Objective To evaluate the short-term results of sleeve wrapping technique using remnant aortic wall in modified Bentall procedure. Methods The patients undergoing modified Bentall procedure with the remnant aortic wall as a sleeve to cover the sewing area of composite valved graft and the aortic annulus for proximal hemostasis between March 2021 and March 2022 in Shenzhen Fuwai Hospital were enrolled. Short-term results were assessed by cardiopulmonary bypass time, aortic clamping time, mechanical ventilation time, ICU stay, postoperative hospital stay, effusion drainage on the first postoperative day, left ventricular ejection fraction (LVEF), left ventricular end diastolic diameter (LVEDD), and follow-up results. Results A total of 14 patients were collected, including 12 males and 2 females, with a mean age of 55.33±10.57 years. There was no postoperative or follow-up death. Cardiopulmonary bypass time was 147.90±21.29 min, aortic clamping time was 115.70±15.23 min, mechanical ventilation time was 19.42±8.98 h, ICU stay was 99.08±49.42 h, and postoperative hospital stay was 16.33±2.74 d. Thoracic drainage volume was 333.33±91.98 mL on the first postoperative day. Only 2 patients required blood transfusion (4.5 U and 2 U, respectively). During the follow-up of 6.17±3.69 months, there was no death, no aortic or valve-related complications. There was statistical difference in the LVEDD between preoperation and before discharge after surgery (P＜0.001), and between half a year after surgery and before discharge after surgery (P＜0.001). There was a little decrease of LVEF before discharge after surgery compared with preoperative LVEF, but there was no statistical difference (P=0.219). There was no statistical difference in the LVEF half a year after operation compared with that before operation (P=1.000). Conclusion Sleeve wrapping technique using remnant aortic wall in modified Bentall procedure has good short-term results. This modification may be a simple, effective way in controlling proximal bleeding.

Objective:To quantitatively evaluate the left ventricular myocardial strains and global myocardial work indices in severe aortic stenosis(AS) patients with preserved left ventricular ejection fraction (LVEF) undergoing transcatheter aortic valve implantation (TAVI) by using two-dimensional speckle tracking imaging (2D-STI) technology and pressure-strain loop (PSL).Methods:Twenty patients undergoing TAVI from January to November 2020 in Cardiovascular Hospital of Xiamen University were selected as the TAVI group, and 20 healthy volunteers (with the matched gender, age) were selected as the control group at the same period. Left ventricular global longitudinal strain (GLS), endocardial, middle, epicardial myocardial longitudinal strain (LSendo, LSmid, LSepi) were measured by 2D-STI. The correlation between aortic pressure and the left ventricular systolic pressure invasively measured by cardiac catheterization, and blood pressure and the left ventricular systolic pressure non-invasively measured by peripheral brachial artery systolic blood pressure combined with Doppler-derived mean aortic gradient was separately compared. The non-invasive PSL was used to evaluate the global work index (GWI), global constructive work (GCW), global wasted work (GWW) and global work efficiency (GWE). The differences of the myocardial strains and myocardial work indices between the two groups, including controls, patients with preoperation, 1 week and 3 months after TAVI, were compared.Results:Compared with the control group, GLS, LSendo, LSmid and LSepi of the left ventricle in the TAVI preoperation group were decreased (all P<0.05), LSendo increased at 1 week after TAVI, and GLS, LSendo, LSmid, and LSepi increased at 3 months after TAVI (all P<0.05). In the TAVI preoperative, invasive aortic pressure was positively correlated with peripheral brachial artery systolic blood pressure, invasive left ventricular systolic pressure was positively correlated with non-invasive left ventricular systolic pressure ( r=0.658, 0.565; all P<0.01). Compared with the control group, the preoperative the GWE decreased and the GWW increased in the TAVI group (all P<0.05). Compared with the preoperation, the GWI and GCW decreased at 1 week after TAVI (all P<0.05). Compared with 1 week after TAVI, GWI, GCW, GWE increased and GWW decreased at 3 months after TAVI (all P<0.05). Conclusions:The application of 2D-STI and PSL can quantitatively evaluate the left ventricular myocardial systolic function before and after TAVI in AS patients, which can provide a more objective reference index for clinical evaluation of the efficacy of TAVI.

Objective: To compare the short-term and long-term results of thoracoscopic and open pneumonectomy for non-small cell lung cancer. Methods: The clinical data of patients with non-small cell lung cancer who underwent pneumonectomy in the Department of Thoracic Surgery, Qingdao University Hospital from January 2008 to December 2016 were collected. Totally 142 patients (55 in the thoracoscopic group and 87 in the open group) were included in the study. A total of 29 pairs of patients were successfully matched by propensity score matching (PSM). Perioperative outcomes and overall survival were compared between the two groups using t test, χ² test, Kaplan-Meier curve and Log-rank test, respectively. Results: Camparion with open group, the thoracoscopic group had longer operative time ((209.7±70.2) minutes vs. (171.3±43.5) minutes, t=2.50, P=0.02), more mediastinal lymph node dissection (M(Q_R): 17(9) vs. 11(10), W=388, P=0.02) and shorter postoperative hospital stay (7.0(3.5) vs. 9.0(3.0), W=285, P=0.03). There was no significant difference in estimated blood loss, postoperative drainage time, dissected lymph node number, dissected lymph node station and perioperative complications. After PSM, there were no signifificant differences found in 3-year survival (71.4% vs. 48.1%, P=0.10) and 3-year disease-free survival (67.4% vs. 47.2%, P=0.13) between the two groups. Conclusion Thoracoscopic pneumonectomy is safe and feasible for the treatment of non-small cell lung cancer with more mediastinal lymph node dissection and accelerating recovery, and equivalent long-term prognosis when compared with open approach.

Objective To investigate the hemodynamic changes before and after Revivent surgery in patients with left ventricular apical aneurysm by cardiac magnetic resonance imaging ( CM R ) and echocardiography . Methods Twenty‐two cases with left ventricular apical aneurysm were examined by two‐dimensional and three‐dimensional transthoracic echocardiography 1 week before operation ,1 month and 12 months after operation ,by CM R 1 week before operation and 12 months after operation .Left ventricular end‐diastolic volume( LVEDV ) ,left ventricular end‐systolic volume ( LVESV ) ,left ventricular end‐diastolic diameter ( LVEDd ) , left ventricular end‐systolic diameter ( LVESd ) , left ventricular ejection fraction ( LVEF) ,stroke volume ( SV ) ,stroke output index ( SVI) ,cardiac output ( CO ) and cardiac output index ( CI) were quantitatively measured and statistical analysis were performed . Results T here were significant differences between preoperation and 1 month after operation for the measurements of LVEDV ,LVESV , LVEDd and LVEF by both CM R and echocardiography ( all P ＜ 0 .05 ) . Compared with preoperation , LVESd decreased significantly 12 months after operation ( P ＜0 .01) . However ,there were no significant differences between preoperation and 1 or 12 months after operation for the measurements of SV ,SVI ,CO and CI ( all P ＞ 0 .05 ) . T he consistency between CM R and echocardiography measurements was good . Conclusions Revivent surgery provides an effective and feasible treatment for patients with left ventricular apical ventricular aneurysm . T he dual‐modality imaging with CM R and echocardiography are reliable technical means to evaluate the changes of left ventricular heamodynamiscs during the perioperative period of Revivent

Objective To evaluate the changes of left ventricular hemodynamics and systolic function in patients with apical aneurysm after percutaneous ventricular restoration ( PVR) by echocardiography . Methods Fifty patients with apical aneurysm were divided into PVR group ( 25 cases) and conservative treatment group ( control group ,25 cases ) . Two-dimensional transthoracic echocardiography ( 2D-TTE ) combined with real-time three-dimensional transesophageal echocardiography( RT-3DTEE) were applied for all the subjects in PVR group on preoperative ,one week after operaction ,three months after operaction and in control group on initial stage of prevent ventricular remodeling therapy ,one week after therapy ,three months after therapy to obtain left ventricular end-diastolic diameter( LVEDD) ,left ventricular end-systolic diameter( LVSDD) ,left ventricular end-diastolic volume( EDV ) ,end-systolic volume( ESV ) ,left ventricular ejection fraction( LVEF) ,left ventricular fractional shortening ( LVFS ) ,body surface area ( BSA ) ,stroke volume( SV) ,stroke volume index ( SVI) ,cardiac output ( CO ) ,cardiac output index ( CI) . Results There were significant differences in all parameters( P < 0 .05) especially in LVEF and SVI( P < 0 .01) between PVR group and control group in the following three months after operaction ,while there was no significant difference of the following one week after operaction( P > 0 .05) .Compared with preoperative ,there was no difference in all parameters in the following one week after operaction ( P > 0 .05) ,there was significant increase in SV and significant reduce in LVEDD and EDV ( P < 0 .01) between preoperative and in the following three months after operaction ,while there was no significant difference between preoperative and in the following one week after operaction ( P > 0 .05 ) .For the control group there was no significant difference between initial stage of prevevt ventricular remodeling therapy and in the following one week or three months after operaction .Conclusions PVR has a definite effect on left ventricular hemodynamics and systolic function in patients with apical aneurysm in the short term ,while 2D-TTE and RT-3DTEE provides a reliable basis for clinical to evaluate the effect of the PVR .

Objective To evaluate the immediate effect of percutaneous ventricular restoration (PVR) using the PARACHUTE system in ischemic cardiomyopathy patients with apical aneurysm.Methods The study included 25 patients who received PARACHUTE partitioning device (PVD) implantation in the Xiamen Cardiovascular Hospital between January 2015 to December 2016.Invasive left ventricular hemodynamic assessments as well as cardiac output and cardiac output index were analyzed.Results Twenty-five patients [mean age (65.4±11.9) years] suffered from left ventricular aneurysm and heart failure patients after anterior myocardial infarction were enrolled.Ventricular partitioning device implantation was successful in 24/25 (96.0%) patients.PVR was failed in 1 patient due to unable to land the PVD in a satisfactory location.After implantation, a significant increase in cardiac output [(3.83±0.72) L/min vs.(4.85±0.93) L/min, P<0.01] and cardiac index [(2.32±0.74) L/(min·m2) vs.(2.90±0.82) L/(min·m2), P<0.01] was found.Conclusions Our preliminary experience on percutaneous ventricular restoration using PARACHUTE system demonstrates its feasibility and safety with increase in cardiac output and cardiac index immediately following the device implantation.

Objective: To evaluate the safety and efifcacy of percutaneous ventricular partitioning (PVP) in ischemic heart failure (IHF) patients with apical aneurysm. Methods: A total of 19 IHF patients with apical aneurysm at the age of (68.1 ± 8.2) years were enrolled. The patients received PVP operation with adequate clinical and medical imaging examinations; the safety of operation was evaluated and post-operative clinical events with cardiac function were followed-up. Results: There were 18/19 (95%) patients with successful PVP and 1 had to stop the operation due to unsatisfactory landing of ventricular partitioning device. 2 patients suffered from vessel access related complication and received femoral artery stent implantation. With (252 ± 170) days follow-up study, no post-operative device failure, cardiac death, thromboembolism and HF re-hospitalization occurred. At 3 months after operation, the patients had improved NYHA classiifcation (2.72 ± 0.67) vs (1.67 ± 0.59) and 6 min walk test (462 ± 96) m vs (484 ± 87) m, bothP<0.01. Echocardiography indicated that post-operative left ventricle end-diastolic volume index (LVEDVI) decreased form (137.4 ± 19.1) ml/m2 to (125.6 ± 18.5) ml/m2,P=0.0056 and LVESVI decreased from (89.7 ± 22.3) ml/m2 to (78.8 ± 20.7) ml/m2,P=0.0019; while LVEF increased from (34.8 ± 8.13) % to (41.3 ± 6.2) %, P=0.031. Conclusion: Our preliminary experience showed that with adequate evaluation, PVP was safe and effective in IHF patients with apical aneurysm; short-term follow-up study implied the improved hemodynamic and cardiac function.

With the development of industrial technology, dust explosion accidents have increased, causing serious losses of people's lives and property. With the development of economy, we should lay further emphasis on causation, prevention, and treatment of dust explosion. This article summarizes the background, mechanism, prevention, and treatment of dust explosion, which may provide some professional knowledge and reference for the treatment of dust explosion.
Dust ; Explosions ; prevention & control ; Humans

Objective To study the relationship between ischemic mitral regurgitation and geometric angles of the mitral valve leaflets in patients with coronary artery disease and papillary muscle dysfunction by transesophageal echocardiography(TEE) ,and to evaluate anatomy and pathophysiology mechanicm of the ischemic mitral regurgitation with left ventricular papillary muscle dysfunction .Methods A total of 84 subjects were enrolled in this study .All of the subjects were divided into group A (healthy volunteers constituted the control group ,n =40) ,group B (chronic inferior or posterior myocardial infarction patients with papillary muscle dysfunction group ,n =44) ,group C(patients from group B after mitral valvuloplasty surgery ,n = 20) .The relationship between mitral regurgitation and geometric angles of the mitral valve leaflets and mitral annulus were studied by TEE .Results Geometric angle between the mitral valve leaflets and mitral annulus were significantly larger in group B ,and geometric angles of the mitral valve leaflets and mitral annulus was positive correlated with degree of mitral regurgitation .Degree of mitral regurgitation significantly reduced in group C ,no significant difference was found at the geometric angles of the mitral valve leaflets and mitral valve annular compared with group A .Conclusions The degree of mitral regurgitation were highly correlated with geometric angles of the mitral valve leaflets and mitral valve annular in patients with left ventricular papillary muscle dysfunction caused by coronary heart disease .Repair of the mitral valve leaflets surgery can significantly reduce geometric angles of the mitral valve leaflets and mitral valve annular ,and reduce the degree of mitral regurgitation significantly .