Left ventricular outflow tract obstruction (LVOTO) in Ebstein's anomaly is a rare complication, and LVOTO related to surgery is rarer. We present a 46 years old female patient who was dignosed with Ebstein's anomaly, then suffered from cardiac arrest because of LVOTO secondary to cone reconstruction in ICU.
【摘要】 目的 研究雙側迷走神經切斷對肺缺血再灌注引起的氧化應激反應的影響。 方法 將24只健康雄性新西蘭大白兔隨機分為:假手術組（S組）、缺血再灌注組（IR組）、雙側迷走神經切斷合并缺血再灌注組（NIR組）。缺血前和再灌注末抽取動脈血進行血氣分析，觀察動脈血氧分壓PaO2及肺泡動脈氧分壓差（A-aDO2）的變化。再灌注末取肺組織檢測肺的濕干重比值（W/D）和氧化應激指標，包括丙二醛（MDA）、超氧化物歧化酶（SOD）及過氧化氫酶（CAT）。 結果 與S組比較，缺血再灌注明顯降低了PaO2，增加了A-aDO2和W/D值，增加了肺組織MDA含量并降低了SOD、CAT活性；雙側迷走神經切斷進一步降低了SOD活性。 結論 切斷實驗兔的雙側迷走神經，降低了肺組織抗氧化酶-超氧化物歧化酶的活性，提示迷走神經在降低肺缺血再灌注引起的氧化應激反應中發揮了重要的調節作用。【Abstract】 Objective To evaluate the effect of bilateral vagal nerves transection on lung ischemia-reperfusion induced oxidative stress. Methods A total of 24 New Zealand male rabbits were randomly divided into 3 groups: sham group (S group), ischemia-reperfusion group (IR group), and bilateral vagal nerves transection with ischemia-reperfusion group (NIR group). Before ischemia and at the end of reperfusion, arterial blood samples were collected for blood gas analysis. Arterial partial pressure of oxygen (PaO2) and alveolo-arterial oxygen tension difference (A-aDO2) were detected. At the end of reperfusion, lung tissues were obtained to measure wet/dry weight ratio (W/D). Evaluation of oxidative stress indicators, including content of lung malondialdehyde (MDA), superoxide dismutase enzyme (SOD) and catalase (CAT) activities was also performed. Results Compared with the S group, lung ischemia-reperfusion significantly decreased the PaO2, elevated A-aDO2 and lung W/D weight ratio. At the same time, MDA level in the lung tissue was elevated and SOD and CAT activities were decreased. After bilateral vagal nerves transection, SOD activity was further decreased. Conclusion Transection of bilateral vagal nerves reduced the activity of antioxidant enzyme, especially superoxide dismutase in lung tissue, suggesting that the integrity of the vagal nerves plays an important regulatory role in ischemia-reperfusion mediated oxidative stress in the lung.
Objective To establ ish an efficient and stable culture method of human umbil ical vein endothel ial cells (HUVECs) in vitro so as to provide good source of seed cells for tissue engineered vascular grafts and for precl inical research. Methods The umbil ical cords were harvested from full-term normal delivered neonates, which were perfused with0.1% collagenase II by self-made needle and were digested at 37 and 5% CO2 humidified incubator. The HUVECs were cultured in endothel ial culture medium (ECM) containing 5% fetal bovine serum (FBS) and 1% endothel ial cell growth factor (ECGS). HE staining of the umbil ical cords before and after digestion was used to observe the detachment of HUVECs, flow cytometry to detect the purity of primary HUVECs, and inverted phase contrast microscope to observe the morphology of the cultured HUVECs. The growth of the 3rd passage cells was measured by MTT assay; immunocytochemical technique and matrigelbased capillary-l ike tube formation assay were carried out to identify the function of HUVECs. Results After digestion of 0.1% collagenase II, marked HUVECs detachment was observed with complete digestion. The purity of the HUVECs was 99.56% by digestion of 0.1% collagenase II at 37 and 5% CO2 humidified incubator for 15 minutes. Primary HUVECs showed a cobblestone or pitching stone-l ike appearance in vitro, forming a confluent monolayer cells after 2-3 days of culture. MTT assay demonstrated that HUVECs showed the fastest growth speed at 3 to 4 days, and showed growth of cell fusion at about 5 days. Immunocytochemistry showed that HUVECs highly expressed endothel ial marker factor VIII. Matrigel based capillary-l ike tube formation assay showed that it could form endothel ial-l ike tube structures after 24 hours of culture. Conclusion Using improved method and ECM could obtain high quantity and high qual ity primary HUVECs, which might be a kind of promising seed cells for tissue engineering and precl inical research.
