Objective This study aims to evaluate the initial results of a hybrid procedure for treating descending thoracic aortic disease that involves distal aortic arch.It also intends to report our initial experience in performing this procedure.Methods A total of 45 patients(35 males and 10 females) with descending thoracic aortic disease underwent a hybrid procedure,namely,thoracic endovascular aortic repair(TEVAR) combined with supra-arch branch vessel bypass,in our center from April 2009 to August 2014.Right axillary artery to left axillary artery bypass(n =20) or right axillary artery to left common carotid artery and left axillary artery bypass(n =25) were performed.The conditions of all patients were followed up from the 14th month to the 77th month postoperative[mean(38.0 ± 17.1) months].Mortality within 30 days,complications such as endoleak after the hybrid procedure,and stenosis or blockage of the bypass graft during the follow-up period were assessed.Results One case of death and one case of cerebral infarction were reported within 30 days.Two patients underwent open surgery beacuse of endoleak.And a newly formed intimal tear was observed in one patient and the patient underwent a second TEVAR during the follow-up period.Condusion Initial results suggest that the one-stage hybrid procedure is a suitable therapeutic option for thoracic aortic pathologies that involve distal aortic arch.However,this procedure is not recommended for type-B aortic dissection,in which a tear is located in the greater curvature or near the left subclavian artery,because of the high possibility of endoleak occurrence.

[Objective]Summarize the Professor GUO Lizhong's experience of treating depression with strengthening Yang-Qi, providing a new perspective for the treatment of depression. [ Methods]Through observing and recording the clinical work with Professor GUO, organizing medical records, prescriptions and collecting lecture materials, theses and writings, analyzing its dialectical ideas, prescription and medication; by retriving ancient TCM books and analyzing famous TCM doctors' academic thoughts, to summarize Professor GUO's point of treating depression academic ideas and prescription drugs by strengthening Yang-Qi. That choosing Sini soup combined with Guipi soup and Tianjing soup receives good effect. [Results]Professor GUO Lizhong's thought mainly originates from classical works, such as "Internal Classics", who thinks that Yang-Qi deficiency is the root cause of depression, the essence and blood deficiency are the key links, frivolous virtual fire is its incentive, treatment of wanning or diving Yang-Qi is the first, then support essence and Yang-Qi. Two cases of depression returned to normal work and life after treatment of warning and diving Yang-Qi and supporting essence and Yang-Qi. [ Conclusion ]lt's unique of Professor GUO's experience in the treatment of depression, it is worthy of further study and experience of the dialectical ideas and election of prescription clinical value. To take GUO's experience for treating depression from the "Yang weakness, essence and blood deficiency, Yin fire up", and apply his rule can markedly relieve depression patients' clinical symptoms and obviously improve patients' life quality.

BACKGROUND:Compared with the cone stem,short stem holds good matching with femoral canal,and remarkably reduces the risk of prosthesis loosening.OBJECTIVE:To further investigate the clinical efficacy of Accolade Ⅱ stem for Crowe type Ⅰ developmental dysplasia of the hip.METHODS:Clinical data of 16 patients with Crowe type Ⅰ developmental dysplasia of the hip undergoing total hip arthroplasty using Accolade Ⅱ stem were collected,the length of both lower limbs before and after surgery was compared,and the Visual Analogue Scale,functional recovery of the hip and general conditions were observed at 12 weeks postoperatively.RESULTS AND CONCLUSION:(1) The change in length of both lower limbs before and after surgery had significant difference (P ＜ 0.05),and 10 patients (62％) with the same length of both lower limbs before surgery,and 15 cases (94％) after surgery.(2) The postoperative acetablar abducent angle was 41°-54° (average 46.9°).(3) The Visual Analogue Scale and Harris hip scores after surgery were significantly improved compared with baseline (P ＜ 0.05).(4) The intraoperative blood loss was 147 mL on average,the mean operation time was 72 minutes,and the hospitalization time was 7.2 days.(5) All patients recovered well and no complications occurred at 3 months postoperatively.(6) To conclude,Accolade Ⅱ stem is safe and reliable for Crowe type Ⅰ developmental dysplasia of the hip,and exhibits good functional recovery of the hip.

Objective To discuss the timing and procedures of reoperations on the residual aortic dissection after initial ascending aortic operations on Stanford type A aortic dissection.Methods From March 2009 to November 2011,16 consecutive patients(13 males,3 females) underwent reoperations on the residual aortic dissection.The mean age was 44 years(23-61 years),8 cases was associated with Marfan syndrome.The right axillary artery or femoral artery cannulation was used for cardiopulmonary bypass,cerebral protection was achieved by unilateral antegrade brain perfusion and nasopharyngeal temperature was dropped to 20℃-25℃.The Sun's procedure (total arch replacement with stented elephant trunk implantation) was performed in all patients,concomitant procedure include aortic root replacement (Bentall procedune) in 3 patients,aortic root replacement and coronary artery bypass grafting (Bentall + CABG) in 1 patient,the coronary artery anastomotic leakage repair in 1 patient,mitral valve replacement (MVR) in 1 patient.Results The interval between two operations averaged(66 ±40)months.The means of cardiopulmonary bypass,cross clamp and selective cerebral perfusion times were(193 ± 49)minutes,(90 ±28) minutes and(22 ± 10) minutes,respectively.The mean time to tracheal extubation was(17 ± 10) hours.All patients survived from the operation.One patient suffered from temporary left lower limb paralysis and recovered after treatment during follow-up.Computed tomography angiography (CTA)of aorta was performed on each patient before discharged from the hospital:descending aortic true lumen was significantly expanded,thrombosis of false lumen was found near stent graft.The average follow-up time was 17 (3-42) months,one patient died of aortic rupture 3 months later,one patient underwent total thoracoabdominal aorta replacement 6 months later,one patient with descending thoracic aortic dilatation combined with endometrial tear underwent thoracic endovascular aortic repair.Conclusion Reoperation should be performed as the following condition:the annual growth rate of residual aortic diameter exceeds 0.5 cm/year,the maximal aortic diameter exceeds 5 cm.The Sun's procedure (total arch replacement with the elephant trunk implantation) is safe and effective in the treatment of residual aortic dissection,low mortality and complications was achieved by it,the mid-and long-term results need the further follow-up.

AIM: To study the effect of mesenchymal stem cells (MSCs) infusion on hematopoietic recovery after peripheral blood stem cell transplantation in mice. METHODS: BALB/c mice conditioned by high dose chemotherapy/radiotherapy were infused with 10 6 peripheral blood mononuclear cells (PBMC) mobilized by granulocyte colony-stimulating factor (PBSCT group), 10 4 MSCs culture-expanded in vitro and 10 6 PBMC(experimental group 1), 10 6 MSCs and 10 6 PBMC(experimental gruop 2). Survival rate within 4 weeks, white blood cell count, bone marrow nucleated cells (BMNC), granulocyte-macrophage colony forming unit(GM-CFU) and fibroblast colony forming unit (F-CFU) were examined. RESULTS: Survival rate, BMNC, GM-CFU, F-CFU were significantly higher in experimental group 2 than that in PBSCT group ( P

Objective:To analyse ZHOU Zhong-ying’effective combination drugs in preventing and treating the systemic lupus erythematosus(SLE).Methods:Association rules based on Chi-squared analysis and influence degree was used.Results:73 Rules of TCM couples were selected in the high frequency drugs distribution,and the drugs were mainly those for heat clearing,antidote medicines and blood act stasis remove medicines,which was in accordance with the main pathological mechanism factor for SLE given by Professor Zhou.Conclusion:The new method could find out many significant TCM couples in the study of the compatibility of TCM.

Objective To explore the clinical effect of stomach-tonifying decoction combined with western medicine on the treatment of patients with yin deficiency syndrome of stomach of chronic atrophic gastritis.Methods Totally 68 patients with yin deficiency syndrome of stomach of chronic atrophic gastritis were randomly divided into control group (n =33) and treatment group (n =35).The control group was treated with western medicines such as amoxicillin capsules,clarithromycin sustained release tablets,omeprazole enteric-coated capsules and bismuth potassium citrate capsules.The treatment group was treated with stomach-tonifying decoction on the basis of the control group.Both groups were treated for 6 weeks.The clinical efficacy,score of TCM syndromes,gastric mucosa pathological score and gastric mucosal inflammation indexes [interleukin-11 (IL-11),interleukin-12 (IL-12),C reactive protein (CRP) and tumor necrosis factor-α (TNF-α)] and gastric mucosal immune function indexes (CD4 +,CD8 + and CD4 +/CD8 +).Results The total effective rate of the treatment group was 94.29％,which was significantly higher than 75.76％ of the control group (P ＜0.05).After treatment of 6 weeks,the scores of TCM syndromes in both groups were significantly lower than those before treatment (P ＜ 0.05),and the scores of main TCM symptom such as epigastric pain,abdominal nausea after eating,loss of appetite and score of minor TCM symptom such as nausea and vomiting and total score in the treatment group were significantly lower than those in the control group (P ＜ 0.05).After 6 weeks of treatment,the gastric mucosa pathological score in both groups was significantly lower than that before treatment (P ＜ 0.05),and the score of the treatment group was significantly lower than that of the control group (P ＜ 0.05).After treatment of 6 weeks,the gastric mucosal inflammation indexes and gastric mucosal immune function indexes in both groups were significantly lower than those before treatment (P ＜ 0.05),and these indexes in the treatment group were significantly lower than those in the control group (P ＜ 0.05).Conclusion Stomach-tonifying decoction combined with western medicine is effective in treating patients with yin deficiency syndrome of stomach of chronic atrophic gastritis,which can significantly improve the clinical symptoms and reduce the degree of inflammatory reactions of gastric mucosa,so it is worthy of clinical application.

Objective To explore the clinical effect of stomach-tonifying decoction combined with western medicine on the treatment of patients with yin deficiency syndrome of stomach of chronic atrophic gastritis.Methods Totally 68 patients with yin deficiency syndrome of stomach of chronic atrophic gastritis were randomly divided into control group (n =33) and treatment group (n =35).The control group was treated with western medicines such as amoxicillin capsules,clarithromycin sustained release tablets,omeprazole enteric-coated capsules and bismuth potassium citrate capsules.The treatment group was treated with stomach-tonifying decoction on the basis of the control group.Both groups were treated for 6 weeks.The clinical efficacy,score of TCM syndromes,gastric mucosa pathological score and gastric mucosal inflammation indexes [interleukin-11 (IL-11),interleukin-12 (IL-12),C reactive protein (CRP) and tumor necrosis factor-α (TNF-α)] and gastric mucosal immune function indexes (CD4 +,CD8 + and CD4 +/CD8 +).Results The total effective rate of the treatment group was 94.29％,which was significantly higher than 75.76％ of the control group (P ＜0.05).After treatment of 6 weeks,the scores of TCM syndromes in both groups were significantly lower than those before treatment (P ＜ 0.05),and the scores of main TCM symptom such as epigastric pain,abdominal nausea after eating,loss of appetite and score of minor TCM symptom such as nausea and vomiting and total score in the treatment group were significantly lower than those in the control group (P ＜ 0.05).After 6 weeks of treatment,the gastric mucosa pathological score in both groups was significantly lower than that before treatment (P ＜ 0.05),and the score of the treatment group was significantly lower than that of the control group (P ＜ 0.05).After treatment of 6 weeks,the gastric mucosal inflammation indexes and gastric mucosal immune function indexes in both groups were significantly lower than those before treatment (P ＜ 0.05),and these indexes in the treatment group were significantly lower than those in the control group (P ＜ 0.05).Conclusion Stomach-tonifying decoction combined with western medicine is effective in treating patients with yin deficiency syndrome of stomach of chronic atrophic gastritis,which can significantly improve the clinical symptoms and reduce the degree of inflammatory reactions of gastric mucosa,so it is worthy of clinical application.

ObjectiveTo explore the surgical techniques and clinical experiences in treating thoracoabdominal aorta dissecting aneurysm following Sun's procedure.MethodsFrom June 2009 to May 2011,thoracoabdominal aorta replacement was performed in thirteen patients with thoracoabdominal aorta dissecting aneurysm following Sun's procedure in Beijing Anzhen Hospital.Among which,eleven were male,and two were female with a mean age 39.3 years (28 -58 years).All cases were Stanford A aortic dissection,and were underwent Sun's Procedure.The pathogeny of the dissection,ten were Marfan's syndrome,and three were hypertension.Thoracoabdominal aorta dissecting aneurysms were all Crawford type Ⅱ,with the diameter( 5.78 ± 1.00 )cm (4.0 -8.0 cm).All the procedures were performed through combined thoracoabdominal incision via the retroperitoneal approach.And thoracoabdominal aorta was replaced by a tetrafurcate graft with short-time interval circulatory arrest.24 - 30 mm tetrafurcate grafts were selected in all patients.The main graft of the tetrafurcate graft was anastomosed to the elephant truck stent graft.Visceral arteries were joined into a patch and were anastomosed to the other end of the main graft.T6 to T12 intercostal arteries were reconstructed by an 8 mm sidearm.Another 8 mm sidearm was anastomosed to the left renal artery.Both 10 mm sidearms were anastomosed to iliac arteries.Among which,seven were underwent by profound hypothermia with circulatory arrest,and six were underwent off pump with normal temperature.ResultsNo early death.Twelve patients were cured and discharged from hospital.Seven patients were underwent profound hypothermia with circulatory arrest.Among which,one patient had paraplegia,sepsis,pseudomembranous colitis,respiratory failure,and died on 102-day after operation.Another one patient had neurological dysfunction and was cured after six-day's dehydrated treatment.The UFCT showed that the tetrafurcate graft was unobstructed,no distortion,no pseudoaneurysms in all patients.The branch to intercostal arteries was obstructed in three cases,but there were no spinal cord ischemia complications.The mean duration of follow-up was (9.6 ±2.1 ) months (range,1 -24 months),with a follow-up rate of 100％.All the tetrafurcate graft were very well,no obstruction,no distortion and no pseudoaneurysms.There were no cerebral,spiral cord and abdominal viscera ischemia complications in all patients.ConclusionThoracoabdominal aorta replacement after Sun's procedure is simple,and it is helpful to reduce complications.Following Sun's procedure,using tetrafurcate graft with short-time interval circulatory arrest and off pump technique in thoracoabdominal aorta replacement is simple,and it is helpful to reduce complications.

Chongqing Medical University attaches great importance to innovation ability training in undergraduates and cultivates the innovation ability of students by strengthening the combination of basic medical theory and practice. In recent years, "Dachuang Project", "Dachuang Platform", and excellent medical undergraduate tutorial research projects have helped to deepen the innovation ability training in medical undergraduates and make good achievements in the publication of scientific research articles, various scientific competitions, and patent applications. However, there are several problems in cultivating the innovation ability of medical undergraduates, such as the weak medical background knowledge of junior students, the single professional of tutors, and the lack of platform instruments and equipment, and therefore, it is necessary to reform innovation ability training in medical undergraduates. On this basis, the research group proposes targeted improvement countermeasures from the three aspects of students, supervisors, and management mechanism after extensive investigation and research, in order to provide new clues for deepening the reform of innovation ability training in medical undergraduates.