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Don’t forget emergency surgery! Lessons to learn from elective indocyanine green-guided gastrointestinal interventions

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World Journal of Gastrointestinal Surgery 2024年第2期16卷 270-275页

作者： Davina Perini Jacopo Martellucci Department of Emergency Emergency and Minimally Invasive Surgery UnitCareggi University HospitalFirenze 50041Italy

Fluorescence-based imaging has found application in several fields of elective surgery,but there is still a lack of evidence in the literature about its use in the emergency *** trials have consistently shown that indocyanine green(ICG)-guided surgery can dramatically reduce the risk of postoperative complic-ations,length of in-hospital stay and total healthcare costs in the elective *** is well-known that emergency surgery has a higher complication rate than its elective counterpart,therefore an impelling need for research studies to explore,validate and develop this issue has been *** present editorial aims to provide a critical overview of currently available applications and pitfalls of ICG fluorescence in abdominal ***,we evidenced how the experience of ICG-fluorescence in elective surgery might be of great help in implementing its use in acute *** the first paragraph we analyzed the tips and tricks of ICG-guided cancer surgery that might be exploited in acute *** then deepened the two most described topics in ICG-guided emergency surgery:Acute cholecystitis and intestinal ischemia,focusing on both the advantages and limitations of green-fluorescence application in these two *** emergency situations,ICG fluorescence demonstrates a promising role in preventing undue intestinal resections or their entity,facilitating the detection of intestinal ischemic zones,identifying biliary tree anatomy,reducing post-operative complications,and mitigating high mortality *** need to improve its application still exists,therefore we strongly believe that the elective and routinary use of the dye is the best way to acquire the necessary skills for emer-gency procedures.

关键词： Indocyanine green Fluorescence Navigation surgery Angiography Emergency surgery Decision-making

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Consensus on glycemic management for patients with coronary heart disease and type 2 diabetes

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Journal of Geriatric Cardiology 2024年第7期21卷 689-702页

作者： Li-Nong JI Yun-Dai CHEN cardiovascular Subcommittee of Chinese International Exchange and Promotion Association for Medical and Healthcare

The prevalence of patients with coronary heart disease(CHD)and diabetes mellitus is notably high,posing sig-nificant residual cardiovascular risks even after routine interventions such as antihypertensive,lipid-lowering,and antithrombot-ic *** studies have demonstrated that certain glucose-lowering medications confer cardiovascular benefits for pa-tients with type 2 ***,a survey indicates that cardiologists may not be fully acquainted with the optimal screen-ing timing,indicators,and diagnostic criteria for type 2 diabetes,and there is insufficient awareness and a low rate of prescrip-tion of novel glucose-lowering medications with proven cardiovascular efficacy,such as glucagon-like peptide-1 receptor agon-ists(GLP-1 RAs)and sodium-glucose co-transporter-2 inhibitors(SGLT-2i).In this context,based on domestic and international guidelines or consensus and the latest evidence-based evidence,this consensus aims to standardize the glycemic management for patients with acute coronary syndrome,chronic coronary syndrome,and perioperative management for percutaneous coronary *** highlights the key points of screening and diagnosis of type 2 diabetes,and the comprehensive management of cardiovascular risk in patients with *** consensus elaborates on the principles and algorithms of glycemic management for CHD patients,without involving acute complications of diabetes,clarifies the clinical practice of glucose-lowering medications with cardiovascular benefits,and promotes the standardized use of these medications in cardiovascular and other related spe-cialty ***,it addresses the glucose-lowering treatment to comprehensively reduce cardiovascular risks.

关键词： coronary patients routine

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Influencing Factors on cardiovascular Health in China

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Journal of Geriatric Cardiology 2024年第1期21卷 4-33页

作者： Sheng-Shou HU 无 Fuwai Hospital Chinese Academy of Medical Sciences BeijingChina the Writing Committee of the Report on cardiovascular Health and Diseases in China

The Annual Report on cardiovascular Health and Diseases in China(2022)intricate landscape of cardiovascular health in *** is the first section of the report,which dissects influential factors across diverse *** investigation identifies tobacco use as a paramount concern,portraying China as the global epicenter of tobacco *** smoking,exacerbated by second-hand smoke exposure,emerges as a critical and preventable risk factor,contributing to a surge in attributable deaths over the past three *** the realm of dietary nutrition,the study discerns an overall improvement,yet discerns worrisome deviations,notably an escalating fat intake surpassing recommended *** shifting dietary structure reveals diminished consumption of cereals and vegetables juxtaposed with an uptick in animal foods,while excessive intake of cooking oil and salt persists,straying substantially from endorsed *** exploration of physical activity patterns unfolds a nuanced *** trends are observed among students,with concerns arising from sedentary behaviors and inadequate adherence to recommended *** analysis spans a trajectory of declining physical activity in Chinese adults,coupled with an alarming surge in sedentary leisure time,ultimately linking these factors to heightened risks of cardiovascular diseases and increased *** examination of overweight and obesity trends uncovers a relentless upward trajectory,projecting substantial prevalence by *** prevalence rates underscore the imperative for targeted interventions to curtail this burgeoning health crisis,with the anticipated prevalence extending to nearly two-thirds of the adult *** factors,notably depression,constitute an integral facet of cardiovascular *** rates among patients with coronary artery disease and acute myocardial infarction underscore the intricate interplay between mental health and cardiovascular

关键词： Influencing smoke linking

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cardiovascular Risk Factors in China

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Journal of Geriatric Cardiology 2024年第2期21卷 153-199页

作者： Sheng-Shou HU the Writing Committee of the Report on cardiovascular Health and Diseases in China Fuwai Hospital National Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina 不详

The Annual Report on cardiovascular Health and Diseases in China(2022) intricate landscape of cardiovascular health in China. This section dissects cardiovascular risk factors in China which including hypertension, dyslipidemia, diabetes mellitus, chronic kidney disease, metabolic syndrome and air pollution. Hypertension prevalence has steadily increased in China,with efforts to control it facing challenges in achieving optimal rates, especially in rural areas. interventions like salt substitutes and intensive blood pressure control show promise but need improvement. Abnormal lipid levels, indicative of dyslipidemia,have risen significantly, posing a risk for cardiovascular diseases. Despite efforts, many patients struggle to achieve target lipid levels, necessitating improved treatment strategies. Both type 1 and type 2 diabetes mellitus affect millions of adults in China,with long-term complications adding to the disease burden. Early intervention and effective management are crucial to mitigate its impact. Prevalent among older adults, chronic kidney disease is associated with diabetes mellitus, hypertension, and cardiovascular diseases, necessitating comprehensive management approaches. The prevalence of metabolic syndrome, characterized by a cluster of risk factors, has increased in both adults and adolescents, calling for lifestyle modifications and public health interventions. Ambient and household air pollution remain significant environmental risk factors, despite some improvements in air quality. Continued efforts to reduce emissions are essential for mitigating associated health risks. Addressing these risk factors requires a multifaceted approach, including public health initiatives, policy interventions, and individual-level strategies to promote healthy lifestyles and reduce environmental exposures. Surveillance and research efforts are crucial for monitoring trends and developing effective strategies to lessen the burden of cardiovascular diseases in

关键词： landscape adding spite

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纳米材料助力合成生物学的生物医学应用

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Science China Materials 2024年第7期67卷 2051-2066页

作者：雷琪赵一帆刘双语肖雅方杨芳郭伟圣顾宁 Department of Minimally invasive Interventional Radiology School of Biomedical Engineering&The Second Affiliated HospitalGuangzhou Medical UniversityGuangzhou 510260China State Key Laboratory of Digital Medical Engineering Jiangsu Key Laboratory for Biomaterials and DevicesSchool of Biological Science and Medical EngineeringSoutheast UniversityNanjing 210096China cardiovascular Disease Research Center Nanjing Drum Tower HospitalAffiliated Hospital of Medical SchoolMedical SchoolNanjing UniversityNanjing 210093China

合成生物学是借助基因工具改造活细胞和生物体的学科,其经历了蓬勃发展阶段,在生物医学领域得到广泛应用,包括新型生物传感器和生物材料设计,以及最新临床治疗药物和疫苗的开发.纳米材料具有独特的物理、化学和生物特性,在拓展合成生物... 详细信息

合成生物学是借助基因工具改造活细胞和生物体的学科,其经历了蓬勃发展阶段,在生物医学领域得到广泛应用,包括新型生物传感器和生物材料设计,以及最新临床治疗药物和疫苗的开发.纳米材料具有独特的物理、化学和生物特性,在拓展合成生物学的生物医学应用场景上具有巨大的潜力,可以提高治疗剂的生产效率,并增强改造生物体的功能.在此,我们简要概述了纳米材料应用于合成生物学领域的最新进展,主要涵盖纳米材料作为递送载体、信号转导器和功能增强剂的角色及其制备过程和性能特点.本综述首先强调了纳米材料作为基因载体的最新成果,包括有机、无机和仿生递送系统;其次,回顾了纳米材料介导的刺激响应型基因表达调控的研究;第三,总结了在可编程的杂化生物活性材料方面的开创性工作,包括纳米材料/细菌杂合系统和纳米材料/哺乳动物细胞杂合系统;最后,讨论了该领域当前面临的挑战,并从个人观点展望了未来的发展前景.

关键词： synthetic biology nanomaterials gene circuit carriers signal transductors hybrid systems

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Role of intravascular ultrasound and optical coherence tomography in intracoronary imaging for coronary artery disease:a systematic review

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Journal of Geriatric Cardiology 2024年第1期21卷 104-129页

作者： Maruf Sarwar Stephen Adedokun Mahesh Anantha Narayanan Department of cardiovascular Sciences White River HealthBatesvilleARUSA Division of Cardiology University of Tennessee at MemphisTNUSA University of Arkansas Medical Sciences Little RockARUSA

Coronary angiography has long been the standard for coronary imaging,but it has limitations in assessing vessel wall anatomy and guiding percutaneous coronary intervention(PCI).Intracoronary imaging techniques like intravascular ultrasound(IVUS)and optical coherence tomography(OCT)can overcome these *** uses ultrasound and OCT uses near-infrared light to visualize coronary pathology in unique ways due to differences in temporal and spatial *** techniques have evolved to offer clinical utility in plaque characterization and vessel assessment during ***-analyses and adjusted observational studies suggest that both IVUS and OCT-guided PCI correlate with reduced cardiovascular risks compared to angiographic guidance *** IVUS demonstrates consistent clinical outcome benefits,OCT evidence is less *** has progressed from early motion detection to high-resolution systems,with smaller compatible *** utilizes near infrared light to achieve unparalleled resolutions,but requires temporary blood clearance for optimal *** visualization and guidance make IVUS and OCT well-suited for higher risk PCI in patients with diabetes and chronic kidney disease by allowing detailed visualization of complex lesions and ensuring optimal stent deployment and positioning in PCI for patients with type 2 diabetes and chronic kidney disease,improving *** and recent advancements in zero-and low-contrast OCT techniques can reduce nephrotoxic contrast exposure,thus helping to minimize PCI complications in these high-risk patient *** and OCT provide valuable insights into coronary pathophysiology and guide interventions precisely compared to angiography *** have comparable clinical outcomes,emphasizing the need for tailored imaging choices based on clinical *** refinement and integration of intravascular imaging will likely play a pivotal role in optimizing coronary interventions and outcomes.

关键词： coronary anatomy limitations

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Local drug-delivery balloon for proliferative occlusive in-stent restenosis after drug-eluting stent

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Journal of Geriatric Cardiology 2011年第1期8卷 65-66页

作者： Gianluca Rigatelli Paolo Cardaioli Fabio Dell＇Avvocata Massimo Giordan cardiovascular diagnosis and Endoluminal interventions unit Rovigo General Hospital 45100 Rovigo Italy

药涂的汽球为 in-stent 狭窄作为 drug-eluting stents 的一种选择被开发了，但是在如此的背景的药注入汽球的表演以前没被描述。我们在场在与药注入汽球的一种新类型对待的药 eluting stent 培植以后的特别地好攻击的 in-stent 狭窄的... 详细信息

药涂的汽球为 in-stent 狭窄作为 drug-eluting stents 的一种选择被开发了，但是在如此的背景的药注入汽球的表演以前没被描述。我们在场在与药注入汽球的一种新类型对待的药 eluting stent 培植以后的特别地好攻击的 in-stent 狭窄的一个盒子发展了以便克服不可能为几膨胀使常规药涂的汽球膨胀。

关键词：药物输送再狭窄支架气球涂层增殖性闭塞洗脱

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Brachial access technique for aortoiliac stenting revisited

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Journal of Geriatric Cardiology 2007年第2期4卷 78-79页

作者： Gianluca Rigatelli Paolo Cardaioli Fabio dell'Avvocata Massimo Giordan cardiovascular invasive diagnosis and interventions unit Rovigo General Hospital Rovigo Italy

We report a modified technique to perform iliac artery stenting through the brachial artery access. A 6F Brite tip sheath (Cordis, Jonhson & Jonhson Medical, Miami Lakes, FL, USA) is inserted into either brachial artery and a standard 4F Judkins Right diagnostic catheter was inserted over a 260 cm 0.038” Terumo Stiff wire (Terumo Corp, Tokyo, Japan) through the sheath. The catheter is navigated down to the aortic bifurcation, and after selecting the common iliac artery ostium, the wire is navigated through the lesion and advanced to the ipsilateral superficial femoral arteries. The catheter should be then moved forward over the wires beyond the lesion and the Terumo guidewire is replaced by two 0.038” 260 cm Supracor wires (Boston Scientific Corporation, San Jose, CA, USA). In order to facilitate advancement of the stent without risk of dislodgement as well as to check the position with low contrast dose injection, a 6 F (or 7F if large stent is selected) 90cm Shuttle Flexor introducer long sheath (Cook Group, Bloomington, IN, USA) should be advanced over the Supracor wire until it reaches the common iliac artery ostium. A road-map technique can be used to check the ostium position in order to properly deploy the selected stent. This technique promises to be safe and effective offering more support than guiding catheter technique; moreover it reduces the stress on the arterial vessel at the subclavian site and enables a stiff balloon or stent catheter to be advanced even through a very elongated and calcified aorta without the risk of stent dislodgement.

关键词： brachial access percutaneous angioplasty stent endovascular peripheral vascular disease

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Congenital coronary artery-left ventricle direct micro-fistulas may cause effort angina and positive stress tests in Western adults

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Journal of Geriatric Cardiology 2016年第1期13卷 94-96页

作者： Gianluca Rigatelli Fabio Dell'Avvocata Massimo Giordan Paolo Cardaioli cardiovascular diagnosis and Endoluminal interventions unit Rovigo General Hospital Rovigo Italy

Coronary artery anomalies (CAAs) occur in 0.64 % to 5.6% of patients undergoing coronary angiography. Most pathophysiology and clinical histories involving CCAs have been fully clarified in the past 30 years. Isolated congenital coronary artery-left ventricle direct microfistulas (CVmF) have been recently described, but the clinical significance and anatomical characteristics associated with this rare type of CAA in a western population are still unclear. The aim of our retrospective, single center study is to assess the clinical significance and anatomical features associated with this anomaly in a western population.

关键词：先天的心疾病冠的动脉 angiography 冠的动脉异例

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Chinese Expert Consensus on Microvascular Protection Strategy During Emergency Percutaneous Coronary Intervention Therapy in Patients With ST-elevation Myocardial Infarction

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Cardiology Discovery 2024年第1期4卷 5-14页

作者： Chinese Society of Cardiology,Chinese Medical Association Editorial Board of Chinese Journal of Cardiology Muwei Li Yabin Wang Yaling Han Yun Zhang Feng Cao 不详 Fuwai Central China cardiovascular Hospital Chinese People’s Liberation Army General Hospital General Hospital of Northern Theater Command Qilu Hospital of Shandong University

Microcirculatory dysfunction(CMD)typically occurs in patients with acute ST-segment elevation myocardial infarction during percutaneous coronary intervention,which is associated with more severe myocardial injury and a worse *** the advancement of intracoronary physiology and imaging technology,the prevention and therapeutic interventions of CMD have attracted more ***,relevant guidelines or consensus on CMD are lacking in *** current consensus summarizes the prevention and diagnostic strategies of emergency percutaneous coronary intervention-related CMD and gives suggestions to improve the prognosis of ST-segment elevation myocardial infarction patients based on evidence from recent clinical studies,guidelines,and consensus from international sources.

关键词： Myocardial infarction Microcirculation dysfunction Percutaneous coronary intervention

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