Perioperative Risk Factors for Post-operative Pneumonia after Type A Acute Aortic Dissection Surgery

Objective Type A acute aortic dissection(TAAAD)is a dangerous and complicated condition with a high death rate before hospital treatment.Patients who are fortunate to receive prompt surgical treatment still face high in-hospital mortality.A series of post-operative complications further affects the prognosis.Post-operative pneumonia(POP)also leads to great morbidity and mortality.This study aimed to identify the prevalence as well as the risk factors for POP in TAAAD patients and offer references for clinical decisions to further improve the prognosis of patients who survived the surgical procedure.Methods The study enrolled 89 TAAAD patients who underwent surgical treatment in Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,Hubei province,China from December 2020 to July 2021 and analyzed the perioperative data and outcomes of these patients.Logistic regression analyses were used to identify the risk factors for POP.Results In the study,31.5%of patients developed POP.Patients with POP had higher proportions of severe oxygenation damage,pneumothorax,reintubation,tracheotomy,renal replacement therapy,arrhythmia,gastrointestinal bleeding,and longer duration of mechanical ventilation,fever,ICU stay,and length of stay(all with P<0.05).The in-hospital mortality was 2.3%.Smoking,preoperative white blood cells,and intraoperative transfusion were the independent risk factors for POP in TAAAD.Conclusion Patients who underwent TAAAD surgery suffered poorer outcomes when they developed POP.Furthermore,patients with risk factors should be treated with caution.

Four-microRNA signature for detection of type 2 diabetes

BACKGROUND Sensitive,novel,and accurate biomarkers for the detection of physiological changes in type 2 diabetes(T2DM)at an early stage are urgently needed.AIM To build a multi-parameter diagnostic model for the early detection of T2DM.METHODS MiR-148b,miR-223,miR-130a,and miR-19a levels were detected by real-time polymerase chain reaction in serum of healthy controls,individuals with impaired glucose regulation,and T2DM patients.The diagnostic value of miR-148b,miR-223,miR-130a,and miR-19a,alone or in combination,was analyzed.RESULTS The area under the curve(AUC)of miR-223,which had the best diagnostic value for discriminating the impaired glucose regulation and T2DM groups,was 0.84,and the sensitivity and specificity were 73.37%and 81.37%,respectively.The AUC of the four-miRNA signature was 0.90,and the sensitivity and specificity were 78.82%and 88.23%,respectively.In the validation set,the AUC was 0.88,and the sensitivity and specificity were 78.36%and 87.63%,respectively.CONCLUSION In summary,we have built a multi-parameter diagnostic model consisting of miR-148b,miR-223,miR-130a,and miR-19a for the detection of T2DM.It may be a potential tool for the early detection of T2DM.