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Objective To observe the clinical efficacy and related complications of modified suture method in treating perimembranous ventricular septal defect(VSD). Methods The clinical data of 110 children with perimembranous VSD were retrospectively analyzed. Among them, 51 cases were treated with conventional suture method (conventional suture group), and 59 cases were treated with modified suture method(modified suture group).The extracorporeal circulation time,intraoperative blood transfusion volume, postoperative drainage volume, total hospital stay and related complications were recorded. The transthoracic echocardiography was performed 1, 6 and 12 months after operation. Results The children successfully completed the operation,and no intraoperative death occurred.The extracorporeal circulation time, intraoperative blood transfusion volume, postoperative drainage volume, total hospital stay and rate of related complications in modified suture group were significantly lower than those in conventional suture group: (41.2 ± 9.6) min vs. (52.1 ± 10.6) min, (182.2 ± 42.9) ml vs. (255.3 ± 56.7) ml, (73.2 ± 18.7) ml vs. (102.3 ± 23.5) ml, (12.8 ± 2.5) d vs. (16.1 ± 3.6) d and 13.6% (8/59) vs. 29.4% (15/51), and there were statistical differences (P<0.01 or <0.05). The blood flow velocity of pulmonary valve and blood flow velocity of aortic valve 1,6 and 12 months after operation in modified suture group were significantly better than those in conventional suture group, blood flow velocity of pulmonary valve: (113.8 ± 21.4) cm/s vs. (126.5 ± 22.6) cm/s, (104.6 ± 18.2) cm/s vs. (112.3 ± 18.5) cm/s, (102.3 ± 15.8) cm/s vs. (113.8 ± 16.5) cm/s; blood flow velocity of aortic valve:(141.9 ± 24.6)cm/s vs.(136.0 ± 25.7)cm/s,(148.3 ± 18.7)cm/s vs.(142.3 ± 20.3)cm/s,(148.8 ± 18.1) cm/s vs. (141.6 ± 18.1) cm/s, and there were statistical differences (P<0.05). Conclusions The modified suture method has the characteristic of short operating time, less blood transfusion and postoperative drainage,and swift recovery.It also can reduce postoperative arrhythmia and residual reflux.
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Objective To discuss the effect of Dickkopf-1 (DKK-1) on Wnt singal pathway during the differentiation of osteoblast in vitro.Methods The osteoblasts were obtained from the new rats and cultured in vitro.The 3 passages were divided into control group and DKK-1 group.The cells were cultured in DKK-1 and normal saline for morphogical detection,ALP activity detection and osteoblasts stained at 1 st,6th,12th,21st day.The Wnt was detected by RT-PCR.Results After cultured by the DKK-1 in vitro,the ALP and mineralization of osterblasts staining were prlonged with culture time.Compared with control group,the expression of Wnt was significantly reduced at the 21st day after induction (t =0.278,P ＜ 0.05).Conclusion DKK-1 can regulate the expression of Wnt during osteoblast differentiation,suggests that Wnt may be involved in osteoblast differentiation and can affect bone remodeling process.
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Stroke is one of the most devastating complications after cardiac surgery,and contributes to both mortality and morbidity.Coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI) are the common procedures for the treatment of coronary artery disease.This article reviews the pathophysiologic mechanisms,risk factors,treatment and prognosis of stroke after CABG and PCI.
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Objective To study the clinical efficacy of autologous peripheral blood stem cell transplantation for the treatment myocardial infarction,in the same period of coronary artery bypass grafting (CABG).Methods From January 2012 to January 2015,76 patients with myocardial infarction were selected.Patients were divided into transplantation group (n =46) and control group (n =30) on the basis of whether being treated by autologous peripheral blood stem cell transplantation.After myocardial infarction patients were taken to the hospital with the therapy of conventional drug,5 days before CABG,transplantation group was given the autologous peripheral blood stem cell mobilization and expansion,24 hours before CABG,taking autologous peripheral blood stem cell collection.76 patients took CABG with non-cardiopulmonary by pass,transplantation group was given autologous peripheral blood stem cell via transplantation vessels and subepicardial,while the control group was not given the injection of autologous peripheral blood stem cell.The LV morphology,wall motion score index (WMSI) and index of cardiac function before and after the operation in both groups were evaluated by echocardiography.Results Six months after CABG,there was a significant decrease in Left ventricular end-diastolic diameter and wall motion score index,Left ventricular ejection fraction was increased.The indexes of cardiac function in the transplantation group were better than the control group.Conclusion Autologous peripheral blood stem cell transplantation for the treatment myocardial infarction can improve the heart function,and has obvious recent clinical curative effect in the same period of CABG.
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Objective To explore the neuroprotection of Shuxuetongmai capsule pretreatment, and the effect on the expression of p38 mitogen-activated protein kinase (p38MAPK) in rats with middle cerebral artery occlusion. Methods Ninety-six male SD rats were divided randomly into sham-operated group,ischemia/reperfusion group (I/R),ischemia preconditioning group (IP),and Shuxuetongmai group(n=24). Each group was further randomly divided into 4 subgroups by 3 h, 6 h, 24 h and 72 h after reperfusion, 6 rats in each subgroup. Sham-operated group was only performed artery separation . The middle cerebral artery occlusion (MCAO) model was set up in I/R rats by Longa method. The IP rats were performed for three minutes on the bilateral carotid artery ligation, and formed MCAO model 24 hours later. The rats in the Shuxuetongmai group were pretreated with Shuxuetongmai capsules for 14 days on gavage before the establishment of MCAO model. The neurological deficits were graded in rats by Zea Longa method. Western Blot was used to determine the protein expression of p38MAPK and P-p38MAPK. Tunel method was applied to detect the apoptosis of neurons and the relationship between expression of p38MAPK, P-p38MAPK and apoptosis of neuron. Results No neurological dysfunction appeared in the sham-operated group at each time points, but not for the other groups, which reached the peak at 24 h. Compared with the I/R group, IP group and Shuxuetongmai group presented the mild neurologic function deficiency at different time points in rats (P0.05). The obvious variation of the value of P-p38MAPK/p38MAPK wasn't detected in sham-operated group at different time points, while obviously presented in I/R group, and the ratios of P-p38MAPK/p38MAPK were increased gradually followed with reperfusion, approaching to the highest level at 24 h. Compared with the I/R group, the P-p38MAPK/p38MAPK declined from 3 h and to the lowest level at 24 h of reperfusion, in both IP and Shuxuetongmai groups(P0. 05). Conclusion Shuxuetongmai capsule pretreatment can induce brain ischemic tolerance, attenuate the apoptosis of neurons in cerebral ischemia reperfusion, and improve neurologic function. The mechanism may be related to the inhibition of p38MAPK phosphorylation.