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find Author "孙宗全" 13 results
  • Role of Radial Artery Graft in Coronary Artery Bypass Grafting

    Abstract: Though the use of the radial artery (RA) as a coronary artery bypass graft has been accepted world widely in myocardial revascularization, there has been no uniformity regarding harvest techniques, assessment of the adequacy of hand collateral circulation, antispasm rotocols, selection of target vessels, and the site of proximal anastomosis. It is widely believed and practiced that the RA should be harvested as a pedicle graft and preferably be used to bypass critically stenosed (gt;70% stenosis) coronary arteries. It is used either as a free graft with proximal anastomosis to the ascending aorta or as a composite arterial graft along with the left or right internal thoracic artery. The patency of RA grafts depends on the severity of the target coronary artery stenosis and target artery location rather than its use as an aortocoronary conduit or composite graft. Though lacking of evidences, most surgeons use antispasm therapy for RA conduits. There are advantages in using RA as an alternative for right internal mammary artery in total artery coronary revascularization.

    Release date:2016-08-30 06:16 Export PDF Favorites Scan
  • 心瓣膜置换术同期行急诊冠状动脉旁路移植术五例

    Release date:2016-08-30 06:01 Export PDF Favorites Scan
  • Experimental Study on Immune Tolerance Induced by Semimature Dendritic Cells with MyD88 siRNA Transfection

    Abstract: Objective To investigate the phonetype and tolerogenic function of semimature dendritic cells (DC) transfected by myeloid differentiation marker 88(MyD88) small interfering ribonucleic acid(siRNA). Methods Bone marrow of BALB/c mice was inoculated and cultured in vitro,and induced into DC by 10ng/ml recombinated granulocyte macrophage colony stimulating factor (rmGM-CSF) ,then DC was divided into three groups at the 8th day: blank control group: added nothing; lipopolysaccharide (LPS)group: added with 1μg/ml LPS; and experimental group: added with 1μg/ml LPS after transfected by MyD88 siRNA for 4 hours. The phonetype of three groups was analysed by fluorescenceactivated cell sorting (FACS). The concentration of interleukin 10(IL-10)and interleukin 12(IL-12) in culture supernatant was detected by enzyme linked immunosorbent assay(ELISA).The function of stimulating alloreactive T cell roliferation were evaluated by primary and secondary mixed lymphocyte reaction (MLR). The cardiac allograft survival time was compared after DC of three groups injected into recipient mice. Results The phonetype of blank control group DC was CD11c+,CD25-,CD40low,CD80low,CD86low,MHC-Ⅱlow, which could be induced to mature DC by LPS. Experimental group DC was phonetypically semimature DC (CD11c+,CD25-,CD40mid,CD80low,CD86low,MHC-IIid) and the IL-10/IL-12 ratio of semimature DC increases significantly. yporesponsiveness of alloactive T cells can be induced by experimental group DC and the survive time of heart allograft was prolonged. Conclusion Immature DC could become semimature DC after transfected by MyD88 siRNA and stimulation by LPS. These semimature DC are more tolerogenic than immature DC.

    Release date:2016-08-30 06:16 Export PDF Favorites Scan
  • 右心室海绵状血管瘤冠状动脉旁路移植术一例

    Release date:2016-08-30 06:22 Export PDF Favorites Scan
  • 心脏手术后床边二次开胸止血94例

    目的总结体外循环心脏手术后床边二次开胸止血的经验,并分析出血的原因,以减少心脏手术后出血并发症的发生率。方法回顾性分析94例心脏手术后床边二次开胸止血患者的临床资料,其中先天性心脏病矫治术47例,心瓣膜置换术36例,冠状动脉旁路移植术5例,大血管病手术4例,心脏肿瘤摘除术2例。结果床边二次开胸见胸腔广泛渗血或心包腔、胸腔积血27例次,主动脉出血25例次,心脏出血24例次.胸骨出血18例次,其他原因引起的出血16例次。床边二次开胸止血术后死亡12例(12.77%),死亡原因为心搏骤停、呼吸衰竭、低心排血量和多器官功能衰竭等。术后伤口感染12例(12.77%)。结论术中严格止血是减少术后二次开胸止血的关键,减少二次开胸手术可降低患者的死亡率和伤口感染的发生率。

    Release date:2016-08-30 06:26 Export PDF Favorites Scan
  • Immature Mouse Myeloid Dendritic Cells Generated with Low-Dose Granulocyte-Macrophage Colony-Stimulating Factor Prolong Cardiac Allograft Survival

    Objective To observe the effect of transfer of immature mouse myeloid dendritic cells (DC) generated with low-dose granulocyte-macrophage colony-stimulating factor (GM-CSF) on cardiac allograft survival. Methods Mouse DC were generated with standard doses or low doses GM-CSF from bone marrow cells, the phenotype and functional properties of these DC were compared through fluorescence-activated cell sorting(FACS) analysis and mixed lymphocyte reaction(MLR), 1. 0 × 106 DC generated with low doses GM-CSF were administered to the recipients 7 days before transplantation, and the cardiac allograft survival were observed. Results In contrast to DC generated with standard doses, DC generated with low doses were phenotypically immature DC (CD11c+, CD80- , CD86- , MHCⅡlow), and induced allogeneic T cell unresponsiveness, and administration of these DC to recipients prolonged cardiac allograft survival from 6.3±1.2 days to 14.3±1.9 days. Conclusions DC generated from mouse bone marrow progenitors in low doses of GM-CSF are phenotypically and functionally immature, and prolong cardiac allograft survival when they are administered 7 clays before transplantation.

    Release date:2016-08-30 06:26 Export PDF Favorites Scan
  • 心肺移植术中对心肺保护的体会

    目的总结室间隔缺损合并艾森门格综合征(Eisenmengersyndrome)患者施行心肺移植术的经验。方法2003年6月25日为1例先天性室间隔缺损合并艾森门格综合征患者施行心肺移植术,采用改良St.Thomas号液保护心肌和Euro-Collins液保护肺。结果术中供者心肺保护良好,术后受者血流动力学稳定,呼吸功能恢复较快,现已生存500d,生活质量良好。结论术中良好的心肺保护、术后防治并发症是提高心肺移植生存率的重要因素。

    Release date:2016-08-30 06:25 Export PDF Favorites Scan
  • 小儿二尖瓣成形术

    目的 总结小儿二尖瓣成形术病例,探讨其适应证、术式选择、手术经验和临床效果. 方法 回顾性分析我科1998年1月~2002年1月收治的40例小于12岁二尖瓣成形术患者的临床资料,二尖瓣主要病变为:瓣叶裂21例,二尖瓣脱垂13例,单纯瓣环扩大6例;二尖瓣修复为二尖瓣裂隙对合21例,腱索转移、包埋14例,后瓣叶切除5例,前瓣叶切除1例,二尖瓣环缩19例.36例合并其它心内畸形者同期给予矫治. 结果 成形结束注水试验满意37例,顺利停机39例,停机后左心房压小于12 cmH2O(1kPa=10.2 cmH2O)33例,术后并发低心排血量2例,死亡1例. 结论 小儿二尖瓣成形术效果肯定,术者需要根据二尖瓣病理解剖及手术经验、技巧选择相应的成形方法,并采取有效手段进行功能评估.

    Release date:2016-08-30 06:30 Export PDF Favorites Scan
  • 抑肽酶对乙型病毒性肝炎患者体外循环术后凝血功能的影响

    目的探讨抑肽酶对乙型病毒性肝炎(HB)患者体外循环(ECC)心脏手术凝血功能的影响. 方法 52例心脏病患者中,合并HB 33例,未合并HB 19例.33例合并HB患者随机分为两组,A组:17例,ECC中应用抑肽酶;B组:16例,ECC中不用抑肽酶;对照组:19例,为未合并HB患者,ECC中不用抑肽酶.动态监测所有患者的凝血因子Ⅺ促凝活性(FXI:C)、抗凝血酶Ⅲ活性(AT-Ⅲ:A)和D-二聚体的水平变化. 结果 A组术后出血量和输血量明显少于B组(P<0.01);术前3组患者FXI:C,AT-Ⅲ:A和D-二聚体组间比较差别均无显著性意义(P>0.05);术后6小时、24小时,A组FXI:C明显高于B组(P<0.05);3组间AT-Ⅲ:A差别无显著性意义(P>0.05);ECC 20分钟至术后24小时,A组D-二聚体明显低于B组(P<0.01). 结论 HB患者ECC后存在较严重的凝血功能障碍;抑肽酶通过抑制继发性纤溶功能亢进,减少凝血因子的消耗,从而减少HB患者的出血量和输血量.

    Release date:2016-08-30 06:32 Export PDF Favorites Scan
  • 用培养人脐静脉内皮细胞法观察体外循环对内皮细胞的损伤作用

    目的 采用体外培养的人脐静脉内皮细胞(HUVEC),观察体外循环(CPB)后人体炎性血浆对内皮细胞(EC)的影响. 方法 选取风湿性心瓣膜病行人工瓣膜置换术患者20例,取不同时间点的CPB血浆.将已培养好的HUVEC随机分为4组,对照组:加入正常培养基;Ⅰ组:加入CPB 45分钟的血浆;Ⅱ组:加入CPB 90分钟的血浆;Ⅲ组:加入CPB 90分钟血浆+抑肽酶.观察未贴壁悬浮EC、组织型纤活酶激活物(t-PA)功能、EC分泌血小板颗粒膜蛋白-140(GMP-140) 、6-酮-前列腺素F1α(6-K-PGF1α)和乙酰胆碱刺激EC合成NO的变化. 结果 悬浮细胞数和t-PA,Ⅱ组和Ⅲ组显著高于对照组,Ⅲ组与Ⅱ组比较显著降低(P<0.01).各组间GMP-140差别均无显著性意义.6-K-PGF1α,Ⅰ组、Ⅱ组和Ⅲ组均显著高于对照组,Ⅲ组与Ⅱ组比较显著降低(P<0.05).NOⅠ组比对照组显著升高,Ⅱ组比对照组显著降低;Ⅲ组与Ⅱ组比较显著升高(P<0.05). 结论 CPB可激活或损伤EC,抑肽酶可减轻此作用,用培养的HUVEC研究CPB损伤EC的机制是一种可行的方法.

    Release date:2016-08-30 06:32 Export PDF Favorites Scan
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