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Background: Postoperative pneumonia (PoP) is the most prevalent of all nosocomial infections in patients underwent cardiovascular surgery. The aim of this study was to identify independent risk factors for pneumonia after cardiovascular surgery, from which we attempted to construct a nomogram for prediction. Methods: Logistic regression was used to identify independent risk factors for PoP in patients underwent cardiovascular surgery. We constructed a nomogram based on these independent risk factors. Model discrimination was assessed via area under the receiver operating characteristic curve (AUC), and calibration was assessed via calibration plot. Results: A total of 105 events occurred in the 1188 cases. Age (>55 years) (OR: 1.83, P=0.0225), preoperative malnutrition (OR: 3.71, P 135 min (OR: 2.80, P 20 hours (OR: 3.11, P

Background: We sought to explore the relationship between dexmedetomidine as an anesthetic adjuvant in cardiac surgery and postoperative complications and length of stay (LOS) in the cardiac intensive care unit (CICU). Methods: We conducted a retrospective study of patients aged 18 years and older who underwent heart valve surgery between October 2020 and June 2022. The study endpoints were a combination of adverse outcomes, which included major postoperative complications (cardiac arrest, atrial fibrillation, myocardial injury/infarction, heart failure) and prolonged CICU LOS (defined as LOS≥90th percentile). Multivariate logistic regression analysis was performed for variables that were significant in the univariate analysis. Results: A total of 856 patients entered our study. Of these, 283（33.06%） patients experienced at least one adverse outcome and the remaining 573 were included in the prognostic control group. Multivariate logistic regression analysis revealed that age > 60years (odds ratio [OR], 1.73; 95% confidence interval [CI], 1.27–2.37; p=0.01), cardiopulmonary bypass( CPB)> 190min (OR, 1.58; 95% CI, 1.01-2.48; p = 0.04) and postoperative mechanical ventilation time > 10 h (OR, 2.03; 95% CI, 1.49-2.77; p < 0.01) were independent risk factors for major complications and prolonged CICU length of stay in patients undergoing heart valve surgery. Intraoperative use of dexmedetomidine as an anesthetic adjuvant was a protective factor for such patients (odds ratio, 0.53; 95% confidence interval, 0.37-0.78; p = 0.01). Conclusions: Age, duration of cardiopulmonary bypass, and duration of mechanical ventilation are associated with major complications and increased CICU stay after heart valve surgery. Intraoperative use of dexmedetomidine may improve such clinical outcomes.

Tight glutenite rservoirs characterization and effective hydrocarbon-bearing formation identification faced great challenge due to ultra-low porosity, utra-low permeability and complicated pore structure. In addition, tight glutenite reservoirs generally had no natural productive capacity, fracturing fracture-building technique always needed to improve hydrocarbon production capacity. Pore structure characterization and friability prediction were essential in improving such type of reservoir evaluation. In this study, fractured tight glutenite reservoirs in Permian Jiamuhe Formation that located in northwest margin of Junggar Basin, northwest China was chosen as an example, 25 typical core samples were drilled and simultaneously applied for mercury injection capillary pressure (MICP), nuclear magnetic resonance (NMR) and whole-rock mineral X-ray diffraction experiments. The limitation of pore structure characterization based on NMR logging was analyzed, and a novel method of synthetizing pseudo pore-throat radius (Rc) distribution from porosity frequency spectra, and used to characterize fractured formation pore structure was established, the porosity frequency spectra were extracted from electrical image logging. Based on whole-rock mineral X-ray diffraction experimental data, quartz and calcite were considered as the fragile mineral in our target formation, and rock mineral component ratio method was used to predict brittleness index (BI). The statistical model that raised by Jin et al. (2015) was used to predict two types of fracture toughness KIC and KIIC. BI, KIC and KIIC were combined to characterize tight glutenite reservoirs friability (Frac). Combining with maximal pore-throat radius (Rmax, reflected rock pore structure) and Frac, our target formations were classified into four clusters. Meanwhile, relationships among Rmax, Frac and daily hydrocarbon production per meter (DI) was analyzed, and positively relations among them was observed. Formations with good pore structure and high Frac always contained high deliverability, and vice versa. A model to predict fractured tight glutenite reservoirs DI from well logging data was established. Comparison of predicted DI with the extracted results from drill stem test (DST) data illustrated the reliability of our raised models. This would be valueable in determining optimal hydrocarbon production intervals and formulating reasonable developed plans.

Background To investigate the risk factors for mortality in patients with acute kidney injury requiring continuous renal replacement therapy (AKI-CRRT) after cardiac surgery. Methods In this retrospective study, patients who underwent AKI-CRRT after cardiac surgery in our centre from January 2015 to January 2020 were included. Univariable and multivariable analyses were performed to identify the risk factors for in-hospital mortality. Results A total of 412 patients were included in our study. Of these, 174 died after AKI-CRRT, and the remaining 238 were included in the survival control group. Multivariable logistic regression analysis revealed that EuroSCORE > 7 (odds ratio [OR], 3.72; 95% confidence interval [CI], 1.92–7.24; p 1 L (OR, 2.14; 95% CI, 1.19–3.86; p = 0.01) and mechanical ventilation time > 70 h (OR, 5.03; 95% CI, 2.40–10.54; p Conclusions In summary, the mortality of patients with AKI-CRRT after cardiac surgery remains high. The EuroSCORE, intraoperative bleeding and mechanical ventilation time were independent risk factors for in-hospital mortality. Continuous application of furosemide may be associated with a better outcome.

BACKGROUND In this study, we compare the clinical characteristics, intraoperative management, and postoperative outcomes of patients with acute type A aortic dissection (ATAAD) between two academic medical hospitals in the United States and China. METHODS From January 2011 to December 2017, 641 and 150 patients from Nanjing Drum Tower Hospital (NDTH) and Massachusetts General Hospital (MGH) were enrolled. Patient demographics, clinical features, surgical techniques, and postoperative outcomes were compared. RESULTS The annual number of patients presenting with ATAAD at MGH remained relatively stable, while the number at NDTH increased significantly over the study period. The average age was 51 years at NDTH and 61 years at MGH (P

Background Deep sternal wound infection (DSWI) is a life-threatening complication after cardiac surgery. The aim of this study was to retrospectively evaluate the outcomes of reconstructing infected poststernotomy wounds with either vacuum-assisted closure (VAC) after previous debridement or bilateral pectoralis major muscle flaps (BPMMFs). Methods In total, 565 patients with postoperative DSWI were enrolled in this study from January 1, 2014, to June 1, 2018. Of these patients, 247 received BPMMFs. To address the indicated biases, a 1:1 propensity score-matched cohort was created based on age, body mass index, preoperative diabetes mellitus, chronic obstructive pulmonary disease (COPD), internal thoracic artery grafting (ITAG), type of cardiac surgery, time before treatment for DSWI and wound classification. After matching, 132 patients who had similar risk profiles were enrolled in the study population (66 in the VAC group: 66 in the BPMMF group). Results At 21.9±12.1 (median: 24, IQR: 14-28) months of follow-up, the survival rate was 93.9% in the BPMMF group and 74.4% in the VAC group (P

In contrast to arterial lactate, previous studies have proposed central venous-to-arterial CO2 difference (P (v-a)CO2) as a more useful guide for categorizing patients at risk of developing septic shock. It is worthwhile studying P (v-a)CO2 in determining whether it could serve as a useful predictor for poor postoperative outcomes in patients undergoing cardiac surgery. We investigated the ability of P(v-a)CO2 to predict poor outcomes of patients with postoperative cardiogenic shock.In total, 1,672 patients were enrolled in this study from January 1, 2014 to June 1, 2017. Of these patients, 143 exhibited complicated and poor outcomes. To address any bias, we derived a propensity score predicting the functions of P(v-a)CO2 on poor outcomes and matched 114 cases to 114 controls with a similar risk profile. In this cohort study, poor outcomes were defined as the occurrence of any adverse complications, including sudden death, cardiac arrest, extracorporeal membrane oxygenation, oliguria, and the administration of a large amount of vasoactive-inotropic drugs.In propensity-matched patients, significant differences in P(v-a)CO2 (6.11 ± 2.94 mm Hg vs. 11.21 ± 5.22 mm Hg, P 0.001) were noted between the control group and poor outcome group. The area under the receiver operating characteristic curve of P(v-a)CO2 (AUC: 0.837, 95% CI: 0.782-0.892) for the detection of poor outcomes was significantly better compared to that of the central venous oxygen saturation and arterial lactate. Additionally, there was a negative correlation between cardiac index and P(v-a)CO2 (R= -0.68, P 0.001).We have shown a correlation between P(v-a)CO2 to cardiac output which may be used as an alternative metric to predict the poor outcomes of patients with postoperative cardiogenic shock.

Study objectiveThe purpose of the present study was to evaluate the efficacy of levosimendan in patients with acute myocardial infarction related ventricular septal rupture (AMI-VSR) underwent cardiac surgery.DesignProspective observational cohort study with propensity score analysis.PatientsThere were 261 patients with AMI-VSR in our study. After 1:1 propensity matching, 106 patients (53 levosimendan and 53 control) were selected in the matched cohort.InterventionsNone.MeasurementsPatients who received levosimendan were assigned to the levosimendan group (n = 164). The patients who were not received were levosimendan assigned to the control group (n = 97). The levosimendan was initiated immediately after cardiopulmonary bypass. Then, it has been maintained during the postoperative 3 days. The poor outcomes were identified as follows: death and postoperative complications (postoperative stroke, low cardiac output syndromeneeded mechanical circulatory support after surgery, acute kidney injury (≥ stage III), postoperative infection or septic shock, new developed atrial fibrillation or ventricular arrhythmias).Main resultsBefore matching, the control group had more length of ICU stay (6.69 ± 3.90 d vs. 5.20 ± 2.24 d,p p ConclusionOur study found that a low-dose infusion of levosimendan in AMI-VSR patients underwent surgical repair did not associated with positively affect to postoperative outcomes.

Background Cannulation strategy in surgery for acute type A aortic dissection (ATAAD) remains controversial. We aimed to retrospectively analyze the safety and efficacy of double arterial cannulation (DAC) compared with right axillary cannulation (RAC) for ATAAD. Methods From January 2016 to December 2018, 431 ATAAD patients were enrolled in the study. Patients were divided into DAC group (n = 341) and RAC group (n = 90). Propensity score matching analysis was performed to compare the early and mid-term outcomes between these two groups. To confirm the organ protection effect by DAC, intraoperative blood gas results and cardiopulmonary bypass parameters were compared between the two groups. Results Demographics and preoperative comorbidities were comparable between two groups, while patients in DAC group were younger than RAC group (51.55 ± 13.21 vs. 56.07 ± 12.16 years, P P = 0.063) and lower incidence of coronary malperfusion (5.3% vs. 12.2%, P = 0.019). No significant difference in cardiopulmonary bypass and cross-clamp time was found between the two groups. The in-hospital mortality was 13.5% (58/431), while there was no difference between the two groups (13.5% vs. 13.3%; P = 0.969). Patients who underwent DAC had higher incidence of postoperative stroke (5.9% vs. 0%, P = 0.019) and lower incidence of postoperative acute kidney injury (AKI) (24.7% vs. 40.3%; P = 0.015). During a mean follow-up period of 31.8 (interquartile range, 25–45) months, the overall survival was 81.5% for DAC group and 78.0% for RAC group (P = 0.560). Intraoperative blood gas results and cardiopulmonary bypass parameters showed that DAC group had more intraoperative urine output volume than RAC group (P = 0.05), and the time of cooling (P = 0.04) and rewarming (P = 0.04) were shorter in DAC group. Conclusions DAC will not increase the surgical risks compared to RAC, but could reduce the incidence of postoperative AKI which may be benefit for renal protection.

The peak strain (PS) of sheet metal highly affects the process design and the quality of roll formed product. Different from the traditional roll forming technology (RFT) that all the cross section contours of the product are rolled simultaneously, a symmetric RFT is developed with respect to the corrugated channels under the study to avoid defects like tearing, twist and redundant deformations. The behaviors of their peak strains are subsequently simulated with Finite Element (FE), and the effects of three factors of the rolling speed, friction coefficient and the bending angle of roll are analyzed, respectively. Finally, both the rationality of RFT and the accuracy of final rolled product are verified by experiments. Results show that for two roll forming channels at the same time, even under the equal bending angles and the pressures of rolls, their maximum peak strains are also distinguished for their different channel widths. The maximum PS of the narrow channel is significantly larger than that of the wide, and the closer to the middle channel, the greater the PS of the narrow channel, which is on the right of bending angle of the trough. Moreover, the maximum PS is dominant by the friction coefficient and bending angle of the first forming pass. This can provide a reference in the design of RFT and improving the quality of the final rolled corrugated channels.

A lateral mini-thoracotomy approach to cardiac surgery causes severe and complicated postoperative pain compared to the sternotomy approach. In this study we assessed the benefits and risks of intermittent bolus erector spinae plane block (ESPB) via a catheter for patients who underwent cardiac surgery through a lateral mini-thoracotomy.A propensity score-matched retrospective cohort study.University hospital.452 consecutive patients that underwent cardiac surgery through a lateral mini-thoracotomy from 2018 to 2020.Patients who received intermittent bolus ESPB through a catheter for 3 days (ESPB group, n = 93) were compared with patients who did not receive any regional anesthesia (Control group, n = 174) after propensity score matching.The primary endpoint was postoperative in-hospital cumulative opioid consumption (calculated as oral morphine milligram equivalents, MME). The secondary outcomes were intraoperative sufentanil doses, therapeutic use of antiemetic, pulmonary infection (assessed using a modified clinical pulmonary infection score, CPIS), durations of ICU and hospital stays, and ESPB related/unrelated complications.There is a lower oral MME in the ESPB group, 266 ± 126 mg in the ESPB group vs. 346 ± 105 mg in the control group (95% CI -113 to -46; P 0.01). Fewer patients received therapeutic antiemetic agents in the ESPB group (30% vs. 42%, odds ratio 0.58; 95% CI 0.34 to 0.99; P = 0.04). The modified CPIS in the ESPB group is lower: 1.4 ± 0.9 vs. 2.0 ± 1.0 (95% CI -0.9 to -0.3; P 0.01) on postoperative day 1; 1.6 ± 0.9 vs. 2.0 ± 0.9 (95% CI -0.7 to -0.2; P 0.01) on postoperative day 2. The observed complications associated with ESPB include pneumothorax (1%), staxis around stomas (5%), hypotension (1%), catheter displacement (3%), and catheter obstruction (2%). None of the patients had any adverse outcomes.Intermittent bolus ESPB is relatively safe and correlated with a reduction in the use of opioids and antiemetics for cardiac surgery through a lateral mini-thoracotomy.

Permeability is an important input parameter in evaluating formation validity and predicting deliverability; its value is always estimated from porosity or other formation parameters based on the statistical methods. However, glutenite reservoir permeability prediction faces a great challenge due to the strong heterogeneity. In this study, to establish a reasonable model to predict heterogeneous glutenite reservoir permeability, 483 core samples were recovered from the Permian Jiamuhe Formation, Shawan Depression, northwestern Junggar Basin, China for routine physical property experiments; 21 of them were chosen to apply for laboratory nuclear magnetic resonance (NMR) measurements. After introducing the hydraulic flow unit (HFU) theory, these 483 core samples are classified into eight categories based on the flow zone indicator (FZI) difference, and applicative relationships of core-derived porosity and permeability are respectively established for every type of core sample. Meanwhile, based on the deeply analyzing of the expression of FZI and the classic Timur-Coates permeability-based model, a theoretical model of calculating FZI from NMR data is proposed. The involved input parameters are calibrated by using the experimental data of 21 core samples. After the established models are extended into field applications, the consecutive FZI curve is estimated from NMR logging to classify formations, and the corresponding relationships are used to predict permeability. Comparisons of the predicted FZI and permeability with core-derived results verify the reliability of the proposed models. They can be well used to precisely predict permeability in our target heterogeneous glutenite reservoirs.

BACKGROUND: Deep sternal wound infection (DSWI) is a life-threatening complication after cardiac surgery. The aim of this study was to retrospectively evaluate the outcomes of reconstructing infected poststernotomy wounds with either vacuum-assisted closure (VAC) after previous debridement or bilateral pectoralis major muscle flaps (BPMMFs). METHODS: In total, 565 patients with postoperative DSWI were enrolled in this study from January 1, 2014, to June 1, 2018. Of these patients, 247 received BPMMFs. To address the indicated biases, a 1:1 propensity score-matched cohort was created based on age, body mass index, preoperative diabetes mellitus, chronic obstructive pulmonary disease (COPD), internal thoracic artery grafting (ITAG), type of cardiac surgery, time before treatment for DSWI and wound classification. After matching, 132 patients who had similar risk profiles were enrolled in the study population (66 in the VAC group: 66 in the BPMMF group). RESULTS: At 21.9±12.1 (median: 24, IQR: 14–28) months of follow-up, the survival rate was 93.9% in the BPMMF group and 74.4% in the VAC group (P

Background Heparin-binding protein (HBP), a potent inducer of increased vascular permeability, is a potentially useful biomarker for predicting outcomes in patients with postoperative myocardial injury-related cardiogenic shock (MIRCS). We aimed to evaluate and validate HBP as a prognostic biomarker for postoperative MIRCS. Methods We performed a case-control study in 792 patients undergoing cardiac surgery from January 1, 2016, to August 1, 2019, including 172 patients with postoperative MIRCS and 620 age- and sex-matched controls. The association between HBP and MIRCS was determined by multivariate logistic regression analysis. Receiver operating characteristic curves (ROCs) with area under the curve (AUC) were performed to calculate the cut-off value, sensitivity and specificity. The association between HBP and cardiac troponin T (cTnT) was determined by multivariable linear regression analysis. Blood samples were drawn from the coronary sinus and arterial line of the cardiopulmonary bypass (CPB) before aortic cross-clamping (time point 1) and 5 min after aortic declamping (time point 2). Results Before aortic cross-clamping, coronary sinus HBP (HBPCS1) showed no differences between the two groups. However, after declamping, the MIRCS group had a significantly higher sinus HBP level (HBPCS2) than did the control group. HBPCS2 predicted MIRCS with an AUC of 0.85 (95% CI: 0.81–0.89, cut-off: 220 ng/ml, sensitivity: 92% and specificity: 70%). After adjusting for confounding factors, we found that HBP was an independent risk factor for MIRCS (OR: 7.65, 95% CI: 4.86–12.06, P 0, P Conclusions Elevated levels of coronary sinus HBP were useful biomarkers for predicting MIRCS after cardiac surgery.

Postoperative vasoplegic shock after cardiac surgery seems to be a frequent complication with poor outcomes. We hypothesized that vasopressin may increase the risk of poor outcomes in patients with preoperative Left Ventricular Dysfunction (pLVD) rather than norepinephrine. The aim of this study was to assess whether vasopressin is superior to norepinephrine to improve outcomes in patients with pLVD after cardiac surgery.This retrospective cohort study included 1,156 patients with postoperative vasoplegic shock (mean arterial pressure65 mmHg resistant to fluid challenge and cardiac index2.20 L/min m) and pLVD (left ventricular ejection fraction ≤35%, left ventricular end-diastolic diameter ≥60 mm, New York Heart Association ≥III) from 2007 to 2017. To address any indicated biases, we derived a propensity score predicting the functions of vasopressin (0.02-0.07 U/min) and norepinephrine (10-60 μg/min) on postoperative vasoplegic shock. The primary outcomes were 30-day mortality, mechanical ventilation more than 48 h, cardiac reoperation, extracorporeal membrane oxygenation, stroke, and acute kidney injury, whereas the secondary outcomes included infection, septic shock, atrial fibrillation and ventricular arrhythmias.There were 338 patients (169 vasopressin and169 norepinephrine) with a similar risk profile in propensity score-matched cohort. In propensity-matched patients, the primary outcomes of vasopressin and norepinephrine showed no significant difference (50.89% vs. 58.58%, P = 0.155). However, compared with norepinephrine, secondary outcomes of vasopressin were increased due to the high rate of atrial fibrillation (11.83% vs. 20.12%, P = 0.038) and ventricular arrhythmias (14.20% vs. 24.85%, P = 0.014).Compared with norepinephrine, vasopressin could not improve the postoperative outcomes in patients with pLVD after cardiac surgery. Vasopressin should be cautious to be used as a first-line vasopressor agent in postcardiac vasoplegic shock.

OBJECTIVES Postoperative fluid overload is common in children after cardiac surgery, especially for those with right ventricular outflow tract obstruction, which is associated with poor outcomes. This study was conducted to investigate whether early peritoneal dialysis (PD) was associated with improved outcomes in these children at high risk of fluid overload. METHODS Between January 2010 and January 2015, a total of 2555 consecutive patients with right ventricular outflow tract obstruction underwent anatomical repair. Using empirical risk evaluation, 219 patients at high risk of fluid overload were identified. A propensity score matching was performed to correct the selection bias and identify the comparable patient groups: the early PD group, in whom PD was initiated within 6 h of admission in paediatric ICU, and the control group, without early PD. The mechanical ventilation time, vasoactive-inotropic score and time to negative fluid balance were compared in 45 matched patient pairs (totally 90). RESULTS After propensity matching, there were no statistically significant differences between the 2 groups in terms of demographics and preoperative characteristics. The early PD group had shorter mechanical ventilation time [median 49 h, interquartile range (IQR) 31-97 h vs median 76 h, IQR 55-166 h; P

IntroductionPostoperative infection (PI) is one of the main severe complications after cardiovascular surgery. Therefore, antibiotics are routinely used during the first 48 hours after cardiovascular surgery. However, there is no effective method for early diagnosis of infection after cardiovascular surgery, particularly, to determine whether postoperative patients need to prolong the use of antibiotics after the first 48 hours. In this study, we aim to develop and validate a diagnostic model to help identify whether a patient has been infected after surgery and guide the appropriate use of antibiotics.Methods and analysisIn this prospective study, we will develop and validate a diagnostic model to determine whether the patient has a bacterial infection within 48 hours after cardiovascular surgery. Baseline data will be collected through the electronic medical record system. A total of 2700 participants will be recruited (n=2000 for development, n=700 for validation). The primary outcome of the study is the newly PI during the first 48 hours after cardiovascular surgery. Logistic regression penalised with elastic net regularisation will be used for model development and bootstrap and k-fold cross-validation aggregation will be performed for internal validation. The derived model will be also externally validated in patients who are continuously included in another time period (N=700). We will evaluate the calibration and differentiation performance of the model by Hosmer-Lemeshow good of fit test and the area under the curve, respectively. We will report sensitivity, specificity, positive predictive value and negative predictive value in the validation data-set, with a target of 80% sensitivity.Ethics and disseminationEthical approval was obtained from Medical Ethics Committee of Affiliated Nanjing Drum Tower Hospital, Nanjing University Medical College (2020-249-01).Trial registration numberChinese Clinical Trial Register (www.chictr.org.cn, ChiCTR2000038762); Pre-results.

Background Extracorporeal membrane oxygenation offers temporary hemodynamic support for patients with refractory cardiogenic shock after cardiovascular surgery. However, the initiation time for such patients is controversial. Changing the initiation time might improve the outcomes. This study aimed to investigate whether early extracorporeal membrane oxygenation could improve postoperative outcomes in patients at a high risk of cardiogenic shock. Methods In this retrospective study, 173 patients with cardiovascular diseases at a high risk of refractory cardiogenic shock which assessed via empirical risk evaluation from 2010 to 2017 were included. After propensity matching, 36 patients, who were matched to patients initiated with extracorporeal membrane oxygenation after cardiovascular operation (delayed extracorporeal membrane oxygenation group, n = 36), were also initiated with such early in the operating room (early extracorporeal membrane oxygenation group, n = 36). The primary outcome was death. The secondary outcomes included receiving continuous renal replacement therapy, ventricular arrhythmia, and pulmonary infection. Results The demographic and baseline variables were similar between the matched groups. The early extracorporeal membrane oxygenation group showed lower mortality (69.44% vs 41.67%, P = 0.03), pulmonary infection morbidity (86.11% vs 55.56%, P

The Chepaizi Bulge of the Junggar Basin contains large-scale fault-controlled petroleum reservoirs in the Carboniferous igneous rock basement. Breccia, tuffaceous breccia, andesite, basalt, and tuff are the major lithology of the igneous rocks, and the major hydrocarbon accumulation was found in the volcanic breccia, andesite, and basalt reservoirs. The types of igneous rocks were predicted by their different logging responses, and were differentiated in the plot of acoustic versus gamma ray loggings when the core is not available. Secondary dissolution pores and fractures (primary tectonic fractures) were the major reservoir spaces. Fractures mainly occurred within 250 m below the top surface of the Carboniferous system. The fractures formed in the early, middle and late stages with different causes were identified. The reservoirs were dominated by mesopores with excessively low permeability, and the volcanic breccia reservoirs exhibited higher porosity (2.0%–16.31%, averages at 7.95%) and permeability (0.01 md–3.13 md, average at 0.11 md) than the basalt–andesite reservoirs (averages at 5.8% and 0.07md) on the whole. Volcanic breccia samples show larger average throat radius, average capillary radius and maximum connected throat radius compared with the basalt samples. The major oil accumulation is mainly distributed along faults, because there is more reservoir space and superior oil migration channels as a result of the induced fractures. Diagenetic cements including minerals of carbonate, clay, zeolite, serpentine, and quartz, were commonly observed in the fault zone, and these types of diagenetic cementation are crucial to the fault sealing, and are of great significance in the formation of large igneous rock reservoirs.

Background Heparinized solution (HS) use for the maintenance of arterial cannulas has been associated with coagulation disorders and has not been conclusively shown to confer additional benefits over normal saline (NS) alone. We tested the hypothesis that in adult patients admitted to the cardiac ICU (T0) after cardiac surgery, HS arterial cannulas might be independently associated with increased heparin-induced coagulation disorders and might not be superior to NS arterial cannulas in reducing arterial cannula occlusion. Methods In this cohort study, 170 patients who received NS arterial cannulas during the period from T0 to ICU discharge were included in this study from June 1, 2017, to May 1, 2018 (NS group). There were 2930 patients who used HS (2.5 U/ml) arterial cannulas from January 1, 2015, to December 31, 2016 (heparin group). To address indicated biases, we derived a propensity score that predicted the functions of NS and HS in the patency of arterial cannulas. Results There were 296 patients (148 in the NS group and 148 in the heparin group) with similar risk profiles in the propensity-score matched cohorts. In the propensity-matched patients, the duration of arterial cannulas (P = 0.4) and arterial cannula occlusion (P = 0.5) showed no differences between the NS and heparin groups. However, the heparin group had a significantly increased activated clotting time (P

AIM: To observe and assess the efficacy and safety of conjunctival papilla grinding technique in the treatment of severe vernal keratoconjunctivitis(VKC)with giant conjunctival papilla. METHODS: The prospective and controlled study was performed in 17 patients(24 eyes)with VKC. Eight patients(12 eyes)with giant conjunctival papillae were treated with grinding technique and 9 patients(12 eyes)were performed with conjunctival papillectomy, respectively. A comparison was made on the changes of symptoms including itching, tearing, light sensitivity and grittiness and physical signs of conjunctival papilla and the corneal epithelium before and after surgery.RESULTS:The symptoms and signs in the first week, the second week and the forth week after the operation were obviously improved in the two groups, and differences in these aspects before and after surgery were of statistical significance(P<0.01). However, by grading of the signs of huge conjunctival nipple in the first week, the second week and the forth week after the operation, and conditions of repair of corneal damage in the second postoperative week, the result showed that efficacy of the grinding group was better than that of the surgical removal group(PCONCLUSION:Conjunctival nipples grinding operation can make the rough conjunctival wound flat quickly, relieve symptoms, and promote the repair of keratoconjunctival epithelium. And it is an effective, safe, and simple method to treat the severe VKC with huge conjunctival nipples.

Transscleral suturing is a commonly applied technique to fix intraocular implants in the sulcus. A major problem after transscleral implantation is suture erosion that normally happens in the late post-surgery period and may result in an increased incidence of endophthalmitis. Here we describe an original cauterization method by using a glass rod to melt the exposed suture end without damaging the suture knot in the sclera to avoid suture exposure in sclera-fixed IOL implantation. This is a simple, quick and effective technique that can be performed without conjunctiva incisions and will help to reduce suture erosion related complications.