RESUMEN
Objective To study the changes of the myocardial cell apoptosis in myocardial infarction of rabbits. Methods The model of rabbit with myocardial infarction was established.HE staining,TUNEL staining, immunohistro-chemistry staining, ultrathin section for electron microscope and DNA electronic gel phorensis were performed in samples of ischemia or infarction in different times.The position of apoptotic myocytes in different phases of ischemia were observed by light microscope and electronic microscope. Results After 30 minutes to 4 weeks ischemia.there were a few TUNEL positive nucleus of myocytes in the margin area of myocardial infarction;HE staining-found typical expressions of apoptosis,such as chromosome conglomeration,chromosome gathered at the edge or chromosome aggregation,dark-stained nucleus,cell shrinkage,were obvious in 4-8 hours.A lot of positive nucleus of myocytes stained by TUNEL were found in the early stages of myocardial ischemia in myocardial infarction.gradually ascended and then became hardly visible from 8 hours to 3 days.Nucleus swelling,karyorrhexis and karyolysis were found in the area of myocardial infarction.then cells were broken.DNA agarose electrophoresis found DNA fragment of most myocytes in 30 minutes of ischemia,just a few cardiocytes decomposed to the big segments.At 4hours of ischemia the most cardiocytes decomposed to big segments,and there were a blurry"ladder"in DNA strand breaks from 8 hours to 1 day.It showed that apoptotic cardiocytes existed in the margin area of myocadial infarction. Conclusions There are cardiocytes apoptosis in the margin area of infarction from 30 minutes to 4 weeks after myocardial ischemia.Maybe it relates to the reperfusion caused by collateralization establishment or infiltration from circumference.
RESUMEN
Objective To summarize the results and experience of coronary artery bypass grafting for coronary artery disease.Methods From Jan. 2001 to Apr. 2002, 218 patients underwent coronary artery bypass grafting. Male 143, female 75. Coronary artery bypass grafting with extracorporeal circulation(ECC) in 152 patients, off-pump coronary artery bypass grafting in 66 patients. Surgical technique, perioperative treatments, death causes and complications were analyzed in all cases.Result 5 patients died in hospital, mortality was 2.3%(5/218), others had favorable outcomes.Conclusions Strict mastery of surgery indictions, advanced oprative methods, excellent myocardial protection and perfect perioperative treatments are pivotal factors of CABG, the efficacy and safety of coronary artery bypass grafting are satisfactory.
RESUMEN
Objective To evaluate the results of coronary artery bypass grafting in forty-one senile cases no less than seventy years old with coronary heart disease. Method Retrospectively analyzed the operative results of 41 cases of CABGs (17-case of OPCABs and 24-case of conventional CABGs(CCABGs))with the age no less than 70 years old from Dec.20 2000 to Jan.31 2002.Results The average bypass grafts per patient was 2.1?0.6 in OPCAB group and 3.4?0.7 in CCABG group(P
RESUMEN
Objective To probe the effects of hypothermia and St Thomas Hospital Ⅱ cardioplegia on immature myocardium.Methods To observe the change of hemodynamics,myocardial enzyme in the coronary effluent and myocardial biochemistry of the perfused immature rabbit heart in vitro after two or four hours ischemia at 14 degrees centigrade.Results There were no significant differences in post ischemic hemodynamics,myocardial enzyme in the coronary effluent and myocardial biochemical parameters of the perfused immature heart The myocardial protective effect provided by St.Thomas Hospital Ⅱ cardioplegia was worsen than that of hypothermia alone,marked by the elevated myocardial enzyme leakage and the decreased hemodynamics.Single dose perfusion was better than multi dose perfusion by characteristics of decreased enzyme leakege and good post ischemic hemodynamics.Conclusions Hypothermia alone can provide immature heart with satisfactory myocardial protection.St.Thomas Hospital Ⅱ cardioplegia can not afford good myocardial protection to immature heart and enhance the myocardial protective effect provided by hypothermia.The myocardial protection effect is better provided by single dose perfusion than by multi dose perfusion