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find Author "高长青" 27 results
  • Recent Research and Development of Aspirin Resistance after Coronary Artery Bypass Grafting

    Abstract: Coronary artery bypass grafting (CABG) has become more and more popular, but how to decrease the thrombotic stenosis of saphenous vein grafts remains a tough problem clinically. Some researchers raised that aspirin resistance (AR) may be one of the most principal causes of graft thrombus and many correlative studies have been reported in recent years.In this article, we reviewed and analyzed the concept and evaluation criterion, incidence rate, mechanisms, clinic significance, and preventing strategy of AR, expecting to deepen the understanding of AR and help to optimize the antiplatelet therapy for postCABG patients with AR.

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  • The Advance of Bone Marrow Mononuclear Cell Transplantation in Treating Ischemia Heart Disease

    The bone marrow mononuclear cell(BMMNC) subset comprises mesenchymal stem cells, hematopoietic stem cells, endothelial progenitor cells. These cells can differentiate into cardiomyocytes, vascular endothelial cells and smooth muscle cells, and they can also release a wide array of cytokines that exert their effects on surrounding cells, including inducing neovascularization, preventing apoptosis of home cells and homing of endogenous systemic repairing cells. Many trials have been developed to evaluate the effect of bone marrow mononuclear cell transplantation in treating ischemia heart diseases in this country and others. Several routes have been used to deliver these cells to human myocardium or to the coronary circulation in these trials, such as intracoronary injection, intravenous infusion, direct injection into the ventricular wall, or transepicardial/transendocardial infusions,and the cells are constructed into fragmented cell sheets to improve cell retention, or some cytokines are used to enhance therapeutic effect. Although the results of the recent clinical trials in this area are rather conflicting, these therapeutic approaches seem to be promising forthe treatment of ischemic heart disease. In this review, many aspects of bone marrow mononuclear cell transplantation in myocardial infarction are summarized such as the mechanism, delivery routes, retaining of cells, homing, survival and future development, etc. 

    Release date:2016-08-30 06:06 Export PDF Favorites Scan
  • Magneticaly Labeled Stem Cells and Magnetic Resonance Imaging Tracking in Vivo

    Magneticaly labeled stem cells and magnetic resonance imaging(MRI) technology is an effective tracking method in vivo study, which has high spatial-temporal resolution. Gadolinium, which shows positive T1 signals and iron oxide showing negative T2 signals are the two often used contrast agents. The latter also include superparamagnetic iron oxide particle and ultrasmall superparamagnetic iron oxide particle. Transfection agents, e.g. poly-L-lysine and protamine sulfate,can enhance magnetical nanoparticles labeling stem cells. The biological characteristics of labeled stem cells did not seem to be altered. MRI can detect the labeled stem cells’ signals and also can track changes of signal in intensity and size with time past. In conclusion, MRI tracking magneticaly labeled stem cells represents a method for noninvasivly monitoring the existence and migration of engrafts.

    Release date:2016-08-30 06:04 Export PDF Favorites Scan
  • Mitral Valvuloplasty for the Treatment of Mitral Regurgitation

    Abstract: Compared with mitral valve replacement, there areseveral advantages in mitral valvuloplasty, so recently more and more sights are caught on mitral valve repair. According to different etiology, the surgeon can apply annuloplasty, triangular resection, quadrangular resection, replacement or transposition of chordae tendineae and so on to treat mitral regurgitation(MR). With the development of minimally invasive surgical technology, robotic mitral valve reconstruction evolve rapidly and percutaneous interventional therapy also commence from lab to bedside.We believe surgeons can repair MR safely and successfully in the majority of patients with proficiency in the basic techniques.

    Release date:2016-08-30 06:08 Export PDF Favorites Scan
  • 原发性心包肿瘤的诊断与治疗

    目的 总结原发性心包肿瘤的诊断和外科治疗方法,以进一步提高其疗效。 方法 2005 年4 月至2009 年9 月中国人民解放军总医院共收治非囊肿性原发性心包肿瘤患者7 例,男3 例,女4 例;平均年龄47(33 ~ 64)岁。 4 例完整切除肿瘤,其中1 例因侵犯相邻肺组织而将相应肺叶切除;2 例行姑息性切除;1 例探查后取一小块组织行活组织检查。 结果 无院内死亡。术后病理证实4 例为恶性,3 例为良性。恶性肿瘤患者术后2 例行化疗,1例行放疗;随访3 例,分别于术后3 个月、7 个月和11 个月后死亡。良性肿瘤患者术后随访6 ~ 8 个月,未见复发。结论 良性肿瘤一经确诊应尽早手术切除;恶性心包肿瘤较易误诊,如无远处转移,应积极争取手术治疗,化疗和放疗效果均不理想。

    Release date:2016-08-30 05:48 Export PDF Favorites Scan
  • Clinical Characteristics of Young Patients with Stanford Type A Aortic Dissection

    Abstract: Objective To summarize the clinical characteristics of young patients with Stanford type A aortic dissection. Methods We retrospectively analyzed 54 patients with Stanford type A aortic dissection who received surgical treatment in General Hospital of PLA between March 2004 and June 2011. All the patients were divided into two groups: a young patient group with patients’ age less than 40 years and a control group with patients’ age more than or equal to 40 years. There were 23 patients including 17 males and 6 females with an average age of 34.2±6.3 years in the young patient group and 31 patients including 27 males and 4 females with an average age of 51.5±6.8 years in the control group. The clinical characteristics and surgical treatment outcomes of the two groups were compared. Results There was no statistical difference in cardiopulmonary bypass(CBP)time(224.4±83.1 min vs. 215.0±88.0 min, t=0.39, P=0.69) and aortic cross-clamping time(152.3±60.8 min vs. 130.9±51.2 min, t=1.34, P=0.18)between the two groups. Compared with the patients in the control group, young patients were more likely to have congenital malformations with rate at 34.7%(8/23) vs. 6.4%(2/31) with χ2=5.27, P=0.02, such as Marfan syndrome and bicuspid aortic valve. The mortality of the young patients was similar to patients in the control group at rate of 13.0%(3/23)vs.12.9%(4/31) with χ2=0.15 and P=0.69, but postoperative mental and neurological complications rate in the young patient group were less frequent than those in the control group at 4.3%(1/23)vs. 32.2%(10/31) with χ2=5.32 and P=0.02. Conclusion Young patients with Stanford type A aortic dissection have fewer cardiovascular risk factors for aortic dissection but are more likely to have congenital malformations. The surgical methods are more active for young patients with less frequency of postoperative mental and neurological complications.

    Release date:2016-08-30 05:50 Export PDF Favorites Scan
  • 尿毒症患者血液透析期间行体外循环心脏手术二例

    Release date:2016-08-30 05:49 Export PDF Favorites Scan
  • 三尖瓣置换术治疗Ebstein畸形合并巨大心脏一例

    Release date:2016-08-30 05:50 Export PDF Favorites Scan
  • 心脏病合并甲状腺功能减退症患者的外科治疗

    目的 总结心脏病合并甲状腺功能减退症患者行外科手术治疗的临床经验。 方法 回顾性分析2001年9月至2009年5月解放军总医院19例心脏病合并甲状腺功能减退症患者行外科手术治疗的临床资料,男7例,女12例;年龄50~76岁,平均年龄63.20岁。冠心病15例,主动脉瓣狭窄1例,房间隔缺损1例,慢性心包炎2例;均合并甲状腺功能减退症。所有患者术前给予左旋甲状腺素钠(40~120 mg/d)口服治疗,根据其耐受程度、促甲状腺激素和甲状腺激素水平调整用量,将甲状腺激素水平调整至基本正常。行体外循环冠状动脉旁路移植术6例,非体外循环冠状动脉旁路移植术9例,房间隔缺损修补术1例,主动脉瓣置换术1例,心包剥脱术2例。术后按原剂量或加量口服左旋甲状腺素钠片,检测手术前、后甲状腺激素指标的改变。 结果 无手术死亡,术后所有患者均未发生低三碘甲状腺原氨酸(T3)综合征,甲状腺功能指标与术前比较均有不同程度的降低,以血清总三碘甲状腺原氨酸和血清游离三碘甲状腺原氨酸降低最为明显,体外循环手术患者下降幅度更大。术后继续给予甲状腺素钠口服,并持续服用维持量的甲状腺素钠。随访19例,随访时间4~7个月,随访期间均持续服用维持量的甲状腺素钠,心功能分级(NYHA)Ⅰ级14例,Ⅱ级5例;患者恢复正常生活。 结论 合并甲状腺功能减退症的心脏病患者行心脏手术是安全、可行的,体外循环和非体外循环心脏手术后甲状腺激素均有所降低,体外循环手术患者下降更明显,术后应警惕发生低T3综合征和低T3、T4综合征。

    Release date:2016-08-30 05:57 Export PDF Favorites Scan
  • Comparison Between Midterm Patency of Sequential and Individual Saphenous Vein Grafts after Off-pump Coronary Artery Bypass Grafting

    Abstract: Objective To compare the midterm patency rates of individual and sequential saphenous vein grafts (SVG) as coronary bypass conduits of offpump coronary artery bypass grafting (OPCAB) and evaluate the impact of the grafting techniques (individual or sequential grafts) on the graft patencyafter OPCAB. Methods The clinical data of 398 patients in General Hospital of the People’s Liberation Army receiving OPCAB with individual and sequential grafts from June 2005 to March 2009 were retrospectively analyzed. There were 301 males and 97 females with their age ranged from 53 to 82 years (63.6±10.3 years). A total of 714 distal coronary anastomoses on 448 SVG were assessed by using 64multislice computed tomography (64MSCTA) at an average of 19.8±23.6 months (3 months to 5 years) after OPCAB procedure. The blood flow of grafts in the proximal segment of individual and sequential SVG and the patency rates of grafts and anastomoses were compared, and the effect of different locations on the patency rate of the anastomoses was analyzed. Results The mean blood flow in double SVG (37.11±16.70 ml/min vs. 25.15±14.24 ml/min, P0.042) and in triple SVG (37.56±19.58 ml/min vs. 25.15±14.24 ml/min, P=0.048) were both significantly higher than the flow in single SVG. The anastomoses on the sequential conduits had better patency (95.1% vs. 90.1%, P=0.013). The patency of sideto side anastomoses was better than that of endtoside anastomoses (97.0% vs. 93.1%, P=0.002) and that of the individual endtoside anastomoses (97.0% vs. 90.1%, P=0.041). There was no significant difference between distal anastomoses in sequential and those in single grafts (P=0.253). No significant difference was observed between the two methods in regard to the three major coronary systems (including the anterior descending branch, the right coronary artery, and the circumflex branch). However, anastomoses on sequential grafts had superior patency to those on individual grafts in the right coronary system (P=0.008). Conclusion The midterm patency of a sequential SVG conduit after OPCAB is excellent and generally superior to that of an individual one. The best runoff coronary artery should be placed at the distal end and the poor coronary vessels should be arranged in the middle of the grafts.

    Release date:2016-08-30 05:57 Export PDF Favorites Scan
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