OBJECTIVES: To analyze the efficacy and safety of concomitant left atrial appendage clipping during heart valve surgery for valvular heart disease patients with atrial fibrillation. METHODS: Fifty-eight patients who underwent concomitant left atrial appendage clipping during cardiac valve surgery in the Second Affiliated Hospital of Nanchang University from January 2017 to June 2023 were included in the analysis, including 1 case who underwent aortic valve replacement, 49 cases who underwent mitral valve replace-ment (or valvuloplasty)+tricuspid valvuloplasty, and 8 cases who underwent double valve replacement+tricuspid valvuloplasty (3 cases combined with coronary artery bypass grafting). The patients were followed up for 3-36 months [(16.69±6.61) months] after operation, and the changes of cardiac function and the occurrence of serious adverse complications were evaluated. RESULTS: The cardiopulmonary bypass time ranged from 75 to 145 min [(102.50±21.03) min], and the aortic cross-clamp time ranged from 35 to 80 min [(58.02±14.63) min]. The length of postoperative intensive care unit stay was 1 to 5 days [(2.47±0.82) d], and the length of postoperative hospital stay was 7 to 22 days [(10.84±2.69) d]. Cardiac ultrasound indicated complete closure of the left atrial appendage in all cases. During the follow-up, New York Heart Association (NYHA) functional classifications were improved in 54 patients. No left atrial appendage-related bleeding events or other perioperative complications were observed; and no cerebral infarction, limb embolism events, or mortality cases occurred during the follow-up. CONCLUSIONS For valvular heart disease patients with atrial fibrillation, concomitant left atrial appendage clipping during cardiac valve surgery demonstrates efficacy and safety, with no severe adverse events during a medium-term follow-up.
Humans ; Atrial Appendage/surgery* ; Atrial Fibrillation/complications* ; Male ; Female ; Heart Valve Diseases/complications* ; Aged ; Middle Aged ; Heart Valve Prosthesis Implantation/methods* ; Treatment Outcome ; Cardiac Surgical Procedures/methods* ; Mitral Valve/surgery*

Objective To compare the effects of propofol with thiopentone on preventing riskiness of tracheal intubation. Methods In 224 elective surgical patients under general anesthesia, the riskiness of tracheal intubation was evaluated following the administration of fentanyl 2?g/kg combined with propofol 2.0mg/kg (group P) or thiopentone 5.0 mg/kg (group T) respectively, with multivariate analysis. Results Risk rate was 36. 04 % in group T and 17. 70 % in group P (P 0 .05). Conclusions There is certainly clinical advantage of propofol compared to thiopentone in terms of preventing riskiness of tracheal intubation if hypotension of propofol is unconcerned.

This study is conducted to evaluate the protein quality of the spray-dried goat's milk powder made from milk of Qingdao's Laoshan dairy goats. Chemical analysis and rat experiment are included in the study with spray-dried powdered cow's milk and isolated soy protein as comparative substances and chemical pure casein as reference protein.The content of crude protein in the powdered goat's milk is 26.01% and the protein's limitting amino acid is sulphur containing amino acids with the AAS and CS being 0.91 and 0.52 respectively, similar to those of cow's milk protein. The percentage of EAA and the EAA index are 49.1% and 96.96%, as high as those of cow's milk. The results of the rat experiment designed according to AOAC showed that the PER, NPR, AD, TD, BV, NPU of the protein are 3.01, 4.62, 90.49%, 96.75%, 86.02 and 83.22% respectively. Except that the AD of goat's milk protein is slightly higher than that of cow's milk protein, there is no significant difference between two milk proteins on other nutritional parameters. The present study gives the conclusion that the protein of powdered goat's milk is at least as nutritious as that of powdered cow's milk, but more nutritious than chemical pure casein and far more nutritious than isolated soy protein.