Medicine
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Multicenter Study Observational Study
Prognostic values of 4 risk scores in Chinese patients with chest pain: Prospective 2-centre cohort study.
Four risk scores for stratifying patients with chest pain presenting to emergency departments (EDs) (namely Thrombolysis in myocardial infarction [TIMI], Global registry for acute coronary events [GRACE], Banach and HEART) have been developed in Western settings but have never been compared and validated in Chinese patients. We aimed to find out to the number of MACE within 7 days, 30 days, and 6 months after initial ED presentation, and also to compare the prognostic performance of these scores in Chinese patients with suspected cardiac chest pain (CCP) to predict 7-day, 30-day, and 6-month major adverse cardiac events (MACE). A prospective 2-center observational cohort study of consecutive patients presenting with chest pain to the EDs of 2 university hospitals in Guangdong and Hong Kong from 17 March 2012 to 14 August 2013 was conducted. ⋯ However, there was no significant difference in AUC between HEART and TIMI scores. Banach had the largest AUC for predicting safety outcome (AUC = 0.856, 0.837, and 0.850, respectively). The HEART score performed better than the GRACE and Banach scores to predict total MACE and effectiveness outcome in Chinese patients with suspected CCP, whereas the Banach score best predicted safety outcomes.
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Comparative Study
Fully automated software for mitral annulus evaluation in chronic mitral regurgitation by 3-dimensional transesophageal echocardiography.
Three-dimensional (3D) transesophageal echocardiography (TEE) is the gold standard for mitral valve (MV) anatomic and functional evaluation. Currently, dedicated MV analysis software has limitations for its use in clinical practice. Thus, we tested here a complete and reproducible evaluation of a new fully automatic software to characterize MV anatomy in different forms of mitral regurgitation (MR) by 3D TEE. ⋯ Annular characteristics and dynamics are abnormal in both FMR and OMR. Full 3D software analysis automatically calculates several significant parameters that provide a correct and complete assessment of anatomy and dynamic mitral annulus geometry and displacement in the 3D space. This analysis allows a better characterization of MR pathophysiology and could be useful in designing new devices for MR repair or replacement.
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Randomized Controlled Trial
Evaluation of dexmedetomidine in combination with sufentanil or butorphanol for postoperative analgesia in patients undergoing laparoscopic resection of gastrointestinal tumors: A quasi-experimental trial.
The aim of this study was to evaluate the efficacy of dexmedetomidine in combination with sufentanil or butorphanol for postoperative analgesia in patients undergoing laparoscopic resection of a gastrointestinal tumor. This quasi-experimental trial was conducted in Nanchang, China, from January 2014 to December 2015. Eighty patients (age 27-70 years, American Society of Anesthesiologists physical status I-II) undergoing laparoscopic resection of a gastrointestinal tumor were randomized into 4 groups and offered intravenous patient-controlled analgesia for pain control after surgery. ⋯ The satisfaction score was higher in group S2 than in the other groups. Dexmedetomidine in combination with sufentanil or butorphanol can be used safely and effectively for postoperative analgesia in patients undergoing laparoscopic resection of a gastrointestinal tumor. The combination of dexmedetomidine 2.0 μg/kg and sufentanil is particularly beneficial in these patients.
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The aim of the present study was to describe the application of 3D printed templates for intraoperative navigation and simulation of periacetabular osteotomies (PAOs) in a cadaveric model. Five cadaveric specimens (10 sides) underwent thin-slice computed tomographic scans of the ala of ilium downwards to the proximal end of femoral shaft. Bernese PAO was performed. ⋯ No osteotomy entered the hip joint and a single posterior column fracture was observed. Comparison of preoperative and postoperative measurements of the 10 sides showed statistically significant changes, whereas no statistically significant differences between postsimulation and postoperative values were noted, demonstrating the accuracy and utility of the 3D printed templates. The application of patient-specific 3D printed bone-drilling and rotation templates in PAO is feasible and may facilitate improved clinical outcomes, through the use of precise presurgical planning and reduced surgical complications with the precisely guided bone drilling.
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Comparative Study Observational Study
Injury of the lower ascending reticular activating system in patients with pontine hemorrhage: Diffusion tensor imaging study.
Many studies have reported about injury of the ascending reticular activating system (ARAS) in patients with various brain pathologies, using diffusion tensor tractography (DTT); however, little is known about injury of the ARAS in patients with pontine hemorrhage. In this study, using DTT, we attempted to investigate injury of the lower ventral and dorsal ARAS in patients with pontine hemorrhage. Twenty-three consecutive patients with pontine hemorrhage and 14 control subjects were recruited into this study. ⋯ In terms of FA value, the lower dorsal ARAS were significantly lower in subgroup A and subgroup B than in the control group (P < 0.05). In conclusion, injury of the lower ventral and dorsal ARAS was demonstrated in patients with impaired arousal following pontine hemorrhage. We believe that analysis of the ARAS using DTT would be helpful in evaluation of patients with impaired consciousness after pontine hemorrhage.