Objective To increase the mechanic characteristic of bovine jugular veins conduit (BJVC) by combined knitted stent outside made of nylon fiber. Methods Get rid of the cells of BJVC by enzymolysis, then combined a fabric stent with a acellular bovine jugular vein conduit that cross-linked dealed by photooxidation method to improve the mechanic function of BJVC. To compare the mechanical function and histology change of BJVC combined with fiber stent outside with that of BJVC only without stent. BJVC combined with fiber stent outside was divided into experiment group and the latter into control group. Two roller pumps on cardiopulmonary bypass unit were designed to simulate the pulmonary circulation. One produce the stream, and the other assist to bring a certain pressure by regulating a degree of tightness. The pressure of forward stream was used in messuring extension rate and leakage volume of two BJVC groups, and the pressure of backward stream was used in messuring the regurgitation volume. Results Set the formula to calculate the rate of variation of BJVC diameter under a certain pressure or not. The experiment group extension rate was zero under pressure of 10-20 mm Hg, about ( 7.7 ± 2.3 ) % under pressure of 40 mm Hg, until 60 mm Hg to ( 11.4 ± 3.1 ) %. While the control group reached about ( 14.8 ± 4.7 ) % at 20mm Hg already. There was no regurgitation volume of the experiment group under pressure of 30 mm Hg vs. the control group' s reached 34ml/min at 30 mm Hg while the two groups were same under pressure that lower than 20 mm Hg. When the pressure higher, the difference between the two groups more notable. There was no leakage of the BJVCs with fabric stent till pressure from 40 mmHg to 60mmHg, vs. the control group 1,5, 13 ml/min at pressure 30, 40, 60 mm Hg. Except the regurgitation and leakage volumes under pressure at 10 -20 mm Hg, as the two numerical values were both zero that can not be caculated by the statistic software, the differences of the two groups above had statistics significance. In vivo, 9 dogs received bovine jugular vein conduit transplant procedure to observe the mechanic fnction and tissue reaction. Five adopted B.JVC with stent and four just BJVC only. Six month later after the transplant procedure, there was no significant difference between the two groups but more inflaming cells than the former group, especially at the location round the nylon fibers. Through the observation in HE stain, that was considered as foreign body reaction. Conclusion Fabric stent can improve the mechanical function of BJVC and relatively easy to get.

Objective To investigate the early surgical outcomes of 86 patients with complete atrioventricular septal defect.Methods Between January 2007 and December 2014,consecutive 86 cases received surgical repair in our department.There were 44 male patients,and 42 female patients.Two-patch repair was performed in 69 cases,and modified single-patch repair in 17 cases.The mean age,height,and weight at the time of operation were (32.3 ± 46.5)months with a range from 1 month to 17 years,(82.1 ±27.6) cm with a range from 53 to 165 cm,and (10.8 ± 8.7) kg with a range from 4.1 to 43 kg,respectively.Rastelli A type was found in 67 cases,B type in 15 cases,and C type in 4 cases.Down's syndrome was complicated in 6 cases.Preoperative mild regurgitation of common atrioventricular valve was shown in 32 cases,moderate regurgitation in 38 cases,and moderate to severe regurgitation in 16 cases.Mild pulmonary hypertension was observed in 15 cases,moderate in 54 cases,and severe in 17 cases.Results After operation,all patients were sent into intensive care units (ICU).The mean duration mechanical ventilation,ICU stay,and hospitalization were (30.9 ± 47.7) h with a range from 2.5 to 244 h,(87.7 ± 76.8) h with a range from 14 to 306 h,and (16.4 ±9.2)d with a a range from 6 to 50 d,respectively.We encountered 4 operatively mortalities (4.7％),including 3 in two-patch repair group,and 1 in modified single-patch repair group.The cause of death was mitral regurgitation.Conclusions Modified single-patch and two-patch technique have a satisfied early outcomes.

Objective Xenografts have poor biocompatibilities,the aim of this study was to improve the biocompatibilities of decellular xenografts via heparin/dihydroxy-iron complex multilayeres (HDCMs) nanomodification.Methods A novel thrombo-resistant surface for decellular xenograft had been developed by alternating linkage of dihydroxy-iron and heparin to decellular bovine jugular vein (DC-BJV),and surface characterization and biocompatibility of HDCMs nanomodified BJV (HDCMs-BJV) were detected.Results Toluidine blue colorimetric method showed the amount of linked heparin was about (808 ±86) μg/cm2 per assembly-cycle.SEM images proved HDCMs were uniformly linked to and formed nanoscale films around the fibrils of DC-BJV.Washing test proved HDCMs were firmly linked to BJV and sustainedly released heparin for a long time.Tensile test showed that biomechanical stability was increased.Antithrombogenicity test showed that the activated partial thrombin time (APTT) and prothrombin time (PT) of all trial groups were above the normal reference ranges.Platelet adhesion test evaluated mean platelet count per 10 000 μm2 area was 8 ±4 for HDCMs-BJV vs.48 ± 16 for DC-BJV.Endothelial cells (ECs) proliferation test showed the number and activity of ECs on luminal surface of HDCMs-BJV were very similar to DC-BJV at 7-day incubation.Calcium content assay evaluated mean calcium content was ( 8.5 ± 1.9 ) μg/mg dry weight for HDCMs-BJV vs.(26.6 ± 3.7) μg/mg dry weight for DC-BJV at 4 weeks and (21.5 ± 6.8 ) μg/mg dry weight for HDCMsBJV vs.( 112.6 ± 16.9) μg/mg dry weight for DC-BJVs at 8 weeks,respectively.Conclusion These results demonstrate HDCMs were firmly linked to BJV and formed nanoscale thrombo-resistant films,and HDCMs nanomodification improves biocompatibilities of decellular xenograft.

Objective To study the anti-calcification function properties of bovine jugular conduit with valves stabilized by dye-mediated photooxidation.Methods Sixteen bovine jugular conduit with valves were divided into two groups and treated with dye-mediated photooxidation(groupⅠ) and glutaraldehyde(group Ⅱ).The bovine jugular vein was cut into pieces and implanted subcutaneously in the 16 weanling SD rats.After 90 days,all the rats were sacrificed and the retrieved specimens were undergone histological examination by electron microscope and microscope.The calcium content was determined by flame atomic absorption spectrophotometer.Results The walls and valves of bovine jugular vein treated by dye-mediated photooxidation had less calcification than those of the group Ⅱ.Conclusion The dye-mediated photooxidation can effectively preserve the calcification of bovine jugular conduit with valves compared with the way treated by glutaraldehyde.

OBJECTIVE: To investigate the characters and surgical treatment methods of anomalous drainage of left superior vena cava to left atrium. METHODS: Clinical data of 8 cases were analyzed retrospectively.The patients aged from 6 months to 168 months with weight between 6 and 29 kg. RESULTS: The associated cardic lesions existed in all patients: 4 had partial atrioventricular septal defect (PAVSD),including 1 coronary sinus orifice atresia (CSOA), 1 ventricle septal defect (VSD), 1 ventricle septal defect associated with right ventricular outlet tract stenosis (VSD/RVOTS), and 1 atrial septal defect (ASD) and complete atrioventricular septal defect (CAVSD), respectively.No patient died. Preoperation diagnosis was in 1 case, intraoperation diagnosis in 5 cases,and postoperation diagnosis in 2 cases due to reoperation for hypoxemia.Three patients were repaired by intratrium tunnel, and the other 5 were managed by extracardic shunt. CONCLUSION This lesion is easily missed in preoperation diagnosis,which can be avoided by awareness and careful inspection.The methods for management of anomalous drainage of left superior vena cava to left atrium depend on time of diagnosis and experience of surgeons.
Adolescent ; Cardiac Surgical Procedures ; methods ; Cardiopulmonary Bypass ; Child ; Child, Preschool ; Female ; Heart Atria ; abnormalities ; Heart Defects, Congenital ; complications ; surgery ; Heart Septal Defects, Ventricular ; complications ; surgery ; Humans ; Infant ; Male ; Retrospective Studies ; Vena Cava, Superior ; abnormalities ; surgery

OBJECTIVE: To improve the hemocompatibility of decellular vascular matrix via heparin-iron complex multilayers (HICMs) nanomodification. METHODS: A novel thrombo-resistant surface for decellular xenograft was developed by alternating linkage of dihydroxy-iron and heparin to decellular bovine jugular vein (DC-BJV), and its surface characterization, biomechanical stability and hemocompatibility were detected by scanning electron microscopy, tensile test and hemocompatibility evaluation, respectively. RESULTS: A toluidine blue colorimetric method indicated the amount of linked heparin was about (808±86) μg/cm2 per assembly-cycle. Scanning electron microscopic (SEM) images proved that HICMs were uniformly linked to and formed nanoscale films around the fibrils of DC-BJV. Toluidine blue staining histologic images showed that HICMs were linked mainly to DC-BJV surfaces. Washing test showed that the release of heparin was (281±43), (422 ± 60), (729±81), (1053±116), (1317±157), (1618±187) and (1945 ± 268 ) μg/cm(2) at 1 day, 1, 2, 3, 4, 6 and 8 week washing, respectively. Tensile tests showed an increased biomechanical stability. Hemocompatibility evaluations showed that PT and APTT of all the trial groups were above the normal reference ranges and that mean platelet count per 10000 μm2 area was 8±4 for HICMs layer-by-layer modified BJV (LBL-BJV) vs 48±16 for DC-BJV. CONCLUSION HICMs are firmly linked to DC-BJV, and can form nanoscale thrombo-resistant films, which yield a sustained release of heparin. HICMs nanomodification improves the hemocompatibility of decellular xenograft.
Animals ; Biocompatible Materials ; Blood Vessel Prosthesis ; Cattle ; Cell-Free System ; Coated Materials, Biocompatible ; chemical synthesis ; chemistry ; pharmacology ; Heparin ; administration & dosage ; chemistry ; Iron ; administration & dosage ; chemistry ; Jugular Veins ; Nanostructures ; chemistry ; ultrastructure ; Surface Properties ; Tissue Scaffolds ; Transplantation, Heterologous

OBJECTIVE: To explore the effect of unidirectional valved patch (UVP) for congenital heart disease (CHD) with severe pulmonary hypertension (PH). METHODS: We retrospectively analyzed the treatment of 37 CHD patients with severe PH by UVP in the operation, and summarized its short-term to mid-term effect to find an optimum therapeutic regimen. RESULTS: Before the operation, the ECG showed that the mean pulmonary artery pressure (MPAP) ranged 65-72 mmHg, and the cardiac catheterization showed the pulmonary artery pressure ranged 80-120 mmHg, P(P)/P(A) ranged 0.8-1.05,PVR ranged 8.5-19.2 (under oxygen inhalation 6.8-14.6) wood unit.After the operation, P(P)/P(A) ranged 0.4-0.72 on weaning-off CPB. Postoperative ECG showed the MPAP ranged 32-48 mmHg. No pulmonary hypertension crisis occurred and no patient died. Mechanical ventilation time ranged from 32 h to 8 d and the SaO₂ ranged 93%-96% at rest after the extubation.The right-to-left shunt situations by ECG were as follows:22 cases had shunt 5 d after the operation, 11 cases had shunt 1 month after the operation,4 cases 3 months after the operation, and none 1 year after the operation but one patient lost follow-up.However,there were no long-term follow-up data: 12 patients had a 1-year follow-up, 5 patients had a 3-year follow-up, and most patients had just 3-month follow-up. CONCLUSION UVP can decrease the operative risk in CHD with severe PH at perioperative period. The short-term to mid-term effect is satisfactory, while long-term effect remains uncertain.
Adolescent ; Cardiac Surgical Procedures ; methods ; Child ; Female ; Heart Defects, Congenital ; complications ; surgery ; Heart Septal Defects, Ventricular ; complications ; surgery ; Humans ; Hypertension, Pulmonary ; etiology ; surgery ; Male ; Pericardium ; transplantation ; Prosthesis Implantation ; Retrospective Studies ; Young Adult

Objective To investigate the clinical value of ultrasound-guided catheterization in intraperitoneal perfusion chemotherapy for postoperative abdominal malignant tumor without ascites. Methods A retrospective analysis were performed in 146 postoperative patients with abdominal malignancies who were admitted to Fujian Cancer Hospital from April 2013 to September 2018, and there were no ascites founded in these patients before abdominal catheterization. Two hundred and seventy-nine times ultrasound-guided catheterization in intraperitoneal perfusion chemotherapy were performed under clinical guidance. Results Two hundred and seventy-seven times abdominal catheterization was completed, with a success rate of 99.3％(277/279), and the one-time success rate was 83.2％(232/279), 2 times (0.7％, 2/279) had to be abandoned for peritoneal adhesions. Fifty-three patients (36.3％, 53/146) underwent catheterization ≥ 2 times. The intraperitoneal perfusion chemotherapy was successfully completed after catheterization, no intestinal injury and bleeding occurred. Conclusions In the absence of ascites, ultrasound guided catheterization in perfusion chemotherapy is safe, reliable, simple, accurate and has a high success rate. This new approach is good for clinical application when the conventional catheterization with ascites is blocked.

Objective To summarize the methods and experiences of one-stage repair of aortic coarctation.Methods During January 2009 and September 2016,31 patients underwent surgery for coarctation of aorta (COA) in our department.Of them,fifteen patients were accompanied by patent ductus arteriosus (PDA),five associated with ventricular septal defect (VSD),five with VSD and PDA,and six patients were single COA.All patients accepted one-stage repair and follow-up.The surgical strategies and follow-up results were retrospectively reviewed.Results Excision of coarctation and anastomoses was performed in 24 patients,a bypass with artificial graft was performed in 3 patients,longitudinally section transverse suture was performed in 2 patients,and aortoplasty with patch graft was used in 2 patients.Accompanied intracardiac malformations were repaired simutaneously.One patient died of low cardiac output syndrome 1 d after operation.Other patients recovered smoothly.Thirty patients were followed up from 6 months to 7 years.The anastomotic systolic pressure difference disappeared in 21 patients.Eight patients still suffered from systolic pressure difference (5-20 mmHg),but had no need of reoperation.One patient suffered from anastomotic recoarctation 2 years and 3 months after operation and the pressure difference was 48 mmHg.After exerting balloon dilatation,the pressure difference reduced to 17 mmHg.Conclusions Surgery is an effective method of COA treatment.The surgical strategies should be selected according to the characters of coarctation lesions,intracardiac malformations,and the age of patient.

Objective To evaluate the diagnostic value of contrast-enhanced ultrasound in breast precancerous lesions . Methods Retrospectively analyzed the contrast-enhanced ultrasound model and angiographic predictive model of 465 cases of the A prospective multicenter study of breast nodules contrast-enhanced ultrasound" that led the Sichuan Provincial People′s Hospital from January 2016 to April 2017 ,which included 69 cases of breast precancerous lesions and 396 other types benign lesions ,and the sensitivity ,specificity and accuracy of the diagnosis of breast precancerous lesions were calculated . Results The sensitivity of ultrasound predictive model for the diagnosis of precancerous lesions was 60 .9％ and AUC was 0 .681 . Precancerous lesions mainly showed non-concentricity , increased homogeneity , and increased lesions;other types of benign lesions mainly showed non-centripetal ,high uniformity enhancement and lesion size unchanged . Conclusions Contrast-enhanced ultrasound shows a potential value in the differential diagnosis of precancerous lesions and other types of benign lesions ,that can help clinicians to take early intervention measures for breast precancerous lesions ,but there are still many problems to be solved .