RESUMO
@#Objective To investigate the influence of prior percutaneous coronary intervention (PCI) on the outcome of coronary artery bypass grafting (CABG). Methods Clinical data of 5 216 patients from Jiangsu Province CABG registry who underwent primary isolated CABG from 2016 to 2019 were retrospectively analyzed. Patients were divided into a PCI group (n=673) and a non-PCI group (n=4 543) according to whether they had received PCI treatment. The PCI group included 491 males and 182 females, aged 62.6±8.2 years, and the non-PCI group included 3 335 males and 1 208 females, aged 63.7±8.7 years. Multivariable logistic regression and propensity score matching (PSM) were used to compare 30-day mortality, incidence of major complications and 1-year follow-up outcomes between the two groups. Results Both in original cohort and matched cohort, there was no statistical difference in the 30-day mortality [14 (2.1%) vs. 77 (1.7%), P=0.579; 14 (2.1%) vs. 11 (1.6%), P=0.686], or the incidence of major complications (myocardial infarction, stroke, mechanical ventilation≥24 h, dialysis for new-onset renal failure, deep sternal wound infection and atrial fibrillation) (all P>0.05). The rate of reoperation for bleeding in the PCI group was higher than that in the non-PCI group [19 (2.8%) vs. 67 (1.5%), P=0.016; 19 (2.8%) vs. 7 (1.0%), P=0.029]. Both in original cohort and matched cohort, there was no statistical difference in 1-year survival rate between the two groups [613 (93.1%) vs. 4 225 (94.6%), P=0.119; 613 (93.1%) vs. 630 (95.2%), P=0.124], while the re-admission rate in the PCI group was significantly higher than that in the non-PCI group [32 (4.9%) vs. 113 (2.5%), P=0.001; 32 (4.9%) vs. 17 (2.6%), P=0.040]. Conclusion This study shows that a history of PCI treatment does not significantly increase the perioperative mortality and major complications of CABG, but increases the rate of cardiogenic re-admission 1 year postoperatively.
RESUMO
Objective:To evaluate the efficacy and safety in the treatment of the visceral artery aneurysms (VAAs) by Viabahn stent graft and the detachable coils combined with Onyx embolization.Methods:A retrospective study on clinical and follow up results of 46 patients in the treatment of visceral aneurysms (VAAs) from Jun 2012 to Jun 2018 was carried out.Result:In 18 patients of VAAs treated with Vabahn endovascular stent grafting, the aneurysm cavity was completely isolated after injection of contrast and the technical success rate was 100% (18/18). In 28 patients of VAAs treated with the detachable coils combined with Onyx embolization, the aneurysm cavities of 26 patients among the 28 cases were filled tightly. In 2 patients the aneurysm neck was still visible. The average follow-up period was (36.5±2.3) months by CTA. After treating VAAs with the Viabahn stent graft, the complete isolation rate and the patency of aneurysm bearing artery were respectively 100% (18/18) and 94.4% (17/18). When VAAs was treated with the detachable coils combined with Onyx embolization, the complete isolation rate and the patency of aneurysm bearing artery were respectively 85.7% (24/28) and 92.9% (26/28) (χ 2=3.915, P=0.048), the difference of the patency of aneurysm bearing artery between the two groups was no significant difference (χ 2=0.074, P=0.786). Conclusion:VAAs treated with Viabahn endovascular stent grafting or detachable coils combined with Onyx embolization are both safe and effective.
RESUMO
Objective To investigate the effects of extended nursing based on relationship, information and management on the self-care behaviors of patients with heart valve replacement. Methods According to admission time, 37 patients with heart valve replacement were set as the control group, which was given routine nursing intervention and another 42 patients as the study group, which received extended nursing based on the trinity of relationship, information and management 2~8 weeks after discharge. Before and after intervention, patients were evaluated by using the improved version of self-care behavior evaluation scale of heart disease (SNBAOHD). Result There were significant differences between the two groups in other items of SNBAOHD, except two items of low salt diet and medication (P<0.05). Conclusions Extended nursing after discharge based on the trinity of relationship, information and management can help the patients to be continuously cared. In this case, it is effective for the enhancement of off-hospital self-care ability and prevention of disease relapses.
RESUMO
Objective To analyze the function of let-7e in the carcinogenesis of non-small-cell lung cancer.Methods The microRNA let-7e expression levels in cancer tissues and adjacent normal lung tissues were detected by quantitative real-time reverse transcription-PCR from 35 non-small-cell lung cancer patients,U6 RNA as an actin.Results The expression of microRNA let-7e in cancer tissues was significantly higher than adjacent normal lung tissues (10.111±6.135,P ＜ 0.0001),there was a significantly different between squamous carcinoma group (9.635±8.300) and adenocarcinoma group (10.301 ±5.228,P ＜ 0.05),independently of sex,smoking history,stage,and histologic characteristics of the tumor.Conclusion The expression of microRNA let-7e in cancerous tissues is high,microRNA let-7e should play oncogene role in process of non-small-cell lung cancer,and would be an useful biomarker.
RESUMO
Objective To study the locations, types and causes of different pseudoaneurysms in order to find out the optimal individualized treatment for different pseudoaneurysms. Methods Different methods were applied in treating 21 patients with pseudoaneurysm, which were located at limb (n = 11 ), spleen (n =3), kidney (n = 2) , common lilac artery (n = 1), internal iliac artery (n = 1), gallbladder (n = 1) and penis (n = 1 ). Different managements were employed in treating these pseudoaneurysms. Temporary obstruction of blood circulation with balloon together with arterial anastomosis or direct incision neoplasty was performed in 9 cases with pseudoaneurysms at limb arteries close to the larger joints. Endovascular stent graft was used to isolate the trunk type of pseudoaneurysm in 4 cases, in 2 of them branch arterial embolism and stent graft endovascular exclusion were applied as they had common iliae artery trunk type of pseudoaneurysm at the opening of internal iliac artery. Gelfoam together with metallic coils embolization was employed in 6 cases with terminal type of pseudoaneurysms. Results After different treatments, tumor cavities disappeared in the 21 cases with pseudoaneurysms. Distal arterial pulse returned to normal and no nerve damage occurred in 11 cases with limb pseudoaneurysms. No internal hemorrhage was observed and distal blood circulation returned to normal after graft endovascular exclusion in 2 eases with pseudoaneurysms at spleen artery trunk and in 2 cases with pseudoaneurysms at iliac artery trunk. In 6 cases with terminal type of pseudoaneurysms,the tumor cavity disappeared, hemorrhage stopped and no ischemic necrosis of organ occurred. But one of them with multiple traumatic pseudoaneurysms located at the second grade branch died one week after embolism due to a serious pelvic trauma accompanied with serious infection. Conclusion Based on the locations, types and causes of pseudoaneurysms, different individualized treatment should be adopted in order to obtain optimal results with least damages.
RESUMO
The receptor of the heart transplantation was a patient with terminal dilated cardiomyopathy, the donor was a patient with congenital ventricular septal defect, in situ double-chamber heart transplantation was performed, and the result of the four-year follow-up was satisfactory. At present, donor is deficient,and those donors with congenital defect can also obtain satisfactory clinical application effects after appropriate handling.
RESUMO
0.05). In the control group, the intima of grafted veins were thickened evidently with proliferated vascular smooth muscle cells (VSMCs) and the media thickness were slight. Compared with the control group, the intima was slightly thickened in the treatment group, but there were significant reductions in proliferated VSMCs. Additionally, the media thickness was unobvious in treatment group. Compared with the control group, the thickness and area of neointima and the expression of PCNA in the treatment group were significantly lower than those in the control group (P