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Objective To investigate the antithrombotic therapy for acute myocardial infarction patients after PCI stenting combined with tricuspid valve repair. Methods The risk of bleeding and embolization was evaluated, relevant data were reviewed, professional knowledges of pharmacy were utilized through the whole treatment process, individualized medication plan for patients was designed and used. Results A better therapeutic effect was achieved through the implementation of pharmaceutical care and medication education to the patients. Conclusion Clinical pharmacists carry out pharmaceutical care in antithrombotic drugs utilities,which could improve the safety level of drug use and provide basis for clinical rational drug use.
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Magnetic resonance imaging (MRI) is a technology with no radiation and high resolution of soft tissues. Therefore, MRI-guided radiotherapy has become a hot spot in the field of radiotherapy. It is of great importance to accurately delineate the targets in radiation oncology. Currently, the delineation of targets is mostly completed by manual segmentation, which is time-consuming, subjective and inconsistent. Automatic segmentation can improve the efficiency and consistency without sacrificing the accuracy of segmentation. In this article, the automatic segmentation methods of MRI applied in radiotherapy were reviewed. The goals, challenges and methods of automatic segmentation for different radiotherapy sites including prostate, nasopharyngeal carcinoma, brain tumors and other organs were analyzed and discussed.
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Objective:To explore the volume resolution of prostate motion target by four-dimensional (4D) ultrasound.Methods:The prostate ultrasound model was selected, and the group comparison study was conducted using 4D ultrasound to outline the prostate target under different motion amplitudes (A) and motion period (T). The simulated A value was set as 0.5 mm, 1 mm, 2 mm, 3 mm, 4 mm, and 5 mm, respectively. The T value was set as 1 s, 2 s, 3 s, and 4 s, respectively. The volume of the target of the model prostate was calculated, and the static ultrasound image of the target was used as the control group to analyze the difference between two groups.Results:When the model was still, the size of the target of ultrasound was consistent with that of CT scan ( P>0.05). When the A values were 0.5 mm and 1 mm, there was no statistical difference between the volume in period 1-4 s and the volume in the target at rest (all P>0.05). When the A values were 2 mm and 3 mm, and the T values were 1 s, 2 s and 3 s there was statistical difference between the volume of target and that of of static ultrasonic target (all P<0.05). When the A value was 2 mm and the T value was 4 s, there was no statistical difference between the target volume and the static target volume ( P=0.710). The range within the group was 6.7 cm 3, and the standard deviation was 1.15 cm 3. When the A value was 3 mm and the T value was 4 s, the volume repeatability of the target was poor, and the range within the group was 14.4 cm 3; when the A values were 4 mm and 5 mm, and the T values were 1-4 s, the range within the group was 3.27-17.63 cm 3 and 6.51-21.02 cm 3, respectively. The volume repeatability of the target under each period was extremely poor, which could not meet the clinical requirements. Conclusion:4D ultrasound can provide reliable reference data for patients′ target delineation within 1-4 s of motion cycle and within 1 mm of motion amplitude, which exerts on effect upon the original position of probe.
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Objective:To develop a 3D visualization technology-assisted patient positioning system for radiotherapy and compare it with traditional patient positioning method for breast and pelvic radiotherapy.Methods:A total of 40 patients receiving radiotherapy in Changzhou No.2 People′s Hospital from June 2020 to April 2021 were selected for this study, including 20 patients with breast cancer and 20 patients with pelvic cancer.3D visualization reconstruction was carried out using the CT data of the patients for positioning. Then the 3D visualization models were integrated with the real treatment environment and were then shifted to the isocentral positions of accelerators through interactive operations. Based on this, the patients were actually positioned. Every week, all of the patients were firstly treated with traditional positioning, followed by 3D visualization-guided positioning. As a result, 240 times of positioning data of all patients were collected in three weeks. They were compared with the data of cone-beam CT(CBCT)-guided positioning, which served as the gold standard.Results:The absolute positioning errors of 3D visualization-guided positioning along x, y and z axes were (1.92±1.23), (2.04±1.16), and (1.77±1.37)mm, respectively for patients with breast cancer and were (2.07±1.08), (1.33±0.88), and (1.99±1.25)mm, respectively for patients with pelvic cancer. Compared with traditional positioning method , the accuracy of 3D visualization-guided positioning along x、 y, and z axes was increased by 38.83%, 52.40% and 33%, respectively for patients with breast cancer and was improved by 36.84%, 54.04% and 52.58% for patients with pelvic cancer, with all differences being statistically significant along y and z axes ( t=2.956-5.734, P< 0.05). Meanwhile, the error distribution of the two positioning method was statistically significant along in y axis for patients with breast cancer( χ2=7.481, P<0.05) and was statistically significant along each axis for patients with pelvic cancer( χ2=5.900, 6.415, 7.200, P<0.05). Conclusions:The positioning method guided by 3D visualization technology can effectively improve the positioning accuracy of patients with breast cancer and patients with pelvic cancer and is of value in potential clinical application.
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Aging is one of the most important risk factors for human diseases such as cancer, cardiovascular diseases, diabetes and neurodegenerative diseases, and many aging diseases are related to cellular aging. Cells show profound phenotypic changes during aging, which are driven by changes in metabolism, chromatin organizationand transcriptional activity. A significant feature of aging is the secretion of inflammatory mediators, including various cytokines, chemokines, extracellular matrix proteins and growth factors, collectively known as the aging-related secreted phenotype (SASP). By secreting SASP, senescent cells have important effects on many biological processes, such as wound healing, tissue repair, tumor formation, or in vivo reorganization. In addition, the inflammatory response associated with SASP is considered to be the basis of aging-related diseases, and the discovery of new targets to control the response of aging effects is crucial. Recent scientific advances have shown that innate immune responses, particularly those involving the cGAS-STING pathway, trigger SASP. In this article, we review the biological function and regulatory mechanism of SASP through the cGAS-STING signaling pathway in aging diseases.
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Anesthesia consciousness monitoring is an important issue in basic neuroscience and clinical applications, which has received extensive attention. In this study, in order to find the indicators for monitoring the state of clinical anesthesia, a total of 14 patients undergoing general anesthesia were collected for 5 minutes resting electroencephalogram data under three states of consciousness (awake, moderate and deep anesthesia). Sparse partial least squares (SPLS) and traditional synchronized likelihood (SL) are used to calculate brain functional connectivity, and the three conscious states before and after anesthesia were distinguished by the connection features. The results show that through the whole brain network analysis, SPLS and traditional SL method have the same trend of network parameters in different states of consciousness, and the results obtained by SPLS method are statistically significant ( <0.05). The connection features obtained by the SPLS method are classified by the support vector machine, and the classification accuracy is 87.93%, which is 7.69% higher than that of the connection feature classification obtained by SL method. The results of this study show that the functional connectivity based on the SPLS method has better performance in distinguishing three kinds of consciousness states, and may provides a new idea for clinical anesthesia monitoring.
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Aiming at the difference between the brain networks of children with attention deficit hyperactivity disorder (ADHD) and normal children in the task-executing state, this paper conducted a comparative study using the network features of the visual function area. Functional magnetic resonance imaging (fMRI) data of 23 children with ADHD [age: (8.27 ± 2.77) years] and 23 normal children [age: (8.70 ± 2.58) years] were obtained by the visual capture paradigm when the subjects were performing the guessing task. First, fMRI data were used to build a visual area brain function network. Then, the visual area brain function network characteristic indicators including degree distribution, average shortest path, network density, aggregation coefficient, intermediary, etc. were obtained and compared with the traditional whole brain network. Finally, support vector machines (SVM) and other classifiers in the machine learning algorithm were used to classify the feature indicators to distinguish ADHD children from normal children. In this study, visual brain function network features were used for classification, with a classification accuracy of up to 96%. Compared with the traditional method of constructing a whole brain network, the accuracy was improved by about 10%. The test results show that the use of visual area brain function network analysis can better distinguish ADHD children from normal children. This method has certain help to distinguish the brain network between ADHD children and normal children, and is helpful for the auxiliary diagnosis of ADHD children.
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Child , Child, Preschool , Humans , Attention Deficit Disorder with Hyperactivity/diagnostic imaging , Brain/diagnostic imaging , Brain Mapping , Cognition , Magnetic Resonance ImagingABSTRACT
To enhance the accuracy of computer-aided diagnosis of adolescent depression based on electroencephalogram signals, this study collected signals of 32 female adolescents (16 depressed and 16 healthy, age: 16.3 ± 1.3) with eyes colsed for 4 min in a resting state. First, based on the phase synchronization between the signals, the phase-locked value (PLV) method was used to calculate brain functional connectivity in the θ and α frequency bands, respectively. Then based on the graph theory method, the network parameters, such as strength of the weighted network, average characteristic path length, and average clustering coefficient, were calculated separately (
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Adolescent , Female , Humans , Brain/diagnostic imaging , Diagnosis, Computer-Assisted , Electroencephalography , Support Vector MachineABSTRACT
Medical images play an important role in clinical diagnosis and treatment. During the radiotherapy, CT can be available for the location and definition of the target volume. The medical images from multiple modalities are used to obtain the information on pathological body from many angles. However, obtaining multiple-modality medical images could be more resource-consuming, and difficult to guarantee the consistency of patients′ state. Medical image translation between multiple modalities can achieve the predication from one modality to another. The studies on medical images from multiple modalities such as CT, ultrasound, MRI and PET are reviewed in detail in this paper, , with discussions provided about characteristics of multiple modalities and challenges faced, as well as the research areas to be developed.
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Objective: To evaluate the efficacy and safety of a domestic human plasma derived coagulation Factor Ⅸ concentrate (pd-FⅨ) in patients with hemophilia B. Methods: The study was a multicenter, open-label and single-arm study. The efficacy of pd-F Ⅸ was evaluated by objective performance criteria. The doses of pd-FⅨ were calculated according to the bleeding symptom and disease severity. The infusion efficiency of pd-FⅨ and improvement of bleeding symptoms were measured at 30 minutes and (24±4) h after the first infusion, respectively. Adverse events were recorded. Viral infection and FⅨ inhibitor were detected 90 d after the first infusion. Results: All 36 subjects with hemophilia B were enrolled in the study. The median age of these patients was 31 years old and the median injection doses were 4 (1-17) times. The hemostatic effect of 27/36 (75.00%) and 9/36 (25.00%) acute bleeding events were rated as "excellent" and "better" , respectively. The recovery rate was 111.92% (65.55%-194.28%) at 30 minutes after infusion of FⅨ. There was no adverse event related to FⅨ. No reactivation of HBV, HCV or HIV and FⅨ inhibitor was detected at 90-104 d after the first FⅨ infusion. Conclusion: This domestically made human plasma derived FⅨ concentrate is safe and effective in the treatment of acute bleeding in patients with hemophilia B. Clinical trial registration: China food and Durg Administration, 2016L08027.
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Adult , Humans , China , Factor IX , Hemophilia A , Hemophilia B/therapy , Hemorrhage , PlasmaABSTRACT
Congenital coarctation of the aorta is a complex and common congenital heart disease, which can be combined with other heart defects. The clinical symptoms vary from the severity of the disease. In 1944, Crafoord successfully performed surgical repair of coarctation of the aorta, along with the progress of surgical Methods and the advent of interventional techniques, the treatment effect is improved, But no matter what kind of treatment it is, restenosis, aortic aneurysm, hypertension and other complications cannot be avoided. From long-term analysis of the followup Results , the overall effect of surgical treatment is still better than interventional treatment. This article reviews the surgical treatment of coarctation of the aorta.
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Objective@#To evaluate the efficacy and safety of a domestic human plasma derived coagulation Factor Ⅸ concentrate (pd-FⅨ) in patients with hemophilia B.@*Methods@#The study was a multicenter, open-label and single-arm study. The efficacy of pd-F Ⅸ was evaluated by objective performance criteria. The doses of pd-FⅨ were calculated according to the bleeding symptom and disease severity. The infusion efficiency of pd-FⅨ and improvement of bleeding symptoms were measured at 30 minutes and (24±4) h after the first infusion, respectively. Adverse events were recorded. Viral infection and FⅨ inhibitor were detected 90 d after the first infusion.@*Results@#All 36 subjects with hemophilia B were enrolled in the study. The median age of these patients was 31 years old and the median injection doses were 4 (1-17) times. The hemostatic effect of 27/36 (75.00%) and 9/36 (25.00%) acute bleeding events were rated as "excellent" and "better" , respectively. The recovery rate was 111.92% (65.55%-194.28%) at 30 minutes after infusion of FⅨ. There was no adverse event related to FⅨ. No reactivation of HBV, HCV or HIV and FⅨ inhibitor was detected at 90-104 d after the first FⅨ infusion.@*Conclusion@#This domestically made human plasma derived FⅨ concentrate is safe and effective in the treatment of acute bleeding in patients with hemophilia B.@*Clinical trial registration@#China food and Durg Administration, 2016L08027.
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Objective@#To understand characteristics of vaginal cervical microbiota in high-risk HPV (hrHPV) infected women and to uncover the relationship between hrHPV infection and vaginal cervical microbiota.@*Methods@#All participants were randomly selected from Peking University First Hospital from September to October of 2017, including 5 subjects of control group, 5 cases of HPV16/18 group, 5 cases of other hrHPV infected group and 3 cases of cervical squamous carcinoma group. All subjects were required to fill in a questionnaire, and cervical and vaginal discharges were separately collected for microscopic examination and new generation sequencing targeting the variable region (V3-V4) of bacterial 16S rRNA gene.@*Results@#Vaginal microbiota analysis: (1) 6 major phylum were found in vaginal microbiota:Firmicutes, Bacteroidetes, Fusobacteria, Actinobacteria, Tenericutes and Proteobacteria. Firmicutes contributed to the majority of normal vaginal flora, Bacteroidetes and Fusobacteria increased in hrHPV infected ones, while Fusobacteria showed significant difference in cervical carcinoma group. (2) Lactobacillus occupied most of normal vaginal flora while genus like Gardnella, Prevotella, Atopobium, Megasphaera and Sneathia increased in hrHPV infected subjects, Sneathia showed significant difference in cervical carcinoma group. (3) No significant difference had been calculated in Alpha diversity of four groups (P=0.073) . Cervical microbiota analysis: (1) Microbial diversity of cervical microbiota was higher than that of vaginal microbiota. (2) Significant difference had been found in Alpha diversity of four groups (P=0.046) . (3) Proteobacteria in normal cervical flora was much more than that in vagina, and Proteobacteria increased significantly in hrHPV infected cervical discharge. (3) Chlamydia increased significantly in cervical carcinoma group.@*Conclusions@#The diversity of cervical microbiota is higher than that of vaginal microbiota. Change in cervical microbiota is more obvious than that of vagina in hrHPV infected subjects. Fusobacteria-Sneathia and Chlamydia significantly increase in cervical carcinoma group. Proteobacteria might relate to hrHPV infection.
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Objective Previously we have reported the early and midterm benifit of autologous pulmonary patch in repairing aortic coarctation of hypoplastic aortic arch.This study aimed to assess its reliability and midterm and longterm outcomes.Methods We retrospectivly analyzed 42 pediatric patients with coarctation of the aorta (CoA) with hypoplastic aortic arch undergoing surgical repair with autologous pulmonary patch from May 2009 to May 2017 in General Hospital of Guangzhou Military Command of PLA.All the patients were allocated into either senior group (> 1 years) or junior group (≤1 years) according to the age of operation.The trans-coarctation gradient,pulmonary pressure and aortic Z value change were compared between two groups before and after the repair.Results There were 8 cases had early postoperative complications.However,no death had been reported during the postoperative time and the followed up period ranged from 4 months to 106 months (40.0± 15.5) months).The average pressure gradient of coarctation segment for all the patients was (11.9±6.4) mmHg,including 5 cases more than 25 mmHg.The pressure gradient and mean pulmonary arterial pressure after operation were significantly lower than those before operation (P<0.05),The postoperative aortic arch Z value was greater than the preoperative value (P<0.05).Compared with the preoperative period,the Z value of proximal transverse arch increased significantly(-0.64±0.44) vs (1.27±0.66),P<0.05.Compared with junior group,the senior group had higher preoperative and postoperative pulmonary artery pressure (P<0.05),and longer CPB time,aortic block time,ventilation time,ICU time and hospital stay time (P<0.05).However,patients in the junior group had a higher pressure gradient through the aorta arch(P<0.05) and a smaller Z value transverse arch aortic proximal and isthmus(P<0.05) during the long-term period.The time of selective cerebral perfusion had no statistical difference between the two groups (P> 0.05).Conclusion Early surgery for coarctation of aorta with hypoplastic aortic arch,autologous pulmonary patch aortoplasty is a relatively ideal option with better midterm and longterm outcomes.
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AIM:To investigate the influence of signal transducer and activator of transcription 3(STAT3)on Warburg effect in the malignant transformation of WB-F344 rat hepatic oval cells.METHODS:The WB-F344 cells were treated with N-methyl-N'-nitro-N-nitrosoguanidine(MNNG)and hydrogen peroxide(H2O2)to induce the malignant trans-formation.Evaluation of the transformed cells were measured by the soft agar colony formation assay and DNA aneuploidy with flow cytometry.The levels of glucose and lactate in the culture medium of the cells were detected by chromatography. The protein levels of alpha-fetoprotein(AFP),STAT3,p-STAT3 and glucose transporter 2(GLUT2)in the cells were ex-amined by Western blot analysis.The cell proliferation were evaluated by WST-1 assay,viable cell counting,measuring the S-phase fraction(SPF)and proliferation index(PI)using the data from flow cytometry analysis,and detecting proliferating cell nuclear antigen(PCNA)protein expression by Western blot.RESULTS:Compared with the control cells,the forma-tion of colonies in soft agar(P<0.05)and DNA aneuploidy(P<0.01)were elevated in transformed cells,and the ex-pression level of AFP was also augmented(P<0.05).The increases in the level of both glucose consumption(P<0.05) and lactate production(P<0.01)show that Warburg effect was enhanced in transformed cells.Meanwhile, the protein levels of GLUT2(P<0.01)and p-STAT3(P<0.01)in transformed cells were higher than those in the control cells.The cell proliferation parameters including SPF(P<0.01),PI(P<0.01), viable cell number and PCNA expression(P<0.01)in transformed cells were also elevated as compared with the control cells.Interestingly, stattic, an inhibitor of STAT3 activation,resulted in declines in glucose consumption(P<0.05)and lactate production(P<0.01)in the trans-formed cells.In addition,compared with transformed cells,formation of colonies in soft agar(P<0.01),DNA aneuploidy (P<0.01),AFP(P<0.05), GLUT2(P<0.05), and cell proliferation parameters including SPF(P<0.01), PI (P<0.01),viable cell number(P<0.05)and PCNA expression(P<0.05)were also decreased following stattic treat-ment in transformed cells.CONCLUSION:STAT3 promotes Warburg effect and cell proliferation probably by upregula-ting GLUT2 expression in the malignant transformation of hepatic oval cells.
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Objective:To observe the clinical efficacy of needling thirteen ghost acupoints for children with autism spectrum disorder. Methods:A total of 90 cases with autism spectrum disorder (ASD) aged between 2 and 6 years were randomly allocated into 2 groups by random number table. The control group (n=45) received routine rehabilitative training, and the treatment group (n=45) received acupuncture at thirteen ghost acupoints plus routine rehabilitative training. The Beijing Gesell developmental (Gesell) scale and autism behavior checklist (ABC) were used to assess the intellectual, language and behavior development before and 3 months after the treatment. Results:After the treatment, the total effective rate in the treatment group was 82.2%, versus 55.6% in the control group, showing a statistical significance (P<0.05). As for the scores of social, emotional and language in Gesell scale, there were significant intra-group differences in the treatment group (allP<0.05), and all the five subscales in the Gesell scale in the treatment group were significantly better than those in the control group (allP<0.05). As for the scores of ABC, there were significant intra-group differences in the treatment group (P<0.05), and the scores in the treatment group were significantly better than those in the control group (allP<0.05). Conclusion: Rehabilitation training plus acupuncture at thirteen ghost acupoints can significantly improve the intellectual, language and abnormal behavior in autism spectrum disorder children.
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Objective To explore the effect of Jian Zu San Zhen acupuncture on tip foot in children with spastic cerebral palsy. Methods From January to December, 2016, 120 children with spastic cerebral palsy aged one to six years were randomly divided into control group (n=60) and observation group (n=60). Both groups were treated with conventional rehabilitation, while the observation group added Jian Zu San Zhen acupuncture. They were evaluated with Gross Motor Function Measure (GMFM), foot dorsiflexion angle and surface electromyog-raphy. Results After treatment, the scores of GMFM in B, C, D and E dimensions and the total score significantly increased in the observa-tion group (t>4.325, P<0.001), and were higher than that of the control group (t>2.711, P<0.01);the foot dorsiflexion angle significantly de-creased in the observation group (t=17.627, P<0.001), and was significantly less than that of the control group (t=15.416, P<0.001). The root mean square (RMS) of surface electromyography of gastrocnemius muscle under active plantarflexion and passive dorsiflexion of ankle joint improved after treatment (t≥3.058, P<0.01), and was better in the observation group than in the control group (t=-2.199, P<0.05). Conclusion Jian Zu San Zhen acupuncture can effectively reduce the gastrocnemius muscle tension, and do not reduce the gastrocnemius muscle strength, which could also improve the ability of foot flexion, and facilitate to recover the function of standing and moving.
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Objective:To observe the clinical efficacy of needling thirteen ghost acupoints for children with autism spectrum disorder. Methods:A total of 90 cases with autism spectrum disorder (ASD) aged between 2 and 6 years were randomly allocated into 2 groups by random number table. The control group (n=45) received routine rehabilitative training, and the treatment group (n=45) received acupuncture at thirteen ghost acupoints plus routine rehabilitative training. The Beijing Gesell developmental (Gesell) scale and autism behavior checklist (ABC) were used to assess the intellectual, language and behavior development before and 3 months after the treatment. Results:After the treatment, the total effective rate in the treatment group was 82.2%, versus 55.6% in the control group, showing a statistical significance (P<0.05). As for the scores of social, emotional and language in Gesell scale, there were significant intra-group differences in the treatment group (allP<0.05), and all the five subscales in the Gesell scale in the treatment group were significantly better than those in the control group (allP<0.05). As for the scores of ABC, there were significant intra-group differences in the treatment group (P<0.05), and the scores in the treatment group were significantly better than those in the control group (allP<0.05). Conclusion: Rehabilitation training plus acupuncture at thirteen ghost acupoints can significantly improve the intellectual, language and abnormal behavior in autism spectrum disorder children.
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Objective To explore the effect of Jian Zu San Zhen acupuncture on tip foot in children with spastic cerebral palsy. Methods From January to December, 2016, 120 children with spastic cerebral palsy aged one to six years were randomly divided into control group (n=60) and observation group (n=60). Both groups were treated with conventional rehabilitation, while the observation group added Jian Zu San Zhen acupuncture. They were evaluated with Gross Motor Function Measure (GMFM), foot dorsiflexion angle and surface electromyog-raphy. Results After treatment, the scores of GMFM in B, C, D and E dimensions and the total score significantly increased in the observa-tion group (t>4.325, P<0.001), and were higher than that of the control group (t>2.711, P<0.01);the foot dorsiflexion angle significantly de-creased in the observation group (t=17.627, P<0.001), and was significantly less than that of the control group (t=15.416, P<0.001). The root mean square (RMS) of surface electromyography of gastrocnemius muscle under active plantarflexion and passive dorsiflexion of ankle joint improved after treatment (t≥3.058, P<0.01), and was better in the observation group than in the control group (t=-2.199, P<0.05). Conclusion Jian Zu San Zhen acupuncture can effectively reduce the gastrocnemius muscle tension, and do not reduce the gastrocnemius muscle strength, which could also improve the ability of foot flexion, and facilitate to recover the function of standing and moving.
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<p><b>OBJECTIVE</b>To investigate the protective effects of high-dose ulinastatin on the vital organs in patients undergoing total arch replacement for type A aortic dissection.</p><p><b>METHODS</b>Between September 2014 and March 2016, 66 patients with type A aortic dissection underwent total arch replacement at our center. Thirty-six of the patients received ulinastatin treatment at 300 000 U/8 h from admission to 3 days postoperatively and at 300 000 U/2 h during cardiopulmonary bypass surgery (UTI group), and the other 30 patients did not receive perioperative ulinastatin treatment (control group). The surgical data and blood biochemistry profiles on days 1, 3, and 5 postoperatively were compared between the two groups, and the postoperative ICU stay, re-operation for bleeding, ventilation for over 7 days, ultrafiltration for postoperative renal failure, tracheotomy, incidences of pulmonary and neurological complications and hospital death were also compared.</p><p><b>RESULTS</b>s The operating time, cardiopulmonary bypass time, ACP time, cardiac arrest time, the lowest rectal temperature and frequency of bilateral and unilateral antegrade selective cerebral perfusion were similar between the two groups (P>0.05). Compared with those in the control group, patients in UTI group had lower lactate, S-100 and neuron specific enolase levels on the first postoperative day and higher OI on the 1st, 3rd, and 5th postoperative days (P<0.05), but serum creatinine, blood urea nitrogen, total bilirubin, and alanine aminotransferase levels were comparable between the two groups (P>0.05). No significant differences were found in the frequency of re-operation for bleeding, ultrafiltration for renal failure, tracheotomy, neurological complications or hospital death after the operation between the two groups, but the patients in UTI group had a shorter ICU time, a less frequent long-term ventilation and a lower incidence of pulmonary infection (P<0.05).</p><p><b>CONCLUSION</b>High-dose ulinastatin offers protection on pulmonary function and lowers the specific brain injury markers in patients with type A aortic dissection after total arch replacement, but its protective effects on brain is uncertain.</p>