Coronary artery bypass grafting in patients over 70 years old / 中华外科杂志

<p><b>OBJECTIVE</b>To retrospectively analyze the experiences, indications, technique, and results of coronary artery bypass grafting (CABG) in patients over 70 years old.</p><p><b>METHODS</b>Ninety-one patients received coronary artery bypass grafting from March 2004 to March 2008. Ages ranged from 70 to 83 years old, 22 patients over 75 years old. Conventional CABG (CCABG) in 72 patients, off-pump CABG (OPCAB) in 19 patients. Clinical data has no significant differences in two groups. The rate of using left internal mammary artery was 96.7%. The number of grafts in CCABG and OPCAB group were 2 to 5 (3.5 +/- 0.8) and 1 to 4 (2.9 +/- 0.7) respectively.</p><p><b>RESULTS</b>In-hospital death in 2 cases, both were from chronic obstructive pulmonary disease and pulmonary infection. Cerebral infarction in 1 case and pulmonary infection in 2 cases in CCABG group, but no significant difference between two groups, and no difference in intubation, ICU stay, respiratory failure, renal function failure. But number of grafts in CCABG was significantly more than that in OPCAB (P < 0.01). Postoperative follow-up was 3 to 36 months, 1 case with recurrent angina in OPCAB.</p><p><b>CONCLUSIONS</b>According to the characteristic of coronary artery disease in elderly, fully revascularization and improving myocardial blood supply, patients over 70 years old with CABG can obtain the same efficacy as younger patients. There were not significant difference between CCABG and OPCAB.</p>

Staged total cavopulmonary connection for complex congenital heart diseases / 中华外科杂志

<p><b>OBJECTIVE</b>To review the experience of staged total cavopulmonary connection (TCPC) in complex congenital heart diseases.</p><p><b>METHODS</b>From June 1998 to March 2008, 22 patients underwent staged TCPC for complex congenital heart diseases. Among them, 9 were univentricular and pulmonary artery valve stenosis; 3 were univentricular and pulmonary artery atresia; 1 was transposition of great arteries, crisscross heart and pulmonary artery valve stenosis; 1 was complete atrioventricular canal defects, left ventricular hypoplasia, pulmonary artery atresia and atrioventricular valvular regurgitation; 1 was complete atrioventricular canal defects, left ventricular hypoplasia, pulmonary artery valve stenosis and atrioventricular valvular regurgitation after Glenn procedure; 1 was mirror image dextrocardia, single ventricle, pulmonary artery atresia, major aortopulmonary collateral arteries (MAPCAs) and right pulmonary arteriovenous fistula after Glenn procedure; 4 were tricuspid atresia and pulmonary artery valve stenosis; 1 was tricuspid atresia and pulmonary atresia; 1 was mirror image dextrocardia, double-outlet of right ventricle, left ventricular hypoplasia, pulmonary artery valve stenosis, tricuspid incompetence, and MAPCAs. Among them, 5 patients received systemic-to-pulmonary artery shunt, bidirectional Glenn procedure and TCPC. Seventeen patients received bidirectional Glenn procedure, the mean age was (5.9+/-4.4) years old. Pulmonary artery pressure pre-Glenn procedure was 17 to 20 mm Hg (1 mm Hg=0.133 kPa). Atrioventricular valve incompetence in 3 patients. Nakata index was less than 200 mm2/m2 in 4 patients before the first stage operation. The age of TCPC procedure was (9.6+/-4.9) years old, the interval time was (3.7+/-1.2) years.</p><p><b>RESULTS</b>There was one in-hospital death, the mortality was 4.5%. The patient with univentricular and pulmonary atresia, received systemic-to-pulmonary artery shunt, bidirectional Glenn procedure and TCPC and died of pneumorrhagia. Other patients were recovered well, postoperative central venous pressure was 12 to 18 mm Hg, percutaneous oxygen saturation was 90% to 96%. The cardiac function were in NYHA class I to II.</p><p><b>CONCLUSIONS</b>The staged TCPC was a good procedure in high-risk Fontan candidates. The results were satisfactory for those patients. This staged strategy may extend the operative indications for the Fontan procedure.</p>

Surgical treatment of complex congenital heart diseases with extracardiac conduit total cavopulmonary connection / 中华外科杂志

<p><b>OBJECTIVE</b>To report the experience of extracardiac conduit total cavopulmonary connection (ECTCPC) in surgical treatment of complex congenital heart diseases.</p><p><b>METHODS</b>From 1998 to 2006, 68 patients underwent ECTCPC for complex congenital heart diseases. Among them, 45 had functional univentricle with transposition of the great artery (TGA) and pulmonary artery valve stenosis, 19 had tricuspid atresia with hypoplasia of right ventricle, 4 had Ebstein's anomaly with hypoplasia of right ventricle. Six had left superior vena cava, 18 had received Bidirectional Glenn operation; Fifty-seven cases were performed under cardiopulmonary bypass with general anesthesia and hypothermia, 11 cases were performed without cardiopulmonary bypass.</p><p><b>RESULTS</b>There were two death, the mortality was 2.9%. All patients were followed up from 1 to 8 years with no clinical symptoms and have been doing well. The arterial oxygen saturation was 90% - 96%, the cardiac function were in NYHA class I - II.</p><p><b>CONCLUSION</b>The extra cardiac conduit TCPC is a simple procedure and superior to other type of Fontan procedure in most patients.</p>

Relationship of remote sensing normalized differential vegetation index to Anopheles density and malaria incidence rate / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To study the relationship of remote sensing normalized differential vegetation index (NDVI) to Anopheles density and malaria incidence rate.</p><p><b>METHODS</b>Data of monthly average climate, environment, Anopheles density and malaria incidence rate, and remote sensing NDVI were collected from 27 townships of 10 counties in southeastern Yunnan Province from 1984 to 1993. The relationship of remote sensing ecological proxy index, NDVI, to Anopheles density and malaria incidence rate was studied by principal component analysis, factor analysis and grey correlation analysis.</p><p><b>RESULTS</b>The correlation matrix showed that NDVI highly correlated with Anopheles density in 4 townships of Mengla, Jinghong, and Yuanjiang counties, but in other 23 townships the relationship was not clear. Principal component and factor analyses showed that remote sensing NDVI was the representative index of the first principal component and the first common factor of Anopheles density evaluation. Grey correlation analysis showed that in rainy season NDVI had a high grey correlation with Anopheles density and malaria incidence rate. The grey correlation analysis showed that in rainy season the grey degree of NDVI correlated with Anopheles. Minimus density was 0.730, and 0.713 with Anopheles sinensis density, and 0.800 with malarial incidence rate.</p><p><b>CONCLUSION</b>Remote sensing NDVI can serve as a sensitive evaluation index of Anopheles density and malaria incidence rate.</p>