Objective To investigate the effect of modified percutaneous closure in the treatment of ventricular septal rupture.Methods This study is a retrospective cohort study.Forty-four patients with ventricular septal ruptur...Objective To investigate the effect of modified percutaneous closure in the treatment of ventricular septal rupture.Methods This study is a retrospective cohort study.Forty-four patients with ventricular septal rupture who underwent percutaneous closure at the Fuwai Central China Cardiovascular Hospital from December 2017 to October 2023 were included.According to the closure method,patients were divided into the modified group(11 cases)and the traditional group(33 cases).Surgical success was defined as successful placement of the occluder.The operation time,X-ray intake,sheath bending rate,incidence of ventricular fibrillation and pericardial tamponade,and postoperative residual shunt were compared between the two groups.Results The age of the patients was(75.0±5.7)years,with 20(45%)males.There were 3 cases of operation failure in the traditional group,while all patients in the modified group were successfully occluded.The procedure time in the modified group was shorter than that in the traditional group(40(35,45)min vs.60(50,65)min,P<0.001);X-ray dose intake was lower((442.43±73.26)mGy vs.(784.45±247.78)mGy,P<0.001).There was no occurrence of sheath bending in the modified group,while the incidence of sheath bending in the traditional surgery group was 46%(15/33),and the difference was statistically significant(P=0.017).Intraoperative ventricular fibrillation and pericardial tamponade occurred in 7 cases(21%)and 2 cases(6%)in the traditional group respectively,while none occurred in the modified group,but the differences between the groups were not statistically significant(both P>0.05).There was no significant difference in residual shunt between the two groups(3.6(2.5,4.3)mm vs.4.0(3.5,4.5)mm,P=0.506).Conclusion The procedure of modified ventricular septal rupture closure is more simplified,with a lower incidence of ventricular fibrillation and pericardial tamponade.展开更多
Objective To explore the survival benefits of the concept of staged treatment of Chinese medicine(STCM)combined with chemotherapy in patients with metastatic colorectal cancer(mCRC).Methods Using a bidirectional cohor...Objective To explore the survival benefits of the concept of staged treatment of Chinese medicine(STCM)combined with chemotherapy in patients with metastatic colorectal cancer(mCRC).Methods Using a bidirectional cohort study method,patients with mCRC who received chemotherapy and"continuously received≥3 months of ST-CM"were considered as the exposure factor.Patients who meet this exposure factor were included in the integrative medicine cohort(Group A),receiving conventional treatment combined with ST-CM;those who do not meet this exposure factor were included in the Western medicine cohort(Group B),receiving conventional treatment.The overall survival(OS)and survival rates from the lst,2nd,and 3rd year were compared between the two groups.Results A total of 519 patients were recruited in this study.The median overall survival(mOS)for cohort A(324 cases)and cohort B(195 cases)were 34.3 months and 21.3 months,respectively(HR 0.65,95%CI:0.535-0.793,P<0.001).The survival rates at 1 st,2nd and 3rd years for Group A and Group B were 95.6%and 83.2%,38.6%and 24.7%,21.6%and 12.4%,respectively,with group A showing better outcomes than group B(P<0.001).Subgroup analysis revealed that regardless of gender,primary tumor site,genetic type,combination with targeted therapy,presence of liver metastasis,and absence of peritoneal metastasis,Group A's mOS was significantly better than Group B,with all differences being statistically significant(P<0.05).Conclusion ST-CM combined with chemotherapy can prolong the OS of mCRC patients,and improve the survival rates from the 1st,2nd and 3rd year.展开更多
文摘Objective To investigate the effect of modified percutaneous closure in the treatment of ventricular septal rupture.Methods This study is a retrospective cohort study.Forty-four patients with ventricular septal rupture who underwent percutaneous closure at the Fuwai Central China Cardiovascular Hospital from December 2017 to October 2023 were included.According to the closure method,patients were divided into the modified group(11 cases)and the traditional group(33 cases).Surgical success was defined as successful placement of the occluder.The operation time,X-ray intake,sheath bending rate,incidence of ventricular fibrillation and pericardial tamponade,and postoperative residual shunt were compared between the two groups.Results The age of the patients was(75.0±5.7)years,with 20(45%)males.There were 3 cases of operation failure in the traditional group,while all patients in the modified group were successfully occluded.The procedure time in the modified group was shorter than that in the traditional group(40(35,45)min vs.60(50,65)min,P<0.001);X-ray dose intake was lower((442.43±73.26)mGy vs.(784.45±247.78)mGy,P<0.001).There was no occurrence of sheath bending in the modified group,while the incidence of sheath bending in the traditional surgery group was 46%(15/33),and the difference was statistically significant(P=0.017).Intraoperative ventricular fibrillation and pericardial tamponade occurred in 7 cases(21%)and 2 cases(6%)in the traditional group respectively,while none occurred in the modified group,but the differences between the groups were not statistically significant(both P>0.05).There was no significant difference in residual shunt between the two groups(3.6(2.5,4.3)mm vs.4.0(3.5,4.5)mm,P=0.506).Conclusion The procedure of modified ventricular septal rupture closure is more simplified,with a lower incidence of ventricular fibrillation and pericardial tamponade.
文摘Objective To explore the survival benefits of the concept of staged treatment of Chinese medicine(STCM)combined with chemotherapy in patients with metastatic colorectal cancer(mCRC).Methods Using a bidirectional cohort study method,patients with mCRC who received chemotherapy and"continuously received≥3 months of ST-CM"were considered as the exposure factor.Patients who meet this exposure factor were included in the integrative medicine cohort(Group A),receiving conventional treatment combined with ST-CM;those who do not meet this exposure factor were included in the Western medicine cohort(Group B),receiving conventional treatment.The overall survival(OS)and survival rates from the lst,2nd,and 3rd year were compared between the two groups.Results A total of 519 patients were recruited in this study.The median overall survival(mOS)for cohort A(324 cases)and cohort B(195 cases)were 34.3 months and 21.3 months,respectively(HR 0.65,95%CI:0.535-0.793,P<0.001).The survival rates at 1 st,2nd and 3rd years for Group A and Group B were 95.6%and 83.2%,38.6%and 24.7%,21.6%and 12.4%,respectively,with group A showing better outcomes than group B(P<0.001).Subgroup analysis revealed that regardless of gender,primary tumor site,genetic type,combination with targeted therapy,presence of liver metastasis,and absence of peritoneal metastasis,Group A's mOS was significantly better than Group B,with all differences being statistically significant(P<0.05).Conclusion ST-CM combined with chemotherapy can prolong the OS of mCRC patients,and improve the survival rates from the 1st,2nd and 3rd year.
