Objective To evaluate the possible protective effect of isoflurane and propofol on myocardium during off pump coronary artery bypass grafting (CABG) surgery. Methods Twenty-six patients undergoing elective CABG without cardiopulmonary bypass were allocated into propofol group (n=13) and isoflurane group (n=13). Anesthesia was performed in propofol group with propofol plus fentanyl, while isoflurane and fentanyl were used in isoflurane group. Artery blood samples were collected before induction of anesthesia, and during and after the surgery. Plasma troponin I (cTnI), creatine kinase-MB (CK-MB), interleukin-6 (IL-6), and lactate concentrations were determined respectively. Results At the 4 hours after operation, plasma level of cTnI was significantly increased in both groups, and no significant differences were found between them. Compared with baseline values, IL-6 in propofol group showed no significant changes at each endpoint. However, IL-6 values in isoflurane group were significantly higher than those in propofol group during and after surgery (P

Objective To explore the correlation between cytomegalovirus pneumonia (CMV-IP) and viral load in renal transplant recipients and to find out the threshold value of viral load for predicting CMV-IP. Methods The blood samples of 56 renal transplant recipients were taken weekly for the first 2 months and every 2 weeks for 2-6 months after transplantation.Real-time PCR were used to quantify the plasma CMV DNA.The mean viral loads of CMV-IP group and non-CMV-IP group in each time were compared using Wilcoxon test.Different cut-off values were tested to find the suitable values to predict the CMV-IP. Results Of the 56 recipients,8 (14.3%) developed CMV-IP.The viral loads were near zero in the first 4 weeks in both groups;from week 5 the viral load of CMV-IP group increased gradually and reached the climax at week 8 and then declined,but the load of non-CMV-IP group fluctuated at a low level.During weeks 5-11,the viral loads of CMV-IP group were higher than those of non-VMV-IP group.At 5,7 and 9 weeks,the differences of the viral loads between the 2 groups were significant (P

To investigate the therapeutic effect of pectoralis major muscle flap transplantation in thoracotomy patients with sternal infection. Methods From January 2014 to December 2017, the treatment group of 39 patients with thoracic bone infection after cardiac surgery was used pectoralis major muscle flap to close the wound, while 26 patients were treated by debridement and vacuum sealing drainagea at the same time as the control group. The hospitalization time, hospital costs, number of operations, satisfaction survey, and relapse rate were compared between the those. Results Compared with the control group, the treatment group has the benefit of shorter hospitalization time [(18. 1 ± 3. 8)days vs. (36. 7 ± 11. 4) days], less hospital costs [(19429 ±4088)yuan vs. (33495 ±10712)yuan], less number of operations [(1. 1 ±0. 3)times vs. (2. 4 ±0. 8)times], higher level of satisfaction(56. 4％ vs. 30. 8％), lower relapse rate(5. 1％ vs. 26. 9％), the differences are statistically significant(all P <0. 05). Conclusion Thoracic reconstruction with pectoralis major muscle flap is an effective treatment for sternal infection in postcardiac surgery.

Objective:To compare the clinical efficacy of radiofrequency ablation and liver resection in the treatment of gastrointestinal stromal tumor liver metastasis.Methods:A retrospective cohort study was conducted, collecting medical records of 46 patients with gastrointestinal stromal tumor liver metastasis treated at the First Medical Center of the Chinese People′s Liberation Army General Hospital from January 2018 to December 2022. Patients were divided into radiofrequency ablation group ( n=20) and liver resection group ( n=26) based on the treatment method. Short-term efficacy and long-term prognosis between the two groups were compared. Short-term efficacy was evaluated based on intraoperative bleeding volume, operative time, hospital stay, hospitalization costs, while long-term efficacy was assessed by progression-free survival and overall survival. Normally distributed measurement data were expressed as mean±standard deviation ( ± s) and compared using the t-test. Non-normally distributed measurement data were expressed as M( Q1, Q3) and compared using the Wilcoxon rank-sum test. Count data were expressed as frequency (%) and compared using the chi-square test. The long-term prognosis of patients in both groups was compared using the Kaplan-Meier curve. Results:The intraoperative blood loss, operative time, postoperative hospital stay, and hospitalization costs for the radiofrequency ablation group were 5 (3, 5) mL, 60 (55, 60) min, 4.0 (3.0, 4.0) d, and 4.6 (3.8, 5.3) ten thousand yuan, respectively; for the liver resection group, these were 100 (50, 275) mL, 180 (155, 215) min, 7.0 (4.5, 9.5) d, and 8.6 (6.1, 10.8) ten thousand yuan, respectively, with statistically significant differences between the two groups( P<0.05). The median progression-free survival for the liver resection group was 37 months, with 1 and 3-year progression-free survival rates of 96% and 50%, respectively. For the radiofrequency ablation group, the median progression-free survival was 20.5 months, with 1 and 3-year progression-free survival rates of 65% and 20%, respectively, showing statistically significant differences between the two groups ( P<0.05). The 1, 3, and 5-year overall survival rates for the liver resection group were 100%, 100%, and 78.3%, respectively, while for the radiofrequency ablation group, they were 100%, 100%, and 82.2%, respectively, with no statistically significant difference ( P>0.05). Conclusions:Both liver resection and radiofrequency ablation can be considered as treatment options for gastrointestinal stromal tumor liver metastasis, with comparable long-term efficacy. Liver resection has a clear advantage in terms of local tumor control compared to radiofrequency ablation, which has the advantages of fewer complications, faster recovery, and shorter hospital stay.