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In some countries and regions,descending branch of lateral circumflex femoral artery(DBLCFA) has been successfully applied to CABG.It is feasible,easy and safe to harvest and apply DBLCFA to CABG.We review the origin,distribution and anatomical features of DBLCFA.And introduce its application,relevant techniques and strategies in CABG.
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Objective@#To discuss a novel method of complete revascularization for multi-vessel coronary diseases on beating heart off-pump surgery through lower ministernotomy.@*Methods@#Clinical data of 79 patients underwent ministernotomy off-pump coronary artery bypass from January 2015 to May 2016 at Department of Cardiac Surgery, Heart Center, Beijing Friendship Hospital, Capital Medical University were analyzed retrospectively. There were 62 male and 17 female patients, with an average age of (65±9) years. All the patients were multi-vessel coronary diseases and planned to receive coronary artery bypass grafting. Left internal mammary artery, radial artery and great saphenous veins were harvested and prepared, respectively. The perioperative clinical data was observed and collected. Postoperative ventilator-assisted time, intensive care time, and 24-hour thoracic mediastinal drainage volume were recorded. Postoperative cardiac function was evaluated by echocardiography. The data were compared between pre- and post-operative using paired t test.@*Results@#Cardiopulmonary bypass was used in 2 patients during operation because of unstable hemodynamic status, but the incision was not needed to extend for those 2 patients. The lower ministernotomy was converted to traditional full sternotomy in 2 patients due to limited space for proximal anastomosis. In total, 79 patients had an average of (2.8±0.6) grafts. One proximal anastomosis was performed in 75 patients and 2 anastomoses in 4 patients. Distal target vessels consisted of left descending arteries for 79 patients, posterior descending artery for 60 patients, obtuse marginal branch and intermediate branch for 56 patients and diagonal branches for 25 patients, respectively. Average postoperative ventilation time was (19.0±2.2) hours and ICU stay was (60±20) hours. One patient developed postoperative myocardial infarction and needed temporary intra-aortic balloon pump support. One patient was subjected to incision infection. None of patient died in this study. There were no significant differences in left ventricular end-diastolic diameter and left ventricular end-systolic diameter between pre- and post-operative. The post-operative ejection fraction was significantly higher than that pre-operative (66.5%±1.6% vs. 61.2%±2.3%, t=4.30, P=0.00).@*Conclusion@#With lower ministernotomy, the various sites of distal target vessels could be reached and complete revascularization could be achieved for selected patients with triple vessel diseases, although the procedure is technical demanding.
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Objective To analyse the research status and research focus in immune thrombocytopenia.Methods The literatures of ITP subject category in the SCI-expanded (SCI-E) database during 2006-2016 were retrieved.Then the co-authorship,time distribution,research regional distribution,institute distribution,keywords distribution,especially the international hot research focus in ITP,were analyzed by using the Cite Space software base on the bibliometrics method.Results A total of 963 journal articles were retrieved,and the quantity of articles about ITP subjective category showed a steady increasing trend during 2006-2015.The researches mainly distributed in the east Asia,Europe and north America areas,and top issuing countries were American,China,Japan,Canada and England.The top issuing institution was the Cornell University.The anima model,thrombopoietin receptor agonist,Helicobacter pylori eradication,systematic review and T lymphocyte proliferation were the research hot points;the high frequency key words such as large dose of dexamethasone,gene polymorphism,correlation and reaction were the latest study direction.Conclusion The co-authorship,regional distribution,research hot points and trend are determined,which can provide references for ITP scientific field of our country.
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The present study aimed to explore the effects of Eerdun-Wurile on brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) expressions in the prefrontal cortex of MCAO / R injury rats.Sixty SD male rats of SPF grade were selected to establish the model of MCAO / R with Zea-Longa thread occlusion,and divided into five groups at random:the sham operation group,the model group,the nimodipine group and the Eerdun-Wurile group.After modeling,rats were anesthetized for preparing the brains.The pathomorphological changes of the brains were evaluated by immunohistochemical techniques,such as HE staining and SP.The protein and mRNA expressions of BDNF and NGF in the prefrontal cortex of rats were detected by ELISA and RT-PCR,respectively.As a result,compared with the model group,it was found that the number of necrotic cells in the prefrontal cortex were significantly reduced in the Eerdun-Wurile group (P ＜ 0.05),while the mRNA and protein expressions of BDNF and NGF were significantly increased (P ＜ 0.05).In conclusion,the BDNF and NGF expressions in the prefrontal cortex were up-regulated for stimulating the activation of astrocytes and protecting the neurons with the treatment of Eerdun-Wurile in MCAO / R injured rats,which may be the mechanism of the treatment of Eerdun-Wurile for white vein disease.
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ObjectiveTo evaluate the biological characteristics of rat bone marrow mesenchymal stem cells (BMSCs) transfected with hypoxia-inducible factor-1α(HIF-1 α) gene.MethodsThe rat BMSCs of 3rd generation and the vector expressing HIF-1α gene (pcDNA3.1-HIF-1α) were provided by department of anesthesia,Tangdu Hospital,the 4th Military Medical University.BMSCs expressing HIF-1α gene (BMSCs-HIF-1α cells) were constructed by transfection of vector pcDNA3.1-HIF-1α into BMSCs by means of electroporation.Successful transfection of HIF-1α gene was confirmed by immuno-cytochemistry.Simple BMSCs and BMSCs-pcDNA3.1 cells were used as control cells.After being cultured in hypoxic condition HIF-1α expression was detected by Western blot analysis.Flow cytometry was used to determine the proportion of cells in G1,G2 and S phase and detect apoptosis.The proliferation index (PI) was calculated.The cell growth curve was described by MTT assay and the number of the 3 types of cells was recorded.ResultsA large number of deep blue granules were observed in the nuclei of BMSCs-HIF-1α cells using immuno-cytochemistry but no such granule was found in the two types of control cells.HIF-1α expression was significantly up-regulated and apoptosis rate (the number of apoptotic cella/the total number of cells examined) decreased in BMSC-HIF-1α cells compared with the control cells.The proportion of cells in S and G2 phase was significantly higher and the proportion of cells in G1 phase was significantly lower and PI higher in BMSCs-HIF-1α cells than in the control cells.The number of BMSCs-HIF-lα cells was significantly higher than the number of the two types of control cells at day 3-8 of culture.There was no significant difference in the above variables between BMSCs and BMSCs-pcDNA3.1 cells.ConclusionBMSCs-HIF-1α is successfully constructed by transfection of vector pcDNA3.1-HIF-1α gene into BMSCs by means of electroporation.
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Objectiye To investgate the effects of isoflurane preconditioning on expression of Toll-like receptor 4 (TLR4) and myeloid differentiation factor 88 (MyD88) during focal cerebral ischemia-reperfusion (IR) in rats. Methods Thirty male SD rats weighing 250-300 g were randomly divided into 3 groups ( n = 10 each):sham operation group (group S);focal cerebral IR group and isoflurane preconditioning group (group IP). The animals were anesthetized with intraperitoneal pentobarbital 40 mg/kg. In group IR and IP a nylon thread with rounded tip was inserted into right internal jugular vein and threaded cranially until resistance was met. Mid-cerebral artery was occluded (MCAO) for 2 h followed by 24 h reperfusion. In group IP the animals inhaled 2% isoflurane98 % O2 for 1 h once a day for 5 consecutive days at 24 h before MCAO. Neurologic function was assessed and scored and cerebral infarct volume was measured at 24 h of reperfusion. The animals were sacrificed at 24, 48 and 72 h of reperfusion respectively. The right ischemic frontal lobes were removed for determination of TLR4, MyD88and NF-κB expression by Western blot analysis. Results MCAO significantly worsened neurologic function. The neurologic function deficit scores were significantly increased and the TLR4, MyD88 and NF-κB expression were significantly up-regulated in group IR as compared with group S (P ＜ 0.05). Isoflurane preconditioning significantly decreased cerebral infarct volumes and neurologic function deficit scores and down-regulated the expression of TLR4, MyD88 and NF-κB in group IP as compared with group IR ( P ＜ 0.05). Conclusion Isoflurane preconditioning can reduce inflammatory response and focal cerebral IR injury by down-regulating the expression of TLR4and Myd88.