Personalized Management of Anastomotic Leak after Surgery for Esophageal Carcinoma

Objective To summarize the management of anastomotic leak following surgery for esophageal car-cinoma. Methods The medical records of the patients developing digestive tract leak after surgery for esophageal carcinoma in our hospital from January 2003 to March 2011 were retrospectively analyzed. Results A total of 36 patients were included, in whom 13 developed cervical anastomotic leak, 18 had intra-thoracic anastomotic leak, and 5 had intra-thoracic gastric necrosis. Of these patients, 7 were treated with resurgery, 6 with esophageal stent implantation, and 23 with conservative treatment. Treatment lasted for 5 to 181 days, averagely 47.0±31.9 days. After management, 9 patients died (25.0%). Among seven patients with resurgery, four had deceased, two were cured, and one developed leak again and was switched to conservative treatment until discharged. All the 6 patients treated with stent implantation were cured. Of the 24 patients receiving conservative treatment (including one switched from resurgery), 18 (75.0%) were cured and 1 was not cured but survived. Conclusions Anastomotic leak following surgery for esophageal carcinoma should be treated individually based on the onset time, location, size, and extent of the leakage. Conservative treatment is still a safe and effective method.The efficacy of stent implantation needs further investigation to confirm.

Analysis of the Current Status and Influencing Factors of the Readiness for Discharge of Patients after Prostate Cancer Surgery Based on the Concept of Enhanced Recovery after Surgery (ERAS)

Objective To investigate the level of readiness for discharge of patients after prostate cancer surgery based on the concept of Enhanced Recovery After Surgery (ERAS), and to explore its influencing factors, so as to provide references for improving the readiness for discharge of patients after prostate cancer surgery. Methods The general information questionnaire, the discharge preparation scale, and the discharge guidance quality scale were used to investigate 119 patients discharged from the urological surgery department of a tertiary A-level hospital in Guangzhou after radical prostatectomy. Results The total score of discharge readiness of patients after radical prostatectomy was 147.74 ± 35.71 points, which was at a lower middle level and the total score of discharge guidance quality was 180.68 ± 38.91 points, which was at a medium level. Multiple linear regression analysis showed that education level, family monthly income, Gleason score, whether to perform lymphatic dissection, whether to discharge with a urinary catheter, and the quality of discharge guidance were the main factors influencing the readiness for discharge of patients after prostate cancer surgery. Conclusion In clinical nursing work, it is necessary to implement individualized health education according to the characteristics and needs of different patients to improve the level of preparation for discharge of patients after prostate cancer surgery.

Cost-utility analysis of transcatheter aortic valve implantation versus surgery in severe aortic stenosis patients with intermediate surgical risk in Thailand

BACKGROUND Transcatheter Aortic Valve Implantation(TAVI) has been shown to provide comparable survival benefit and improvement in quality of life to surgical aortic valve replacement(SAVR) for treating patients with severe aortic stenosis(AS) at intermediate surgical risk.This study aimed to evaluate the cost-utility of TAVI compared with SAVR for severe aortic stenosis with interme diate surgical risk in Thailand.METHODS A two-part constructed model was used to analyze lifetime costs and quality-adjusted life-years(QALYs) from societal and healthcare perspectives.The study cohort comprised severe AS patients at intermediate surgical risk with an average age of 80 years.The landmark trials were used to populate the model in terms of mortality and adverse event rates.All cost-related data and quality of life were based on Thai population.Costs and QALYs were discounted at 3% armually and presented as2021 values.Incremental cost-effectiveness ratios(ICERs) were calculated.Deterministic and probabilistic sensitivity analyses were conducted.RESULTS In comparison to SAVR,TAVI resulted in higher total cost(THB 1,717,132 [USD 52;415.51] vs.THB 893,524 [USD27,274.84]) and higher QALYs(4.88 vs.3.98) in a societal perspective.The estimated ICER was THB 906,937/QALY(USD27,684.27/QALY).From a healthcare system perspective,TAVI also had higher total cost than SAVR(THB 1,573,751 [USD48,038.79] vs.THB 726,342 [USD 22,171.63]) with similar QALYs gained to the societal perspective.The estimated ICER was THB933,145/QALY(USD 933,145/QALY).TAVI was not cost-effective at the Thai willingness to pay(WTP) threshold of THB160,000/QALY(USD 4,884/QALY).The results were sensitive to utility of either SAVR or TAVI treatment and cost of TAVI valve.CONCLUSION In patients with severe AS at intermediate surgical risk,TAVI is not a cost-effective strategy compared with SAVR at the WTP of THB 160;000/QALY(USD 4,884/QALY) from the perspectives of society and healthcare system.

Quality of Sleep at the Ward after Cardiothoracic Surgery

Objective: Sleeping problems are among the issues most mentioned by patients after cardiothoracic surgery. These problems can have a negative effect on duration of the hospital stay and recovery. In the ward of our cardiothoracic surgery department, a study was initiated to assess the quality of sleep after cardiothoracic surgery. The primary objective was to investigate the effect of cardiothoracic surgery on the quality of sleep. The secondary objective was to investigate the quality of sleep. Correlations with perioperative factors and related issues such as the type of surgery and medication were sought. Methods: A consecutive prospective cohort study was initiated (N = 72). The study used validated questionnaires to assess sleep: the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS), the Verran Snyder-Halpern Sleep Scale (VSH) and the Factors Influencing Sleep Quality (FISQ). Results: The PSQI showed that the quality of sleep one month after surgery was inferior to the quality of sleep before surgery (p-value: 0.03). The efficiency of sleep (time spent in bed) was higher after surgery then before surgery (p-value: 0.01). The VSH showed increased impaired sleep on the third night after surgery. The most disruptive factors were not being comfortable in a hospital bed, pain and the noise of medical devices. Conclusions: The quality of sleep after cardiothoracic surgery is worse when compared with the preoperative situation. The chief influencing factors are discomfort in bed, pain and disturbance from medical devices. The use of pain medication does not improve the quality of sleep.

Postoperative Complication in Overweight Patients Undergoing Coronary Artery Bypass Graft Surgery

Background: Obesity has a great impact on overall mortality and morbidity in cardiac surgery. The magnitude of obesity is defined by means of body mass index (BMI). At this study we aim to correlate between grade of BMI and postoperative complications in patients undergoing coronary revascularization. Methods: A prospective observational study was conducted in Ain Shams University hospitals and the National Heart Institute of Egypt. 98 patients with multi-vessel CAD and candidate for CABG were included in the study and divided into two groups Group I: 53 patients with BMI over 30. Group II: 45 patients with a BMI under 30. The primary endpoint was wound infection and mediastinitis. Secondary endpoints included mortality, prolonged ICU and hospital stay, stroke, renal and hepatic impairment. Results: As regard primary ending point, eight patients of Group I had their wounds infected which is significantly higher than the other group (p-value 0.034). The total ward stay in days was significantly higher in Group I (p-value 0.027). Conclusion: BMI more than 30 is associated with increased rates of wound complications either superficial or deep wound infections. Robust measures should be taken to prevent such grave complications.

Factors related to self-management behavior among persons with mild-to-moderate chronic obstructive pulmonary disease in Wenzhou,China

Objective:To describe the self-management(SM)behavior among persons with mild-to-moderate chronic obstructive pulmonary disease(COPD),and it examines the correlation between COPD knowledge,self-efficacy,perceived social support,and SM behavior among persons with mild-to-moderate COPD in Wenzhou,China.Methods:A simple random sampling technique was used to recruit 121 persons with mild-to-moderate COPD who visited the respiratory outpatient department of the First Affiliated Hospital of Wenzhou Medical University in Wenzhou,China.Research instruments include a demographic data questionnaire,COPD SM scale,COPD knowledge questionnaire,6-item chronic disease self-efficacy scale,and perceived social suppor t scale.Descriptive statistics and Pearson's Correlation were used for data analysis.Results:The findings show that the mean score of COPD SM scale was 2.70(SD=0.45).The Pearson correlation analysis revealed that the COPD knowledge(r=0.47,P<0.001),self-efficacy(r=0.28,P=0.001),and perceived social support(r=0.48,P<0.001)were positively correlated to the COPD SM behavior among persons with mild-to-moderate COPD in Wenzhou,China.Conclusions:The findings indicate that disease knowledge,self-efficacy,and perceived social support were related to SM behavior in persons with mild-to-moderate COPD,which provides a theoretical basis for developing SM interventions for persons with mildto-moderate COPD and improving this population's SM behavior.

Relationship between Methylation Status of Multi-drug Resistance Protein(MRP) and Multi-drug Resistance in Lung Cancer Cell Lines

Objective： To study the relationship between the methylation status of multi-drug resistance protein （MRP） gene and the expression of its mRNA and protein in lung cancer cell lines. Methods： Human embryo lung cell line WI-38, lung adenocarcinoma cell line SPCA-1 and its drug-resistant cells induced by different concentrations of doxorubicin were treated with restriction endonuclease Eco47III. The methylation status of MRP was examined by PCR, and the expressions of its mRNA and protein were evaluated by in situ hybridization and immunohistochemistry. Results： MRP gene promoter region of WI-38 cells was in hypermethylation status, but the promoter region of MRP in SPCA-1 cells and their resistant derivatives induced by different concentrations of doxorubicin were in hypomethylation status. There were significant differences in the expression of MRP mRNA among WI-38 cell line, SPCA-1 cells and their drug-resistant derivatives induced by different concentration of doxorubicin. Consistently, MRP immunostaining presented similar significant differences. Conclusion： The promoter region of MRP in SPCA-1 lung adenocarcinoma cells was in hypomethylation status. The hypomethylation status of 5＇ regulatory region of MRP promoter is an important structural basis that can increase the activity of transcription and results in the development of drug resistance in lung cancer.

Rabbit model of radiation-induced lung injury

Objective:To explore the feasibility of establishing an animal model of chronic radiationinduced lung injury.Methods:Twenty-eight New Zealand white rabbits were randomly divided into 3 groups(the right lung irradiation group,the whole lung irradiation group and the control group).Animal model of radiation-induced lung injury was established b) highdoes radiotherapy in the irradiation groups,then all rabbits underwent CT and pathological examinations at 1.2.4.8.12.16 weeks,respectively after radiation.Results:Within 4 weeks of irradiation,some rabbits in the right lung irradiation group and whole lung irradiation group died. CT and pathological examinations all showed acute radiation pneumonitis.At 8-12 weeks after irradiation,CT scanning showed ground glass samples signs,patchy shadows and fibrotic stripes. Pathological examination showed the fibrosis pulmonary alveolar wall thickened obviously. Conclusions:The clinical animal model of chronic radiation-induced lung injury which corresponds to practical conditions in clinic can be successfully established.

Preferred Revascularization Strategies in Patients with Ischemic Heart Failure: A Meta-Analysis

Clinically,coronary artery bypass grafting (CABG)or percutaneous coronary intervention (PCI)is generally used to treat patients with ischemic heart failure.However, the optimal treatment strategy remains unknown.This study examined the efficacy of the two coronary revascularization strategies for severe ischemic heart failure by using a meta-analysis.Studies comparing the efficacy of CABG and PCI were obtained from PubMed,EMBASE,Google Scholar and Cochrane Central Register of Controlled Trials (CENTRAL).The quality of each eligible article was evaluated by Newcastle-Ottawa Quality Assessment Scale (NOS),and the meta-analysis was performed using Stata version 12.0 software.Eventually,12 studies involving 9248 patients (n=4872 in CABG group;n=4376 in PCI group)were subject to the meta-analysis for subsequent pooling calculation.The pooled hazard ratio (HR)[HR=0.83,95%CI (0.76,0.90),P<0.001; heterogeneity,P=0.218,I^2=22.9%]of CABG compared with that of PCI revealed a statistical superiority of CABG to PCI in terms of the long-term mortality.Furthermore, CABG showed more advantages over PCI with respect to the incidence of myocardial infarction [HR=0.51,95%CI (0.39,0.67),P<0.001;heterogeneity,P=-0.707,I^2=0%]and repeat revascularization [HR=0.40,95%CI (0.27,0.59),P<0.001;heterogeneity,P<0.001, I^2=80.1%].It was concluded that CABG appears to be more advantageous than PCI for the treatment of ischemic heart failure in the given clinical setting.

Discrepancy of blood pressure between the brachial artery and radial artery

BACKGROUND:In this study,we attempted to find the relations between blood pressure(BP)measured on the brachial artery(bBP) and BP assessed on the radial artery(rBP) in the right arm.METHODS:Three hundred and fifteen patients were enrolled in this study.Those who had peripheral vascular disease,wounds of arm skin or subcutaneous tissue infection were excluded.After a 15-minute equilibration and stabilization period after inducation of anesthesia,three bBP and rBP records were obtained sequentially using an oscillometric device with an adult cuff and infant cuff,respectively.Order for each BP was randomized.RESULTS:The bBP was significantly lower than the rBP(P<0.05).The difference between the two values varied from 13 to 18 mmHg in systolic BP(SBP),diastolic BP(DBP) and mean blood pressure(MAP) respectively.And the rBP was positively correlated with the bBP(r=0.872,0.754,0.765;P<0.001,<0.001,<0.001;SBP,DBP,MAP,respectively).CONCLUSION:The bBP value can be evaluated by the noninvasive measurements of rBP using an appropriate cuff in clinical practice.

The current situation of Sunitinib in treating non-small cell lung cancer

Sunitinib malate is one of the multitargeted tyrosine kinase inhibitor,which are being used in clinic.It can inhibit more than 80 kinds of receptor`s tyrosine kinase,including epidermal growth factor receptor (EGFR),platelet-derived growth factor receptors,vascular endothelial growth factor receptors (VEGFR),etc.And tyrosine kinase inhibitor is involved in connection with the generation and progression of many kinds of cancer including lung cancer.Several studies have evaluated the effect of Sunitinib on non-small cell lung cancer (NSCLC),by single agent,continuous daily dosing or in combination with chemotherapeutics (with docetaxel or gemcitabine plus cisplatin),which all showed certain effect.The test of Sunitinib in combination with gemcitabine plus cisplatin for advanced NSCLC shown that at the maximum tolerated dose:oral Sunitinib 37.5 mg/day intermittently (Schedule 2/1:2 weeks on treatment,1 week off treatment) schedule with intravenous infusions of gemcitabine (1000 mg/m2 days 1,8) and cisplatin (80 mg/m2 day 1),administered in 3-week cycles,66.7% patients achieved partial responses.And adverse effects were mild to moderate in severity (grades 1 to 2).Therapy was generally well tolerated.In summary,all the evidence above suggests that Sunitinib may play an important role in the treating of NSCLC.

The Influence of Pain: Quality of Life after <i>Pectus excavatum</i>Correction

Introduction: The main indication for surgery of thoracic wall deformities (TWD) is psychological due to cosmetic complaints. The assumption is that appearances have a negative effect on?self-esteem and quality of life?(QoL). Correction should result in improvement. Methods: Prospective trial. QoL was assessed using the?CHQ and the WHOQOL-bref. Measurements were taken before surgery (T1) and 6 weeks thereafter (T2). Results: Forty-two patients were included.?WHOQOL-bref showed differences between pre-operative and?six weeks past surgery on facet body image (p = 0.003).?Self-esteem (CHQ) did not show a significant improvement at T2.?Concerning the scores on the single step questionnaire (SSQ),?33 patients were “very” to “extremely satisfied” with appearance and increased self-esteem (p < 0.001). Concerning the domain “pain and physical complaints”, CHQ did show a significant change (p < 0.001) with more complaints at T2. Conclusion: Six weeks after surgical correction of a TWD satisfaction with the “new” chest is good;pain seems to be a problem with possible negative influence on self-esteem.

Pulse Wave Analysis in Patients with Coronary Heart Disease Based on Hilbert-Huang Transformation and Time-domain

Objective: To study the characteristics of pulse tracings in CHD, and objectively evaluate the significance of pulse signal in diagnosis and appreciation of therapeutic effect in patients with coronary heart disease(CHD), and accordingly provide with theoretic proofs for developing non-invasive technique of pulse diagnosis. Methods: By using the pulse detection system, pulse graphs in CHD patients, patients without CHD and "health" adults were collected and compared. Then characters of the pulse signal were analyzed with Hilbert-Huang transformation routine (HHT) and time-domain method respectively. Results: There existed characteristic change in pulse graph in CHD. ① h1,h3,h4,h3/h1,t,t5/t4 in time domain parameters of pulse graph increased and w1 was widened. ② 44% of C2 wave in HHT display showed chaotic and disorderly wave and irregularly wave amplitude in CHD. And 72% of C5 Wave exhibited in irregular wave with average wave amplitude over 10 gram-forces. These changes were significantly different from health adults. Conclusion: Characteristic wave of pulse graph extracted with methods of time domain or HHT routine might be considered as proofs for diagnosis and differentiation in CHD. Our researches prognosticate that pulse diagnosis can be used as an ancillary determination in occurrence of CHD for reasons of the advantage of convenient operation and non-invasion.

The Treatment of Ostial Coronary Arteriopathy Secondary to Thoracic Irradiation With Off-pump Coronary Artery Bypass Grafting: A Case Report and Review of Literatures

Objectives We report a case in which a patient who suffered from angina secondary to mediastinal irradiation and have been treated by off-pump coronary artery bypass （OPCAB） in our hospital since 3 years ago. A 34-year-old man presented with angina for 8 years after receiving radiation therapy for Hodgkin＇s lymphoma. We retrospectively reviewed all the cases of OPCAB in our hospital and followed-up data for up to 3 years post-operatively. Mediastinal irradiation is probably the cause of significant ostial stenosis of left main coronary and right coronary artery. OPCAB grafting was performed on this patient 3 years ago. His angina disappeared after operation, and he recovered well during follow-up. Conclusions Patients with malignancies who have received mediastinal irradiation should be carefully followed up and routinely screened for the premature development of coronary artery disease. OPCAB may be an appropriate treatment for coronary artery disease caused by mediastinal irradiation.

Effect of dobutamine combined with meropenem on serum BNP, IGF-1, IGFBP-3, TNF-a, IL-6 and hs-CRP in children with congenital heart disease and pneumonia

Objective:To study the effect of dobutamine combined with meropenem on serum BNP, IGF-1, IGFBP-3, TNF-a, IL-6 and hs-CRP in children with congenital heart disease and pneumonia.Methods:A total of 70 children with congenital heart disease and pneumonia in our hospital from June 2014 to Octomber 2016 were enrolled in this study. The subjects were divided into the control group (n=35) and the treatment group (n=35) randomly. The control group was treated with dobutamine, the treatment group were treated with dobutamine combined with meropenem. The two groups were treated for 10 days. The serum BNP, IGF-1, IGFBP-3, TNF-a, IL-6 and hs-CRP levels of the two groups before and after treatment were compared.Results: There were no significantly differences of the serum BNP, IGF-1, IGFBP-3, TNF-a, IL-6 and hs-CRP levels of the two groups before treatment. The serum BNP, TNF-a, IL-6 and hs-CRP levels of the two groups after treatment were significantly lower than before treatment, the serum IGF-1 and IGFBP-3 levels of the two groups after treatment were significantly higher than before treatment, and that of the treatment group were significantly better than the control group.Conclusion:Dobutamine combined with meropenem can significantly reduce the serum BNP, TNF-a, IL-6 and hs-CRP levels, improve serum IGF-1 and IGFBP-3 levels of children with congenital heart disease and pneumonia, and it was worthy clinical application.

Development of Biofunctionalized Cellulose Acetate Nanoscaffolds for Heart Valve Tissue Engineering

Currently-used mechanical and biological heart valve prostheses have a satisfactory short-term performance, but may exhibit several major drawbacks on the long-term. Mechanical prostheses, based on carbon, metallic and polymeric components, require permanent anticoagulation treatment, and their usage often leads to adverse reactions, e.g. thromboembolic complications and endocarditis. In recent years, there is a need for a heart valve prosthesis that can grow, repair and remodel. The concept of tissue engineering offers good prospects into the development of such a device. An ideal scaffold should mimic the structural and purposeful profile of materials found in the natural extracellular matrix (ECM) architecture. The goal of this study was to develop cellulose acetate scaffolds (CA) for valve tissue regeneration. After their thorough physicochemical and biological characterization, a biofunctionalization process was made to increase the cell proliferation. Especially, the surface of scaffolds was amplified with functional molecules, such as RGD peptides (Arg-Gly-Asp) and YIGSRG laminins (Tyrosine-Isoleucine-Glycine-Serine-Arginine-Glycine) which immobilized through biotin-streptavidin bond, the strongest non-covalent bond in nature. Last step was to successfully coat an aortic metallic valve with CA biofunctionallized nanoscaffolds and cultivate cells in order to create an anatomical structure comparable to the native valve. Promising results have been obtained with CA-based nanoscaffolds. We found that cells grown successfully on the biofunctionalized valve surface thereby scaffolds that resemble the native tissues, elaborated with bioactive factors such as RGD peptides and laminins not only make the valve’s surface biocompatible but also they could promote endothyliazation of cardiac valves causing an anti-coagulant effect

Severe mitral annular calcifi cation in rheumatic heart disease:A rare presentation

Severe mitral annular calcification(MAC)is frequently seen in patients with advanced age and chronic kidney disease,but it is rare in rheumatic heart disease(RHD).We hereby report a case of 45-year-old female with chronic RHD,who had severe MAC and mitral regurgitation.Fluoroscopy revealed a "crown"-like severe calcification of the mitral annulus.Autopsy of the heart revealed a calcified posterior mitral annulus,fused commissures,and calcified nodules at the atrial aspect of the mitral valve.

Preoperative application of combination of portal venous injection of donor spleen cells and intraperitoneal injection of rapamycin prolongs the survival of cardiac allografts in mice

Objective:To investigate the effects of preoperative portal venous injection of donor spleen cells(PVIDSC) and intraperitoneal injection of rapamycin in the acute rejection of cardiac allograft in mice and the underlying mechanisms. Methods:Homogenous female B6 mice and BALB/c mice were used as recipients and donors of heart transplantation. These mice were randomly divided into different groups and received PVIDSC alone,rapamycin alone,or PVIDSC and rapamycin combined therapy. In addition,the underlying mechanism was studied by measuring a number of cytokines. Results:Preoperative combination of PVIDSC and intraperitoneal injection of rapamycin significantly prolonged the survival of heterotopic cardiac allograft in mice,but had no effects on the survival time of cardiac allografts in mice pre-sensitized by skin grafting. Preoperative combination of PVIDSC and intraperitoneal injection of rapamycin increased the expression of IL-10 and Foxp3 and reduced the expression of INF-γ. Short-term preoperative administration of rapamycin promotes the expression of CD4^+CD25^+Foxp3^+ regulator T cells. However,preoperative using alone of rapamycin,or combination of PVIDSC and rapamycin had no effects on the inhibition of proliferation of memory T cells. Conclusions:Preoperative application of combination of PVIDSC and rapamycin significantly prolonged the survival time of cardiac allografts in mice but not in mice pre-sensitized by skin grafting. This may be explained by the fact that combination of PVIDSC and rapamycin inhibited the cellular immune response and induced the expression of IL-10 from Tr1 cells and CD4^+CD25^+FoxP3^+ regulatory T cells.

Impact of metabolism-related mutations on the heart rate of gastric cancer patients after peritoneal lavage

BACKGROUND During surgery for gastric cancer,peritoneal lavage using warm distilled water can cause temporary hemodynamic changes.AIM To examine the associations between changes in heart rate and single nucleotide polymorphisms(SNPs).METHODS This was a prospective observational study of patients with gastric cancer who underwent gastrectomy and peritoneal hypotonic lavage at the Third Afliated Hospital of Soochow University from March 2018 to March 2019.Related SNPs were selected,and the verified exons were analyzed.Heart rate and blood pressure(BP)were measured before and after lavage.The patients were grouped as heart rate change≥30%vs<30%.Comparison and regression analyses of the selected SNPs were performed between the two groups.RESULTS According to the inclusion/exclusion criteria,194 patients were included in the analysis.Of these patients,138 were male,with a mean age of 65.9±0.8 years,and 56 were female,with a mean age of 65.0±1.3 years.Heart rate dropped by 0%-10%in 65 participants,by 10%-15%in 29,by 15%-20%in 23,by 20%-50%in 39,by 50%-100%in four,six had a cardiac arrest,and 28 had an increase in heart rate.Considering the possible impact of exonic SNPs on the phenotypes,TEP1(rs938886),TEP1(rs1713449),and RECQL5(rs820196)were analyzed.The haplotype analysis suggested that the haplotypes CTT[odds ratio(OR)=2.018,95%confidence interval(CI):1.012-4.025,P=0.0430]and GCC(OR=2.293,95%CI:1.174-4.477,P=0.0131)of TEP1(rs938886),TEP1(rs1713449),and RECQL5(rs820196)increased the risk of a drop in heart rate>30%.CONCLUSION The TEP1(rs938886),TEP1(rs1713449),and RECQL5(rs820196)SNPs were associated with changes in heart rate≥30%during intraperitoneal lavage using distilled water after gastrectomy for gastric cancer.

Giant left ventricular pseudoaneurysm presenting with hemoptysis

Left ventricular (LV) pseudoaneurysm is a late mechanical complication of myocardial infarction (MI). A giant LV pseudoaneurysm is a rare presentation. We report a case of a giant LV pseudoaneurysm in a post MI patient, who presented with hemoptysis. Hemoptysis is a rare clinical presentation of LV pseudoaneurysm. The patient had successful surgical repair of the aneurysm and had a favorable outcome in 9 mo’ follow-up. The imaging modalities and surgical treatment of a pseudoaneurysm is discussed.