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ObjectiveTo summarize the one-year follow-up clinical result of patients undergoing Endoscopic vein harvest (EVH) technology to collect greater saphenous vein( GSV )in coronary artery bypass operation (CABG),and to assess the related factors influencing the outcome.Methods248 patients underwent off-pump coronary artery bypass grafting (OPCAG) from May 2009 to May 2010.Among these patients,136 patients with coronary artery disease received EVH technology to gain GSV,and 112 patients received conventional open vein harvesting (OVH).Then 71 EVH (group 1 ) patients and 64 OVH ( group 2 ) patients had one-year follow-up analysis.We compared and evaluated the data of two groups about operation information,lower limb wound complication,bridge blood vessels patency rate,and psychologic status.ResultsThe date of wound surface size,wound healing and appearance,wound infection rate,the second debridement rate and the overall lower limb wound complication rate show that EVH was better than OVH.After one-year follow-up,we contrasted the patency rate of bridge blood vessels between two groups.The patency rate of arterial bridge blood vessels was 96.8％ ( venous bridge blood vessels was 85.7％ )in group of EVH when we followed up 63 patients;while the patency rate of arterial bridge blood vessels was 94.9％ ( venous bridge blood vessels was 86.4％ ) in group of OVH that we followed up 59 patients.We compared the outcome between two groups,and found that there were no statistical significance in angina recurrence rate,patency rate of venous graft and patency rate of arterial graft.But the psychologic status was different,the EVH group was better than OVH group.ConclusionCompared to OVH,EVH technique has more advantages.Through taking a more secure method in the collection process of the bridging vein material,EVH group also maintained a satisfactory one-year graft patency rate.
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Objective To assess the effect of EDFS40 on the structure and vasomotoricity of rabbit carotids in cryopreservation. Methods The fresh carotids, taken from rabbits under aseptic conditions, were preserved for 14 days in liquid nitrogen by vitrification or slow freezing method with both fresh and thawed carotids were observed by visual examination, optical and electron microscopes, respectively. Their endothelium-independent vasoconstriction and vasodilatation were detected in organ bath. Results The morphological changes of the EDFS40-vitrified arteries were similar to those of the fresh carotids under macrography, optical and electron microscopes. And there was no obvious difference in contraction to KCl between the cryopreservation group and the slow-freezing group (P>0.05). The contractile and relaxant responses of vitrified arteries to NE or SNP were significantly better than those of the frozen arteries (P<0.05); both, however, were still inferior to the vasomotoricity of the fresh arteries (P<0.05). Conclusion The rabbit carotids vitrified with EDFS40 can have their structure and vasomotor function maintained without obvious damage, which may indicate the usage of EDFS40 in vitrification of blood vessels.
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Objective To study the change of angiotensin Ⅱ in the applications of pumpless ECMO, and its effect on prognosis of the acute respiratory failure. Methods The study was performed in ten dogs [ weight 18 - 35 kg, mean weight ( 23.4 ± 4.7 ) kg].A respiratory failure animal model was established end then was treated by bilateral femoral artery-venous ECMO. Collection right atriurn blood end constitution of lung at different time (before ECMO, during ECMO 1h, 2h, 3h, 4h). Angiotensin Ⅱ content in blood and lung homogenate was detected by radio-immunity mothod. Angiotensin Ⅱ expression loci in lung were detected by immunohistochemistry mothod. Results Angiotensin Ⅱ content in plasma was decreased at completion of the model, it was back up at 1 hour and reached the peak at 3 hours, then it slowly declined. Angiotensin Ⅱ content in lung homogenate increased at the beginning, peaked by 2 hours, end then it decreased. Loci angiotensin Ⅱ in lung by immunohistochemistry were expressed in most of epithelial cells cytoplast of bronchiole dissepimont, smooth muscle cell cytoplast of small blood vessel around it end a few macrophage cytoplasts during the model time..Conclusion It is valuable to measure engiotensin Ⅱ in blood through the bilateral femoral artery-venous ECMO, because it can reflect angiotensin Ⅱ in lung and the resume of lung in certain degree.
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Objective To explore the correlation between endothelia cells activation and cytokines (ET-1, NO) levels in patients with pulmonary hypertension (PH), and to discuss their roles in the development of PH. Methods Twenty patients with simple ventricular septal defect (VSD) were chosen as controls, and 30 patients with PH were studied. Plasma levels of ET-1 and NO were measured by radioimmunoassay or colorimetric method. Before cardiopulmonary bypass was established, the specimens from right lung were fixed with formaldehyde solution, embedded with paraffin and stained by SP immunohistochemistry. Intercellular adhesion molecule-1 (ICAM-1) expression was measured through the determination of the light density with computer imaging technology. Results Compared with that of the patients with simple VSD, the light density of ICAM-1 and plasma level of ET-1 increased in patients with PH; but plasma level of NO decreased (P<0.05). Positive correlation was observed between ICAM-1 and ET-1/NO (P<0.05). Conclusion Endothelia cells activation and imbalance of ET-1/NO might play an important role in the development of PH.
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Objective To study the changes of endothelin-1(ET-1) and tumor necrosis factor alpha(TNF?) in lung homogenate and plasm when acute respiratory failure(ARF) animal models are treated by bilateral femoral arteriovenous extracorporeal membrane oxygenation(bAV-ECMO).Methods Ten ARF dog models were treated by the bAV-ECMO.Right atrium blood and lung tissues were collected at different time points,and ET-1 and TNF? were assayed by radioimmunological method.Results ET-1 content in plasm decreased at first,and at 1h it was elevated and at 2h reached the peak.ET-1 content in lung homogenate reached the peak at 2h and then started to decrease.The analysis of variance showed notable differences(P
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Objective To discuss the role of endothelicyte activation in the development of pulmonary hypertension (PH) and vascular remodeling. Methods A total of 10 patients with simple ventricular septal defect(VSD)of congenital heart disease(CHD)were choosen as controls, and 30 patients with different degree of PH were studied. Plasma levels of interleukin-1(IL-1), endothelin-1 (ET-1) and nitric oxide (NO) which represented the degree of endothelicyte activation were measured by radioimmunoassay and commercial available kit. The specimens taken from right lung before cardiopulmonary bypass were fixed by formaldehyde solution. The percentage of vascular wall thickness/vascular external diameter (WT/D) and the percentage of vascular area/total vascular area (WA/A) which represented vascular remodeling, were measured by QTM970 analysator. Results Compared with patients of simple VSD, the plasma levels of IL-1, ET-1/NO and WA/A, WT/D increased in patients with PH. Conclusion The activation of endothelicytes and imbalance of ET/NO play an important role in the development of PH and vascular remodeling. Positive correlations were seen between IL-1, ET-1/NO and WA/A, WT/D(P
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The electromicroscopic observation of atrialbiopsy was carried out in 10 patients with ventric-ular septal defect (VSD) and middle, severe pul-monary hypertension (PH). The observation sug-gests that there are myofibrillar lysis to disappearwith various degrees, dilated rough endoplasmreticulum and the increase in lipofuscin granulesand lipid droplets; mitochondral hyperplasia, theirsize and shape being different, disorganizing of mi-tochondria, disintegration of cristae, mitochondralretrograde degenration and decreased matrix elec-tron density. The dilated intercalated discs and in-crease in myocardial fibrous tissue were found inpart of patients. These structural changes areprobably due to chronic myocardial ischemia.
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We find that there is a correlation among thesize of ventricular septal defect (VSD) (X_2), PaO_2(X_3), V. /V. (X_7) and pulmonary systolic pressure(Y_1), diastolic pressure (Y_2), mean pressure (Y_3)by multivariate stepwise regression analysis, andso there are their parameters in the regression e-quations. The regression equations are Y_1 = 13. 24+ 0. 22X_2 - 0. 09X_3 + 0. 14X_7; Y_2 = 0. 65 + 0. 24X_2+ 0. 12X_7; Y_3 = 3. 54+ 0. 17X_2 + 0. 16X_7. But thecourse of the disease, ∑9 leads QRS dimension,R. /R., L. /L. are non-dominant factors, and sothere are not their parameters in the regression e-quation. The above-mentioned equations mayavoid the patients. with mild, moderate pulmonaryhypertension to have invasive examination, and re-duce its complications.