简介：AbstractIntroduction:Obstructed total anomalous pulmonary venous connection (TAPVC) is one of the commonest seen emergencies in pediatric cardiology centers.Case presentation:Our case was diagnosed to have this anomaly, showing early respiratory distress resulting from severe pulmonary congestion. Palliative stenting of the obstruction was done, which helped in stabilizing the debilitated hemodynamics of the baby before surgery, thus a good surgical outcome and prognosis are expected.Conclusion:This intervention may be listed as a vital measurement in the preoperative cardiac stabilization plan for infants with obstructed TAPVC.

简介：ObjectivesWedidaretrospectivestudytosummarizethesurgicalexperienceofanomalouspulmonaryvenousdrainage(APVD)correctionanddiscusseffectivewayofimprovingthesurgicaloutcome.MethodsFromJanuary1985toMay2008,127patients[56menand71women,aged14-55yearswithanaverageof(26.79±10.62)years]withAPVDunderwentsurgicaltreatments.Amongthem,13patientshadsimplepartialAPVDwithintactatrialseptum,104patientshadpartialAPVDwithatrialseptaldefectand10patientshadtotalAPVD.Seventy-onepatientsofthemaccompaniedwithothercardiacanomalieswhichwerealsocorrectedintheiroperations.ResultsOneearlyoperativedeathduetoseverelowcardiacoutputsyndrome(LCOS)developedpostoperatively,whichresultedinamortalityrateof0.78%.Amongotherpatients,10patientscomplicatedwithLCOS,11patientswitharrhythmia,7patientswithacuterenalfailureand4patientswithpoorwoundhealing,alldischargedfromhospitalaftertreatment.Postoperativeechocardiographyreexaminationrevealed1caseofmildresidualshuntinatrialseptumbutwithoutpulmonaryveinstenosis.ConclusionForrightatrialandventricleenlargedpatientswithorwithoutpulmonaryhypertension,surgeonsshouldbevigilanceofaccompaniedAPVDwhetheratrialseptaldefectsexistornot.Aslongasnocontraindicationsarefound,surgicaltreatmentshouldbeperformedonceaccuratediagnosisisobtained.

简介：BackgroundPleuraleffusionaftertheFontanoperationcontributessignificantlytomorbidityandprolongedhospitalization.Thepurposeofthepresentstudywastoinvestigatewhetherchesttubesplacedindifferentcavitiesduringthesurgerywouldcontributetothedrainageandalsotoevaluateriskfactorsofthoracicdrainagewithcentralvenouscatheteraftertotalcavopulmonaryconnectionintheeraofthecentralvenouscatheter.MethodsFromJanuary2009toJune2012,109consecutivepatientsunderwenttotalcavopulmonaryconnectionatGuangdongGeneralHospital.With102patientsforinvestigation,preoperative,intraoperativeandpostoperativefactorswereobtained.Thoracicdrainagewithcentralvenouscatheterwaswhenevernecessary.Durationofchesttubedrainageandtimeofthoracicdrainagewithcentralvenouscatheteraddeduptototaldurationofpleuraldrainage.BinarylogisticregressionusingforwardLRmethodwasappliedfortheanalysisoftheriskfactorsforthoracicdrainagewithcentralvenouscatheter.ResultsAftertotalcavopulmonaryconnection,comparedwithchesttubesplacedinsinglepleuralcavitywithorwithoutpericardialorretrosternalcavity,thoseinbothpleuralcavitiesseemedtohavethechanceoflongerhospitalstay(P=0.028).Noothersignificantdifferenceswereobtainedinfactorsofventilationtime,extubatedcentralvenouspressureinsuperiorvenacava,ICUstay,totaldurationofpleuraldrainage.Sildenafilwasthepreventivefactorforreducingcentralvenouspressureandpreventingfrompostoperativepleuraleffusion.ConclusionsAftertotalcavopulmonaryconnection,patientswithtubesplacedinbothpleuralcavitieswouldnothavethechanceofshortertotaldurationofpleuraldrainageandsurprisinglyturnsouttohavelongerhospitalstay.Sildenafilisapreventivefactorforthoracicdrainagewithcentralvenouscatheter.

简介：无

简介：

简介：BackgroundAnomalousoriginoftheleftcoronaryarteryfromthepulmonaryartery(ALCAPA)isararecongenitalanomaly.Itdemonstratedthecombinedeffectsoftheabsenceofanormalcoronaryflowwithacoronarystealandtheprofoundischemiathatcanproduceleftventriculardysfunctionandmitralregurgitation.Wehereintroducethepostoperativemanagementofpatientswithrepairofanomalousoriginoftheleftcoronaryarteryfromthepulmonaryartery,withanemphasisonitsoutcome.MethodsRecordsof31patientswithanomalousoriginoftheleftcoronaryarteryfromthepulmonaryarteryreceivingsurgeryfrom1998to2010werereviewedretrospectively,10ofwhichweretreatedwiththemitralvalvesurgicallyatthesametime.Theageofpatientswas4monthsto16years(median,1year)andweightofthosewas5to53kilograms(median,7.8kilograms),allofwhichwerediagnosedofanomalousoriginoftheleftcoronaryarteryfromthepulmonarybyechocardiographyandcardiaccatheterization.Aftersurgery,electrocardiogram,echocardiography,arterialbloodpressure,transcutaneousoxygensaturationandcentralvenouspressureweremonitored.Commonpostoperativecomplicationsinourgroupwereanalysed.Andpreoperativeandpostoperativedataincludingareaofmitralregurgitation,leftventricularsystolicdiameterandleftventriculardistolicdiameterwereobtained.Cardiopulmonarybypasstimeandmechanicalventilationtimeofpostoperativepatientswithnopneumoniawerecomparedwiththosewithpneumonia.Binarylogisticregressionwasappliedfortheanalysisoftheriskfactorsofpostoperativepneumonia.ResultsOf31patients,30survivedaftersurgerywithearlymortalityof3.23%.Onepatientdiedofseverelowcardiacoutputsyndrome.Mechanicalventilationtimewas4hoursto168hourshours(mean,39.68±50.52hours;median,18hours).ICUstaywas16hoursto425hours(mean,111.65±127.03hours;median,44hours).Inourgroup,commonpostoperativecomplicationsweremyocardialischemia(n=12,36.4%),infection(n=

简介：BackgroundAnomalousoriginoftheleftcoronaryarteryfromthepulmonaryarteryisararecongenitalcardiaclesionresultinginmyocardialischemiaeveninfarction,morphologicalimpairmentanddysfunctionofleftventricle,togetherwithmitralregurgitation.Herewewillintroduceourexperienceinthesurgicalrepairofthiskindofcongenitallesionandtheretrospectiveanalysisabouttheimprovementofleftventriculardimensionandmitralregurgitationinearlypostoperativeterm.MethodFromMay1998toJuly2012,38consecutivepatientswithanomalouscoronaryarteryfromthepulmonaryarteryunderwentsurgicalcorrection(33receivedleftcoronaryarteryre-implantation,4leftcoronaryarteryligationorprimaryclosure,1Takeuchiprocedure,and10simultaneousmitralvalveplasty).Leftventriculardimension,mitralregurgitation,andejectionfraction,weremeasuredbycolorDopplerechocardiographypreoperatively,and1monthafterdischarge.ResultsHospitalsurvivalwas94.7%(2in-hospitaldeaths).Tenpaptientswithmorethanmoderatemitralregurgitationreceivedsimultaneousmitralplasty,oneofwhomwasconvertedtomechanicalprostheticvalvereplacement.Mitralvalveannuloplastywasappliedin9casesofcoronaryre-implantationcorrection,3ofwhomalsoreceivedadditionalmitralleafletcleftrepair.Meanwhile8patientsunderwentotherdifferentconcomitantoperations.Echocardiographicresultsforthesurvivals1monthafterdischargeshowedthatleftventricularend-diastolic,endsystolicdimensiondecreasedfrom40.05±5.56mmand28.94±6.21mmto33.07±6.82mm(P<0.01)and23.04±5.87mm(P<0.01)respectively.Theaveragemitralregurgitationgradewasalsoreducedfrom2.36±1.08to1.64±93(P<0.05)inthegroup.AllsurvivalpatientsimprovedclinicallyandNYHAfunctionalclassdecreasedsignificantlyfrom2.37±1.08to2.10±0.54(P<0.05).ConclusionsThesurgicalrepairofanomalousoriginoftheleftcoronaryarteryfromthepulmonaryarteryissafeandeffective,andcange

简介：AbstractBackground:Aspirin has demonstrated safety and efficacy for venous thromboembolism (VTE) prophylaxis following total hip arthroplasty (THA); however, inconsistent dose regimens have been reported in the literature. This study aimed to evaluate and compare the safety and efficacy of 100 mg aspirin twice daily with rivaroxaban in VTE prophylaxis following THA.Methods:Patients undergoing elective unilateral primary THA between January 2019 and January 2020 were prospectively enrolled in the study and randomly allocated to receive 5 weeks of VTE prophylaxis with either oral enteric-coated aspirin (100 mg twice daily) or rivaroxaban (10 mg once daily). Medication safety and efficacy were comprehensively evaluated through symptomatic VTE incidence, deep vein thrombosis (DVT) on Doppler ultrasonography, total blood loss (TBL), laboratory bloodwork, Harris hip score (HHS), post-operative recovery, and the incidence of other complications.Results:We included 70 patients in this study; 34 and 36 were allocated to receive aspirin and rivaroxaban prophylaxis, respectively. No cases of symptomatic VTE occurred in this study. The DVT rate on Doppler ultrasonography in the aspirin group was not significantly different from that in the rivaroxaban group (8.8% vs. 8.3%, χ2 = 0.01, P = 0.91), confirming the non-inferiority of aspirin for DVT prophylaxis (χ2 = 2.29, P = 0.01). The calculated TBL in the aspirin group (944.9 mL [658.5-1137.8 mL]) was similar to that in the rivaroxaban group (978.3 mL [747.4-1740.6mL]) (χ2 = 1.55, P = 0.12). However, there were no significant inter-group differences in HHS at post-operative day (POD) 30 (Aspirin: 81.0 [78.8-83.0], Rivaroxaban: 81.0 [79.3-83.0], χ2 = 0.43, P = 0.67) and POD 90 (Aspirin: 90.0 [89.0-92.0], Rivaroxaban: 91.5 [88.3-92.8], χ2 = 0.77, P = 0.44), the incidence of bleeding events (2.9% vs. 8.3%, χ2 = 0.96, P = 0.33), or gastrointestinal complications (2.9% vs. 5.6%, χ2 = 1.13, P = 0.29).Conclusion:In terms of safety and efficacy, the prophylactic use of 100 mg aspirin twice daily was not statistically different from that of rivaroxaban in preventing VTE and reducing the risk of blood loss following elective primary THA. This supports the use of aspirin chemoprophylaxis following THA as a less expensive and more widely available option for future THAs.Trial Registration:Chictr.org, ChiCTR18000202894; http://www.chictr.org.cn/showproj.aspx?proj=33284

简介：

简介：AbstractChronic obstructive pulmonary disease (COPD) is a common, preventable, and treatable disease. The incidence of COPD is growing annually in China, and it is a significant and growing public health burden. Multivariate analysis showed that COPD was one of the independent risk factors for the occurrence of pulmonary embolism (PE), and the incidence of PE was significantly higher in COPD patients than in normal subjects. However, PE is often overlooked in patients with acute exacerbation of COPD (AECOPD) because there are many similarities in clinical symptoms between PE and AECOPD, which are difficult to distinguish, resulting in the failure of timely treatment and poor prognosis. Therefore, it is of great significance to understand the clinical manifestations, diagnosis, and treatment of COPD combined with PE for making a more accurate diagnosis, providing timely and effective treatment, and improving the prognosis of such patients.

简介：

简介：静脉的thromboembolism(VTE)作为深静脉血栓(DVT)和肺的栓塞(PE)被表明，代表死亡，残疾，和不快的一个重要原因。他们是各种各样的外科的过程的经常的复杂并发症。变老的人口和更严重地受伤的病人的幸存可以在损伤病人建议thromboembolism的增加的风险。在风险挑战医生扩展了人口的理解小心地检验风险因素让VTE识别能得益于预防的高风险的病人。基于证据的风险因素的精确知识在预言并且阻止手术后的DVT是重要的，并且能为appropriatethromboprophylaxis使用被合并到一个决定支持系统。在一张高风险的损伤人口的DVT预防的标准使用在下导致DVT的发生。VTE的发生在亚洲是普通的。评估包括实验室测试，Doppler测试和phlebography。屏蔽Dopplersonography应该在所有非常受伤的病人上为监视被执行识别DVT。D暗淡是一个有用标记在损伤外科病人监视预防。开始预防的最佳的调子以前在2hours之间并且在外科以后的10个小时，而是PE的风险继续因为几weeks.Thromboprophylaxis为预防包括毕业压缩袜子和抗凝剂。抗凝剂包括Warfarin，它属于维生素K对手，unfractionatedheparin，低分子的重量肝磷脂，因素Xa间接禁止者Fondaparinux，和口头的IIainhibitorMelagatran和ximelagatran。Recombinant人的solublethrombomodulin是一个新、高度有效的antithrombotic代理人。在选择损伤病人的venacaval过滤器的预防放置可以减少PE的发生。为预防劣等的静脉cava过滤器插入的指示与多重损害，关上的头损害，骨盆的破裂，脊骨破裂，多重长骨头破裂，和出席谨慎包括延长固定。多重损伤的病人在为DVT的增加的风险，但是也在流血，和肝磷脂的使用的增加的风险可以被禁忌。连续压缩设备(SCD)是为DVT预防的一种选择。压缩设备向足够的DVTprophylaxis提供低失败率和没有设�

简介：

简介：

简介：TelomeraseisanenzymethatmaintainstelomeresindividingcellsusingatemplateonitsinherentRNAcomponent.Additionally,theproteinpartTERT(TelomeraseReverseTranscriptase)hasvariousnon-canonicalfunctions.Forexample,itcanlocalizetomitochondriaunderincreasedstressandprotectcellsinvitrofromoxidativestress,DNAdamageandapoptosis.RecentlyithasbeendemonstratedthatTERTproteinpersistsinadultneuronsinthebrainanddataemergesuggestingthatitmighthaveaprotectivefunctioninthesepost-mitoticcellsaswell.WehaverecentlypublishedthatTERTproteinaccumulatedinmitochondriafrombraintissueofmicethathaveundergoneshort-termdietaryrestriction(DR)andrapamycintreatment.Thislocalizationcorrelatedtolowerlevelsofoxidativestressinthesebrainmitochondria.SincerapamycintreatmentdecreasesmTORsignalingwhichisalsothoughttoplayanimportantroleforthebeneficialeffectsofDR,weconcludethatthemTORpathwaymightbeinvolvedintheTERTlocalizationanditseffectsinbrainmitochondriainvivo.ThesedataareinlinewithpreviousfindingsfromourgroupaboutincreasedmitochondriallocalizationofTERTinAlzheimer'sdisease(AD)brainsandaprotectivefunctionofTERTproteininneuronsinvitroagainstpathologicaltau.

简介：

简介：Pulmonaryhypertensionisnotasingleentityandnotallformshavethesameprognosis.Thepurposeofthiseditorialistoprovideinformationtothegeneralcardiologistrelatingtowhichtypeofpulmonaryhypertensionthepatientisexperiencing.Inordertodothisproperly,onemustdeterminethecause,theseverity,theprognosis,anddeveloptreatmentplansforthedifferentformsofpulmonaryhypertension.Pulmonaryarterialhypertension(PAH)isthemostmalignantofthedifferenttypesofpulmonaryhypertension.Whiletypicallybeingdiagnosedinayoungerpopulationthantheothertypes,PAHmaybeshowingatrendtowardsdiagnosislaterinthelifethanwhatwasthoughtfromolderregistrydata[1].TheusualcausesofcardiovasculardeathinpatientswithPAHincludesrightheartfailureandsuddendeath[2].

简介：Venousmalformations(VMs)areproblematiccommonvascularmalformationsthatarechallengingevenforexperiencedphysicians.Severaltreatmentsareavailableincludingsclerotherapy,surgery,laserorcombinationsoftheseprocedures.Asnoneoftheseisspecific,westillneedtherapiesthatwouldallowtocurethesepatientswithoutcomplications.Hopefully,theunravelingofthecausativedefectsofVMswillgiveusnewtoolsforthemanagementofthisdifficultcondition.

简介：

简介：无