Dear Editor,The primary objective of the letter is to emphasize the importance of personalized management of arterial blood pressure(ABP)in the context of off-pump coronary artery bypass grafting(CABG)surgery.Coronary...Dear Editor,The primary objective of the letter is to emphasize the importance of personalized management of arterial blood pressure(ABP)in the context of off-pump coronary artery bypass grafting(CABG)surgery.Coronary artery disease,a leading global cause of mortality,necessitates a substantial number of cardiac surgeries,with approximately 400,000 CABG operations conducted annually in the United States.Postoperative heart failure(HF)is a common occurrence after CABG surgery,with readmission rates within 30 d due to HF ranging from 12% to 16%.展开更多
Background: Following coronary artery bypass grafting (CABG), delirium emerges as a prevalent complication. This study aimed to assess the correlation between elevated serum cortisol levels and the occurrence of posto...Background: Following coronary artery bypass grafting (CABG), delirium emerges as a prevalent complication. This study aimed to assess the correlation between elevated serum cortisol levels and the occurrence of postoperative delirium subsequent to off-pump CABG. Methods: Conducted in the Department of Cardiac Surgery at B中央人民政府 from October 2020 to September 2022, this comparative cross-sectional study included a total of 44 participants. Subjects, meeting specific criteria, were purposefully assigned to two groups based on off-pump CABG. Group A (n = 22) consisted of patients with normal serum cortisol levels, while Group B (n = 22) comprised individuals with high serum cortisol levels on the first postoperative day. Delirium onset was assessed at the bedside in the ICU on the 1st, 2nd, 3rd, 4th, and 5th postoperative days using standard tools, namely the Richmond Agitation Sedation score (RASS) and The Confusion Assessment Method (CAM-ICU). Data were collected based on the presence or absence of delirium. Statistical analysis utilized SPSS version 26.0, employing an independent Student’s t-test for continuous data and chi-square and Fischer’s exact test for categorical data. A p-value ≤ 0.05 was considered statistically significant. Results: Group-A had a mean age of 54.50 ± 17.97, and Group-B had a mean age of 55.22 ± 15.45, both with a male predominance (81.81% and 86.36% respectively). The mean serum cortisol level was significantly higher in Group B (829.71 ± vs. 389.98 ± 68.77). Postoperative delirium occurred in 27.3% of Group B patients, statistically significant compared to the 4.5% in Group A. However, patients in Group B who developed delirium experienced significantly longer postoperative ICU and hospital stays (79.29 ± 12.27 vs. 11.44 ± 2.85, p ≤ 0.05). There was one mortality in Group B, which was statistically not significant. Conclusion: This study observed a significant association between elevated serum cortisol levels in the postoperative period and the occurrence of postoperative delirium after off-pump coronary artery bypass grafting.展开更多
Objective: To validate the hypothesis that camel pericardium could be more protected than bovine pericardium against calcification process according to the huge difference in their respective lifestyle and lifetime. M...Objective: To validate the hypothesis that camel pericardium could be more protected than bovine pericardium against calcification process according to the huge difference in their respective lifestyle and lifetime. Methods: Glutaraldehyde (GA) fixed bovine and camel pericardium samples (BP and CP respectively) were both implanted in 30 New Zealand white rats (2 BP and 2 CP matched specimens in each animal) and explanted after 60 days. Unimplanted GA-fixed samples of both species served as control. Matched implanted samples and unimplanted samples were randomly submitted to elemental analysis by spectroscopy, phospholipid extraction, macroscopic and X-ray examination and histology. Results: At 60 days, calcium and phosphorus content were respectively 9.54% ± 3.1% and 4.79% ± 1.4% of tissue dry weight in BP, and 12.52% ± 2.7% and 6.14% ± 1.3% of tissue dry weight in CP (ns). In X-ray analysis, the calcification score was 1.28 ± 0.45 and 2.14 ± 0.98 in BP and CP samples respectively without significant difference (p < 0.08). In histology, calcifications were lower in BP than in CP: 1.37 ± 0.85 vs 2.28 ± 0.83 (ns);collagen fibers were better conserved in BP than in CP: 2.4 ± 0.48 vs 1.87 ± 0.78 (ns), and less disoriented: 25% vs 62% (ns). In unimplanted samples, there was a higher but not significant rate of extracted lipids in CP: 5.7 ± 1.8 vs 9.5 ± 3.8 nanomoles in PS fraction and 11.3 ± 3.7 vs 19 ± 7.7 nanomoles in total fatty acids, in BP and CP samples respectively. All results were in conjunction and demonstrated a higher but not significant rate of mineralization in camel pericardium after implantation, which could be related to a higher but not significant basic rate of phospholipid and fatty acids. Conclusion: This experiment study in a subcutaneous rat model has failed to valid our hypothesis. Because the differences observed between bovine and camel pericardium did not reach the significance, at the best, there is no difference between both species and at the worst, camel pericardium has a higher rate of the phosphatidylserine fraction of phospholipid, and is more sensitive and prompt to calcification.展开更多
BACKGROUND Atrial fibrillation(AF)is a common cardiac arrhythmia in the elderly.This study aimed to evaluate urban-rural disparities in its prevalence and management in elderly Chinese.METHODS Consecutive participants...BACKGROUND Atrial fibrillation(AF)is a common cardiac arrhythmia in the elderly.This study aimed to evaluate urban-rural disparities in its prevalence and management in elderly Chinese.METHODS Consecutive participants aged≥65 years attending outpatient clinics were enrolled for AF screening using handheld single-lead electrocardiogram(ECG)from April 2017 to December 2022.Each ECG rhythm strip was reviewed from the research team.AF or uninterpretable single-lead ECGs were referred for 12-lead ECG.Primary study outcome comparison was between rural and urban areas for the prevalence of AF.The Student’s t-test was used to compare mean values of clinical characteristics between rural and urban participants,while the Pearson’s chi-square test was used to compare between-group proportions.Multivariate stepwise logistic regression analysis was performed to estimate the association between AF and various patient characteristics.RESULTS The 29,166 study participants included 13,253 men(45.4%)and had a mean age of 72.2 years.The 7073 rural participants differed significantly(P≤0.02)from the 22,093 urban participants in several major characteristics,such as older age,greater body mass index,and so on.The overall prevalence of AF was 4.6%(n=1347).AF was more prevalent in 7073 rural participants than 22,093 urban participants(5.6%vs.4.3%,P<0.01),before and after adjustment for age,body mass index,blood pressure,pulse rate,cigarette smoking,alcohol consumption and prior medical history.Multivariate logistic regression analysis identified overweight/obesity(OR=1.35,95%CI:1.17–1.54)in urban areas and cigarette smoking(OR=1.62,95%CI:1.20–2.17)and alcohol consumption(OR=1.42,95%CI:1.04–1.93)in rural areas as specific risk factors for prevalent AF.In patients with known AF in urban areas(n=781)and rural areas(n=338),60.6%and 45.9%,respectively,received AF treatment(P<0.01),and only 22.4%and 17.2%,respectively,received anticoagulation therapy(P=0.05).CONCLUSIONS In China,there are urban-rural disparities in AF in the elderly,with a higher prevalence and worse management in rural areas than urban areas.Our study findings provide insight for health policymakers to consider urban-rural disparity in the prevention and treatment of AF.展开更多
Introduction Albumin,which is a 65-kDa liver-synthesized protein,accounts for nearly 50%of total plasma protein and contributes to approximately 80%of intravascular oncotic pressure.Albumin helps maintain microvascula...Introduction Albumin,which is a 65-kDa liver-synthesized protein,accounts for nearly 50%of total plasma protein and contributes to approximately 80%of intravascular oncotic pressure.Albumin helps maintain microvascular integrity,functions as an antioxidant,and transports hormones,fatty acid,bile salts,bilirubin,electrolytes(e.g.,calcium,magnesium,copper,zinc,et al.),and drugs.[1–3]Human serum albumin(HSA)is a sterile,liquid albumin product derived from large pools of human plasma by fractionation and pasteurization.The medical use of HAS could date back to approximately the time of World War II.展开更多
Standalone systems cannot handle the giant traffic loads generated by Twitter due to memory constraints.A parallel computational environment pro-vided by Apache Hadoop can distribute and process the data over differen...Standalone systems cannot handle the giant traffic loads generated by Twitter due to memory constraints.A parallel computational environment pro-vided by Apache Hadoop can distribute and process the data over different desti-nation systems.In this paper,the Hadoop cluster with four nodes integrated with RHadoop,Flume,and Hive is created to analyze the tweets gathered from the Twitter stream.Twitter stream data is collected relevant to an event/topic like IPL-2015,cricket,Royal Challengers Bangalore,Kohli,Modi,from May 24 to 30,2016 using Flume.Hive is used as a data warehouse to store the streamed tweets.Twitter analytics like maximum number of tweets by users,the average number of followers,and maximum number of friends are obtained using Hive.The network graph is constructed with the user’s unique screen name and men-tions using‘R’.A timeline graph of individual users is generated using‘R’.Also,the proposed solution analyses the emotions of cricket fans by classifying their Twitter messages into appropriate emotional categories using the optimized sup-port vector neural network(OSVNN)classification model.To attain better classi-fication accuracy,the performance of SVNN is enhanced using a chimp optimization algorithm(ChOA).Extracting the users’emotions toward an event is beneficial for prediction,but when coupled with visualizations,it becomes more powerful.Bar-chart and wordcloud are generated to visualize the emotional analysis results.展开更多
基金supported by the National Key Technologies Research and Development Program(2021YFF1200602)the National Science Fund for Excellent Overseas Scholars(0401260011)+1 种基金the National Defense Science and Technology Innovation Fund of Chinese Academy of Sciences(c02022088)Tianjin Science and Technology Program(20JCZDJC00810).
文摘Dear Editor,The primary objective of the letter is to emphasize the importance of personalized management of arterial blood pressure(ABP)in the context of off-pump coronary artery bypass grafting(CABG)surgery.Coronary artery disease,a leading global cause of mortality,necessitates a substantial number of cardiac surgeries,with approximately 400,000 CABG operations conducted annually in the United States.Postoperative heart failure(HF)is a common occurrence after CABG surgery,with readmission rates within 30 d due to HF ranging from 12% to 16%.
文摘Background: Following coronary artery bypass grafting (CABG), delirium emerges as a prevalent complication. This study aimed to assess the correlation between elevated serum cortisol levels and the occurrence of postoperative delirium subsequent to off-pump CABG. Methods: Conducted in the Department of Cardiac Surgery at B中央人民政府 from October 2020 to September 2022, this comparative cross-sectional study included a total of 44 participants. Subjects, meeting specific criteria, were purposefully assigned to two groups based on off-pump CABG. Group A (n = 22) consisted of patients with normal serum cortisol levels, while Group B (n = 22) comprised individuals with high serum cortisol levels on the first postoperative day. Delirium onset was assessed at the bedside in the ICU on the 1st, 2nd, 3rd, 4th, and 5th postoperative days using standard tools, namely the Richmond Agitation Sedation score (RASS) and The Confusion Assessment Method (CAM-ICU). Data were collected based on the presence or absence of delirium. Statistical analysis utilized SPSS version 26.0, employing an independent Student’s t-test for continuous data and chi-square and Fischer’s exact test for categorical data. A p-value ≤ 0.05 was considered statistically significant. Results: Group-A had a mean age of 54.50 ± 17.97, and Group-B had a mean age of 55.22 ± 15.45, both with a male predominance (81.81% and 86.36% respectively). The mean serum cortisol level was significantly higher in Group B (829.71 ± vs. 389.98 ± 68.77). Postoperative delirium occurred in 27.3% of Group B patients, statistically significant compared to the 4.5% in Group A. However, patients in Group B who developed delirium experienced significantly longer postoperative ICU and hospital stays (79.29 ± 12.27 vs. 11.44 ± 2.85, p ≤ 0.05). There was one mortality in Group B, which was statistically not significant. Conclusion: This study observed a significant association between elevated serum cortisol levels in the postoperative period and the occurrence of postoperative delirium after off-pump coronary artery bypass grafting.
文摘Objective: To validate the hypothesis that camel pericardium could be more protected than bovine pericardium against calcification process according to the huge difference in their respective lifestyle and lifetime. Methods: Glutaraldehyde (GA) fixed bovine and camel pericardium samples (BP and CP respectively) were both implanted in 30 New Zealand white rats (2 BP and 2 CP matched specimens in each animal) and explanted after 60 days. Unimplanted GA-fixed samples of both species served as control. Matched implanted samples and unimplanted samples were randomly submitted to elemental analysis by spectroscopy, phospholipid extraction, macroscopic and X-ray examination and histology. Results: At 60 days, calcium and phosphorus content were respectively 9.54% ± 3.1% and 4.79% ± 1.4% of tissue dry weight in BP, and 12.52% ± 2.7% and 6.14% ± 1.3% of tissue dry weight in CP (ns). In X-ray analysis, the calcification score was 1.28 ± 0.45 and 2.14 ± 0.98 in BP and CP samples respectively without significant difference (p < 0.08). In histology, calcifications were lower in BP than in CP: 1.37 ± 0.85 vs 2.28 ± 0.83 (ns);collagen fibers were better conserved in BP than in CP: 2.4 ± 0.48 vs 1.87 ± 0.78 (ns), and less disoriented: 25% vs 62% (ns). In unimplanted samples, there was a higher but not significant rate of extracted lipids in CP: 5.7 ± 1.8 vs 9.5 ± 3.8 nanomoles in PS fraction and 11.3 ± 3.7 vs 19 ± 7.7 nanomoles in total fatty acids, in BP and CP samples respectively. All results were in conjunction and demonstrated a higher but not significant rate of mineralization in camel pericardium after implantation, which could be related to a higher but not significant basic rate of phospholipid and fatty acids. Conclusion: This experiment study in a subcutaneous rat model has failed to valid our hypothesis. Because the differences observed between bovine and camel pericardium did not reach the significance, at the best, there is no difference between both species and at the worst, camel pericardium has a higher rate of the phosphatidylserine fraction of phospholipid, and is more sensitive and prompt to calcification.
基金supported by the National Natural Science Foundation of China (No.82070432&No.82070435&No.82270469&No.82370426)the Ministry of Science and Technology,Beijing,China (2018YFC1704902&2022YFC3601302)+2 种基金the Shanghai Commissions of Science and Technology and Health (a special grant for“leading academics”)(No.19DZ2340200)the Three-year Action Program of Shanghai Municipality for Strengthening the Construction of Public Health System Big Data and Artificial Intelligence Application,Shanghai,China (GWV-10.1-XK05)the Clinical Research Program,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine (2018CR010).
文摘BACKGROUND Atrial fibrillation(AF)is a common cardiac arrhythmia in the elderly.This study aimed to evaluate urban-rural disparities in its prevalence and management in elderly Chinese.METHODS Consecutive participants aged≥65 years attending outpatient clinics were enrolled for AF screening using handheld single-lead electrocardiogram(ECG)from April 2017 to December 2022.Each ECG rhythm strip was reviewed from the research team.AF or uninterpretable single-lead ECGs were referred for 12-lead ECG.Primary study outcome comparison was between rural and urban areas for the prevalence of AF.The Student’s t-test was used to compare mean values of clinical characteristics between rural and urban participants,while the Pearson’s chi-square test was used to compare between-group proportions.Multivariate stepwise logistic regression analysis was performed to estimate the association between AF and various patient characteristics.RESULTS The 29,166 study participants included 13,253 men(45.4%)and had a mean age of 72.2 years.The 7073 rural participants differed significantly(P≤0.02)from the 22,093 urban participants in several major characteristics,such as older age,greater body mass index,and so on.The overall prevalence of AF was 4.6%(n=1347).AF was more prevalent in 7073 rural participants than 22,093 urban participants(5.6%vs.4.3%,P<0.01),before and after adjustment for age,body mass index,blood pressure,pulse rate,cigarette smoking,alcohol consumption and prior medical history.Multivariate logistic regression analysis identified overweight/obesity(OR=1.35,95%CI:1.17–1.54)in urban areas and cigarette smoking(OR=1.62,95%CI:1.20–2.17)and alcohol consumption(OR=1.42,95%CI:1.04–1.93)in rural areas as specific risk factors for prevalent AF.In patients with known AF in urban areas(n=781)and rural areas(n=338),60.6%and 45.9%,respectively,received AF treatment(P<0.01),and only 22.4%and 17.2%,respectively,received anticoagulation therapy(P=0.05).CONCLUSIONS In China,there are urban-rural disparities in AF in the elderly,with a higher prevalence and worse management in rural areas than urban areas.Our study findings provide insight for health policymakers to consider urban-rural disparity in the prevention and treatment of AF.
文摘Introduction Albumin,which is a 65-kDa liver-synthesized protein,accounts for nearly 50%of total plasma protein and contributes to approximately 80%of intravascular oncotic pressure.Albumin helps maintain microvascular integrity,functions as an antioxidant,and transports hormones,fatty acid,bile salts,bilirubin,electrolytes(e.g.,calcium,magnesium,copper,zinc,et al.),and drugs.[1–3]Human serum albumin(HSA)is a sterile,liquid albumin product derived from large pools of human plasma by fractionation and pasteurization.The medical use of HAS could date back to approximately the time of World War II.
文摘Standalone systems cannot handle the giant traffic loads generated by Twitter due to memory constraints.A parallel computational environment pro-vided by Apache Hadoop can distribute and process the data over different desti-nation systems.In this paper,the Hadoop cluster with four nodes integrated with RHadoop,Flume,and Hive is created to analyze the tweets gathered from the Twitter stream.Twitter stream data is collected relevant to an event/topic like IPL-2015,cricket,Royal Challengers Bangalore,Kohli,Modi,from May 24 to 30,2016 using Flume.Hive is used as a data warehouse to store the streamed tweets.Twitter analytics like maximum number of tweets by users,the average number of followers,and maximum number of friends are obtained using Hive.The network graph is constructed with the user’s unique screen name and men-tions using‘R’.A timeline graph of individual users is generated using‘R’.Also,the proposed solution analyses the emotions of cricket fans by classifying their Twitter messages into appropriate emotional categories using the optimized sup-port vector neural network(OSVNN)classification model.To attain better classi-fication accuracy,the performance of SVNN is enhanced using a chimp optimization algorithm(ChOA).Extracting the users’emotions toward an event is beneficial for prediction,but when coupled with visualizations,it becomes more powerful.Bar-chart and wordcloud are generated to visualize the emotional analysis results.
