Causal relationship between atrial fibrillation/warfarin and cutaneous melanoma: a two-sample Mendelian randomization study.

Purpose: In recent years, the relationship between malignant tumors and atrial fibrillation has attracted more and more attention. Atrial fibrillation can also cause a series of adverse events, such as the risk of thromboembolism. Also, Warfarin is often used here. But, the relationship between cutaneous melanoma and atrial fibrillation, and between cutaneous melanoma and warfarin is still unclear. Therefore, we used a two-sample Mendelian randomization to assess the causal relationship between atrial fibrillation/warfarin and cutaneous melanoma (cM). Methods: Firstly, atrial fibrillation (ukb-b-11550; nCase = 3,518, nControl = 459,415) and warfarin (ukb-b-13248; nCase = 4,623, nControl = 458,310) as exposures, with genome-wide association studies (GWAS) data from the United Kingdom Biobank. And cM (ieu-b-4969; nCase = 3,751, nControl = 372,016) as outcome, with GWAS data from the IEU Open GWAS project. Subsequently, single-nucleotide polymorphisms (SNPs) were filtered from GWAS studies using quality control measures. In addition, two-sample Mendelian randomization (MR) analysis was performed to explore the causal relationship between atrial fibrillation or warfarin and cM and used inverse variance weighting (IVW) as the primary analytical method. Finally, relevant heterogeneity and sensitivity analysis were performed to ensure the accuracy of the results. Results: A causal relationship between atrial fibrillation and cutaneous melanoma was observed, and between warfarin and cutaneous melanoma. Conclusion: The atrial fibrillation may play a causal role in the development of cutaneous melanoma, but the mechanism and the causal relationship between warfarin and cutaneous melanoma needs to be further elucidated.

Immunomodulatory effects of icariin in a myocardial infarction mouse model.

Myocardial infarction (MI) is a prevalent cardiovascular disease defined by myocardial ischemia and hypoxic damage caused by plaque rupture, thrombosis, lumen stenosis, or blockage in the coronary artery. However, the development of emergency percutaneous coronary interventional therapy has enabled the rapid restoration of blood perfusion to ischemic myocardium and the rescue of dying myocardium cells. Some dying myocardium cells have caused irreversible damage and impaired cardiac function recovery in recent years. Icariin has been utilized to treat various ailments as a natural chemical extract. In this study, we employed a variety of approaches to observe MI, including western blotting, quantitative RT-PCR, immunohistochemistry, and flow cytometric analysis using icariin. As demonstrated by the research findings, icariin may prevent MI-induced cell apoptosis. This is accomplished by inhibiting proinflammatory factors via the Nrf2/HO-1 signaling pathways. These data imply that icariin may be an effective treatment for MI.

Application of 3D printing technology in the diagnosis and treatment of valvular heart disease / 中国胸心血管外科临床杂志

@#The incidence of valvular heart disease (VHD) increases with age, and its principal therapy is valve replacement. However, in recent years, the emergence of transcatheter interventions has changed the traditional therapy, making high-risk patients of surgery see dawn of hope. 3D printing technology has developed rapidly since it was applied to the medical field in 1990. Moreover, it has been widely applied in many surgical majors via refined reduction technology. However, the application of 3D printing technology in cardiovascular surgery is still in the preliminary stage, especially in the field of VHD. This article aims to review basic principles of 3D printing technology, its advantages in the therapy of VHD, and its current status of clinical application. Furthermore, this article elaborates current problems and looks forward to the future development direction.

Optimized arterial perfusion strategy in total arch replacement for acute type A aortic dissection with malperfusion syndrome / 中国胸心血管外科临床杂志

@#Objective    To investigate the effect of optimized arterial perfusion strategy on total arch replacement for acute type A aortic dissection (AAAD) with malperfusion syndrome (MPS). Methods    From 2017 to 2019, 51 patients with AAAD and MPS who had received total arch replacement with optimized arterial perfusion strategy in our hospital were included in the optimized perfusion group, including 40 males and 11 females, with an average age of 47.43±13.39 years. A total of 40 patients with AAAD and MPS who had been treated with traditional Sun's surgery were taken as the traditional control group, including 31 males and 9 females, with an average age of 50.66±12.05 years. The perioperative clinical data of the two groups were compared. Results    The preoperative baseline data of the two groups were basically consistent (P>0.05). The comparison of operative data between the optimized perfusion group and the traditional control group showed that in the optimized perfusion group, the extracorporeal circulation time, aortic occlusion time, and circulation-out cerebral perfusion time were significantly less than those in the traditional control group (223.64±65.13 min  vs. 266.77±87.04 min, 114.48±27.28 min vs. 138.20±39.89 min, 8.28±3.81 min vs. 50.53±23.60 min, all P≤0.05). The lowest intraoperative nasopharyngeal temperature in the optimized perfusion group was significantly higher than that in the traditional control group (27.10±1.18℃ vs. 23.6±3.30℃, P=0.000). Postoperative wakefulness time of the optimized perfusion group was earlier than that of the traditional control group (4.50±1.35 h vs. 5.27±1.15 h, P=0.019). The volume of blood transfusions in the optimized perfusion group was significantly less than that in the traditional control group (13.25±9.06 U vs. 16.95±7.53 U, P=0.046). There was no significant difference in ICU time and invasive ventilation time between the two groups (P>0.05). Postoperative complications of the two groups showed that the incidence of postoperative continuous renal replacement therapy in the optimized perfusion group was significantly lower than that in the traditional control group, with a statistically significant difference (21.6% vs. 42.5% P=0.003). The incidence of postoperative delirium, coma, low cardiac row syndrome and limb ischemia in the optimized perfusion group was lower than that in the traditional control group, but the difference was not statistically significant (P>0.05). The incidence of postoperative hemiplegia, sepsis, and secondary thoracotomy in the optimized perfusion group was higher than that in the traditional control group, and the difference was not statistically significant (P>0.05). Postoperative mortality in the optimized perfusion group was significantly lower than that in the traditional control group (13.7% vs. 27.5%), but the difference was not statistically significant (P=0.102). Conclusion    Optimized arterial perfusion strategy and its related comprehensive surgical technique reduce surgical trauma, shorten the operation time, reduce perioperative consumption of blood products. Postoperative wakefulness is rapid and the incidence of complications of nervous system, kidney and limb ischemia is low. Optimized arterial perfusion strategy is suitable for operation of AAAD with MPS by inhibiting the related potential death risk factors to reduce operation mortality.

Evaluation of corneal nerve damage in diabetic patients after panretinal photocoagulation based on the wide-field mosaic analysis of corneal subbasal nerve plexus / 中华实验眼科杂志

Objective:To explore the damage of panretinal photocoagulation (PRP) to the subbasal nerve plexus (SNP) and its related mechanisms by comparing SNP changes in wide-field mosaic between before and after PRP treatment in diabetic patients.Methods:A randomized controlled study was conducted.Fifty-seven patients (114 eyes) with type 2 diabetes mellitus and binocular diabetic retinopathy (DR) stage IV to receive PRP treatment in Shanxi Eye Hospital from April to November 2019 were enrolled.The subjects were randomly divided into horizontal-vertical laser group and vertical-horizontal laser group according to a random number table.Twenty-nine eyes from 29 patients were assigned to the horizontal-vertical laser group with the photocoagulation sequence of temporal-nasal-inferior-superior.Twenty-eight eyes from 28 patients were assigned to the vertical-horizontal laser group with the photocoagulation sequence of inferior-superior-temporal-nasal.The severer eyes of each subject were chosen as the treatment eye and the contralateral eyes were chosen as the control eye.Corneal confocal laser scanning microscopy (CCM) was performed before PRP treatment, 1 week after each photocoagulation, and 1 month after the completion of PRP treatment to collect images of the SNP over an area of 2-3 mm around the whorl-like pattern.Captured images at each time were merged into one image by using the Photoshop CC 2017 image processing software, and then the nerve fiber length (NFL) of whorl-like pattern was measured by Neuron J image analysis software.McGill pain questionnaire was used to investigate the pain of patients after each photocoagulation.The NFL changes of SNP at different time points were compared between different eyes and different photocoagulation sequence groups.The study protocol adhered to the Declaration of Helsinki and was approved by an Ethics Committee of Shanxi Eye Hospital (No.201804b). Written informed consent was obtained from each patient prior to entering the study cohort.Results:After PRP treatment, there were different degrees of neural structure loss of SNP nerve fibers in 11 treatment eyes, but there was no significant change in SNP nerve fibers in the control eyes.There were significant differences in NFL between the treatment eyes and the control eyes at various time points ( Feyes=2.020, P=0.039; Ftime=4.062, P=0.001). In the horizontal-vertical laser group, different degrees of neural structure loss on the photocoagulation side were found in SNP nerve fibers after the first and second photocoagulation.In the vertical-horizontal laser group, different degrees of neural structure loss on the photocoagulation side were found in SNP nerve fibers after the third and fourth photocoagulation.There was no significant difference in NFL of treatment eyes between the two groups ( Fgroup=0.099, P=0.754), but there was a significant difference in NFL at various time points before and after treatment ( Ftime=5.231, P<0.001). There were 9 (9/57) patients who complained of pain after PRP, which occurred at the first time of photocoagulation in 7 of them. Conclusions:SNP damage may occur after PRP in patients with DR, and SNP is prone to be damaged on the photocoagulation side when performing horizontal photocoagulation.

Application of 3D printing technology in the personalized surgery of right ventricular double outlet / 中国胸心血管外科临床杂志

@#Objective    To evaluate the clinical value of three-dimensional (3D) printing model in accurate and minimally invasive treatment of double outlet right ventricle (DORV). Methods    From August 2018 to August 2019, 35 patients (22 males and 13 females) with DORV aged from 5 months to 17 years were included in the study. Their mean weight was 21.35±8.48 kg. Ten patients who received operations guided by 3D printing model were allocated to a 3D printing model group, and the other 25 patients who received operations without guidance by 3D printing model were allocated to a non-3D printing model group. Preoperative transthoracic echocardiography and CT angiography were performed to observe the location and diameter of ventricular septal defect (VSD), and to confirm the relationship between VSD and double arteries. Results    The McGoon index of patients in the 3D printing model group was 1.91±0.70. There was no statistical difference in the size of VSD (13.20±4.57 mm vs. 13.40±5.04 mm, t=−0.612, P=0.555), diameter of the ascending aorta (17.10±2.92 mm vs. 16.90±3.51 mm, t=0.514, P=0.619) or diameter of pulmonary trunk (12.50± 5.23 mm vs. 12.90±4.63 mm, t=−1.246, P=0.244) between CT and 3D printing model measurements. The Pearson correlation coefficients were 0.982, 0.943 and 0.975, respectively. The operation time, endotracheal intubation time, ICU stay time and hospital stay time in the 3D printing model group were all shorter than those in the non-3D printing model group (P<0.05). Conclusion    The relationship between VSD and aorta and pulmonary artery can be observed from a 3D perspective by 3D printing technology, which can guide the preoperative surgical plans, assist physicians to make reasonable and effective decisions, shorten intraoperative exploration time and operation time, and decrease the surgery-related risks.

Evaluation of the auxiliary diagnostic value of antibody assays for the detection of novel coronavirus (SARS-CoV-2).

The spread of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has taken on pandemic proportions, affecting over 100 countries in a matter of weeks. The goal of this study was to assess the diagnostic values of different methods of detecting and estimating the SARS-CoV-2 infection, and the auxiliary diagnostic potential of antibody assays. By retrospectively analyzing the data of viral RNAs and serum immunoglobulin M-immunoglobulin G antibodies against SARS-CoV-2 from 38 cases with confirmed coronavirus disease 2019 in the Second People's Hospital of Fuyang, we found that, in the early phase of the illness, the viral RNA was most abundant in the sputum specimens, followed by that in the throat swabs, while the antibody assays identified fewer positive cases at this stage. However, the sensitivity of the antibody assays overtook that of RNA test from the eighth day of disease onset. Simultaneous use of antibody assay and reverse transcription-quantitative real-time polymerase chain reaction improved the sensitivity of the diagnoses. Moreover, we found that most of these cases with no detectable viral RNA load during the early stages were able to be seropositive after 7 days. Our findings indicate that the antibody detection could be used as an effective supplementary indicator of SARS-CoV-2 infection in suspected cases with no detectable viral RNA, and in conjunction with nucleic acid detection in confirming the infection.

Issues about pulmonary valve replacement: retrospective single center analysis with 9 years of follow-up data / 中华胸心血管外科杂志

Objective To study the pulmonary valve replacement(PVR) operation indications and timing,the choice of prosthetic valve,and the anticoagulation methods.Methods Between June 2006 and April 2017,10 patients(median age 22.5 years,range 10 to 46) underwent PVR at our hospital.These issues above were discussed by analysing data from the patients and literature review.Results The 10 patients were all diagnosed with congenital heart disease(CHD),6 with CHD and infective endocarditis and 4 with postoperation of complex CHD like tetralogy of Fallot or pulmonary artery atresia.Five patients had prior cardiac operations.Bioprosthesis valve was implanted in 2 cases,while mechanical valve in 8.The international normalized ratio(INR) was maintained between 1.8 and 2.5 for patients with mechanical valve.There was one in-hospital death,and the other 9 patients were all followed up.The median follow-up was 65 months(range,3-110 months).During follow-up,there was no death,and reoperation was undertaken in one patient who had ceased anticoagulation for 2 years with a mechanical valve,and bioprosthesis valve was chosed in reoperation,Except of this patient,no valve thrombus or severe bleeding complication happened.All prosthetic valves demonstrated normal function by cardiac color ultrasound.The mean peak transvalvular pressure gradient for the mechanical valves was 12.0 mmHg(range,8.7-14.0 mmHg),while for the bioprosthesis valves was 24.7 mmHg(1 mmHg =0.133 kPa) (range,22-27 mmHg) (P ＜ 0.01).Overall actuarial survival at 7 years for patients receiving bioprosthesis valve PVR was 100％,while for mechanical valve was 85 ％ (P =0.617);Overall actuarial freedom from reoperation at 7 years for patients receiving bioprosthesis valve PVR was 100％,while for mechanical valve was 71％ (P =0.414).The findings of literature review were as follows:the risk of valve thrombus or severe bleeding complication for mechanical pulmonary valve was not higher than bioprosthesis pulmonary valve under standard anticoagulant therapy;the durability of bioprosthesis pulmonary valves was unsatisfactory,while the medium and long term effects of mechanical valves were good;the hemodynamic properties of mechanical pulmonary valve were better than bioprosthesis pulmonary valve;the lowintensity anticoagulation method was safe and effective for Chinese people.Conclusion PVR is a safe and effective treatment for patients with severe pulmonary valve regurgitation or stenosis,and the medium and long term effects of mechanical valve are satisfactory.PVR is recommended as early as meeting the operation indications.The choice of a prosthetic valve should be careful and individual.At present,the bioprosthesis valves are implanted in pulmonery valve position more than mechanical valves.However,in select patients and by standard anticoagulant therapy,mechanical pulmonry valves will bring better benefit.The low-intensity anticoagulation method(INR 1.8-2.5) is safe and effective,and recommened for Chinese people.

Mid-term outcomes follow- up of meniscal repair with FasT-Fix system throw arthroscopy / 中国内镜杂志

Objective To evaluate the mid-term clinical effect of meniscus tear with FasT-Fix system throw arthroscopy.Methods From January 2013 to January 2016, FasT-Fix system (Smith & Nephew, USA) was used for arthroscopic meniscal repair in 32 patients. The clinical outcome of the patients were evaluated by assessing the symptoms and signs, Lysholm, etc.Results The follow-up time was 6~12 months. According to Barrett standards, 28 patients were healed (87.5%). Lysholm scores were improved significantly after the operation.Conclusions Arthroscopic meniscal repair using FasT-Fix system can provide good mid-term results.

Protective effect of growth differentiation factor 11 on myocardial injury in type II diabetic mice / 中国实验动物学报

Objective To observe the protective effect of growth differentiation factor 11(GDF11) on myocardial injury and the changes of myocardial apoptosis in type 2 diabetic C57BL/6J mice.Methods Sixty male C57BL/6J mice weighing 20-25 g were randomly divided into three groups: control group (control), type 2 diabetes mellitus group (DM) and GDF11 intervention group (DM + GDF11).To establish mouse model of type 2 diabetes, the mice were fed with high fat and high sugar diet for 4 weeks, and i.p.injected consecutively three times of streptozotocin (STZ) in a dose of 60 mg/kg.After the continuous high-fat and high-sugar diet for 4 weeks, the cardiac function was detected by small animal ultrasound, TUNEL staining was used to detect the apoptosis in myocardium, and the expressions of cleaved-caspase-3, Bcl-2, Bax were measured.Results Diabetic injury significantly reduced the left ventricular ejection fraction and left ventricular short axis shortening rate, and increased myocardial apoptosis.Recombinant GDF11 protein significantly improved cardiac function and reduced myocardial apoptosis.Conclusions Exogenous GDF11 can significantly reduce myocardial apoptosis and improve heart function after diabetic injury.

Effect of Edaravone Combining Ulinastatin on Brain Protection in Patients of Type A Aortic Dissection After Total Arch Replacement / 中国循环杂志

Objective: To observe the effect of edaravone combining ulinastatin on brain protection in patients of type A aortic dissection (AAD) after total arch replacement. Methods: A total of 60 AAD patients with total arch replacement in our hospital from 2014-09 to 2016-01 were prospectively studied. Based on peri-operative application of edaravone and ulinastatin, the patients were divided into 2 groups: EU group: 1) the patients received ulinastatin 300000 U/8h and edaravone 0.5mg/Kg/12h from administration to 3 days post-operation, 2) during cardiopulmonary bypass, the patients received ulinastatin 300000 U/2h and edaravone 0.5mg/Kg; Control group, the patients had no such treatment.n=30 in each group. The following items were observed:①operative condition;②blood levels of speciifc brain injury markers as S-100 and neuron speciifc enolase (NSE) at different time points: beginning of surgery (T0), opening aorta clamp (T1), right after cardiopulmonary bypass (T2), entering ICU (T3), 24h post-operation (T4) and 3 days post-operation (T5); ③post-operative condition. Results:①Durations of operation, cardiopulmonary bypass, cardiac arrest and bilateral antegrade selective cerebral perfusion (BACP), the frequency of BACP and UACP (unilateral antegrade selective cerebral perfusion), the lowest rectal temperature and blood levels of S-100, NSE at T0 were similar between 2 groups.②Compared with Control group, EU group had decreased S-100 and NSE from T1 to T5,P0.05. Conclusion: Edaravone combining ulinastatin had brain protective effect in AAD patients after total arch replacement;it may reduce blood speciifc brain injury markers while the clinical signiifcance should be further investigated.

Biological properties of the transcatheter heart valve surface with RGD and EC anti-calcification treatments / 中华胸心血管外科杂志

Objective Anti-calcification and surface modification of the transcatheter heart valve is the priority research area and development direction of bioprosthesis heart valve.In present study,the Arginine-Glycine-Aspartic acid(RGD) coating technology and anti-calcification with epoxy chloropropane(EC) treatment were applied to investigate surface modification property of the transcatheter heart valve compared to the traditional anti-calcification method with glutaraldehyde (GA) treatment to demonstrate the improvement of structure and surface biological properties of the transcatheter heart valve.Methods Morphological characteristics of mesenchymal stem cells(MSCs) seeded on the transcatheter heart valve with the various anticalcification treatments were observed by scanning electron microscopy and the apoptosis rates of MSCs seeded on the transcatheter heart valve with the various anti-calcification interventions were studied by TUNEL staining.The cell adhesion and expression of the cytoskeletal protein,Vinment of MSCs treated as described were analyzed by cell-counting method and fluorescence immunohistochemical method respectively.Results The apoptosis rate of MSCs was markedly decreased while the expression of vinment and the cell adhesion strength of MSCs were elevated in the groups of GA-EC and RGD-EC treatments.The biological indices of RGD-EC group has significant difference(P ＜ 0.05) compared with GA group.Conclusion Biological properties of the surface of transcatheter heart valve can be remarkably improved by GA-EC and RGD-EC anti-calcification treatments.

Research progress of resveratrol on coronary atherosclerosis / 医学研究生学报

Coronary atherosclerosis , the principal cause of death in atherosclerosis , and the cardiovascular protective proper-ties of RES, a polyphenol compounds , have been explained by a substantial body of evidence in cell , animal and clinical research . Which through it′s biological pleiotropy , inhibit oxidative stress , reduce cytokines , then activate the inhibition of platelets aggregation , anti-proliferation, anti-oxidant, anti-inflammatory and vasodilatation .However, the discrepancy between laboratory and clinical call for further investigation .The review will summarize the novel mechanisms of RES on CAS .

Effects of electromagnetic pulses on apoptosis and TGF-β3 expression of mouse testis tissue / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To investigate the effects of electromagnetic pulses (EMP) on the apoptosis and transforming growth factor beta 3 (TGF-β3) expression of mouse testis tissue.</p><p><b>METHODS</b>Thirty-two male BALB/c mice were randomly and equally divided into one control group and three EMP treated groups, which were whole-body exposed to EMP at 200 kV/m with 100, 200, and 400 pulses, respectively. The control group received no treatment. The pathological changes and cell apoptosis in testis tissue were analyzed by TUNEL assay. The mRNA expression of TGF-β3 in testis tissue was determined by RT-PCR, and the protein expression of TGF-β3 was determined by immunohistochemistry and Western blot.</p><p><b>RESULTS</b>No obvious pathological changes were found in testis tissue after EMP exposure at 200 kV/m with 100 and 200 pulses. However, after EMP exposure with 400 pulses, degeneration and shedding of testis tissue, accompanied by significant increase in apoptosis rate (P < 0.05), was observed. The RT-PCR, immunohistochemistry, and Western blot showed that the expression of TGF-β3 mRNA and protein increased significantly after EMP exposure with 400 pulses as compared with that of the control group (P < 0.05).</p><p><b>CONCLUSION</b>EMP exposure at 200 kV/m with 400 pulses increases the incidence of apoptosis and expression of TGF-β3 in mouse testis tissue, which is potentially one of the mechanisms by which EMP increases blood-testis barrier permeability in mice.</p>

Normothermic arch-first technique without extracorporeal circulation in total aortic arch replacement for acute Stanford type A dissection: analysis of 23 cases / 南方医科大学学报

<p><b>OBJECTIVE</b>To assess the effect of normothermic arch-first technique without extracorporeal circulation in total aortic arch replacement for management of acute Stanford type A dissection.</p><p><b>METHODS</b>The surgical data were reviewed for 23 patients (age range 32-58 years) with Stanford type A dissection undergoing total aortic arch replacement with the arch-first technique in our department between January, 2006 and November, 2011. During the surgery, a 4-branched prosthetic graft was connected with the inflow tube and femoral artery using the Y-type tube. The 3 aortic branches were disconnected and anastomosed to the respective branches of the graft, with continuous perfusion of the brain by femoral arterial return. After clamping of the ascending aorta, the graft was connected to the remaining arch before the common stem of the graft was anastomosed with the aortic root.</p><p><b>RESULTS</b>The operations were successfully completed in all the 23 cases with a mean total bypass time of 187∓60 min (117-254 min), mean ascending aorta clamping time of 35∓8 min, and mean nasopharyngeal temperature of 22∓2 celsius;. Death occurred in one case (4.3%) after the operation, and 2 (8.7%) patients experienced temporary neurological dysfunctions. The postoperative consciousness recovery time was 6-8 h in these cases. The shortest postoperative mechanical ventilation time was 18 h, and 11 (48%) patients were weaned from mechanical ventilation within 48 h postoperatively. The ICU stay ranged from 3 to 7 days in these cases.</p><p><b>CONCLUSION</b>Normothermic arch-first technique without extracorporeal circulation can provide better brain protection and reduced the incidence of postoperative complications by shortening the time of circulation bypass and aortic clamping.</p>

Using two dimensional strain echocardiography technique to estimate the short axis of the left Ventricular function / 中国医师杂志

Objective To evaluate the two-dimensional strain by speckle tracking echocardiography in healthy piglets.Methods 9 small Guizhou-Panama pigs were used.High frame rate two-dimensional images were recorded from the left ventricular short-axis views at the levels of mitral annulus,papillary muscle and apex.Radial strain,circumferential strain and rotation were measured in the left ventricular short-axis views using two-dimensional strain software.Results Left ventricular two-dimensional radial strain gradually increased from the base to apex.As seenfromthe apex.LV performs a wringing motion with a clockwise rotation at the base and counterclockwise rotation at the apex.Conclusion 2DS technique is a rapid,accurate,easy,repeatable and no angle reliant method to quantitatively estimate the left ventrlcle function.

The value of echocardiography for early diagnosis of dose cardiac muscle contusion in piss / 中国医师杂志

Objective To study the value of two-dimensional Echocardiography(2DE)and doppler tissue synchronization imaging (TSI) during early diagnosis of close myocardial contusion.Methods 9 small Guizhou-Panama pigs were used.The close myocardial contusion animal model was successfully established by using the serf made small impactor.Echocardiography wag applied before and after injury for 0.5,2,4,8 and 12h respectively,these data were analyzed together with the TYC pathological results.Results After the strike for 0.5h,the location and area of the damage call be directly and rapidly shown by 2DE and TSI,which showed that after myocardial contusion (MC),main damaged areas are anterior and lateral myocardial walls.After myocardial contusion MC,three echocardiography techniques were used to observe the scale of the abnormal segment,the movement of the myocardial wall,Time tO Peak of Systolic Velocity and wall motion segmental inter(WMSI),Time to Peak of Systolic Velocity index(TPI),which all were increased than that pre-injury.Conclusion 2DE and TSI can be used for accurately early diagnosis of the location of myocardial contusion.TSI is more specific for the diagnosis of myocardial contusion.

Early survival analysis and tissue typing of 9 cases of cardiac transplantation / 中华器官移植杂志

Objective To evaluate the matching degree of donor's and receptor's tissue typing and analyze the relationship between the degree and the early survival of cardiac transplantation with donor's and receptor's tissue typing of 9 cases of cardiac transplantation. Methods In accordance with the international standard, donor's and receptor's blood type, HLA antibody, lymphocytotoxicity and panel reactive antibody were determined in 9 cases of cardiac transplantation, and the donor's and receptor's matching degree evaluated by methods of amino acid triplets and cross-reactive group. Results Of 9 cases, 6 survived while 3 died. Of the 3 dead cases, 2 came respectively from the two best comprehensively evaluated matching cases and two worst, and postoperative biopsy showed that there was no rejection in either survival cases or the dead cases. Conclusion With the effective immunosuppressant, the HLA typing doesn't affect the early survival.

PERIOPERATIVE TREATMENT IN 11 CASES OF ORTHOTOPIC ALLOGENEIC HEART TRANSPLANTATION / 解放军医学杂志

Objective To summarize the experience of 11 orthotopic allogeneic heart transplantations for patients suffering from terminal heart disease, and to discuss how to improve the selection of donor and recipient, protection for the donated heart, postoperative treatment and immune surveillance suitable for our country. Methods 1.All the donated hearts were protected by perfusing cold modified St.Thomas cardioplegia and cold oxygenated blood. 2. Orthotopic heart transplantation was performed with the standard technique of medium low temperature extracorporeal circulation. 3. FK506, mycophenolate mofetil(MMF) and steroid were given to prevent rejection. 4. Troponin I, ? 1 and ? 2 microglobulin, C reactive protein (CRP), interleukins, lymphocyte subgroups and mixed lymphocyte reaction (MLR) were employed to monitor the immune rejection reactions. Furthermore, myocardial biopsy and coronary arteriography were conducted periodically. Results Three patients died of systemic failure and infection due to hepatic failure and mental disorder after operation. All the others survived with no complications. Conclusion Strictness in selection of the recipient, high quality of donor heart, correct early postoperative treatment and sound use of immunosurppressant are key to achieving successful cardiac transplantation.