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Biomedical subjects

Qingyu Wu

Publications and source records attributed to Qingyu Wu.

48 records · Page 3Linked to original sources
PubMed2003

Autotransfusion of shed mediastinal blood after open heart surgery.

OBJECTIVE: To determine the safety and effectiveness of autotransfusion of shed mediastinal blood after open heart surgery. METHODS: Sixty patients undergoing coronary artery bypass grafting (CABG) were selected randomly to receive either nonwashed shed mediastinal blood (Group 1, n = 30) or banked blood (Group 2, n = 30). Drainage and transfusion volume were determined after the operation. Hb, RBC, HCT and PLT were detected immediately before and after the operation, as well as 24 hours and 7 days after the operation. Data were analyzed using Fisher's exact test. A P < 0.05 was considered significant. RESULTS: There were no significant differences in Hb, HCT, PLT or length of cardiopulmonary bypass (CPB) (P > 0.05). In the two groups, no significant difference in the mean blood loss was observed during 24 hours after the operation (660 +/- 300 ml in Group 1 and 655 +/- 280 ml in Group 2, P > 0.05). In Group 1, the mean volume autotransfused was 280 +/- 160 ml, and the patients required 360 +/- 80 ml banked blood compared with 660 +/- 120 ml in Group 2. In other words, the banked blood requirement in Group 1 was 40% lower. CONCLUSIONS: Autotransfusion of shed mediastinal blood after an open heart operation is safe and effective.

Adult↗
PubMed2002

[Correction of total anomalous pulmonary venous connection in infant less than one year old].

OBJECTIVE: To evaluate the effects of early correction for total anomalous pulmonary venous connection (TAPVC) in infant under one. METHODS: Twenty-eight infants less than one year old with TAPVC were admitted and prepared to be treated surgically from July 1995 to August 2001. Total correction was performed on 24 cases, 20 males and 4 females, aged 6.04 +/- 3.34 months, with the mean body weight of 5.74 +/- 1.22 kg, of which 10 (41.67%) being of supracardic type, 11 (45.83%) being of intracardiac type, 1 (4.17%) being of infracardiac type, and 2 (8.33%) being of mixed type. Four patients died of hypoxic attack during anteoperative preparation and failed to be operated upon. RESULTS: Three infants (12.5%) died within 30 days after operation. One case of intracardiac type died of circulatory failure because of severe postoperative bleeding and late exploratory thoracotomy. One case of supracardiac type died of cardiac sufficiency because of bleeding at anastomotic stoma during operation. One case of mixed type died of circulatory failure because of high pressure of left cardiac atrium. All of the 4 cases who underwent emergent operation survived. The most common complication was arrhythmia (41.67%). CONCLUSION: The early effect of early correction for TAPVC is satisfactory and its long-term effect is to be observed. A wide anastomosis between the posterior wall of the left atrium and common pulmonary vein is more important for the supracardic type. The diameters of left atrium, left ventricle and atrial septum defect have little effect on operative results. Arrhythmia after operation has no significant increase in supracardic type through. With rather high incidence rate of arrhythmia (5/8, 62.5%), the combined left atrium incision and right atrium incision approach assures a sufficiently large incision for the supracardiac type. However, this approach is statistically different in the incidence rate of arrhythmia only between supracardiac type and intracardiac type.

Cardiac Surgical Procedures↗
PubMed2002

Genomic structures of the human and murine corin genes and functional GATA elements in their promoters.

Corin is a multiple-domain type II transmembrane serine protease highly expressed in the heart. It converts pro-atrial natriuretic peptide to atrial natriuretic peptide, a cardiac hormone that regulates blood volume and pressure. Here we describe the genomic structures of the human and murine corin genes and functional analysis of their promoters. Both corin genes contain 22 exons and span >200 kb. Their intron/exon boundaries are well conserved, with most exons encoding distinct structural domains, supporting the idea that corin evolved as a result of exon duplication and rearrangement. Comparison of the 5'-flanking regions of the human and murine corin genes revealed several conserved sequences, including binding sites for TBX5, GATA, NKX2.5, and Krüppel-like transcription factors. Transfection experiments with reporter gene constructs driven by the human or murine corin 5'-flanking region indicated that the sequences from -405 to -15 in human and from -646 to -77 in mouse are sufficient to promote high levels of gene expression in murine cardiomyocytes. In contrast, these sequences produced only minimal levels of expression in HeLa cells. Within these sequences, we identified a conserved GATA element that bound to GATA-4. Mutation of the core sequence impaired both GATA-4 binding and gene expression. These data indicate that the GATA element and its binding to GATA-4 are essential for cardiac expression of the human and murine corin genes.

Animals↗
PubMed2002

Processing of pro-atrial natriuretic peptide by corin in cardiac myocytes.

Corin is a type II transmembrane serine protease abundantly expressed in the heart. In a previous study using transfected 293 cells, we showed that corin converted pro-atrial natriuretic peptide (pro-ANP) to atrial natriuretic peptide (ANP), suggesting that corin is likely the pro-ANP convertase. Because other serine proteases such as thrombin and kallikrein had previously also been shown to cleave pro-ANP in vitro, it remained to demonstrate that corin is indeed the endogenous pro-ANP convertase in cardiomyocytes. In this study, we examined pro-ANP processing in a murine cardiac muscle cell line, HL-5. Northern analysis showed that corin mRNA was present in HL-5 cells. In HL-5 cells transfected with a plasmid expressing pro-ANP, recombinant pro-ANP was converted to mature ANP as determined by Western analysis, indicating the presence of the endogenous pro-ANP convertase in these cells. The processed recombinant ANP was shown to be active in an enzyme-linked immunosorbent assay-based cGMP assay in baby hamster kidney cells. The processing of recombinant pro-ANP in HL-5 cells was highly sequence-specific, because mutation R98A, but not mutations R101A and R102A, in pro-ANP prevented the conversion of pro-ANP to ANP. Expression of recombinant wild-type corin enhanced the processing of pro-ANP in HL-5 cells. In contrast, overexpression of active site mutant corin S985A or transfection of oligonucleotide small interfering RNA duplexes directed against the mouse corin gene completely inhibited the processing of recombinant pro-ANP in HL-5 cells. These results indicate that corin is the physiological pro-ANP convertase in cardiac myocytes.

Animals↗
PubMed2002

Surgical treatment of dissecting aneurysm of the interventricular septum.

OBJECTIVE: We reviewed our experience in the surgical treatment of an extremely rare disease, dissecting aneurysm of the interventricular septum (DAIS). The definition of DAIS is that the interventricular septum is dissected and forms an aneurysm which bulges into both the left and right ventricles, causing obstruction of both ventricular outflow tracts. It communicates with the aortic root, and may communicate with the ventricle. It is usually associated with aortic valve regurgitation and aortic annular enlargement. DAIS might also be related to the sinus of Valsalva aneurysm [Ann Thorac Surg 65 (1998) 735; Ann Thorac Surg 51 (1991) 996; Eur J Thorac Surg 12 (1997) 759]. But in three of our six patients DAIS was not associated with sinus of Valsalva enlargement or aneurysm. METHODS: Between May 1992 and November 2000, six of 30,701 patients were diagnosed with DAIS, and underwent surgery at Fu Wai Hospital in Beijing. Aortic valve replacement was performed in five patients, and the perforation at the bottom of the right sinus of Valsalva was repaired in one. The aneurysm was resected simultaneously in all these patients. RESULTS: One of the six patients required re-operation. And all patients recovered uneventfully without hospital mortality. CONCLUSIONS: DAIS has a progressive course and poor prognosis. Early diagnosis and surgical treatment are mandatory.

Adult↗
PubMed2002

Inhibition of PAI-1: a new anti-thrombotic approach.

Proteolytic degradation of fibrin (fibrinolysis) is mediated by plasminogen and its activators, tissue-type plasminogen activator (tPA(1)) and urokinase (uPA). Fibrinolysis is critical for preventing thrombus growth and restoring blood flow following thrombotic vascular occlusion. Plasminogen activator inhibitor-1 (PAI-1), a member of the serine protease inhibitor (serpin) superfamily, is the principal inhibitor of tPA and uPA in the fibrinolytic system. High levels of circulating PAI-1 are associated with a number of thrombotic diseases. In animal studies, transgenic mice overexpressing human PAI-1 develop spontaneous thrombosis, whereas PAI-1-deficient mice are more resistant to venous or arterial thrombosis. Furthermore, inhibition of PAI-1 activity prevents thrombus formation in animal models. The antithrombotic effects of PAI-1 inhibition are achieved by enhancing endogenous fibrinolytic activity without directly affecting blood coagulation and platelet function. Phenotypic analysis of PAI-1 deficiency in both human and mouse suggests that inhibition of PAI-1 will not lead to severe bleeding or other major adverse effects. Thus, PAI-1 inhibitors represent a new class of antithrombotic drugs with a possible wider therapeutic index than conventional antiplatelet and anticoagulant agents. This review summarizes the role of PAI-1 in thrombotic diseases and recent progress in the development of small molecule PAI-1 inhibitors.

Animals↗
PubMed2002

Predictors of atrial fibrillation after coronary artery bypass graft surgery.

OBJECTIVE: To identify the clinical predictors of atrial fibrillation (AF) after coronary artery bypass grafting (CABG). METHODS: 322 consecutive patients who had undergone isolated CABG were reviewed. Preoperative, intraoperative and postoperative data were collected. Patients were grouped according to whether AF appeared postoperatively. RESULTS: AF occurred in 75 patients (23.3%). Most cases of AF (85.6%) appeared on or before the third postoperative day. The mean age for patients with AF was 62.5 years compared with 56.7 years for patients without AF (P < 0.05). The mean aortic crossclamp time for patients with AF was 67 min compared with 60.3 min for patients without AF (P < 0.05). The mean duration of cardiopulmonary bypass for patients with AF was 109.6 min compared with 97.3 min for patients without AF (P < 0.05). The mean duration of mechanical ventilation for patients with AF was 19.1 h compared with 15.7 h for patients without AF (P < 0.05). Multivariate logistic regression analysis was used to identify the following independent predictors of postoperative AF (P < 0.05): age > or = 65 years (OR 2.7; 95% CI 1.5 to 5.1), lesions in the right coronary artery (OR 2.5; 95% CI 1.4 to 4.5), and early postoperative withdrawal of beta blocker (OR 3.9; 95% CI 2.1 to 7.7). CONCLUSIONS: AF remains the most common complication after CABG. Age and lesions in the right coronary artery can influence the incidence of AF, and beta blocker and magnesium may be the most economical and effective prevention for AF early after CABG.

Adult↗
PubMed2002

[Surgical treatment of aorta-pulmonary window].

OBJECTIVE: To summarize the experience of surgical treatment of aorta-pulmonary window. METHODS: Between January 1980 and August 2000, 18 patients suffering from aorta-pulmonary window, 11 males and 7 females, with a mean age of 6.5 years (2 approximately 14 years), underwent surgical treatment. Eleven cases were type I, 3 were type II and 4 were type III. Sixteen patients underwent surgical repair under cardiopulmonary bypass at moderate hypothermic temperatures. Deep hypothermic circulatory arrest was used in 2 of them. Closed surgical ligation under cardiopulmonary bypass at normal thermic temperature was performed on 1 case. External division and ligation under general anesthesia through left thorax was performed on 1 case. Thirteen patients underwent surgical repair through the anterior wall of aorta. Surgical repair was performed through the anterior wall of pulmonary artery in 3 cases. Other associated malformations were repaired simultaneously. RESULTS: Three patients died during the peri-operative period. Fifteen patients who survived the operation were followed up for 108 months on average. One patient was noted to have residue shunt on aorta pulmonary window. The other patients showed alleviation of symptoms and improvement of life quality. CONCLUSION: Early diagnosis, suitable surgical procedure and prevention and treatment of postoperative complications are the key factors for treatment of aorta pulmonary window.

Adolescent↗
PubMed2002

[Surgical treatment of coronary artery aneurysm].

OBJECTIVE: To describe the diagnosis and surgical management of coronary artery aneurysm. METHODS: Between October 1996 and May 2000, 6 patients with coronary artery aneurysm underwent surgical treatment. Of these patients, 3 had Kawasaki disease and 3 coronary artery fistula. All patients underwent coronary artery bypass grafting. Three patients had aneurysms resected and fistulous ostium closed. One patient received aortic valve replacement. RESULTS: There were no deaths and later death, nor major complications during the hospital stay. The results of follow-up were satisfactory. CONCLUSIONS: Coronary artery aneurysm is rare and its prognosis is poor. Early diagnosis and operation are necessary. The aneurysm should be resected, the coronary artery should be bypassed, and other associated diseases should be treated properly.

Adult↗
PubMedDate not supplied

Repair of partial atrioventricular septal defect through a minimal right vertical infra-axillary thoracotomy.

OBJECTIVE: To report a new minimally invasive and cosmetic approach for partial atrioventricular septal defect (PAVSD) repair. METHODS: From November 1997 to January 2000, six patients with a mean age of 19.2 +/- 7.7 years underwent minimal right vertical infra-axillary thoracotomy for PAVSD repair. Left atrioventricular (AV) valve regurgitation was assessed on the beating heart before and after valvuloplasty. Commissuroplasty of the left AV valve and atrial septum repair were done in all patients. RESULTS: There were no operative or late mortality, and no morbidity directly related to the thoracotomy approach. The average length of the incision was 8.3 +/- 131 cm. The arrest times averaged 32.8 +/- 8.3 minutes, and the cardiopulmonary bypass times averaged 66.0 +/- 9.0 minutes. One patient had a mild to moderate left AV valve regurgitation postoperatively. All patients were free of symptoms during the follow-up. CONCLUSION: The minimal right vertical infra-axillary thoracotomy is a safer, more cosmetic and less invasive approach than median sternotomy for the repair of PAVSD.

Adolescent↗
PubMedDate not supplied

Repair of partial atrioventricular septal defect through a minimal right vertical infra-axillary thoracotomy.

OBJECTIVE: To report a new minimally invasive and cosmetic approach for partial atrioventricular septal defect (PAVSD) repair. METHODS: From November 1997 to January 2000, six patients with a mean age of 19.2 +/- 7.7 years underwent minimal right vertical infra-axillary thoracotomy (VIAT) for PAVSD repair. Left atrioventricular (AV) valve regurgitation was tested on the beating heart before and after valvuloplasty. Commissuroplasty of the left AV valve and atrial septum repair were done in all patients. RESULTS: There was no operative or late mortality, and no morbidity directly related to the thoracotomy approach. The average length of the incision was 8.3 +/- 1.3 cm. The arrest times averaged 32.8 +/- 8.3 minutes, and the cardiopulmonary bypass times averaged 66.0 +/- 9.0 minutes. One patient had mild-to-moderate left AV valve regurgitation postoperatively. All patients were free of symptoms during follow-up. CONCLUSION: Minimal right VIAT is a safe, more cosmetic, and less invasive approach than median sternotomy for the repair of PAVSD.

Adolescent↗