Objective: To discuss the value of preserving ICBN during modified radical mastectomy for breast neoplasms. Methods: Sixty-three cases of breast carcinoma who underwent modified radical mastecto-my were studied. Of them, ICBN was completely preserved in 33 cases and was dissected in 30 cases. Sen-sory function of the medial upper arm of all patients was followed up after surgery. Results: No local recur-rence or metastasis was found among the 63 patients during the first, sixth, and twelveth month of follow-up period. Among the 33 cases with ICBN reserved, 29 cases (87.88%) had normal sensation of the skin in up-per medial arm and axilla, while 4 cases (12.12%) had paresthesia. Conclsion: Preserving ICBN can en-hance the quality of life of breast cancer patients after surgery.

Objective To evaluate the impact of cerebrospinal fluid drain(CSFD) on the incidence of acute spinal cord injury(SCI) following extensive TAAA repair.Methods From February 2009 to July 2016,153 patients underwent extensive TAAA repairs with a consistent strategy of normal thermia,non-circulatory bypass,sequential aortic cross clamping,aortic-lilac bypass,and intercostal artery reconstruction.The repairs were performed with preoperative CSFD (n =78) or without CSFD (n =75).In the former group,CSFD was inserted after the patient has been anaesthetized and continued for 72 hours after surgery.The target CSF pressure was 10 mmHg or less.Results The mean age of patients was (38 ± 10) years and 108 (70.6％) were male.There were 87 (53.8％) patients with previous aortic surgeries and 33 (22％) with Marfan syndrome.The two groups had similar risk factors for paraplegia.Aortic clamp time,operation time and number of reattached intercostal arteries were similar in both groups.In-hospital mortality rates were 1.3％ (one patient) and 6.7％ (five patients) for CSFD and the group without CSFD,respectively (P =0.086).Ten patients (13.3 ％) in the group without CSFD had paraplegia develop.In contrast,only two patients in the CSFD group(2.6％) had postoperative paraplegia(P =0.013).Stepwise logistic regression analysis identified CSFD had spinal cord protection,P =0.026;OR =0.171;95％ CI:0.036-0.809).No patients occurred CSF catheter related complications.Conclusion This randomized clinical trial showed that preoperative CSFD placement could be an effective strategy in preventing SCI following extensive aortic aneurysm repair.Care should be taken to prevent complications related to overdrainage.

OBJECTIVETo evaluate the efficacy and safety of meropenem in Chinese patients, we conducted a study for the treatment of patients with lower respiratory tract infections, urinary tract infections and other infections.

METHODSA total of 182 hospitalized patients were enrolled in the study. 90 patients received 500 mg meropenem every 12 hours (or 1 g every 12 hours if necessary) and 92 patients received imipenem/cilastatin 500 mg/500 mg every 12 hours (or 1 g every 12 hours if necessary) by intravenous infusion. The duration of treatment was 7 - 14 days for both groups.

RESULTSSeventy of 90 cases receiving meropenem and 70 of 92 cases receiving imipenem/cilastatin were assessable for clinical efficacy. The overall efficacy rates were 90% for the meropenem group and 87% for the imipenem/cilastatin group, and the bacterial eradication rates were 86% in both groups. 93 (76%) of 123 strains isolated from patients produced beta-lactamases. Adverse drug reactions were evaluated in 72 cases in the meropenem group and 70 cases in the imipenem/cilastatin group. The adverse drug reaction rates were 9.7% and 8.6%, respectively. The results showed that there were no statistical differences between these two groups (P > 0.05).

CONCLUSIONMeropenem is effective and safe for the treatment of bacterial infections caused mainly by beta-lactamase-producing strains.

Adult ; Aged ; Alanine Transaminase ; blood ; Aspartate Aminotransferases ; blood ; Cilastatin ; administration & dosage ; adverse effects ; therapeutic use ; Female ; Humans ; Imipenem ; administration & dosage ; adverse effects ; therapeutic use ; Male ; Middle Aged ; Respiratory Tract Infections ; drug therapy ; Thienamycins ; adverse effects ; therapeutic use ; Urinary Tract Infections ; drug therapy

Objective:Analysis the protective effect of the partial femoral to femoral cardiopulmonary bypass(CPB) on thoracoabdominal aortic aneurysm repair(TAAAR).Methods:From September 2016 to August 2020, 50 cases of TAAAR under partial CPB were performed at our hospital. Thirty males and 20 females with an average age of(40.5±12.4) years old(ranging 21 to 69 years old) were involved. Partial CPB without selective organ perfusion were applied at the early stage. Since November 2019, the adjunct of perfuse the celiac and superior mesenteric artery with warm blood and irrigate the renal artery with 4℃ HTK solution was used in TAAAR, and 25 patients were operated under this adjunct.Results:The average CPB time was(116.9±35.4) min, the lowest central body temperature during the partial CPB was(34.7±0.7)℃. Total early postoperative mortality was 6%(3/50, 3 deaths in partial CPB alone group). Paraplegia occurred in 4 cases(8%), new happened postoperative hemodialysis was in 6 cases(16%). Among the hemodialysis event, 2 cases(8%, 2/25) were in the group with selective organ perfusion, and 4 cases(16%, 4/25) in the group without using the adjunct.Conclusion:Mild hypothermic partial cardiopulmonary bypass combined with selective organ perfusion have protective effects on spinal cord and abdominal organ in patients underwent TAAAR.

The end of the COVID-19 infection peak in 2022 prompts a backlog of cardiovascular surgical patients to gradually return to the hospital, resulting in a surge in cardiovascular surgeries. However, against the backdrop of the COVID-19 pandemic, the clinical practice of cardiovascular surgery faces many problems. Therefore, organized by Beijing Anzhen Hospital, experts in cardiovascular surgery and related fields have formulated hospital expert experience on perioperative treatment principles of cardiovascular surgery for patients infected with COVID-19. This article summarizes the clinical decision-making of patients requiring cardiovascular surgery after COVID-19 infection, and advises on the corresponding recommendations according to the existing evidence-based medical evidence as well as the actual clinical practice experience of relevant experts. The main content of the article includes special requirements for cardiovascular surgical treatment indications in patients with COVID-19 infection, selection of surgical timing, special requirements of preoperative, intraoperative and postoperative management, etc., which aims to provide COVID-19-infected patients with guidance on rational decision-making when receiving cardiovascular surgery.