The valvo-pump, an axial blood pump implanted at the heart valve position: concept and initial results

The valvo-pump, an axial nonpulsatile blood pump implanted at the heart valve position, has been developed. The valvo-pump consists of an impeller and a motor, which are encased in a housing. An impeller with 5 vanes (22.0 mm in diameter) is used. The impeller is connected to a samarium-cobalt-rare earth magnet direct current (DC) brushless motor measuring 21.3 mm in diameter and 18.5 mm in length. Sealing is achieved by means of a ferrofluidic seal. A pump flow of 10.5 L/min was obtained at a pump differential pressure of 3.3 kPa (25 mm Hg), and a flow of 4.9 L/min was obtained at 7.0 kPa (53 mm Hg). Sealing was kept perfect against a pressure of 29.3 kPa (220 mm Hg) at 9,000 rpm.     

Cyclosporin A induced internalization of the bile salt export pump in isolated rat hepatocyte couplets.

Isolated rat hepatocyte couplets were used to perform the comparative study of two widely used immunosuppressors, cyclosporin A (CsA) and tacrolimus (FK506) on hepatocanalicular function. We assessed canalicular function by counting the percentage of couplets that were able to accumulate the fluorescent cholephile, cholyl-lysyl-fluorescein (CLF), into the canalicular vacuole between the two cells, i.e., canalicular vacuole accumulation (CVA) of CLF. Compared to controls (DMSO-treated cells), CsA, in the approximate range of concentrations used therapeutically, caused inhibition of CVA of CLF, disorganization of the bile salt export pump (Bsep) localization at canalicular level resulting in its relocation into the cell, and disruption of the pericanalicular F-actin cytoskeleton. In contrast, FK506, at both approximately therapeutic and supratherapeutic concentrations, had no deleterious effect upon CVA of CLF, upon the localization of the bile salt transporter at the canalicular membrane, or on the organization of the pericanalicular F-actin cytoskeleton. These results point to transporter and cytoskeletal disorganization as contributors or determinants of CsA-induced cholestasis at canalicular level, whereas FK506 does not appear to produce these cholestasis-determining responses even at supratherapeutic concentrations.     

Magnetically suspended rotary blood pump with radial type combined motor-bearing

A magnetically suspended centrifugal blood pump is being developed with a combined motor-bearing for long-term ventricular assist systems. The combined motor-bearing actively suspends a rotor in a radial direction to deal with radial force unbalance in the pump and rotates the rotor by using the electric magnetic field. Therefore, the pump has no mechanical parts such as bearings of the motor and has a long lifetime. The developed pump consists of a thin rotor with a semi open-type 6 vane impeller and a stator to suspend and rotate the rotor. The rotor has 4-pole permanent magnets on the circumferential surface. The outer diameter and the thickness of the rotor are 60 mm and 8 mm, respectively. Axial movement and tilt of the rotor are restricted by passive stability based on the thin rotor structure. Radial movements of the rotor, such as levitation in radial direction and rotation, are controlled actively by using electric magnets of the stator. The electric magnet coils to produce levitation and rotation forces are constructed on the periphery stator. The p +/- 2-pole algorithm and the synchronous motor mechanism are adopted to levitate and rotate the rotor. The radial gap between the rotor and the stator is 1 mm. A closed-loop circuit filled with water was connected to the developed pump to examine the basic performance of the pump and the magnetic suspension system. Maximum rotational speed, flow rate, and head were 2,800 rpm, 11 L/min, and 270 mm Hg, respectively. The rotor with the impeller could be suspended completely during the entire pumping process. We conclude the pump with the combined motor-bearing has sufficient performance for the blood pump.     

Paradoxical effects of viscosity on the VentrAssist rotary blood pump

The ability of the VentrAssist blood pump to perform at its optimum design point is determined by a number of factors such as geometry of the pump, surface roughness, and fluid properties. Once the fluid properties are known, the performance characteristics of the pump can be optimized for that fluid. It is important to understand the effects of dynamic viscosity mu (called simply viscosity hereafter) on the performance characteristics and stability of the pump. The performance envelope of the pump and the needs of the patient must be matched. The VentrAssist pump has no shaft, seals, or fixed bearings and relies on the fluid-dynamic forces to maintain its effective performance. A number of different fluids have been tested to determine the effects of viscosity and density on pump performance. These include aqueous glycerol, red blood cells (RBCs) suspended in phosphate buffered saline solution (PBS), and Haemaccel. The effects of viscosity on the bearing stiffness, stage efficiency, and the pressure-flow rate (HQ) are characterized. The experimental results show a slight increase in the pressure rise across the pump shown as a positive upward shift of the H-Q curves with a decrease in viscosity; however, this is relatively small. A paradox in system efficiency exists: for a given fluid asymptotic viscosity, the system efficiency (product of magnetic and stage efficiency) using Haemaccel or PBS is greater than for the same viscosity of aqueous glycerol.     

Computational flow study of the continuous flow ventricular assist device, prototype number 3 blood pump

A computational fluid dynamics study of blood flow in the continuous flow ventricular assist device, Prototype No. 3 (CFVAD3), which consists of a 4 blade shrouded impeller fully supported in magnetic bearings, was performed. This study focused on the regions within the pump where return flow occurs to the pump inlet, and where potentially damaging shear stresses and flow stagnation might occur: the impeller blade passages and the narrow gap clearance regions between the impeller-rotor and pump housing. Two separate geometry models define the spacing between the pump housing and the impeller's hub and shroud, and a third geometry model defines the pump's impeller and curved blades. The flow fields in these regions were calculated for various operating conditions of the pump. Pump performance curves were calculated, which compare well with experimentally obtained data. For all pump operating conditions, the flow rates within the gap regions were predicted to be toward the inlet of the pump, thus recirculating a portion of the impeller flow. Two smaller gap clearance regions were numerically examined to reduce the recirculation and to improve pump efficiency. The computational and geometry models will be used in future studies of a smaller pump to determine increased pump efficiency and the risk of hemolysis due to shear stress, and to insure the washing of blood through the clearance regions to prevent thrombosis.     

质子泵抑制剂预防化疗所引起胃炎的随机对照临床研究

为了探讨质子泵抑制剂预防及抑制化疗所引起的化学性胃炎的有效性 ,随机对照研究了不同治疗方法 ,预防基于多柔比星、氮烯咪胺、铂类、伊立替康和 5 -氟尿嘧啶所组成的化疗方案所致的胃炎的疗效 ,研究组采用质子泵抑制剂、安定和 5 HT3 受体拮抗剂预防胃炎和呕吐方法 ,对照组使用常规传统的地塞米松加 5 HT3 受体拮抗剂 ,进行跟踪观察、疗效比较 ,并从不良反应、耐受性及安全性等方面加以分析比较。研究组胃炎发生率 0 ( 0 /11) ,对照组为 72 .73 % ( 8/11) ,P =0 0 0 1;化疗后完全无上消化道症状 /体征者 ,研究组 75 0 0 % ( 3 3 /4 4) ,对照组 5 2 2 8% ( 2 4/4 6) ,P =0 0 2 5 ;化疗后 7d无症状 /体征者 ,研究组 10 0 % ( 4 4/4 4) ,对照组 76 0 9% ( 3 5 /4 6) ,P =0 0 0 1。初步研究结果提示 ,质子泵抑制剂对化疗过程中所引起的化学性胃炎有明显的预防及抑制作用 ,而且有效率高、不良反应小、安全性好 ,患者有良好的耐受性。     

Lanzoprazole promotes gastric carcinogenesis in rats with duodenogastric reflux

Background Duodenogastric reflux is known to cause an increased frequency of cancer in the glandular portion of the stomach in rats. Furthermore, it is debated whether inhibition of gastric acid secretion may promote gastric carcinogenesis. In the present study we examined the combined effect of gastroduodenal reflux and acid inhibition with respect to the development of gastric carcinoma in the rat.Methods Following the construction of a gastrojejunostomy in male Wistar rats, half of them were given the proton pump inhibitor lanzoprazole for 1 year. The rats were then killed and the pH in the stomach and gastrin in blood were measured. The stomach was examined macroscopically as well as histologically.Results Gastrin levels at autopsy were significantly increased in treated rats compared to the control group, confirming an effect of lanzoprazole on gastric acid secretion. Body weight was significantly reduced in the treated rats. Thirty of 79 rats developed gastric cancer, and they were all adenocarcinomas of the Lauren intestinal type. Gastric cancers occurred significantly more often in lanzoprazole-treated rats (50%) compared with controls (27%).Conclusion Lanzoprazole given orally enhances the carcinogenic effect of duodenogastric reflux in rats.     

Is Avoidance of Air Contact Necessary for the In Vitro Evaluation of Thrombogenicity in Mechanical Circulatory Assist Devices?

An effective in vitro protocol for the investigation of thrombogenicity can provide many advantages in the development of mechanical circulatory assist devices. Strict avoidance of air contact with blood recently was proposed for reliable in vitro evaluation. This study was performed to confirm the necessity of avoidance of air contact for the in vitro test of thrombogenicity in a rotary pump. Two sets of mock circuits with the same rotary blood pumps, reservoirs, and connecting tubes were made. In one system, blood came in contact with air while the other did not. The test blood was heparinized at the dose of 1 IU per 1 ml of blood. The tests were terminated at an activated coagulation time of 1.5 times the control value. The levels of hematocrit, platelet, factors VIII and XII, fibrinogen, thromboxane B2, and plasma-free hemoglobin were measured during the procedures. After the experiments, the thrombi formed were observed, measured, and compared with those formed in in vivo circumstances. The tests were repeated 12 times. There were no statistically significant differences between the 2 groups in hematologic parameters and the amounts of thrombi formed. The thrombi observed in both groups showed the same pathologic findings as those formed in vivo with the exception of intermittent multiple air bubbles found in thrombi of the air-contact group. In conclusion, the effect of air contact in the in vitro investigation of thrombogenicity was negligible while the proposed in vitro test models of thrombogenesis in the mechanical circulatory assist device proved to be reliable.     

Development of a miniature undulation pump for the distributed artificial heart

Research of the distributed artificial heart is important not only to acquire the means of individual organ perfusion but also to clarify the characteristics of the organ and the mechanism of blood distribution. To investigate the distributed artificial heart, the miniature undulation pump was developed. The outer diameter and the thickness of the developed pump were 38 mm and 11 mm, respectively. The priming volume of the pump was 3.2 ml. The total size including the motor unit was 38 mm in diameter and 32 mm in length. The total weight was 67.5 g. The total volume was 27.5 ml. The pump was driven with pulse width modulation by using a 1 chip motor controller. More than 5 L/min of continuous output could be obtained. The results showed that the developed miniature undulation pump system had enough performance for individual organ perfusion.     

便携式输液设备的研制

本文介绍一种由8031单片机控制的便携式输液设备，阐述了其原理和组成，它可以自动控制输液速度和输液量，具有报警功能，成本低但性能好，可以广泛应用于临床输液以及药品成分分析等场合。