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Objective:To investigate the experience of moderate hypothermia(28℃) using in Stanford A aortic dissection.Methods:A retrospective analysis of 100 patients with Stanford A aortic dissection from January 2012 to March 2014, including 50 cases with deep(25℃) hypothermic circulatory surgery and 50 moderate(28℃) hypothermic circulatory surgery. The operation was performed with ascending aortic replacement, inclusiong aortic arch angioplasty, and stent implantation with descending aorta stent. The difference between the 2 groups during and after the operation was compared.Results:2 cases died in the hypothermia group, and 3 cases died in the deep hypothermia group. There were significant differences( P<0.05) between the middle and low temperature groups in the cooling time, the time of stopping circulation, the time of rewarming, the time of cardiopulmonary bypass, the time of operation, the time of operation, the time of conscious, the time of mechanical ventilation and the first day after the operation( P<0.05), but there was no significant difference between the creatinine and the bilirubin( P>0.05). Conclusion:Under the condition of sufficient cerebral perfusion and spinal cord protection, moderate hypothermia is safe, and it can reduce the operation time and postoperative complications. It has certain clinical significance.
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Objective To summarize and evaluate the clinical effect of extraco-rporeal membrane oxygenation(ECMO) support for critically ill patients after heart surgery,and to explore the factors that influenced the prognosis of ECMO.Methods The clinical data of 67 patients undergoing ECMO admitted to the Second Hospital of Jilin University from August 2013 to July 2017 were retrospectively analyzed.The patient's age ranged from 22 months to 78 years,including 3 infants aged 22,24,30 months and 64 adults ranged from 32 to 78 years,the mean age was(56.52 ± 10.99) years.Results The average ECMO support time was (235.79 ± 123.87) h,the mean mechanical ventilation time was (166.11 ± 148.31) h.49 patients weaned off successfully from ECMO,38 of them were discharged and 11 died within 28 days.18 patients gaved up treatment.42 patients suffered the complications.Conclusion VA-ECMO is a significant supportive method for preoperative intensive care in patients undergoing cardiovascular surgery.The keys to optimal results are grasping the indications of ECMO,earlier stopping mechanical ventilation,cluster curing(which involves reasonable anticoagulation,protection of organ function,prevention of hemorrhage,infection and limb distal ischemia).
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Objective To establish rat models with pulmonary artery hypertension induced by monocrotaline(MCT) and to observe the pathological changes of lung tissue.Methods Seventy male Wistar rats were randomly devided into three group:control group(n=10),50 mg?kg-1 MCT group(n=30),60 mg?kg-1 MCT group(n=30).At two weeks and four weeks after injected intraperitoneally with MCT(injected intraperitoneally with equal normal saline in control group),the right ventricular systolic pressure(RVSP)and right ventricle weight/left ventricle+septum weight [RV/(LV+S)] ratio were measured.Hematoxylin-eosin staining and orcein technique were used to observe the pathological changes of lung tissue and pulmonary arterioles'medial thickness.Results Two weeks or four weeks after MCT administration,RVSP in 50 mg?kg-1 MCT group was higher than that in control group(respectively 36.6 mmHg?5.1 mmHg,39.1 mmHg?7.0 mmHg versus 26.1 mmHg?3.8 mmHg,both P
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Objective To explore the possibility of differentiation of canine bone marrow-derived mesenchymal stem cells(BMSCs) into smooth muscle cells(SMCs) and the potential of using these SMCs as cell sources for engineering of blood vessel construction.Methods Canine BMSCs were isolated by density gradient centrifugation and cultivated in DMEM supplemented with PDGF-BB and vitamin C(VIT-C).The phenotypic characteristics of BMSCs were identified by morphological observation,?-SMA and SMMHC in SMCs at passage 4-6 were analyzed by immunofluorescent staining,and the positive rates of SMCs at passage 5,6 were detected by flow cytometry.Results The BMSCs cultivated in the conditioned medium for SMCs showed SMC-like morphology:they displayed spindle-shape in morphology and were positive for ?-SMA but negative for SMMHC.42 d and 33 d were needed to obtain 107-108 seeding cells without or with PDGF-BB/VIT-C in culture medium respectively.With the subculture,the percentage of ?-SMA positive cells increased from 57.8% at passage 5 to 66.8% at passage 6,suggesting under aforementioned cultured conditions,more BMSCs turned into SMCs.Conclusion BMSCs can be differentiated into SMCs under appropriate culture conditions,suggesting the potentiality of using these SMCs as cell sources for tissue engineering of blood vessel construction.