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Objective:To investigate the predicting value of European system for cardiac operative risk evaluation ( EuroSCORE ) and sino system for coronary operative risk evaluation ( SinoSCORE ) in early quality of life of patients after coronary artery bypass surgery (CABG).Methods:A total of 218 consecu-tive patients who underwent CABG from March 2010 to January 2013 were evaluated with both systems before operation .Health related quality of life ( QoL) was estimated by using 36-item short form health survey ( SF-36) preoperatively and postoperatively in order to evaluate the predicting value of the two sys -tems in early post-operative QoL.Calibration was evaluated by Hosmer-l,emeshow goodness-of-fit test. Discrimination was tested by determining the area under the receiver operating characteristic ( ROC ) curve .Results:There was no significant difference between the accumulation of the EuroSCORE and SinoSCORE in the all patients (t=-0.904, P=0.368), When using Wilcoxon test on life quality in the preoperative and postoperative patients respectively ,the data showed that the quality of life improved significantly in various dimensions of the postoperative patients (Z=-2.886, P1 , P<0 .05 ) .Furthermore , the EuroSCORE predicted the outcome with a higher OR.For SinoSCORE the Hosmer-Lemeshow test was significant (P=0.628) and the area under ROC curve was 0.754.For the EuroSCORE the Hosmer-Lemeshow test was significant (P=0.538) and the area under ROC curve was 0.854.Conclusion:Both EuroSCORE and SinoSCORE could be viewed as a predictor for several aspects of postoperative QoL , while EuroSCORE might have a greater predicting value.
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Objective To investigate the expression of chemokine-like factor 1(CKLF1) in the balloon injured aorta of Sprague-Dawley rats.Methods Balloon expansion induced aorta injury model was established in 80 male Sprague-Dawley rats.Model rats were randomly divided into 8 groups.Rats were sacrificed at the postoperative periods of 12 hours,1 day,3 days,1 week,2 weeks,4 weeks,6 weeks,and 8 weeks respectively.Sham injury operation was applied to 5 rats as control.The ratio of intimal area (IA) and medial area (MA) was calculated to determine the extent of neointimal hyperplasia.Expression of CKLF1 was examined at protein level with immunohistochemistry and at mRNA level with RT-PCR.Software IPP6.0 was used to examine the mean optical density of positive staining.With β-actin expression as an internal control,semi-quantity of CKLF1 expression was calculated by CKLF1/β-actin.Results Visible neointima was noticed at 1 week postoperation.Extend of intimal hyperplasia(IA/MA)was most remarkable at 4 weeks and receded afterwards. Immnohistochemistry study showed that expression of CKLF1 was stronger in the neointima than in the media(P=0.016).The expression was most obvious in the neotima at 1 week postoperation.RT-PCR showed peak expression at 3 days postoperation and declined gradually but still at a higher level than control(P<0.05).The extent of intimal hyperplasia(IA/MA)was positively correlated to the expression of CKLF1(R=0.70,P=0.188).Conclusion The expression of CKLF1 was up regulated in balloon injured rat aorta.The expression was more obvious in the neointima than in the media.CKLF1 may play a role in the development of intimal hyperplasia.
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OBJECTIVE To evaluate the use of antibiotics after coronary artery bypass.METHODS Forty patients were assigned into two groups,vancomycin group and cefradine group.Each included 20 patients.We compared the infection cases,cost of hospitalization,and cost of medicine after CABG.RESULTS There were no difference of(infection) between two groups,the cost of hospitalization was fewer in cefradine group.(CONCLUSIONS) The short-term use of cefradine after CABG could achieve the goals of preventing infection of CABG,and save medical resources.
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Objective To analyze the risk factors impeding early extubation after off-pump coronary artery bypass grafting (OPCAB) in Chinese patients, so that to identify the applicable patients for "fast track recovery". Methods Clinical data of 680 consecutive patients who had received OPCAB were analyzed retrospectively. The patients were divided into two groups according to the time of extubation (group Ⅰ,n=333, extubation was performed within 12 h postoperation; group Ⅱ,n=347, extubation failed in 12 h). Univariate and multivariate analyses were used to determine risk factors prolonging mechanical ventilation. Results Univariate analyses showed significant difference between the two groups in the percentages of patients over 70 years [25% (84/333) vs 39% (136/347), ?2=15.148, P=0.000], with history of stroke [14% (46/333) vs 22% (75/347), ?2=7.068, P=0.008], with LVEF70 (OR=2.003), LVEF70, severe coronary artery lesion, emergency operation, and poor cardiac function are risk factors impeding early extubation. "Fast track recovery" protocol is applicable to young patients who have good cardiac function without left main lesion and do not need IABP during perioperative period.
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Objective To investigate the effect of CD34+ stem cells seeded stent graft in venous system. Method Twelve mongrel dogs were randomized into 2 groups. Stent grafts covered with PTFE or Dacron were implanted into infrarenal vena cava through a delivery system. In each group, 4 stent grafts were seeded by autogenous bone marrow CD34+ cells, and 2 treated by autogenous blood only as control. The grafts were explanted at 2 weeks. Light and electron microscopy were used to examine endothelialization of neointima. CD34 and Ⅷ factor stain were applied to identify endothelial cells. Results All stent grafts were patent except for one Dacron stent without seeding. Light, electron microscopy, CD34 and Ⅷ factor stain demonstrated that confluent endothelial cells appeared on the neointima of seeded grafts. No endothelial cells were detected in the non-seeding grafts. Conclusions Rapid endothelialization of stent grafts can be achieved through bone marrow CD34+ cells seeding in venous systems.