted thoracoscopic sympathictomy plus bypass fiber resection from October 2008 to June 2011 were analyzed retrospectively. RESULTS: The operation was performed successfully on all patients, and their palmar hyperhidrosis was completely alleviated after operation. No severe, surgery-related, postoperative complications occurred. CONCLUSION Video-assisted thoracoscopic sympathictomy is an effective, safe and minimally invasive procedure for primary palmar hyperhidrosis.
Adolescent ; Adult ; Female ; Hand ; Humans ; Hyperhidrosis ; etiology ; surgery ; Nerve Fibers ; Postoperative Complications ; prevention & control ; Sympathectomy ; methods ; Thoracic Surgery, Video-Assisted ; methods ; Young Adult

OBJECTIVE: To summarize the characteristics of reoperative valve surgery after previous open-heart valve surgery. METHODS: From 1996 to 2010, 155 patients who underwent reoperative valve surgery, either valve replacement or tricuspid annuloplasty or the repair of perivalvular leakage were included in the study. The reoperative interval was 1-266 (94.82 ± 85.37) months. All surgeries were carried out with extracorporeal circulation under moderated hypothermia. The cardioplegic solution in cold crystal or blood was used if heart beating was stopped during the surgery. RESULTS: The total in-hospital mortality was 5.81%, while it was 2.75% from 2005 to 2010. The end-diastolic dimension, size of atrium and ventricles were reduced after the reoperation. Ventricular arrhythmia and low cardiac output were the most frequent complications. CONCLUSION The success rate of reoperative valve surgery can be improved by the distinctive therapeutic strategies based on the clinical characteristics and therapy principles obtained from practice experiences.
Adolescent ; Adult ; Aged ; Cardiac Output, Low ; etiology ; Cardiopulmonary Bypass ; Child ; Female ; Heart Valve Diseases ; mortality ; surgery ; Heart Valve Prosthesis ; Heart Valve Prosthesis Implantation ; adverse effects ; methods ; mortality ; Humans ; Male ; Middle Aged ; Reoperation ; Tachycardia, Ventricular ; etiology ; Young Adult