Objective To investigate early and midterm outcomes after minimally invasive1-stop or 2-stage MICSCABG and PCI hybrid surgery.Methods Between June 2011 and February 2015, 28 patients(19 males and 9 females) with multiple coronary artery disease underwent MICS-CABG and PCI hybrid surgery, 4 cases of which were1-stop hybrid surgery and 24 cases were 2-stage.All patients were followed up to major adverse events(recurrent angina, secondary myocardial infarction, congestive heart failure, serious arrhythmias, secondary bypass graft) as the end point event.Results All patients were no perioperative deaths, shock, infection and myocardial infarction.ICU stay time was(22.9 ± 12.5) h, hospital stay time was(6.75 ±2.10) days, intubation time was(21.1 ± 17.7) h.Perioperative1-stop and2-stages hybrid surgery had significant statistical differences in ICU stay time and intubation time[(41.8 ±32.9) h vs.(16.5 ± 8.5) h;(40.0 ± 34.2) h vs.(18.8 ± 8.5) h;P ＜ 0.05].Patients were followed up for 1-44 months, averaged (17.9 ± 12.8) months.The postoperative major adverse event rate was 7.14％, one patient died of cerebral hemorrhage after 6 months, and one patient underwent coronary angiography because angina.Conclusion l-stop or 2-stage MICS-CABG and PCI hybrid surgery provides a safe,effective and cosmetic revascularized method to patients with multiple coronary artery disease.Meanwhile,the procedure does not destroy the way of re-operation.The perioperative and early results of follow-up are satisfactory.

Objective To evaluated the early-term results of the right or left anterolateral minithoracotomy used for the repair of various congenital heart defects.Methods All the patients with congenital heart defects who were operated with this incision between April 2010 and December 2012 were reviewed.There were 63 patients (41 females,22 males) underwent openheart surgery through right or left anterolateral minithoracotomy.Ages ranged from 12 to 69 years,mean (30.63 ± 11.74) years.Corrected defects included atrial septal defect(ASD) closure in 38,closure of ventricular septal defect(VSD) in 19,correction of partial atrioventricular canal defect (PECD) in 3,correction of partial anomalous pulmonary venous connection (PAPVC) in 1,correction of Ebstein's anomalyin 1,and repair of ruptured aneurysm of the sinus of Valsalva in 1.Results In all patients,length of incision was (4.76 ± 0.95) cm.There was no early or late death.No patient required conversion to full sternotomy.The median CPB and aortic clamp times were (76.38 ± 29.97) and (33.49 ± 31.50) minutes,respectively.Median intubation time was (10.53 ± 6.13) hours.Median duration of intensive care and postoperative hospital stay was (14.93 ± 7.65) hours and (5.42 ± 1.98) days,respectively.Only 9 patients(14.3％) received blood transfusion.Follow-up echo showed no residual defect.All patients have gratifying cosmetic results and are in excellent condition after a median follow-up of (13.75 ± 8.91)months.Conclusion The small anterolateral thoracotomy in congenital cardiac surgery is a safe and feasible approach,and with a excellent cosmetic results.

Objective Discuss the different between minimally invasive and conventional thoracotomy mitral valve replacement surgery.Methods Select 141 cases from February 2009 to December 2012 in our hospital suffer mitral valve replacement surgery.69 cases minimally invasive surgery and the 72 cases conventional thoracotomy mitral valve replacement surgery,mechanical valve 90 cases,the bioprosthesis 51 cases.The establishment of cardiopulmonary bypass is through the femoral artery and vein and the right jugular vein with cannulation.Under the guide of transesophageal echocardiography (TEE) and adjust the the intubation position to the inferior vena cava and superior vena cava junction.Double-lumen endotracheal intubation in trachea.Transthoracic approach through the right side of the stemum 4 intercostal,the left lung unilateral breathing and fight lung collapse.Open the pericardium with minimally invasive surgical instruments away 2 cm from the phrenic nerve.Transthoracic chitwood clamp blocking the ascending aorta,HTK or crystalloid cardioplegia aortic root perfusion.Arrest heart minimally invasive mitral valve replacement surgery.After CPB,unplug the femoral artery and vein catheter,6-0 prolene suture femoral artery reconstruction pathway.Results Minimally invasive compared to the conventional median thoracotomy mitral valve replacement surgery have no significant difference in operative time,cardiopulmonary bypass time,aortic clamping timeand the intensive care unit (ICU) time.Conclusion Overcome the learning curve,minimally invasive mitral valve surgery have many advantages than the conventional median thoracotomy surgery is a safe,effective,and easy to spread surgery.

Objective To summarize the short-term therapeutic results of valve-sparing reimplantation procedure (David Ⅰ procedure) using Valsalva conduit in patients with aortic valve insufficiency due to aortic root disease.Methods From January 2008 to May 2011,David Ⅰ procedure was performed using Valsalva conduit in 15 patients with aortic insufficiency caused by aortic root disease,of which 14 males and 1 female,mean age was (49.5 ± 10.3) years old (from 33 to 67 years old).The evaluation of pre-operative heart functional and aortic valve regurgitation:11 in class Ⅰ,4 in class Ⅱ ; 9 with moderate and 6 with severe aortic insuffciency.Concomitant procedures included 4 CABG operations,9 aortic arch replacements,1 mitral annuloplasty and tricuspid annuloplasty,and 1 ASD repair operation.Results There was two intra-operative deaths occurred,one died of pulmonary infection,another one died of hemategenous septic shock and multiple organ failure.The mean extracorporeal circulation time was (230.0 ± 54.4) min,the aortic cross clamp time was (181.2 ± 30.6) min.One week after operation,the heart functional of all patients changed into class Ⅰ ; 8 patients had no aortic regurgitation,6 had gentle aortic regurgitation and 1 had moderate aortic regurgitation.After leaving hospital,13 patients were followed-up by (8.8 ± 5.9)months (ranged 3 to 24 months),3 were no and 9 with gentle (3 of which showed no aortic regurgitation in half past year)and 1 with moderate aortic regurgitation (this patient showed gentle aortic regurgitation in 3 months later).Conclusion David Ⅰ procedure using Valsalva conduit was a good option for patients with aortic valve insufficiency with approximate normal aortic leaflets and valvular ring,which could provide a good short-term operative effect.

Objective To observe the clinical results of the valve-sparing root reimplantation procedure(David Ⅰ procedure) in patients with aortic valve insufficiency due to aortic root disease.Methods From august 2005 to May 2011,aortic valve-sparing root reimplantation was performed in 24 patients with aortic insufficiency due to aortic root disease,21 males and 3 females; mean age (47.0 ± 12.3) years old (from 24years to 69years) ; 20 being of heart functional class Ⅰ,3 of class Ⅱ,and 1 of class Ⅲ; 13 with moderate and 11 with severe aortic insufficiency ; The tubular graft was used in 9 patients and valsalva conduit was used in15 patients in David Ⅰ procedure.Concomitant procedures included 6 CABG operations,11 aortic arch replacement operations,1 mitral annuloplasty and tricuspid annuloplasty,1 VSD repair and 1 ASD repair operation.Conversion to Bentall procedure was necessary in only one patient because transesophageal echocardiography (TEE) showed moderate aortic insufficiency due to aortic valve prolapse.Post-operative aortic valve regurgitation and heart function were followed up.Results There were two peri-operative deathes(one died of pulmonary infection in the 22th day postopertatively,another one died of haemategenous septic shock and multiple organ failure in the 9th day postopertatively),one late death other than operation-related reasons(died of pulmonary infection in the 54th day postopertatively).The mean extracorporeal circulation time was (235.9 ± 58.5) min,the aortic crossclamp time was(182.7 ± 35.8) min.11 patients had no aortic regurgitation,11 gentle and 1 moderate regurgitation postopertatively ; The heart functional of all patients changed into class Ⅰ one week post-operatively.20 patients were followed-up 3 to 74 months,of which 3 with no and 15 with gentle (3 of which showed no aortic regurgitation in half year later) and 2 with moderate aortic regurgitation (1 patient with Marfan syndrome used tubular graft showed severe postopertative aortic regurgitation 55 months later).Conclusion David Ⅰ procedure is a good option for patients with aortic valve insufficiency due to aortic root disease,and with more or less normal aortic leaflets and valvular ring normal.Furthermore using Valsalva conduit in David Ⅰ procedure could provide a more stable mid and long-term effect.

Objective The purpose of this study was to evaluate the safety and clinical oulcomes of aortic valve replacement (AVR) performed with minimally invasive technique.Methods From June 2010 to October 2011,20 cases of minimally invasive AVR were performed.The mean age was (47.60±12.28) ;12 males and 8 females.All patients are ventilated with a double-lumen endotracheal tube,through the 3nd anterior intercostals space with a 5 -6cmskin incision,right femoral artery and vein cannulation are used to establish CPB,direct aortic cross-clamped by Chitwood sliding clamp through the right 4th intercostals space,and completed the aortic valve replacement.Results Mean length of incision was (4.73±0.54)cm.Mean duration of cardiopulmonary bypass was (124±39.83)min,crossclamp time was (97.21±33.17) min.Median intubation time was (13.55±3.87)hours.Median duration of intensive care and postoperative hospital stay was (16.34±3.82)hours and (6.63±1.45) days,respectively.Hospital mortality was 0.There was no perivalvular leakage,Conclusion Minimally invasive aortic replacement with a modified Port-Access approach is feasible,small incisions,more cosmetic,shorter length of bospital stay and less need for blood transfusion are attainable.

Objective To explore the relation between the expression of PBMCs IP-10 mRNA and systemic lupus erythematosus.Methods The expression of PBMCs IP-10 mRNA was investigated by RT-PCR semi quantitative method and samples from 46 patients with SLE,20 patients with RA,11 non-SLE patients with renal impairment and 20 healthy volunteers.Results The expression of PBMCs IP-10 mRNA in active SLE group was significantly higher than that in inactive group(P0.05).Serum levels of IP-10 were highly correlated with the expression levels of PBMCs IP-10 mRNA(r=0.897 1,P

In this paper, three spoilage organisms were separated from five transmutative soy milks, and all the three spoilage bacteria could survive condition of both 1?105Pa,30min and 300mg/kg Nisin. Morpha character, physiological and biochemical characteristics, and a phylogenetic analysis based on 16S rDNA gene sequences reveal that these three strains are Bacillus licheniformis, Bacillus pumilus and Brevibacillus borstelensis respectively. GenBank accessions for these three strains are EF439666-EF439668。

Objective To study the protective role of AngiotensinⅡreceptor inhibitor in ventilator-induced lung injury of rats.Method Forty healthy male SD rats were equally divided into four group (A,B,C,D group,n=10).Group A served as control group,group B had low tidal volume (V_T=10 ml/kg) with breathing rate (P)=80/min;group C had high tidal volume (V_T=40 ml/kg) group with breathing rate 80/min;group D had high tidal volume (V_T=40 ml/kg) group with breathing rate 80/min,all rats in group D were pretreated with Losartan.The duration of ventilation in 'all groups was two hours.Rats were sacrificed after experiment finished. The lung lavage liquid and lung tissue were collected and preserved with well established methods.Lung pathological change was observed by microscope;lung cell apoptosis was assessed with TUNEL;the expression of ANGⅡwas assayed with RT-PCR.The measured variables also included total protein,WBC,W/D,MPO. Results In comparison with B group,all variables in group C were significantly increased (P

A surgical technique of lateral crus strut graft to correct the deformity of nostril contour and improve asymmetric nostril shape by autologous rib cartilage was reported. Thirty-five patients (20 males and 15 females), with a mean age of 19 years (range of 16-26 years) were included in this study. All of the patients suffered moderate to severe unilateral cleft lip nostril deformity and underwent surgical technique of lateral crus strut graft by autologous rib cartilage to correct the asymmetric nostril contour from 2010 to 2012. The views of the nostril contour on both sides were reviewed and some parameters were measured at different time points (preoperatively, and 3 months and one year postoperatively) including the long axis and short axis of the nostrils. The differences in nostrils including long axis, short axis, elliptical area and eccentricity on the both sides were compared at different time points. The differences in the long axis and eccentricity of the nostrils on the two sides were decreased significantly between the preoperative view and postoperative view (P<0.05). The surgical technique of lateral crus graft with autologous rib cartilage is effective to correct the abnormal nostril contour and improve the asymmetry for unilateral cleft clip patients.