Objective To evaluate the clinic outcomes of coronary artery bypass grafting (CABG) on patients of coronary artery disease complicated with chronic obstructive pulmonary disease(COPD). Methods The data of 27 patients of coronary artery diseases complicated with COPD who had received CABG from Jan. 1998 to Dec. 2004, were retrospectively summarized. 18 patients received off-pump CABG (off-pump group),and 9 cases received on- pump CABG (on-pump group). All patients accepted the evaluation about clinical respiratory complications, oxygenation index (PaO2/FiO2), related respiratory function index, plasma intercellular adhesion molecule 1 (ICAM-1) and the amount of neutrophil in pulmono-alveolar perfusion fluid at the different time point including the start of CPB (for off-pump group, the measurement accepted at the start of operation), end of CPB (end of operation for off-pump group), and at 2, 6, 12, and 24h after operation. Results There was no operation-related death in two groups. One died of respiratory failure 14 days after operation in the hospital in off-pump group, there were more respiratory complications in on-pump group than that in off-pump group, and PaO2/FiO2 in on-pump group was higher than that in off-pump group at CPB 30min (at the start of operation), but lower than that in off-pump group postoperative at 6 h, 12 h(P〈0. 05), the concentration of plasma ICAM-1 had obvious difference between two groups from CPB 30 min (at the start of operation) to post-operative 24 h (P 〈 0. 05). The neutrophils in bronchoalveolar lavage in on-pump group was higher than that in off-pump group from CPB 30 min (at the start of operation) to 24 h after operation (P〈0. 05). Conclusion Off-pump CABG seems more suitable than on-pump CABG for coronary artery disease patients with COPD due to less damage on oxygen-exchange capability and less respiratory complication.
The biocompatible hydrogel was fabricated under suitable conditions with natural dextran and polyethylene glycol (PEG) as the reaction materials. The oligomer (Dex-AI) was firstly synthesized with dextran and allylisocyanate (AI). This Dex-AI was then reacted with poly (ethyleneglycoldiacrylate) (PEGDA) under the mass ratio of 4∶6 to get hydrogel (DP) with the maximum water absorption of 810%. This hydrogel was grafted onto the surface of medical catheter via diphenyl ketone treatment under ultraviolet (UV) initiator. The surface contact angle became lower from (97 ± 6.1)° to (25 ± 4.2)° after the catheter surface was grafted with hydrogel DP, which suggests that the catheter possesses super hydrophilicity with hydrogel grafting. The in vivo evaluation after they were implanted into ICR rats subcutaneously verified that this catheter had less serious inflammation and possessed better histocompatibility comparing with the untreated medical catheter. Therefore, it could be concluded that hydrogel grafting is a good technology for patients to reduce inflammation due to catheter implantation, esp. for the case of retention in body for a relative long time.