ObjectiveTo analyze the variation of perioperative concentration of mitochondrial DNA (mtDNA) in circulation system after cardiac surgery with cardiopulmonary bypass (CPB). MethodsBetween July and December 2014, 40 continuous patients underwent aortic valve replacement (AVR) and mitral valve replacement (MVR) in Department of Cardiovascular Surgery, West China Hospital, Sichuan University, including 16 males and 14 females with their mean age of 48.7±11.0 years and mean body weight of 59.0±6.9 kg. Perioperative mtDNA concentrations of circulatory blood were tested at different time points:before general anesthesia (T1), 1 min before CPB (T2), reperfusion of the ascending aorta (T3), 6 h after operation (T4), 24 h after operation (T5), 48 h after operation (T6). ResultsAll the surgeries were successfully performed without early death. Postoperative complications were low cardiac output syndrome in 3 cases and acute kidney failure in 1 cases. The concentration of mtDNA in circulation system rising gradually after CPB. The mtDNA concentration of T3, T4 and T5 were significantly higher than T1 (P < 0.05). The peak level was observed at T5 and the mtDNA concentration of T6 was still significantly higher than that of T1 (P < 0.05). ConclusionThe concentration of mtDNA in circulation system was rising after CPB and peak level appeared at 24 h after CPB.
ObjectiveTo observe systemic inflammatory response (SIR)of patients in different stages after the onset of aortic dissection (AD), and preliminarily explore a new staging system of AD based on SIR. MethodsFrom September 2011 to February 2012, 46 AD patients were admitted to the Department of Cardiovascular Surgery, West China Hospital of Sichuan University. There were 33 male and 13 female patients with their age ranging from 22 to 77 years (53.2±13.6 years). Blood samples were collected in 9 different periods after the onset of AD (0-12 hours (T1), 12-24 hours (T2), 24-48 hours (T3, 1-2 days), 48-96 hours (T4, 2-4 days), 96-168 hours (T5, 4-7 days), 168-336 hours (T6, 7-14 days), 336-720 hours (T7, 14-30 days), 720-1440 hours (T8, 30-60 days) and > 1 440 hours (T9, > days))to measure blood concentrations of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), C-reactive protein (CRP), endotoxin (ET), white blood cell (WBC)and neutrophils (Neut). SIR changes after the onset of AD were summarized. ResultsBlood concentrations of different inflammatory mediators were all significantly elevated within 14 days (T1-T6), significantly decreased in 14-60 days (T7-T8), and returned to normal range 60 days (T9)after the onset of AD. Peak levels of ET and TNF-α appeared in T1 with 263.42±29.98 pg/ml and 86.75±18.83 pg/ml respectively. Peak level of IL-6 appeared in T2 with 95.70±22.64 pg/ml. Peak level of CRP appeared in T5 with 123.74±54.78 mg/L. There was no obvious peak level of WBC or Neut. ConclusionDisease progression of AD can be divided into 3 stages including acute stage (within 14 days), subacute stage (14-60 days)and chronic stage ( > 60 days)based on the degree of SIR.
ObjectiveTo study the growth of adipose-derived stem cells (ADSCs) planted in three-dimensional (3D) materials, a 3D cultured ADSCs system based on microbial transglutaminase (mTG) enzyme crosslinked gelatin hydrogel was constructed. MethodsADSCs were isolated from the subcutaneous adipose tissue of a Sprague Dawley rat by collagenase digestion and centrifugation, and were cultured for passage. The mTG enzyme crosslinked gelatin hydrogel was firstly synthesized by mixing gelatin and mTG, and then the ADSCs were encapsulated in situ (2D environment) and cultured in the 3D materials (3D environment). The morphology and adhesion of cells were observed by inverted phase contrast microscope. In addition, HE staining and Masson staining were carried out to observe the distribution of cells in the material. Living and death situation of ADSCs in the materials was observed by fluorescence microscope and laser scanning confocal microscopy. Scanning electron microscopy was used to observe the adhesion of ADSCs on hydrogel surface. Alamar-Blue method was used to detect the proliferation of ADSCs in the hydrogel. Moreover, the results were compared between the cells cultured in 2D environment and those in 3D environment. ResultsThe result of 2D culture showed that ADSCs grew well on the hydrogel surface with normal functioning and had good adhesion. The results of 3D culture showed that ADSCs grew well in 3D cultured mTG enzyme crosslinked gelatin hydrogel, and presented 3D shape. Cells obviously extended in all directions. The number of apoptotic cells was very small. The cells of 3D culture at each time point was significantly less than that of the conventional culture cells, difference was statistically significant (P < 0.05). But after 8 days culture, the proliferation of the cells cultured in the mTG enzyme crosslinked gelatin hydrogel increased more quickly. ConclusionADSCs can grow well with good adhesion and show high viability in 3D culture system constructed by mTG enzyme crosslinked gelatin hydrogel.
ObjectiveTo analyze the reason of 45 patients with cardiac valve reoperation and to evaluate the safety of redo heart valve replacement. MethodsWe retrospectively analyzed the clinical data of 45 patients in our hospital between January 2010 and January 2015. There were 45 patients with 14 males and 31 females at an average age of 51.21± 8.36 years. ResultsThree of 45 patients (6.67%) were died after surgery. Mean follow-up was 36 (4-68) months. A total of 42 patients were alive and without reoperation again. The main reasons of heart valve reoperation included lesions of untreated valve, paravalvular leakage, thrombosis associated with valvular dysfunction, bioprosthesis degeneration, endocarditis, valvular lesions after angioplasty. ConclusionTricuspid regurgitation should be treated aggressively when the mitral valve involved in the first operation. Patients received the secondary heart valve replacement is safe and effective. Strict follow-up system should be established and surgical intervention should be taken timely and appropriately.