Objective This retrospective study was perform to assess risk factors of the type A aortic dissection after aortic valve replacement,in order to provide a basis for devising a strategy for future treatment.Methods From 2009 to 2012,23 patients were found type A aortic dissection and 20 patients were found aortic aneurysm after aortic valve replacement in Beijing Anzhen hospital.Analysis the clinical,pathology and surgery procedure characteristics of these patients,and assess the risk factors for type A aortic dissection after aortic valve replacement.Results After aortic valve replacement,There were significant different in age (P =0.012),bicuspid aortic valves (P =0.014),aortic valve regurgitation (P =0.009) and postoperative pathoanatomical characteristics(P =0.001) between type A aortic dissection group and ascending aortic aneurysm group.Multivariate logistic regression analysis indicated that age(P =0.032),aortic valve regurgitation(P =0.046) and pathoanatomical characteristics(P =0.002) were important risk factor for type A aortic dissection after aortic valve replacement,respectively.Conclusion Older age,aortic regurgitation combined and thinned or fragile aortic walls with systemic hypertension in patients with ascending aortic dilatation (≥45 mm diameter) at the time of AVR might be predisposing factors for postsurgical type A aortic dissection.These patients should be considered for concomitant replacement or repair of the ascending aorta unless the patient has a high operative risk.

Objective: We studied immunological and physiological effect by the polarized infrared light irradiation near the neck stellate ganglion. Methods: Subjects were eleven healthy volunteers (age 21-22 years old, male). The polarized infrared light irradiation system (Super Lizer HA-550) for 20 minutes was used for the irradiation near the stellate ganglion. In the dummy, they were treated by the same irradiation instrument that the light were obstructed completely. We analyzed hematological test and perspiration quantity and temperatures of limbs and blood pressure before and after the irradiation. Results: The leukocytes decreased (p<0.01) and NK cells decreased after the irradiation significantly. The hormone and blood pressure did not significantly change. The perspiration of right hand (irradiated side) was significantly decreased. The peripheral temperature of bilateral upper and lower limbs elevated after the irradiation. Conclusion: It was considered that the effect by the polarized infrared light irradiation near the stellate ganglion was the same with the sympathetic nervous ganglion block which dilated arteries and increased of peripheral circulation, and inhibited the sympathetic nervous function.

Objective To investigate the health security requirements on food and drinking water during military training on the plateau,and explore ways to improve military health security support capability.Methods Seven army units were randomly chosen.By means of on-site check and sample detection,both internal and external environmental factor changes and health and safety conditions of food and drinking water were surveyed on the plateau.Internal and external standard methods were used to test the stability of portable instruments.Results There was considerable difference in diurnal temperature and relative humidity between indoors and outdoors.In two field units,raw materials of foods were purchased in a centralized manner and suppliers were fixed,they were purchased independently in the othev five units. Facilities of food storage and transportation were lacking in all the seven units.In one of the fifty-three food samples, residues of pesticides exceeded the national standard.Among the three water samples,the level of turbidity,ammonia nitrogen and nitrate nitrogen was lower than the standard limits,but free residual chlorine and total chlorine were not detected.The plateau environment had no significant effect on spectrophotometers,but had significant influence on enzyme-linked immune detectors.Conclusion There are potential health hazards to training troops on the plateau that arise from foods and drinking water.Improvement of management and equipment adaptability is needed to further enhance the field health security efficacy.

The present experiment was to study the effect of stromal cell infusion on hematopoietic recovery after peripheral blood stem cell transplantation in mice. BALB/c mice pre conditioned with high dose chemotherapy/radiotherapy were infused with peripheral blood stem cells (PBSCT group) or a combination of peripheral blood stem cells and bone marrow stromal cells (experimental group). Four week survival rate, white blood cell (WBC) count, bone marrow nucleated cells (BMNC), granulocyte macrophage colony forming units (GM CFU), fibroblast colony forming units (F CFU) were determined. The results showed that survival rate, BMNC, GM CFU, and F CFU were significantly higher in experimental group than that in PBSCT group ( P

Objective: To evaluate the surgical results of aortic regurgitation caused by aortitis. Methods: Results: Between 1990 and 2002, 20 patients with aortic regurgitation caused by aortitis underwent surgery. The surgical procedures included aortic valve replacement in 12 patients and aortic root replacement in 8 (Bentall type operation in 5, Cabrol type operative in 2, and David type operation in one). Conclusion: There was no operative death. The follow-up duration ranged from 2 to 61 months (mean, 24 months). Postoperative perivalvular leakage and/or detachment of the prosthetic valve occurred in 7 patients after aortic valve replacement. 7 patients required re-operation, and 3 patients underwent third operation due to perivalvular leakage. There were 4 later deaths (20%). Conclusion: The timing for the operation, selection of operative procedure, and preoperative control of active inflammation were essential for successful treatment of aortic regurgitation caused by aortitis.

Objective: To review the experience of one-stage surgical management of thoracic aortic aneurysm associated with coronary artery disease. Methods: From June 1999 to July 2002, fifteen patients (all the male, average age 57.21 year-old, ranged 40-66 year-old) underwent thoracic aortic aneurysm repair and concomitant coronary revascularization. The diagnosis are aortic root aneurysm in 5 cases,ascending aortic aneurysm in 2,arch aortic aneurysm in 3,and aortic dissecting in 5. 14 patients received operation through midsternotomy,including ascending aorta replacement in 2, Bentall technique in 4, David technique in 1 and total arch replacements in 3 patients. Left thoracotomy and off-pump CABG was done in 1 case. Results: 1 patient died in 30 days after operation. Followed up for a mean duration of 17 months,there were no late death and no reoperation and no related events occurred. Conclusion: Thoracic aortic replacement and CABG (coronary artery bypass grafting) could be done at one-stage. Concomitant coronary revascularization may aggressively obviate CAD events.

Objective: To compare the clinical outcome between ministernotomy and standard median sternotomy in aortic root replacement. Methods: A total of 60 patients underwent aortic root replacement (ARR) between July 1999 and October 2001 in Fu Wai Hospital. 15 patients who underwent ARR by ministernotomy were defined as the MINI group. The comparable group was 45 patients who underwent ARR by standard median sternotomy (STD group). Results: There was no post-operative death in each group. Early postoperative complications occurred in 3 (20.0%) of the MINI group and in 5 (11.1%) of the STD group (P= 0.661). In the MINI group, both the mean opera ting time and the cardiopulmonary bypass time were significantly longer than that in STD group (P=0.027, P=0.015). There was no significantly difference in ao rtic cross-clamping time between two groups. In the MINI group, the mean intubation time, postoperative blood transfusion amount, the mediastinal drainage and duration of hospital stay were less than that of the STD group. But, they all showed no statistical significant differences. Conclusion: Both approaches for patients undergoing AAR resulted in acceptable morbidity. AAR by ministernotomy provides a potential benefit of less trauma and reduction of blood transfusion.

Objective To compare the cerebral protection effect of unilateral and bilateral antegrade selective cerebral perfusion during total aortic arch replacement. Methods From June 2003 to March 2004, 16 patients undergoing total aortic arch replacement were divided into two groups, randomized: unilateral antegrade selective cerebral perfusion (unilateral group, n=8) and bilateral antegrade cerebral perfusion (bilateral group, n=8). Preoperative and postoperative brain CT scan were performed. During the operation, the pressure in innominate artery and left common carotid artery were monitored. Blood gas samples were drawn from jugular venous bulb. Results There was no postoperative death and all patients were discharged from hospital. No new brain infarction occurred. Transient neurological dysfunction occurred in 1 patient of each group. In unilateral group, the pressure in innominate artery was higher than that in left common carotid artery during antegrade selective cerebral perfusion (P0.05). Conclusion Both methods of brain protection for patients undergoing total aortic arch replacement resulted in favorable levels of mortality and morbidity. The circle of Willis was patent and collateral flow was adequate. Unilateral antegrade selective cerebral perfusion has the advantage of simplicity. The bilateral perfusion pressure was more even in bilateral antegrade selective cerebral perfusion, and whether bilateral antegrade selective cerebral perfusion carry a higher risk of embolism need further investigation.

180 min and arterial blood pressure instability are independent determinats for cerebral complication. Conclusion No single risk factor explained the onset of cerebral complication. Rather, a combination of factors, especially longer CPB time, postoperative arterial blood pressure instability produced the highest odds of deficit.

Objective To studied perioperative changes in blood coagulation and the fibrinolytic system in patients undergoing acute aortic disec tion repair analyse the reason and outcome for these changes.Methods Between August 2011 and December 2011,30 patientsk[22 male and 8 female,mean aged (43.0±9.13) years] had undergone open repairs of aortic dissection or aneurysm with DHCA.Indications for surgical intervention were type A sortic dissection in 26 patients and aortic aneurysm in 4 patients.According to the time from clinical onset of the dissection to operation,acute group(less than 7 days,A group) 20 patients; chronic group (more than 30 days and aortic aneurysm,C group) 10 patients.Data were gathered for muhiple preoperative and intraoperative factors including age,sex,diagnosis,aortic dissection type,preoperative ejection fraction,aortic surgery history,surgical intervention type,cardiopulmonary bypass (CPB) time,aortic cross-clamp time,blood transfusion volume (PRBC),mechanic ventilation time,ICU length of stay and hospital length of stay.Platelet (PLT),fibrin degredation product (FDP),D-dimmer,thrombin-antithrombin (TAT),and soluble fibrin monomer complex (SFMC) were assayed before and after operation,as well as 0 h,24 h,48 h,72 h.These valuables were recorded and compared statistically between two groups.Results Preoperative serum level and postoperative peak level of FDP and D-dimmer in group A were significant higher than in gnoup C (P ＜ 0.05)and postopertive serum peak level in group C were significant higher than preoperative level (P ＜ 0.05 ).Preoperative snd postoperative most hours there was significant intergroup difference on the serum levels of SFMC and TAT (P ＜ 0.05 ).Preoperative level of PLT in group A is lower than in group C significantly (P ＜ 0.05 ).The level of PLT in each hour after surgery were much lower than the level before surgery in both group (P ＜0.05 ).In addition,thromhus fonantion in ascending aortic falsc lumen in group A was much moee common than in group C (P ＜0.05 ).There was significant difference on incidence of postoperative complications between two groups (P ＜ 0.05 ).Conclusion Activation of coagulation and fibrinolysis which results from acute aortic dissection and surgical procedure was obscrved before and after surgery to treat acute aortic dissection.There is increasing risk for consumption coagulopathy and thromboembolism during perioperative period.