Objective To investigate the clinical efficacy of off-pump coronary artery bypass grafting (OPCABG) comparing with the conventional coronary artery bypass grafting (CCABG) for treating the patients with coronary heart disease (CHD) and its impact on brain natriuretic peptide (BNP).Methods One hundred and twenty-two patients undergoing elective coronary artery bypass grafting were divided into CCABG group and OPCABG group according to the surgical method.The operative condition and postoperative clinical data,postoperative complications and death of the two groups were observed.The level of BNP was detected before surgery,immediately after surgery,postoperative 6,24,72 h and 1 week.Results The operative time,postoperative mechanical ventilation time,ICU monitoring time,24 h after drainage and blood transfusion,hospital stay in OPCABG group was(210.08 ± 60.02) min,(9.01 ± 2.57) h,(32.08 ±9.17) h,(343.43 ± 98.12) ml,(341.75 ±97.64) ml,(9.70 ±2.77) d,significantly lower than those in CCABG group [(309.38 ± 88.39) min,( 15.25 ±4.36) h,(45.14 ± 12.90) h,(530.24 ± 151.50) ml,(752.90 ± 215.11 ) ml,( 15.44 ± 4.41 ) d] ( P ＜ 0.05 ).The incidence of postoperative complication of OPCABG group and CCABG group was 15.9％(10/63) and 47.5％(28/59),there was significant difference ( χ2 =14.172,P ＜ 0.01).The mortality rate of OPCABG group and CCABG group was 1.6％(1/63) and 8.5％(5/59),there was no significant difference ( x2 =3.091,P ＞ 0.05 ).The level of BNP in CCABG group before surgery,immediately after surgery,postoperative 6 h was (104.54 ±29.87),(114.74 ±32.36),( 129.10 ± 36.15 ) ng/L,and in OPCABG group was ( 103.46 ± 29.56 ),( 109.49 ± 31.28 ),( 126.42 ± 36.12 )ng/L respectively,there was no significant difference (P ＞ 0.05).The level of BNP in CCABG group postoperative 24,72 h and 1 week [(335.57 ± 95.83 ),(429.98 ± 122.85 ),(350.92 ± 100.26) ng/L] were significantly higher than those in OPCABG group [(241.22 ± 68.92 ),( 317.49 ± 90.71 ),(256.86 ± 73.39)ng/L] (P ＜ 0.05).The levels of BNP in both groups postoperative 24,72 h and 1 week were significantly higher than those before surgery (P＜ 0.05).Conclusion The OPCABG surgery is safe and effective,and has certain advantages for maintenance of cardiac function.

Along with recent advances in biological signal molecule and tissue engineering technology,periodontal regeneration has been gained more and more new opportunities,but also faces many challenges.This paper briefly reviewes the preclinical and clinical studies of periodontal tissue regeneration,highlighting the latest achievement and progress in the clinical study of biological signal molecules and stem cell therapy in the treatment of periodontal disease worldwide.

Objective:To compare the severity of sepsis caused by severe acute pancreatitis (SAP) and community-acquired pneumonia (CAP), improve the understanding of sepsis caused by different types of inflammatory reaction, and provide basis for clinical evaluation of condition and prognosis.Methods:From November 2018 to October 2020, 42 patients with SAP (SAP induced sepsis group) and 68 patients with CAP (CAP induced sepsis group) were selected from Beijing Shunyi Hospital and Dongzhimen Hospital of Beijing University of Chinese medicine. All patients met the diagnostic criteria of sepsis-3 in 2016. The clinical data were analyzed retrospectively, and the indexes, Acute Physiology and Chronic Health Enquiry (APACHE Ⅱ) score and Sequential Organ Failure Assessment (SOFA) score at different time points between the two groups were compared. The correlation between APACHE Ⅱ score and SOFA score and other indicators was analyzed.Results:(1) The mortality rate of SAP induced sepsis group was significantly lower than that of CAP induced sepsis group (2.38% vs 41.18%, P<0.001). The APACHE Ⅱ score and SOFA score of SAP induced sepsis group on the 1st, 3rd and 7th day of hospitalization were significantly lower than those of CAP induced sepsis group at the same time point (APACHE Ⅱ: 10.55±1.16 vs 18.51±0.69, P<0.001, 8.78±0.79 vs 15.45±1.12, P<0.001, 7.77±0.77 vs 12.98±1.08, P<0.001; SOFA: 3.71±0.53 vs 5.57±0.37, P<0.001, 3.24±0.44 vs 5.21±0.52, P<0.001, 2.87±0.14 vs 5.19±0.55, P<0.001). (2) In SAP-induced sepsis group, APACHE Ⅱ score was correlated with lactic acid(Lac), platelet (PLT), PCO 2, creatinine (Cr), aspartate transaminase (AST) and SOFA score, while SOFA score was correlated with Lac, C-reactive protein (CRP), PLT, PO 2, PCO 2, Cr, AST, alanine aminotransferase (ALT) and APACHE Ⅱ score. In CAP-induced sepsis group, APACHE Ⅱ score was correlated with SOFA score. Conclusions:The combination of APACHE Ⅱ score, SOFA score and different clinical indexes has a good indication for judging the severity and prognosis of sepsis patients with different pathogenesis.