ObjectiveTo investigate the feasibility of animal model of the reconstruction of right ventricular outflow tract in rats.MethodsA total of 15 female Sprague-Dawley (SD) rats underwent right ventricular outflow tract reconstruction surgery. Before the operation, the collagen scaffolds were treated with g 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide hydrochloride chemistry (EDC), and seeded with human bone marrow stem cells (h-MSCs). Three days after the surgery, 3 rats were randomly sacrificed to evaluate the transmural resection of right ventricular outflow tract. One or 3 months later, other 3 rats at each timepoint were sacrificed, stained with Masson’s Trichrome to observe the degradation of scaffold. Furthermore, 4 weeks after the surgery, 4 rats were sacrificed and the hearts were sliced. Anti-human mitochondria staining was used to identify the survival of seeding cells.ResultsThe transmural resection of right ventricular outflow tract was feasible in rats at an acceptable mortality (13.3%). After EDC treatment, the degradation rate of collagen scaffold was extended greatly. The seeding cells were detected by anti-mitochandria immunofluorescent staining in all patches 4 weeks after the operation.ConclusionRat model of right ventricular outflow tract reconstruction could be a stable, reliable and economical screening model for engineered heart tissue research.
The engineered heart tissues (EHTs) is regarded as a hope for myocardial repair and regeneration. But a series of " bottleneck” problems, such as vascularization, hinder their clinical translation. This review focuses on the strategies to vascularization of EHTs and encourages the emergence of novel EHTs that can meet clinic requirement properly.
Autologous blood patch pleurodesis (ABPP) was first proposed in 1987. Now it is mainly used to treat intractable pneumothorax and persistent air leakage after pneumonectomy, and also used to treat pneumothorax in children and other rare secondary pneumothorax. Persistent air leakage and pneumothorax of various causes are essentially alveolar pleural fistula. It can usually be treated by closed thoracic drainage, continuous negative pressure suction and surgery. Pleurodesis is a safe and effective alternative to surgery for patients who have failed conventional conservative treatment and can not receive operations. Compared with other pleurodesis adhesives, autologous blood (ABPP) is safer and more effective, and it is simple, painless, cheap and easy to be accepted by patients. But in the domestic and foreign researches in recent years, many details of ABPP treatment have not been standardized. For further research and popularization of ABPP, this article reviews the detailed regulations, efficacy and safety of this technology.
目的 探讨带记忆弹簧圈（MK）补片在无张力修补中、小切口疝中的应用。方法 回顾性分析2005年1月至2007年1月期间我院实施MK补片下置术修补腹壁中、小切口疝25例患者的临床资料，其中初发21例，复发4例。结果 22例一期愈合，3例发生切口皮下积液，经穿刺抽吸处理后治愈。住院7～15 d，均痊愈出院。随访10个月至2年，无复发病例。结论 用MK补片下置术修补腹壁中、小切口疝经济、安全、有效、感染风险降低。
目的 探讨改良区域神经阻滞麻醉在腹股沟疝无张力修补术中的优势和应用价值。方法 回顾性总结和分析2008年2月至2010年3月期间张掖医学高等专科学校附属医院运用改良区域神经阻滞麻醉行腹股沟疝无张力修补59例患者的临床资料。结果 59例患者按照神经阻滞麻醉效果分级标准，Ⅰ级52例，Ⅱ级6例， Ⅲ级1例。7例Ⅱ、Ⅲ级患者在分离腹膜前间隙内侧时自诉疼痛，经静脉给予杜非合剂2 ml后完成手术，但均未更改麻醉方式。术后无皮疹、皮下硬结、精索水肿、阴囊血肿、尿潴留、切口感染等并发症发生。结论 改良区域神经阻滞麻醉下行腹股沟疝无张力修补术效果好、安全性高、操作简单、费用低。
摘要:目的:回顾性研究大动脉转换术同时进行主动脉弓矫治的I期手术治疗完全性大动脉错位或TaussigBing合并主动脉弓畸形的早中期效果。方法:2000年1月至2008年12月,连续对26例存在主动脉弓畸形的完全性大动脉错位或TaussigBing畸形的小婴儿进行了I期手术矫治,其中完全性大动脉错位13例(TGA/VSD 11例,TGA/IVS 2例),TaussigBing 13例;主动脉弓畸形中主动脉弓中断(A型)7例,CoA19例,6例伴有冠状动脉异常类型。平均手术年龄(28±35) d,lt;2个月占62％,手术平均体重为(4.19±1.15) kg。在深低温停循环或深低温低流量下进行主动脉弓畸形矫治,采用自身组织直接吻合扩大或重建弓,伴有弓部发育不良者补片扩大成形。伴有冠状动脉畸形者在大动脉转换手术中冠状动脉移植方法予改良处理。〖HTH〗结果〖HTSS〗:手术住院死亡3例(11.5%),死因与冠脉移植无关。平均插管时间102 h,监护室时间平均8 d。术后早期生存者主动脉瓣上压力阶差gt;30 mm Hg有2例,主动脉瓣反流轻度2例。单因素分析中伴有冠状动脉异常类型者与术后早期死亡或并发症的风险相关,多因素分析示其与手术年龄、肺动脉高压、术前FS、主动脉阻断时间、术后血清乳酸水平相关。随访期3个月~7年,无死亡,术后5年实际生存率为88.5％(95％ 可信度范围CI 76％～96％),术后1年、5年无需介入干预或手术分别为91.4％、87％。结论:TGA和TaussigBing伴有主动脉弓畸形者I 期进行大动脉转换术和主动脉弓畸形矫治早中期效果良好,早期手术并发症和死亡的风险因素为年龄偏大,肺高压严重,把握手术时机是手术成功要则之一。Abstract: Objective: The study was to evaluate earlymid term results after onestage arterial switch operation (ASO) associated with aortic arch repair for D Transposition of the great arteries (DTGA) and TaussigBing Anomaly with arch abnormally in infant. 〖WTHZ〗Methods〖WTBZ〗: Between January 2000 and December 2008, a primary operation including aortic arch repair through a midline sternotomy was performed in 26 patients, 13 patients with DTGA and 13 TaussigBing. Most patients (62%) underwent operation during the first two months. The repair of arch was accomplished under deep hypothermic circulatory arrest or low flow, employing a wide pericardial patch to reconstruction of arch in some patients or direct ananstomosis. Results: There were 3 (11.5%) hospital deaths. The high risk factors for early mortality and morbidity were unsuitable reconstructed arch, higher age, severe pulmonary hypertension and longer aortic crossclamp time. There were no late deaths. Actuarial 5year survival was 88.5% (95% CI 70% to 96%). Actuarial freedom from overall reintervention, reoperation among operative survivors was 91.4% at 1 year and 87% at 5 years, respectively. Conclusion: the singlestage repair for DTGA and TaussigBing with aortic arch abnormally is suitable choice for infant, and followup of operative survivors is favorable. Optimal operative time was as sooner as possible.
The engineered heart tissues (EHTs) present a promising alternative to current materials for native myocardial tissue due to the unique characteristics. However, until now, the clinical application of EHTs is limited by a serial of practical problems yet. Generally, the challenges need to further optimize include biomaterials, cell sources, and strategies of revascularization or establishment of EHTs. This review focuses on the newly progress on these aspects to encourage the emergence of novel EHTs that can meet clinic requirement properly.
ObjectiveTo compare the efficiency of total extraperitoneal inguinal herniorrhaphy with laparoscopic technique using an innovative self-gripping mesh and polypropylene mesh. MethodsThe clinical data of 142 cases of unilateral inguinal hernia who underwent total extraperitoneal prosthesis (TEP) in our hospital form June 2012 to March 2015 were retrospectively analyzed. the operation type was total extraperitoneal inguinal herniorrhaphy with laparoscopic technique. Depending on the kind of mesh, all patients were divided into two groups from the self-gripping mesh group (n=60) and the polypropylene mesh group (n=82). ResultsThere was no significant difference in the operation time, intraoperative blood loss, hospital stay, and The Visual Analogue Score of post-operative (at 12, 24, 48, and 72 hours after operation) between the 2 groups (P>0.05). On the post-operative complications, there was no significant difference in incidences of total complication, scrotal edema, seroma, bladder injury, vascular injury of abdominal, and urinary reten-tion too (P>0.05). All the patients were followed up for 3-36 months (the median time was 19-month), and no recurrence occurred during the follow-up period. ConclusionInnovative self-gripping mesh is safe and effective, and maybe a good direction of mesh for material development.