Objective To investigate the effects of the free radical scavenger,edaravone,on patients undergoing cardiac valve replacement under cardiopulmonary bypass (CPB). Methods Thirty patients,including 7 males and 23 females,at a mean age of 41.4?10.4 (23 to 63),undergoing mitral or/and aortic valve replacement (MVR or AVR) under CPB from March to December 2009 in our hospital were subjected,and then divided into 2 matched groups by means of random number table,study group (n=14) and control group (n=16).Inclusion criteria: patients received valve replacement surgery under CPB; aging from 20 to 65; heart function: class Ⅰto Ⅲ; liver,kidney and lung function properly; blood gas and electrolyte properly. Exclude criteria: preoperatively used scavenger and the like; there was a history of cerebrovascular or neuropsychiatric symptoms; had a history of myocardial infarction or other coronary artery disease. In the intervention group,0.5 mg/kg of edaravone was diluted to 20 ml and introduced into CPB unit at the beginning,while the same dose of saline water was given in control group in the same way. Blood samples were collected from radial artery at following 5 time points,the beginning of CPB (T0),the end of CPB (T1),30 min (T2),6 h (T3),and 24 h (T4) after CPB. After the blood samples of all cases were collected,the serum level of hematocrit (HCT),malondialdehyde (MDA),inducible nitric oxide synthase (iNOS),cardiac troponin I (cTnI),creatine kinase-MB (CK-MB),myoglobin (Myo),S100 protein and neuron-specific enolase (NSE) was detected. Cardiac resuscitation and critically postoperative complications were observed. Results The level of HCT at T1-T3,cTnI at T4 was lower in study group than that in control (P

Cryopreservation is the best preserving method of the homograft heart valve at present, but at the same time it may damage the valve structural integrity. This study was performed to probe into the effects of cryopreservation on the histology of aortic valve. The viability of the cardiac valves was evaluated by XTT-tetrazolium colorimetric assay and the histologic property was assayed by light microscopy, transmission electron microscopy, and indirect immunofluorescent examination. The results of the experiments showed that the valve cellular viability was markedly decreased (P < 0.05), the cellular ultrastructure was damaged, the soluble extracellular matrix fibronectin and chondroitin sulfate were leached at different degree, and the interstitial collagen fibers were irregularly aligned after cryopreservation, but the damaged degree has no relation to storage within a period of 3 months.
Aortic Valve ; Cryopreservation ; Extracellular Matrix ; ultrastructure ; Heart Valve Prosthesis ; Humans ; Transplantation, Homologous

To investigate the feasibility of making up bovine pericardium into scaffolds for tissue engineering valve, it was decellularized by 0.5% trypsin incubation for three hours. The rats were divided into fresh bovine group, acellular pericardium group and control group, and OD value of rat anti-bovine IgG was measured. Serum levels of IgG showed no difference among the three groups on the 7th day postoperatively (P > 0.05). The OD values of IgG at other time-points displayed distinct difference among the three groups (P < 0.05). Fresh bovine pericardium group produced more IgG than acellular bovine pericardium group did at the same time-point. The IgG level of fresh bovine pericardium group reached the peak postoperatively, but in acellular bovine pericardium group its peak value appeared on the 30th day postoperatively. Histological examination demonstrated that the bovine pericardium was thoroughly decellularized, the fibrous structure was slightly loose, but remained essentially intact. These results indicate that the acellularization procedure can result in a complete removal of cells and decrease of immunogenicity.
Animals ; Antibodies, Anti-Idiotypic ; immunology ; Bioprosthesis ; Cattle ; Cell Separation ; methods ; Immunoglobulin G ; immunology ; Implants, Experimental ; Pericardium ; cytology ; immunology ; Rats ; Rats, Sprague-Dawley ; Tissue Engineering ; methods ; Trypsin ; pharmacology

ObjectiveTo observe the clinical efficacy and mechanism of Tongnao Yizhi Formula （通脑益智方， TYF） in treating vascular cognitive impairment no dementia （VCIND） with spleen and kidney depletion， phlegm and stasis obstructing collaterals syndrome. MethodsNinety-two VCIND patients with spleen and kidney depletion， phlegm and stasis obstructing collaterals syndrome were randomly divided into control group （42 cases） and treatment group （52 cases）. Both groups received routine basic treatment. The control group was given donapezil hydrochloride capsules orally， 5 mg each time， once at night， while the treatment group was given TYF orally， 1 dose per day. Both groups were treated continuously for 3 months. The scores of Mini-Mental State Examination （MMSE）， Vascular Dementia Assessment Scale-Cognitive Subscale （VaDAS-Cog）， Activity of Daily Living Scale （ADL）， and TCM syndrome scores （the primary symptoms such as sluggish thinking， forgetfulness， temperament changes， and language confusion， and secondary symptoms such as weakness of waist and knees， dizziness and headache， occasional tinnitus， fatigue， heaviness of limbs， insomnia and irritability， poor appetite and abdominal distension， numbness of face） were observed before and after treatment in both groups. The changes in gut microflora diversity and flora abundance structure as well as fecal short-chain fatty acids （SCFAs） levels including acetic acid， propionic acid， butyric acid， isobutyric acid， isovaleric acid， valeric acid， and caproic acid were compared between groups. The feces of 20 healthy subjects in the same period were included as reference. Safety was evaluated during the study. ResultsAfter treatment， both groups exhibited significant increases in MMSE scores and decreases in VaDAS-cog scores （P＜0.05 or P＜0.01）， and ADL scores in the treatment group significantly increased （P＜0.05）. Scores of symptoms including sluggish thinking， forgetfulness， temperament change， language confusion， heaviness of limbs， insomnia， irritability， poor appetite， abdominal distension， and facial numbness as well as the total score significantly decreased in both groups after treatment （P＜0.05 or P＜0.01）. When compared between groups， the treatment group showed substantial reductions in scores of weakness of waist and knees， tinnitus， fatigue， heaviness of limbs， insomnia， irritability， loss of appetite and abdominal distension （P＜0.05 or P＜0.01）. The gut microflora diversity analysis showed that the Shannon index of the treatment group significantly increased after treatment （P＜0.05）.PCoA analysis and ANOSIM test indicated significant differences between groups， suggesting changes in microflora species （P＜0.01）. After treatment， the relative abundance of Bacteroidetes and Fusobacteria in the treatment group increased， while the relative abundance of Actinobacteria， Verrucomicrobia and Cyanobacteria decreased （P＜0.05）； the relative abundance of Faecalibacterium prausnitzii， Bifidobacterium， Lactobacillus， and Ruminococcus increased significantly （P＜0.05）. Compared to the the gut microflora species diversity of the healthy people， it is indicated that the gut microflora structure in the treatment group was close to that of the healthy people， while there was no such trend in the control group. In the treatment group， acetic acid， propionic acid， and butyric acid in the treatment group were all higher after treatment （P＜0.05 or P＜0.01）. ConclusionsTYF can improve the cognitive ability and quality of life of VCIND patients with spleen and kidney depletion， phlegm and stasis obstructing collaterals syndrome， and this improvement may be related to regulating intestinal microecology.

Objective To investigate the clinical efficacy of mitral valve repair technique in the treatment of rheumatic mitral valve lesions. Methods The clinical data of patients diagnosed with rheumatic mitral valve lesions and undergoing mitral valve repair under extracorporeal circulation in our department from 2021 to 2022 were retrospectively analyzed. Results A total of 100 patients were collected, including 78 females and 22 males with an average age of 52 years. There were no secondary open heart or death in the whole group. Extracorporeal circulation time was 136.3±33.1 min, aortic cross-clamping time was 107.6±27.5 min, ventilator use time was 12.9±5.9 h, ICU stay was 2.6±1.4 d, and vasoactive medication use was 823.4±584.4 mg. Before and after the surgery, there were statistical differences in the left ventricular end diastolic diameter, left atrial end systolic diameter, effective mitral valve orifice area, shortening rate of left ventricular short axis, mitral E-peak blood flow velocity, mean mitral transvalvular pressure difference, mitral pressure half-time, and cardiac function graded by New York Heart Association (P＜0.05). While there was no statistical difference in left ventricular ejection fraction or left ventricular end-diastolic volume (P>0.05). Conclusion Overall repair of rheumatic mitral valve lesions can significantly improve the cardiac function and hemodynamics of the patients, and is a good choice for patients with rheumatic mitral valve lesions.