Clinical characteristic of aortitis in cardiac surgery in a single center / 中国胸心血管外科临床杂志

@#Objective    To review and analyze the clinical manifestations of common aortitis in cardiac surgery. Methods    We screened 41 552 patients who were hospitalized in the Department of Cardiac Surgery of Zhongshan Hospital, Fudan University from 2010 to 2020, analyzed the patients' clinical data, and classified according to the type of diseases. Then we summarized all their clinical manifestations. Results    In our center 145 patients were operated for aortitis diseases, including 75 males and 70 females, with the age of 24-76 (45.6±11.3) years. There were 61 patients of Takayasu's arteritis, 51 patients of Behcet's disease, 8 patients of syphilitic aortitis, 8 patients of systemic lupus erythematosus, 2 patients of Kawasaki disease, 4 patients of ankylosing spondylitis, 10 patients of dry syndrome, and 1 patient of scleroderma. Conclusion    Aortitis is not uncommon in cardiac surgery, and awareness of the disease should be enhanced. So that we can distinguish various types of aortitis and to make proper management to improve patients' prognosis.

The experience in reoperation of Behcet's disease patient with perivalvular leakage after aortic valve replacement / 中华胸心血管外科杂志

Objective:To introduce the application of sleeve reconstruction with bovine pericardium in the reoperation of Behcet's disease with advanced aortic annulus invasion, and to report our experience and the early outcomes.Methods:From August 2012 to May 2022, 19 patients with Behcet's disease developed perivalvular leakage after previous surgery underwent aortic root replacement. They were analyzed retrospectively. Fifteen out of 19 cases underwent conventional aortic root replacement, 4 cases with advanced aortic annulus invasion underwent sleeve reconstruction with bovine pericardium. The medical records were reviewed. Demographic and perioperative data were collected, which included the aortic crossclamp time, intraoperative RBC consumption, length of ICU stay, and major postoperative complications.Postoperative follow-up was accomplished through telephone visit.Results:The median age was 39(36, 42) years old. Five were female. The median interval of diagnosis of perivalvular leak from index surgery was 5(3, 14)months. There was no perioperative death. Fifteen patients underwent conventional aortic root replacement. One patient had intraoperative ECMO impant due to low cardiac output as well as another one had IABP support. CABG was performed in 5 patients. One patient underwent permanent pacemaker implantation after surgery. The median follow-up time for the 15 patients was 55.00(29.25, 71.25)months. Two patients were lost during follow-up. One patient died of infection 3 years after surgery. One patient developed perivalvular leak. Two patient developed distal anastomotic pseudoaneurysm which need reintervention. The median follow-up time for the 4 patients with sleeve reconstruction was 5.5(5, 11.25)months. One patient underwent tracheotomy. Perivalvular leakage and pseudoaneurysm were not appreciated. Four patients were in NYHA class Ⅰ-Ⅱ.Conclusion:The sleeve reconstruction with bovine pericardium is safe and effective in reoperation treating patients with Behcet's disease and advanced aortic annulus invasion.

A preliminary experience of retroperitoneal approach by partial resection of the tenth rib for repairing Crawford type Ⅳ thoracoabdominal aortic aneurysm and complex abdominal aortic aneurysm / 中华普通外科杂志

Objective:To evaluate a surgical approach for partial resection of the tenth rib through a retroperitoneal approach for the exposure of Crawford type IV thoracoabdominal aortic aneurysm and complex abdominal aortic aneurysm from 2014 to 2019.Methods:A retrospective analysis was conducted on clinical data and follow-up results of 7 patients who underwent treatment for Crawford type IV thoracoabdominal aortic aneurysm and complex abdominal aortic aneurysm through partial resection of the tenth rib via a retroperitoneal approach.Results:One case (14.3%) had associated Marfan syndrome, and 5 cases (71.4%) underwent left renal artery reconstruction. None of the patients experienced severe complications such as cardiopulmonary complications or renal failure postoperatively, and there was no statistically significant difference in serum creatinine levels between preoperative and postoperative stages during hospitalization ( P=0.205). Follow-up examinations showed no long-term vascular stenosis. Conclusions:Partial resection of the tenth rib through a retroperitoneal approach can avoid incisions of the pleura and diaphragm. It allows for the exposure of the aorta below the diaphragm and has the ability to treat aortic diseases below the diaphragm with smaller incisions and lower complication risks.

Effects of manual digitorum sensory stimulation on spasticity of fingers for stroke patients: a surface electromyography study / 中国康复理论与实践

ObjectiveTo investigate the changes of surface electromyography (sEMG) of the flexors and extensors of the affected fingers after manual digitorum sensory stimulation (MDSS) in the hemiplegic patients after stroke. MethodsFrom April to August, 2020, 50 stroke patients in Department of Rehabilitation Medicine, the Second Hospital of Anhui Medical University accepted MDSS on the nail beds and the third knuckles of affected fingers, until the fingers extended actively. The tension of affected flexor pollicis brevis, flexor digitorum superficialis and extensor digitorum were assessed with modified Ashworth Scale (MAS) before and immediately after stimulation; while the root mean square (RMS) of sEMG of bilateral flexor pollicis brevis, flexor digitorum superficialis and extensor digitorum were recorded. ResultsThe MAS score of all the muscles decreased after stimulation (|Z| > 2.699, P < 0.01), while the RMS of affected extensor digitorum increased (t = -2.069, P < 0.05). Compared with the unaffected ones, RMS of affected flexor pollicis brevis and extensor digitorum decreased before and after stimulation (t > 2.450, P < 0.05). ConclusionMDSS may immediately relieve the spasm of flexors of hemiplegic fingers after stroke, which associates with the promoting muscle strength of the extensors.

Current status and progress of left ventricular assist device for end-stage heart failure / 中国胸心血管外科临床杂志

@#Although heart transplantation remains to be the optimal treatment for advanced heart failure, its use has been largely limited due to shortage of available donor organs. Over the past two decades, left ventricular assist device (LVAD) has been significantly modified in size, durability and hemocompatibility. In addition to the bridge to transplantation, LVAD has become an attractive alternative to heart transplantation for end-stage heart failure as destination therapy for unsuitable candidates. Although the performance of LVAD has been improving greatly in recent years, there are still great challenges in the management of device complications and low quality of life after implantation. This review will summarize the types of LVAD, indications for implantation, postoperative management and adverse events.

Establishment of large animal model of bicuspid aortic valve / 中国胸心血管外科临床杂志

@#Objective    To discuss the feasibility of establishment of animal model of "functional" bicuspid aortic valve with swine and observe its effect on the wall shear stress inside the aorta. Methods    Four common Shanghai White Swine with body weight between 50 kg to 55 kg were selected. Under general anesthesia and cardiopulmonary bypass, the aortic transverse incision approach was used, continuous suture with 6-0 polypropylene to align the left and right coronary valve leaflets to create a bicuspid valve morphology. After the operation, echocardiography was used to observe the aortic valve morphology and the hemodynamic changes of the aortic valve orifice. The effect on the wall shear stress inside the aorta was studied with 4D-Flow magnetic resonance imaging (MRI). Results    A total of 4 swine "functional" bicuspid aortic valve models were established, with a success rate of 100.0%. Echocardiography showed that the blood flow velocity of the aortic valve orifice was faster than that before the operation (0.96 m/s vs. 1.80 m/s). 4D-Flow MRI showed abnormally increased wall shear stress and blood flow velocity in the aorta of the animal models. After the surgery, in model animals, the maximal wall shear stress inside the ascending aorta was greater than 1.36 Pa, and the maximum blood flow velocity was greater than 1.4 m/s. Conclusion    Establishment of the animal model of "functional" bicuspid aortic valve in swine is feasible, scientific and reliable. It can be used in researches on evaluating the pathophysiological changes.

Minimally invasive ascending aorta surgery through a right anterior thoracotomy via the second intercostal incision: A single-center experience of 13 patients / 中国胸心血管外科临床杂志

@#Objective    To evaluate the feasibility, safety, and short-term effect of minimally invasive ascending aorta surgery through a right anterior thoracotomy via the second intercostal incision. Methods    The clinical data of 13 patients who underwent minimally invasive ascending aorta surgery (including minimally invasive Bentall operation in 7 patients, minimally invasive Wheat operation in 2 patients, and minimally invasive ascending aorta replacement in 4 patients) through a right anterior thoracotomy via the second intercostal incision in our center from October, 2019 to September, 2020 were retrospectively analyzed. There were 12 males and 1 female at age of 19-69 (52.4±13.7) years. Results    The aortic cross-clamping time was 84.3±18.3 min. Three patients received blood transfusion, with the rate of 23.1%. The drainage volume in the first 24 hours after operation was 214.5±146.3 mL, with no redo for bleeding. The duration of mechanical ventilation was 19.0±11.3 hours and the length of intensive care unit stay was 1.8±1.3 days. The drainage tube was removed 2.5±1.0 days after operation. All the 13 patients recovered and discharged 6.4±2.0 days after operation, with no dead patients found. All patients survived with New York Heart Association (NYHA) functional classⅠandⅡduring a median follow-up of 8 months. Conclusion    Minimally invasive ascending aorta surgery through a right anterior thoracotomy via the second intercostal incision may be a safe and effective method with less injury and quick recovery.

Prevention and treatment of right ventricular failure after left ventricular assist device transplantation / 中华胸心血管外科杂志

Left ventricular assist devices(LVAD) has become the main treatment for advanced heart failure, which effectively reduced the mortality of patients with advanced heart failure. However, postoperative right ventricular failure(RVF) has been a long-term challenge in the treatment of LVAD. At present, postoperative RVF is not only difficult to predict, but also difficult to treat. The lack of long-term right ventricular assist device has limited the impact that mechanical circulatory support can provide to patients with biventricular failure. This review summarizes the prevention and treatment of right heart failure after left ventricular assist device transplantation and explores the direction of future research.

Expression of IFN-γ and IL-10 in peripheral blood and intestinal mucosa of patients with diarrhea post-infectious irritable bowel syndrome / 重庆医学

Objective To investigate the expression change of cytokines in peripheral blood and intestinal mucosa in the patients with diarrhea post-infectious irritable bowel syndrome(PI-IBS) and its relation with clinical symptoms scores.Methods Thirty outpatients and inpatients with diarrhea PI-IBS(observation group) and contemporaneous 30 individuals undergoing physical examination(control group) in the Hainan Provincial People's Hospital from January to December 2013 were selected.The peripheral blood mononuclear cells(PBMC) were separated and cultured.Then the levels of IFN-y and IL-10 in peripheral blood and cell culture supernatant fluid were detected by ELISA.The colonic mucosal tissue was taken by coloscopy.Then colonic mucosal IFN-γ and IL-10 protein expression was detected by immunohistochemistry staining.Furthermore,the correlationship between the level change of IFN-γ and IL-10 with clinical symptom score was analyzed by using the Spearman correlation method.Results Peripheral blod IL-10 and IFN-γ levels had no statistical difference between the two groups(P＞0.05).Compared with the control group,in PBMC seperation and cuture,the IFN-γ level in the observation group was increased and IL-10 level was decreased,the difference was statistically signifieant(P＜0.01).The intestinal main symptom score in the observation group had the positive correlation with IFN-γ expression level of PBMC culture supernatant fluid and colonic mucosal IFN-γ expression level(r=0.45,0.94,P＜0.01),and had the negative correlation with IL-10 expression level(r=-0.52,-0.79,P＜0.01).Conclusion The unbalance of IFN-γ and IL-10 level could be involved in the pathogenesis of diarrhea PI-IBS,which can serve as the observation indicators of disease activity.

Mid-term outcome of coronary artery bypass graft surgery in patients aged≤40 years with coronary heart disease / 复旦学报（医学版）

Objective To investigate the clinical characteristics,surgical experience and mid-term outcome of coronary artery bypass graft surgery in patients aged ≤ 40 years.Methods From Jan.,2009 to Dec.,2015,12 patients with median age of (37.9 ± 2.5) years (range 32-40 years,10 males) were diagnosed with coronary artery disease and underwent coronary artery bypass graft surgery at Zhongshan Hospital,Fudan University.The clinical characteristics included five cases with hypertension,three cases with diabetes mellitus,four cases with hyperlipemia,eight cases with smoking history,seven cases with myocardial infarction.Six cases had at least one branch totally occluded.Two cases once underwent percutaneous coronary intervention surgery and implanted with five and three stents respectively.The perioperative data and follow-up results were retrospectively analysed.Results There was no in-hospital death and no death during follow-up period.Surgical techniques included bilateral internal mammary arteries combined with radial artery were operated in six cases,bilateral internal mammary arteries combined with great saphenous vein in two cases,left internal mammary arteries combined with great saphenous vein in four cases,off-pump in nine cases and on-pump in three cases.The mean follow-up time was (47.8 ± 24.3) months.During the follow-up one case suffered with saphenous vein graft restenosis 5 years after the surgery and underwent percutaneous coronary intervention.Other cases were all alive and assessed New York Heart Association's function class Ⅰ-Ⅱ.Conclusions Younger patients usually suffer with severe coronary artery disease when diagnosed because they often have excellent compensative capacity and the pathogenesis is concealed.The mid-term results of coronary artery bypass graft surgery in patients aged ≤40 years are satisfactory.

Comparison of ultrasound-guided transperineal and transrectal prostate biopsies with 12+X method / 中国综合临床

Objective To compare the positive rates and complications of ultrasound?guided transperi?neal and transrectal prostate biopsies with 12+X method. Methods From January 2011 to January 2015,252 cases patients underwent ultrasound?guided prostate biopsies with 12+X method for suspected prostate carcinoma were selected as research subjects,including 114 cases were perineal puncture( transperineal group) and 138 ca?ses were transrectal puncture( transrectal group) . The positive rates and complications of biopsy were compared between the two groups. Results The positive rates in the transperineal and transrectal groups were 43. 5%( 50/114) and 41. 3%( 57/138) ,and there was no significant difference( P>0. 05) . No statistically significant differ?ences were observed between the two groups according to different PSA levels(≤4. 0,>4. 0-≤10. 0,>10. 0-≤20. 0,>20. 0 μg/L) ( P>0. 05) . There were no significant differences between two groups in complications such as:hematuria,lower urinary tract symptoms and acute urinary retention( P>0. 05) . The incidence rates of post?biopsy infection and rectal bleeding were remarkably lower(2. 6%(3/114) vs. 13. 0%(18/138),1. 8%( 2/114) vs. 11. 6%( 6/138) ,P=0. 005,0. 002) in transperineal group than in transrectal group. However,the perineal swelling rate was remarkably higher in the transperineal group than that in the transrectal group( 8. 8%( 10/114) vs. 0. 7%( 11/138) ,P=0. 003) . Conclusion Ultrasound?guided transperineal and transrectal pros?tate biopsies with 12+X method are both effective for the diagnosis of prostate carcinoma. The positive rates of the two approaches are similar,but the complications are different. The choice between the two approaches depended on the clinical features of the patients.

Study on phenotype and function of intestinal gamma delta T lymphocytes in mice with post-infectious irritable bowel syndrome / 中国免疫学杂志

Objective:To investigate the phenotype and function of the intestinal γδT lymphocytes in post-infectious irritable bowel syndrome mouse model. Methods:The mouse model for post-infectious irritable bowel syndrome was established by the infection with trichinella spiralis. The intestinal inflammation,abdominal withdrawal reflex( AWR) and colon transportation test were observed. 2 and 8 weeks later,the animals were sacrificed and the lymphocytes in the intestinal lymph nodes and spleen were collected,from which the γδT lymphocytes were isolated and purified by monoclonal antibody-immuno-microbeads method. The functions of the purified γδT lymphocytes were evaluated,including proliferation by 3 HTdR;CD69,CD62L molecule staining by flow cytometry. Furthermore,the con-centration of cytokine IL-17 and IFN-γ in the supernatant of the cultured γδT lymphocytes were detected by ELISA. Results: At 2nd weeks after infection,significant intestinal inflammation was observed,with increasingγδT lymphocytes,proliferating and activating with increasing production of IL-17. At 8th weeks after infection, the intestinal inflammation disappeared, whereas the number of γδT lymphocytes remained increasing,also with proliferating and activating with increasing production of IL-17. Meanwhile,the mice show higher AWR score and Bristol score. Conclusion: γδT lymphocytes could participate in the pathogenesis of PI-IBS via their proliferation,activation and production of IL-17.

Investigation on the allocation status of neonatology nursing human resources in China's economically developed areas / 中国实用护理杂志

Objective To study the status quo of nursing human resource configuration and structure of neonatology department in China's economically developed areas.Methods Using judgment sampling and multi-stage stratified sampling,investigations were conducted by the self-designed questionnaire in letter in 2012.Results In 2012,both the bed nurse ratio(1:0.79) and doctor nurse ratio (1: 1.22) met the Health Ministry's standards (1:0.58-0.61 and 1: 2) respectively.Age distribution of neonatology nursing staff was from 25 to 34 years old (55％).The distribution of wordng experience was average.Nurses with junior college degree as the main body took up 48％,with primary title as the main body 66％,and the appointment system accounted for 42％.The nursing personnel with young ages,senior skilled,higher education degree,and advanced titles were concentrated in Grade Ⅲ-A hospitals and public hospitals of women and children.In terms of distribution equity,two Gini coefficients of geographical and population distribution were both less than 0.35 and near zero,which indicated relatively perfect equity.Conclusions The stock and per capita of neonatology nursing human resources in China's economically developed areas were insufficient in the long run and showed imbalanced allocation among hospitals with different levels.The allocation structure failed to meet the needs of nursing disciplinary development.

Metabolic syndrome in heart transplant recipients: prevalence and risk factors (a retrospective study) / 中华器官移植杂志

Objective To determine,in our experience,the prevalence and presence of risk factors for metabolic syndrome (MS) in heart transplant recipients.Methods We studied 135 patients who underwent heart transplantation in our hospital from September 2000 to December 2011,According to the diagnostic criteria of MS,they were divided into two groups.All variables that could be related to the development of MS during the follow-up period were analyzed.The prevalence and presence of risk factors for MS in our experience were determined.Student t-test,Wilcoxon rank sum test and x2 test were used for univariate statistical analysis and logistic regression for multivariate analysis.Results (1) Of the 135 patients,63 developed MS (46.67％) during a mean follow-up period of 47.3 months.The multivariate analysis identified the follows as predictive factors for the development of MS:age (OR=1.09,95％ CI 1.01-1.22,P＜0.05),body mass index (BMI) (OR=1.65,95％ CI 1.16-1.87,P＜0.05),history of DM (OR =3.27,95％ CI 1.12-34.21,P＜0.05).Conclusion In our population,the prevalence of MS after heart transplant is 46.67％ during a mean follow-up period of 47.3 months.Age,pre-operative overweight especially BMI,and history of DM were significant and independent risk factors for the development of MS during the follow-up period.For these patients,dose of immunosuppressant and diet control are important.

Pokemon reduces Bcl-2 expression through NF-κ Bp65: A possible mechanism of hepatocellular carcinoma

OBJECTIVE@#To investigate the relationship among Pokemon, NF-κ B p65 and Bcl-2 in hepatoma cells.@*METHODS@#HCC cell HepG2, SMMC7721 and human fetal liver cell line LO2 cells were used, and expression of Pokemon, NF-κ B p65 and Bcl-2 in three cells were detected by real-time PCR and western blot. Then siRNA of Pokemon was applied to inhibit the expression of Pokemon and NF-κ B p65 and apoptotic rate was determined by flow cytometric analysis.@*RESULTS@#Expressions of Pokemon, NF-κ B p65 and Bcl-2 in human hepatoma cell HepG2, SMMC7721 expression were significantly higher than those in human embryonic stem cells LO2. siRNA of Pokemon inhibited the expression of Pokemon, NF-κ B p65 and Bcl-2 in liver cancer cells, and significantly increased apoptosis of liver cells. While siRNA of NF-κ B p65 inhibited the expression of NF-κ B p65 and Bcl-2, but Pokemon expression in hepatoma cells had no significant change.@*CONCLUSIONS@#The proto-oncogene Pokemon can inhibit P14ARF by specific transcription regulation of cell cycle and can induce tumors. In addition, Pokemon can regulate NF-κ B p65 through the expression of apoptosis repressor, and promote the development of liver cancer. It suggests signal network in the liver include the regulation of new non-classical NF-κ B regulatory pathway.

Colonic expression of Runx3 protein and TGF-β(1) and their correlation in patients with irritable bowel syndrome

OBJECTIVE@#To investigate the role of Runx3 protein and TGF-β(1) in the pathogenesis of irritable bowel syndrome (IBS), as well as the correlation of these two proteins.@*METHODS@#Colonic tissue was collected from patients with IBS and normal persons. The colonic expression of Runx3 protein and TGF-β(1) was detected with immunohistochemistry method. Semi-quantitative analysis was used to evaluate the staining degree of these two proteins.@*RESULTS@#Compared with their counterparts, patients with IBS did not show any changes in the colonic expression of Runx3 protein and TGF-β(1) (P>0.05). Interestingly, there was a significant correlation between Runx3 protein and TGF-β(1) in patients with IBS(P<0.05).@*CONCLUSIONS@#The role of Runx3 protein and TGF-β(1) in the pathogenesis of IBS remains to be further studied.

Study on the expression of Runx3 and TGF-β₁ protein in the colonic tissue from rats with irritable bowel syndrome

OBJECTIVE@#To investigate the expression of Runx3 and TGF-β(1) protein in the colon from rats with irritable bowel syndrome (IBS).@*METHODS@#Rat model for IBS was established by intracolonic instillation with acetic acid and restraint stress methods, which was confirmed by determinating the visceral sensitivity of the animals, including abdominal withdrawal reflex (AWR) score and the electronic behavior of the abdomen wall. The rats were randomly assigned into three groups: IBS(1) group (restraint stress, n = 25); IBS(2) group (both instillation with acetic acid and restraint stress, n = 25) and Control group (n=16). The colonic tissue samples were collected for histological study and the expression of Runx3 and TGF-β(1) proteins were detected by immunohistochemistry. Meanwhile, the relationship of these two proteins was calculated.@*RESULTS@#Visceral hypersensitivity (AWR and abdominal electrical activity) was significantly enhanced in IBS(1) and IBS(2) groups than other groups. The colon tissue in all groups did not show any signs of inflammation. Furthermore, the expression of Runx3 and TGF-β(1) protein in the colon from all groups show no significant difference (P>0.05), with no remarkable relevancy between each other (P>0.05).@*CONCLUSIONS@#The rat model for IBS was successfully established. We did not find any significant changes in the expression of Runx3 and TGF-β(1) protein in the colon tissue from IBS rats, suggesting that the quantitative changes may be not the way by which Runx3 and TGF-β(1) protein play their roles in IBS. The accurate roles of Runx3 and TGF-β(1) proteins in the pathogenesis of IBS remains to be further studied.

The role of endotoxin in the pathogenesis of gastric mucosal damage in cirrhotic rats with portal hypertensive gastropathy

OBJECTIVE@#To study the role and the mechanism of endotoxin in the pathogenesis of gastric mucosa during portal vein hypertension gastrography (PHG) in the rats with cirrhosis.@*METHODS@#Rat model for PHG was established by injection of tetrachloride. The animals were injected with endotoxin i.p. at 3 mg/kg and endotoxin antagonist BPI21 i.v. at 2.0 mg/kg. The plasma level of endotoxin as well as the gastric mucosal level of tumor necrosis factor alpha (TNF-α) was measured with azobenzene and ELISA respectively. Furthermore, the pathological changes of the gastric mucosa were studied with HE stainning.@*RESULTS@#In rats with PHG, increased endotoxin and TNF-α as well as the gastric pathological lesion were observed. Injection of endotoxin remarkably increased plasma level of endotoxin as well as the gastric mucosal level of tumor necrosis TNF-α and induced more serious gastric lesion. Animals injected with endotoxin antagonist BPI21 showed improved gastric mucosal lesion, accompanied by the declining TNF-α level.@*CONCLUSIONS@#Our results suggestes that endotoxin may play a pathogenetic role in PHG by inducing the expression of TNF-α.

Value of intraoperative closure atrial sepetal defect with deficient rims inducted by transoesophageal echocardiography / 中华超声影像学杂志

Objective To evaluate the application valve of intraoperative device closure secundum atrial sepetal defect (ASD) associated with deficient rims inducted by transoesophageal echocardiography (TEE). Methods Twenty-three patients with ASD were diagnosed by transthoracic echocardiography (TTE) ,and underwent an attempted intraoperative device closure through a right antierior minithoraetomy. The positon, type and size and rim of ASD were defined by TEE in preoperation, the placement of the device inducted and evaluated by TEE intraoperation,and followed by TTE after one week. Results Twenty-three patients with ASD were closed excellently. There were not shunt of atrial level in 20 patients, trivial shunt in 3 patients. However,follow-up after one week TTE indicated that all patients had no shunt,and the diameter of right atrium and right ventricle was decrease significantly (P <0.05), and pulmonary artery pressure was less than before (P <0.05). Conclusions It is very important that TEE induct the closure of ASD associated with deficient rims in micro-operative room.

Experience of Percutanous Coronary Intervention in 57 Cases with Chronical Total Occlusion / 中国慢性病预防与控制

Objective To explore clinical characteristics of chronic total occlusion(CTO) in population with routine coronary angiography,and to cumulate therapeutic experience.Methods Retrospective analysis was performed on clinical data of 57 cases with CTO selected from 825 patients undergone coronary angiography.Results Among 57 cases,the percentage of male,myocaridial infarction,diabetes mellitus,hyperlipidermia and left ventricular dysfunction was 73.7%,84.2%,22.8%,73.7% and 22.8%,respectively.The types of lesions included single branch(n=11),double branches(n=29) and three branches(n=17).Of 70 branches lesion vessels,44 were TIMI 0 of blood flow classification and 26 were TIMI1.The position of lesions occurred at left anterior descending branch(n=32),left circumflex branch(n=16),right coronary artery(n=22).The occlusion time was less than three months(n=41) and more than three months(n=29).The lengths of lesion was divided into less than 20 mm(n=43) and more than 20 mm(n=27).The shapes of terminal lesion looked like rat-tail(n=42) and blaze knife-edge(n=28).The coronary stents were performed at 57 lesions among 70 branches and the successful rate of operation was 82.9%.Conclusions Timely coronary angiography and selecting suitable treatment on different kinds of lesions for male patients with myocardial infraction,especially complicated with diabetes mellitus,might play important roles in prevention of CTO and in improvement of the successful rate of percutanous coronary intervention for the complex lesion.