Objective To analyze clinical outcome of the technique of comprehensive aortic root and valve reconstruction (CARVAR) applying in aortic valve and root disease. Methods We retrospectively analyzed the clinical data of 106 patients with aortic valve and root disease underwent CARVAR technique in our hospital from July 2012 to July 2015. There were 72 males and 34 females at the average age of 57.3 (11-67) years. We operated the CARVAR technique and analyzed the early and midterm clinical outcomes. Results There was no mortality and low cardiac output syndrome postoperatively. But there were 2 cases of renal insufficiency or failure and 1 case of infective endocarditis. The average ejection fraction was 54%. The mean area of aortic valve orifice was 2.2±0.8 cm2. The aortic valve pressure gradient was 11.2±2.3 mm Hg. There were 2 cases of mild aortic valve regurgitation. The result of operation was satisfying with a stable hemodynamics and few complications. The follow-up after surgery showed that there was no obvious abnormity in aortic valve and root. Conclusion Using CARVAR technique to cure aortic valve and root disease is an effective treatment and it can achieve satisfactory early and midterm clinical outcomes.
ObjectiveTo evaluate Micron Ⅳ retinal imaging system in three mouse models of retinal diseases. MethodsMouse models of oxygen induced retinopathy (OIR) model (OIR group), N-methyl-N nitrosourea (MNU) model (MNU group) and N-methyl-D-aspartate (NMDA) model (NMDA group) were induced in 24 healthy male C57BL/6J mice. Fundus photograph, fundus fluorescein angiography (FFA) and optical coherence tomography (OCT) and electroretinogram (ERG) were used to evaluate these mice. All the imaging examinations were performed by Micron Ⅳ retinal imaging system. ResultsOIR mice showed tortuous and dilated retinal vessels in fundus photograph, neovascularization plexus and vascular leakage in FFA, and epiretinal fibrovascular tissue and tortuous expansion vascular vessels in OCT. MNU mice showed wax yellow optic disk without retinal pigmentary changes, slight thinning of retinal blood vessels in FFA, and normal structure and thickness in OCT. The a-wave amplitudes of the maximum mixed response decreased significantly, and were (15.38±4.36) μV and (13.78±5.52) μV at 2 or 3 days of modeling, respectively. NMDA mice showed a pale retina with vasospasm. ERG revealed that there was no obvious change in latency of a- and b-wave, but significantly decreased amplitude of b-wave at 12 hours and 24 hours after modeling with (72.28±7.18) μV and (65.35±9.18) μV, respectively. ConclusionMicron Ⅳ retinal imaging system is a real-time, non-invasive tool to study the retinal structure and function in animal models of retinal diseases.
ObjectiveTo analyze the clinical characteristics, risk factors, and drug resistance of pathogenic bacteria in patients with blood stream infections (BSI) after orthopedic surgery, so as to provide reference and basis for clinical diagnosis and treatment.MethodsA retrospective analysis was made on the clinical data of 6 348 orthopedic patients admitted for surgery between January 2017 and December 2019. There were 3 598 males and 2 750 females. Their age ranged from 18 to 98 years, with an average of 66 years. The data of patients were collected, and the risk factors of BSI were analyzed by univariate analysis and logistic regression analysis. The distribution of BSI pathogenic bacteria, the results of drug sensitivity test, the incidence of BSI in patients after orthopedic surgery in different years, and the common sites of BSI secondary infection were summarized.ResultsBSI occurred in 106 (1.67%) of 6 348 patients after orthopedic surgery. There were 71 cases (66.98%) of secondary infection. The mortality of postoperative BSI patients was 1.89%, and the difference was significant when compared with that of non-postoperative BSI patients (0.24%) (χ2=5.313, P=0.021). The incidences of BSI in 2017, 2018, and 2019 were 1.18%, 1.53%, and 2.17%, respectively, showing an increasing trend year by year (trend χ2=6.610, P=0.037). Statistical analysis showed that the independent risk factors for BSI after orthopedic surgery (P<0.05) included the trauma, length of hospital stay≥14 days, emergency surgery, postoperative leukocyte counting<4×109/L, level of hemoglobin≤90 g/L, albumin≤30 g/L, the time of indwelling ureter>24 hours, use of deep vein catheter insertion, and merging other site infection. Blood culture showed 56 strains (52.83%) of Gram-positive bacteria, 47 strains (44.34%) of Gram-negative bacteria, and 3 strains (2.83%) of fungi. The top three pathogenic bacteria were coagulase negative Staphylococci (CNS; 36 strains, 33.96%), Escherichia coli (16 strains, 15.09%), and Staphylococcus aureus (15 strains, 14.15%). The detection rates of extended-spectum β-lactamases producing strains of Escherichia coli and Klebsiella pneumoniae were 56.25% (9/16) and 44.44% (4/9), respectively. The detection rates of methicillin-resistant strains in Staphylococcus aureus and CNS were 46.67% (7/15) and 72.22% (26/36), respectively.ConclusionPostoperative BSI in orthopedic patients is caused by multiple factors. Preventive measures should be taken according to related risk factors and perioperative risk assessment should be strengthened. Staphylococcus and Escherichia coli are the most common pathogenic bacteria in BSI after orthopedic surgery. The infection rate and drug-resistant bacteria are increasing year by year. Therefore, drug resistance monitoring should be strengthened.