Objective To verify the predictive value of Sino System for Coronary Operative Risk Evaluation（SinoSCORE） on quality of life in patients undergoing coronary artery bypass graft （CABG） surgery. Method A total of 234 patients in Peking University People’s Hospital undergoing CABG between November 2008 and September 2010 hadcompleted the preoperative and 6-month postoperative Short Form-36 （SF-36）. There were 172 （73.5%） male patients and63 （26.5%） female patients. The average age was 63.0±10.1 years. According to the SinoSCORE， 234 patients were dividedinto three groups：low risk （SinoSCORE score less than 1 point，n=67）， medium risk （SinoSCORE score 2-5 points，n=77） and high risk （SinoSCORE score more than 6 points，n=90） group. Clinical information of the 234 patients was collected， andthe score values of all patients were calculated according to the SinoSCORE model. Statistic methods were performed toevaluate the relationship between quality of life and SinoSCORE. Results The postoperative quality of life have improvedsignificantly， but the improvement of quality of life have no significantly different between groups. There was statisticallysignificant correlation between quality of life and SinoSCORE （P＜0.05， r value at-0.150 to 0.255）.Linear regression analysis showed that SinoSCORE was significantly collected with quality of life in multiple subgroups （P＜0.05， r 2＜0.1） .Conclusion SinoSCORE have statistically correlated with quality of life， and have certain but limited predictive value on quality of life in CABG patients.
ObjectiveTo explore the effect of transplanting neonatal porcine islet cells of pig via hepatic portal vein in type Ⅰ diabetic monkeys.MethodIn this study, three pig-monkey islet xenotransplantation experiments were carried out by using α-1, 3-galactosyltransferase (GGTA1) gene knockout neonatal pig islet cells.ResultsThree macaques were successfully transplanted with islet cells. After the operation, their vital signs were stable and no symptoms of venous embolism occurred. After transplantation, the blood glucose and the dosage of exogenous insulin were significantly reduced, and the specific porcine C-peptide could be detected. Three macaques developed symptoms of ketoacidosis, and one macaque developed wound infection. After symptomatic treatment, all of them survived for 16 weeks.ConclusionGGTA1 knockout neonatal porcine islet cells transplanted through hepatic portal vein is effective for the treatment of type Ⅰ diabetes.
Objective To investigate the relationship between preoperative mean daily step counts and pulmonary complications after thoracoscopic lobectomy in elderly patients. Methods From 2018 to 2021, the elderly patients with pulmonary complications after thoracoscopic lobectomy were included. A 1∶1 propensity score matching was performed with patients without pulmonary complications. The clinical data were compared between the two groups. ResultsTotally, 100 elderly patients with pulmonary complications were enrolled, including 78 males and 22 females, aged 66.4±4.5 years. And 100 patients without pulmonary complications were matched, including 71 males and 29 females aged 66.2±5.0 years. There was no significant difference in the preoperative data between the two groups (P>0.05). Compared to the patients with pulmonary complications, the ICU stay was shorter (8.1±4.4 h vs. 12.9±7.5 h, P＜0.001), the first out-of-bed activity time was earlier (8.8±4.5 h vs. 11.2±6.1 h, P=0.002), and the tube incubation time was shorter (19.3±9.2 h vs. 22.5±9.4 h, P=0.015) in the patients wihout pulmonary complications. There was no statistical difference in other perioperative data between the two groups (P>0.05). The mean daily step counts in the pulmonary complications group were significantly less than that in the non-pulmonary complications group (4 745.5±2 190.9 steps vs. 6 821.1±2 542.0 steps, P＜0.001). The daily step counts showed an upward trend for three consecutive days in the two groups, but the difference was not significant. Conclusion The decline of preoperative mean daily step counts is related to pulmonary complications after thoracoscopic lobectomy in elderly patients. Recording daily step counts can promote preoperative active exercise training for hospitalized patients.
Objective To explore whether interleukin-10 ( IL-10 ) gene single nucleotide polymorphisms are associated with asthma. Methods The frequency of three single nucleotide polymorphisms ( rs1800896, rs3024492, and rs3024496) and haplotypes of IL-10 gene were analysed in 302 adult asthmatic subjects and 275 controls of Han Chinese in Guangzhou using MALDI-TOF-MS and MassARRAY-IPLEX. The genotype and allele frequencies were analyzed by Chi-square test in both groups.Logistic regression analysis with adjustment for age and sex was conducted. Odds ratio ( OR) and 95%confidence interval ( 95% CI) were calculated to analyze the associations between the susceptibility of asthma and genotypes. Results ①Three genotypes GG, GA, and AA of rs1800896 were found in Han Chinese inGuangzhou. The frequencies of GG, GA, and AA genotypes were 2. 12% , 39. 65% , and 58. 23% ,respectively. The relative risk of developing asthma in the carriers of GA was significantly higher than that in the carriers of AA ( OR=4. 827, P lt;0. 001) . ②Two genotypes AA and AT of rs3024492 were found in Han Chinese in Guangzhou. The frequencies of AA and AT genotypes were 1. 22% and 98. 78% , respectively.The rs3024492 polymorphism was not related to susceptibility in asthma. ③Two genotypes TT and CT of rs3024496 were found in Han Chinese in Guangzhou. The frequencies of TT and CT genotypes were 90. 59% and 9. 41% , respectively. The rs3024496 polymorphism was not related to susceptibility in asthma. Conclusion In IL-10 gene single nucleotide polymorphisms, rs1800896 but not rs3024492 and rs3024496 isstatistically related with the development of asthma.
ObjectiveTo investigate the epidemiology, etiology and prognosis of pneumonia in lung transplantation recipients. MethodsWe retrospectively analyzed the follow-up data of 42 case times (40 patients) of allogenic lung transplantation between March 2005 and August 2014. There were 29 males and 11 females with a mean age of 52.4±13.8 years. There were 32 case times with double lung transplantation, and 10 case times with single lung transplantation. Two patients underwent lung transplantation twice at an interval of 6.5 years and 4.0 years, respectively. ResultsIn 42 case times of lung transplantation, 26 case times had forty-two episodes of pneumonia throughout the follow-up period of median 146 days (range 3 to 2 704 days). Microbiological etiology was established in 36 case times of pneumonia. Bacterial pneumonia (68.1%) was more frequent than fungal (10.6%) and viral pneumonia (8.5%). The cumulative risk of a pneumonia episode increased sharply in the first 30 days after transplantation. A percentage of 38.1% of total pneumonia episodes occurred within 30 days after transplantation, predominately due to Gram negative bacilli. While pneumonia of gram-negative bacilli occurred earliest with a median of 20 days (range 8-297 days). pneumonia caused by viruses (283 days, range 186-482 days) appeared significantly later than gram-negative bacilli, and unknown etiology (44.5 days, range 3-257 days) (P=0.001 and P=0.019, respectively). The survival rate in 1 year, 3 years, and 5 years was 66.1%, 56.3%, and 36.2%, respectively. pneumonia episode within 30 days after lung transplantation was associated remarkably with mortality risk (P=0.03) in lung transplantation recipients. The total blood loss during transplantation procedure and post-transplantation intubation time were associated significantly with early onset of pneumonia (≤30 days) by univariate analysis. ConclusionRecognition of epidemiology, etiology and chronology of post-transplantaion pneumonia has implications relevant for appropriate management and optimal antibiotic prescription in lung transplantation recipients.
ObjectiveTo analyze the clinical outcomes of Cabrol procedure for the treatment of Stanford type A aortic dissection. MethodsClinical data of 37 patients with Stanford type A aortic dissection underwent Cabrol procedure at the Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute from January 2009 to April 2014 were retrospectively analyzed. There were 34 males and 3 females aged at 21 to 66 years. The average interval time from onset to getting operation was 15.2±28.5 days. All patients received Cabrol procedure was performed for aortic root. According to different aortic arch conditions, hemiarch replacement or total arch replacement combined endovascular aortic repair with stent were performed. ResultsAll the operations were successfully performed including isolated Cabrol procedure in 4 patients, right hemiarch replacement in 10 patients and total arch replacement combined endovascular aortic repair with stent in 23 patients. One patient (2.7%) underwent reexploration for postoperative bleeding. Postoperative mortality was 10.8% (4/37). Follow-up duration was 1-24 months, 2 patients died during follow-up. ConclusionCabrol procedure has satisfactory clinical outcomes for Stanford type A AD and long-term patency of aortic without coronary oppression.
Objective To analyze the risk factors for delirium of the Stanford A aortic dissection patients after surgery. Method We retrospectively analyzed the clinical data of 335 patients with type A aortic dissection in Guangdong Cardiac Institution from January 2012 through December 2014. There were 280 males and 55 females. The average of age was 48.5±10.3 years. Delirium status of the patients were evaluated based on confusion assessment method for intensive care unit (CAM-ICU). The patients were divided into two groups including a delirium group and a control group. We tried to find the risk factors for postoperative delirium. Results There were 169 patients of delirium with a incident rate of 50.4%. One-way analysis of variance and multivariate analysis indicated that pre-operative D-dimer level (OR=2.480, 95% CI 1.347-4.564, P<0.01), the minimum mean arterial pressure during operation (OR=0.667, 95% CI 0.612-0.727, P<0.01), the postoperative ventilation time (OR=2.771, 95% CI 1.506-5.101, P<0.01) and the postoperative acute kidney failure (OR=1.911, 95% CI 1.065-3.430, P<0.05) were the independent risk factors for delirium of the Stanford A aortic dissection patient after surgery. Conclusion The incident rate of postoperative delirium of the Standford A aortic dissection patient is relatively high. Patients in this study with elevated pre-operative D-dimer level, lower intraoperative mean arterial pressure, longer postoperative ventilation and combination of acute kidney failure have a higher rate of postoperative delirium. Better understanding and intervention of these factors are meaningful to reduce the occurrence of postoperative delirium.
Lung transplantation has been a standard treatment option for patients with end-stage lung disease. However, the demand for donor lungs exceeds the poor of available organs, resulting in considerable waiting list mortality. Among all the useful methods so far, ex vivo lung perfusion (EVLP) has been considered a useful technique in lung transplantation, which helps prolong donor lung preservation and repair donor lung injuries. Current studies have demonstrated EVLP can evaluate the donor lung function continuously and provide platform for pharmaceutical or even gene therapy. Moreover, EVLP improves the function of marginal donor lungs and increases the quantity of lungs meeting the transplant criteria, which could extend the donor pool. This article reviews the clinical application and research progress of EVLP in lung transplantation.