Clinical application of redo coronary artery bypass grafting / 中华外科杂志

<p><b>OBJECTIVE</b>To determine the clinical characteristics and outcomes of redo CABG.</p><p><b>METHODS</b>The outcomes of 42 consecutive patients who underwent redo CABG from January 2002 to December 2010 was analyzed. There were 29 males and 13 females, aging from 46 to 78 years old with a mean of (61.2 ± 2.1) years. Off-pump CABG was applied for 31 patients and on-pump CABG for 11 patients. There were 1 patient underwent concomitant aortic valve replacement and 1 patient underwent aortic root and right aortic arch replacement respectively.</p><p><b>RESULTS</b>Three patients died of right ventricle rupture, heart failure and multiple system organ failure respectively and the perioperative mortality rate was 4.8%. The post-operatively mechanical ventilation time varied from 9 to 27 h with a mean of (17 ± 7) h. There was no residual angina and perioperative myocardial infarction in the remaining patients who were all discharged uneventfully. Intraoperative 6 patients had accepted intraaortic balloon counterpulsation. During the follow-up from 6 months to 4.5 years for 38 patients, which showed no evidence of recurrent angina and postoperative coronary CT angiography in 12 patients showed the patency of grafts is good.</p><p><b>CONCLUSION</b>Satisfactory outcome of redo coronary artery bypass grafting can be achieved if proper indication were choose and reasonable management were performed.</p>

The early and middle-long term clinical results of surgical treatment for ventricular septal rupture / 中华外科杂志

<p><b>OBJECTIVE</b>To explore the way of promoting the efficacy of surgical treatment for ventricular septal rupture (VSR) after acute myocardium infarction in terms of perioperative and long term survival.</p><p><b>METHODS</b>The clinic data of 37 VSR cases underwent surgical treatment from October 1994 to October 2007 were analyzed retrospectively. There were 24 male and 13 female, and the age was (63.4 +/- 7.6) years old. The whole group was divided into the VSR repair plus revascularization group (group A, 26 cases) and simple VSR repair group (group B, 11 cases).</p><p><b>RESULTS</b>There were 4 operative deaths in group A (15.4%), 7 deaths in group B (63.6%), P = 0.006. With the follow-up of (34.0 +/- 29.8) months ranged from 2 to 103 months of the 26 operational survivors, there were 5 late deaths, of which 2 deaths in group A and 3 deaths in group B. According to the Kaplan-Meier survival curve, the actuarial survival rate at 6 to 8 year was (64.3 +/- 21.0)% for group A and the actuarial survival rate at 4 year was (25.0 +/- 21.7)% for group B, P = 0.011. Of the 21 mid-long term survivors, 17 cases were in NYHA class I to II and 4 cases in NYHA class III to IV. There were 4 cases suffered from VSR recurrence. According to Logistic regression, the risk factors for the early death were not adoptive of revascularization, cardiogenic shock and emergency surgical procedure, while the risk factors for late death were not adoptive of revascularization and low cardiac output after the procedures.</p><p><b>CONCLUSIONS</b>VSR repair plus revascularization could improve the perioperative and mid-long term survival for the surgical treatment of VSR. The appropriate timing and procedures of the surgical operation are very important to promote perioperative survival and to prevent VSR recurrence.</p>

Long-term results of surgical repair of ruptured sinus of aortic sinus aneurysm / 中华外科杂志

<p><b>OBJECTIVE</b>To summarize the clinic characteristics and effect of surgical repair of ruptured aortic sinus aneurysm.</p><p><b>METHODS</b>From September 1997 to September 2007, 43 patients with ruptured aortic sinus aneurysm underwent surgical procedures. There were 32 male and 11 female patients. The age ranged from 11 to 50 years old with a mean of (29.0 +/- 11.5) years old. The origins of rupture were the right coronary sinus in 34 patients and the noncoronary sinus in 9 patients. The aneurysms ruptured into the right ventricle in 30 patients, the right atrium in 8 patients, the right ventricle and right atrium in 3 patients, and the ventricular septum and then the right ventricle in 2 patients. Associated cardiac anomalies included ventricular septal defect in 26 patients, aortic regurgitation in 15 patients, infectious endocarditis in 8 patients, tricuspid regurgitation in 6 patients, atrial septum defect in 4 patients, mitral valve regurgitation in 2 patients, patent ductus arteriosus in 2 patients, and pulmonary valve vegetation in 1 patient. All the patients underwent the repair of ruptured aortic sinus aneurysm and correction of associated anomalies with cardiopulmonary bypass.</p><p><b>RESULTS</b>There were no deaths after the operation and during the follow-up. The complications, including acute heart failure and III atrioventricular block, occurred in 5 patients. Follow-up was 6 to 120 months with a mean of (68.0 +/- 17.7) months. Two patients underwent reoperation for aortic valve replacement at the 6(th) and 8(th) year after the first operation. There were 2 patients which the aortic regurgitation deteriorated from grade I to II.</p><p><b>CONCLUSIONS</b>Repair of ruptured aortic sinus aneurysm presents a satisfactory result. Aggressive treatment in early time, prevention of post-operative complications and long-term follow-up are recommended in the treatment for patients of ruptured aortic sinus aneurysm with infectious endocarditis and aortic regurgitation.</p>

Effects of Huafenqinutang and vardenafil for treatment of chronic prostatitis/chronic pelvic pain syndrome with concomitant erectile dysfunction / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the effects of Huafenqinutang combined with vardenafil for the treatment of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) with erectile dysfunction.</p><p><b>METHODS</b>One hundred and thirty-eight cases diagnosed as CP/CPPS with erectile dysfunction were randomized into trial group (70 cases) and control group (68 cases) for treatment with Huafenqinutang for 8 weeks, and in the former group, vardenaffil was added since the fifth weeks. All the cases were evaluated according to NIH-CPSI and IIEF-5 scores at 4 weeks and 8 weeks, respectively.</p><p><b>RESULTS</b>At the end of the fourth weeks, NIH-CPSI score was 13.1-/+4.7 in the trial group and 13.3-/+4.5 in the control group, which were comparable between the two groups (P>0.05) but significantly decreased compared with the pre-treatment scores in both groups (P<0.01). IIEF-5 score was also similar between the two groups (14.1-/+3.3 vs 14.3-/+5.0, P>0.05) but significantly increased compared with the pre-treatment scores in both groups (P<0.01). At the end of the eighth week, NIH-CPSI score was 7.8-/+2.2 and IIEF-5 score 20.1-/+4.4 in the trial group, which were significantly different from those at the end of the fourth week (P<0.01). In the control group, NIH-CPSI score was 12.7-/+2.3 and IIEF-5 score 14.3-/+4.5 at the eighth week, similar to those at the end of the fourth week (P>0.05). There were significant differences in NIH-CPSI and IIEF-5 scores between the 2 groups (P<0.01), and the change of NIH-CPSI score was negatively correlated with IIEF-5 score in the trial group (r=-0.89, P<0.01).</p><p><b>CONCLUSION</b>For patients with CP/CPPS with erectile dysfunction, Huafenqinutang treatment in combination with vardenafil can effectively improve the erectile functions and decrease the NIH-CPSI score to favor the recovery from CP/CPPS.</p>

Jingjielianqiao Decoction promotes leg ulcer healing in rabbits / 南方医科大学学报

<p><b>OBJECTIVE</b>To study the effect of Jingjielianqiao Decoction in promoting leg ulcer in rabbits.</p><p><b>METHODS</b>Nine adult male New Zealand albino rabbits with chronic leg ulcers were randomized into 3 groups, namely group A treated with Jingjielianqiao Decoction, group B with Shengjiyuhong Decoction, and group C with normal saline. Gross observation of the wounds was carried out regularly for evaluating the changes in the ulcerous area, depth and wound surface excretion. After 3 weeks of treatment, the tissues on the edge of the ulcer were sampled and prepared for routine pathological examination, electron microscopy and immunohistochemistry for vascular endothelial growth factor (VEGF) and CD34. The number of blood vessels and their areas were also recorded.</p><p><b>RESULTS</b>The wounds showed no significant differences between the 3 groups by gross observation during the treatment, but after completion of the 3-week treatment, routine pathological examination and electron microscopy revealed significant differences between the groups. Immunohistochemistry for VEGF and CD34 yielded comparable results between groups A and B (positive control), but showed significant differences between group C and the other two groups (P<0.01).</p><p><b>CONCLUSION</b>Jingjielianqiao Decoction and Shengjiyuhong Decoction can obviously promote the healing of leg ulcer in rabbits.</p>