Objective To evaluate the outcome of off-pump coronary artery bypass grafting （OPCABG） using a bilateral internal mammary artery （BIMA） Y configuration graft to achieve total arterial myocardial revascularization....Objective To evaluate the outcome of off-pump coronary artery bypass grafting （OPCABG） using a bilateral internal mammary artery （BIMA） Y configuration graft to achieve total arterial myocardial revascularization. Methods From October 2002 to December 2008, 208 patients （196 males and 12 females） underwent OPCABG using a BIMA Y configuration graft. The average age of the patients was 56.5 ± 11.3 years, with an age range of 33-78 years. A total of 167 （80.2%） cases had triple-vessel disease. Left main stem disease was found in 33 （15.9%） cases, and double-vessel disease was found in 8 （3.9%） cases. The semi-skeletonization technique was used to harvest the two internal mammary arteries （IMAs）, and then the free right internal mammary artery was connected end-to-side to the left internal mammary artery （LIMA） in situ to complete the Y configuration graft. Off-pump and sequential anastomosis methods were used to perform coronary artery bypass surgery in all patients. Graft patency was assessed intm-operatively with the HT311 transit time flowmeter. Results A total of 728 distal anastomoses were performed in 208 patients, with the average being 3.5± 1.3 per person. No one died or experienced recurrent angina within 30 days after the operation. Conclusions OPCABG using the BIMA Y graft was safe and effective to achieve total arterial revascularization. This method avoids surgical operation on the ascending aorta and other incisions.展开更多
Objective To analyze the short-term outcomes of redo coronary artery bypass grafting(CABG) using on-pump and off-pump CABG techniques. Methods From January 2003 to August 2013, non-randomized 80 patients were treated ...Objective To analyze the short-term outcomes of redo coronary artery bypass grafting(CABG) using on-pump and off-pump CABG techniques. Methods From January 2003 to August 2013, non-randomized 80 patients were treated with redo CABG in the Department of Cardiac Surgery, Peking University Third Hospital. Among these patients, 40 underwent on-pump CABG technique(redo-ONCAB group) and 40 underwent off-pump CABG technique(redo-OPCAB group). Furthermore, transmyocardial laser revascularization was performed in high-risk patients who were not suitable to conventional grafting. Clinical data of the two groups were recorded and analyzed including operation time, coronary grafts, incomplete revascularization, postoperative ventilation, perioperative stroke, and low output syndrome, etc. Results There were no significantly differences in age, gender distribution, incidences of hypertension, stroke, and other clinical characteristics between redo-OPCAB group and redo-ONCAB group(all P>0.05), except for incidences of renal dysfunction and pulmonary disease(all P<0.05). The number of grafting vessels in the redo-ONCAB and redo-OPCAB groups was 2.1 ± 0.74 and 1.4 ±0.52 respectively. There was significant difference between the two groups(P=0.0243). Compared with the redo-ONCAB group, there was shorter operation time(P=0.0045), postoperative ventilation(P=0.0211) and intensive care unit stay(P=0.0400), as well as fewer use of platelet(P=0.0338) and blood transfusion(P=0.0034) in the redo-OPCAB group. The incidence of incomplete revascularization(P=0.0253) and the use of transmyocardial laser revascularization(P=0.0052) were higher in the redo-OPCAB group than those in the redo-ONCAB group(all P<0.05). However, no significant differences were showed for the incidence of the use of intra aortic balloon pump and continuous renal replacement therapy, perioperative stroke, low output syndrome, and in-hospital mortality between the two groups(all P>0.05). Conclusion Redo CABG is the safety and efficacy surgical procedure, and redo-OPCAB technique with better outcomes is commended especially in high-risk patients.展开更多
An aircraft cabin is a narrow,closed-space environment.To keep the air quality in cabin healthy for passengers,especially during an epidemic such as SARS-CoV-2(or 2019-nCoV)in 2020,a novel aircraft air conditioning sy...An aircraft cabin is a narrow,closed-space environment.To keep the air quality in cabin healthy for passengers,especially during an epidemic such as SARS-CoV-2(or 2019-nCoV)in 2020,a novel aircraft air conditioning system,called the ultra-high-temperature instantaneous sterilization air conditioning system(UHTACS),is proposed.Based on the proposed system,a simulation of the UHT-ACS is analysed in various flight states.In the UHT-ACS,the mixing air temperature of return and bleed air can reach temperature up to 148.8°C,which is high enough to kill bacilli and viruses in 2一8 s.The supply air temperature of the UHT-ACS in a mixing cavity is about 12 C in cooling mode both on the ground and in the air.The supply air temperature is about 42 C in heating mode.Compared with the air conditioning systems(ACS)of traditional aircraft the supply air temperatures of the UHT-ACS in the mixing cavity are in good agreement with those of a traditional ACS with 60%fresh air and 40%return air.Furthermore the air temperature at the turbine outlet of the UHT-ACS is higher than that of a traditional ACS which will help to reduce the risk of icing at the outlet.Therefore the UHT-ACS can operate normally in various flight states.展开更多
While traditional open vein harvest was related to postoperative wound complications, endoscopic vein harvest was developed to minimize the morbidity in the greater saphenous vein harvest procedure. In this study, the...While traditional open vein harvest was related to postoperative wound complications, endoscopic vein harvest was developed to minimize the morbidity in the greater saphenous vein harvest procedure. In this study, these two procedures were compared for postoperative wound healing and long-term graft patency. We reviewed all consecutive patients undergoing elective off-pump coronary artery bypass grafting from January 2004 to December 2005 and collected data regarding wound complications and coronary events. Wound complications included dehiscence, excessive discharge, edema, altered sensation, cellulitis, hema-toma, pain scale, and superficial and deep wound infection. Coronary events were defined as diagnosis of myocardial infarction during the first year's follow-up. A total of 392 patients were included in our series, among whom 44 were excluded from the study due to emergent operation, preoperative intra-aortic balloon pump support, or the greater saphenous vein varicose characteristic, 78 belonged to open vein harvest group, and 270 to endoscopic vein harvest group. Wound complications were significantly less in the endoscopic group (5.2%) compared to the open group (19.2%) (P=0.0002). There was no significant difference on preopera-tive risk factors, total operative time, or hospitalization days. During one-year follow-up, both the early and late graft patency rates were similar between the two groups. Endoscopic vein harvest is safe and effective, which carries less risk for wound complica-tions and is associated with better satisfaction and cosmetic result than the traditional greater saphenous vein harvest procedure. The endoscopic vein harvest also demonstrates a great long-term patency.展开更多
Objective:To study the relationship between plasma adiponectin concentration and the functional activities of circulating endothelial progenitor cells(EPCs) in patients with coronary artery disease(CAD).Methods:Circul...Objective:To study the relationship between plasma adiponectin concentration and the functional activities of circulating endothelial progenitor cells(EPCs) in patients with coronary artery disease(CAD).Methods:Circulating EPCs were enumerated as AC133+/KDR+ cells via flow cytometry and identified by co-staining with DiI-acLDL and fluorescein isothiocy-anate(FITC)-conjugated lectin under a fluorescent microscope.The migratory capacity of EPCs was measured by modified Boyden chamber assay.Adhesion capacity was performed to count adherent cells after replating EPCs on six-well culture dishes coated with fibronectin.Results:The number of circulating EPCs(AC133+/KDR+ cells) decreased significantly in CAD patients,compared with control subjects [(74.2±12.3) vs(83.5±12.9) cells/ml blood,P<0.01].In addition,the number of EPCs also decreased in CAD patients after ex vivo cultivation [(54.4±8.6) vs(71.9±11.6) EPCs/field,P<0.01].Both circulating EPCs and differentiated EPCs were positively correlated with plasma adiponectin concentration.The functional activities of EPCs from CAD patients,such as migratory and adherent capacities,were also impaired,compared with control subjects,and positively correlated with plasma adiponectin concentration.Conclusion:The study demonstrates that the impairment of the number and functional activities of EPCs in CAD patients is correlated with their lower plasma adiponectin concentrations.展开更多
文摘Objective To evaluate the outcome of off-pump coronary artery bypass grafting （OPCABG） using a bilateral internal mammary artery （BIMA） Y configuration graft to achieve total arterial myocardial revascularization. Methods From October 2002 to December 2008, 208 patients （196 males and 12 females） underwent OPCABG using a BIMA Y configuration graft. The average age of the patients was 56.5 ± 11.3 years, with an age range of 33-78 years. A total of 167 （80.2%） cases had triple-vessel disease. Left main stem disease was found in 33 （15.9%） cases, and double-vessel disease was found in 8 （3.9%） cases. The semi-skeletonization technique was used to harvest the two internal mammary arteries （IMAs）, and then the free right internal mammary artery was connected end-to-side to the left internal mammary artery （LIMA） in situ to complete the Y configuration graft. Off-pump and sequential anastomosis methods were used to perform coronary artery bypass surgery in all patients. Graft patency was assessed intm-operatively with the HT311 transit time flowmeter. Results A total of 728 distal anastomoses were performed in 208 patients, with the average being 3.5± 1.3 per person. No one died or experienced recurrent angina within 30 days after the operation. Conclusions OPCABG using the BIMA Y graft was safe and effective to achieve total arterial revascularization. This method avoids surgical operation on the ascending aorta and other incisions.
文摘Objective To analyze the short-term outcomes of redo coronary artery bypass grafting(CABG) using on-pump and off-pump CABG techniques. Methods From January 2003 to August 2013, non-randomized 80 patients were treated with redo CABG in the Department of Cardiac Surgery, Peking University Third Hospital. Among these patients, 40 underwent on-pump CABG technique(redo-ONCAB group) and 40 underwent off-pump CABG technique(redo-OPCAB group). Furthermore, transmyocardial laser revascularization was performed in high-risk patients who were not suitable to conventional grafting. Clinical data of the two groups were recorded and analyzed including operation time, coronary grafts, incomplete revascularization, postoperative ventilation, perioperative stroke, and low output syndrome, etc. Results There were no significantly differences in age, gender distribution, incidences of hypertension, stroke, and other clinical characteristics between redo-OPCAB group and redo-ONCAB group(all P>0.05), except for incidences of renal dysfunction and pulmonary disease(all P<0.05). The number of grafting vessels in the redo-ONCAB and redo-OPCAB groups was 2.1 ± 0.74 and 1.4 ±0.52 respectively. There was significant difference between the two groups(P=0.0243). Compared with the redo-ONCAB group, there was shorter operation time(P=0.0045), postoperative ventilation(P=0.0211) and intensive care unit stay(P=0.0400), as well as fewer use of platelet(P=0.0338) and blood transfusion(P=0.0034) in the redo-OPCAB group. The incidence of incomplete revascularization(P=0.0253) and the use of transmyocardial laser revascularization(P=0.0052) were higher in the redo-OPCAB group than those in the redo-ONCAB group(all P<0.05). However, no significant differences were showed for the incidence of the use of intra aortic balloon pump and continuous renal replacement therapy, perioperative stroke, low output syndrome, and in-hospital mortality between the two groups(all P>0.05). Conclusion Redo CABG is the safety and efficacy surgical procedure, and redo-OPCAB technique with better outcomes is commended especially in high-risk patients.
基金the Project Funded by the Priority Academic Program Development of Jiangsu Higher Education Institutions(PAPD)and the Foundation of Jiangsu Postdoctoral(No.2019K126)。
文摘An aircraft cabin is a narrow,closed-space environment.To keep the air quality in cabin healthy for passengers,especially during an epidemic such as SARS-CoV-2(or 2019-nCoV)in 2020,a novel aircraft air conditioning system,called the ultra-high-temperature instantaneous sterilization air conditioning system(UHTACS),is proposed.Based on the proposed system,a simulation of the UHT-ACS is analysed in various flight states.In the UHT-ACS,the mixing air temperature of return and bleed air can reach temperature up to 148.8°C,which is high enough to kill bacilli and viruses in 2一8 s.The supply air temperature of the UHT-ACS in a mixing cavity is about 12 C in cooling mode both on the ground and in the air.The supply air temperature is about 42 C in heating mode.Compared with the air conditioning systems(ACS)of traditional aircraft the supply air temperatures of the UHT-ACS in the mixing cavity are in good agreement with those of a traditional ACS with 60%fresh air and 40%return air.Furthermore the air temperature at the turbine outlet of the UHT-ACS is higher than that of a traditional ACS which will help to reduce the risk of icing at the outlet.Therefore the UHT-ACS can operate normally in various flight states.
文摘While traditional open vein harvest was related to postoperative wound complications, endoscopic vein harvest was developed to minimize the morbidity in the greater saphenous vein harvest procedure. In this study, these two procedures were compared for postoperative wound healing and long-term graft patency. We reviewed all consecutive patients undergoing elective off-pump coronary artery bypass grafting from January 2004 to December 2005 and collected data regarding wound complications and coronary events. Wound complications included dehiscence, excessive discharge, edema, altered sensation, cellulitis, hema-toma, pain scale, and superficial and deep wound infection. Coronary events were defined as diagnosis of myocardial infarction during the first year's follow-up. A total of 392 patients were included in our series, among whom 44 were excluded from the study due to emergent operation, preoperative intra-aortic balloon pump support, or the greater saphenous vein varicose characteristic, 78 belonged to open vein harvest group, and 270 to endoscopic vein harvest group. Wound complications were significantly less in the endoscopic group (5.2%) compared to the open group (19.2%) (P=0.0002). There was no significant difference on preopera-tive risk factors, total operative time, or hospitalization days. During one-year follow-up, both the early and late graft patency rates were similar between the two groups. Endoscopic vein harvest is safe and effective, which carries less risk for wound complica-tions and is associated with better satisfaction and cosmetic result than the traditional greater saphenous vein harvest procedure. The endoscopic vein harvest also demonstrates a great long-term patency.
文摘Objective:To study the relationship between plasma adiponectin concentration and the functional activities of circulating endothelial progenitor cells(EPCs) in patients with coronary artery disease(CAD).Methods:Circulating EPCs were enumerated as AC133+/KDR+ cells via flow cytometry and identified by co-staining with DiI-acLDL and fluorescein isothiocy-anate(FITC)-conjugated lectin under a fluorescent microscope.The migratory capacity of EPCs was measured by modified Boyden chamber assay.Adhesion capacity was performed to count adherent cells after replating EPCs on six-well culture dishes coated with fibronectin.Results:The number of circulating EPCs(AC133+/KDR+ cells) decreased significantly in CAD patients,compared with control subjects [(74.2±12.3) vs(83.5±12.9) cells/ml blood,P<0.01].In addition,the number of EPCs also decreased in CAD patients after ex vivo cultivation [(54.4±8.6) vs(71.9±11.6) EPCs/field,P<0.01].Both circulating EPCs and differentiated EPCs were positively correlated with plasma adiponectin concentration.The functional activities of EPCs from CAD patients,such as migratory and adherent capacities,were also impaired,compared with control subjects,and positively correlated with plasma adiponectin concentration.Conclusion:The study demonstrates that the impairment of the number and functional activities of EPCs in CAD patients is correlated with their lower plasma adiponectin concentrations.
