Objective To observe the clinical value of doppler ultrasound in evaluation of the treatment outcome of alcoholic liver disease.Methods 212 patients with alcoholic liver disease were selected.Ultrasound and liver function tests were applied before and after treatment,and temperance and medicines were applied for treating.The effects were used to observe the senlitivity of ultrasound applied in evaluation the treatment outcome of alcoholic liver disease.Results Of 212 cases,95 cases were diagnosed as alcoholic fatty liver disease by ultrasound before treatment,and the detection rate before treatment was 96.70％.51 cases were diagnosed as alcoholic hepatitis and 59 cases were alcoholic cirrhosis.After treatment,there were 37 cases had abnormal ultrasound images in 43 patients with alcoholic liver disease,and the detection rate was 86.04％.And 9 cases were diagnosed as alcoholic fatty liver disease by ultrasound,12 cases were diagnosed as alcoholic hepatitis and 16 cases were alcoholic cirrhosis.Conclusion It was noninvasive,cheap,convenient and repeated by using doppler ultrasound,and it was conducive to grasp the change of the condition of the patients for doctors.Ultrasound could be chosen as the preferred method for diagnosis of alcoholic liver disease.

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 summarize the methods and results of surgical treatment of coarctation of the aorta associated with aortic dissection.Methods Analyzed the clinical data of 10 patients with aortic coarctation associated type B aortic dissection who underwent one-stage surgical repair between 2011 and 2013 in Anzhen Hospital.There were 7 males and 3 females with the age ranged from 23 to 56 years,average at 41.2 years.All patients were diagnosed by UCG and CTA.There are three key points to determine the operation method,diameter of the aortic arch and descending aorta,and the extent of dissection.Descending thoracic aortic replacement with short stented elephant trunk was performed in 3 patients,thoracic and abdominal aortic replacement in 1 patient,ascending-abdominal aorta bypass with arch or descending aortic ligature in 3 patients.Results One hospital death occurred(10％).There was no severe surgical complication.No death or reoperation occurred during follow up period.Conclusion Aortic coarctation associated type B aortic dissection is a rare and complex disease.Surgical treatment is an effective and safe method for the disease.

Objective To observe the clinical effect of Biafine cream to prevent acute irradiation-induced dermal injury. Methods 104 patients who had to accept radiotherapy were randomized into two groups:treatment group(56 cases) was give Biafine cream application since the first radiotherapy session while the other 48 served as control without this medication when general and health education program was given. Results Dermal toxic rate and degree in the treatment group were obviously lower than those of the control group, with the difference between the two groups significant. Conclusions Biafine cream can effectively prevent acute irradiation-induced dermal injury. It can alleviate the patients' suffering and improve their quality of life, so as to ensure uneventful radiotherapy .

Objective To summarized the experience of simultaneous aortic operation and coroanry artery bypass graft (CABG).Methods Ninety seven patients who underwent combined aortic operation and CABG were reviewed from January 2009 to December 2011.All patients are divided into four groups according to etiology,63 aortic aneurysm,other 25 aortic dissection,7 coarctation of aorta or occlusion of main branch,and the other two aortic ulcer.Mean age of all patients is(57.6 ±9.5) years.The rate of preoperational diagnosis of coronary disease (CAD) were respectively 93.7％ (59/63),40.0％(10/25),100.0％,100.0％.The patients made the preoperative diagnosis of CAD were performed selective simultaneous CABG with aortic procedures.The others without diagnosis of CAD had to receive urgent CABG during the aortic procedures.Results The aortic procedures with simultaneous urgent CABG had signilicant higher mortality than with selective CABG,16.7％,3.8％,Fisher's exact test P =0.078.Conclusion Selective simultaneous CABG with aortic procedures is safely.In aortic surgery,patients with risk factors of CAD should undergo preoperative coronary artery angiography or spiral computed tomography.

Objective To summarize our clinical experience and results of intraoperative stented elephant trunk technique on Stanford type B dissection.Methods From March 2009 to December 2011,24 patients of Stanford type B aortic dissection with insufficient anchored zone or the left subclavian artery involvement underwent intraoperative stented elephant trunk technique in Beijing AnZhen Hospital.Of these patients,20 were male and 4 female,with a mean age of (50.6 ± 9.8) years,(36-77 years).Associated with hypertension in 20 cases,aortic root aneurysm in 1 case,aortic insufficiency in 2 cases,mitral insufficiency in 1 case,coarctation of the aorta in 1 case; 14 cases had a history of smoking.The postoperative internal fistula after descending thoracic aortic stent-graft occurred in 4 cases.Results 24 patients of Stanford type B aortic dissection with insufficient anchored zone or the left subclavian artery involvement underwent intraoperative stented elephant trunk technique.Concomitant procedures included the bypass from the left subclavian artery to the left common carotid artery in 5 cases,aortic valve replacement and ascending aortic plasty in 3 cases,left subclavian artery reconstruction in 2 cases,double valve replacement in 1 cases,the bypass from ascending aorta to descending aorta each in one.The times of cardiopulmonary bypass and selective cerebral perfusion averaged (163.1 ±48.6) min and (29.1 ± 12.4) min,respectively.There was no in-hospital mortality.Complications occurred in 2 patients (2/24,8.3％),including respiratory insufficiency and mediastinal bleeding requiring reoperation,each in one.No paraplegia or stroke occurred postoperatively.Follow-up was available in 23 patients (23/24,95.8％).During the follow-up,type Ⅰ endoleak occurred in 2 patient and needed surgical repair.One patient underwent endovascular aortic repair due to pseudoaneurysm of the distal end of the stent.The complete thrombosis ratio of the false lumen was 86.4％ (20/24).Conclusion The intraoperative stented elephant trunk technique was safe and feasible for Stanford type B aortic dissection with insufficient anchored zone or the left subclavian.artery involvement,a low rate of morbidity and mortality were achieved.The long-term results need the further follow-up.

Objective To summarize the experience of surgical repair for Stanford type A aortic dissection after cardiac surgery.Methods From February 2009 to December 2011,11 patients who underwent previous cardiac surgery accepted the aortic surgery for Stanford type A aortic dissection.There were 8 males and 3 females.The range of age was from 29 to 64 years,the mean age was(52.27±9.90) years.In these patients,one patient had underwent ventrical septal defect,one patient atrial septal defect,nine patients aortic valve replacement.The interval between the two operations was 1-26 years.The types of aortic dissection was A1S(4 patients),A1C(1 patient),A2S(1 patient),A2C(4 patients),A3C(1 patient).All the patients underwent aortic surgery for aortic dissection.Results The time of cardiopulmonary bypass was 75-409 minutes,the mean value was(185.36± 99.67) minutes.Aortic cross clamp time was 37-203 minutes,the mean value was (84.09± 48.36) minutes.Total six patients needed deep hypothermia and selective cerebral perfusion time was 8-32 minutes.The mean value was(17.71 ± 9.48) minutes.One patient dead in the hospital and the mortality was 9％.The morbidity was 27％.Ten patients followed up 16-45 months.No aortic rupture,paraplegia and death were observed in follow-up time.Conclusion The delayed Stanford type A aortic dissection after cardiac surgery should be attached great importance and always need emergency surgery to save patients' life.The technique is demanding and risk is great for surgeons and patients.For the patients who suffered aortic valve disease combined with dilation of ascending aorta larger than 4.5 cm,the ascending aorta also should be repaired while aortic valve replacement is performed,which could avoid delayed aortic dissection in the future.

Purpose To evaluate the diagnostic significance of non-contrast enhanced magnetic resonance angiography (NCE-MRA) for lower extremity arterial stenosis on a 3.0T MR scanner, in order to provide a reliable method for clinical application. Materials and Methods Thirty patients with arterial disease in lower extremity underwent NCE-MRA before contrast enhanced magnetic resonance angiography (CE-MRA). Image quality of the two methods was compared. The diagnostic accuracy for significant stenosis ( ≥50%) of NCE-MRA was assessed using CE-MRA as a golden standard. The consistency of the two methods in diagnosis of significant stenosis ( ≥ 50%) was analyzed. Results All patients successfully underwent both NCE-MRA and CE-MRA examination. There were 532 arterial segments detected by NCE-MRA. In the calf region, venous artifacts presented more frequently on CE-MRA (Z=4.92, P<0.01), while in the abdominal and the femoral regions, venous artifacts presented more frequently on NCE-MRA (Z=4.58 and 3.56, P<0.01). The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of NCE-MRA for the diagnosis of significant stenosis ( ≥ 50%) were 97.89%, 97.69%, 97.74%, 93.92% and 99.22%, respectively. There was good agreement (Kappa=0.94, P<0.05) between the two methods. Conclusion For the imaging of lower extremity arterial stenosis, NCE-MRA shows similar image quality and diagnostic accuracy with CE-MRA, thus can be used as an alternative method for lower extremity arterial stenosis in patients who have renal insufficiency or other contraindication of contrast media.

Objective The aim of this study was to evaluate whether the reoperation is the risk factor for mortality after Sun's procedure(Total aortic arch replacement + frozen elephant trunk) for Stanford type A aortic dissection involving aortic arch.Methods Between February 2009 to February 2012,data from 383 patients who underwent Sun's procedure for Stanford type A aortic dissection involving aortic arch were collected retrospectively.35 patients had history of cardiac surgery.Of these patients,16 patients had underwent Bentall procedure,7 patients ascending aortic replacement,4 patients Wheat surgery,4 patients aortic valve replacement,2 patents Bentall combined with mitral valve replacement or plasty,1 patient bivalve replacement,1 patient atrial septal defect repair,1 patient coronary artery surgery.All the risk factors related to mortality were analyzed by univariate statistical analysis.Significant univariate variables were entered into multiple logistic analysis.Results Total 31 patients died in the hospital and the mortality was 8.07％.Of the 35 patients with history of cardiac surgery,3 patients died and the mortality was 8.33％.Univariate analysis showed that symptom onset before surgery less than 1 week,preoperative limb ischemia,combining with coronary artery surgery and cardiopulmonary bypass time longer than 300 minutes in the operative were risk factors for mortality.After these factors were entered into multiple logistic regression analysis,the result showed that symptom onset before surgery less than 1 week (P =0.038,OR =2.43),cardiopulmonary bypass time longer than 300 minutes(PP ＜0.001,OR =12.05) were final independent risk factors for mortality.Reoperation was not the independent risk factor for mortality.The intensive care unit and mechanical ventilation length of reoperation group was (2.09 ± 1.89) days and(30.09 ±33.42) hours respectively,while that of primary group was(2.71 ±3.01) days (P =0.25) and(33.86 ±40.98) hours(P =0.61) respectively.The incidence of postoperative bleeding of reoperation group was 3.03％,while that of primary group was 1.88％ (P =0.50).Conclusion Reoperation was not the independent risk factor for mortality after Sun's procedure for Stanford type A aortic dissection involving aortic arch and the morbidity was also not higher than primary surgery.For these patients,sun' s procedure should be advocated.