Objective To investigate the effect of non-restrictive external stent on both cell proliferation of rabbit vein grafts and prevention from hyperplasia of the grafts' neointima. Methods 36 New Zealand white rabbits were randomly divided into two groups, each animal was subjected to a reversed autologous venous graft between external jugular vein and common carotid artery. In stenting group (group S), the vein grafts were surrounded by a 6 mm in diameter non-restrictive stent, and in non-stenting group (group NS), there is no stent to support the vein grafts. The grafts were harvested 1 week (1W), 2 weeks (2W) and 4 weeks (4W) after surgery, respectively. The sections were stained with hematoxylin and eosin stain, ?-smooth muscle actin (?-SMA) and proliferating cell nuclear antigen (PCNA) immunocytochemistry stain. PCNA index was calculated in intima, media and adventitia, respectively. Results (1) HE staining: From 1W to 4W, the hyperplasia of intima and media appeared gradually in both group S and group NS, nevertheless such hyperplasia in group S was lessintense than in group NS. (2) ?-SMA staining: Almost all cells in media were positive, but few cells were positive in intima of both groups at 1W; the thickness of intima of both groups increased gradually, and almost all cells except endothelial cells were positive in intima in both groups, though the thickness of intima of group S was smaller than in group NS at 2W and 4W. (3) PCNA index: the index of intima in both two groups peaked at 2W, and the index of intima in group S was less than in group NS at 2W and 4W, P

0.05; at 14 d,28 d, the thickness and area of the intiam in group S were smaller than those in group NS,P

The minimally invasive approach is the direction of cardiac surgery.With the development of telemanipulation and computer technology,the minimally robotic surgery has become reality.As the one of the most minimally invasive cardiac surgery,the robotic surgical system provides cardiac surgeons with less invasive manner and dexterity manipulation.Robotic cardiac surgery is an evolutionary process and has resulted in a substantial increased attention to surgeons and patients.This review is to introduce the recent clinical application of robotic technology in cardiac surgery.

Objective To study the changes in protease and cytokines,and to evaluate the protective effect of ulinastatin on ischemia-reperfusion lung injury in rabbits.Methods Thirty New Zealand rabbits were randomly divided into three groups(n=10): control group,traumatic hemorrhagic shock group(shock group) and ulinastatin-treated group.Blood samples were taken at four time points: pre-shock,post-shock,as well as 2h and 4h after blood volume repleshment.The serum levels of TNF-? and IL-8 were measured.4h after blood volume repleshment,the rabbits were sacrificed.The activity of myeloperoxidase(MPO) in lung tissue and neutrophil elastase(NE) in bronchoalveolar lavage fluid(BALF) were determined.Results In control group,the serum concentrations of TNF-? and IL-8 showed no obvious changes during the experiment.While in shock group and ulinastatin-treated group,the serum concentrations of TNF-? and IL-8 increased significantly in the duration of experiment compared with the values before shock(P

0.05). While the significant differences existed between postoperative hypoxemia group and non-hypoxemia group (P

0.05). The levels of PT, APTT, TT were longer and INR was higher and FB, PTA were lower in two groups at the end of operation than at the preoperative day (P0.05). CCABG group was higher than OPCABG group in Allogeneic blood transfusion (P

Objective To analyze the hemodynamic changes during coronary artery bypass grafting with or without cardiopulmonary bypass.Methods Thirty patients undergone coronary artery bypass grafting from January to June,2006 were retrospectively analyzed.Among them,12 patients were operated on with cardiopulmonary bypass(CCABG)and 18 without cardiopulmonary bypass(OPCAB).The stabilizator(type Octops III)was used to fix target vessels in OPCAB group.In CCBAG group,the extracorporeal circulation was used routinely,and internal mammary artery and saphenous vein were used to anastomose with target branches of coronary artery.The hemodynamic changes at different time points during and after operation were monitored,and the relevant parameters were also recorded.Results The anaesthesia time,intraoperative blood loss and fluid input,and ventilating time after operation in CCABG group were significantly higher than those in OPCAB group,and the postoperative haematocrit(HCT)was significantly lower in CCABG group than that in OPCAB group(P

Objective To introduce the strategy of perioperative blood glucose control and the early outcome in diabetic and non-diabetic patients undergone coronary artery bypass grafting (CABG). Methods A total of 1019 CABG were performed and the patients were divided into diabetic and non-diabetic groups (n=211, 808, respectively). The demography was comparable between the two groups with the exception that the percentage of preoperative myocardial infarction was significantly higher in diabetic group than that in non-diabetic group. Off-pump and conventional CABG were routinely performed and the left internal mammary artery (IMA) and great saphenous vein (GSV) were used as conduit. Perioperative blood glucose was controlled according to the close supervision. The aim of preoperative 6mmol/L and postoperative 8mmol/L was achieved by means of oral medication or subcutaneous injection of insulin, which was complimented by continuous pump infusion of regular insulin to optimize the glucose level. Results 99.2% patients were discharged. The overall perioperative mortality was 0.8% and the percentage was 1.4% and 0.6% respectively in diabetic and non-diabetic group with significant difference(P0.05), respectively. Cerebral infarction occurred in 1.4% diabetic patients and in 0.5% non-diabetic patients(P

Objective To summarize the clinical experience of coronary angiography before coronary artery grafting (CABG) with concomitant valvular surgery in patients with valvlar disease. Methods From April 2000 to May 2005, two hundred and eleven patients over 50 years old (mean age 60 3.5) with valvlar diseases were studied retrospectively. Coronary angiography was utilized for patients who were found to have risk factors for atherosclerosis. Coronary stenosis over 50% of its calibre was considered positive, and 75% stenosis (including LMCA stenosis more than 50%) was used as the indication for coronary artery bypass surgery. Results Coronary angiography was employed in 128 patients and 30 cases (23.4%) had coronary artery stenosis exceeding 50%. CABG was concomitantly performed during cardiac valvular surgery in 24 patients. In-hospital mortality in patients with valve surgery alone was 0.5%, which was significantly lower compared with patients with valve surgery combined with CABG group (4.2%)(P

Objective To summarize the technique and evaluate the effect of anesthesia for off-pump coronary artery bypass surgery (OPCAB). Methods From 1997 through March of 2005, five hundred and forty-three consecutive patients undergoing OPCAB were retrospectively studied. Anesthesia was induced with midazolam 0.05～0.12mg/kg, ketamine 0～0.5mg/kg and fentanyl 5～15?g/?kg. Anesthesia was maintained with isoflurane 0.3%～1.5% and oxygen, combined with propofol 1～3mg/(kg?h). Intraoperative hypotension resulting from either surgical procedure or anesthetics should be dealt with inotropes immediately. Results Intraoperative hemodynamics deviation was tolerated with the support of inotropics. The mean extubation time was 5.8?1.6h. The ICU stay was 0.5 to 2.0 day. The patients were discharged in 8.0?1.2 days. Two patients met sudden death in the second postoperative day. Conclusion Rational use of anesthetics and inotropics to stabilize hemodynamics during operation plays a key role in successful OPCAB.