Association of lean tissue index with arteriovenous fistula dysfunction in maintenance hemodialysis patients / 中华肝脏病杂志

The clinical data of maintenance hemodialysis (MHD) patients from twenty hemodialysis centers in Guizhou province from June to September 2020 were collected by cross-sectional study. The patients were divided into AFD group and non-AFD group according to whether AFD had occurred. LTI was measured by body composition monitor. The results showed that the incidence of AFD in 2 781 MHD patients was 30.0% (835/2 781). Median LTI level was 15.2 (13.2, 17.5) kg/m2. The LTI level in the AFD group was higher than that in the non-AFD group (P < 0.05). According to the tertiles of LTI, low LTI group (LTI ≤ 13.9 kg/m2) had the highest incidence of AFD (35.5%, 334/940), and the high LTI group had the lowest incidence of AFD (26.3%, 241/916), and the difference among the three groups was statistically significant (χ2=20.182,P < 0.001). Multivariate logistic regression analysis showed that low LTI group as the reference, the risk of AFD in moderate LTI group (13.9 kg/m2 < LTI ≤ 16.6 kg/m2) and high LTI group were associated with the 20.0% (OR=0.800, 95% CI 0.650-0.986, P=0.036) and 22.8% (OR=0.772, 95% CI 0.616-0.966, P=0.024) decrease, respectively. These results suggest that low LTI level is independently associated with an increased risk of AFD in MHD patients.

Effect of small incision versus traditional incision thoracotomy for aortic valve replacement: A case control study / 中国胸心血管外科临床杂志

@#Objective    To compare the clinical efficacy of small incision with traditional thoractomy for aortic valve replacement. Methods    We retrospectively analyzed the clinical data of 78 patients with heart valve replacement in our hospital between May 2014 and June 2016. The patients were divided into a small incision group and an open chest group with 39 patients in each group. In the small incision group, 18 males and 21 females, aged 56.4±10.8 years, underwent cardiac surgery with a small incision. And in the open chest group, 17 males and 22 females, aged 57.1±9.7 years, underwent cardiac surgery by thoracotomy. Results    The extracorporeal circulation time, aortic cross clamping time of the small incision group were longer than those of the open chest group (P<0.05). But the amount of intraoperative blood transfusion and postoperative 24 h drainage volume of the small incision group were significantly less than those of the open chest group (P<0.05). Postoperative mechanical ventilation time, and postoperative hospitalization time of the small incision group were significantly shorter than those of the open chest group (P<0.05). Pain score of the small incision group was significantly lower than that of the open chest group significantly (P<0.05). There was no statistical difference in complications rate between the two groups after 6 months (P>0.05). Conclusion    Compared with traditional open chest cardiac surgery, small incision cardiac surgery is effective and safe, and is worth popularizing in clinic.