Humans ; Spirituality

Objective:To research expression and function of c-myc gene in hyperacute r ejection of xenotransplantation. 　　Method:Through the model of hyperacute rejection of xenotransplantation wit h isolated rat heart perfused with human plasma,we detected c-myc mRNA expressi on and cell localization with in situ hybridization in hyperacute rejection. 　　Result:c-myc mRNA increased expression in the endothelium cell of heart.Th e value of signal is 450.09±409.99.The value of signal of group of control is 1 74.40±51.50(p＜0.05)。 　　Conclusion:From these study findings,it would appear that hyperacute rejecti on is associated with the elevation of c-myc mRNA expression.

Objective: To investigate the protective effect of 11,12-EET(11,12-epoxyeicosatrienoic acid)on myocardium of immature rabbit hearts from ischemic reperfusion injury. Methods: 16 isolated immature rabbit hearts were performed to ischemic reperfusion model in a Langendorff perfusion apparatus and randomlyassigned to on two groups. Control group, the hearts were arrested with St.Thomas No.2 solution and stored in the same solution (n=8). EET group, the hearts were arrested with St.Thomas No.2 plus 11,12-EET solution and stored in the same solution (n=8). These isolated rabbit hearts were stored for 8 hours at 4℃ hypothermia , and underwent 30 minutes of reperfusion (37℃). We measured the preischemia and postreperfusion indexes of left ventricle developed pressure (LVDP), left ventricle end-diastolic pressure (LVEDP), ?dp/pt_ max , myocardial water content (MWC), coronary blood effluent (CBE) and arrhythmia score (AS). The myocardial ultrastructure and value of creatine kinase (CK) and lactic dehydrogenase (LDH) were also observed. Results: (1) After 30 minutes reperfusion, the indexes of CK, LDH, CBE, AS,and the recovery rate of heart function were significantly better in EET group compared with controls. At the same time, no ultrastructural changes were found in the EET group while the capillary endothelial base membrane edema and mitochondrion edema was observed in the control group. (2) In EET group, compared with preischemia, there were no significantly changes of myocardial function at the end of 30-minutes reperfusion. Conclusion: These data suggest that 11,12-EET add to the St.Thomas No.2 solution could offer more little myocardial injury and little arrhythmia and provide better preservation of the isolated immature hearts.

Objective: To evaluate the clinical application of total cavopulmonary connection with off-pump technique. Methods: Between May 2000 and December 2002, 9 patients underwent total cavopulmonary connection without cardiopulmonary bypass. The patients were 5 males and 4 females, mean age (10.3?6.4) years, ranged 4～24 years and mean body surface area (0.95?0.35) m 2, range 0.65～1.66 m 2. SpO 2 before operation was (73?6)% (60%～80%). Pulmonary pressure was (12.7?2.4) mmHg (10～16 mmHg) at operation. Results: Patient died after surgery. Chylothorax occurred in 1 patient. 2 patients were reoperated for fenestration between the extracardiac conduit and right atrial during the early postoperative period. All survivors were noncyanotic, the average SpO 2 on breathing air was (94?3)% (89%～97%). On d ischarged. Conclusion: Total cavopulmonary connection with off-pump technique is a useful procedure in management of patients with a functional univentricular heart. It is easy to perform. However, much remains to be studied about this unique physiologic status.

Objective To evaluate the clinical effect and safety of the thrombus aspirated catheter (DIVER~(TM)) in primary PCI for acute myocardial infarction. Methods Seventy four AMI patients with total occluded infarct-related coronary artery(IRA)and intra-coronary thrombus from March 2005 to April 2006 were divided into two groups according to admission time and the treatment they received. After the 0.014 in BMW coronary wire crossed the lesion, the thrombus aspirated catheter (DIVERTM) was advanced over the wire to the lesion and continuously aspirated 2-3 times until the thrombus disappeared and stents were directly implanted in patients in group A (n=36) admitted from December 2005 to April 2006. Routine PCI applied in patients in group B (n=38) admitted from March 2005 to December 2005. Sirolimus eluting stents were implanted in both groups. The artery re-opened rate, no-reflow rate and the rate of major adverse cardiac events during hospitalization and 6 months after discharge were compared between two groups. Results Coronary arteriography showed the artery re-opened rate was 100% in both groups. The rates of no-reflow and major adverse cardiac events during hospital stay were significantly lower in group A than those in group B (2.78% vs 21.05% and 2.78% vs 10.53% respectively,P

Objective To investigate the mechanism of albtrans retinoic acid (atRA)attenuating cardiac allograft vasculopathy and myocardial fibrosis. Methods With inbred Wistar rats as donors and Sprague Dawley (SD) rats as recipients, heterotopic heart transplantation model was rejection group received same doses of cyclosporine A for 60 days. Grafts were removed on the day 60 post-transplant. Paraffin-embedded sections of cardiac allograft were stained with Masson's trichrome and Van Gieson for examination of myocardial fibrosis and vascular stenosis. Immunohistochemistry was performed to observe CD68 positive cell infiltration. Platelet-derived growth factor-A (PDGF-A)mRNA was detected by using reverse transcription-polymerase chain reaction (RT-PCR). Results The index of fibrosis in chronic rejection group and atRA-treated group was 64. 0 ± 11.9 and 34. 7 ±6. 3 respectively with the significant difference (P<0. 01). Chronic rejection all,grafts showed severe vessel disease. The luminal occlusion index of coronary arteries in chronic rejection group was 62. 9 4± 17. 2, and 40. 1± 8. 2 in atRA-treated group with significant difference (P<0. 01). CD68-positive cell count in atRA-treated group and chronic rejection group was 17. 6 4± 4. 2 and 32. 1 ± 9. 3 with significant difference (P<0. 01). The relative expression levels of PDGF-A mRNA in atRA-treated group and chronic rejection group were 0. 46 ± 0. 08 and 0. 94 4±0. 11 respectively with significant difference (P<0. 01). Conclusion AtRA attenuates cardiac all,graft vasculopathy and myocardial fibrosis. The effects might be induced by inhibition of CD68 positive cell infiltration and PDGF-A mRNA expression.

Objective To investigate the effect of PDGF-A on cardiac allograft vasculopathy and myocardial fibrosis in rats.Methods By using inbred Wistar rats as donors,and Sprague Dawley (SD)rats as recipients,heterotopic heart transplantation model was established,Four groups,each having 8 animals,were used.In normal heart group,Wistar rat hearts as blank control;In no rejection group,inbred Wistar rats as donors and recipients without immunosuppressive drugs,and grafts were removed on the day 60;In acute rejection group and chronic rejection group,Wistar rats as donors,SD rats as recipients,and the grafts were harvested on the day 5 without immunosuppresslve drugs in acute rejection group;In chronic rejectlon group,the graits were Immunohistochemistry was used for macrophages(CD68 positive cells)and reverse transcriptionpolymerase chain reaction(RT-PCR)assay for expression of PDGF-A mRNA in cardiac allografts.Results Macrophage infiltration was not found in normal heart group and no rejection group.In acute rejection group and chronic rejection group,macrophage infiltration was found around coronary vessels and in myocardial interstitium,especially in myocardial fibrosis area in chronic rejection allografts.The relative content of PDGF-A mRNA in normal heart group,no rejection group,acute rejection group,and chronic rejection group was 0.26±0.06,0.31±0.04,0.88±0.12,0.94±0.11respectively.PDGF-A mRNA was increased in chronic rejection group and acute rejection group significantly as compared with that in normal heart group and no rejection group(P＜0.01).Conclusion Macrophage infiltration and expression of PDGF-A are associated with cardiac allograft vasculopathy and myocardial fibrosis.

Objective To observe the protective effect of 11,12-epoxyeicosatrienoic acid(11,12-EET)on immature isolated rabbit hearts.Methods Forty-eight isolated immature rabbit hearts were randomly assigned to two groups: Control group,the hearts were arrested with St.Thomas No.2 solution and stored in the same solution ( n =24);EET group,the hearts were arrested with St.Thomas No.2 plus 11,12-EET solution and stored in the same solution ( n =24). All rabbit hearts were stored for 8,16 and 24 h with 4 ℃ hypothetmia, and underwent 30 min reperfusion ( 37 ℃ ). On the Langendorff perfusion apparatus,left ventricle developed pressure (LVDP),left ventricle end-diastolic pressure (LVEDP),+dp/pt max ,coronary blood effluent (CBE) and arrhythmias score were measured before and after ischemia. Myocardial water content,the value of creatine kinase (CK) and lactic dehydrogenase (LDH) were also measured,and myocardial ultrastructure observed. Results Postischemic recovery of myocardial function and myocardial edema were significantly better in EET group at different time points. The changes of arrhythmias score,CK,LDH and myocardial ultrastructure in EET group were superior to those in control group. After the hearts were preserved for 16 h ,the recovery of myocardial function and arrhythmias score in EET group were basically close to the measured values before heart preservation,while those in control group were significantly decreased. After the hearts were stored for 24 h ,all hearts in EET group beated again during reperfusion,but 5 hearts in control group could not beat anymore.Conclusion Addition of 11,12-EET into the St.Thomas No.2 cardioplegic solution could prolong the storage time and enhance the myocardial protective effect to the isolated immature hearts.

Objective To observe the protective effect of dexamethasone, the inhibitor of nuclear factor-Kappa B, on the ischemia-perfusion injury of rat lung during the period of lung preservation. Methods Twenty-four rats were randomly divided into two groups: the control group and the trial group. The harvested lung blocks were flushed with and stored in the low-potassium-dextran (LPD) solution in control group, but in the trail group LPD containing dexamethasone solution was used. The lungs were stored at 4 ℃ for 16 h in both groups. The isolated rat lung reperfusion models were established and the donor lungs were perfused for 1 h. PaO_2 and PawP were measured at every 15 min intervals during reperfusion. After reperfusion, the lung tissue wet-to-dry (W/D) ratio and myeloperoxidase (MPO) activity were obtained. The protein and mRNA expression of intercellular adhesion molecule-1 (ICAM-1), nuclear factor-Kappa B (NF-?B) was also detected by using immunohistochemistry and semi-quantitative RT-PCR at the end of reperfusion. Results The levels of decreased PaO_2 and increased PawP in trail group were lower than in control group at the every interval time in the samples obtained 15 min after reperfusion (P

Objective To summarize the early effect of orthotopic heart transplantation for 5 patients with end-staged coronary heart disease.Methods Orthotopic heart transplantations were performed on 1 patient with left ventricular mechanic circulatory support for 25 months after twice acute myocardial infarction, 3 patients with failing heart after acute myocardial infarction, 1 patient with failing heart after PTCA and CABG.Results Five patients recovered well. No any severe acute rejection and infection have been found. All survivors had good life quality and good heart function (NYHA I).Conclusion Orthotopic heart transplantation is an effective treatment for patients with end-staged coronary heart disease. Proper donor heart, excellent donor myocardial conservation, suitable immurosuppression treatment and appropriate control of hypertension, hyperglycemia, hypercholesterolemia and uricacidemia are key measures of successful orthotopic heart transplantation for patients with end-staged coronary heart disease.