简介：BackgroundTheprognosticvalueofserumC-reactiveprotein(CRP)inpatientswithinfectiveendocarditis(IE)isnotwellelucidated.ThisstudyaimedtoevaluatetheusefulnessofCRPinpredictingtheoutcomeofIE.MethodsTwohundredninty-sixpatientsfrom2009to2012intheDepartmentofCardiologyatGuangdongGeneralHospitalwerescreenedanddividedintosurgicalandconventionaltreatmentgroups.CRP,whitebloodcell(WBC),erythrocytesedimentationrate(ESR)andotherclinicaldatawereobtainedwithfollow-upfor12months.ResultsTwohundredthirty-sixpatientswereassignedtoreceivesurgerytreatmentwhile60patientsreceivedconventionaltreatment.Inthesurgerygroup,thelevelofCRPinthedeathpatientswassignificantlyhigherthanthatinthesurvivalpatients(P<0.001).TheareaunderthecurveofROCwasabout0.749(SE0.064,P=0.005,95%CI,0.624-0.874)andthecut-offpointofCRPwas23.8mg/L.Inconventionalgroup,therewassignificantdifferencebetweendeathandsurvival(P<0.001).TheareaunderthecurveofROCwasabout0.701(SE0.095,P=0.032,95%CI,0.515-0.888)andthecut-offpointsofCRPwas65.6mg/L.TherewerenosignificantdifferencesinWBCandESRbetweensurgeryandconventionalgroups.ConclusionAmoreaggressivesurgicalinterventionresultsinabetteroutcomeoverconventionaltreatmentandCRPcouldbeservedasapredictivemarkerforadverseoutcomeinIEpatients.

简介：ObjectivesToassesstheefficiencyandsafetyofdual-wireballoonangioplastysidebranchcombinedstentingthemainbranchinthetreatmentofcoronarybifurcationlesions.MethodsThisstudyincludedthirty-sixpatientswith41coronarybifurcationlesions.Selectivedual-wireballoonangioplastywasperformedinsidebranchand/orinmainbranch,andimplantationofstentswasperformedinmainbranchonly.Clinicaloutcomeandmajoradversecardiaceventswereobservedin-hospitalandfollow-up.ResultsSuccessrateofsidebranchdilatationbeforemainbranchstentingwas100%;mainbranchdirectstentingperformedin4cases;successmainbranchdilatationperformedintheother37cases;kissingtechniquewasperformedsuccessfullyin5cases,whichsidebranchwasjailedaftermainbranchstentingwithTIMIgrade0-2flow.NoQ-wavemyocardialinfarction,acuterevascularizationanddeathoccurredduringin-hospital.Clinicalfollow-upwasavailableinallpatients.NoQ-wavemyocardialinfarction,revascularizationanddeathoccurred,anginapectorisrecurredinthreepatients,releasedbystrengthendrugtreatment.ConclusionsDual-wireballoonangioplastysidebranchcombinedstentingthemainbranchissimple,safeandeffectiveforthetreatmentofcoronarybifurcationlesions.

简介：ObjectivesToanalyzethesix-minutewalktest(6MWT)andgasexchangeof5hearttransplantationpatientsandtoapproachthevariationtendencyofexercisetolerance,oxygenuptake(VO2)andheartratechronotropicresponse.Methods5casesofhearttransplantationpatients(age25～52years)wereundertaken6MWT6～30monthsafteroperation,synchronizinggasexchangingparametersweremeasuredbywirelessportableremotesensingK4B2gasanalyzer,51normalcontrolswerecompared.ResultsThesix-minutewalkdistance(6MWD)of5patientswere(592.6±26.7)m(558～625)m,theascendingtendencyduringexercisewasslower,themaximumheartrateswere80%±6%ofage-predictingmaximalheartrate,lowerthannormalcontrol(86%);theendpointVO2/kgwere(21.8±1.4)mL/min·kg(19.94～23.60)mL/min·kg.ConclusionsThe6WMDandVO2of5patientsreachednormalrange,buttheheartratechronotropicresponseandVO2ascendingtendencywereslowerthanthoseofnormalcontrols.

简介：BackgroundUltrasound-guidedtemporarypacemakerimplantationhasbeenprovensafeandefficient.However,fewstudieshavefocusedonelderandcriticalpatients.MethodsTwelveelderandcriticalpatientsunderwenttemporarycardiacpacingthroughthejugularveinorsubclavianvein,withbedsideultrasoundimagestoassisttheplacementofelectrodewithintherightventricle.ResultsUltrasound-guidedtemporarycardiacpacemakerinsertionwassuccessfulinallofthe12patients.Electrodesweresentintotherightventriclecorrectlywiththehelpofultrasoundimaging.Inallcases,temporarypacemakerfunctionedwellwithoutprocedure-relatedcomplications.ConclusionTemporarycardiacpacingguidedbyultrasoundissafeandeffectiveinelderandcriticalpatients,whichisworthofpromoting,especiallyinintensivecareunit.

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简介：ObjectivesToevaluateretrospectivelythepotentialbenefitsofcombinedutilizationofvariousassistedcirculationdevicesincardiacarrestpatientswhodidnotrespondtoconventionalcardiopulmonarycerebralresuscitation(CPCR).MethodsAssistedcirculationdevices,includingemergencycardiopulmonarybypass(ECPB),intra-aorticballoonpump(IABP),andleftventricularassistdevice(LVAD),wereappliedto16adultpatientswhohadcardiacarrest82min-56hafteropenheartsurgeryanddidnotrespondto20minorlongerconventionalCPCR.ECPBwasappliedto2patients,ECPBplusIABPto8patients,ECPBplusIABPandLVADto6patients.ResultsOnepatientrecoveredfullyandonepatientdied.Oftheother14patients,13resumedspontaneouscardiacrhythmandonedidnot;noneofthemcouldbeweanedfromECPB.Furthertreatmentofthe14patientswithcombinationsofassistedcirculationdevicesenabled6patientstorecover.Oneofthe7recoveredpatientsdiedofreoccurringcardiacarrestafter11days;theother6weredischargedingoodconditionandwerefollowedupfor3-49months(mean=22months).Ofthe6dischargedpatientsonesufferedcerebralembolismduringLVADtreatment,resultinginmildlimitationofmobilityoftherightlimbs;theother5nevermanifestedanycentralnervoussystemcomplications.Therewasnolatedeathsgivinga37.5%(6/16)long-termsurvivalrate.ConclusionsECPBcouldeffectivelyreestablishbloodcirculationandoxygensupply,rectifyacidosis,andimproveinternalmilieu.ThecombinedutilizationofECPB,IABP,andLVADreducesthedurationofECPB,improvestheincidenceofrecovery,andoffersbeneficialalternativestorefractorycardiacarrestpatients.

简介：backgroundToinvestigatetheeffectofintra-aorticballoonpumping(IABP)onno-reflowphenomenoninprimarypercutaneouscoronaryintervention(PCI)forST-ElevationMyocardialInfarction(STEMI).MethodsClinicaldataof22acutemyocardialinfarctionpatientsafterPCIwithangiographicno-reflowphenomenonwereretrospectivelyanalyzedbetweenJanuary2006andDecember2009.12patientsunderwentIABP,other10patientsascontrolgroup.Weobserveddifferenceofcardiacstructure,brainnatriureticpeptide(BNP)andventricularsystolicfunctionbetweentwogroup,aswellascardiacinjurymarkers(MYO,CK-MB,cTnI)inbothgroupsonthedaysof1,2,3,5,7,10afterthedifferentinterventions.Inaddition,cardiacstructureandventricularsystolicfunctionincludingleftatriummedialdiameter(LAMD),leftventricularmedialdiameter(LVMD),leftventricularejectionfraction(LVEF)wasevaluatedafter10days,3months,6months.Finally,statisticswasusedtoanalysisthedata.ResultsTheseveralvasoactivesubstancesaswellascardiacinjurymarkersandLAMD,LVMD,LVEFof10days,3months,6monthsofIABPgroupweresignificantdifferencewithcontrolgroup(P<0.05).BNPtargetsofIABPgroupcomparedwiththecontrolgroupnosignificantdifference(P>0.05).ConclusionsIABPhaseffectsonprognosisinSTEMIpatientswhoperformedPCIwithangiographicno-reflowphenomenon,whichisconducivetorecoveryofheartfunction.

简介：BackgroundHospital-acquiredpneumonia(HAP)isthemostcommonandmostseriousnosocomialinfectionforcardiacsurgerypatients,withhighincidenceandfatalityrate1.ItisimportantforcardiacsurgeonstocorrectlyidentifyHAP,assesstheseverity,andthenadjustanti-infectionmethod,whichcanreducethemortalityrate,shortenhospitalizationtime,andreducethewasteofmedicalresources.ThepurposeofthisresearchistoevaluatetheapplicationvalueoflungCTindiagnosisandtreatmentofHAPaftercardiacsurgery.MethodsAretrospectiveanalysiswasconductedforclinicaldataabout76cardiacsurgerypatientswhowerediagnosedwithHAPduringJanuarytoDecember2013.Theclinicaldatamainlyincludedsymptoms,physicalsigns,laboratoryexaminations(suchasroutinebloodtestsandserumprocalcitonin),andlungCTandX-raydata.OurfocusisonthecomparisonbetweenlungCTandX-raydata.ResultsThepositivediagnosticrate,falsenegativerate,andfalsepositiverateoflungCTwere71/76(93.4%),5/76(6.6%),and1/76(1.3%)respectively.ThecoincidencerateofX-rayandCTwas45/76(59.2%),andthefalsenegativerateofX-raywas23/76(30.3%).ConclusionLungCTisbetterthanX-rayindiagnosisofHAPaftercardiacsurgeryandassessmentofseverity,andhasgreatersignificanceforguidingtherationaluseofantibiotics.Therefore,lungCTisworthyofapplicationandpopularization.

简介：Thesubcutaneousimplantablecardioverter-defibrillator(ICD)isanoveltechnologyusingasubcutaneous(extrathoracic)systemfortreatmentofpotentiallethalventriculararrhythmias.ItavoidsmanyoftherisksoftransvenousICDimplantation.ItmaybeconsideredinpatientshavinganICDindicationwhodonothaveapacingand/orcardiacresynchronizationtherapyindication,andwhoareunlikelytobenefitfromantitachycardiapacingtherapy.Wereviewpatientselection,systemcomponents,theimplantationtechnique,andscreeningconsiderationsforsubcutaneousICDimplantation.Itsusesinspecificpatientpopulations,includingchildren,patientswithcongenitalheartdisease,hypertrophiccardiomyopathy,orend-stagerenaldisease,andpatientswithpreexistingpacemakers,arehighlighted.Areasoffutureinvestigationarereviewed,includingpotentialusewithleadlesspacingandmagneticresonanceimaging.