1.THE APPLICATION OF CARDIOPULMONARY BYPASS IN NONCARDIAC SURGERY (28 CASES REPORT)
Jiachun LI ; Jiali WANG ; Jin LUO
Medical Journal of Chinese People's Liberation Army 1981;0(04):-
To summarize the experience of application of the cardiopulmonary bypass (CPB) technique in non cardiac surgery in 28 patients, including 22 cases of Budd Chiari syndrome, 2 cases of renal cell carcinoma with cancer cell emboli in the inferior vena cava, 2 cases of tracheal carcinoma, 1 case of intracranial basilar artery aneurysm, and 1 case of leiomyolipoma of the liver with excision and replantation of remaining liver. Different types of CPB were adopted as follows: 10 cases were supplemented by hypothermia and low flow perfusion, 15 cases by deep hypothermia and circulation arrest (DHCA) and 3 cases with vena vena bypass in normothermia, respectively. 2 patients died in early post operative period. It is our opinion that CPB can be used in non cardiac surgery, when it is difficult or almost impossible to carry out with routine surgical technique. The technique can make operations more convenient and safer to perform, even though there are some disadvantages, such as more trauma and higher cost.
2.STUDY ON EXTRACORPOREAL CIRCULATION IN 1286 PEDIATRIC PATIENTS
Jiali WANG ; Jiachun LI ; Changqin GAO
Medical Journal of Chinese People's Liberation Army 1981;0(04):-
To study retrospectively on extracorporeal circulation (ECC) in pediatric patients with congenital heart diseases. 1286 cases were divided into two groups. In groupⅠ( n =883) ECC were performed with nonpatterned tubing system, and in group Ⅱ( n =403) patterned tubing system was used. GroupⅠandⅡwere both primed with Ringer′s solastion and colloid. There were no stastistically significant difference in age or body weight between groupⅠand Ⅱ. The crystalloid priming volume in group Ⅱ was less than that in groupⅠ( P
3.RETROSPECTIVE STUDY OF CARDIOPULMONARY BYPASS IN CORONARY ARTERY BYPASS GRAFTING
Jiachun LI ; Changqing GAO ; Jial WANG
Medical Journal of Chinese People's Liberation Army 1981;0(06):-
cases of coronary artery bypass grafting (CABG) were analyzed retrospectively. They were divided into four groups. In group 1 ( n =63,1985~1996), group 2 ( n =160, 1997~1999), and group 3 ( n =209, 2000~2002), CABG was performed with cardiopulmonary bypass (CPB). In group 4 ( n =291, 2000~2002) CABG was performed with off pump (OP). The durations of CPB and aortic cross clamp (ACC), temperature, hemodilusion, duration of using ventilator postoperatively, and ICU stay days were analyzed and compared. The patients in the groups 3 and 4 were older than those of the group 1, but younger than group 2. Pre operative supersonic EF value was lower in patients in the group 3 compared with group 2. A tendency of shortening of CPB time and ACC time, raising of temperature, lowering of hemodilusion, and shortening of ventilator time and ICU stay days could be discerned from group 1 down to group 4 ( P
4.Application of deep hypothermic extracorporeal circulation technique in surgical procedures
Jiachun LI ; Jiali WANG ; Jin LUO
Medical Journal of Chinese People's Liberation Army 1983;0(05):-
Objective To explore the application and management of deep hypothermic extracorporeal circulation (DHECC) in surgical procedures. Methods From Dec. 1997 to Dec. 2007, DHECC was applied in 54 patients suffered from great vessel diseases (34/54), complex congenital heart disease (10/54), giant basilar artery aneurysm (5/54), and abdominal tumor with tumor embolus intruding into right atrium or inferior vena cava (5/54) in the General Hospital of PLA. Extracorporeal circulation was performed with arterial perfusion by ascending aorta (n=25), axillary artery (n=18) and femoral artery (n=11), and venous drainage by superior vena cava and inferior vena cava (n=21), right atrium (n=25), and femoral vein (n=8). Clinical data were analyzed retrospectively including extracorporeal circulation (ECC) time, aortic clamping time, deep hypothermic circulation time, the lowest temperature, and the use of ultrafiltration. Results The ECC time was 63-414 (178.55?74.42)min. Aortic clamping time was 16-259 (123.39?52.21) min in 46 patients. Deep hypothermic circulatory arrest (DHCA) was performed in 43 patients, and the duration was 2-109 (30.00?22.37)min. The lowest nasopharyngeal temperature was 13.6-25.7 (19.61?3.40)℃, and the lowest rectal temperature was 15.2-30.5 (21.58?3.63)℃. Ultrafiltration technique was used in 49 cases. 36 of 54 cases (66.7%) self-awakened. Four cases (7.41%) died in the early post-operation period. Conclusion The DHECC can offer a clear and exsanguinated operating field, and is helpful to execute complicated or major operations which are hard to complete with common techniques.
5.Influence of psychological intervention on the quality of life in the hysteromyoma patients with surgery
Xiaoling ZHANG ; Jiachun WANG ; Qingxian ZHU
Clinical Medicine of China 2010;26(7):690-693
Objective To explore the influence of psychological intervention on quality of life(QOL) in the hysteromyoma patients underwent surgery. Methods Three hundred and twenty patients with hysteromyoma were divided into the psychological intervened group ( all cases were treated with the comprehensive psychological intervention) and the control group (without intervention). Before and after treatment, the scores of the Olson's Enrich Questionary and the Nottingham Health Poofity (NHP) were assessed in the two groups. Results Before surgery, the scores of N HP and Olson were not significantly different between the psychological intervened group and the control group ( P > 0. 05 ). The scores of NHP of total hysterectomy in the control group after surgery were higher than that before surgery,and the scores of Olson were lower significantly ( P <0. 05 or P <0. 01). The scores of NHP of subtotal hysterectomy, myomectomy and blood vessel involvement treatment in the control group after surgery were significantly lower than that before surgery, and the scores of Olson were higher ( P < 0. 05 or P < 0. 01 ). After surgery,the scores of NHP of all patients in the psychological intervened group were significantly lower than that in the control group,and the scores of Olson were higher significantly (P <0. 05 or P <0. 01). There was no significant difference in ovarian hormones level between pre- and post- surgery (P > 0. 05). Conclusions The comprehensive psychological intervention pre- and post- surgery is good for the quality of life in hysteromyoma patients.
6.Effect of interaction of chemo-mechanics on the microstructure and properties of thermal-sprayed bioactive coatings
Jiachun LIANG ; Weize WANG ; Fuzhen XUAN
Chinese Journal of Tissue Engineering Research 2010;14(16):2953-2957
BACKGROUND: With the bio-coated prosthesis implanted in the body by a complex interaction of chemo-mechanics, the cases of clinical revision increased.OBJECTIVE: To summarize the research progress of effect of interaction of chemo-mechanics on the microstructure and properties of thermal-sprayed bioactive coatings.METHODS: The relevant articles were retrieved from Elsevier with the key words of "apatite, coating, spraying" in English between January 1999 to November 2009. Meanwhile, the relevant articles were searched from database of Vip Information with the key words of "apatite, coating, spraying" in Chinese between January 1989 to November 2009. The articles that were highly related to the effect of chemo-mechanics on the microstructure and properties of thermal-sprayed bio-coatings were collected. The repetitive researching results and those with weak correlation were excluded.RESULTS AND CONCLUSION: It was shown that loading affected the dissolution of bio-coatings significantly. Tensile stress promoted the dissolution, while compressive stress inversely. In addition, the mechanical properties decreased after immersion in simulation body fluid. Moreover, the mechanical properties increased when it was implanted in bone tissue. However, there were only investigation of microstructure and properties of bio-coatings under simple loading. The coupling effect of complex loading, such as tension, torsion and fatigue, etc., and the specific chemical environment on the bio-coatings should be studied in order to ensure the integrity of its structure and properties.
7.The improving effect and mechanisms of Rhodiola compound on memory-damaged mice
Shu ZHANG ; Zhifa ZENG ; Zhiyong CHU ; Jiachun WANG
Chinese Journal of Behavioral Medicine and Brain Science 2012;21(9):797-799
ObjectiveTo investigated the effects of Rhodiola Compound on improving the intellective function in mice and provide the basis for clinical application.MethodsMice were divided to different groups of three doses of rhodiola compound (0.3 g/kg,0.6 g/kg,1.2 g/kg) and swimming abilities were tested.Other mice were administrated single dose of compound rhodiola( 1.2 g/kg) and training by Morris water maze.Drug's improving intelligence function was assessed using memory acquisition impaired models made by scopolamine or alcohol.When the Morris water maze test was finished,mice were killed and brains were removed immediately to measure SOD and NO levels.ResultsGroups of three doses of compound rhodiola could significantly prolong the swimming time(P < 0.05,P < 0.01 ).Compound Rhodiola group can significantly reduce the swimming distance than the untreated group( ethanol model group:(26 906.6 ± 2769.7 ) mm,RCE treated group:( 19 586.1 ± 6826.7 ) mm ; P <0.05 ).Swimming distance and time of cross-platform quadrant was significantly increased,comparing with model group (P < 0.05 ).Compound Rhodiola significantly enhanced the activity of mouse brain's SOD ( Scopolamine model group:( 150.3 ± 17.7 ) U/ml,RCE treated group:( 197.9 ± 16.8 ) U/ml ; P < 0.05 ) and NO levels ( Scopolamine model group:( 44.7 ± 16.7 ) μmol/gprot,RCE treated group:( 65.4 ± 14.5 ) μmol/gprot ; P < 0.05 ) significantly.ConclusionCompound Rhodiola could promote mice learning and memory function,SOD and NO in brain maybe play a important role in this effect.
8.Expression of DNA repair gene ERCC1 and its relationship with PAH-DNA adducts in lung cancer tissues
Yunnan WANG ; Jiachun L ; Bohang ZENG ; Xiaonong BIN
Chinese Journal of Pathophysiology 2000;0(07):-
AIM: To investigate the expression of nucleotide excision repair gene ERCC1 and its relationship with PAH (polycyclic aromatic hydrocarbons)-DNA adducts in lung cancer tissues. METHODS: ERCC1 mRNA expression and the PAH-induced DNA adducts were detected in 150 lung cancer tissues, 120 adjacent lung tissues without cancer cells, 40 benign lung lesions and 40 normal lung tissues. The effects of some exposure factors on the expression of ERCC1 gene and the connection between ERCC1 and PAH-DNA adduct was analyzed. RESULTS: Reduced expression levels of ERCC1 were observed in 46 of 150 (30.7%) lung cancer specimens and 1 of 40 (2.5%) normal lung tissues. Smoking may suppress the expression of ERCC1 gene. The level of PAH-DNA adduct was negatively correlated with the expression of ERCC1 gene, the Spearman coefficient was -0.648, P
9.Management of extracorporeal circulation for totally robotic assisted cardiac surgery
Jiali WANG ; Changqing GAO ; Jiachun LI ; Too ZHANG ; Lan MA
Chinese Journal of Thoracic and Cardiovascular Surgery 2011;27(7):407-408
Objective To discuss the way and management of extracorporeal circulation (ECC) for totally robotic assisted cardiac surgery. Methods A Total of 226 patients underwent cardiac surgery using da Vinci S robotic surgical system, including 111 patients underwent atrial septal defect repair ( ASDR) , 9 patients underwent ventricular septal defect repair ( VSDR) ,51 patients underwent mitral valvuloplasty ( MVP) , 20 patients underwent mitral valve replacement( MVR) , 27 patients underwent left atrial myxoma excise and 4 patient underwent right atrial myxoma excise. ECC for most of patients was achieved with femoral arterial cannula, femoral venous cannula and right internal jugular venous cannula, except for 1 patient underwent MVP with femoral arterial cannula and femoral two-stage venous cannula. In all the cases, vacuum-assist venous drainage ( VAVD) , continuous blood gas monitoring and ultrafiltration were used during ECC. myocardial protection was pertic cross-clamp time was 40 ~219 (105.9+38. 8)min and 21 ~166 (69.5±30.0)min respectively. During ECC, the mean urine volume was 100-2100 (771.7±477.6) ml, ultrafiltration volume was 1000-4800 (2495.4 ±811.6) ml, and the total fluid balance was subzero-balanced (172 cases) or zero-balanced(13 cases) in most of patients. Conclusion The establishment of ECC system through peripheral vessels, using VAVD and continuous blood gas monitoring are the key points of ECC for totally robotic assisted cardiac surgery, also certain learning curve of perfusion technique and close communication between the surgical team are essential during ECC.
10.Septal anterior ventricular exclusion operation for left ventricular anterior aneurysm:effects on left ventricular shape,volume and function by intraoperative transesophageal echocardiography
Yao WANG ; Changqing GAO ; Gang WANG ; Yang WU ; Weihua YE ; Guopeng LIU ; Jiachun LI ; Jiali WANG
Chinese Journal of Ultrasonography 2008;17(8):657-660
Objective To assess the effects of septal anterior ventricular exclusion(SAVE)procedure on left ventricular(LV)shape,volume and function in patients with post-infarction LV anterior aneurysm by intraoperative transesophageal echocardiography(TEE).Methods Twenty patients with LV anterior aneurysm underwent surgical ventrieular restoration(SVR)with the SAVE procedure.Intraoperative TEE was performed before cardiopulmonary bypass(CPB)and after weaning from CPB.LV volume and ejection fraction(EF)was measured using the biplane Simpson's method.LV end-diastolic and end-systolic volumes,indexed by body surface area(EDVI and ESVI,respectively)were calculated.To estimate the shape of LV,end-diastolic sphericity index(SI)of LV was determined.Results Compared with pre- CPB,after SVR,LV shape became more elliptical:SI increased from 0.76±0.04 to 0.84±0.05,P<0.001.LV size became more normal:EDVI decreased from(121.51±16.91)ml/m2 to(60.27±9.93)ml/m2,P<0.001,and ESVI decreased from(85.81±15.02)ml/m2 to (32.44±5.36)ml/m2,P<0.001,respectively.EF was increased significantly:(46.02±3.90)% vs(29.52±6.0)%,P<0.001.Conclusions The SAVE technique is easy to reshape LV to ellipsoid fogln and normal size and the resultant improved configuration may contribute to improving EF for patients with post-infarction LV anterior aneurysm.