Publications by authors named "Shouguo Yang"

21 Publications

  • Page 1 of 1

Simplified, minimally invasive, beating-heart technique for redo isolated tricuspid valve surgery.

J Cardiothorac Surg 2020 Jun 18;15(1):146. Epub 2020 Jun 18.

Department of Cardiovascular Surgery, Zhongshan Hospital, Fudan University, The Shanghai Institute of Cardiovascular Diseases, No. 1609 Xietu Road, Xuhui District, Shanghai, 200032, China.

Background: Redo isolated tricuspid valve surgery is associated with a high morbidity and mortality, and its optimal timing remains controversial. Hence, here we reviewed the early and midterm results of simplified, minimally invasive, beating-heart technique for redo isolated tricuspid valve surgery in patients at high risk.

Methods: A total of 32 consecutive patients underwent a redo isolated tricuspid valve surgery using minimally invasive, beating-heart technique through a right lateral thoracotomy in our center between June 2016 and April 2020. The mean age of patients was 57.4 ± 8.3 years, and 18 patients (56.3%) were women. The mean preoperative EuroSCORE was 7.8 ± 1.4 (range: 6-11). Follow-up was 87.1% complete, with a mean duration of 26.3 ± 12.3 months.

Results: Both in-hospital and 30-day mortalities were 3.1%. Tricuspid valve replacement with bioprosthesis was performed in 30 patients (93.8%), and the remaining two patients (6.2%) underwent tricuspid repair (annuloplasty and leaflet reconstruction). The mean cardiopulmonary bypass time was 81.5 ± 29.0 min. The overall in-hospital duration and intensive care unit (ICU) times were 13.6 ± 7.6 days and 4.1 ± 2.8 days, respectively. Postoperative complications included prolonged ventilation in six patients (18.8%), acute kidney injury in three patients (9.4%), and neurologic event, wound infection, or permanent third-degree atrioventricular block, in one patient (3.1%) each. A total of 96.9% patients were discharged uneventfully. Four patients were lost to follow-up; there were no midterm deaths in patients who were followed up.

Conclusions: Simplified, minimally invasive, beating-heart technique for redo tricuspid valve surgery is both feasible and safe, and the early and midterm results are excellent.
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http://dx.doi.org/10.1186/s13019-020-01192-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7301080PMC
June 2020

Suppression of microRNA-155 exerts an anti-inflammatory effect on CD4+ T cell-mediated inflammatory response in the pathogenesis of atherosclerosis.

Acta Biochim Biophys Sin (Shanghai) 2020 Jun;52(6):654-664

Department of Cardiac Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China.

In the current study, we aimed to investigate the effects of miR-155 on CD4+ T cell-mediated immune response in the pathogenesis of atherosclerosis. CD34+ hematopoietic stem cells, CD4+ T lymphocytes, endothelial cells (ECs), and vascular smooth muscle cells (VSMCs) were harvested from the same donor. Knockdown of miR-155 in the CD4+ T cells was achieved by lentiviral transfection, whereas control RNA-transfected or untransfected lymphocytes were used as controls. The transfected CD4+ T cells were activated by incubating with oxidized low-density lipoprotein-treated dendritic cells. The proliferative capacities, phenotype distribution, and cytokine secretion profiles of the activated CD4+ T cells from different groups were evaluated. The activated lymphocytes were used to treat ECs co-cultivated with VSMCs. The ability of the CD4+ T cells to induce the apoptosis of the ECs and to promote the proliferation of the VSMCs was investigated. Inhibition of miR-155 was found to significantly reduce the proliferation rate of the transfected CD4+ T cells. CD4+ T lymphocytes transfected with the miR-155 inhibitor showed increased populations of T helper type 2 and regulatory T cells, as well as more production of anti-inflammatory cytokines. MiR-155 knockdown was also shown to significantly hamper the ability to CD4+ T cells to induce EC apoptosis and to promote the growth of VSMCs. Our data suggested that inhibition of miR-155 in CD4+ T cells could slow down the formation of atherosclerotic plaques. These results lay the groundwork for future research on the therapeutic potential of miR-155 against atherosclerosis-associated cardiovascular diseases.
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http://dx.doi.org/10.1093/abbs/gmaa040DOI Listing
June 2020

Efficacy of Early Goal-Directed Renal Replacement Therapy for the Treatment of Acute Kidney Injury After Heart Transplantation: A Single-Center 10-Year Experience.

J Cardiothorac Vasc Anesth 2020 Jun 21;34(6):1534-1541. Epub 2019 Nov 21.

Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China; Shanghai Institute of Kidney Disease and Dialysis, Shanghai Laboratory of Kidney Disease and Dialysis, Shanghai Medical Center of Kidney Disease, Shanghai, China. Electronic address:

Objective: Acute kidney injury (AKI) after heart transplantation is a common and serious complication. The present study aimed to evaluate the efficacy of early goal-directed renal replacement therapy (GDRRT) for the treatment of AKI after heart transplantation.

Design: Retrospective, observational study.

Setting: Grade A tertiary hospital that performs more than 4,000 cardiac surgery procedures per year.

Participants: Patients who underwent heart transplantation with postoperative AKI and received renal replacement therapy from January 2008 to June 2018.

Interventions: Patients were divided into a late GDRRT group (LGDRRT) (January 2008-September 2012) or an early GDRRT group (EGDRRT) (October 2012-June 2018).

Results: The LGDRRT group comprised 30 patients, and the EGDRRT group comprised 46 patients. Duration between surgery to renal replacement therapy (RRT) initiation in the EGDRRT group was significantly shorter than in the LGDRRT group (1 [1-3] d v 2 [2-3] d; p = 0.020). The in-hospital mortality in the EGDRRT group was significantly lower than that of the LGDRRT group (39.1% v 63.3%; p = 0.039). After multivariate adjustment for confounding factors, the hazard ratio for death in the LGDRRT group relative to the EGDRRT group was 2.028 (95% confidence interval 1.072-3.655; p = 0.048). Length of intensive care unit and hospital stays in the EGDRRT group was significantly shorter than that of the LGDRRT group (26 ± 18 d v 38 ± 20 d; p = 0.008 and 38 ± 33 d v 64 ± 45 d; p = 0.005, respectively). The complete renal recovery rate was much greater in the EGDRRT group than that of the LGDRRT group (50.0% v 20.0%; p < 0.001). Serum creatinine at discharge was significantly less in the EGDRRT group than that of the LGDRRT group (134.8 ± 97.3 μmol/L v 220.7 ± 113.6 μmol/L; p < 0.001). Cost of RRT in the EGDRRT group was significantly less than that of the LGDRRT group (0.54 ± 0.10 v. 0.63 ± 0.11 ten thousand USD; p < 0.001).

Conclusions: For heart transplantation recipients with AKI, EGDRRT can reduce the in-hospital mortality and the length of intensive care unit and hospital stays, improve the complete renal recovery rate, and reduce the cost of RRT.
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http://dx.doi.org/10.1053/j.jvca.2019.11.022DOI Listing
June 2020

Complete plastid genome of (Rhodophyta) and phylogenetic analysis.

Mitochondrial DNA B Resour 2019 21;4(1):10-11. Epub 2018 Nov 21.

Hainan Academy of Ocean and Fisheries Sciences, Haikou, Hainan Province, People's Republic of China.

The complete plastid genome was determined and analyzed in this work. It had a circular mapping molecular with the length of 185,129 bp and contained 231 genes including 193 protein-coding, 3 rRNA, 1 tmRNA, 29 tRNA genes, and 5 unidentified open reading frames. Phylogenetic analysis showed that clustered together with and . The complete plastid genome provided in this work would be useful for elucidation of evolution.
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http://dx.doi.org/10.1080/23802359.2018.1535844DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7510674PMC
November 2018

Bicuspid aortic valve with critical coarctation of the aorta: single- or two-stage operation?

J Thorac Dis 2018 Jul;10(7):4353-4359

Department of Cardiac Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China.

Background: A bicuspid aortic valve (BAV) with critical coarctation of the aorta (CoA) is a rare but dangerous congenital cardiac malformation. The aim of this study was to compare the benefits of a single- versus two-stage operation for patients of BAV with CoA.

Methods: We retrospectively evaluated 20 patients of BAV and CoA who underwent surgery from 2000 to 2016 in our center. Eight patients underwent a single-stage procedure through a median sternotomy approach, while 12 patients underwent two-stage operation.

Results: The patients' baseline characteristics were similar between the two groups, and the overall mortality rate was 0%. No significant differences were found in the postoperative pressure gradient (P=0.64), use of implants (P=0.81), reoperation for bleeding, phrenic nerve injury, blood transfusion (P=1.00), or thromboembolic events between the two groups. However, patients in the single-stage group sustained less surgical trauma and ICU stay hours (P<0.01) than those in the two-stage group.

Conclusions: Performance of a single-stage operation was feasible for patients of BAV with CoA. It was a safe and optimal choice with less surgical trauma compared with a two-stage operation.
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http://dx.doi.org/10.21037/jtd.2018.06.112DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6105975PMC
July 2018

Survival after heart transplantation for non-metastatic primary cardiac sarcoma.

J Cardiothorac Surg 2016 Oct 3;11(1):145. Epub 2016 Oct 3.

Department of Cardiac Surgery, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, Shanghai, China, 200032.

Background: Heart transplantation is an uncommon treatment for unresectable and non-metastatic primary cardiac sarcomas, and the role of it is unclear. This study aims to offer a survival analysis of it.

Methods: This study consists of 6 patients from our institution and 40 patients identified in a literature search who underwent heart transplantation for non-metastatic primary cardiac sarcomas. Seven patients with unresectable cardiac angiosarcoma who received palliative therapies at our institution were included for comparison. All the clinicopathologic data were collected, retrospectively reviewed and statistically analyzed.

Results: Among the 46 patients receiving heart transplantation for primary cardiac sarcomas, the overall median survival was 16 months (2-112 months). The most common histologic type receiving heart transplantation was angiosarcoma. Its median survival time after heart transplantation (n = 14) was much less than that of other histologic types (n = 31) (9 vs 36 months; P = 0.002), which means it was not different from the median survival of 8 months for patients (n = 7) receiving palliative therapies (P = 0.768). The patients with grade 2 cardiac sarcomas (n = 5) survived much longer after heart transplantations than patients with grade 3 tumors (n = 15) (mean survival: 85 vs 18 months; P = 0.006). Neoadjuvant or adjuvant chemotherapy didn't provide survival benefits after heart transplantation.

Conclusions: Cardiac angiosarcoma seems to be not the proper indication of heart transplantation. The role of heart transplantation in other histologic subtypes still remains undefined. Lower grade and less aggressive histologic subtypes benefit more from heart transplantation.
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http://dx.doi.org/10.1186/s13019-016-0540-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5048623PMC
October 2016

Open aortic arch reconstruction for acute type a aortic dissection: a single-center experience with 267 consecutive patients.

J Cardiothorac Surg 2016 Jul 22;11(1):111. Epub 2016 Jul 22.

Shanghai Institute of Cardiovascular Disease, Zhongshan Hospital, Fudan University, Shanghai, China.

Background: This study aimed to analyze the mortality and morbidity of patients undergoing open aortic arch reconstruction for acute type A aortic dissection.

Methods: Between September 2005 and January 2012, 267 consecutive patients underwent open aortic arch reconstruction for acute type A aortic dissection at our center. The mean age was 51.2 ± 10.0 years, and 200 patients were male. Sixty-three and 184 patients underwent hemiarch replacement and total arch replacement, respectively, whereas the remaining 20 patients underwent single- or triple-branched stent graft implantation. Long-term mortality was estimated by Kaplan-Meier method.

Results: The in-hospital and operative mortality rates within 30 days were 11.2 % and 8.2 %, respectively. The cardiopulmonary bypass, myocardial ischemic, and antegrade cerebral perfusion times were 150.2 ± 43.3, 71.9 ± 33.2, and 33.6 ± 14.4 min, respectively. The overall in-hospital and intensive care unit durations and mean ventilation time were 23.9 ± 18.4 and 9.5 ± 12.7 days and 122.7 ± 183.4 h, respectively. We observed new postoperative permanent neurological dysfunction in 29 patients and temporary neurological dysfunction in 17 patients. The mean follow-up duration was 52.4 ± 27.9 months; 76.4 % of patients completed follow-up and 143 remained alive. Overall long-term survival was 82.2 % at 5 years.

Conclusions: The open aortic arch reconstruction technique for acute type A dissection carries a relatively high in-hospital mortality risk, although the late results are encouraging. Patients with an advanced age or impaired renal function may opt for endovascular or modified single- or triple-branched stent graft implantation therapy.
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http://dx.doi.org/10.1186/s13019-016-0500-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4957365PMC
July 2016

Tricuspid annular plane systolic excursion (TAPSE) can predict the outcome of isolated tricuspid valve surgery in patients with previous cardiac surgery?

J Thorac Dis 2016 Mar;8(3):369-74

1 Cardiac Department, Zhongshan Hospital Fudan University, Shanghai 200032, China ; 2 Cardiac Echocardiography Department, 3 Cardiac Department, Zhongshan Hospital Fudan University, Shanghai 200032, China.

Background: Isolated tricuspid valve replacement is rare when performed as a re-operation after a left side operation. It is important to know the factors that determine mortality and morbidity. Tricuspid Annular Plane Systolic Excursion (TAPSE) is a scoring system that is used with non-invasive Doppler echocardiography to determine right ventricular (RV) function. This study analyzed TAPSE scores and adverse outcomes of isolated tricuspid valve surgery in patients with previous cardiac surgery.

Methods: All patients who underwent tricuspid valve replacement between January 2014 and December 2015 were retrospectively reviewed. Patients having concomitant mitral or aortic valve surgery were excluded. These patients were divided into two groups: TAPSE >14 mm and TAPSE ≤14 mm. In-hospital outcomes were compared.

Results: A total of 26 patients with severe tricuspid valve regurgitation underwent tricuspid valve replacement. There were 5 males (19.2%) and 21 females (80.8%). The average age at operation was 54.77±9.61 years (range, 27-69 years). There were 16 patients in the TAPSE >14 mm group and 10 patients in the TAPSE ≤14 mm group. The BNP in the TAPSE >14 mm group was significant (TAPSE >14 mm 672.34±229.98 versus TAPSE ≤14 mm 1,054.79±684.69, P=0.03). The median cardiopulmonary bypass (CPB) time and red blood cell (RBC) transfusions in the two groups were not different. The need for prolonged ventilatory support (>48 h) in the two groups was also not different (TAPSE> 14 mm 91.2±12.31 vs. TAPSE ≤14 mm 39.00±36.80, P=0.46). Moreover, hospital stays were similar between the two groups. No differences were found in postoperative renal and respiratory complications.

Conclusions: It is important to determine the right ventricule function quantitatively. The TAPSE score is an important parameter that determines the cardiac index and right ventricle function. It should be used for the prediction of mortality and morbidity with all the other parameters as a whole.
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http://dx.doi.org/10.21037/jtd.2016.02.38DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4805791PMC
March 2016

Multiple-Parameter Estimation Method Based on Spatio-Temporal 2-D Processing for Bistatic MIMO Radar.

Sensors (Basel) 2015 Dec 14;15(12):31442-52. Epub 2015 Dec 14.

Air and Missile Defense College, Air Force Engineering University, Xi'an 710051, China.

A novel spatio-temporal 2-dimensional (2-D) processing method that can jointly estimate the transmitting-receiving azimuth and Doppler frequency for bistatic multiple-input multiple-output (MIMO) radar in the presence of spatial colored noise and an unknown number of targets is proposed. In the temporal domain, the cross-correlation of the matched filters' outputs for different time-delay sampling is used to eliminate the spatial colored noise. In the spatial domain, the proposed method uses a diagonal loading method and subspace theory to estimate the direction of departure (DOD) and direction of arrival (DOA), and the Doppler frequency can then be accurately estimated through the estimation of the DOD and DOA. By skipping target number estimation and the eigenvalue decomposition (EVD) of the data covariance matrix estimation and only requiring a one-dimensional search, the proposed method achieves low computational complexity. Furthermore, the proposed method is suitable for bistatic MIMO radar with an arbitrary transmitted and received geometrical configuration. The correction and efficiency of the proposed method are verified by computer simulation results.
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http://dx.doi.org/10.3390/s151229865DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4721785PMC
December 2015

Type A Aortic Dissection Occurring After Previous Cardiac Surgery.

J Card Surg 2015 Nov 8;30(11):830-5. Epub 2015 Oct 8.

Department of Cardiothoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China.

Background: We retrospectively reviewed our experience of total arch replacement in patients undergoing repair of an ascending aortic dissection following previous cardiac surgery.

Methods: Data were collected for patients with acute type A aortic dissection following previous cardiac surgery between January 2005 and December 2014. Clinical and prognostic features were retrospectively analyzed.

Results: Twenty-eight eligible patients (nonelective: 10, elective: 18) were identified. There was a mean period of 44.5 months between the first operation and the subsequent surgery. The overall 30-day mortality rate was 21.4%; 30.0% for nonelective patients and 16.7% for elective patients. Postoperative morbidity rate was higher among nonelective patients versus elective group. During follow-up, two patients died: one from intracranial hemorrhage and the other from a noncardiac cause. One patient received endografting as a result of the true lumen being compressed by the false lumen following aortic repair.

Conclusions: When hemodynamically stable, patients with acute ascending aortic dissection following previous cardiac surgery may have improved outcomes if the surgery can be performed on an elective basis.
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http://dx.doi.org/10.1111/jocs.12650DOI Listing
November 2015

Endothelial progenitor cells induce transplant arteriosclerosis via VEGFR-1/2 activity.

Atherosclerosis 2015 Jan 18;238(1):26-32. Epub 2014 Nov 18.

Department of Cardiothoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, No 180 Fenglin Road, Shanghai 200032, China. Electronic address:

Background: Acute rejection (AR) after organ transplantation results in transplant arteriosclerosis (TA). Endothelial progenitor cells (EPCs) are involved in tissue repair and blood vessel formation but are suspected to be a cause of TA.

Methods: In this study, we introduced a syngeneic and allogeneic abdominal aortic transplant model with C57BL/6 and BALB/c mice. Syngeneic and allogeneic grafts were histopathologically analyzed after transplantation. Bone marrow-derived EPCs were injected into transplant model animals to observe their distribution and temporal concentration changes. Changes of vascular endothelial growth factor receptor 1 (VEGFR-1), phosphorylated VEGFR-1 (pVEGFR-1), VEGFR-2, pVEGFR-2, protein kinase B (Akt), pAkt, extracellular signal-regulated kinase 1 (Erk1), pErk1 levels in EPCs upon VEGF165 and the VEGFR inhibitor Vandetanib exposure were analyzed in vitro with western blotting.

Results: In the allogeneic transplant group, two weeks after transplantation, formations of new intima layers could be observed, and its proliferation gradually increased to four and six weeks post-transplantation (p < 0.05), accompanied by significant arterial stenoses. Exogenous EPCs mainly localized to the damaged sites of the transplant arteries. In vivo, Vandetanib caused a significant dose dependent decrease of transplant hyperplasia (p < 0.05) and inhibited VEGF related proliferation, migration and adhesion of EPCs.

Conclusion: Vandetanib treatment can reduce arteriosclerosis induced by abdominal aorta transplantation by blocking VEGFRs in EPCs.
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http://dx.doi.org/10.1016/j.atherosclerosis.2014.11.014DOI Listing
January 2015

Repair for mitral valve aneurysm using autologous pericardium: a case of our experience.

J Cardiothorac Surg 2014 Sep 18;9:148. Epub 2014 Sep 18.

Mitral Valve Aneurysm (MVA) is rarely reported and occurs most in association with infective endocarditis of the aortic valve. In our case, the 46-yr-old Chinese man was referred to our hospital with dyspnea and orthopnea. Transesophageal echocardiography during operation revealed a localized, thin-walled saccular structure in the anterior leaflet that bulged into the left atrium, and severe mitral and aortic regurgitation. Aortic valve was replaced with mechanical prostheses and mitral valve was repaired with autologous pericardium. Transesophageal echocardiography during operation and transthoracic echocardiography 3 months later showed mild regurgitation.
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http://dx.doi.org/10.1186/s13019-014-0148-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4182794PMC
September 2014

Acute aortic dissection in pregnant women.

Gen Thorac Cardiovasc Surg 2016 May 2;64(5):283-5. Epub 2014 Aug 2.

Department of Cardiothoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, 200032, China.

Acute aortic dissection occurring during pregnancy represents a lethal risk to both the mother and fetus. Management of parturient with acute aortic dissection is complex. We report our experience of two pregnancies with type A acute aortic dissection. One patient is a 31-year-old pregnant woman (33rd gestational week) with a bicuspid aortic valve and the other is a 32-year-old pregnant woman (30th gestational week) with the Marfan syndrome. In both cases, a combined emergency operation consisting of Cesarean section, total hysterectomy prior to corrective surgery for aortic dissection was successfully performed within a relatively short period of time after the onset. Both patients' postoperative recovery was uneventful, and we achieved a favorable maternal and fetal outcome.
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http://dx.doi.org/10.1007/s11748-014-0460-4DOI Listing
May 2016

Synthetic ePTFE grafts coated with an anti-CD133 antibody-functionalized heparin/collagen multilayer with rapid in vivo endothelialization properties.

ACS Appl Mater Interfaces 2013 Aug 29;5(15):7360-9. Epub 2013 Jul 29.

Shanghai Institute of Cardiovascular Disease, Zhongshan Hospital, Fudan University, Shanghai 200032, China.

An anti-CD133 antibody multilayer functionalized by heparin/collagen on an expanded polytetrafluoroethylene (ePTFE) graft was developed to accelerate early endothelialization. The surface modification of ePTFE grafts demonstrated that the multilayer is stable in static incubation and shaking conditions and that the anti-CD133 antibodies were successfully cross-linked onto the surface. Blood compatibility tests revealed that the coimmobilized heparin/collagen films in the presence or absence of anti-CD133 antibodies prolonged the blood coagulation time and that there was less platelet activation and aggregation, whereas the hemolysis rate was comparable with the bare ePTFE grafts. Cellular proliferation was not inhibited, as the heparin/collagen synthetic vascular grafts coated with CD133 antibody showed little cytotoxicity. The endothelial cells adhered well to the modified ePTFE grafts during a cell adhesion assay. A porcine carotid artery transplantation model was used to evaluate the modified ePTFE grafts in vivo. The results of histopathological staining and scanning electron microscopy indicated that the anti-CD133 antibody was able to accelerate the attachment of vascular endothelial cells onto the ePTFE grafts, resulting in early rapid endothelialization. The success of the anti-CD133 antibody-functionalized heparin/collagen multilayer will provide an effective selection system for the surface modification of synthetic vascular grafts and improve their use in clinical applications.
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http://dx.doi.org/10.1021/am401706wDOI Listing
August 2013

Isolation and culture of smooth muscle cells from human acute type A aortic dissection.

J Cardiothorac Surg 2013 Apr 12;8:83. Epub 2013 Apr 12.

Shanghai Institute of Cardiovascular Disease, Zhongshan Hospital, Fudan University, Fenglin Road 180, Xujiahui District, Shanghai 200032, China.

Background: Acute type A aortic dissection (TAAD) is a life-threatening vascular disease. Smooth muscle cells (SMCs) are the main composition of aortic media and dysfunction of SMCs may lead to acute TAAD. The aim of this work was to investigate whether the SMCs of acute TAAD could be isolated and cultured for further research.

Methods: TAAD tissues were obtained from acute TAAD patients who underwent emergent surgical treatment. A simple and economical technique of collagenase digestion method was used to isolate and culture human SMCs. Confocal laser scanning microscopy was applied to identify SMC phenotypes. Purity of isolated and cultured SMCs was analyzed with flow cytometry and fluorescence microscopy respectively.

Results: The purity of isolated SMCs was 78.2%, including α-smooth muscle cell actin positive 13.9%, calponin positive 35.0% and double positive 29.3%. For cultured SMCs, abundant expression of α-smooth muscle cell actin was observed universally under fluorescence microscope. Confocal laser scanning microscope testified that cultured cells were double positive of α-smooth muscle actin and calponin.

Conclusions: This is the first report of successful culture of SMCs isolated from human acute TAAD tissues. Living human SMCs of acute TAAD provides us with a new method for studying formation of acute TAAD.
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http://dx.doi.org/10.1186/1749-8090-8-83DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3639144PMC
April 2013

Surgical management for acute type A aortic dissection in patients over 70 years-old.

J Cardiothorac Surg 2013 Apr 11;8:78. Epub 2013 Apr 11.

Shanghai Institute of Cardiovascular Disease, Zhongshan Hospital, Fudan University, Shanghai, China.

Background: This study aimed to retrospectively investigate our experience of surgical treatment for acute type A aortic dissection in patients older than 70 years.

Methods: From September 2005 to January 2012, eleven patients who were older than 70 years underwent surgical treatment for type A aortic dissection at our center and were included in this study. Total arch replacement was performed in three patients, seven patients underwent subtotal arch replacement and one with single-branched stent graft implantation. One patient underwent a valve-sparing (David) procedure while another underwent a concomitant aortic valve replacement (Wheat procedure). One patient required coronary artery bypass grafting. All operations were performed under deep hypothermic circulatory arrest and selective antegrade cerebral perfusion.

Results: There was one in-hospital death (9.1%) and no operative mortality within 30 days. Cardiopulmonary bypass time, myocardial ischemic time and antegrade cerebral perfusion time accounted for 151.4 ± 33.5 minutes, 68.5 ± 41.4 minutes and 30.3 ± 12.9 minutes, respectively. Overall in-hospital duration, intensive care unit (ICU) time and mean ventilation time were 40.9 ± 40.3 days, 16.5 ± 22.5 days and 90.5 ± 139.4 hours, respectively. New postoperative permanent neurological dysfunction and temporary neurological dysfunction were observed in one patient (9.1%) and in three patients (27.3%), respectively. Mean follow-up was 49.0 ± 19.9 months and nine patients are still alive, one patient died of cancer after 24 months postoperation.

Conclusions: Surgical management for acute type A dissection in patients older than 70 years is a safe alternative with acceptable risk of death and the early and late results are satisfactory.
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http://dx.doi.org/10.1186/1749-8090-8-78DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3639068PMC
April 2013

Open triple-branched stent graft placement for the surgical treatment of acute aortic arch dissection.

J Cardiothorac Surg 2012 Dec 15;7:130. Epub 2012 Dec 15.

Department of Cardiac Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.

Background: The primary experience of open triple-branched stent graft placement for acute aortic arch dissection was reported.

Methods: Between January 2011 and October 2011, 13 well-selected patients (mea age, 46±8.2 years; approximate range, 30~58 years) with acute aortic arch dissection underwent open triple-branched stent graft placement for total arch reconstruction. The triple-branched stent graft was a branched 1-piece graft consisting of a self-expandable nitinol stent and polyester vascular graft fabric (Yuhengjia Sci Tech Corp Ltd, Beijing, China). During hypothermic circulatory arrest, through the transverse incision of the ascending aorta, the main graft of the triple-branched stent graft was inserted into the true lumen of the arch and proximal descending aorta, and then each sidearm graft was positioned one by one into the aortic branch. Once the main graft and sidearm grafts were properly positioned, the restraining strings were withdrawn and then the main graft and sidearm grafts were deployed. Enhanced electric beam computed tomography was performed in each patient before discharge to evaluate the postoperative time course of the residual false lumen.

Results: Open triple-branched stent graft placement was technically successful in all patients. The mean cardiopulmonary bypass time, aortic cross-clamp time and arrest time were 138.40±47.75 min, 70.60±28.94 min and 28.60±12.48 min, respectively. All patients were discharged from hospital. Their computed tomographic scans postoperatively showed that all stent grafts were fully opened and not kinked, there was no blood flow surrounding the triple-branched stent graft.

Conclusion: Open triple-branched stent graft placement is a new effective technique for total arch reconstruction in acute arch dissection.
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http://dx.doi.org/10.1186/1749-8090-7-130DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3608000PMC
December 2012

Bilateral versus unilateral antegrade cerebral perfusion in arch reconstruction for aortic dissection.

Ann Thorac Surg 2012 Jun 3;93(6):1917-20. Epub 2012 May 3.

Shanghai Institute of Cardiovascular Disease, Department of Cardiovascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.

Background: The superiority of bilateral versus unilateral antegrade cerebral perfusion (ACP) has been the subject of much debate. This study aimed to compare the two methods of cerebral perfusion.

Methods: Between September 2005 and June 2011, 263 patients (median age 51.4±10.1 years, range, 26 to 75; 200 men) underwent open aortic arch reconstruction with hypothermic circulatory arrest and bilateral or unilateral ACP. Among them, 231 patients had acute aortic dissection, 12 had subacute aortic dissection, 20 had chronic aortic dissection, 7 had Marfan syndrome, 8 had reconstruction secondary to endovascular stent graft placement for type B dissection, and 9 had bicuspid aortic valve. Our patient cohort is divided into those protected with hypothermic circulatory arrest and bilateral ACP (group A, n=128) and those with hypothermic circulatory arrest and unilateral ACP (group B, n=135).

Results: There was no significant difference between groups A and B in cardiopulmonary bypass time, cross-clamp time, or cerebral perfusion time. Overall in-hospital mortality was 11.7% for group A and 11.1% for group B (p=0.877). Postoperative temporary and permanent neurologic dysfunction was 5.5% versus 6.7% and 12.5% versus 10.4%, respectively (group A versus group B: p=0.685, p=0.587). Intensive care unit time was 9.4±9.8 days for group A and 8.4±14.0 days for group B (p=0.972). Hospitalization was 24.3±14.6 days for group A and 23.1±21.1 days for group B (p=0.172).

Conclusions: Unilateral ACP with hypothermic circulatory arrest is a safe cerebral protection technique for open aortic arch reconstruction, and is not inferior to bilateral ACP with hypothermic circulatory arrest.
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http://dx.doi.org/10.1016/j.athoracsur.2012.02.090DOI Listing
June 2012

Partial aortic annulus avulsion and formation of aortic-left ventricle tunnel through interventricular septum after blunt cardiac trauma.

Eur J Cardiothorac Surg 2011 Jul 9;40(1):255-6. Epub 2010 Dec 9.

Department of Cardiothoracic Surgery, Zhongshan Hospital Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China.

Traumatic aortic-left ventricle tunnel through interventricular septum was particularly a rare event that has never previously been described. A 58-year-old male, with a history of blunt thoracic trauma caused by falling from height, was admitted to our institute for effort dyspnea. Chest computed tomography scan showed subaortic interventricular septal lumen communicating with coronary sinus and left ventricular outflow tract (LVOT). Transthoracic echocardiography revealed a shuttle flow from coronary sinus to LVOT bypassing aortic annulus during diastole. Operation examination found partial aortic annulus avulsion outside right coronary cusp involving superior interventricular septum dissection forming a tunnel breakthrough into left ventricular outflow tract. Both aortic orifice and LVOT orifice of the tunnel were closed with running Prolene suture and right coronary cusp annulus was fastened to aortic root with intermittent mattress suture. The postoperative course was uneventful. Echocardiography confirmed complete closure of the tunnel with residual trivial to mild aortic regurgitation during 1-month follow-up.
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http://dx.doi.org/10.1016/j.ejcts.2010.10.039DOI Listing
July 2011

[Determination of azaspiracid-1 in shellfishes by liquid chromatography with tandem mass spectrometry].

Se Pu 2010 Apr;28(4):363-7

Yellow Sea Fisheries Research Institute, Chinese Academy of Fishery Sciences, Qingdao 266071, China.

A liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for the determination of azaspiracid-1 (AZA1) in shellfishes was described. After being extracted using methanol and water (80:20, v/v), the extract was cleaned-up by solid phase extraction (SPE) of MAX column, then determined by using a reversed-phase high performance liquid chromatography (HPLC) isocratic program coupled with tandem mass spectrometry in selected reaction monitoring mode (SRM). And the extract was eluted with acetonitrile-water (80:20, v/v) on an Atlantis dC18 column (150 mm x 4.6 mm, 5.0 microm) with mobile phase containing 50 mmol/L formic acid and 2 mmol/L ammonium formate. The detection limit was 11.00 pg/g. The calibration curve was linear (R2 = 0.998 1) in the range of 48.85-2 442 ng/L. The average recoveries of the shellfish tissue extract at three spiked levels (36.64, 73.27, 146.54 pg/g) were from 75.8% to 82.5% (n = 6). The relative standard derivations (RSDs) were less than 10%. The 112 shellfish samples from the local markets of Dalian, Qingdao, Guangzhou were detected by the method, and AZA1 was detected in some samples from Dalian and Guangzhou. The results showed that the method is simple, rapid, sensitive and suitable for the detection of AZA1 in shellfishes.
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http://dx.doi.org/10.3724/sp.j.1123.2010.00363DOI Listing
April 2010

Investigation of pectenotoxin profiles in the Yellow Sea (China) using a passive sampling technique.

Mar Drugs 2010 Apr 15;8(4):1263-72. Epub 2010 Apr 15.

Yellow Sea Fisheries Research Institute, No.106 Nanjing Road, 266071 Qingdao, China.

Pectenotoxins (PTXs) are a group of lipophilic algal toxins. These toxins have been found in algae and shellfish from Japan, New Zealand, Ireland, Norway and Portugal. PTX profiles vary with geographic location of collection site. The aim of the present study was to investigate PTX profiles from the Yellow Sea, China. The sampling location was within an aquatic farm (N36 degrees 12.428', E120 degrees 17.826') near the coast of Qingdao, China, in the Yellow Sea from 28 July to 29 August 2006. PTXs in seawater were determined using a solid phase adsorption toxin tracking (SPATT) method. PTXs were analyzed by HPLC-MSMS. PTX-2, PTX-2 sec acid (PTX-2 SA) and 7-epi-PTX-2 SA were found in seawater samples. The highest levels of PTXs (107 ng/g of resin PTX-2, 50 ng/g of resin PTX-2 SA plus 7-epi-PTX-2 SA) in seawater were found on 1 August, 2006. From 1 August to 29 August, the levels of PTX-2 and PTX-2 SA decreased. In the same area, the marine algae, Dinophysis acuminata was found in the seawater in the summer months of 2006. This indicated that Dinophysis acuumuta might be the original source of PTXs. PTX-11 and PTX-12a/b were not found in seawater.
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http://dx.doi.org/10.3390/md8041263DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2866485PMC
April 2010