Surgical treatment for aortic periannular abscess / 中国胸心血管外科临床杂志

@#Objective    To summarize the clinical data and efficacy of surgical treatment of aortic periannular abscess. Methods    The clinical data of 35 aortic periannular abscess patients admitted to our hospital from January 2009 to June 2019 were retrospectively analyzed, including 21 males and 14 females, aged 36 to 67 (53.0±12.3) years. Among them, there were 14 patients of native aortic valve endocarditis and 21 patients of prosthetic valve endocarditis (16 patients of mechanical valve and 5 patients of biological valve). Preoperative blood cultures were positive in 15 patients, including 8 patients of Staphylococcus aureus, 2 patients of Staphylococcus epidermidis, 3 patients of Streptococcus grass green, 1 patient of Pseudomonas aeruginosa, and 1 patient of Enterococcus. Results    Eleven patients underwent emergency or urgent surgery. Thirty patients underwent aortic valve replacement, and 5 patients underwent modified Cabrol surgery to replace the aortic root. Early postoperative complications included 1 patient of bleeding, 8 patients of low cardiac output syndrome, 5 patients of renal insufficiency, 10 patients of respiratory insufficiency, 3 patients of tracheotomy, 8 patients of pulmonary infection and 1 patient cerebrovascular accident. The postoperative follow-up period was 6 to 120 (53.6±20.8) months. During the follow-up, 4 patients died and 4 patients were lost. No infection recurred during the follow-up. Perivalval leakage occurred in 3 patients, and one patient underwent occlusion 12 months following the procedure. The survival curve indicated that the 1-year survival rate was 85.5%, and the 5-year survival rate was 67.3%. Conclusion    Although the lesions of periannular abscesses are complicated and critical, effective perioperative antibiotic treatment, individualized surgical timing, and appropriate surgical strategies can significantly reduce mortality and achieve better results.

A uniqueness-and-anonymity-preserving remote user authentication scheme for connected health care.

Connected health care provides new opportunities for improving financial and clinical performance. Many connected health care applications such as telecare medicine information system, personally controlled health records system, and patient monitoring have been proposed. Correct and quality care is the goal of connected heath care, and user authentication can ensure the legality of patients. After reviewing authentication schemes for connected health care applications, we find that many of them cannot protect patient privacy such that others can trace users/patients by the transmitted data. And the verification tokens used by these authentication schemes to authenticate users or servers are only password, smart card and RFID tag. Actually, these verification tokens are not unique and easy to copy. On the other hand, biometric characteristics, such as iris, face, voiceprint, fingerprint and so on, are unique, easy to be verified, and hard to be copied. In this paper, a biometrics-based user authentication scheme will be proposed to ensure uniqueness and anonymity at the same time. With the proposed scheme, only the legal user/patient himself/herself can access the remote server, and no one can trace him/her according to transmitted data.