Preparation and Mechanical Properties of Solid-phase Grafting Nanocomposites of PVC/Graft Copolymers/MMT

In order to improve the mechanical properties of PVC, by solid-phase grafting reaction, grafting on and nano-modifying the PVC process synchronously, acrylic monomers not only graft on PVC, but also are intercalated into the layers of MMT in the heating process. Blending PVC and the MMT-PVC grafting copolymers , we can get nanocomposites of PVC/ grafters/ MMT, and the mechanical performance of the material is improved.

Grafting Maleic Anhydride onto Carbon Fiber via a Solid-phase Grafting Method

By combining the strong and light carbon fibers （CFs） with polymers, composite materials with extraordinary mechanical properties are achieved. However, the mechanical properties of the as-prepared CF-reinforced polymer composites can not satisfy the applications in certain fields, especially for the poor interactions between CFs and the polymers. To enhance the mechanical properties of composite materials, a solid phase grafting method has been developed to improve the adhesion forces between CFs and the polymer, by modifying the surfaces of CFs. The effects of the reaction temperature, reaction time, as well as the dosage of the initiator and maleic anhydride （MAH） on the grafting efficiency have been investigated systematically. The structure and the surface chemistry of functionalized CFs have been characterized by Fourier Transform Infrared （FT-IR）, Scanning Electron Microscope （SEM）, X-ray Photoelectron Spectroscopy （XPS）, Thermogravimetric （TG）, and contact angle test. All of these results demonstrate that MAH is grafted onto the surface of CFs successfully by the solid phase grafting method. The MAH grafted CFs significantly improve its wettability, which further improves the interfacial adhesion between CFs and the polymeric matrix. The optimal reaction conditions are determined, such as the MAH/CF molar ratio, the dosage of initiator, the reaction temperature and the reaction time to be 3/1, 2%, 90℃ and 4 h, respectively. These attractive interracial characteristics of modified CFs suggest that the method proposed herein is a novel and efficient approach to develop CF-reinforced polymer composites with outstanding mechanical properties for cutting-edge industrial applications.

“Grafting from”法制备高载量大孔弱阳离子交换层析介质

针对大孔聚合物层析介质孔径大、比表面积低而导致的蛋白结合容量低的问题,采用“graftingfrom”策略,以大孔聚丙烯酸酯微球为基质,通过氧化还原引发甲基丙烯酸在微球表面接枝聚合,制备了高载量弱阳离子交换层析介质.研究了单体浓度、过硫酸钾浓度及反应温度等因素对蛋白结合容量的影响.所得介质的蛋白静态结合容量和动态结合容量分别达到252.21和157.25mg/mL;同时发现具有一定离子交换容量的该类介质能够在0.2 mol/L NaCl缓冲液中保持100 mg/mL的蛋白结合容量.将该层析介质用于鸡卵清中溶菌酶的纯化,获得了较高的纯化效率.

Implications of Elevated Serum Cortisol in the Onset of Postoperative Delirium Following Off-Pump Coronary Artery Bypass Grafting: Insights from a Bangladesh-Based Single Center Experience

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 BSMMU 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.

Surgical Treatment of Osteonecrosis of the Femoral Head Using Minimally Invasive Surgical Drilling and Cancellous Grafting at Brazzaville University Hospital

Introduction: Osteonecrosis of the femoral head (ONTF) is a debilitating condition. Several treatments have been proposed with controversial results. The aim of our study was to evaluate treatment by surgical drilling coupled with in situ cancellous grafting. Materials and methods: Our study was a case-control study conducted at Brazzaville University Hospital from 1st January 2018 to 31 December 2023. It compared two groups of patients with ONTF: non-operated (13 patients, 20 hips) and operated (22 patients, 35 hips). We used the visual digital scale (VDS) for pain assessment, the Merle D’Aubigne-Postel (MDP) scoring system for clinical and functional assessment, and the evolution of necrosis. Results: The group of non-operated patients had a mean age of 35.69 ± 3.4 years, no improvement in pain with an EVN above seven at the last recoil and a mean global MDP score falling from 12.7 before offloading to 10.13 at one year. The group of patients operated on had a mean age of 37.86 ± 7.02 years, a significant reduction in pain (p = 0.00004) and a significantly increased MDP score (p = 0.0034). A comparison of the two groups of patients showed significant stabilization of the necrotic lesions in the operated patients (p = 0.00067), with better satisfaction in the same group. Conclusion: Surgical drilling combined with grafting in the treatment of early-stage ONTF has improved progress in our series. The technique is reproducible and less invasive. It has made it possible to delay unfavorable progression and, consequently, hip replacement surgery.

Efficient and selective removal of Pb(Ⅱ) from landfill leachate using L-serine-modified polyethylene/polypropylene nonwoven fabric synthesized via radiation grafting technique

In this study,to efficiently remove Pb(Ⅱ) from aqueous environments,a novel L-serine-modified polyethylene/polypropylene nonwoven fabric sorbent(NWF-serine)was fabricated through the radiation grafting of glycidyl methacrylate and subsequent L-serine modification.The effect of the absorbed dose was investigated in the range of 5–50 kGy.NWF-serine was characterized by Fourier transform infrared spectroscopy,thermogravimetric analysis,and scanning electron microscopy.Batch adsorption tests were conducted to investigate the influences of pH,adsorption time,temperature,initial concentration,and sorbent dosage on the Pb(Ⅱ) adsorption performance of NWF-serine.The results indicated that Pb(Ⅱ) adsorption onto NWF-serine was an endothermic process,following the pseudo-second-order kinetic model and Langmuir isotherm model.The saturated adsorption capacity was 198.1 mg/g.NWF-serine exhibited Pb(Ⅱ) removal rates of 99.8% for aqueous solutions with initial concentrations of 100 mg/L and 82.1% for landfill leachate containing competitive metal ions such as Cd,Cu,Ni,Mn,and Zn.Furthermore,NWF-serine maintained 86% of its Pb(Ⅱ) uptake after five use cycles.The coordination of the carboxyl and amino groups with Pb(Ⅱ) was confirmed using X-ray photoelectron spectroscopy and extended X-ray absorption fine structure analysis.

Impact of specialized nursing outpatient case management on postcoronary artery bypass grafting patients

BACKGROUND Some patients with coronary atherosclerotic heart disease experience major adverse cardiac events(MACE)and require readmission after Coronary Artery Bypass Grafting(CABG)surgery.This is often attributed to patients'unhealthy lifestyles and dietary habits,inadequate understanding of the disease,and poor disease management compliance.Thus,searching for more targeted nursing intervention models that can enhance patients'self-management abilities and reduce the risk of readmission after CABG surgery is significant.AIM To observe the impact of specialized nursing outpatient case management on patients after CABG surgery.METHODS A total of 103 patients who underwent CABG surgery in our hospital between April 2021 and April 2022 comprised the study sample.The patients were divided into two groups using an odd-even number grouping method.The control group received routine nursing care,while the case management group received specialized nursing outpatient case management.The differences in psychological status,adherence to medical treatment,self-care ability,knowledge mastery,quality of life scores,and the occurrence rate of MACE were compared between the two groups.RESULTS After the intervention,the case management group had lower scores on the selfrating depression scale and self-rating anxiety scale and lower MACE rate,as well as higher scores for adherence to a healthy diet,medication adherence,good lifestyle habits,regular exercise,and timely follow-up,higher scores on the Coronary Heart Disease Self-Management Scale,higher scores for managing adverse habits,symptoms,emotional cognition,emergency response,disease knowledge,general lifestyle,and treatment adherence,higher scores for understanding coronary heart disease,recognizing the importance of medication adherence,understanding selfcare points after CABG surgery,and being aware of post-CABG precautions,higher scores for physical well-being,disease condition,general health,social-psychological well-being,and work-related aspects(P<0.05).CONCLUSION Specialized nursing outpatient case management can enhance patient adherence to medical treatment,knowledge mastery,psychological well-being,and overall quality of life in patients after CABG surgery.

Delayed Grafting as a Valid Technique in Burn Management: Experience from a Burn Unit in Oman

Background: Early excision and grafting has been the preferred method of managing major burns around the world since 1970. Considering the advances in health care and the development of new antibiotics over the past 50 years, delayed grafting as a technique for the management of burns over 15%-20% of total body surface area (TBSA) could have comparable results to that of early excision. This study aims to highlight the outcomes of practicing delayed grafting in burn patients. Methods: A case series analysis was performed of 51 patients who were admitted to the burns unit in Sultan Qaboos Hospital Salalah with over 20% TBSA between January 2014 and December 2019. The patients received prophylactic antibiotics and silver sulphadiazine dressing until the burn eschar had completely separated, followed by grafting. Results: Two patients were lost during the entire duration of the study. The mortality rate was comparable to that of early excision, while the rate of hypertrophic scarring was lower than the range reported by other studies. Conclusion: In the management of patients with over 20% TBSA, delayed grafting after complete separation of eschar is still a valid technique.

Solid-phase microextraction of endogenous metabolites from intact tissue validated using a Biocrates standard reference method kit

Improved analytical methods for the metabolomic profiling of tissue samples are constantly needed.Currently,conventional sample preparation methods often involve tissue biopsy and/or homogenization,which disrupts the endogenous metabolome.In this study,solid-phase microextraction(SPME)fibers were used to monitor changes in endogenous compounds in homogenized and intact ovine lung tissue.Following SPME,a Biocrates AbsoluteIDQ assay was applied to make a downstream targeted metabolomics analysis and confirm the advantages of in vivo SPME metabolomics.The AbsoluteIDQ kit enabled the targeted analysis of over 100 metabolites via solid-liquid extraction and SPME.Statistical analysis revealed significant differences between conventional liquid extractions from homogenized tissue and SPME results for both homogenized and intact tissue samples.In addition,principal component analysis revealed separated clustering among all the three sample groups,indicating changes in the metabolome due to tissue homogenization and the chosen sample preparation method.Furthermore,clear differences in free metabolites were observed when extractions were performed on the intact and homogenized tissue using identical SPME procedures.Specifically,a direct comparison showed that 47 statistically distinct metabolites were detected between the homogenized and intact lung tissue samples(P<0.05)using mixed-mode SPME fibers.These changes were probably due to the disruptive homogenization of the tissue.This study's findings highlight both the importance of sample preparation in tissue-based metabolomics studies and SPME's unique ability to perform minimally invasive extractions without tissue biopsy or homogenization while providing broad metabolite coverage.

Scalable solid-phase synthesis of defect-rich graphene for oxygen reduction electrocatalysis

Defect-engineered carbon materials have been emerged as promising electrocatalysts for oxygen reduction reaction(ORR)in metal-air batteries.Developing a facile strategy for the preparation of highly active nanocarbon electrocatalysts remains challenging.Herein,a low-cost and simple route is developed to synthesize defective graphene by pyrolyzing the mixture of glucose and carbon nitride.Molecular dynamics simulations reveal that the graphene formation is ascribed to two-dimensional layered feature of carbon nitride,and high compatibility of carbon nitride/glucose systems.Structural measurements suggest that the graphene possesses rich edge and topological defects.The graphene catalyst exhibits higher power density than commercial Pt/C catalyst in a primary Zn-air battery.Combining experimental results and theoretical thermodynamic analysis,it is identified that graphitic nitrogen-modified topological defects at carbon framework edges are responsible for the decent ORR performance.The strategy presented in this work can be can be scaled up readily to fabricate defective carbon materials.

Carbon Doping Triggered Efficient Electrochemical Hydrogen Evolution of Cross-Linked Porous Ru-MoO_(2) Via Solid-Phase Reaction Strategy

The defect-free structure of Mo-based materials is a“double-edged sword”,which endows the material with excellent stability,but limits its chemical versatility and application in electrochemical hydrogen evolution reaction(HER).Carbon doping engineering is an attractive strategy to effectively improve the performance of Mo-based catalyst and maintain their stability.Herein,we report a cross-linked porous carbon-doped MoO_(2)(C–MoO_(2))-based catalyst Ru/C–MoO_(2) for electrochemical HER,which is prepared by the convenient redox solid-phase reaction(SPR)of porous RuO_(2)/Mo_(2)C composite precursor.Theoretical studies reveal that due to the presence of carbon atoms,the electronic structure of C–MoO_(2) has been properly adjusted,and the loaded small Ru nanoparticles provide a fast water dissociation rate and moderate H adsorption strength.In electrochemical studies under a pH-universal environment,Ru/C–MoO_(2) electrocatalyst exhibits a low overpotential at a current density of 10 mA cm^(-2) and has a low Tafel slope.Meanwhile,Ru/C-MoO_(2) has excellent stability for more than 100 h at an initial current density of 100 mA cm^(-2).

Grafting effects on bioactive compounds,chemical and agronomic traits of‘Corbarino’tomato grown under greenhouse healthy conditions

In tomatoes,grafting onto resistant rootstocks represents an effective strategy to control several soil-borne diseases that reduce crop profitability,especially for landraceswith little or no resistance tomultiple pathogens/pests.In this study,the high-value‘Corbarino’tomato landrace was grafted onto seven commercial Solanum interspecific rootstocks to evaluate graft compatibility,yield performance,and qualitative characteristics under greenhouse healthy conditions.Three rootstocks were themost effective in improving fruit yield without negatively affecting the carpometric,technological,and health-related traits of the traditional tomato.‘Dinafort’rootstock increased fresh and dry yield,harvest index,and fruit/clusters,while mean fruit weight,shape index,total and soluble solid content,simple sugars,organic acids,flavonoids,ascorbic acid,and trans-lycopene content did not differ with respect to the ungrafted‘Corbarino’.‘Interpro’rootstock also showed promising results for the overall yield and quality traits,although it reduced the trans-lycopene content in the fruit.‘Silex’rootstock showed the highest harvest index as result of decreased vigour.The fruit quality induced by‘Silex’was satisfactory and high levels of simple sugars,flavonoids,ascorbic acid,and trans-lycopene were also observed.However,graft success,especially for‘Dinafort’and‘Silex’,needs to be improved by investigating more suitable methods for seedling production,grafting,acclimatization,etc.

Nicotiana benthamiana XYLEM CYSTEINE PROTEASE genes facilitate tracheary element formation in interfamily grafting

Grafting is a plant propagation technique widely used in agriculture.A recent discovery of the capability of interfamily grafting in Nicotiana has expanded the potential combinations of grafting.In this study,we showed that xylem connection is essential for the achievement of interfamily grafting and investigated the molecular basis of xylem formation at the graft junction.Transcriptome and gene network analyses revealed gene modules for tracheary element(TE)formation during grafting that include genes associated with xylem cell differentiation and immune response.The reliability of the drawn network was validated by examining the role of the Nicotiana benthamiana XYLEM CYSTEINE PROTEASE(NbXCP)genes in TE formation during interfamily grafting.Promoter activities of NbXCP1 and NbXCP2 genes were found in differentiating TE cells in the stem and callus tissues at the graft junction.Analysis of a Nbxcp1;Nbxcp2 loss-of-function mutant indicated that NbXCPs control the timing of de novo TE formation at the graft junction.Moreover,grafts of the NbXCP1 overexpressor increased the scion growth rate as well as the fruit size.Thus,we identified gene modules for TE formation at the graft boundary and demonstrated potential ways to enhance Nicotiana interfamily grafting.

The role of DNA methylation in the maintenance of phenotypic variation induced by grafting chimerism in Brassica

Grafting facilitates the interaction between heterologous cells with different genomes,resulting in abundant phenotypic variation,which provides opportunities for crop improvement.However,how grafting-induced variation occurs and is transmitted to progeny remains elusive.A graft chimera,especially a periclinal chimera,which has genetically distinct cell layers throughout the plant,is an excellent model to probe the molecular mechanisms of grafting-induced variation maintenance.Here we regenerated a plant from the T-cell layer of a periclinal chimera,TCC(where the apical meristem was artificially divided into three cell layers–from outside to inside,L1,L2,and L3;T=Tuber mustard,C=red Cabbage),named rTTT0(r=regenerated).Compared with the control(rsTTT,s=self-grafted),rTTT0 had multiple phenotypic variations,especially leaf shape variation,which could be maintained in sexual progeny.Transcriptomes were analyzed and 58 phenotypic variation-associated genes were identified.Whole-genome bisulfite sequencing analyses revealed that the methylome of rTTT0 was changed,and the CG methylation level was significantly increased by 8.74%.In rTTT0,the coding gene bodies are hypermethylated in the CG context,while their promoter regions are hypomethylated in the non-CG context.DNA methylation changes in the leaf shape variation-associated coding genes,ARF10,IAA20,ROF1,and TPR2,were maintained for five generations of rTTT0.Interestingly,grafting chimerism also affected transcription of the microRNA gene(MIR),among which the DNA methylation levels of the promoters of three MIRs associated with leaf shape variation were changed in rTTT0,and the DNA methylation modification of MIR319 was maintained to the fifth generation of selfed progeny of rTTT0(rTTT5).These findings demonstrate that DNA methylation of coding and non-coding genes plays an important role in heterologous cell interaction-induced variation formation and its transgenerational inheritance.

Coupling Agent Grafting Assisted Synthesis of C3N4-ZrO_(2) Heterojunction Composites with Enhanced Photocatalytic Performance

Heterojunction composites were prepared by silane coupling agent grafting from synthesized graphitic carbon nitride(g-C_(3)N_(4))and commercially available zirconia(ZrO_(2)).The samples were characterized by X-ray diffraction(XRD),scanning electron microscopy(SEM),Fourier transform infrared(FT-IR)spectroscopy,UV-vis diffuse reflectance spectroscopy(DRS),photoluminescence(PL)spectroscopy,and electrochemical impedance spectroscopy(EIS).The photocatalytic activity of the composites was evaluated by the degradation of methylene blue(MB)under visible light irradiation.The results showed that heterojunction composites of g-C_(3)N_(4) and ZrO_(2) could be successfully prepared by coupling agent grafting.The optimal mass ratio of g-C_(3)N_(4) and ZrO_(2) was 2:1,with an activity that was 3.8 times higher than g-C_(3)N_(4) and 15.3 times higher than ZrO_(2).This was ascribed to the stronger light absorption,faster interfacial charge transfer,and lower photogenerated carrier recombination of the heterojunction composites.

Comparison of different approaches for direct coupling of solid-phase microextraction to mass spectrometry for drugs of abuse analysis in plasma

The direct coupling of solid-phase microextraction(SPME)to mass spectrometry(MS)(SPME-MS)has proven to be an effective method for the fast screening and quantitative analysis of compounds in complex matrices such as blood and plasma.In recent years,our lab has developed three novel SPME-MS techniques:SPME-microfluidic open interface-MS(SPME-MOI-MS),coated blade spray-MS(CBS-MS),and SPME-probe electrospray ionization-MS(SPME-PESI-MS).The fast and high-throughput nature of these SPME-MS technologies makes them attractive options for point-of-care analysis and anti-doping testing.However,all these three techniques utilize different SPME geometries and were tested with different MS instruments.Lack of comparative data makes it difficult to determine which of these methodologies is the best option for any given application.This work fills this gap by making a comprehensive comparison of these three technologies with different SPME devices including SPME fibers,CBS blades,and SPME-PESI probes and SPME-liquid chromatography-MS(SPME-LC-MS)for the analysis of drugs of abuse using the same MS instrument.Furthermore,for the first time,we developed different desorption chambers for MOI-MS for coupling with SPME fibers,CBS blades,and SPME-PESI probes,thus illustrating the universality of this approach.In total,eight analytical methods were developed,with the experimental data showing that all the SPME-based methods provided good analytical performance with R^(2)of linearities larger than 0.9925,accuracies between 81%and 118%,and good precision with an RSD%≤13%.

Functional recovery and muscle atrophy in pre-clinical models of peripheral nerve transection and gap-grafting in mice:effects of 4-aminopyridine

We recently demonstrated a repurposing beneficial effect of 4-aminopyridine(4-AP),a potassium channel blocker,on functional recove ry and muscle atrophy after sciatic nerve crush injury in rodents.However,this effect of 4-AP is unknown in nerve transection,gap,and grafting models.To evaluate and compare the functional recovery,nerve morphology,and muscle atrophy,we used a novel stepwise nerve transection with gluing(STG),as well as 7-mm irreparable nerve gap(G-7/0)and 7-mm isografting in 5-mm gap(G-5/7)models in the absence and presence of 4-AP treatment.Following surgery,sciatic functional index was determined wee kly to evaluate the direct in vivo global motor functional recovery.After 12 weeks,nerves were processed for whole-mount immunofluorescence imaging,and tibialis anterior muscles were harvested for wet weight and quantitative histomorphological analyses for muscle fiber crosssectional area and minimal Feret's diameter.Average post-injury sciatic functional index values in STG and G-5/7 models were significantly greater than those in the G-7/0 model.4-AP did not affect the sciatic functional index recovery in any model.Compared to STG,nerve imaging revealed more misdirected axons and distorted nerve architecture with isografting.While muscle weight,cross-sectional area,and minimal Feret's diameter were significantly smaller in G-7/0 model compared with STG and G-5/7,4-AP treatment significantly increased right TA muscle mass,cross-sectional area,and minimal Feret's diameter in G-7/0 model.These findings demonstrate that functional recovery and muscle atrophy after peripheral nerve injury are directly related to the intervening nerve gap,and 4-AP exerts diffe rential effects on functional recove ry and muscle atrophy.

Long-Term Outcomes after Coronary Artery Bypass Grafting with Risk Stratification

Background: Risk stratification of long-term outcomes for patients undergoing Coronary artery bypass grafting has enormous potential clinical importance. Aim: To develop risk stratification models for predicting long-term outcomes following coronary artery bypass graft (CABG) surgery. Methods: We retrospectively revised the electronic medical records of 2330 patients who underwent adult Cardiac surgery between August 2016 and December 2022 at Madinah Cardiac Center, Saudi Arabia. Three hundred patients fulfilled the eligibility criteria of CABG operations with a complete follow-up period of at least 24 months, and data reporting. The collected data included patient demographics, comorbidities, laboratory data, pharmacotherapy, echocardiographic parameters, procedural details, postoperative data, in-hospital outcomes, and follow-up data. Our follow-up was depending on the clinical status (NYHA class), chest pain recurrence, medication dependence and echo follow-up. A univariate analysis was performed between each patient risk factor and the long-term outcome to determine the preoperative, operative, and postoperative factors significantly associated with each long-term outcome. Then a multivariable logistic regression analysis was performed with a stepwise, forward selection procedure. Significant (p < 0.05) risk factors were identified and were used as candidate variables in the development of a multivariable risk prediction model. Results: The incidence of all-cause mortality during hospital admission or follow-up period was 2.3%. Other long-term outcomes included all-cause recurrent hospitalization (9.8%), recurrent chest pain (2.4%), and the need for revascularization by using a stent in 5 (3.0%) patients. Thirteen (4.4%) patients suffered heart failure and they were on the maximum anti-failure medications. The model for predicting all-cause mortality included the preoperative EF ≤ 35% (AOR: 30.757, p = 0.061), the bypass time (AOR: 1.029, p = 0.003), and the duration of ventilation following the operation (AOR: 1.237, p = 0.021). The model for risk stratification of recurrent hospitalization comprised the preoperative EF ≤ 35% (AOR: 6.198, p p = 0.023), low postoperative cardiac output (AOR: 3.622, p = 0.007), and the development of postoperative atrial fibrillation (AOR: 2.787, p = 0.038). Low postoperative cardiac output was the only predictor that significantly contributed to recurrent chest pain (AOR: 11.66, p = 0.004). Finally, the model consisted of low postoperative cardiac output (AOR: 5.976, p < 0.001) and postoperative ventricular fibrillation (AOR: 4.216, p = 0.019) was significantly associated with an increased likelihood of the future need for revascularization using a stent. Conclusions: A risk prediction model was developed in a Saudi cohort for predicting all-cause mortality risk during both hospital admission and the follow-up period of at least 24 months after isolated CABG surgery. A set of models were also developed for predicting long-term risks of all-cause recurrent hospitalization, recurrent chest pain, heart failure, and the need for revascularization by using stents.

Application of negative pressure wound therapy after skin grafting in the treatment of skin cancer:A case report

BACKGROUND Skin cancer is a common malignant tumor in dermatology.A large area must be excised to ensure a negative incisal margin on huge frontotemporal skin cancer,and it is difficult to treat the wound.In the past,treatment with skin grafting and pressure dressing was easy to cause complications such as wound infections,subcutaneous effusion,skin necrosis,and contracture.Negative pressure wound therapy(NPWT)has been applied to treat huge frontotemporal skin cancer.CASE SUMMARY Herein,we report the case of a 92-year-old woman with huge frontotemporal skin cancer.The patient presented to the surgery department complaining of ruptured bleeding and pain in a right frontal mass.The tumor was pathologically diagnosed as highly differentiated squamous cell carcinoma.The patient underwent skin cancer surgery and skin grafting,after which NPWT was used.She did not experience a relapse during the three-year follow-up period.CONCLUSION NPWT is of great clinical value in the postoperative treatment of skin cancer.It is not only inexpensive but also can effectively reduce the risk of surgical effusion,infection,and flap necrosis.

Artificial dermis combined with skin grafting for the treatment of hand skin and soft tissue defects and exposure of bone and tendon

BACKGROUND The recovery time of hand wounds is long,which can easily result in chronic and refractory wounds,making the wounds unable to be properly repaired.The treatment cycle is long,the cost is high,and it is prone to recurrence and disability.Double layer artificial dermis combined with autologous skin transplantation has been used to repair hypertrophic scars,deep burn wounds,exposed bone and tendon wounds,and post tumor wounds.AIM To investigate the therapeutic efficacy of autologous skin graft transplantation in conjunction with double-layer artificial dermis in treating finger skin wounds that are chronically refractory and soft tissue defects that expose bone and tendon.METHODS Sixty-eight chronic refractory patients with finger skin and soft tissue defects accompanied by bone and tendon exposure who were admitted from July 2021 to June 2022 were included in this study.The observation group was treated with double layer artificial dermis combined with autologous skin graft transplantation(n=49),while the control group was treated with pedicle skin flap transplantation(n=17).The treatment status of the two groups of patients was compared,including the time between surgeries and hospital stay.The survival rate of skin grafts/flaps and postoperative wound infections were evaluated using the Vancouver Scar Scale(VSS)for scar scoring at 6 mo after surgery,as well as the sensory injury grading method and two-point resolution test to assess the recovery of skin sensation at 6 mo.The satisfaction of the two groups of patients was also compared.RESULTS Wound healing time in the observation group was significantly longer than that in the control group(P<0.05,27.92±3.25 d vs 19.68±6.91 d);there was no significant difference in the survival rate of skin grafts/flaps between the two patient groups(P>0.05,95.1±5.0 vs 96.3±5.6).The interval between two surgeries(20.0±4.3 d)and hospital stay(21.0±10.1 d)in the observation group were both significantly shorter than those in the control group(27.5±9.3 d)and(28.4±17.7 d),respectively(P<0.05).In comparison to postoperative infection(23.5%)and subcutaneous hematoma(11.8%)in the control group,these were considerably lower at(10.2%)and(6.1%)in the observation group.When comparing the two patient groups at six months post-surgery,the excellent and good rate of sensory recovery(91.8%)was significantly higher in the observation group than in the control group(76.5%)(P<0.05).There was also no statistically significant difference in two point resolution(P>0.05).The VSS score in the observation group(2.91±1.36)was significantly lower than that in the control group(5.96±1.51),and group satisfaction was significantly higher(P<0.05,90.1±6.3 vs 76.3±5.2).CONCLUSION The combination of artificial dermis and autologous skin grafting for the treatment of hand tendon exposure wounds has a satisfactory therapeutic effect.It is a safe,effective,and easy to operate treatment method,which is worthy of clinical promotion.