Objective:To evaluate the novel technique of carotid-carotid bypass combines with windowed stent-graft in the treatment of aneurysms at the aortic arch without thoracotomy. Methods:Firstly,a right to left common carotid artery bypass was established with a graft with rings.Then the stent-graft was windowed at the determined position.Finally,the stent-graft was deploied into the aortic arch to exclude the aneurysm with the anonyma maintained patent.Results: The grafts were patent,and no brain ischemia or cranial accident occurred.The left upper limbs maintained there function.The left common carotid artery and the left subclavian artery were sealed.The aneurysms were occluded.Conclusions:The technique is a suitable method for the arch aneurysm,and is mini-invasive which may avoid of macro-trauma,large volume of blood loss, and the unstable of the blood dynaminc statement resulting from thoracotomy.The lumen of the aneurysm is still occluded thoroughly,and the procedure is simplified.But only a veteran endovascular doctor may control it safely.

OBJECTIVE:To investigate the compatible stability of ondansetron hydrochloride injection and carboplatin for injection.METHODS:The content of the mixture of ondansetron hydrochloride injection and carboplatin for injection was determined within8hours at a room termperature by ultraviolet-visible spectrophotography;its outward appearance was ob?served and the pH value of the mixture was determined.RESULTS:The appearance and pH value of the mixture had no distinct change.CONCLUSION:The mixture of ondansetron hydrochloride injection and carboplatin for injection was stable within8hours after interaction.

Objective To evaluate the curative effect and toxic reaction of pemetrexed combination with carboplatin as the therapy in advanced non-small cell lung cancer(NSCLC) of senium.Methods A total of 49 chemotherapy naive patients with ⅢB or Ⅳ NSCLC were enrolled in this study.Pemetrexed was given at a dose of 500mg/m2.Carboplatin dosed to an area under the time-concentration curve( AUC ) of 5.The chemotherapy was repeated every 21 days.Each patient was given at least 2 cycles.Results The curative effects of all the patients were evaluated.Among the 49 patients, the symptoms of 23 had been partially response ,21 stabilized and 5 progressed.The total effective rate was 46.9% ( 23/49 ).The efficiency of 68.2% in NSCLC with ⅢB phase were significantly higher than,29.6% in NSCLC with IV phase( X2 = 3.879, P < 0.05 ), Median time to progression (TIP) was 5.3 months.Median survival duration was 11.2 months( 3～ 21 months), and one year survival rate was 54.3%.The major toxicity included neutropenia, nausea, vomiting and diarrhea, impaired liver function, febrile neutropenia, etc.The severity of these side effect was in grade Ⅰ-Ⅱ and well tolerated.Among 49 cases,23 cases of leukopenia(46.9% ) was significantly higher than that of nausea in 11 cases (22.4%), vomiting in 5 cases ( 10.0% ), abnormal liver function in 4 cases( 8.0% ).Fever in 1 case ( 2.0% ) ( X2 = 3.879, P < 0.05 ; X2 = 8.451,8.778,9.123,9.741, all P < 0.01 ).Conclusion Pemetrexed combination with carboplatin was effective in the first line treatment of advanced non-small cell lung cancer,with mild to moderate side effect and safety in clinical practice.

Objective To explore the effectiveness and safety of CT-guided chemical thoracic sympathectomy(CTS) for Raynaud′s phenomenon in the upper limbs.Methods Ten patients with Raynaud′s phenomenon in 20 limbs were enrolled in this study.Among the patients,4 were recurrent cases,who had undergone X-ray-guided CTS.Under CT guidance,a needle was punctured through the back skin to the second or third thoracic sympathetic ganglion beside the thoracic vertebrae,and then 3 ml of 5% phenol was injected into each located point.Results After the treatment,10 limbs achieved excellent outcomes,3 were good,4 were improved,and 3 were non-effective.The totally effective rate was 85.0%(17/20).The effective rate was 92.9%(13/14) in the limbs with primary Raynaud′s phenomenon,66.7%(4/6) in those with secondary Raynaud′s phenomenon,and 75.0%(6/8) for the recurrent cases.No patient developed pneumothorax. Conclusions CT-guided CTS is a minimally invasive surgery for Raynaud′s phenomenon in upper limbs with a high effective rate.The procedures can be used to treat recurrent cases.

Objective:To provide anatomic basis for the location and protection of the tributaries of the inferior vena cava (IVC) in the retroperitoneal surgery.Methods:Fifty adult cadavers fixed with formalin were collected at random for study.The IVC and its tributaries were dissected,observed and measured in the region from the confluence of the left and right common iliac vein to the superior border of left renal vein(the initiative segment of IVC).Results:(1)The length of this segment of IVC was 13.12+1.51cm,and outer-diameter was 2.25?0.24cm.The number of vein tributaries from this segment was 8.75?2.02,66.3% of the tributaries entered the IVC posteriorly,and 66.4% of the tributaries entered the IVC on renal region(renal segment of IVC i.e.segment from the inferior end of right kidney to the superior border of left renal vein).(2)Vein tributaries:①Right gonad vein:84.9% of these veins entered the IVC anteriorly.The average distance from the point where the right gonad vein entering the anterior wall of IVC was approximately 3.56?0.85cm away from the superior border of left renal vein.②Lumbar vein(100%):The location of the lumbar veins in the infrarenal portion of the IVC was highly variable.A great number of veins was noted on the left(3～4)than on the right side(2～3). The veins tended to enter the IVC at different levels and not in pairs.③Surgical vein of mesentery(86%):The average distance from the point where the surgical vein entered the left side of anterior wall of IVC to the superior border of left renal vein was approximatately 6.94?1.21cm.④Right suprarenal vein(20%).⑤Right assistant renal vein (25%)⑥Right vein around kidney (36%).⑦Right inferior phrenic vein (6%).Conclusion:The result provides further morphological basis for retroperitoneal surgery.

0.05); in group C and D,there were still significant difference at 8 weeks. there were different histopatholog- ical changes in groups during the test. Conclusion:A mouse model of contusive spinal cord injury is a reasonable model and provides theory basis for SCI studies.

Objectives: To evaluate the analgesic effect of electronic dental anesthesia(EDA).　Methods: Sixty patients with dental caries in need of cavity preparation and 15 patients with pulpitis in need of pulp treatment were anesthetized with EDA, another 60 patients with dental caries in need of cavity preparation and 15 patients with pulpitis in need of pulp treatment were anesthetized with traditional local anesthesia(LA).　 Results: For patients with dental caries in need of cavity preparation, the effective rates in EDA group and LA group were 93.33% and 98.33% respectively(P>0.05).For patients with pulpitis in need of pulp treatment ,the effective rates in EDA group and LA group were 26.7% and 93.33% respectively(P<0.01).　Conclusions: EDA can be an effective analgesic method for cavity preparation, but not for pulp treatment.

Acute Disease ; Child ; Humans ; Respiratory Tract Infections ; virology

OBJECTIVE:To study the application of antimicrobials in patients undergoing elective cesarean section and to promote rational use of drugs in our hospital. METHODS: 240 cases of elective cesarean section were randomly selected from our hospital during Jan.～Apr. in 2009 and Jul.～Oct. in 2009, respectively (n=120). Retrospective analysis was applied to analyze the application of antimicrobials in those cases. RESULTS: Prophylactic application of antimicrobials was rational after intervention with cephalosporins as the main category. The phenomena of excessive dose of drugs were controlled effectively to shorten medication duration. The rate of medication 0.5～2 h before operation increased and the cost of medicines reduced. CONCLUSION: Relevant measures of intervention can improve rational use of drugs in perioperative patients undergoing elective cesarean section in our hospital and reduce the cost of operation.

Objective: To explore correlation among concentrations of high sensitive C reactive protein (hsCRP), uric acid (UA), brain natriuretic peptide (BNP) and coronary heart disease (CHD).Methods: A total of 120 CHD patients treated in our department were enrolled as CHD group, and they were divided into single vessel coronary disease group (single-vessel group, n=51) and multi-vessel coronary disease group (multi-vessel group, n=69).Meanwhile, another 40 healthy subjects were randomly selected from our physical examination center as healthy control group.Serum concentrations of hsCRP, BNP and UA were measured in all groups, and compared with pairwise comparisons.Results: Compared with healthy control group, there were significant rise in serum concentrations of hsCRP[(3.95±2.24) mg/L vs.(19.78±5.15) mg/L], BNP[(70.57±19.47) pg/ml vs.(196.17±54.84) pg/ml], UA[(184.51±79.47) μmol/L vs.(407.17±96.84) μmol/L]in CHD group, and those of multi-vessel group were significantly higher than those of single-vessel group, P<0.05 or <0.01;Spearman rank correlation analysis indicated that serum UA concentration was significant positively correlated with hsCRP and BNP concentrations (r=0.551, 0.398, P<0.05 both), Gensini score was significant positively correlated with serum concentrations of hsCRP, BNP, UA (r=0.478, 0.552, 0.741, P<0.05 all), Sullivan score was significant positively correlated with serum concentrations of hsCRP, BNP, UA (r=0.503, 0.674, 0.892, P<0.05 or <0.01) in CHD patients.Conclusion: Serum concentrations of hsCRP, BNP, UA are closely related to occurrence and development of CHD.These three indexes can be used as screening indexes for CHD, and the effect of combined detection may be better.