Background: Antegrade cerebral perfusion (ACP), including unilateral and bilateral, is most commonly used for cerebral protection in aortic surgery. There is still no consensus on the superiority of the two methods. Our research aimed to investigate the clinical effects of u-ACP and b-ACP. Methods: 321 of 356 patients with type A aortic dissection were studied retrospectively. 124 patients (38.6%) received u-ACP, and 197 patients (61.4%) received b-ACP. We compared the incidence of postoperative neurological complications and other collected data between two groups. Besides, we also analyzed perioperative variables to find the potential associated factors for neurological dysfunction (ND). Results : For u-ACP group, 54 patients (43.5%) had postoperative neurological complications, including 22 patients (17.7%) with permanent neurologic dysfunction (PND) and 32 patients (25.8%) with temporary neurologic dysfunction (TND). For b-ACP group, 47 patients (23.8%) experienced postoperative neurological complications, including 16 patients (8.1%) of PND and 31 patients (15.7%) of TND. The incidence of PND and TND were significantly different between two groups along with shorter CPB time (p=0.016), higher nasopharyngeal temperature (p≦0.000), shorter ventilation time (p=0.018), and lower incidence of hypoxia (p=0.022). Furthermore, multivariate stepwise logistic regression analysis confirmed that preoperative neurological dysfunction (OR=1.20, P= 0.028), CPB duration (OR=3.21, P=0.002), and type of cerebral perfusion (OR=1.48, P=0.017) were strongly associated with postoperative ND. Conclusions: In our study, it was observed that b-ACP procedure exhibited shorter CPB time, milder hypothermia, shorter ventilation time, lower incidence of postoperative hypoxia, and neurological dysfunction compared to u-ACP. Meanwhile, the incidence of ND was independently associated with three factors: preoperative neurological dysfunction, CPB time, and type of cerebral perfusion.

Background: Antegrade cerebral perfusion (ACP), including unilateral and bilateral, is most commonly used way for cerebral protection in aortic surgery. There is still no consensus on the superiority of the two methods. Our research was aimed to investigate the clinical effects between u-ACP and b-ACP. Methods: 321 of 356 patients with type A aortic dissection were studied retrospectively. 124 patients (38.6%) received u-ACP and 197 patients(61.4%) received b-ACP. We compared the incidence of postoperative neurological complications and other collected data between two groups. We also analyzed perioperative variables in order to find the potential associated factors for neurolocial dysfunction (ND). Results: For u-ACP group, 54 patients (43.5%) had postoperative neurological complications including 22 patients (17.7%) with permanent neurologic dysfunction (PND) and 32 patients (25.8%) with temporary neurologic dysfunction (TND). For b-ACP group, 47 patients (23.8%) experienced postoperative neurological complications including 16 patients (8.1%) of PND and 31 patients (15.7%) of TND. The incidence of PND and TND were significantly different between two groups along with shorter CPB time (p=0.016), higher nasopharyngeal temperature (p≦0.000), shorter ventilation time (p=0.018) and lower incidence of hypoxia (p=0.022). Furthermore, multivariate stepwise logistic regression analysis confirmed that preoperative neurological dysfunction (OR=1.20, P= 0.028), CPB duration (OR=3.21, P=0.002 ) and type of cerebral perfusion (OR=1.48, P=0.017) were strongly associated with postoperative ND. Conclusions: In our study, we found that b-ACP procedure had shorter CPB time, milder hypothermia, shorter ventilation time, lower incidence of postoperative hypoxia and neurological dysfunction compared to u-ACP. Meanwhile, we discovered the incidence of ND was independently associated with there factors, including preoperative neurological dysfunction, CPB time and type of cerebral perfusion.

Objective: To study the risk factors of oxygenation impairment in patients with type-A acute aortic dissection who underwent total arch replacement with a stented elephant trunk. Methods: In this study, 169 consecutive patients were enrolled who were diagnosed with type-A acute aortic dissection and underwent a total arch replacement procedure at the Qilu Hospital of Shandong University between January 2015 and February 2017. Postoperative oxygenation impairment was defined as arterial oxygen partial pressure/inspired oxygen fraction <= 200 with positive end expiratory pressure >= 5 cm H2O that occurred within 72 hours of surgery. Perioperative clinical characteristics of all patients were collected and univariable analyses were performed. Risk factors associated with oxygenation impairment identified by univariable analyses were included in the multivariable regression analysis. Results: The incidence of postoperative oxygenation impairment was 48.5%. Postoperative oxygenation impairment was associated with prolonged mechanical ventilation time, intensive care unit stay, and hospital stay. Multivariable regression analysis demonstrated that body mass index (odds ratio [OR], 1.204; 95% confidence interval [CI], 1.065-1.361; P=.003), preoperative oxygenation impairment (OR, 9.768; 95% CI, 4.159-22.941; P<.001), preoperative homocysteine (OR, 1.080; 95% CI, 1.006-1.158; P=.032), circulatory arrest time (OR, 1.123; 95% CI, 1.044-1.207; P=.002), and plasma transfusion (OR, 1.002; 95% CI, 1.001-1.003; P=.002) were significantly associated with postoperative oxygenation impairment. Conclusions: Postoperative oxygenation impairment is a common complication of surgery for type-A acute aortic dissection. Body mass index, preoperative oxygenation impairment, preoperative homocysteine, circulatory arrest time, and plasma transfusion were independent risk factors for oxygenation impairment after a total arch replacement procedure.

This study aimed to investigate the effect of bone marrow-derived mesenchymal stem cells (BMSCs) on disseminated intravascular coagulation (DIC) model rats and to further explore the underlying mechanism. A rat model of lipopolysaccharide (LPS)-induced DIC was successfully established, as indicated by impaired plasma hemostatic parameters and damaged organ functions in rats. Importantly, pre-treatment with rat allogeneic BMSCs before LPS injection significantly alleviated systemic intravascular coagulation, reduced plasma levels of organ dysfunction indicators and pro-inflammatory cytokines, suppressed fibrin microthrombi formation, ameliorated liver, heart, and renal injuries, and increased 24-hour survival rates in LPS-induced DIC rats. The protection of BMSCs against DIC was in a moderately dose-dependent manner. Further investigation revealed that BMSCs co-cultured with peripheral blood mononuclear cells (PBMCs) significantly inhibited the LPS-stimulated PBMCs proliferation and the release of pro-inflammatory cytokines from PBMCs. Of note, upregulation of immunosuppressive factors including indoleamine 2,3-dioxygenase and interleukin-10, which was induced by interferon-γ, contributed to BMSCs-mediated inhibition of LPS-stimulated PBMCs proliferation. These effects do not depend on the direct cell-cell contact. In conclusion, BMSCs pre-treatment ameliorates inflammation-related tissue destruction in LPS-induced DIC model rats. The protection of BMSCs may be attributed to their anti-inflammatory and immunomodulatory properties, which render BMSCs a promising source for stem cell-based therapeutic approaches in inflammation-related DIC.

Disseminated intravascular coagulation (DIC) is a fatal thrombohemorrhagic disorder. Bone marrow-derived mesenchymal stem cells (BMSCs) are multipotent stem cells that have tremendous therapeutic effect. Our aim was to explore whether the immune mechanisms were associated with BMSCs-afforded protection against DIC. We generated a rat model of DIC by lipopolysaccharide (LPS, 3 mg/kg) injection via the tail vein. In the treatment group, rats were pre-treated with 1 × l03 , 1 × l04 , 1 × l05 , and 1 × l06 allogeneic BMSCs before LPS injection. Blood sample was withdrawn from the abdominal aorta at 0 (before), 4, and 8 h after LPS injection and used for biochemical analyses. After experiments, the mice were sacrificed and their organs were harvested and observed by H&E and PTAH staining. Continuous infusion of LPS into the rats gradually impaired the hemostatic parameters and damaged organ functions. However, pre-treatment with BMSCs dose-dependently improved the hemostatic parameters. Meanwhile, the treatment significantly suppressed the fibrin microthrombi formation and alleviated liver, heart, lung, and renal injuries. Flow cytometry analysis demonstrated that BMSCs pre-treatment inhibited LPS-induced upregulation of CD3+ CD8+ T cells and CD3+ /CD161a+ NKT cells in the peripheral blood. BMSCs pre-treatment reversed the upregualtion of the B-cell population and the percentage of CD43+ /CD172a+ monocytes in the DIC models. Finally, BMSCs pre-treatment decreased the levels of tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ), interleukin-1β (IL-1β), and interleukin-6 (IL-6) and increased the levels of interleukin-10 (IL-10) in LPS-induced DIC models. Pre-treatment with BMSCs can reduce coagulation and alleviate organ dysfunction via peripheral immune responses in LPS-induced DIC rat model. J. Cell. Biochem. 118: 3184-3192, 2017. © 2017 Wiley Periodicals, Inc.

OBJECTIVE To study the incidence and related risk factors for postoperative delirium after type-A aortic dissection in patients who underwent Sun's procedure (total arch replacement using a tetrafurcate graft with stented elephant trunk implantation). DESIGN A retrospective study. SETTING A cardiac surgical intensive care unit. PARTICIPANTS The study comprised 100 patients admitted to the intensive care unit for type-A aortic dissection. INTERVENTIONS All patients underwent Sun's procedure with uniform preoperative and anesthetic treatment. MEASUREMENTS AND MAIN RESULTS Delirium was evaluated using the Confusion Assessment Method for the intensive care unit. Baseline demographics and preoperative, intraoperative, and postoperative data were recorded and analyzed retrospectively via univariate analysis and multivariate logistic regression. The incidence of postoperative delirium was 34%, according to Confusion Assessment Method for the intensive care unit criteria. Univariate analysis revealed that 17 variables differed significantly among patients with and without delirium. Additional multivariate stepwise logistic regression analysis confirmed that cerebrovascular disease history, surgery duration, cardiopulmonary bypass duration, intubation time, and hypoxia were strongly associated with postoperative delirium. CONCLUSIONS Delirium is a common postoperative complication of aortic dissection. Cerebrovascular disease history, surgery and cardiopulmonary bypass duration, postoperative hypoxia, and intubation time are independently associated with the development of delirium. Early diagnosis of delirium and modifying these factors properly may be helpful to improve patients' prognosis.

目的 总结完全胸腔镜下心脏手术的体外循环(ECC)管理经验.方法 2013年1月至2015年8月200例全胸腔镜心脏手术,其中房间隔缺损92例,部分性肺静脉异位引流2例,室间隔缺损36例,二尖瓣病变66例,左房黏液瘤3例,肥厚型心肌病1例.ECC采用浅、中低温,186例行股动、静脉插管,14例行股动、静脉及右颈内静脉插管.119例患者ECC中予以负压辅助静脉引流107例手术采用含血停搏液灌注法心肌保护,心脏不停跳93例.结果 200例患者除1例术中死亡外,其余全部痊愈出院.ECC时间38～ 279(112.4± 31.6) min.升主动脉阻断时间35～ 170(89.2±26.8) min.术后5～20 d痊愈出院.出院患者随访时间3 ～ 24个月,结果满意.结论 完全胸腔镜下心脏手术ECC是安全、可行、微创的,ECC期间需加强监护及防治各种并发症.

Objective To evaluate the effects of ethyl pyruvate (EP)on hyperkinetic pulmonary arterial hypertension (PAH).Methods Rat hyperkinetic PAH models were established by shunting common carotid artery and internal jug-ular vein.After that,30 rat models were randomly divided into 3 groups,with 10 rats in each group:EP treatment group,control group,and shunt group.Another 10 rats were enrolled in the sham-operation group as negative controls. Rats in the EP treatment group were given intraperitoneal injection of EP [50 mg /(kg·d)]for 30 days,and rats in the control group were injected with the same volume of normal saline.The systolic pulmonary arterial pressure (SPAP) was measured after that and then the right ventricular hypertrophy index (RVHI)was calculated after the heart was removed.The percentage of diameter thickness (WT%)and wall area (WA%)were calculated in lung tissues stained with HE.The levels of TNF-αand IL-6 in the serum were measured with ELISA and expression of NF-κB p65 in lung tissues was detected with Western blotting.Results Compared with shunt group,EP treatment group had significantly decreased SPAP,RVHI,WT%,WA%,the levels of TNF-αand IL-6 in serum,and expression of NF-κB p65 in lung tissues.Conclusion EP could ameliorate PAH and inhibit the remodeling of pulmonary blood vessels in hyperkinetic PAH rats by reducing the expression of NF-κB p65,synthesis and release of cytokines (TNF-α,IL-6,etc.)and alle-viate inflammation reaction.

Background: Hyperkinetic pulmonary arterial hypertension (PAH) is a common complication in congenital heart disease, and affects operations, indications, and prognoses for patients. Gene-based stem cell transplantation is an alternative treatment that can attenuate PAH.Methods: Hyperkinetic PAH rabbit models were successfully established, using common carotid artery and jugular vein anastomosis. Endothelial progenitor cells (EPCs) were isolated from the bone marrow, cultured, and transfected with human hypoxia inducible factor-1 alpha (hHIF-1 alpha), using lentiviruses. Two weeks after the transfected EPCs were transplanted into the rabbits, catheterization was applied to collect hemodynamic data. The hypertrophy of the right ventricle and pulmonary vascular remodeling were evaluated by measuring the right ventricle hypertrophy index, the medial wall thickness, and the medial wall area. Western blot and immunohistochemistry analyses were used to detect the expression of hHIF-1 alpha in the pulmonary small arteries.Results: Two weeks after transplantation, systolic pulmonary arterial pressure and mean pulmonary arterial pressure were both attenuated. The hypertrophy of the right ventricle, and pulmonary vascular remodeling were reversed. Expression of hHIF-1 alpha in the hHIF-1 alpha-transfected EPCs that had been transplanted was high, and the number of pulmonary small arteries had increased. In addition, combined HIF-1 alpha and homogeneous EPC therapy was more effective at attenuating PAH and increasing the density of pulmonary small arteries, compared with EPC transplantation alone.Conclusions: Both the therapy with HIF-1 alpha-transfected EPCs, and EPC transplantation, attenuated shunt flow-induced PAH, by means of an angiogenic effect. The former therapeutic method was more effective.

亚砷酸是目前治疗急性早幼粒细胞白血病最有效的药物之一，常规治疗剂量的砷剂相对安全，但随着亚砷酸临床应用的日益广泛，其心脏不良反应报道也不断增加，包括心律失常、心肌损害、心功能不全等，但其所致的恶性心律失常鲜有报道，现将临床中所见的亚砷酸导致反复室颤1例报道如下。

目的：观察连续静脉-静脉血液滤过（ CVVH）对主动脉夹层术后急性肾功能衰竭（肾衰）的治疗效果。方法对37例主动脉夹层术后急性肾衰患者，尽早及时进行CVVH救治，比较治疗前后患者肾功能、血电解质、氧合情况。治疗前后进行APACHE Ⅲ评分、MODS评分，分别采用硫代巴比妥酸（ TBA）法、黄嘌呤氧化酶法、紫外比色法检测丙二醛（ MDA）、超氧化物歧化酶（ SOD）、谷胱甘肽过氧化物酶（ GSH-Px）水平变化。结果共有30例患者经CVVH治疗后肾功能及临床症状显著好转，其中8例在2周后肾功恢复正常，22例在4周后恢复正常。 CVVH治疗后血清肌酐、尿素氮浓度下降，高钾血症显著好转，APACHE Ⅲ评分、MODS评分、MDA、SOD、GSH-Px等氧化应激损伤指标显著下降，氧合情况改善。7例患者经血液净化治疗病情无改善，预后极差。结论 CVVH对大部分主动脉夹层开胸直视术后并发急性肾衰患者有效。治疗效果与患者基础肾功能、救治时机、治疗的连续性监护有关。

OBJECTIVE:To investigate the effect of continuous venovenous hemofiltration (CVVH) for aortic dissection patients with acute renal failure after surgery in retrospective manner.METHODS:A total of thirty-seven aortic dissection patients with postoperative acute renal failure accepted CVVH therapy. The effect of CVVH was evaluated by analyzing clinical condition changes and laboratory examination results.RESULTS:After treatment of CVVH, renal function and clinical symptoms were significantly improved in thirty patients. Eight of the thirty patients got completely renal function recovery within two weeks after CVVH therapy; and twenty-two of the thirty patients got completely renal function recovery within four weeks after CVVH therapy. Nevertheless, seven patients got no benefit from CVVH therapy with poor prognosis.CONCLUSION:CVVH is an effective treatment to most aortic dissection patients with postoperative acute renal failure. The effect of CVVH was correlated with original renal function, early CVVH therapy, and continuous intensive care.

OBJECTIVES:We sought to explore and create a reliable, convenient, and economic hyperkinetic pulmonary artery hypertension (PAH) model and confirm the exact time of establishing a reversible or irreversible model to serve as a platform for future studies.METHODS:We used a common carotid artery and jugular vein shunt with an anastomosis and cuff to create a hyperkinetic PAH model in rabbits. At 1, 2, 3, 6, and 12 months postoperatively, the systolic pressure, mean pulmonary arterial pressure, and mean arterial pressure were measured by catheterization and the right ventricle hypertrophy index was calculated. Pathologic changes in the small pulmonary arteries were observed with hematoxylin and eosin staining, and the Heath-Edwards classification system was used to evaluate PAH.RESULTS:The anastomosis and cuff graft groups both increased in systolic pressure, mean pulmonary arterial pressure (P<.05), and right ventricle hypertrophy index (P<.05). However, the anastomosis method resulted in a lower mortality rate, greater patency, and overall success rate compared with the cuff graft method (P<.05). Furthermore, from the observed pathologic changes and the Heath-Edwards classification system, a reversible and an irreversible PAH model was established at 3 and 6 months postoperatively, respectively.CONCLUSIONS:The common carotid artery and jugular vein anastomosis method is a stable hyperkinetic PAH model in rabbits. Reversible and irreversible PAH models were established at 3 and 6 months postoperatively, respectively.

OBJECTIVE:Levosimendan is a calcium sensitizer that enhances myocardial contractility without increasing myocardial oxygen use. Limited data are available on its renal-protective effect, and no statistically significant effects have been found. A meta-analysis was conducted for randomized studies to show whether perioperative levosimendan use could reduce acute kidney injury (AKI) in patients undergoing cardiac surgery.DATA SOURCES:BioMed Central, PubMed EMBASE, and the Cochrane Central Register of Controlled Trials were searched for pertinent studies.STUDY SELECTION:Randomized trials that compared levosimendan versus placebo or any other control in cardiac surgery with data on AKI were included. Exclusion criteria were duplicate publications, nonadult studies, oral administration of levosimendan, and studies with no data on AKI.DATA EXTRACTION:Study endpoints, study design, population, clinical setting, levosimendan dosage, and treatment duration were extracted.DATA SYNTHESIS:Data from 529 patients in 5 randomized trials were analyzed. The analysis showed that levosimendan decreased postoperative incidence of AKI in the levosimendan group.CONCLUSIONS:This analysis suggests that levosimendan might reduce renal injury in adult patients undergoing cardiac surgery. More prospective randomized studies are needed to further demonstrate the benefits of levosimendan on renal protection in cardiac surgery.

BACKGROUND:Ethyl pyruvate (EP) is an anti-inflammatory and anti-oxidant agent associated with many diseases. In this study, we evaluated whether EP could attenuate monocrotaline-induced pulmonary arterial hypertension (PAH).METHODS:A PAH model was established by subcutaneously injecting a single dose of monocrotaline (60 mg/kg). And then a daily intraperitoneal injection of EP (50 mg/kg) was administered on day 1 to day 28 (preventive EP treatment) or day 15 to day 28 (therapeutic EP treatment). Hemodynamic changes were measured by catheterization, and the right ventricle hypertrophy index, the medial wall thickness, and the medial wall areas were also calculated. Enzyme-linked immunosorbent assay and immunohistochemical analysis were used to determine the serum levels and expression of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and endothelin-1 (ET-1) in the lung tissue.RESULTS:Both preventive and therapeutic EP treatment significantly ameliorated hemodynamic changes and vascular remodeling indicators (all P < 0.05). The serum levels and expression of TNF-α, IL-6, and ET-1 in the lung tissue were also significantly decreased (all P < 0.05).CONCLUSIONS:EP ameliorates monocrotaline-induced PAH and reverses pulmonary vascular remolding in rats by inhibiting the release of TNF-α and IL-6 and reducing the expression of ET-1.

UNLABELLED:Abstract Background: Radiotherapy is an important treatment for the patients with advanced pancreatic cancer. Emerging studies determined apurinic/apyrimidinic endonuclease 1/redox factor-1 (APE1/Ref-1) might associate with the resistance of human pancreatic cancer cells to radiotherapy.AIMS:To investigate whether downregulation of APE1/Ref-1 expression by ribonucleic acid interference would increase the sensitivity of chromic-P32 phosphate to pancreatic cancer cells.METHODS:The plasmids containing APE-specific and unspecific short hairpin were transfected into Patu-8898 cells. Stable cell clones were selected by G418. The mRNA expression of APE1/Ref-1 was detected by semiquantitative reverse transcription-polymerase chain reaction and the protein expression of APE1/Ref-1 was detected by Western blot analysis; cell proliferation was studied by 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT) and colony formation assay; apoptosis was detected by flow cytometry.RESULTS:After 24 hours irradiation, APE1/Ref-1 mRNA and protein expression were upregulated, in a concentration-dependent manner. Suppression of APE1/Ref-1 by siRNA increased the pancreatic cancer cells hypersensitive to (32)P-CP. In the combination of (32)P-CP and siRNA group, MTT assay showed that the cell inhibition increased to (74.33%±9.02%), the surviving fraction in the colony formation assay was only 25.00%, and the apoptosis rate was up to (16.77%±0.98%).CONCLUSIONS:Knockdown APE1/Ref-1 gene expression may significantly sensitize the Patu-8988 cells to radiotherapy, which may be a useful target for modifying radiation resistance of pancreatic cancer cells to irradiation.

Background Whether obesity is related to late mortality with implantation of small aortic prosthesis remains to be clarified. This study was aimed to evaluate the effect of obesity on late survival of patients after aortic valve replacement (AVR) with implantation of small aortic prosthesis (size ≤ 21 mm). Methods From January 1998 to December 2008, 307 patients in our institution who underwent primary AVR with smaller prostheses survived the 30 days after surgery. Patients were defined as normal if body mass index (BMI) was < 24 kg/m 2 , as overweight if BMI 24–27.9 kg/m 2 , and as obese if BMI ≥ 28 kg/m 2 . Data of New York Heart Association (NYHA) functional classification, left ventricular ejection fraction (LVEF), effective orifice area index (EOAI), and left ventricular mass index (LVMI) of the patients collected at the 3rd month (M), 6th M, 1st year (Y), 3rd Y, 5th Y, 8th Y after operation respectively. Results By multivariable analysis, obesity was an independent factor of late mortality (hazard ratio [HR]: 1.62; P = 0.01). The obesity and overweight group had more poor survival (p < 0.001) and higher proportion of NYHA class III/IV (p < 0.01) compared with the normal group. Lower EOAI and higher LVMI were found in obesity and overweight group, but we saw no significant difference about LVEF among the three groups. Conclusions Obesity was associated with increased late mortality of patients after AVR with implantation of small aortic prosthesis. Being obese or and overweight may also affect the NYHA classification, even in the longer term. EOAI should be improved where possible, as it may reduce late mortality and improve quality of life in obese or overweight patients.

　　心肌梗死后室间隔穿孔的发病率占急性心肌梗死的1％～2％，约占急性心肌梗死死亡病例的5％［1］。急性心肌梗死后室间隔穿孔是急性心肌梗死的严重并发症，如不治疗患者很快死亡。24 h之内病死率为25％，1周内病死率50％，2周内死亡65％，4周内死亡80％。仅有8％的患者可存活至1年。心肌梗死后室间隔穿孔的真正原因还不清楚，但是人们发现穿孔多发生在透壁性心肌梗死面积较大的患者，心肌梗死面积较小者少见。尽管室间隔穿孔可在急性心肌梗死后数小时到2周内发生，但大部分发生在急性心肌梗死后2～4 d。室间隔穿孔后，产生左向右分流，分流量与穿孔的大小有关。心室水平的分流导致肺循环血流量增加，体循环血流量减少，因而出现心力衰竭，严重者出现心源性休克、多器官功能衰竭。内科药物治疗，可短暂缓解病情，但大多数患者仍难免死于心力衰竭和并发症。外科手术治疗是目前唯一挽救患者生命的手段。

Objective: The study objective was to investigate the effect of recombinant human hepatocyte growth factor gene transfection via an endotracheal approach on hyperkinetic pulmonary artery hypertension rabbit models.Methods: The rabbits with established pulmonary artery hypertension were separated into a gene transfection group (rabbits treated with intratracheal instillation of human hepatocyte growth factor 2 x 10(9) plaque-forming units coded by replication-defective recombinant adenovirus), an empty vector group, and a control group. Two weeks after endotracheal gene transfection, immunohistochemistry examination and Western blot were used to detect the protein expression of human hepatocyte growth factor. The hemodynamic data were measured, and pulmonary angiography was performed to investigate the pulmonary collateral vessels. The vascular density in lung also was analyzed.Results: Two weeks after gene transfection, human hepatocyte growth factor was expressed in the gene transfection group. The mean pulmonary artery pressure in the gene transfection group was lower than in the control and empty vector groups (P < .05 for both). The arteriolar density in the lung tissues of the gene transfection group was higher than in the other groups (P < .05), which was confirmed by immunohistochemistry, double-labeling immunofluorescence, and pulmonary angiography.Conclusions: Human hepatocyte growth factor was expressed in rabbit lung after gene transfection via an airway approach. Recombinant human hepatocyte growth factor transfection ameliorates the pulmonary artery hypertension induced by shunt flowby promoting angiogenesis in lung tissues.