高校应用数学学报最新文献

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Inflammatory Cytokines as Risk Factors for Mortality After Acute Cardiac Events. 炎性细胞因子是急性心脏事件后死亡的风险因素。

高校应用数学学报

Pub Date : 2016-07-27 DOI: 10.5455/medarh.2016.70.252-255

Aida Hamzic-Mehmedbasic

Introduction: Inflammatory markers have been identified as potential indicators of future adverse outcome after acute cardiac events.

Aim: This study aimed to analyze baseline inflammatory cytokines levels in patients with acute heart failure (AHF) and/or acute coronary syndrome (ACS) according to survival. The main objective was to identify risk factors for mortality after an episode of AHF and/or ACS.

Methods: In this prospective longitudinal study 75 patients with the diagnosis of AHF and/or ACS were enrolled. Baseline laboratory and clinical data were retrieved. Serum and urine interleukin-6 (IL-6) and interleukin-18 (IL-18) levels, plasma B-type natriuretic peptide (BNP) and serum cystatin C values were determined. The primary outcome was in-hospital mortality while secondary outcome was six-month mortality.

Results: Median serum and urine IL-6 levels, serum and urine IL-18 levels, as well as median concentrations of plasma BNP and serum cystatin C, were significantly increased in deceased in comparison to surviving AHF and/or ACS patients. Univariate Cox regression analysis identified serum IL-6, serum IL-18, urine IL-6, urine IL-18 as well as serum cystatin C and Acute Physiology and Chronic Health Evaluation (APACHE) II score as risk factors for mortality after an episode of AHF and/or ACS. Multivariate Cox regression analysis revealed that only serum IL-6 is the independent risk factor for mortality after acute cardiac events (HR 61.7, 95% CI 2.1-1851.0; p=0.018).

Conclusion: Present study demonstrated the strong prognostic value of serum IL-6 in predicting mortality of patients with AHF and/or ACS.

简介：炎症标志物被认为是急性心脏事件后未来不良预后的潜在指标：目的：本研究旨在根据急性心力衰竭（AHF）和/或急性冠状动脉综合征（ACS）患者的生存情况分析其基线炎症细胞因子水平。主要目的是确定急性心力衰竭和/或急性冠状动脉综合征发作后的死亡风险因素：在这项前瞻性纵向研究中，共纳入了 75 名确诊为 AHF 和/或 ACS 的患者。研究人员检索了基线实验室和临床数据。测定了血清和尿液中的白细胞介素-6（IL-6）和白细胞介素-18（IL-18）水平、血浆B型钠尿肽（BNP）和血清胱抑素C值。主要结果是院内死亡率，次要结果是六个月死亡率：结果：与存活的AHF和/或ACS患者相比，死亡患者的血清和尿液IL-6水平中位数、血清和尿液IL-18水平中位数以及血浆BNP和血清胱抑素C浓度中位数均显著升高。单变量考克斯回归分析确定血清IL-6、血清IL-18、尿液IL-6、尿液IL-18以及血清胱抑素C和急性生理学和慢性健康评估（APACHE）II评分是AHF和/或ACS患者死亡的风险因素。多变量 Cox 回归分析显示，只有血清 IL-6 是急性心脏事件后死亡率的独立风险因素（HR 61.7，95% CI 2.1-1851.0；P=0.018）：本研究表明，血清 IL-6 在预测 AHF 和/或 ACS 患者死亡率方面具有很高的预后价值。

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引用次数: 0

Free toe pulp flap for finger pulp and volar defect reconstruction. 用于指髓和指腹缺损重建的游离趾髓瓣。

IF 0.8

高校应用数学学报

Pub Date : 2016-05-01 DOI: 10.4103/0970-0358.191319

Jyoshid R Balan

Background: Fingertip injury requiring flap cover is very common in the modern era. The ideal cover should fulfill both functional and aesthetic improvement.

Materials and methods: From June 2015 to April 2016, we performed seven free toe pulp flaps for finger defect reconstruction. All patients were males. Five flaps were done in emergency post-traumatic cases, and two were done in elective set up. The cases included reconstruction of three thumbs, one index and one ring finger in an emergency set up and two ring fingers in the elective. Thumb reconstruction was done with great toe lateral pulp and the other digits reconstructed with second toe pulp flap. Follow-up evaluation included both functional and aesthetic assessment.

Results: Five flaps survived completely, one suffered partial loss, and one flap failed completely. The median follow-up period was 9 months. The median duration of surgery was 255 min (range 210 to 300 min). The median two-point discrimination was 6.5 mm (range 4-8 mm). There was the return of temperature sensation in all patients; two had cold intolerance. The Semmes-Weinstein monofilament score varied from 3.61 to 5.07 (median filament index value 4.31/pressure value of 2 g/mm²). Three patients had delayed donor site wound healing.

Conclusions: The free toe pulp flap is an efficient choice for fingertip and volar finger defects reconstruction with an excellent tissue match.

背景：指尖损伤需要皮瓣覆盖在现代非常常见。理想的覆盖应同时满足功能和美观的改善：从 2015 年 6 月到 2016 年 4 月，我们为 7 名患者实施了游离趾髓瓣手指缺损重建术。所有患者均为男性。其中五例为创伤后急诊病例，两例为择期手术病例。在急诊病例中重建了三个拇指、一个食指和一个无名指，在择期病例中重建了两个无名指。拇指用大趾外侧髓瓣重建，其他手指用第二趾髓瓣重建。随访评估包括功能和美学评估：结果：5个皮瓣完全存活，1个皮瓣部分缺损，1个皮瓣完全失败。中位随访时间为 9 个月。手术时间中位数为 255 分钟（210 至 300 分钟不等）。两点辨别中位数为 6.5 毫米（范围为 4-8 毫米）。所有患者都恢复了温度感觉，其中两名患者不耐寒。Semmes-Weinstein单丝评分从3.61到5.07不等（中位数单丝指数值为4.31/压力值为2克/平方毫米）。三名患者的供体部位伤口愈合延迟：结论：游离趾髓瓣是指尖和指腹缺损重建的有效选择，具有良好的组织匹配性。

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