Objective To evaluate the outcome of off-pump coronary artery bypass grafting （OPCABG） using a bilateral internal mammary artery （BIMA） Y configuration graft to achieve total arterial myocardial revascularization....Objective To evaluate the outcome of off-pump coronary artery bypass grafting （OPCABG） using a bilateral internal mammary artery （BIMA） Y configuration graft to achieve total arterial myocardial revascularization. Methods From October 2002 to December 2008, 208 patients （196 males and 12 females） underwent OPCABG using a BIMA Y configuration graft. The average age of the patients was 56.5 ± 11.3 years, with an age range of 33-78 years. A total of 167 （80.2%） cases had triple-vessel disease. Left main stem disease was found in 33 （15.9%） cases, and double-vessel disease was found in 8 （3.9%） cases. The semi-skeletonization technique was used to harvest the two internal mammary arteries （IMAs）, and then the free right internal mammary artery was connected end-to-side to the left internal mammary artery （LIMA） in situ to complete the Y configuration graft. Off-pump and sequential anastomosis methods were used to perform coronary artery bypass surgery in all patients. Graft patency was assessed intm-operatively with the HT311 transit time flowmeter. Results A total of 728 distal anastomoses were performed in 208 patients, with the average being 3.5± 1.3 per person. No one died or experienced recurrent angina within 30 days after the operation. Conclusions OPCABG using the BIMA Y graft was safe and effective to achieve total arterial revascularization. This method avoids surgical operation on the ascending aorta and other incisions.展开更多
Breast cancer is defined as a chronic disease.Increasing amounts of attention have been paid to the healthmanagement of breast cancer survivors. An important issue ishow to find the most appropriate method of follow-u...Breast cancer is defined as a chronic disease.Increasing amounts of attention have been paid to the healthmanagement of breast cancer survivors. An important issue ishow to find the most appropriate method of follow-up in orderto detect long-term complications of treatment, local recurrenceand distant metastasis and to administer appropriate treatmentto the survivors with recurrence in a timely fashion. Differentoncology organizations have published guidelines for followingup breast cancer survivors. However, there are few articles onthis issue in China. Using the published follow-up guidelines,we analyzed their main limitations and discussed the content,follow-up interval and economic benefits of following up breastcancer survivors in an effort to provide suggestions to physicians.Based on a large number of clinical trials, we discussed the roleof physical examination, mammography, liver echograph, chestradiography, bone scan and so on. We evaluated the effects ofthe above factors on detection of distant disease, survival time,improvement in quality of life and time to diagnosis of recurrence.The results of follow-up carried out by oncologists and primaryhealth care physicians were compared. We also analyzed thecorrelation factors for the cost of such follow-up. It appears thatfollow-up for breast cancer survivors can be carried out effectivelyby trained primary health care physicians. If anything unusualarises, the patients should be transferred to specialists.展开更多
文摘Objective To evaluate the outcome of off-pump coronary artery bypass grafting （OPCABG） using a bilateral internal mammary artery （BIMA） Y configuration graft to achieve total arterial myocardial revascularization. Methods From October 2002 to December 2008, 208 patients （196 males and 12 females） underwent OPCABG using a BIMA Y configuration graft. The average age of the patients was 56.5 ± 11.3 years, with an age range of 33-78 years. A total of 167 （80.2%） cases had triple-vessel disease. Left main stem disease was found in 33 （15.9%） cases, and double-vessel disease was found in 8 （3.9%） cases. The semi-skeletonization technique was used to harvest the two internal mammary arteries （IMAs）, and then the free right internal mammary artery was connected end-to-side to the left internal mammary artery （LIMA） in situ to complete the Y configuration graft. Off-pump and sequential anastomosis methods were used to perform coronary artery bypass surgery in all patients. Graft patency was assessed intm-operatively with the HT311 transit time flowmeter. Results A total of 728 distal anastomoses were performed in 208 patients, with the average being 3.5± 1.3 per person. No one died or experienced recurrent angina within 30 days after the operation. Conclusions OPCABG using the BIMA Y graft was safe and effective to achieve total arterial revascularization. This method avoids surgical operation on the ascending aorta and other incisions.
文摘Breast cancer is defined as a chronic disease.Increasing amounts of attention have been paid to the healthmanagement of breast cancer survivors. An important issue ishow to find the most appropriate method of follow-up in orderto detect long-term complications of treatment, local recurrenceand distant metastasis and to administer appropriate treatmentto the survivors with recurrence in a timely fashion. Differentoncology organizations have published guidelines for followingup breast cancer survivors. However, there are few articles onthis issue in China. Using the published follow-up guidelines,we analyzed their main limitations and discussed the content,follow-up interval and economic benefits of following up breastcancer survivors in an effort to provide suggestions to physicians.Based on a large number of clinical trials, we discussed the roleof physical examination, mammography, liver echograph, chestradiography, bone scan and so on. We evaluated the effects ofthe above factors on detection of distant disease, survival time,improvement in quality of life and time to diagnosis of recurrence.The results of follow-up carried out by oncologists and primaryhealth care physicians were compared. We also analyzed thecorrelation factors for the cost of such follow-up. It appears thatfollow-up for breast cancer survivors can be carried out effectivelyby trained primary health care physicians. If anything unusualarises, the patients should be transferred to specialists.
