Objective To analyze the short-term outcomes of redo coronary artery bypass grafting(CABG) using on-pump and off-pump CABG techniques. Methods From January 2003 to August 2013, non-randomized 80 patients were treated ...Objective To analyze the short-term outcomes of redo coronary artery bypass grafting(CABG) using on-pump and off-pump CABG techniques. Methods From January 2003 to August 2013, non-randomized 80 patients were treated with redo CABG in the Department of Cardiac Surgery, Peking University Third Hospital. Among these patients, 40 underwent on-pump CABG technique(redo-ONCAB group) and 40 underwent off-pump CABG technique(redo-OPCAB group). Furthermore, transmyocardial laser revascularization was performed in high-risk patients who were not suitable to conventional grafting. Clinical data of the two groups were recorded and analyzed including operation time, coronary grafts, incomplete revascularization, postoperative ventilation, perioperative stroke, and low output syndrome, etc. Results There were no significantly differences in age, gender distribution, incidences of hypertension, stroke, and other clinical characteristics between redo-OPCAB group and redo-ONCAB group(all P>0.05), except for incidences of renal dysfunction and pulmonary disease(all P<0.05). The number of grafting vessels in the redo-ONCAB and redo-OPCAB groups was 2.1 ± 0.74 and 1.4 ±0.52 respectively. There was significant difference between the two groups(P=0.0243). Compared with the redo-ONCAB group, there was shorter operation time(P=0.0045), postoperative ventilation(P=0.0211) and intensive care unit stay(P=0.0400), as well as fewer use of platelet(P=0.0338) and blood transfusion(P=0.0034) in the redo-OPCAB group. The incidence of incomplete revascularization(P=0.0253) and the use of transmyocardial laser revascularization(P=0.0052) were higher in the redo-OPCAB group than those in the redo-ONCAB group(all P<0.05). However, no significant differences were showed for the incidence of the use of intra aortic balloon pump and continuous renal replacement therapy, perioperative stroke, low output syndrome, and in-hospital mortality between the two groups(all P>0.05). Conclusion Redo CABG is the safety and efficacy surgical procedure, and redo-OPCAB technique with better outcomes is commended especially in high-risk patients.展开更多
Pollen analysis was carried out on the Core MD982194 of 29.78 m retrieved from the Middle Okinawa Trough which was dated as old as -200 ka BP. The results revealed that pollen assemblages mainly presented an alternati...Pollen analysis was carried out on the Core MD982194 of 29.78 m retrieved from the Middle Okinawa Trough which was dated as old as -200 ka BP. The results revealed that pollen assemblages mainly presented an alternation of coniferous and herb pollen. The coniferous saccate pollen, principally Pinus and Tsuga, predominated in most parts of the core, especially highlighted in the interstadial stages including MIS 1,3, 5 and MIS7, whereas the herb pollen significantly increased in the gla- cial periods. Thus the pollen flora and their percentages showed the sensitive changes under the influence of ice volume during the glacial and interglacial periods. Our record from this core has first documented that the percentage of Cyperaceae was ex- tremely high in the glacial stages with a notable increase in Artemisia, Gramineae, Asteraceae, Cbenopodiaceae, and freshwa- ter algae, which can be used as a proxy for sea-level change at the study site because of their close negative correlation of the orbital-scale changes in sea level. The distance between the continental coastline and the Okinawa Trough has deeply short- ened due to the sea-level drop in the LGM. As a result, the sediment materials from Yangtze River were extensively deposited on the flat, exposed continental shelf owing to the rapid decline of river flow speed, leading to that pollen grains from Okinawa Trough are derived mainly from the flat coastal vegetation of exposed continental shelf at glacial stages. Changes of pollen as- semblage were consistent with the variation of temperature and humidity, which showed that the percentage of arboreal pollen was highly augmented at MIS 7, 5 and MIS 1, corresponding to the strengthening of the East Asian summer monsoon and in- creasing of rainfall. Moreover, the peak of Pinus percentage in MIS 5.3, 5.1 and MIS 3.3 may be closely linked by orbital and sub-orbital cycles of solar radiation and monsoonal variability. The present study of core MD981294 implied lower tempera- ture and precipitation during the lowest sea-level stage （LGM）, and more visibly testified that the vegetation of the flat plain on the exposed continental shelf was dominated by intrazonal communities such as halophyte grasslands and freshwater wetlands instead of zonal steppe or semi-arid desert. All above evidence demonstrated that the fundamental changes of pollen assem- blage and their origins in Okinawa Trough since -200 ka BP were affected by combine factors including the coastline position and climate fluctuation. Moreover, the substantial shortening of distance between shoreline and the Okinawa Trough driven by orbital insolation cycles was clearly indicated by the pollen spectra, whereas the source-area climate signal of the pollen record was largely weakened.展开更多
文摘Objective To analyze the short-term outcomes of redo coronary artery bypass grafting(CABG) using on-pump and off-pump CABG techniques. Methods From January 2003 to August 2013, non-randomized 80 patients were treated with redo CABG in the Department of Cardiac Surgery, Peking University Third Hospital. Among these patients, 40 underwent on-pump CABG technique(redo-ONCAB group) and 40 underwent off-pump CABG technique(redo-OPCAB group). Furthermore, transmyocardial laser revascularization was performed in high-risk patients who were not suitable to conventional grafting. Clinical data of the two groups were recorded and analyzed including operation time, coronary grafts, incomplete revascularization, postoperative ventilation, perioperative stroke, and low output syndrome, etc. Results There were no significantly differences in age, gender distribution, incidences of hypertension, stroke, and other clinical characteristics between redo-OPCAB group and redo-ONCAB group(all P>0.05), except for incidences of renal dysfunction and pulmonary disease(all P<0.05). The number of grafting vessels in the redo-ONCAB and redo-OPCAB groups was 2.1 ± 0.74 and 1.4 ±0.52 respectively. There was significant difference between the two groups(P=0.0243). Compared with the redo-ONCAB group, there was shorter operation time(P=0.0045), postoperative ventilation(P=0.0211) and intensive care unit stay(P=0.0400), as well as fewer use of platelet(P=0.0338) and blood transfusion(P=0.0034) in the redo-OPCAB group. The incidence of incomplete revascularization(P=0.0253) and the use of transmyocardial laser revascularization(P=0.0052) were higher in the redo-OPCAB group than those in the redo-ONCAB group(all P<0.05). However, no significant differences were showed for the incidence of the use of intra aortic balloon pump and continuous renal replacement therapy, perioperative stroke, low output syndrome, and in-hospital mortality between the two groups(all P>0.05). Conclusion Redo CABG is the safety and efficacy surgical procedure, and redo-OPCAB technique with better outcomes is commended especially in high-risk patients.
基金supported by the National Natural Science Foundation of China(Grant Nos.41072128 and 40772113)the Fundamental Research Funds for the Central Universities(Grant Nos.11LGJC13 and 10LGZD08)Young Scientist’s Fund of the State Oceanic Administration of China
文摘Pollen analysis was carried out on the Core MD982194 of 29.78 m retrieved from the Middle Okinawa Trough which was dated as old as -200 ka BP. The results revealed that pollen assemblages mainly presented an alternation of coniferous and herb pollen. The coniferous saccate pollen, principally Pinus and Tsuga, predominated in most parts of the core, especially highlighted in the interstadial stages including MIS 1,3, 5 and MIS7, whereas the herb pollen significantly increased in the gla- cial periods. Thus the pollen flora and their percentages showed the sensitive changes under the influence of ice volume during the glacial and interglacial periods. Our record from this core has first documented that the percentage of Cyperaceae was ex- tremely high in the glacial stages with a notable increase in Artemisia, Gramineae, Asteraceae, Cbenopodiaceae, and freshwa- ter algae, which can be used as a proxy for sea-level change at the study site because of their close negative correlation of the orbital-scale changes in sea level. The distance between the continental coastline and the Okinawa Trough has deeply short- ened due to the sea-level drop in the LGM. As a result, the sediment materials from Yangtze River were extensively deposited on the flat, exposed continental shelf owing to the rapid decline of river flow speed, leading to that pollen grains from Okinawa Trough are derived mainly from the flat coastal vegetation of exposed continental shelf at glacial stages. Changes of pollen as- semblage were consistent with the variation of temperature and humidity, which showed that the percentage of arboreal pollen was highly augmented at MIS 7, 5 and MIS 1, corresponding to the strengthening of the East Asian summer monsoon and in- creasing of rainfall. Moreover, the peak of Pinus percentage in MIS 5.3, 5.1 and MIS 3.3 may be closely linked by orbital and sub-orbital cycles of solar radiation and monsoonal variability. The present study of core MD981294 implied lower tempera- ture and precipitation during the lowest sea-level stage （LGM）, and more visibly testified that the vegetation of the flat plain on the exposed continental shelf was dominated by intrazonal communities such as halophyte grasslands and freshwater wetlands instead of zonal steppe or semi-arid desert. All above evidence demonstrated that the fundamental changes of pollen assem- blage and their origins in Okinawa Trough since -200 ka BP were affected by combine factors including the coastline position and climate fluctuation. Moreover, the substantial shortening of distance between shoreline and the Okinawa Trough driven by orbital insolation cycles was clearly indicated by the pollen spectra, whereas the source-area climate signal of the pollen record was largely weakened.
