1.Prediction function of preoperative B-type natriuretic peptide in patients to receive on-pump coronary artery bypass grafting with postoperative complications
Jingfeng JIAN ; Jiatao FENG ; Feng PENG ; Yanling SU ; Huaan YE ; Jiawang LIN
The Journal of Practical Medicine 2015;(18):2984-2987
Objective To investigate the prediction function of preoperative B-type natriuretic peptide in patients to receive on-pump coronary artery bypass grafting with postoperative complications. Methods One hundred and thirty-two patients , including 78 males and 54 females , received on-pump coronary artery bypass grafting from January 2013 to November 2014 and were enrolled in the study. The patients were (63 ± 11.35) years old ( range from 35 to 82 years). The level of BNP was determined before operation, after operation, and on day 1, 2, 3 and 7 post-operation. Relationships were analyzed between BNP and LVEF,ventilation time, length of stay in ICU, the need for inotropic agents or intra-aortic balloon pump (IABP), incidence of postoperative atrial fibrillation, and acute renal failure. Receiver operating characteristic (ROC) curve analysis was also performed to predict the role of BNP in postoperative complications. Result A negative correlation between preoperative BNP level and preoperative LVEF(r = -0.512,P < 0.05) was found. The preoperative BNP level was positively correlated with a series of adverse events. The preoperative BNP was used to predict incidence of postoperative atrial fibrillation , the possibility of using IABP , renal failure , length of stay in ICU exceeding 48h or mortality at 28 days, and the area under the ROC curve (AUC) was 0.780, 0.893, 0.818 and 0.820, respectively. Conclusion The preoperative BNP level is well correlated with the cardiac function before CABG , which may be a good predictor of postoperative complications after CABG.
2.Early outcomes of 203 neonates with low birth weight undergoing cardiac surgery and analysis of death causes
LU Chao ; YU Lina ; WEI Jingfeng ; LIANG Jiexian ; ZHUANG Jian ; WANG Sheng
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2018;25(11):971-976
Objective To analyze the early outcomes of 203 neonates with low birth weight (<2 500 g) undergoing cardiac surgery, and to analyze the causes of death during hospitalization. Methods From June 2003 to June 2017, medical records of 203 neonates with low birth weight undergoing congenital heart surgery in Guangdong General Hospital were reviewed retrospectively. There were 124 males and 79 females, including 151 premature infants. The average birth weight was 1 719±515 g, the average age at operation was 32.7±20.2 d and the average weight at operation was 1 994±486 g. The causes of death during hospitalization (including neonates given up on treatments) were analyzed. Results Totally 103 patients had pneumonia, 98 patients needed mechanical ventilation to support breathing and 26 patients needed emergency operation before operation. All patients undergoing congenital heart surgery were treated with general anesthesia with tracheal intubation, including 107 patients under non cardiopulmonary bypass (CPB) and 96 patients under CPB with a mean CPB time of 96.5±71.7 min and a mean aorta cross-clamp time of 51.8±45.5 min. The average postoperative mechanical ventilation time was 9.1±21.5 d and the average postoperative length of stay was 26.7±19.3 d. The major postoperative complications included pneumonia, anemia, atelectasis, septicemia, intrapleural hemorrhage, diaphragm paralysis and cardiac dysfunction. Twenty-nine patients died during hospitalization and the overall mortality rate was 14.3%. Four patients died in the operation room, 14 patients died 72 hours after operation and 2 patients were given up. The main causes of hospitalized death were low cardiac output syndrome, severe infection, disseminated intravascular coagulation disorder, acute renal failure and pulmonary hypertension crisis. Conclusion Overall, early cardiac surgery for low birth weight neonates is safe and effective. The difficulty of the cardiac surgery is the key to the prognosis. Strengthening perioperative management can improve the quality of operation and reduce the risk of mortality and morbidity during hospitalization.
3. A multicenter retrospective study on clinical value of lymph node dissection in the radical resection of intrahepatic cholangiocarcinoma
Lei WANG ; Ziguo LIN ; Tian YANG ; Jianying LOU ; Shuguo ZHENG ; Xinyu BI ; Jianming WANG ; Wei GUO ; Fuyu LI ; Jian WANG ; Yamin ZHENG ; Jingdong LI ; Shi CHENG ; Yongyi ZENG ; Jingfeng LIU
Chinese Journal of Digestive Surgery 2020;19(1):72-80
Objective:
To investigate the clinical value of lymph node dissection (LND) in the radical resection of intrahepatic cholangiocarcinoma (ICC).
Methods:
The propensity score matching and retrospective cohort study was conducted. The clinicopathological data of 448 patients with ICC who were admitted to 12 medical centers from December 2011 to December 2017 were collected, including 279 in the Eastern Hepatobiliary Surgery Hospital of Navy Medical University, 32 in the Mengchao Hepatobiliary Hospital of Fujian Medical University, 21 in the First Hospital Affiliated to Army Medical University, 20 in the Cancer Hospital Chinese Academy of Medical Science and Peking Union Medical College, 19 in the West China Hospital of Sichuan University, 18 in the Second Hospital Affiliated to Zhejiang University School of Medicine, 18 in the Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine, 16 in the Beijing Friendship Hospital Affiliated to Capital Medical University, 10 in the Xuanwu Hospital Affiliated to Capital Medical University, 7 in the Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology, 5 in the Beijing Tiantan Hospital Affiliated to Capital Medical University, and 3 in the Affiliated Hospital of North Sichuan Medical College. There were 281 males and 167 females, aged from 22 to 80 years, with a median age of 57 years. Of the 448 patients, 143 with routinely intraoperative LND were divided into LND group and 305 without routinely intraoperative LND were divided into control group, respectively. Observation indicators: (1) the propensity score matching conditions and comparison of general data between the two groups after matching; (2) intraoperative and postoperative situations; (3) follow-up; (4) survival analysis. Patients were followed up by outpatient examination, telephone interview and email to detect survival of patients and tumor recurrence up to October 31, 2018 or death. Follow-up was conducted once every 3 months within postoperative 1-2 years, once every 6 months within postoperative 2-5 years, and once a year after 5 years. The propensity score matching was realized using the nearest neighbor method with 1∶1 ratio. Measurement data with normal distribution were represented as