Short-term outcome of ascending aorta replacement combined with total aortic arch fenestration technique for acute type A aortic dissection / 中国胸心血管外科临床杂志

@#Objective    To report our clinical experience and outcomes of thoracic endovascular aortic repair (TEVAR) for acute Stanford type A dissection using ascending aorta replacement combined with implantation of a fenestrated stent-graft of the entire aortic arch through a minimally invasive technique. Methods    From 2016 to 2020 in our hospital, 24 patients (17 males and 7 females, aged 45-72 years) with complicated Stanford type A aortic dissection, underwent replacement of the proximal ascending aorta with TEVAR. None of the patients with dissection involved the three branches of the superior arch, and all patients were replaced with artificial blood vessels of the ascending aorta under non-hypothermic cardiopulmonary bypass, preserving the arch and the three branches above the arch, and individualized stent graft fenestration. Results    Surgical technical success rate was 100.0%. There was no intraoperative complication or evidence of endo-leak in 1 month postoperatively. Hospital stay was 10±5 d. During postoperative follow-up, the stent was unobstructed without displacement, the preserved branch of the aortic arch was unobstructed, and the true lumen of the descending aorta was enlarged. Conclusion     This hybrid technique by using TEVAR with fenestrated treatment is a minimally invasive and effective method to treat high-risk patients with acute Stanford type A aortic dissection.

Hybrid or open surgery for aortic arch diseases: Which one is better? / 中国胸心血管外科临床杂志

@#The conventional total arch replacement (cTAR) with frozen elephant trunk implantation is commonly regarded as the gold standard for aortic pathologies involving ascending aorta and proximal aortic arch. By combining open supra-aortic vessels debranching and emerging endovascular technologies, hybrid arch repair (HAR) has been increasingly performed as a promising alternative in risky patients with comorbidities and frailties. Nevertheless, the advantages or disadvantages of hybrid arch procedures and cTAR in terms of survival and related outcomes remain controversial. This study is aimed to briefly review the role and results of HAR in the management of aortic arch pathology in comparison of contemporary cTAR.

Hybrid coronary revascularization versus off-pump coronary artery bypass grafting for treatment of multivessel coronary artery diseases / 中国胸心血管外科临床杂志

@#Objective    To investigate the feasibility and safety of hybrid coronary revascularization (HCR) in patients with multivessel coronary artery disease (MVCAD). Methods    A total of 50 patients with MVCAD who underwent HCR technique in our heart center from May 2016 to April 2019 were included in this study (a HCR group), including 38 patients who underwent two-stage HCR and 12 patients one-stop HCR. There were 39 males and 11 females, with an average age of 62.4 (46-82) years. Another 482 patients who underwent conventional median incision under off-pump coronary artery bypass grafting (OPCAB) at the same period were selected as control (an OPCAB group), including 392 males and 90 females, with an average age of 64.2 (48-84) years. The safety and feasibility of HCR were evaluated and compared with conventional OPCAB technique. Results    There was no perioperative death in both groups. Compared with the OPCAB, HCR was associated with shorter operation time, less chest tube drainage, lower requirement of blood transfusion, shorter mechanical ventilation time and shorter postoperative intensive care unit (ICU) stay (P<0.05). There was no statistical difference in the incidence of major adverse cardiac or cerebrovascular events during the follow-up of 6 to 36 months between the two groups. Conclusion    HCR provides favorable short and mid-term outcomes for selected patients with MVCAD compared with conventional OPCAB.

One-stop hybrid technique to treat coronary atherosclerotic disease concomitant with penetrating atherosclerotic ulcers in 23 patients / 中华胸心血管外科杂志

Objective Retrospectively reviewed the early outcomes of one-stop hybrid technique to treat coronary atherosclerotic disease concomitant with penetrating atherosclerotic ulcers (PAU).Methods This study enrolled in 23 cases (male 21,female 2) of coronary atherosclerotic disease concomitant with penetrating atherosclerotic ulcers from Jan 2016 to Dec 2017 in our institute,with the mean age(67.5 ±7.5) years (51-79 years).Coronary artery bypass graft (CABG) surgery was performed by cardiopulmonary bypass (CPB),the procedure to treat aortic arch lesion included isolated CABG + thoracic endovascular stent graft in 2 patients,CABG + brachiocephalic arteries debranching + thoracic endovascular stent graft in 18 patients,CABG + hybrid total aortic arch replacement + thoracic endovascular stent graft in 3 patients.Results Mean CPB time was(94.3 ±25.7) min(55-145 min),mean aortic cross-clamp time was (61.4 ± 19.3) min(26-97 min),intraoperative blood loss was (654.8 ± 78.7) ml (510-900 ml),20 patients (87.0％) needed blood transfusion therapy . Median mechanical ventilation time was 18 hours(9-249 hours),with 1 patient (4.3 ％)exceeded 48 hours.Median intensive care unit stay time was 2.8 days(1-23 days),with 6 patients(26.1％) exceeded 4 days.There was no in-hospital mortality.The postoperative complications included:paresis in 2 patients (8.7％),re-exploration for bleeding in 1 patient (4.3％),pleural effusion in 1 patient (4.3％),pneumothorax in 1 patient (4.3％),paraplegia、pulmonary infection、acute renal insufficiency、respiratory failure、re-intubation in 1 patient (4.3 ％).Conclusion The one-stop hybrid technique for treating coronary atherosclerotic disease concomitant with PAU was effective and safe.The early clinical outcome was satisfactory.Mid and long-term result need further follow-up to study.

A Hybrid Technique For Ganglion Management

Background- the ganglions on dorsum of the wrist is a common and recurring problem, unless dealt with properly. So, we use an easy to learn, simple OPD based hybrid method for the same. Materials and Methods- we treated 16 ganglion cysts with this method, and the follow-up was seen at 3 weeks time. Result- there was recurrence in only 1 case out of 16 (~5%), with no recurrence or any complication in the others. Thus, this hybrid technique is effective, safe procedure for management of ganglions.

Application and progress of hybrid technique in cardiovascular surgery / 天津医药

The hybrid technique is a technique that combines minimally invasive cardiac surgery with intracardiac intervention. It has the advantages of definite curative effect, good visual field and slight trauma. It provides advanced treatment options for patients with cardiovascular diseases.With the gradual improvement of technical level,diagnosis and treatment concept and medical equipment,especially the popularization of"hybrid operation room",hybridization technology has been applied in many sub-specialized fields of cardiac surgery. In some fields this technology has become a routine treatment program.At present,it is mainly used for treatment of congenital heart disease,coronary heart disease,heart valve disease,aortic disease and atrial fibrillation.

Hybrid Technique for Extensive Aortic Arch Aneurysm after Thoracoabdominal Aortic Aneurysm Repair / 日本心臓血管外科学会雑誌

We report a case of operations using a hybrid technique for repeated extensive aortic aneurysm. A 71-year-old man had extensives aneurysms of the aortic arch and descending aorta. In the first operation, he had undergone thoracoabdominal aortic replacement with island repair for thoracoabdominal aortic aneurysm (Crawford type 3) at age 64. Six years later, computed tomography showed an aortic aneurysm around the region of the island repair and penetrating atherosclerotic ulcer (PAU). Therefore, he underwent abdominal debranching and thoracic endovascular aortic repair (TEVAR) at 70 years old. At the same time, he had an extensive aortic arch aneurysm. Considering the complicated surgical history and the affected region, we judged that conventional graft replacement was difficult. So, in the third operation, we performed TEVAR for the descending aorta at 71 years old. One month later, total arch replacement (TAR) with a frozen elephant trunk (FET) was performed (4th operation). The patient was discharged home 22 days after the 4th operation. This strategy of operations using hybrid techniques for extensive aortic aneurysm may be useful in high risk cases of surgical procedures and postoperative complications.

Screening of host proteins interacting with GP, VP30, NP,and L proteins of Ebola virus by yeast two-hybrid system / 军事医学

Objective To study the biological function of GP,VP30,NP and L proteins in Ebola virus(EBOV) infectious diseases,and to screen the host proteins which interact with GP,VP30,NP,and L proteins of EBOV from human liver cDNA library using yeast two-hybrid technique.Methods Recombinant PCR was used to construct bait plasmids pGBKT7-GP,pGBKT7-VP30,pGBKT7-NP and pGBKT7-L.Bait strains were combined with human liver cDNA library strains.The positive clones were analyzed by DNA sequencing and bioinformatics.A yeast recovery experiment was performed to further verify and exclude false positive results.Results We constructed bait plasmids pGBKT7-GP,pGBKT7-VP30,pGBKT7-NP and pGBKT7-L with the recombinant PCR method.Six host proteins which could interact with GP,VP30,NP,and L proteins were screened,including COMMD1,ALB,PSMD8,APOA2,CYP2E1,and HP.The yeast recovery experiment proved that COMMD1 and APOA2 might interact with NP protein.Conclusion A number of prey proteins which interact with GP,VP30,NP,and L proteins of EBOV are screened,which may provide reference for the research of EBOV.

Application of one-stage hybrid technique in treatment of pernicious placenta previa / 实用医学杂志

Objective To assess the value of one-stage hybrid technique for treatment of pernicious placenta previa. Methods 12 patients with pernicious placenta previa who had received simultaneously Cesarean section and temporary balloon occlusion of abdominal aorta or internal iliac artery in the hybrid operation room were included in this study. 12 patients with pernicious placenta previa who had preserved balloon ducts in internal iliac artery before Cesarean section were chosen as a control group. Balloons were filled to control hemorrhage during the procedure. The hemodynamic parameters including blood pressure and heart rate were monitored during the opera-tion. Surgical duration ,amount of blood loss ,amount of blood transfusion ,volume of infusion ,urine volume during the procedure,postoperative volume of blood loss within 24 hours,uterine hysterectomy rate and neonatal conditions were compared between the two groups. Results During the operation,the blood pressure and heart rate in hybrid group were more stable. The mean surgical duration was(72 ± 8)min,the intraoperative mean amount of blood loss was(620 ± 95)mL,the mean amount of blood transfusion was(550 ± 40)mL,the mean volume of infusion was(1850 ± 160)mL,the mean amount of blood loss in 24 h after the operation was(75 ± 9) mL in the hybrid group,which were significantly lower than those in the control group(P<0.05 for all comparisons). No serious complications occurred in any of the two groups after the operation. There were no significant differences in neonatal conditions between the two groups. Conclusions One-stage hybrid technique has an obvious effect in the control of intraoperative bleeding in patients with pernicious placenta previa. It is worth popularizing in the hospital whose conditions are permitted.

Laparoscopic and hybrid technique for the repair of incisional hernia : a report of 70 cases / 中华普通外科杂志

Objective To analyze the clinical value of laparoscopic and hybrid technique for the repair of incisional hernia.Methods The clinical data of 70 cases of incisional hernia undergoing laparoscopic and hybrid repair from Jan 2014 to Dec 2015 in Huadong Hospital were analyzed retrospectively.Results All cases were operated on successfully and recovered.The operation time was (60 ± 27) min for laparoscopic and (120 ± 32) min for hybrid repair.The length of incision was (6 ± 4) cm for laparoscopic repair and (8 ± 6) cm for hybrid.Postoperative complications included seroma in 1 case in laparoscopic group,incisional fat liquefation in 1 case in hybrid group.All were cured with conservative treatment.Hospital stay was (8 ± 5) days in hybrid group and (14 ± 16) days in hybrid group.No recurrence was observed during 6-30 months of follow-up.Conclusion Both laparoscopic and hybrid technique for incisional hernia repair are safe and effective.

Minimally Invasive Coronary Bypass by Using Bilateral Internal Mammary Arteries Combine with Percutaneous Coronary Intervention for Multivessel Coronary Artery Disease:Case Report / 中国微创外科杂志

[Summary] A 60-year-old man was admitted with main complaint of chest pain on exertion.Coronary angiogram showed severe triple vessel disease.He underwent the hybrid technique of treatment through two left minithoracotomy incisions.Both internal thoracic arteries were harvested under direct vision.The left internal mammary artery (LIMA)and right internal mammary artery (RIMA) compositing Y grafts was constructed. The LIMA was anastomosed to the left anterior descending branch and the RIMA was anastomosed to the ramus intermedius.The operation time was 306 min.The amount of bleeding during operation was 50 ml.Five days later he underwent percutaneous coronary intervention at right coronary artery lesion successfully.He was discharged from hospital 8 days after operation,and didn’t complain of chest pain during fellow-up for one month.This technique demonstrates to be an effective and minimally invasive alternative to treat patients with multivessel coronary artery disease.

A survey of experience-based preference of Nickel-Titanium rotary files and incidence of fracture among general dentists

OBJECTIVES: The purpose was to investigate the preference and usage technique of NiTi rotary instruments and to retrieve data on the frequency of re-use and the estimated incidence of file separation in the clinical practice among general dentists. MATERIALS AND METHODS: A survey was disseminated via e-mail and on-site to 673 general dentists. The correlation between the operator's experience or preferred technique and frequency of re-use or incidence of file fracture was assessed. RESULTS: A total of 348 dentists (51.7%) responded. The most frequently used NiTi instruments was ProFile (39.8%) followed by ProTaper. The most preferred preparation technique was crown-down (44.6%). 54.3% of the respondents re-used NiTi files more than 10 times. There was a significant correlation between experience with NiTi files and the number of reuses (p = 0.0025). 54.6% of the respondents estimated experiencing file separation less than 5 times per year. The frequency of separation was significantly correlated with the instrumentation technique (p = 0.0003). CONCLUSIONS: A large number of general dentists in Korea prefer to re-use NiTi rotary files. As their experience with NiTi files increased, the number of re-uses increased, while the frequency of breakage decreased. Operators who adopt the hybrid technique showed less tendency of separation even with the increased number of re-use.

Evaluation of single root canals filled using the lateral compaction, tagger's hybrid, microseal and guttaflow techniques

The aim of this study was to determine the percentage of voids, gutta-percha and root canal sealer using 4 different filling techniques. Fifty-two extracted maxillary lateral incisors were prepared using the crown-down pressureless technique. The teeth were randomly divided in 4 groups (n=13): Lateral compaction (LC), Tagger's hybrid (TH), MicroSeal (MS) and GuttaFlow (GF) techniques. Horizontal cross-sections were made at the 2, 10 and 15 mm levels from the apex. Digital images of the root canal areas were acquired using a stereomicroscope and examined using the Image Tool 3.0 software. Statistical analysis was performed using the Kruskal-Wallis test (α=0.05). In general, a significant decrease in the gutta-percha filled area and increase of sealer area were observed at the apical level for all the evaluated techniques (p<0.05). With regard to the presence of voids, no significant difference was found. MS and TH techniques showed a larger gutta-percha filled area than LC and GF techniques at the coronal and middle third level (p<0.05). From the results of the present study, it may be concluded that the gutta-percha filled area of fillings decrease at the apical level, regardless of the filling technique used.

O objetivo do estudo foi determinar a porcentagem de espaços vazios, guta-percha e cimento após a obturação por 4 diferentes técnicas. Cinquenta e dois incisivos laterais superiores humanos extraídos foram instrumentados pela técnica coroa-ápice sem pressão. Os dentes foram randomicamente divididos em 4 grupos (n=13): Condensação lateral (LC), Técnica híbrida de Tagger (TH), MicroSeal (MS) e GuttaFlow (GF). Foram feitas secções horizontais a 2, 10 e 15 mm do ápice. Imagens digitais foram obtidas dos canais por meio de estereomicroscópio e analisadas no programa Image Tool 3.0. A análise estatística foi feita utilizando o teste de Kruskal-Wallis (α=0,05). Em geral foi observado um significante decréscimo na área de guta-percha e um aumento na área de cimento para todas as técnicas analisadas (p<0,05). Com relação à presença de espaços vazios, não houve diferença estatística entre as técnicas (p>0,05). As técnicas MS e TH apresentaram área de guta-percha maior que as técnicas LC e GF nos terços médio e cervical (p<0,05). Após análise dos resultados foi possível concluir que a área de guta-percha nas obturações diminui em sentido apical, independente da técnica utilizada.

Hybrid technique for DeBakey type Ⅰ aortic dissection / 中国医师进修杂志

Objective To explore the efficacy,indication and the treatment of complication of concomitant thoracic aortic replacement and endoluminal stent grafting (hybrid technique) for DeBakey type Ⅰ aortic dissection. Methods From September 2005 to June 2009,12 patients with acute DeBakey type Ⅰ aortic dissection were diagnosed by contrast-enhanced CT or MRI scan, and underwent hybrid technique.Computed tomography angiography (CTA) was performed in each patient at 2,6 months after operation to check up the post-operative course,such as ascending aortic and vascular prosthesis of aortic arch and decending aorta. The time of the post-operational follow-up was 6 -36 months. Results All patients successfully recovered from surgery procedure,no serious complication. The time of cardiopulmonary bypass was 196 -298 (264.0 ± 36.6) min,arrest time of ascending aortic was 89 -276 (213.6 ±43.8) min. All patients were discharged from hospital. Contrast-enhanced CT or MRI indicated the vascular prosthesis to been unobstructed,no endo-stent dislocation and no organ ischemia, the false lumen and thrombosis disappeared in 10 patients,but false lumen and leakage happened in 2 patients at 2 months after operation.The false lumen disappeared at 6 months after operation. Conclusions Hybrid technique for DeBakey type Ⅰ aortic dissection is satisfactory in short term effect with less invasiveness and definite safety. However,further studies are needed to evaluate its long-term outcomes.

Interactions between secreted GRA proteins and host cell proteins across the paratitophorous vacuolar membrane in the parasitism of Toxoplasma gondii

Interactions between GRA proteins of dense granules in Toxoplasma gondii and host cell proteins were analyzed by yeast two-hybrid technique. The cMyc-GRA fusion proteins expressed from pGBKT7 plasmid in Y187 yeast were bound to host cell proteins from pGADT7-Rec-HeLa cDNA library transformed to AH109 yeast by mating method. By the selection procedures, a total of 939 colonies of the SD/-AHLT culture, 348 colonies of the X-alpha-gal positive and PCR, 157 colonies of the X-beta-gal assay were chosen for sequencing the cDNA and finally 90 colonies containing ORF were selected to analyze the interactions. GRA proteins interacted with a variety of host cell proteins such as enzymes, structural and functional proteins of organellar proteins of broad spectrum. Several specific bindings of each GRA protein to host proteins were discussed presumptively the role of GRA proteins after secreting into the parasitophorous vacuoles (PV) and the PV membrane in the parasitism of this parasite.

A comparison of shaping ability of the three ProTaper(R) instrumentation techniques in simulated canals / 대한치과보존학회지

The purpose of this study was to compare the shaping ability of the three ProTaper(R) instrumentation techniques in simulated canals. Thirty resin blocks were divided into 3 groups with 10 canals each. Each group was instrumented with manual ProTaper(R) (Group M), rotary ProTaper(R) (Group R), and hybrid technique (Group H). Canal preparation time was recorded. The images of pre- and post-instrumented root canals were scanned and superimposed. The amounts of canal deviation, total canal width, inner canal width, outer canal width and centering ratio were measured at apical 1, 2, 3, 4, 5 and 6 mm levels. 1. Canal preparation time was the shortest in R group (p 0.05). 3. The amounts of inner canal width in R group was larger than M group at the 1 mm level and H group was larger than R group at the 6 mm level (p < 0.05). The amounts of outer canal width in R group was larger than H group only at the 1 mm level (p < 0.05). 4. The direction of canal deviation in H, R group at the 1, 2, 3 mm levels was outward and that in M group at the 1, 2 mm levels was inward. The amounts of canal deviation in H group was larger than R group at the 6 mm level (p < 0.05). 5. The amounts of centering ratio in H group was larger than R group at the 6 mm level (p < 0.05).