Effects of off-pump coronary artery bypass graft on the clinical efficacy, surgical indicators, and cardiac function of patients with coronary heart disease.

BACKGROUND: Coronary heart disease (CHD) is a common clinical cardiovascular disease. This study aimed to analyze the effects of off-pump coronary artery bypass graft on the clinical efficacy, surgical indicators, and cardiac function of patients with CHD. METHODS: We retrospectively analyzed the clinical data of 120 patients with CHD who were treated in our hospital from May 2017 to May 2020. And they were divided into the control group (extracorporeal coronary artery bypass graft) and the observation group (off-pump coronary artery bypass graft). The clinical efficacy, surgical indicators, cardiac function, myocardial injury, the degree of cardiac autonomic nerve imbalance, incidence of complications and quality of life one year after the operation in the 2 groups were compared. RESULTS: The total effective rate of the observation group was significantly higher than that of the control group. Intraoperative blood loss, operation time, intraoperative blood transfusion, and hospital stay in the observation group were significantly better than those in the control group. After treatment, the levels of cardiac index (CI), ejection fraction (EF), stroke volume (SV), and cardiac output (CO) in the observation group and the control group were higher than those before treatment, especially in the observation group. Compared with those before operation, CK-MB and cTnI of the two groups significantly increased at all time points after surgery. After treatment, SDNN, LF, HF, and TP of patients in the two groups increased, which was significant in the observation group. The incidence of complications such as myocardial infarction, ischemic changes, respiratory insufficiency, and intraoperative ventricular fibrillation in the observation group was significantly lower than that in the control group. The score of quality of life in the observation group was significantly higher than the control group. CONCLUSIONS: In the treatment of patients with CHD, off-pump coronary artery bypass graft has good clinical effects, which can significantly improve the heart function, and cardiac autonomic nerve imbalance of patients, reduce myocardial damage, decrease the incidence of complications, and improve the quality of life. Therefore, off-pump coronary artery bypass graft is worthy of clinical application.

Treatment of tibial fracture with interlocking intramedullary nail and tripus / 中国骨伤

<p><b>OBJECTIVE</b>To explore the method and effect of inter-locking intramedullary nail and tripus in closed reduction for treating tibial fracture.</p><p><b>METHODS</b>One hundred and twenty-six patients of tibial fractures were treated by inter-locking intramedullary nail and tripus in closed reduction. There were 76 males and 50 females aged from 25 to 68, the mean age was 38; There were 86 close fractures and 40 open fractures (Gustilo I and II type). AO classification system was used for all cases, fracture type A in 49 cases, type B in 41 cases, type C in 36 cases.</p><p><b>RESULTS</b>All patients were followed up for 10 to 16 months. Fratures were cured, according to the criteria of Johner-Wruhs, the results were excellent in 103 cases, good in 18 cases, fair in 5 cases.</p><p><b>CONCLUSION</b>Inter-locking intramedullary nail is the optimal operation method in treating tibial fracture. Static locking should be a routine way, and closed reduction, no stripping periosteum, infectious rate and complications are reduced. Through tripus work intensity are reduced and reduction easily during operation.</p>