Objective To investigate the incidence and risk factors of acute kidney injury(AKI) requiring continuous renal replacement treatment(CRRT) in patients with acute type A aortic dissection after Sun's operation.Methods A retrospective analysis of consecutive patients with acute type A aortic dissection underwent Sun's operation in Beijing Anzhen Hospital,Capital Medical University from January 2009 to December 2015.These patients were divided into two groups according to whether had severe postoperative AKI requiring CRRT treatment:the dialysis group(AG,65 cases) and the control group(CG,618 cases),we compared the clinical outcomes of patients in two groups and analyzed the related risk factors.Results 50 patients(7.3％) died in hospital.Compared with patients in CG group,patients in AG group had higher age,more patients with preoperative coronary heart disease,pericardial tamponade,and higher rates of intraoperative coronary artery hypass surgery or valve surgery,the results were statistically different between the two groups(P ＜0.05).The patients in AG group had a higher mortality rate in hospital(26.2％ vs.5.3％),and the difference was statistically significant(P ＜0.001).The results of multiple regression analysis suggested that the age ＞ 50 years,preoperative history of pericardial tamponade,intraoperative need for combined coronary artery bypass grafting or valve surgery,and cerebral perfusion time ＞40 min were independent risk factors for CRRT treatment of postoperative severe AKI(P ＜0.05).Conclusion The incidence of severe AKI requiring CRRT treatment in patients with acute type A aortic dissection after Sun's operation was 9.5％,and the discharge survival rate in AG group was lower than that in CG group.An important way to reduce the incidence of severe AKI requiring CRRT after sun's surgery is to shorten the intraoperative cerebral perfusion time as much as possible.

Objective:To investigate the safety and the efficacy of percutaneous and surgical approach in femoro-femoral veno-arterial extracorporeal membrane oxygenation (VA-ECMO) cannulation.Methods:All consecutive patients implanted with femoro-femoral VA-ECMO between January 2018 and December 2020 in Beijing Anzhen Hospital, Capital Medical University. Propensity score matching was used to compare outcomes of percutaneous and surgical groups while controlling for confounders.Results:Among the 276 patients who received femoro-femoral VA-ECMO (62 surgical and 214 percutaneous), propensity-score matching selected 52 pairs of patients with similar characteristics with mean age of(59.6±13.0)years old, in which 26 patients were female. There were a lower ECMO cannulation-associated complication (28.8% vs. 48.1%, P=0.044) and a lower hospital mortality (42.3% vs. 67.3%, P=0.010) in the percutaneous group. The circuit blood flow after ECMO initiation was similar in both groups[(3.3±0.8)L·min -1·kg -1 in percutaneous group vs. (3.2±0.7)L·min -1·kg -1 in surgical group, P=0.738]. The serum lactate was declined in both group after ECMO initiation[(5.4±5.8)mmol/L vs. (9.2±6.9)mmol/L, P<0.001 in percutaneous group; (6.3±6.2)mmol/L vs. (10.5±7.0)mmol/L, P=0.003 in surgical group]. Conclusion:Percutaneous approach is a safe and efficient technique in emoro-femoral VA-ECMO cannulation. Compared with surgical cannulation, percutaneous approach is associated with lower ECMO cannulation-associated complication and lower hospital mortality.

ObjectiveTo investigate the psychometric features of MATRICS Consensus Cognitive Battery （MCCB） in adolescents with bipolar disorder， so as to evaluate its appropriateness for the measurement of cognitive deficits in adolescents with bipolar disorder. MethodsAdolescents with bipolar disorder （n=38）， adolescents with major depressive episode （n=40） and healthy controls （n=41） matched on age， sex and educational background were enrolled. Adolescents with bipolar disorder were assessed using Montreal Cognitive Assessment Scale （MoCA） and MCCB at baseline and 2 weeks later， while the rest were only assessed using MCCB at baseline. Thereafter， the psychometric features of MCCB such as internal consistency， test-retest reliability and criterion-related validity， discriminant validity and structural validity were evaluated using Cronbach's α coefficient， Pearson correlation analysis， analysis of covariance and confirmatory factor analysis. Results①The Cronbach's α coefficient of MCCB in adolescents with bipolar disorder was 0.784 at baseline and 0.773 at two weeks later， respectively. ②Among adolescents with bipolar disorder， the test-retest reliability over a two-week interval of each dimension in MCCB ranged from 0.630 to 0.812 （P<0.01）. ③ The criterion-related validity denoted that the score of short-term memory domain in MoCA was positively correlated with the speed of processing， verbal learning and working memory in MCCB （r=0.487， 0.522， P<0.05 or 0.01）. ④ Discriminant validity analysis implied that the scores of the processing speed， attention/vigilance， working memory， verbal learning and memory， visual learning and memory， reasoning and problem solving in MCCB yielded statistical differences among adolescents with bipolar disorder， adolescents with major depressive episode and healthy controls （F=3.790~7.243， P<0.01）. ⑤ Exploratory factor analysis showed that cumulative total variance contribution rate of MCCB amounted to 71.65% of four factors， and the confirmatory factor analysis indicated that the ideal 7-factor model had poor structural validity. ConclusionMCCB has good internal consistency， retest reliability and acceptable validity in adolescents with bipolar disorder.