In the American Heart Association’s Scientific Sessions 2021, the results of six clinical trials related to cardiovascular surgery were revealed. The PALACS trial demonstrated that posterior left pericardiotomy during open heart surgery was associated with a significant reduction in postoperative atrial fibrillation; the EPICCURE study found that injection of mRNA encoding vascular endothelial growth factor (VEGF-A mRNA) directly into the myocardium of patients undergoing elective coronary artery bypass grafting (CABG) improved patients’ heart function; the VEST trial once again proved the safety and potential value of external stent for vein graft. This article will interpret the above-mentioned three studies.
Mitral regurgitation (MR) with multi-pathogenesis is a common disease in cardiac surgery department. MR can be classified into two categories-primary mitral regurgitation and secondary mitral regurgitation. With the development of cardiac intervention, numerous patients who cannot tolerate open heart surgery for the reason of high risk of surgery receive the treatment of intervention and achieve the favorable endpoint. The technique of transcatheter therapy which could be used to treat MR is comprised of leaflet repair, annuloplasty and implantation of artificial chordae. Comparing to primary mitral regurgitation, surgical effect of secondary mitral regurgitation is not desirable for the reasons of complex pathophysiologic mechanism. Hence, based on the perspective of surgeon, we will introduce the research progress of transcatheter interventional mitral valve repair which is focused on the treatment of primary mitral valve regurgitation and reviewed from three aspects of surgical risks, surgical types and outlook.
Left atrial appendage occlusion is a common procedure for patients with atrial fibrillation history when they underwent cardiac surgery. Before the LAAOS Ⅲ research results, this operation has been lacking strong evidence-based support. LAAOS Ⅲ is a prospective, double-blind, international multicenter, randomized blinded trial. According to the results of LAAOS Ⅲ, the left atrial appendage occlusion can reduce the risk of stroke and systemic embolism. This article will perform detailed interpretation of LAAOS Ⅲ research.
【摘要】 目的 观察自制富血小板血浆治疗难治性创口的临床疗效。 方法 2007年4月-2009年11月对38例难治性创口患者进行自制富血小板血浆治疗，观察创面愈合变化情况。 结果 38例患者中30例愈合，2例显效，2例有效，总有效率为90%。 结论 自制富血小板血浆治疗难治性创口是一种简便、安全、价廉、有效的治疗方式，特别适合中小（25~60 cm2）创面的难治性创口。【Abstract】 Objective To observe the clinical effect of homemade platelet-rich plasma on refractory wound. Methods Thirty-eight patients with refractory wound from April 2007 to November 2009 were treated by homemade platelet-rich plasma, and the changes in wound healing were observed. Results Thirty patients were healed, two patients were markedly effective, two patients were effective and the total effective rate was 90%. Conclusion Homemade platelet-rich plasma is a simple, safe, inexpensive and effective treatment on refractory wound, especially for small and medium refractory wounds (25-60 cm2).
目的:探讨经后路椎弓根钉棒系统内固定治疗胸腰椎骨折的临床疗效。方法: 对本组35例胸腰椎骨折行后路椎弓根钉棒系统内固定,其中20例行术中后路减压, 8例经椎弓根行病椎植骨。35例均行关节突及横突间植骨。并测量术前、术后伤椎前后缘平均高度(百分比)和Cobb’s角,椎管截面积.结果: 术后伤椎前后缘平均高度(百分比)和Cobb’s角,椎管截面积各项指标与术前相比较,差异有显著性 (Plt;0.01)。术后随访9~21个月,平均13.2个月。无一例出现神经症状加重,2例出现内固定断裂并完整取出。结论: 经后路椎弓根钉棒系统内固定治疗胸腰椎骨折疗效确切,是治疗胸腰椎骨折的一种创伤小,操作简单,固定可靠的手术方法。
摘要:目的:探讨小切口全髋关节置换的疗效及优缺点。方法:针对性选取我院行THA的病员48例,分为初期小切口THA组、熟练小切口THA组、传统切口THA组,各组16例。记录切口长度、术中出血量、术后12小时引流量、手术时间及Harris评分,对其治疗效果进行回顾性分析。结果:初期小切口THA组平均出血量,术后12小时平均引流量,平均手术时间等指标均高于传统组,术后Harris评分低于传统组,熟练组与传统组比较,切口长度较短、术中出血量略少,术后早期Harris评分高,远期Harris评分接近。结论:熟练小切口THA与传统切口THA比较远期疗效无明显优点,初期小切口THA不具微创优势,不必强求小切口THA,并应注重学习曲线。
This paper reports the study and design of a visualization system of the ultrasonic rhinitis therapeutic apparatus with the function of endoscopic sinus. On Linux operating platform, we captured the video data of a video capture card that connected the endoscopic sinus using Video4Linux (V4L2) that was provided by the operating system. The video images were displayed by Qt. The visualization system solved the problem that the current ultrasonic rhinitis therapeutic apparatus had to rely on the large and expensive endoscopy equipment. And this simplified the doctors' operation, met the need of monitoring nasal cavity in the process of operating, greatly reduced the costs of treatment and would contribute to the promotion of the instrument. As a result, it has been tested that the nasal endoscopic image achieved by the system is clear and smooth, and fully meet the clinical needs of ultrasonic treatment of rhinitis.
Coronary artery bypass grafting (CABG) is the "gold standard" for revascularization of left main diseased and/or complex multi-vessel diseased coronary artery disease. Post-CABG stroke is a relatively rare but catastrophic complication with a serious health and economic burden. In recent years, the further understanding of the concept of "panvascular disease", the implementation of the philosophy of "cardio-cerebral integrated treatment", and the improvement of related diagnostic and therapeutic techniques have provided new options for the recognition, prevention and cure of post-CABG stroke. Focusing on the key factor of carotid-cerebral artery disease, this review systematically scrutinizes the incidence, epidemiology, risk factors, mechanisms and prevention and treatment of post-CABG stroke. This review analyzes the association between post-CABG stroke and carotid-cerebral artery disease, summarizes the status of evidence-based prophylactic carotid-cerebral artery revascularization strategy, and prospects for future research directions.