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Objective:To investigate the postoperative complications and in-hospital mortality of reoperative cardiac surgery, and to explore the feasibility and safety of reoperative cardiac surgery.Methods:The baseline data and clinical information of patients undergoing cardiac surgery in Nanjing First Hospital from November 2012 to November 2021 were retrospectively conducted, and they were divided into the reoperative cardiac surgery group and the primary surgery group according to whether they underwent reoperative cardiac surgery using a propensity score analysis. The intraoperative indicators, postoperative complications and in-hospital mortality were compared between the two groups after matching.Results:After propensity score analysis, 146 cases were included in each of the group. In terms of intraoperative indicators, the cardiopulmonary bypass time [(141.48±47.88)min vs.(105.31±33.56)min], aortic occlusion time [87.0(70.5, 113.3)min vs. 71.5(53.0, 92.0)min], ICU stay time[2( 1, 4)days vs. 2(1, 2)days], postoperative drainage volume [750(460, 1300)ml vs. 610(410, 840)ml], postoperative transfusion of red blood cells [0(0, 3.5)U vs. 0(0, 2)U], the reoperative cardiac surgery group increased with statistically significant differences( P<0.05). Postoperative complications, the two groups had postoperative hypoxemia [15(10.3%) vs. 6(4.1%)], acute kidney injury [10(6.8%) vs. 0(0)], postoperative infection [24(16.4%) vs. 4(2.7%)], cerebral complications [7(4.8%) vs. 1(0.7%)] )], the incidence rate in the reoperative cardiac surgery group was higher with statistically significant differences( P<0.05). There was no significant difference in in-hospital mortality[7(4.8%) vs. 4(2.8%)]( P>0.05). Conclusion:The time of reoperative cardiac surgeryis is longer, postoperative recovery is slower, and postoperative complication rate is higher, but does not increase in-hospital mortality.
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The purpose of this paper was to introduce how to combine the propensity score analysis to reasonably carry out multiple linear regression analysis. Firstly， it introduced 3 basic concepts related to the propensity score analysis. Secondly， it presented the core contents of the propensity score analysis， that was， three matching methods. Thirdly， through an epidemiological survey example， it gave the whole process of how to use SAS software for the analysis. The contents were as follows： ① for the original data set， test whether the difference of covariates between the treatment group and the control group was statistically significant； ② directly implement the multiple linear regression analysis for the original data set； ③ the propensity score analysis was used to generate the matched data set； ④ for the matched data set， test whether the difference of covariates between the treatment group and the control group was statistically significant； ⑤ a reasonable multiple linear regression analysis was used for the matched data set.
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[Objective]To evaluate the effects of sutureless technique in comparison to conventional techniques for repair of total anomalous pulmonary venous connection(TAPVC)with the method of propensity score analysis.[Methods]From October 2007 to December 2013,179 consecutive patients were enrolled in this study. Patients were operated with sutureless technique(n = 81)or Conventional technique(n=98),and followed up at an interval of 1 month,3 months,6 months and then once a year post-operation. During analysis,three type of propensity-score matching methods,including nearest neighbor caliper matching,Mahalanobis metric matching with propensity score ,optimal full matching were used to create balanced groups of patients receiving each treatment. Surgeons’performance difference was assessed with random frailty proportional hazards models with gamma. Composite endpoints was defined by postoperative death or late death or postoperative pulmonary venous obstruction(PVO),which was evaluated with Kaplan-Meier curve and multivariable Cox proportional hazard model,adjusted by Preoperative-PVO,age,gender,weight and TAPVC type.[Results]Nearest neighbor caliper matching method was the best choice during propensity score analysis. After matching ,sutureless group included 73 patients and Conventional group73 patients. In sutureless group,cardiopulmonary bypass(CPB)time(Z=2.18, P=0.030),cross-clamp time(Z=3.63,P<0.001),rate of composite endpoints(HR 95%CI=0.20(0.06~0.61),P=0.005),late death(HR 95%CI=0.03(0.01~0.55),P=0.017)were significantly better than that in Conventional group. In subgroup analysis ,for patients with pre-PVO,decreased composite endpoints was seen in sutureless group.[Conclusion]Comparison using thepropensity score analysis demonstrated that sutureless strategy for primary repair of TAPVC may associate with decreased mortality rate of post-PVO and CPB time and cross-clamp time.
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Objective To study the rationality of biochemistry teaching of liberal arts students and science students in one class and further to improve the quality of teaching.Methods A total of 138 students of seven-year traditional Chinese medicine of Grade 2013 as the objects of study,among whom there were 58 liberal arts students and 80 science students.Questionnaire were surveyed at the end of the teaching of biochemistry,including evaluation of the teaching effect and teaching reform.138 valid questionnaires were dispatched and recovered.And at the same time unified examination was carried out to both liberal arts students and science students.The t test,chi square test or the exact probability method were used to compare the data of two types of students with SPSS 19.0.Results Questionnaire survey:31.03％ (18/58) arts students and 27.50％ (22/80) science students felt that the class hours were not enough.48.28％ (28/58) arts students thought the weak chemical base to be the main factor affecting learning,and 50.00％ (40/80) science students thought that lack of interest was the most important factor.53.45％ (31/58) arts and 47.50％ (38/80) science students would agree that a metabolic reaction of the material was the most difficult problem.51.72％ (30/58) arts students and 42.50％ (34/80) science students preferred blackboard-writing.Test scores:arts and science students got average grades (70.81 ± 9.71) and (77.05 ± 8.46) respectively,and the difference was statistically significant (t=-4.02,P=0.000).Conclusions Survey results and analysis of test scores shows that teaching of liberal arts students and science students in one class is feasible.However,it is necessary to strengthen the students' chemical basis,improve their learning interest and optimize their learning methods,so as to realize the harmonious development of the students of arts and science,and to improve the overall teaching level.
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Objective The exam quality of ‘Probability’ course for foreign medical undergraduates was analyzed,aiming at providing some reference for the improvement of the student evalua-tion system and course quality.Methods The ‘Probability’ course exam scores of 167 foreign un-dergraduates of 2014 batch were collected,the students were divided into two classes according to their entrance date,the former part class A consisted of 90 students,the latter part class B consisted of 77 students.The reliability of the test paper was judged according to Cronbach's α,Hotelling's T2 and Pearson correlation coefficient.The Spearman correlation analysis was adopted to evaluate the cor-relation between the question items.For the two classes,the impact of the entrance time on the test scores was explored on the basis of Student's t-test of question item scores and the total scores.Results The average score of the course exam was 82.587 points with the standard deviation of 13.520,Kol-mogorov-Smimov statistic was 1.627 (P=0.010),the exam scores could not follow normal distribution.The Cronbach's α for the exam paper was 0.808,the standardized Cronbach's α was 0.815.The Spearman correlation coefficients between the five question items were all with statistical significance and varied from 0.315 to 0.657.As the students were divided into two classes according to their entrance date,for the ‘Probability’ section scores of the latter batch students were less than the scores of the former batch,with the difference 4.017 points,the same situation was also found that all the five items in the ‘Probability’ section.Conclusions The entrance time for the foreign medical freshman has an impact on their exam scores,suggesting that more attention should be paid to those students.
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In order to evaluate our teaching results and improve the teaching quality,we designed this study to analyze the scores of nuclear medicine examination for the students of 2001 majoring in clinical medicine.There were 345 students participating in the examination.The results showed that the scores was Gassion distribution,the average score was 82.26,and the difficulty and discrimination of the test paper were appropriate.This analysis method as an objective index can be used to evaluate the response of teaching in nuclear medicine as well as improve the quality of test paper.
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Objective To explore the effects of examination scores of surgical experiment on introducing simulated vessel(ISV).Method 200 students of clinical medicine were randomly taken out and divided into two groups,namely the experimental group and routine group(n=100),who were respectively tested by the surgical experiment operating and theory after were trained by the ISV and routine surgical experimentation to compare the variability of their scores.Results The scores of the surgical experiment operating and theory of the experimental group were significantly higher than the routine group(P0.05),middle score groups were higher than the routine groups(P
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Xuzhou Medical Collage developed a set of test result analysis software.It uses Visual Basic for Application(VBA)and statistics function in database Excel2000.It is simple to use and powerful in function.A brief introduction was given below to help you to use it.