Objective To study the effects of acute hypervolemic hemodilution (AHH) with hydroxyethly starch 130/0.4 on function of blood clotting in patients undergoing spinal operation. Methods Thirty patients scheduled for spinal operation were randomly divided into AHH group and control group with 15 cases each. Patients in AHH group were performed AHH by transfusing hydroxyethly starch 130/0.4 (15 ml/kg) with 25 ml/min before skin incision, to achieve expansion of 20% to 30%. Patients in control group were transfused routinely. Blood samples were taken from internal jugular vein before anesthesia induction (T0), at 1 h after anesthesia induction (T1) and termination of operation (T2) for determination of hemoglobin (Hb), hematocrit (Hct), platelet (Plt), prothrombin time(PT), partial thromboplastin time ( APTT), thrombin time( TT) and fibrinogen( FIB), at the same time heart rate( HR), mean arterial pressure (MAP) and central venous pressure (CVP) were observed and recorded. Results HR and MAP in both groups had no statistical difference within or between groups (P > 0.05). CVP at T1 and T2 in AHH group [(11.8 ± 1.0,(11.3 ± 1.0) cm H2O (1 cm H2O = 0.098 kPa)]were higher than that at T0 [(6.3 ±0.7) cm H2O]and that in control group ( P < 0.05). Hb and Hct at T1 and T2 in AHH group were lower than that at T0 and that in control group (P< 0.05). Plt and FIB at T1 and T2 in AHH group decreased significantly than that at T0(P<0.05), while there were no statistical difference between two groups(P> 0.05). PT, TT and APTT in both groups had no statistical difference within or between groups (P > 0.05). Conclusion AHH with hydroxyethly starch 130/0.4 has no significant effect on function of blood clotting in patients undergoing spinal operation.

Objective To investigate the value of emergency interventional embolization in the treatment of traumatic splenic rupture.Methods Clinical data of 45 patients with traumatic splenic rupture in our hospital were analyzed retrospectively.Selective splenic artery embolization (embolization group) was performed in 29 patients guided by DSA,and surgical resection or repair operation (operation group) was performed in 16 patients.Results Data of two groups were compared:①For operation time and length of hospital stay,the intervention group was significantly better than the operation group (P<0.05);②For incidence of postoperative fever and pleural effusion,the operation group was lower than the intervention group (P<0.05);③For the postoperative abdominal pain index,there was no significant difference between the two groups (P>0.05);④Compared with the operation group,patients in the intervention group had less long-term complications,and did not require long-term anticoagulation therapy.Conclusion Interventional embolization in the treatment of traumatic splenic rupture is safe and effective, and has less postoperative complications.The interventional embolization improves spleen preservation rate and improved the life quality.

Objective To summarize experiences in surgical treatments of 18 patients suffered from Ebstein's anomaly with intracardiac repair and bi-directional cavopulmonary shunt from January 1999 to June 2003. Methods Of 18 patients, 10 male (55.6%) and 8 female (44.4%), mean age was (18.47?13.85) years old (range from 9 months～54 years old),and mean weight of body (36.09?19.78) kg (range from 8.5～80.0 kg). All patients were in type II of Ebstein's anomaly according to WANG (Zenwei's) classification, while 15 (83.3%) were in type B, and 3 (16.7%) in type C according to Carpentier's classification. Danielson repair of Ebstein's malformation and other intracardiac repair were performed on all patients, followed by bi-directional cavopulmonary anastomosis, on pump with heart beating. Results There was no death, and no severe heart dysfunction and refractory low cardiac output in all patients postoperatively. No reoperation for residual or recurrent tricuspid incompetence was required in all patients. At follow-up of 13 (72.2%) patients ranging from 1 to 53 months, 12 patients were in New York Heart Association ((NYHA)) class I, 1 in class II. Four were with 1 grade, 2 with 2 grades tricuspid regurgitation. The patency of bi-directional cavopulmonary anastomoses was verified by echocardiography. Conclusion Ventricular unloading added to intracardiac repair appears to be effective to improve left and right ventricular function and tricuspid valve performance in Ebstein's anomaly with moderate or massive tricuspid dysfunction and physiological right ventricular outlet tract obstruction.

Objective To investigate the application of repeated myocardial perfusion on difficult cardiac resuscitation after aortic unclamping under open heart operation. Methods Fifteen cases met difficult cardiac resuscitation after release of aortic cross-clamping under open heart operation were analyzed retrospectively. They were perfused with or without repeated aortic clamping, with warm blood cardioplegic solution until electric activity of cardiac muscle stop. Results All cases got cardiac resuscitation and detached from-cardiopulmonary bypass (CPB) successfully,9 cases perfused with warm blood cardioplegic solution without repeated aortic clamping got cardiac resuscitation automatically(7 cases) or after defibrillation for one time (2 cases),5 cases experiencing repeated aortic clamping and perfused with warm blood cardioplegic solution for two times got cardiac resuscitation automatically (3 cases) or after defibrillation for one time (2 cases) and another one experiencing for four times. Conclusion Application of repeated perfusion on difficult cardiac resuscitation after aortic unclamping under open heart operation is effective.

Objective To investigate the roles of the expressions of B cell lymphoma-2 (bcl-2) and Bcl-assosiated X (bax) in the pulmonary vascular remodeling (PVR) of pulmonary arterial hypertension (PAH) secondary to left-right shunt congenital heart disease (CHD).Methods A total of 80 SPF SD rats were randomly divided into 8 groups,shunt groups (SⅠ,SⅡ,SⅢ and SⅣ) and control groups (CⅠ,CⅡ,CⅢ and CⅣ).PAH rat model was established in the shunt groups by left-to-right shutting,and the control groups received sham operation.The rats from Ⅰ,Ⅱ,Ⅲ and Ⅳ groups were sacrificed in 4,8,12 and 16 weeks after operation.Mean pulmonary arterial pressure (mPAP) was recorded.Pathologic observations were made to assess pulmonary vascular remodeling.Their lung tissues were detected by in situ hybridization histochemistry (ISHH) technique and Western blotting for bcl-2 and bax.And apoptosis of pulmonary artery smooth muscle cells (PSMCs) and endothelial cells (ECs) were also detected by TUNEL.Results After 12 weeks or 16 weeks shunt,following indexes of the shunt groups were significantly higher than the control groups (P

[Objective]To investigate the efficacy of early Chinese biotype total hip arthroplasty(THA) in clinical application.[Methods]From October 1997 to March 2004,THA was done in 46 patients(49 hips) with early Chinese biotype.The efficacy was evaluated according to the clinical score and X-ray photographs.[Results]Forty-six patients were followed up for 5~11.5 years(average 8.5 year).The mean Harris hip score improved from 38(35~50) points preoperatively to 82(70~90) points at final follow-up.The imaging observation showed that prothesis loosening occurred in 9 cases.There were hip dislocation in 3 cases.One dislocation occurred on the way to the ward after operation,and the other 4 events occurred after the patients were discharged.Close reduction was all successful.There was 1 case of ectopic ossification,Brooker classification was GradeⅠ.One patient had hip pain and limping.The X-ray photographs showed that there was obvious osteoporosis,but no prothesis loosening occurred.No infection was found.The total good to excellent result was 73.9%.[Conclusion]The early Chinese biotype total hip arthroplasty can relieve the pain.However,the design and the moding parts of the domestic prosthesis need to be modified in order to improve the prosthetic efficacy.

Objective To study the relationship between ? 1-aderenergic receptor (? 1-AR) and cardiac function in hypoxic newborn guinea-pig myocardia undergoing ischemic reperfusion, and the effects of St. Thomas Hospital cardioplegic solution Ⅱ (STS) and cold blood cardioplegia (CBC) on the ? 1-AR and cardiac function. Methods Normobaric hypoxic guenia-pig model and isolated perfused working heart preparation were established. Cardiac functions were recorded by a multichannel biologic signal analyzer. Myocardial ? 1-AR density (B max ) and affinity (K d) were investigated by radial ligand binding. Results Significant decrease of B max was found in hypoxic newborn guinea-pig myocardia suffering from hypothermic (20 ℃)-ishemic reperfusion (P0.05). Conclusion The impairment of cardiac function in hypoxic newborn guinea-pig undergoing myocardial ischemic reperfusion might be associated with the decline of B max , but not with K d. Different effects of STS and CBC on cardiac function may result from their different influences on B max .

Objective: To explore the effects of ligustrazine on the secretion of hydrogen sulfide in the ventricular tissues of rats under physiological condition.Methods:32 rats were divided into control group,high dose group of ligustrazine(150?g/ml),medium dose group of ligustrazine(15?g/ml) and low dose group of ligustrazine(1.5?g/ ml) at random.The left and right ventricular tissues were incubated in 37℃ thermostatic water bath for 4 hours with Krebs solution as supernatant.After incubation of the ventricular tissues,the sensitive electrode-based method was used to detect the content of H2S in the supernatant.Results: In the left ventricular tissues,there were on dif-ference of the H2S level betweenthe 1.5?g/ml ligustrazine group(0.17?0.03),15?g/ml ligustrazine group(0.17?0.03)and control group.However,compared with control group, the H2S level in hige dose group of ligustrazine decreased obviously(P0.05),but the H2S level in the 150?g/ml ligustrazine group(0.46?0.09)was significantly lower than that in the control group(0.64?0.13)(P

Peripheral artery disease is a cardiovascular risk factor. Exercise training may benefit patients with peripheral artery disease from preserving or improving functional capacity and reducing cardiovascular events. Accordingly, this article reviewed the effects of exercise training on peripheral artery disease, and the possible mechanisms

Objective To present the clinical features and to evaluate interventional therapy for Budd-Chiari syndrome in Chinese youth.Methods From January 1990 to April 2012,227 cases who hospitalized at the age ＜ 29 underwent color Doppler ultrasound scan and digital subtraction angiography (DSA).87 cases were with occlusive inferior vena cava (IVC type),105 cases with occlusive hepatic veins (HV type) and 35 cases with occlusive inferior vena cava and hepatic veins (MIX type).The occlusive veins were opened by percutaneous transluminal angioplasty (PTA),endovascular stent placement,intravenous catheter thrombolysis or combination.Postoperative anticoagulation was given to all patients.Results The symptoms and signs of portal hypertension disappeared or were alleviated in successful cases.Technical success was achieved in 210 patients.The success rate was 100％ in IVC type,85.7％ in HV type and 94.3％ in MIX type.IVC pressure decreased from (26.52 ± 8.16) cm H2O to (14.28 ±4.08) cmH2O(P ＜ 0.05) and HV pressure dropped from(35.70 ± 13.26) cm H2O to(18.36 ±8.16) cm H2O (P ＜0.05).Restenosis or occlusion was found in 21.4％ (45/210) patients after a follow-up of 1 month to 15 years.The rate was 13.8％ (12/87) in IVC type,31.1％ (28/90) in HV type and 15.2％ (5/33) in MIX type.These patients were managed by interventional procedures.Technical successwas achieved in 44 cases with restenosis.Conclusions Hepatic vein occlusion was the most common type of BCS in Chinese youth.The symptoms and signs of portal hypertension were the initial clinical manifestations.Postoperative recurrence rate in HV type was higher than that in the other two types.