Efficacy comparison between total aortic arch reconstruction with open placement of triple-branched stent graft and total aortic replacement combined with stented elephant trunk implantation for patients with Stanford A aortic dissection / 中华心血管病杂志

<p><b>OBJECTIVE</b>To compare the clinical efficacy between total aortic arch reconstruction with open triple-branched stent graft placement and total aortic replacement combined with stented elephant trunk implantation for patients with Stanford A aortic dissection.</p><p><b>METHODS</b>Patients with Stanford A aortic dissection treated with surgical treatment from January 2006 to May 2011 were included in this study. The patients were divided into two groups. Group I (n = 20) patients were treated by total arch replacement with stented elephant trunk procedure. Group II (n = 8) patients received open triple-branched stent graft placement. Echocardiography and aortic CT angiography were performed before and at 1 month after operation.</p><p><b>RESULTS</b>Age, gender and disease severity were similar between the 2 groups (all P > 0.05). Operation was successful in all 28 patients. Cardiopulmonary bypass time, aortic cross clamp time, circulation arrest time and duration of ventilator assisted breathing were significantly longer; postoperative drainage volume and blood transfusion volume were significantly larger and hospitalization cost was significantly higher in group I patients compared those in group II patients (all P < 0.05). One month after operation, the maximum internal diameter of aorta was smaller than pre-operation in both group I [(30.2 ± 3.1) mm vs. (42.5 ± 6.5) mm, P < 0.05] and group II [(31.5 ± 2.5) mm vs. (44.1 ± 7.3) mm, P < 0.05].</p><p><b>CONCLUSIONS</b>Short-term procedural success rate was similar between the two groups. The total aortic arch reconstruction with open triple-branched stent graft placement procedure is simpler, shortens the operation time, reduces the blood transfusion volume and is more cost-effective compared to the classical aortic arch operation.</p>

Influence and significance of intermittent ventilation on lung cytokines during cardiopulmonary bypass / 中南大学学报(医学版)

OBJECTIVE@#To determine the influence and significance of intermittent ventilation on lung cytokines during cardiopulmonary bypass (CPB).@*METHODS@#Thirty-six patients with rheumatic heart disease (RHD) were divided into 2 groups randomly: Treatment group (n = 18, given intermittent ventilation once every 5 minutes during CPB; control group ( n = 18), no ventilation during CPB. A brochioalveolar lavage was performed at 2 hours after the CPB. The numbers of granulocytes and the contents of IL-1, IL-6, TNF-alpha, and LDH in the brochioalveolar lavage fluids were measured, and lung PaO2/FiO2 were measured preoperatively and at 1 hour, 4 hours, and 8 hours after the CPB termination.@*RESULTS@#The numbers of granulocytes and the contents of IL-1, IL-6, TNF-alpha, and LDH of the treatment group in the brochioalveolar lavage fluids were significantly lower than those of the control group (P < 0.05), and the lung PaO2/FiO2 of the treatment group at 1 hour, 4 hours, and 8 hours after the CPB termination significantly increased than those of the control group (P < 0.05). A significant decrease of lung PaO2/FiO2 occurred in both groups at 1 hour, 4 hours, and 8 hours after the CPB compared with the same group at the baseline before the CPB (P < 0.01).@*CONCLUSION@#Intermittent ventilation has protective effects on the lung injury during CPB by decreasing granulocyte adhesion and the level of lung cytokines, alleviating the lung inflammatory reaction and endothelial cell injury.

The transformation of energy metabolism in rat transplant heart / 中华器官移植杂志

Objective To analyze the changes of energy metabolism-related proteins(enzymes) and transformation of energy metabolism in transplanted heart.Methods The hearts transplanted from Lewis to Wister rats as allografts and from Lewis to Lewis rats as isografts were used to estab- lish Ono model.The changes in proteins were observed by using proteomics technique and compared between allografts and isografts in the left ventricular myocardial tissues 2 and 8 weeks after heart transplantation.Peptide mass fingerprint map was obtained by using matrix-assisted laser desorption/ ionization time of flight mass spectrometry(MALDI-TOF-MS)and the matched proteins achieved by using Matrix Science software.Results Eighty proteins(enzymes)of total 65 differential proteins that regulated energy metabolism were identified in allografted hearts,which correlated to the Krebs cycle and electron transport system involving glycometabolism,fatty acid and branched-chain amino acids oxidation.Conclusion The energy metabolism in allografts heart was transformed:mitochondria function was decreased in Krebs cycle but enhanced in electron transport system and outer mitoehon- drial membrane permeability to ATP,accelerated in glycolysis and fatty acid oxidation,however, branched-chain amino acids oxidation were suppressed.

Concentration and significance of s-ICAM-1, s-VCAM-1, and vWF in the plasma of patients with rheumatic heart disease / 中南大学学报(医学版)

OBJECTIVE@#To measure the concentrations of soluble intercellular adhesion molecule-1 (s-ICAM-1), soluble vascular cell adhesion molecule-1 (s-VCAM-1), and von Willebrand factor (vWF) in the plasma of patients with rheumatic heart disease (RHD), and to provide basic theory for the mechanism of valvular and myocardial damage.@*METHODS@#The consecutive patients with RHD (n=40) and healthy people (n=40) were chosen. All blood samples were taken from the peripheral veins. s-ICAM-1, s-VCAM-1 and vWF levels in all samples were measured by enzyme-linked immunosorbant assay.@*RESULTS@#s-ICAM-1, s-VCAM-1 and vWF levels were significantly elevated in patients with RHD compared with healthy people (P < 0.01. The level of sICAM-1 was elevated in patients with atrial fibrillation compared with patients without atrial fibrillation.@*CONCLUSION@#The concentrations of s-ICAM-1, s-VCAM-1 and vWF levels were significantly elevated in patients with static rheumatic fever, which might be one of the pathogenic mechanisms of valvular damage, endothelial dysfunction, and myocardial damage in rheumatic heart disease.