Therapy experience and clinical features of patients with acute type A aortic dissection involving coronary malperfusion / 中华胸心血管外科杂志

Objective:To investigate the clinical characteristics, surgical methods and prognosis of patients with acute type A aortic dissection combining coronary artery involvement.Methods:415 patients diagnosed with acute type A aortic dissection from October 2016 to September 2019 were included in the study.Among them, 358 were males and 57 were females; aged(51.2±10.7) years old.According to the results of intraoperative coronary probes, 342 patients in the group were without coronary involvement, and the other 73 were with coronary involvement.Data on the coronary involvement classification, site, and treatment methods of the coronary involvement group were collected by consulting the ward medical record system.Meanwhile, preoperative baseline data, surgical data and prognostic results were retrospectively collected between the two groups. The data of the two groups were compared by chi- square test, t-test and Mann- Whitney U test. Results:Coronary involvement group: Among 73 (17.6%, 73/415) patients with coronary involvement, 8 (11.0%) in the left coronary, 48 in the right (65.8%), and 17 (23.3%)cases with involvement of both left and right coronary arteries. Classification of coronary artery(90) involvement: Neri A in 47(52.2%, 47/90), 33 with Neri B (36.7%, 33/90), and 10 with type Neri C (11.1%, 10/90). Type Neri B/C coronary artery involvement was mostly treated with artificial vascular coronary artery replacement or coronary artery bypass grafting. Comparison between the two groups show, patients in the coronary involvement group had higher preoperative levels of CK-MB, D-dimer and more severe aortic valve regurgitation compared to the coronary non-involvement group. The comparison of surgical data suggests that the coronary involvement group had a higher proportion of aortic root treatment, longer operation time, cardiopulmonary bypass time and aortic clamping time. A higher percentage of intimal tear located in the ascending aorta or aortic root was found in the coronary involvement group. The mortality rate in the coronary involvement group was significantly higher than that of the non-involvement group (12% versus 4%), and it was more likely to combine heart failure (5% versus 1%) and renal failure (26% versus 13%).Conclusion:Compared with pure type A dissection, patients with coronary artery involvement are more common in patients whose primary intimal tear were found at the proximal aorta, and are more prone to severe aortic valve regurgitation. Coronary artery treatment procedures include direct suture and fixation, coronary artery replacement, and coronary artery bypass grafting. Among them, Neri A coronary involvement can mostly be fixed with direct suture and stabilization, while the Neri B / C type mostly requires artificial vascular replacement of the affected coronary artery or coronary artery bypass. Patients with coronary artery involvement have a higher proportion of deaths and confer relatively higher risk of post-operative renal/cardiac failure.

Association of long frozen elephant trunk and incidence of spinal cord injury in patients with acute type A aortic dissection: A single center retrospective cohort study / 中国胸心血管外科临床杂志

@#Objective    To evaluate whether long frozen elephant trunk (FET) increases the risk of spinal cord injury in patients with acute type A aortic dissection. Methods    From 2018 to 2019, 172 patients with acute type A aortic dissection were treated in Guangdong Provincial People’s Hospital. They were divided into two groups according to the length of FET: patients treated with stents of 100 mm in length were enrolled into a short FET group, and those with stents of 150 mm in length into a long FET group. There were 124 patients in the short FET group, including 108 (87.1%) males and 16 (12.9%) females with a mean age of 51.8±7.9 years. There were 48 patients in the long FET group, including 44 (91.7%) males and 4 (8.3%) females with a mean age of 50.6±9.7 years. The clinical data and prognosis of the patients were analyzed. Results    The mean distal stent graft was at the level of T 8.5±0.7 in the long FET group, and at the level of T 6.8±0.6 in the short FET group (P=0.001). Sixteen patients died after operation in the two groups, including 13 (10.5%) in the short FET group and 3 (6.2%) in the long FET group (P=0.561). There were 7 patients of spinal cord injury in the two groups, including 6 (4.8%) in the short FET group and 1 (2.2%) in the long FET group (P=0.675). There was no statistical difference in other complications between the two groups. The follow-up time was 16.7 (1-30) months. During the follow-up, 2 patients died in the long FET group and 5 died in the short FET group. No new spinal cord injury or distal reintervention occurred during the follow-up. Conclusion    Long FET does not increase the incidence of spinal cord injury in patients with acute type A aortic dissection.

Analysis of pain management and satisfaction on pain management of home-based advanced cancer patients with pain / 中华内分泌外科杂志

Objective:To detect the pain status and the pain management of home-based advanced cancer patients, and to investigate the key factors impacting the satisfaction on pain management.Methods:Totally the data of 138 cases from the hospice department in the duration from Jan. 2019 to Jun. 2019 were collected and analyzed by χ2 test with SPSS 23.0. Results:109 cases in 138 cases received analgesics treatment before, 54.13% of these participants expressed satisfaction with the effect of their pain management, and 45.87% showed unsatisfied on their pain management. Cancer clinical stage and PMI (pain management index) were both detected to be the significant factors for satisfaction of pain management ( P<0.05, P=0.029; P<0.01, P=0.001) . Conclusions:Cancer clinical stage and PMI are found to be related to the satisfaction for pain management. The percentage of patients who use opioids increased. while there was still a part of patients suffering from inadequacy of pain management. The pain management for home-based advanced patients needs to be paid more attention by medical staff.

Assessment of supra-arch branches bypass on cerebral oxygen saturation and carotid hemodynamics in patients with Stanford type B aortic dissection / 中华胸心血管外科杂志

Objective:To evaluate the effects of supra-arch branches bypass on cerebral oxygen saturation and hemodynamics in patients with Stanford type B aortic dissection.Methods:From January to December 2018, consecutive 27 patients with Stanford type B aortic dissection were enrolled in the study. All patients received hybrid treatment, including supra-arch branches bypass(right axillary artery-left common carotid artery-left subclavian artery) and thoracic endovascular aortic repaire(TEVAR). All the operations were performed by the same surgical team. The left and right cerebral oxygen saturation were measured after anesthesia(T1), left carotid artery occlusion(T2) and after operation(T3); peak systolic velocity(PSV) and resistance index(RI) of left and right carotid arteries were measured before(t1) and after operation(t2).Results:The left cerebral oxygen saturation was 0.62 ±0.01, 0.54±0.01 and 0.62±0.01 at T1, T2 and T3, respectively. There was significant difference between T2 and T1 and T3( P=0.002, P=0.001), but there was no significant difference between T1 and T3. The PSV of left carotid artery at t1 and t2 were(0.91±0.11)m/s and(0.76±0.09)m/s respectively, with no significant difference( P= 0.191). The RI of left carotid artery at t1 and t2 were 0.83±0.06 and 0.93±0.13 respectively, with no significant difference( P= 0.575). Conclusion:If one side of carotid artery was blocked for a short time during supra-arch branches bypass, the cerebral oxygen saturation would be decreased temporarily, but the changes of cerebral oxygen metabolism could be completely restored after operation. However, the hemodynamics of carotid artery would not change significantly. In the hybrid treatment strategy for the patients with aortic dissection Stanford type B, blocking bilateral carotid arteries can be avoided. Making the right axillary artery-left common carotid artery-left subclavian artery shunt is a safe and effective choice.

Effect of soft tissue thickness of upper lip on lip retraction in orthodontical-treated Class II, Division 1 females / 中南大学学报(医学版)

OBJECTIVE@#To establish the Chinese Han national criteria for the thickness of upper lip in Chongqing and to investigate the effect of lip thickness on lip retraction in orthodontic treatment.
@*METHODS@#A total of 240 adult patients (male=120, female=120) of Chinese Han nationality aged 18-35 years in Chongqing were treated with cephalograms and measured the thickness of upper lip. We established the Chinese Han national criteria for the thickness of upper lip in Chongqing according to the results. Sixty-eight female patients with Angle II 1 from Department of Orthodontics Stomatological Hospital of Chongqing Medical University were treated with maxillary premolars extraction, and pre- and post-treated with lateral cephalograms, then divided into 3 groups according to our criteria: a thin lips group, a normal lips group and a thick lips group. The ratio of the incisors retraction and the upper lip retraction were measured and calculated. The correlation between incisors retraction and the upper lip retraction was analyzed by the Pearson correlation method.
@*RESULTS@#There was statistical significance in the thickness of upper lip between males and females (P<0.01). The ratio of maxillary inscior retraction to the upper lip soft tissue retraction was 1.6:1, 2.2:1 and 2.9:1 in the thin lips group, the normal lips group and the thick lips group, respectively.
@*CONCLUSION@#Gender differences exist in the thickness of upper lip. Upper lip retraction with the incisors was negatively correlated with the soft tissue thickness of the upper lip in females with Angle II 1.

The clinical efficacy of supra-arch branches bypass combined with endovascular aortic repair for aortic diseases / 中华胸心血管外科杂志

Objective To summarize the effect of supra-arch branches bypass combined with endovascular aortic repair for aortic diseases.Methods From January 2012 to August 2015,120 cases of thoracic aortic diseases (aortic dissection 103,aortic aneurysm 16,penetrating aortic ulcer 1) received hybrid operation in Guangdong Cardiovascular Institute.Vascular bypass was established among the brachiocephalic arteries,followed by endovascular repair through femoral artery either one-stage or two-stage.Patients were followed up for 3-24 months.Results Technical success was achieved among all the patients.Five patients died after the operation(one patient had retrograde aortic dissection,2 patients had pericardial tamponade,one patient had apnea,and one patient had respiratory and cardiac arrest.The death rate is 4.1％),4 patients had stroke,among them,symptoms were relieved in three patients,one patient was not cured.Total 92 patients were followed-up and had no symptoms of up-limb ischemia or dizziness.CT scan showed bypass graft and endovascular stent patency.6 patients had endoleak (type Ⅰ b 2 cases,type Ⅱ 3 cases,and type Ⅲ 1 case),distal aortic dissection occurred in one patient,three patients had mild contrast agent leakage around the distal endovascular stent,type A aortic dissection occurred in one patient,there were no late stage death.Conclusion Supraarch branches bypass combined with endovascular aortic repair for treating aortic disease is minimally invasive,safe,and can reduce the incidence of postoperative complications.

Application of da Vinci robotic surgical system in thyroidectomy / 中华内分泌外科杂志

Objective To discuss the safety and effectiveness of robot-assisted thyroidectomy using Da Vinci system.Methods Endoscopic thyroidectomy assisted by Da Vinci system was performed in 20 patients,including 5 cases of thyroidadenoma,4 cases of nodular goiter,and 11 cases of thyroid carcinoma.The max diameter of thyroid lump is 5.33 cm.Among 9 cases of benign thyroid neoplasm,5 cases underwent unilateral subtotal lobectomy,and 4 cases underwent unilateral near total thyroidectomy.Among 11 cases of thyroid carcinoma,7 cases underwent bilateral near total thyroidectomy,and 4 cases underwent bilateral total thyroidectomy,at the same time,all the 11 cases underwent central region lymph node dissection.Results The robot-assisted endoscopic thymidectomy was successfully carried out in 20 cases.The mean operation time was 206.4 (105～372)min.The mean operative blood loss was 27.3 ml.The draining tube was moved 3 to 6 days after surgery.The mean postoperative hospital stay was 4.9 days.The mean hospital expense was 60 172 yuan RMB.No complication occurred.20 patients were satisfied with the cosmetic effect and compararive curative effect.Conclusions The robot-assisted endoscopic thymidectomy is an efective method for thyroid diseases.The methed can get more clear vision,higher safety,and good cosmetic efect.

Distribution of serum antibodies against human papillomavirus 16 and 18 among high-risk women to cervical cancer / 中华流行病学杂志

<p><b>OBJECTIVE</b>To explore the distribution of serum antibodies against human papillomavirus (HPV) 16/18 among women at high-risk for cervical cancer.</p><p><b>METHODS</b>All women when tested positive for anyone of the cervical cancer screening programs, from Xinmi county of Henan province in 2011, were recruited as the subjects of this study. Cervical exfoliated cells were collected, using cervical brush for HPV DNA testing, and 10 ml venous blood was drawn for HPV-16, 18 serum antibodies testing, by enzyme-linked immunosorbent assay.</p><p><b>RESULTS</b>Among the 952 women under study, 230 cases (24.2%)showed HPV DNA positive, with positivity rates of HPV16 and 18 L1 virus-like particle (VLP)antibodies as 23.2% and 6.5%, respectively. The overall positivity rate of any type of HPV16, 18 VLP antibodies was 26.8% . Geometric means of HPV16, 18 VLP antibody titers were 79.1 (Yangshengtang Unit,YU/ml) and 125.0(YU/ml). Positivity rate of HPV16 antibody was significantly associated with age, viral load of HPV DNA, and cervical lesion severity (P < 0.05). Seropositivity of HPV18 was also increasing with the increase of viral load (P < 0.01) with different cervical lesion significantly showing different titer of HPV18 antibody (P < 0.01). Based on the results of HPV DNA detection among the two years of study, women with HPV persistent infection showed significant higher positive rate of HPV16/18 antibodies than women who did not have HPV infection or emerging infection (P < 0.001). When comparing to those women without HPV infection, the ones with transient infection showed higher seropositivity rates on both HPV16 antibodies and titer of HPV16 antibody (P < 0.001).</p><p><b>CONCLUSION</b>Seroprevalence rates on HPV16 and 18 among the unvaccinated high-risk women in Henan were high. Prevalence of both HPV16 and 18 antibodies were correlated with age, viral load, cervical lesion and history of infection.Women with high viral load, high grade cervical lesion or history of infection would more likely to be seropositive.</p>

Protective effect of adenosine preconditioning against spinal cord ischemia-reperfusion injury in rats / 南方医科大学学报

<p><b>OBJECTIVE</b>To study the effect of adenosine preconditioning on cell apoptosis and expressions of glucose-regulated protein (GRP-78) and cysteinyl aspartate-specific protease 12 (caspase-12) in rats with spinal cord ischemia-reperfusion injury.</p><p><b>METHODS</b>Twenty-seven rats were randomized into 3 equal groups and subjected to sham operation (group A), spinal cord ischemia-reperfusion injury (group B), or ischemia-reperfusion injury with adenosine treatment. Spinal cord ischemia-reperfusion injury was induced by cross-clamping of the abdominal aorta inferior to the left renal artery. The spinal cord function was assessed using the Modified Tarlov Scale at 6, 12, and 24 h after reperfusion. At 24 h after reperfusion, histological analysis was carried out with HE staining; cell apoptosis and viability were determined with TUNEL staining, and the expressions of GRP-78 and caspase-12 proteins were determined with Western blotting.</p><p><b>RESULTS</b>HE staining of the spinal cord showed extensive spinal cord injury such as cell edema in group B as compared with group C. Compared with group A, group B showed a significantly increased number of apoptotic cells; the number of apoptotic cells in group B was greater than that in group C. Compared with group B, group C showed significantly increased GRP-78 expression (P<0.01) and decreased caspase-12 expression (P<0.01).</p><p><b>CONCLUSION</b>Adenosine can up-regulate GRP-78 expression and down-regulate caspase-12 expression, and protects the spinal cord against ischemia-reperfusion injury by inhibiting cell apoptosis.</p>

Serum anti-hepatitis E virus IgG antibody and risk factors among female residents of Xinmi in Henan Province / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To determine the distribution of anti-hepatitis E virus (HEV) IgG antibody and anti-human papilloma virus (HPV) IgG antibody among female residents of Xinmi and investigate the risk factors of HEV infection.</p><p><b>METHODS</b>A questionnaire was used to collect data on the demographic characteristics and suspected risk factors of HEV infection, including behavioral habits. All questionnaire responders also provided peripheral blood samples for investigation by enzyme-linked immunosorbent assay to detect HEV-IgG. Demographic data were statistically evaluated by t-test and univariate analysis, and HEV infection risk factors were statistically evaluated by a binary logistic regression model.</p><p><b>RESULTS</b>The average age of the 952 questionnaire responders was 47.16 + 8.09 years. The demographic parameters of education level, income, experience of stillbirth, and age were associated with HEV-IgG positivity (all P less than 0.05). Age, occupation, and income were identified as independent risk factors for HEV-IgG positivity (all P less than 0.05). No statically association was found between sexual behavior and anti-HEV or anti-HPV levels, or HEV infection.</p><p><b>CONCLUSION</b>The female population surveyed in Xinmi, Henan Province showed a higher HEV-IgG positive rate than generally reported in the literature, and this rate shows an increasing trend with age, Risk factors for HEV infection among this group are age, income and occupation.</p>

Feasibility of HEV vaccine as control in HPV vaccine study and comparison of serological and risk factors between HEV and HPV infection among females / 中华肿瘤杂志

<p><b>OBJECTIVE</b>Investigating the distribution of anti-hepatitis E virus (HEV-IgG), anti-human papillomavirus (HPV L1-IgG) and risk factors among female residents in Xinmi County, to explore the influencing factors of HPV vaccine study using HEV vaccinated population as a control.</p><p><b>METHODS</b>A screening study of cervical cancer in Xinmi County, Henan Province, was performed. The information of demographic characteristics and risk factors was collected using standard questionnaire. Nine ml blood was drawn from each woman for enzyme-linked immunosorbent assay to detect HEV-IgG and HPV L1-IgG antibody. Percentile, histogram and binary logistic regression model were used to describe the distribution of risk factors and their correlation to HPV and HEV infection.</p><p><b>RESULTS</b>The average age of the Xinmi female residents was 47.2 years, their positive rate of HPV L1 antibody was 26.8%, and that of HEV-IgG antibody was 31.0%, both of which were raised with age (P < 0.001). Single factor analysis showed that non-education, low-income and growing age were associated with HEV-IgG antibody positivity, and non-education, lowering ages of first sexual life and growing age were associated with HPV L1-IgG antibody positivity. Multivariable analysis showed that growing age, low-income and work as peasantry were independent risk factors for HEV-IgG antibody positivity, and lowering ages of first sexual life, non-education and growing age were independent risk factors for HPV L1-IgG antibody positivity.</p><p><b>CONCLUSIONS</b>Both the HEV-IgG and HPV L1-IgG antibodies positive rates increase with age. Age is the common risk factor of HEV-IgG and HPV L1-IgG antibodies in female residents in Xinmi County. The risk factors of HEV-IgG and HPV L1-IgG antibodies have no statistical association, neither cross reaction was found in the HEV-IgG and HPV L1-IgG detection.</p>

The analysis on risk factors of postoperative acute renal injury in acute Stanford type A aortic dissection / 中华胸心血管外科杂志

Objective To analyze the risk factors of postoperative acute renal injury (AKI) for acute Stanford type A aortic dissection in 137 cases.Methods From January 2010 to December 2011,137 patients with acute Stanford type A aortic dissection were received surgical operations in our hospital.There were 106 males and 31 females with their mean age of(46.8 ± 13.1)years and mean weight of (69.9 ± 18.0) kg.The postoperative acute renal injury diagnosis was according to AKIN diagnosis standard of acute kidney injury network working group in 2005.All patients were received surgical repair with cardiopulmonary bypass,including 120 patients with deep hypothermic circulatory arrest and selective cerebral perfusion.Among them,there were 54 cases with total arch replacement and 66 with right half arch replacement.The postoperative managements were include control the patients' mean arterial blood pressure at 80 to 90 mmHg (1 mmHg =0.133 kPa),supplement the blood volume timely,and correction of hypoxia and hypoproteinemia.The patients were received renal replacement therapy if still oliguria after medical treatments,or their blood creatinine raising continually more than 500 μmol/L.Results A total of 12 patients died in hospitalization with a total in-hospital mortality of 8.74％ (12/137).76 cases had AKI in the first day after operations,including 38 cases (27.7％) with stage Ⅰ and 21 cases (15.3％) with stage Ⅱ and 17 cases (12.4％) with stage Ⅲ.There were 36 patients have acute renal failure (ARF) with morbility of 26.3％ (36/137),and 34 patients among them were received renal replacement therapy.Single factor analysis showed that preoperative creatinine,total arch replacement,cardiopulmonary bypasstime,intraoperative day transfusion of concentrated red cells are risk factors of ARF.Logistic regression was used for multivariate analysis showed that total arch replacement and preoperative creatinine abnormalities are independent risk factors for postoperative AFR.Conclusion Total arch replacement and preoperative creatinine abnormalities were independent risk factors of AFR for acute type A dissection after operation.

Distribution of serum antibodies against human papillomavirus 16 and 18 among high-risk women to cervical cancer / 中华流行病学杂志

Objective To explore the distribution of serum antibodies against human papillomavirus(HPV)16/18 among women at high-risk for cervical cancer. Methods All women when tested positive for anyone of the cervical cancer screening programs,from Xinmi county of Henan province in 2011,were recruited as the subjects of this study. Cervical exfoliated cells were collected,using cervical brush for HPV DNA testing,and 10 ml venous blood was drawn for HPV-16, 18 serum antibodies testing,by enzyme-linked immunosorbent assay. Results Among the 952 women unders study,230 cases(24.2%)showed HPV DNA positive,with positivity rates of HPV16 and 18 L1 virus-like particle(VLP)antibodies as 23.2%and 6.5%,respectively. The overall positivity rate of any type of HPV16,18 VLP antibodies was 26.8%. Geometric means of HPV16,18 VLP antibody titers were 79.1(Yangshengtang Unit,YU/ml)and 125.0(YU/ml). Positivity rate of HPV16 antibody was significantly associated with age,viral load of HPV DNA,and cervical lesion severity (P<0.05). Seropositvity of HPV18 was also increasing with the increase of viral load (P<0.01) with different cervical lesion significantly showing different titer of HPV18 antibody (P<0.01). Based on the results of HPV DNA detection among the two years of study,women with HPV persistent infection showed significant higher positive rate of HPV16/18 antibodies than women who did not have HPV infection or emerging infection (P<0.001). When comparing to those women without HPV infection,the ones with transient infection showed higher seropositivity rates on both HPV16 antibodies and titer of HPV16 antibody (P<0.001). Conclusion Seroprevalence rates on HPV16 and 18 among the unvaccinated high-risk women in Henan were high. Prevalence of both HPV16 and 18 antibodies were correlated with age,viral load,cervical lesion and history of infection. Women with high viral load,high grade cervical lesion or history of infection would more likely to be seropositive.

Distribution of serum antibodies against human papillomavirus 16 and 18 among high-risk women to cervical cancer / 中华流行病学杂志

Objective To explore the distribution of serum antibodies against human papillomavirus(HPV)16/18 among women at high-risk for cervical cancer. Methods All women when tested positive for anyone of the cervical cancer screening programs,from Xinmi county of Henan province in 2011,were recruited as the subjects of this study. Cervical exfoliated cells were collected,using cervical brush for HPV DNA testing,and 10 ml venous blood was drawn for HPV-16, 18 serum antibodies testing,by enzyme-linked immunosorbent assay. Results Among the 952 women unders study,230 cases(24.2%)showed HPV DNA positive,with positivity rates of HPV16 and 18 L1 virus-like particle(VLP)antibodies as 23.2%and 6.5%,respectively. The overall positivity rate of any type of HPV16,18 VLP antibodies was 26.8%. Geometric means of HPV16,18 VLP antibody titers were 79.1(Yangshengtang Unit,YU/ml)and 125.0(YU/ml). Positivity rate of HPV16 antibody was significantly associated with age,viral load of HPV DNA,and cervical lesion severity (P<0.05). Seropositvity of HPV18 was also increasing with the increase of viral load (P<0.01) with different cervical lesion significantly showing different titer of HPV18 antibody (P<0.01). Based on the results of HPV DNA detection among the two years of study,women with HPV persistent infection showed significant higher positive rate of HPV16/18 antibodies than women who did not have HPV infection or emerging infection (P<0.001). When comparing to those women without HPV infection,the ones with transient infection showed higher seropositivity rates on both HPV16 antibodies and titer of HPV16 antibody (P<0.001). Conclusion Seroprevalence rates on HPV16 and 18 among the unvaccinated high-risk women in Henan were high. Prevalence of both HPV16 and 18 antibodies were correlated with age,viral load,cervical lesion and history of infection. Women with high viral load,high grade cervical lesion or history of infection would more likely to be seropositive.

Risk Factors Analysis on Acute Respiratory Dysfunction Caused Death in Patients After Type A Aortic Dissection Surgery / 中国循环杂志

Objective: To analyze the risk factors on acute respiratory dysfunction caused death in patients after type A aortic dissection surgery. Methods: A total of 223 patients who received aorta replacement surgery in our hospital from 2010-01 to 2012-12 were retrospectively studied. 80 patients suffered from post-operative acute respiratory dysfunction including 61 male and 19 female with the mean age of (49.2 ± 11.6) years. Those patients were divided into 2 groups as Death group, n=18 and Survival group, n=62. We analyzed the most relevant risk factors for death, such as gender, age, histories of smoking, diabetes, hypertension, Marfan syndrome;pre-operative acute or chronic dissection, hypoxemia, mal-perfusion, LVEDD and LVEF;CPB time, aortic-clamping time;post-operative ICU retention time, mechanical ventilation time, permanent neurologic dysfunction, pulmonary infection, MACE, renal failure, hypohepatia, septicemia and wound mal-healing, et al. Results: The early post-operative ( Conclusion: The occurrence and mortality were high in patients after type A aortic dissection surgery especially in those with female gender and post-operative renal failure.

Effects of L-carnitine on renal anemia and nutritional status in maintenance hemodialysis patients:a Meta analysis / 中国基层医药

Objective The aim of this study was to analyze the influence of combined therapy with L-carnitine and erythropoietin on renal anemia and nutritional status in patients treated with maintenance hemodialysis.Methods The combination of computer and manual searches were used.A Meta analysis was made regarding the effect of combined therapy with L-carnitine and erythropoietin on the improvement of renal anemia and nutritional status in patients treated with maintenance hemodialysis.The quality of the 9 studies was evaluated with the Jadad score.Statistical analysis was carried out by RevMan 5.0.Results A total of 428 patients in 9 reports were analyzed.Metaanalysis showed that there were significant improvement in hemoglobin (Hb) [WMD =9.21,95％ CI (7.69 ～10.73)] and hematocrit (Hct) [WMD =2.61,95％ CI (2.28 ～ 2.93)],albumin (ALB) [WMD =1.64,95％ CI (1.04 ～ 2.24)] and total protein (TP) [WMD =2.72,95 ％ CI (0.67 ～ 4.77)] in the treatment group compared with the control group.The level of erythropoietin dosage [WMD =-38.24,95％ CI (-76.87 ～ 0.39)] was decreased significantly.But there were no significant differences in triglyceride and serum phosphorus.Conclusion Combined therapy with L-carnitine and erythropoietin in patients treated with maintenance hemodialysis leads to significant improvement of renal anemia and nutritional status.

Comparison of the intrusion effects on the maxillary incisors between implants and conventional method：a Meta-analysis / 重庆医学

Objective To objectively evaluate the intrusion effects on the maxillary incisors of implants versus conventional method(J-hook headgear ,utility arch) .Methods Such online databases as Cochrane library ,PubMed ,EMbase ,VIP ,Wanfang and CNKI were searched by randomized control test and prospective case controlled study about implants vs conventional anchorage for the maxillary incisor intrusion .After study selection ,assessment and data extraction conducted ,meta-analyses were performed by u-sing the RevMan 5 .1 software .Results Totally 11 studies were included ,6 studies involving 154 patients were included in the J-hook headgear group ,5 studies involving 127 patients were included in the utility arch group .The results of meta-analyses showed that :(1)Compared with the J-hook headgear ,implants had more decrement in the distance of upper center incisior cutting to palatal plane(P0 .05) .(2)Compared with the utility arch ,implants had more decrement in the distance of the center of resistance of the upper incisor to palatal plane (P=0 .010) ,less increase in U6-PP angle (P0 .05) .Conclusion The implants anchorage intruded the maxillary incisor was better than conventional method (J-hook headgear ,utility arch) ,it has more incisor intrusion ,shorter treatment time and more comfortable for the patients ,there was no difference in root resorption between the two groups .

The surgical methods and efficacy of 70 cases over 65 years old patients with aortic dissection / 中华胸心血管外科杂志

Objective To retrospectively analyze the surgical methods and efficacy in 70 cases of type A aortic dissection patients over 65 years old.Methods From January 2005 to May 2012,70 type A aortic dissection patients over 65 years old received surgical treatment.Among them,there were 47 males aged 65 to 78 years old with mean 71,23 females,aged 65 to 72 years old with mean 68.55 cases were acute onset,while 15 cases were chronically onset.Different surgical methods were selected depend on patients' situations.We followed up all patients after discharged from hospital to continue to observe their health situation and evaluate the therapeutic effects.Results After surgery,eight patients died in the hospital,62 patients were recovered and discharged from the hospital.The mortality rate is 11.4％.During the follow up period from 3 to 72 months,there were no dead,aneurysm rupture and others severe complications.9 cases received endovascular graft exclusion within 6 months after discharged from hospital.The survival patients were satisfactory healed with their daily living activity resumed.Conclusion For over 65 years old patients with aortic dissection,the accurate and rapid selection of surgical method could improve the survival rate and the quality of life with a lower occurrence rate of complications.

Application of team-based learning model in periodontics theoretical teaching / 中华医学教育探索杂志

Objective To explore the role of team-based learning(TBL)in the teaching of pe-riodontics for undergraduates. Methods Totally 38 2008 grade undergraduates majored in stomatology were divided into six groups according to previous test scores. Individual test,group test and group re-sponder were conducted successively . Average test scores before and intra class were calculated and questionnaires survey was conducted after the course. Results There was no significant correlation be-tween average test scores intra class and basic knowledge and preview effect(r=0.028,P>0.05). Ques-tionnaire survey demonstrated that learning motivation,learning interests,knowledge mastering and com-munication ability of students were significantly improved. Conclusion TBL teaching promotes the class-room atmosphere and improves team collaboration and learning enthusiasm. Students show high accep-tance for this new teaching modes,so it can be tried in the teaching of stomatology.