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Inflammatory response to coronary artery bypass surgery: Does the heme-oxygenase-1 gene microsatellite polymorphism play a role?

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Chinese Medical Journal 2005年第15期118卷 1285-1290页

作者： LI Ping Jules Sanders Emma Hawe David Brull Hugh Montgomery Steve Humphries Cardiovascular Department Second Affiliated Hospital of Jiangxi Medical College Nanchang 330006 China Centre for Cardiovascular Genetics British Heart Foundation Laboratories Department of Medicine Royal Free ＆ University College London Medical School Rayne Building 5 University Street London WC1E 6JF UK

Background Heme-oxygenase 1 （HO-1） is a rate-limiting enzyme in the degradation of heme to bilirubin, ferritin and carbon monoxide （CO） and may have significant anti-inflammatory function. The HO-1 gene promoter region shows microsatellite polymorphism with different （GT）n repeats, reported to differently induce gene expression, with the short allele associated with higher gene expression. We measured the acute inflammatory response using coronary artery bypass surgery （CABG） as a well-characterized and uniform stimulus and examined the correlation between levels of IL-6, C-reactive protein （CRP） and fibrinogen and their relationship to HO-1 genotype. Methods Two hundred and seventy-five consecutive patients undergoing CABG were genotyped for the HO-1 promoter polymorphism using PCR and automated DNA capillary sequencer. IL-6, CRP and fibrinogen were measured at baseline and 6, 24, 48, 72, 96 and 120 hours after CABG. Results Complete IL-6, CRP and fibrinogen measures were available in 220 patients. Before surgery IL-6 levels showed a strong correlation with CRP and fibrinogen （ r = 0. 48, P 〈 0. 0001 ; r = 0. 41, P 〈 0. 0001 respectively）, with a significant correlation between CRP and fibrinogen （r=0. 61, P 〈 0. 0001 ）. All three acute phase reactants showed a significant increase after CABG. After surgery, peak IL-6 was strongly correlated with peak CRP （r=0. 34, P =0.0009） but not with peak fibrinogen （r=0. 15, P =0. 13 ）, while peak CRP and peak fibrinogen were significantly correlated （r = 0. 15, P 〈 0. 0001 ）. HO-1 allelic repeats ranged from 22- 42, with （GT）25 and （GT）32 being the two most common alleles, and subsequently divided into three groups according to previous published work：〈 30 （GT） n were designated as S （short） , 30 - 37 （GT） n as M （middle） and long repeats with 〉 37 （GT） n as L （long） ; allele frequency 0. 35, 0. 58 and 0.07 respectively. Baseline CRP differed by genotype： those carrying at least one long allele having higher CRP than those

关键词： heine oxygenase polymorphism inflammation bypass surgery

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Achalasia after bariatric Roux-en-Y gastric bypass surgery reversal

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World Journal of Gastroenterology 2017年第37期23卷 6902-6906页

作者： Mouhanna Abu Ghanimeh Ayman Qasrawi Omar Abughanimeh Sakher Albadarin Wendell Clarkston Division of Gastroenterology Henry Ford Hospital Department of Internal Medicine University of Missouri-Kansas City Division of Gastr-oenterology Saint Luke’s Hospital of Kansas City

Achalasia is a rare esophageal motility disorder that is characterized by a loss of peristalsis in the distal esophagus and failure of lower esophageal sphincter relaxation. The risk of developing esophageal motility disorders, including achalasia, following bariatric surgery is controversial and differs based on the type of surgery. Most of the reported cases occurred with laparoscopic adjustable gastric banding. To our knowledge, there are only three reported cases of achalasia after Roux-en-Y gastric bypass and no reported cases after revision of the surgery. We present a case of a 70-year-old female who had a previous history of Roux-en-Y gastric bypass with revision. She presented with persistent nausea and regurgitation for one month. Esophagogastroduodenoscopy showed a dilated esophagus without strictures or stenosis. A barium study was performed after the endoscopy and was suggestive of achalasia. Those findings were confirmed by a manometry. The patient was referred for laparoscopic Heller's myotomy.

关键词： Esophagus Bariatric Gastric band bypass surgery Achalasia Esophagogastroduodenoscopy Heller's myotomy Motility disorder

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Off-pump and on-pump coronary artery bypass surgery:reply to Dr. Shahzad G Raja

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Chinese Medical Journal 2004年第6期117卷 960-960页

作者： ChenXin DepartmentofThoracicandCardiovascularsurgery NanjingFirstHospitalNanjingMedicalUniversityNanjing210006China

To the editor:We appreciate Dr. Shahzad's interest in our study and his comments regarding off-pump coronary bypass grafting.

关键词： bypass surgery coronary bypass grafting

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The Role of Chlamydia pneumoniae in the Atherosclerotic Process of Patients under 50 Years of Age Who Underwent Coronary Artery bypass Graft surgery

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World Journal of Cardiovascular surgery 2013年第5期3卷 146-151页

作者： Selami Gurkan Suat Canbaz Ozcan Gur Serhat Huseyin Turan Ege Enver Duran Department of Cardiovascular surgery Namik Kemal University HospitalTekirdagTurkey Department of Cardiovascular surgery Trakya University HospitalEdirneTurkey

Background: To evaluate the presence of C. pneumoniae DNA in the tissues and C. pneumoniae DNA antibodies in the blood samples of patients who underwent CABG surgery. Material and Methods: Fifty-one patients aorta. C. pneumoniae DNA was evaluated in the tissues collected from the atrium, left internal thoracic artery and ascending aorta of patients. Results: Although, C. pneumoniae DNA was negative in the atrial and left internal thoracic artery tissues of all patients, it was positive in the tissues obtained from the ascending aortas of twelve patients. C. pneumoniae DNA positivity was significantly higher in patients with increased aortic intimal thickness compared to those without increased aortic thickness. Conclusion: The question whether C. pneumoniae is triggering atherosclerosis or is involved as a super-infection could not be clarified.

关键词： bypass surgery Chlamydia pneumoniae Atherosclerosis

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胃旁路术缓解2型糖尿病的机制

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中华糖尿病杂志 2009年第3期1卷 -页

作者：曹怡邹大进第二军医大学附属长海医院内分泌科上海200433

目前已有证据表明,外科手术治疗能够使50%～85%的严重肥胖者获得持久的体质量减轻以及糖尿病的缓解,并且显著降低患者的死亡率 [1].在众多外科减肥手术中,Roux-en-Y胃旁路术(Roux-en-Y gastric bypass,RYGB)由于具有长期稳定的减重以及... 详细信息

目前已有证据表明,外科手术治疗能够使50%～85%的严重肥胖者获得持久的体质量减轻以及糖尿病的缓解,并且显著降低患者的死亡率 [1].在众多外科减肥手术中,Roux-en-Y胃旁路术(Roux-en-Y gastric bypass,RYGB)由于具有长期稳定的减重以及改善胰岛素抵抗的作用而成为重度肥胖的首选治疗方法之一.

关键词：胃旁路术型糖尿病机制 bypass surgery control Roux-en-Y 外科手术治疗胰岛素抵抗重度肥胖治疗方法外科减肥体质量死亡率手术中肥胖者证据稳定减重患者持久

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Treatment of portal hypertension from portal vein cavernoma with the meso-Rex bypass

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Chinese Medical Journal 2013年第5期126卷 971-973页

作者： LI Jin-liang CHEN Wei-xiu XU Chang-xian WANG Ruo-yi CHEN Yu-li Division of Pediatric surgery Department of Surgery SecondHospital and Medical School of Shandong University JinanShandong 250033 China

Extrahepatic or prehepatic portal vein cavernoma and thrombosis is a more common condition in children than that in adult patients with extrahepatic or prehepatic portal vein obstruction （EHPVO）, which involves approximately 30% of children with portal hypertension and can involve all the portal hypertension complications. Cavernomatous transformation of the portal vein is common after portal thrombosis in non-cirrhotic patients. This challenging situation is relatively more frequent after liver transplantation, particularly in pediatric recipients. Acute bleeding from esophageal and gastric varices is temporarily treated by sclerotherapy or variceal banding. Children who experience continued bleeding despite medical management or who experience clinically significant hypersplenism are referred for surgery.

关键词： hypertension portal extrahepatic bypass surgery

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Significance of a new hemodynamic classification of recipient vessels in predicting postoperative hyperperfusion during STA-MCA bypass for adult patients with moyamoya disease

Significance of a new hemodynamic classification of recipien...

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第十四届中国医师协会神经外科医师年会

作者： Jianjian Zhang Jincao Chen

BACKGROUND: Postoperative cerebral hyperperfusion（CHP） could cause severe complications after superficial temporal artery-middle cerebral artery（STA-MCA） bypass surgery for adult patients with moyamoya disease（MMD）. OBJECTIVE: We aim to predict the occurrence of CHP through a new classification by the hemodynamic sources of the parasylvian cortical arteries（PSCAs） which is commonly selected as the recipient vessels. METHODS: We retrospectively collected data of consecutive adult MMD patients that underwent combined revascularization. The PSCAs were classified as M-PSCA, A-PSCA, CA-PSCA, P-PSCA and E-PSCA based on their hemodynamic sources from MCA, anterior cerebral artery（ACA）, contralateral ACA, posterior cerebral artery（PCA） and extracranial artery（ECA）, respectively. Their distributional characteristics were studied. The patients’ demographics, incidence of postoperative CHP, and post-/pre-operative relative cerebral blood flow（rCBF） values were analyzed. RESULTS: A total 68 patients（75 hemispheres） were identified. The total incidence of postoperative focal CHP was 42.7%（32/75）. The M-PSCA group had a significant higher risk of focal（26/45, 57.8%） and symptomatic CHP（12/45, 26.7%） than the non-M-PSCA group（focal, 6/30, 20%;symptomatic, 2/30, 6.7%, both P ＜.05）. The post-/pre-operative rCBF values of the M-PSCA group were significantly higher than the non-M-PSCA group（P ＜.001）. 12（85.7%） in the 14 symptomatic CHPs and all the 4（100%） postoperative hemorrhages were from the M-PSCA group. CONCLUSIONS: Preoperative classification of PSCAs is recommended in the surgical procedure of STA-MCA anastomoses for adult MMD patients, which may help to predict the occurrence of postoperative CHP.

关键词： moyamoya disease cerebral hyperperfusion cerebral blood flow hemodynamics bypass surgery

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Intimal hyperplasia thickness and blood flow in an axis-deviated arterial bypass

Intimal hyperplasia thickness and blood flow in an axis-devi...

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中国畜牧兽医学会2010年学术年会——第二届中国兽医临床大会

作者： Zaipin Xu~1,Wei Zhao~1,Anqiang Sun~2,Xiaoyan Deng~2,Yubo Fan~2,Qingyu Wang~1, Dingkun Wang~1,Junbo Gao~1,Peng Luo~1,Yao Peng~1,Yuhuan Lv~1,Zhe Ma~1,Ke Wang~3 (1.Department of Veterinary medicine,College of Animal Science,Guizhou University, Guiyang 550025,China 2.Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University,Beijing 100191,China 3.The First Affiliation Hospital,Dalian Medical University,Dalian 116011,China)

Extensive work has shown that slow recirculation flow zone with low wall shear stress and high oscillatory shear index occurred in a bypassed artery is an important factor for the development of intimal hyperplasia(IH) in the distal *** substantiate our hypothesis that intentionally inducing swirling flow in a bypassed artery can suppress IH development along the floor of the host artery,we constructed an axis-deviated arterial bypass(ADAB) on canine common carotid artery in which swirling flow was created in the host artery and compared it with a conventional arterial bypass(CAB) in terms of IH development along the host artery *** flows in the two bypass models were characterized *** animal experiment showed that intimal thickness was 110.50±9.62μm in the CAB group and 60.32±3.52μm in the ADAB group, *** blood flow simulation revealed that the flow structure in the host artery of the ADAB model was in the form of swirling flow that was very different from the vortex flow in the conventional model,which characterized with flow stagnation and low wall shear stress along the host artery *** swirling flow created by the axis-deviated bypass eliminated the stagnation flow and enhanced wall shear stress,hence suppressed IH development along the host artery ***,the present study has pointed out a new way to eliminate and/or suppress the slow recirculation flow zones in bypassed arteries.

关键词： Axis-deviated arterial bypass bypass surgery Intimal hyperplasia Computational fluid dynamics Swirling flow Canine

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