1.Analysis of risk factors for neurological complications in patients with Stanford type A aortic dissection
Chuanwen LI ; Qingyan SUN ; Yanqing GAN ; Xianqing LI ; Teng CAI ; Hongsheng LIU ; Liangchun NI ; Zhonghua FEI
Chinese Journal of Postgraduates of Medicine 2025;48(7):635-642
Objective:To explore how one-sided/two-sided brain blood flow affects the occurrence of neurological complications in patients with Stanford type A aortic dissection, as well as to assess the factors that contribute to the development of neurological complications.Methods:A total of 162 patients diagnosed with Stanford type A aortic dissection who had undergone ascending aorta and total aortic arch replacement at Affiliated Hospital of Jining Medical College from August 2020 to December 2023 were retrospectively reviewed. These patients were categorized into two groups based on the presence of postoperative neurological complications: a group with neurological complications comprising 77 cases and a group without neurological complications comprising 85 cases. A comparative analysis was carried out on general clinical data, surgical and brain perfusion characteristics, as well as preoperative test indicators between these two groups in order to investigate the factors influencing the occurrence of postoperative neurological complications in patients with Stanford type A aortic dissection. The data was analyzed using Logistic regression to identify the risk factors associated with postoperative neurological complications and to develop a predictive nomogram model. Calibration curves, receiver operating characteristic (ROC) curves and decision curve (DCA) were generated to assess the accuracy and predictive capability of the nomogram model.Results:In the group of patients who experienced neurological complications, there was a higher prevalence of a history of hypertension, longer operation time, extended periods of cardiopulmonary bypass, cross-clamping, brain perfusion, cooling, and rewarming, as well as increased postoperative drainage volume. Additionally, the levels of preoperative blood urea nitrogen (BUN), creatinine (Cr) and lactic acid (Lac) were elevated compared to those in the non-neurological complications group: 77.9% (60/77) vs. 52.9% (45/85), (409.99 ± 104.26) min vs. (348.29 ± 63.12) min, (223.36 ± 66.86) min vs. (179.25 ± 38.59) min, 112 (94, 133) min vs. 96 (84, 113) min, (35.23 ± 9.89) min vs. (32.14 ± 6.81) min, (82.19 ± 28.69) min vs. (68.76 ± 29.06) min, (79.30 ± 22.60) min vs. (69.54 ± 16.42) min, 806 (529, 1 127) ml vs. 663 (449, 925) ml, 6.78 (5.38, 8.84) mmol/L vs. 6.08 (4.66, 7.76) mmol/L, 86.3 (64.0, 131.9) μmol/L vs. 71.0 (55.6, 84.9) μmol/L, 2.1(1.2, 4.0) mmol/L vs. 1.5 (0.9, 2.3) mmol/L. On the other hand, the percentage of patients who underwent bilateral brain perfusion was lower, and they experienced lower lowest temperature, preoperative platelet count, and ejection fraction levels than those in the non-neurological complications group: 57.1% (44/77) vs. 75.3% (64/85), (25.69 ± 1.04) ℃ vs. (26.04 ± 0.82) ℃, (175.79 ± 58.14) ×10 9/L vs. (213.87 ± 77.29) ×10 9/L, (54.18 ± 3.84)% vs. (55.34 ± 3.56)% ( P<0.05). Multivariate Logistic regression analysis revealed that a prior history of high blood pressure, prolonged cardiopulmonary bypass duration were identified as autonomous risk factors for the development of postoperative neurological issues in individuals with Stanford type A aortic dissection, while simultaneous brain perfusion emerged as an independent protective element ( P<0.05). Subsequently, a predictive nomogram was constructed incorporating these three pivotal factors to assess the likelihood of postoperative neurological complications in patients with Stanford type A aortic dissection. The calibration curve exhibited a noteworthy level of accuracy for the nomogram predictive model ( χ2 = 9.01, P = 0.342). Additionally, the ROC curve analysis displayed an area under the curve of 0.84 (95% CI 0.78 to 0.90) for the nomogram model in predicting postoperative neurological complications in patients with Stanford type A aortic dissection, indicating a high predictive accuracy. Moreover, DCA analysis indicated that the nomogram model provided a net benefit above 0 across the spectrum of 0 to 90%. Conclusions:Postoperative neurological complications in patients with Stanford type A aortic dissection is linked to factors such as a previous history of hypertension, unilateral brain perfusion, an extended cardiopulmonary bypass duration. By developing a nomogram model that incorporates these factors, it becomes feasible to accurately forecast the likelihood of postoperative neurological complications in this patient population. This predictive tool holds significant value in facilitating proactive clinical risk evaluation and preventive measures.
2.Dietary patterns and their influencing factors among patients with coronary heart disease in severe cold regions
Rui WANG ; Ping WANG ; Jiaonan NI ; Ting XIONG ; Yini WANG ; Xinrui MA ; Zhonghua HU ; Zhenjuan ZHAO
Chinese Journal of Modern Nursing 2025;31(22):2986-2993
Objective:To explore the current dietary patterns and influencing factors of patients with coronary heart disease (CHD) in severe cold regions, aiming to provide scientific evidence for developing targeted dietary interventions.Methods:A total of 340 patients with CHD who visited the Department of Cardiology at the Second Affiliated Hospital of Harbin Medical University between September and December 2023 were selected using convenience sampling. Patients were assessed using a general information questionnaire, Semi-Quantitative Food Frequency Questionnaire, Food Choice Questionnaire, Nutritional Knowledge Questionnaire, 7-Item Generalized Anxiety Disorder Scale, and Patient Health Questionnaire-9.Results:A total of 340 questionnaires were distributed, and 333 valid questionnaires were collected, with an effective response rate of 97.94% (333/340). Two dietary patterns were identified among patients with CHD in severe cold regions: a "fruit-nut-dairy" dietary pattern and a "meat-seafood-grain" dietary pattern. Factors influencing the "fruit-nut-dairy" dietary pattern included gender, nutritional knowledge, and food choice motivations such as accessibility, sensory appeal, brand and packaging, and emotional dimensions ( P<0.05). Factors influencing the "meat-seafood-grain" dietary pattern included body mass index (BMI), living alone or not, monthly income, and food choice motivations such as convenience, health attributes, sensory appeal, and price ( P<0.05) . Conclusions:When providing dietary interventions for CHD patients, targeted control of factors such as gender, BMI, living alone or not, monthly income, nutritional knowledge, and key elements of food choice motivations may optimize patients' irrational dietary structures and reduce adverse disease outcomes.
3.Dietary patterns and their influencing factors among patients with coronary heart disease in severe cold regions
Rui WANG ; Ping WANG ; Jiaonan NI ; Ting XIONG ; Yini WANG ; Xinrui MA ; Zhonghua HU ; Zhenjuan ZHAO
Chinese Journal of Modern Nursing 2025;31(22):2986-2993
Objective:To explore the current dietary patterns and influencing factors of patients with coronary heart disease (CHD) in severe cold regions, aiming to provide scientific evidence for developing targeted dietary interventions.Methods:A total of 340 patients with CHD who visited the Department of Cardiology at the Second Affiliated Hospital of Harbin Medical University between September and December 2023 were selected using convenience sampling. Patients were assessed using a general information questionnaire, Semi-Quantitative Food Frequency Questionnaire, Food Choice Questionnaire, Nutritional Knowledge Questionnaire, 7-Item Generalized Anxiety Disorder Scale, and Patient Health Questionnaire-9.Results:A total of 340 questionnaires were distributed, and 333 valid questionnaires were collected, with an effective response rate of 97.94% (333/340). Two dietary patterns were identified among patients with CHD in severe cold regions: a "fruit-nut-dairy" dietary pattern and a "meat-seafood-grain" dietary pattern. Factors influencing the "fruit-nut-dairy" dietary pattern included gender, nutritional knowledge, and food choice motivations such as accessibility, sensory appeal, brand and packaging, and emotional dimensions ( P<0.05). Factors influencing the "meat-seafood-grain" dietary pattern included body mass index (BMI), living alone or not, monthly income, and food choice motivations such as convenience, health attributes, sensory appeal, and price ( P<0.05) . Conclusions:When providing dietary interventions for CHD patients, targeted control of factors such as gender, BMI, living alone or not, monthly income, nutritional knowledge, and key elements of food choice motivations may optimize patients' irrational dietary structures and reduce adverse disease outcomes.
4.Analysis of risk factors for neurological complications in patients with Stanford type A aortic dissection
Chuanwen LI ; Qingyan SUN ; Yanqing GAN ; Xianqing LI ; Teng CAI ; Hongsheng LIU ; Liangchun NI ; Zhonghua FEI
Chinese Journal of Postgraduates of Medicine 2025;48(7):635-642
Objective:To explore how one-sided/two-sided brain blood flow affects the occurrence of neurological complications in patients with Stanford type A aortic dissection, as well as to assess the factors that contribute to the development of neurological complications.Methods:A total of 162 patients diagnosed with Stanford type A aortic dissection who had undergone ascending aorta and total aortic arch replacement at Affiliated Hospital of Jining Medical College from August 2020 to December 2023 were retrospectively reviewed. These patients were categorized into two groups based on the presence of postoperative neurological complications: a group with neurological complications comprising 77 cases and a group without neurological complications comprising 85 cases. A comparative analysis was carried out on general clinical data, surgical and brain perfusion characteristics, as well as preoperative test indicators between these two groups in order to investigate the factors influencing the occurrence of postoperative neurological complications in patients with Stanford type A aortic dissection. The data was analyzed using Logistic regression to identify the risk factors associated with postoperative neurological complications and to develop a predictive nomogram model. Calibration curves, receiver operating characteristic (ROC) curves and decision curve (DCA) were generated to assess the accuracy and predictive capability of the nomogram model.Results:In the group of patients who experienced neurological complications, there was a higher prevalence of a history of hypertension, longer operation time, extended periods of cardiopulmonary bypass, cross-clamping, brain perfusion, cooling, and rewarming, as well as increased postoperative drainage volume. Additionally, the levels of preoperative blood urea nitrogen (BUN), creatinine (Cr) and lactic acid (Lac) were elevated compared to those in the non-neurological complications group: 77.9% (60/77) vs. 52.9% (45/85), (409.99 ± 104.26) min vs. (348.29 ± 63.12) min, (223.36 ± 66.86) min vs. (179.25 ± 38.59) min, 112 (94, 133) min vs. 96 (84, 113) min, (35.23 ± 9.89) min vs. (32.14 ± 6.81) min, (82.19 ± 28.69) min vs. (68.76 ± 29.06) min, (79.30 ± 22.60) min vs. (69.54 ± 16.42) min, 806 (529, 1 127) ml vs. 663 (449, 925) ml, 6.78 (5.38, 8.84) mmol/L vs. 6.08 (4.66, 7.76) mmol/L, 86.3 (64.0, 131.9) μmol/L vs. 71.0 (55.6, 84.9) μmol/L, 2.1(1.2, 4.0) mmol/L vs. 1.5 (0.9, 2.3) mmol/L. On the other hand, the percentage of patients who underwent bilateral brain perfusion was lower, and they experienced lower lowest temperature, preoperative platelet count, and ejection fraction levels than those in the non-neurological complications group: 57.1% (44/77) vs. 75.3% (64/85), (25.69 ± 1.04) ℃ vs. (26.04 ± 0.82) ℃, (175.79 ± 58.14) ×10 9/L vs. (213.87 ± 77.29) ×10 9/L, (54.18 ± 3.84)% vs. (55.34 ± 3.56)% ( P<0.05). Multivariate Logistic regression analysis revealed that a prior history of high blood pressure, prolonged cardiopulmonary bypass duration were identified as autonomous risk factors for the development of postoperative neurological issues in individuals with Stanford type A aortic dissection, while simultaneous brain perfusion emerged as an independent protective element ( P<0.05). Subsequently, a predictive nomogram was constructed incorporating these three pivotal factors to assess the likelihood of postoperative neurological complications in patients with Stanford type A aortic dissection. The calibration curve exhibited a noteworthy level of accuracy for the nomogram predictive model ( χ2 = 9.01, P = 0.342). Additionally, the ROC curve analysis displayed an area under the curve of 0.84 (95% CI 0.78 to 0.90) for the nomogram model in predicting postoperative neurological complications in patients with Stanford type A aortic dissection, indicating a high predictive accuracy. Moreover, DCA analysis indicated that the nomogram model provided a net benefit above 0 across the spectrum of 0 to 90%. Conclusions:Postoperative neurological complications in patients with Stanford type A aortic dissection is linked to factors such as a previous history of hypertension, unilateral brain perfusion, an extended cardiopulmonary bypass duration. By developing a nomogram model that incorporates these factors, it becomes feasible to accurately forecast the likelihood of postoperative neurological complications in this patient population. This predictive tool holds significant value in facilitating proactive clinical risk evaluation and preventive measures.
5.Metabolic Changes of Acanthopanax senticosus Fruits During Development
Feiyang SUN ; Xiaorui GUO ; Ying SONG ; Mingyuan XU ; Jing ZHANG ; Zhonghua TANG ; Hongwei NI
Chinese Journal of Experimental Traditional Medical Formulae 2022;28(21):163-170
ObjectiveTo study the changes of primary metabolites and phenols in the fruits of Acanthopanax senticosus at different development stages, so as to provide a theoretical basis for the rational utilization of A. senticosus fruit resources. MethodThe primary metabolites and phenols in the fruits at different development stages were determined via gas chromatography-mass spectrometry (GC-MS) and liquid chromatography-mass spectrometry (LC-MS) and then compared by multivariate statistical analysis. ResultA total of 274 chromatographic peaks were obtained by GC-MS-based non-targeted metabonomics and 24 differential metabolites were screened out by multivariate statistical analysis. The differential metabolites were mainly concentrated in pentose phosphate pathway, galactose metabolism, ascorbic acid and aldose metabolism pathways. After color conversion, the pentose phosphate pathway and galactose metabolism were activated and increasing sugars were accumulated. The ascorbic acid and aldose metabolism pathways were active before color conversion, with high accumulation of the end product ascorbic acid. The ultra-high liquid chromatography-mass spectrometry (UPLC-MS) identified 28 phenols in the fruits at different development stages. Flavonoids were accumulated mainly at the green ripening stage before color conversion, and phenolic acids were accumulated mainly after color conversion. ConclusionThe accumulation of primary metabolites and phenols in A. senticosus fruits varies significantly among different development stages
6. Clinical analysis of modified standard traumatic craniectomy in the treatment of severe craniocerebral trauma
Zhonghua XU ; Yanshen TANG ; Lanchun NI
Chinese Journal of Primary Medicine and Pharmacy 2019;26(10):1178-1181
Objective:
To analyze the clinical effect of modified standard traumatic craniectomy and standard large trauma craniectomy in the treatment of severe craniocerebral trauma.And to evaluate the clinical value of modified standard traumatic craniectomy in the treatment of severe craniocerebral trauma.
Methods:
Ninety-two patients with severe craniocerebral trauma treated in Rugao Bo′ai Hospital (GCS3-8, acute subdural hematoma) from January 2015 to January 2017 were divided into two groups using random envelope drawing method, with 46 cases in each group.The control group was treated by standard large trauma craniectomy, and the observation group was treated by modified standard traumatic craniectomy.The intracranial pressure levels and activity of daily living scale (ADL) were compared between the two groups.
Results:
At 1 d, 5 d, 10 d after operation, the intracranial pressure levels of the observation group were (23.19±2.82)mmHg, (15.26±2.77)mmHg and (11.22±2.75)mmHg, respectively, which were lower than those of the control group[(28.12±2.32)mmHg, (19.14±2.17)mmHg and (14.23±2.17)mmHg](
7.Survey of coronary stents development for restenosis prevention.
Jie CHEN ; Zhonghua NI ; Xingzhong GU
Chinese Journal of Medical Instrumentation 2009;33(6):429-434
Coronary stents are playing an effective way of curing cardiovascular diseases while a major drawback of restenosis is in general still present. Restenosis is resulting from neointimal hyperplasia and thrombosis which induced by the vascular lesion, hemodynamic modification and the reduction or oscillation of wall shear stress (WSS). The crucial factors that would determine the restenosis were reviewed in this paper, including the material bio-compatibilities, surface treatments, stent configuration designs and hemodynamics analyses. In particular, the hemodynamics after stents implantation based on in vivo, in vitro or Computational Fluid Dynamics (CFD) methods was discussed. A novel CFD and experimental approach of dynamics in the stent-vascular coupling system was proposed.
Biocompatible Materials
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Blood Vessel Prosthesis
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Coronary Restenosis
;
prevention & control
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Equipment Design
;
Hemodynamics
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Models, Cardiovascular
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Shear Strength
;
Stents

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