Daily average temperature data from 48 meteorological stations in Chinese oases that are within the distribution area of Populus euphratica were analyzed to determine the spatiotemporal responses of this tree to climate change. Specifically, the start and end date as well as the number of days that comprised the growing season were analyzed with a multi-year trend line and using the Mann-Kendall mutation test, inverse distance weighted interpolation (IDW) in the software ArcGIS, a Morlet wavelet power spectrum, and correlation analysis. The results of this study show that, over the last 56 years, the start date of the P. euphratica growing season has advanced, while the end date has been postponed, and the number of days that comprise the growing season have gradually increased. The changing trend rates recovered in this analysis for these three time slices are-1.34 d/10 a, 1.33 d/10a, and 2.66 d/10a (α ≥ 0.001), respectively. Data show that while spatial disparity is extremely significant, it is nevertheless the case that along a southwest-to-northeast transect of Chinese oases, the later the start date of the P. euphratica season, the sooner the end data and the shorter the growing season. Mutations points in start and end date, as well as for the growing season overall were observed in 2001, 1989, and 1996, respectively, and the data presented in this paper show that, in particular, the date of this end of this period is most sensitive to climate warming. Growing season cycles for P. euphratica are between 3.56 years and 7.14 years, consistent with the periodicity of El Niño events, while a start date cycle between 3.56 years and 4.28 years is consistent with atmospheric circulation cyclicity. The causal analysis presented in this paper shows that the Asian polar vortex area index (APVAI), the Qinghai-Tibet Plateau index (TPI), the westerly circulation index (WCI), and carbon dioxide emissions (CDE) are the main factors influencing spatiotemporal changes in the growth of P. euphratica, the effect of latitude during the growing season is more significant than altitude, and the start date of the growing season is more significantly influenced by these factors than end date. In addition, data show that the start date, end date, and length of the growing season are all significantly correlated with their average corresponding monthly temperature (corre-580 Journal of Geographical Sciences lation coefficients are-0.875, 0.770, and 0.897; α≥0.001). Thus, if the average temperature in March increases by 1℃, the start date of the growing season will advance by 2.21 days, while if the average temperature in October increases by the same margin then the seasonal end date will be delayed by 2.76 days. Similarly, if the average temperature between March and October increases by 1℃, the growing season will be extended by 7.78 days. The results of this study corroborate the fact that changes in the P. euphratica growing are sensitive to regional warming and are thus of considerable theoretical significance to our understand...
Background Mitral valve replacement with the total leaflet preservation technique can yield good results; however, its development is limited by patient-valve mismatch. Therefore, we compared the efficacies of the modified total leaflet preservation technique, posterior leaflet preservation technique, and no leaflet preservation technique in mitral valve replacement. Methods Clinical records and echocardiographic data of 180 patients who underwent mitral valve replacement for rheumatic mitral valve disease between 2009 and 2017 were analysed retrospectively to summarise the operative experience and short-term (six months) results. The patients were divided into three groups: group A ( n = 62), treated with the modified total leaflet preservation technique; group B ( n = 80), treated with the posterior leaflet preservation technique; and group C ( n = 38), treated with the no leaflet preservation technique. Results No significant difference in the preoperative clinical data was noted between the groups ( p > 0.05). The clamp and recovery times of group A were longer ( p < 0.05) and shorter ( p < 0.05), respectively, than those of groups B and C. The postoperative left ventricular end-diastolic diameter, left ventricular end-systolic diameter, and left ventricular ejection fraction of group A were significantly better than those of groups B and C. The incidence of low cardiac output syndrome in group A was lower than that in group C ( p < 0.05). There was no postoperative left ventricular posterior wall rupture or mechanical valve dysfunction in group A. Conclusions The short-term results of the modified total leaflet preservation technique were better than those of the other techniques. This technique is also suitable for patients with rheumatic mitral valve stenosis.
Background Bilateral internal mammary artery (BIMA) grafting has a good long-term survival rate and graft patency rate, but it is only recommended in young patients due to its high technical requirements and high incidence of sternal complications. Previous studies indicated that BIMA grafting has a significant benefit in patients aged 50–59 years, but this benefit does not extend to patients aged > 60 years. Thus, this study was designed to analyse the immediate artery graft function, short-term (3 months) results, and experience in preventing sternal complications for BIMA grafting in elderly patients (60–75 years old). Methods Clinical records and echocardiographic and coronary artery computed tomography angiography data of 155 patients who underwent BIMA grafting for coronary artery disease between 2015 and 2017 in our hospital were analysed retrospectively to summarise the operative experience and short-term (3 months) results. Patients were divided into two groups: Group A (n = 95), aged < 60 years and Group B (n = 60), aged 60–75 years. The operation time, aortic clamp time, and cardiopulmonary bypass time of these two groups were compared to analyse the operation difficulty and the flow and pulsatility index were compared to analyse the immediate artery graft function. The left ventricular end-diastolic dimension (LVEDD) and left ventricular ejection fraction (LVEF) of these two groups were compared to analyse heart function. Results There were no significant differences in the operation time, aortic clamp time, and cardiopulmonary bypass time as well as the flow and pulsatility index between these two groups (P > 0.05). There was no significant difference in the incidence of sternal wound complications, graft occlusion, and other common complications 3 months post-BIMA grafting between these two groups (P > 0.05). Furthermore, there was no significant difference in LVEDD and LVEF between the groups 3 months post-operation (P > 0.05). Conclusions BIMA grafting was safe and effective for older patients (60–75 years). Similar to younger patients (< 60 years), BIMA grafting in elderly patients (60–75 years) can also achieve a satisfactory short-term (3 months) result. Thus, advanced age (60–75 years) should not be a contraindication for BIMA grafting.
Background: As one of the most common cardiac manifestations of systemic lupus erythematous (SLE), Libman-Sacks (LS) endocarditis is a nonbacterial form of thrombotic endocarditis characterized by sterile vegetations deposited on heart valves consisting of fibrin mixed with immune complexes and platelets. Although patients with LS endocarditis usually have no significant valvular disease, persistent LS endocarditis may be complicated by bacterial endocarditis, leading to serious complications, including acute valve regurgitation, acute heart failure, and even cardiogenic shock, which are rare in pregnant patients. Therefore, such patients with atypical SLE manifestations combined with various complications deserve more attention. Case presentation: We reported a rare case of a pregnant patient without an SLE history who progressed to cardiogenic shock resulting in a preterm birth. After the delivery of the fetus, it was considered that the patient had bacterial endocarditis according to the results of lab tests and echocardiography. LS endocarditis was also found after surgery. Moreover, SLE with catastrophic antiphospholipid syndrome (CAPS) was also confirmed during the course of treatment. Finally, the combined use of methylprednisolone and human immunoglobulin injection was carried out, the patient’s condition improved, and she was discharged on the 13th postoperative day. Conclusion: The interference of infective endocarditis with the type of preexisting lesion in the disease process can influence our judgment and treatment decisions, which is worth noting.
Background: Delirium is a common postoperative complication of acute type an aortic dissection, which is a serious threat to the patient's life after operation. However, there are many risk factors for delirium and there are different conclusions. The aim of this study was to systematically analyze the risk factors for postoperative delirium in patients with acute type a aortic dissection by means of meta-analysis. Methods: Literature related to the risk factors of postoperative delirium in patients with acute type A aortic dissection was searched via the China National Knowledge Infrastructure (CNKI), cqvip.com (VIP), WanFang, PubMed, Willey Library, Embase, and Web of Science databases. Two persons independently conducted literature screening, data extraction and literature quality evaluation according to the inclusion and exclusion criteria. The quality of literature was evaluated with Newcastle-Ottawa Scale (NOS). R 4.2.1 was used to compare the risk factors for meta-analysis.Results: After screening, 12 articles were included with a total of 2,511 cases, and 4 articles were at medium risk of bias and 8 articles were at low risk of bias. The meta-analysis results showed that patients in the delirium group had a higher probability of postoperative hypoxemia [odds ratio (OR) =1.65, 95%
Background As one of the most common cardiac manifestations of systemin lupus erythematous (SLE), Libman-Sacks (LS) endocarditis is a non-bacterial form of thrombotic endocarditis characterized by sterile vegetations deposited on heart valves consisting of fibrin mixed with immune complexes and platelets. Although patients with LS endocarditis usually have no significant valvular, persistent LS endocarditis may be complicated by bacterial endocarditis, leading to serious complications including acute valve regurgitation, acute heart failure, and even cardiogenic shock, which were rare in maternal. Therefore, such case with atypical SLE manifestations combining with various complications deserves more attention. Case presentation We reported a rare case of a maternal without SLE history who progressed to cardiogenic shock resulting in preterm. After delivery of fetus, she was considered as bacterial endocarditis according to the results of lab tests and echocardiography. Then, LS endocarditis was also found after surgery. Moreover, SLE with catastrophic antiphospholipid syndrome (CAPS) was also confirmed during the course of treatment. Finally, Combined use of methylprednisolone and human immunoglobulin injection was carried out and the patient’s condition improved and discharged on the 13th post-operative day. Conclusion The interference of infective endocarditis with the type of pre-existing lesion in the disease process can influence our judgement and treatment decisions, which is worth noting.
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