Biopsy ; methods ; Drainage ; Humans ; Jaundice, Obstructive ; etiology ; therapy ; Lymph Node Excision ; methods ; Neoplasm Staging ; Pancreatic Neoplasms ; complications ; diagnosis ; pathology ; surgery ; Pancreaticoduodenectomy ; methods ; Salvage Therapy

Objective To evaluate results of surgical treatment for patients with acute type A aortic dissection using Sun’s operation and triple-branched stent graft. Methods According to the operation mode, thirty-three patients with type A aortic dissection were divided into Sun’s operation group (n=22) and triple branches aortic arch stent-graft placement op?eration (triple-branched) group (n=11). Preoperative examinations included cardiac ultrasound, aortic CT angiography (CTA), hepatic and renal functions and blood routine test in all patients. Intraoperative monitoring included the index about cardiopulmonary bypass and blood loss. The perioperative hepatic and renal functions and complications were also recorded. Survival and recovery rates were evaluated by follow-up between two groups of patients. Results There were six periopera?tive death in Sun’s group, and three patients died in triple-branched group. In triple-branched group, the intraoperative blood loss was significantly increased than that in Sun’s group [(3 586.4±2 926.8) mL vs. (2 630.5±1 821.2) mL, P<0.05]. Postoperative echocardiographic examinations revealed that the left ventricular size (LVEDd) and the aortic diameter were decreased while the left ventricular ejection fraction (LVEF) was elevated after surgery in Sun’s group [(50.9±6.9) mm vs. (55.0±7.5) mm,(28.2±1.6) mm vs. (48.8±11.0) mm, 0.620±0.031 vs. 0.469±0.104, P<0.05]. Whereas, only the aortic diame?ter was decreased after surgery in triple-branched group [(28.6±3.9) mm vs. (50.9±9.2) mm, P<0.05]. Kaplan-Meier surviv?al curve showed that five-year survival rate of Sun’s group was similar with that of triple-branched group (Log-rank χ2=0.095,P>0.05). At 5 year after operation, there were no significant differences in the recurrence of new aortic dissection, the incidence of cerebral infarction and mortality between Sun’s group and triple-branched group (P>0.05). Conclusion Sun’s operation can significantly decrease patient’s intraoperative blood loss and improve cardiac function. But its survival rate and long term results need advanced observation.

BACKGROUND: Studies have shown that basic fibroblast growth factor has effects on stimulating vessel regeneration and collateral reconstruction. However, administration was performed mostly by peripheral vein, left atrium or percutaneous coronary intervention, and it is difficult to achieve an effective therapeutic concentration in the local myocardium. OBJECTIVE: Based on the property of poly(D, I-lactic-coglycolic acid) (PLGA), to investigate outcomes of inducing neovascularization in the myocardium in combination of basic fibroblast growth factor (bFGF) by ensuring target release of protein growth factor in local tissue. METHODS: PLGA and bFGF were dissolved in dichloromethane. This liquid mixture was rolled into the form of a hollow tube (3.0 mm outer diameter, 2.8 mm inner diameter, 0.1 mm thick, 10 mm length) for further use. The middle third of the left anterior descending coronary artery of mini-swines was ligated, and the local myocardium became dark purple. After the successful establishment by abnormal regional wall motion in the cardiac apex at anterior wall using ultrasound, the mini-swines were assigned to channels and bare scaffolds (BS) group and channels and bFGF-incorporating scaffolds (FS) group. The scaffold was implanted in the myocardium using self-made hollow bit. At 6 weeks, the number of proliferative cells was quantified by immunohistochemical staining. New vessels were quantified utilizing Image-Pro Plus software package in both groups. Quantitative analysis of changes in mass defect percentage was performed by Emory Cardiac Toolbox software combined with single-photon-emission computed tomography. RESULTS AND CONCLUSION: At 6 weeks, number of proliferative cells and the density of new vessels were significantly increased in the FS group compared with BS group(P<0.001). Single-photon-emission computed tomography illustrates that MDP was significantly lower in the FS group compared with the BS group (P < 0.001). Results have suggested that PLGA scaffolds that incorporate bFGF were able to induce angiogenesis and enhance blood-flow perfusion.

Objective To explore the clinical effects and safety of treatment for colorectal cancer to pulmonary metastases with percutaneous multiple electrodes radiofrequency-2000 (RF-2000) under CT-guided.Methods 26 pulmonary metastatic tumors in 11 cases were treated with RF-2000. The following extents were observed: (1) blood pressure,pulse rate and oxygen saturation during the treatment;(2)the variety of the liver function,the lung function and renal function after treatment;(3) the variety of the volume and low dense shadow of tumors after treatment;(4)the survival rate for 5 years. Results (1) The blood pressure,pulse rate and oxygen saturation were not changed during the treatment;(2) the liver function,the lung function and renal function after treatment were also not changed;(3) the volume of tumors were increased one month after treatment,three months later,23 lesions of 26 tumors were disappeared,2 decreased to more than 80% and 1 to 50%~80% in volume,and the low dense shadow within the tumors appeared as Ⅰtype (less than 50%) in one,Ⅱtype (50%~80%) in 3 and Ⅲ type (more than 80%) in 22;(4)The survival rate for 5 years was 81.82%(9/11). Conclusion The clinical effects and safety of treatment of colorectal cancer to lung metastases with percutaneous radiofrequency-2000 (RF-2000) under CT-guided is excellent.

Objective:To explore the clinical effect of lenalidomide combined with anti-B-cell maturation antigen chimeric antigen receptor T cell (anti-BCMA CAR-T) in the treatment of relapsed/refractory multiple myeloma (RRMM).Methods:The clinical data of a patient with RRMM who underwent lenalidomide combined with anti-BCMA CAR-T therapy in Henan Province Hospital of Traditional Chinese Medicine in January 2020 were analyzed. Clinical manifestations, diagnosis and treatment were also analyzed, and the related literature was reviewed.Results:The patient was a 51-year-old man who was diagnosed as IgD-λ multiple myeloma (MM) in October 2015. The patient achieved remission after 10 courses of chemotherapy regimens including immunomodulators and proteasome inhibitors, followed by autologous hematopoietic stem cell transplantation. MM relapsed after 14 months of transplantation. His disease continued to progress after multiple chemotherapy regimens and mouse or human-derived anti-BCMA CAR-T therapy. After a conditioning chemotherapy regimen of fludarabine and cyclophosphamide, the patient took lenalidomide on day 1 and was infused human-derived anti-BCMA CAR-T cells on the next day. Grade 3 cytokine releasing syndrome (CRS) appeared after infusion, and was resolved after symptomatic treatment. Very good partial response (VGPR) was achieved on day 14 after anti-BCMA CAR-T treatment. VGPR had been maintained for more than 3 months by press time.Conclusion:Lenalidomide combined with anti-BCMA CAR-T therapy is feasible and effective in the treatment of RRMM.

Objective To evaluate the efficiency and toxicities of Gemcitabine combined with S -1 cap-sule in the treatment of advanced esophageal cancer .Methods Twenty-nine patients with advanced esophageal cancer were treated with S-1 capsule 80 mg/m2 ,twice daily for 14 days and Gemcitabine (1 000 mg/m2 ) was in-travenously administrated on day 1 and 8.The chemotherapy was repeated every 21 days.After two consecutive treatment circles ,the short term efficacy ,adverse effects and follow -up condition were evaluated .Results One case showed complete remission (CR),11cases showed partial remission (PR),9 cases showed stable disease (SD),8 cases showed progressive disease(PD).The responsive rate(CR+PR)was 41.4%;the illness control rate(CR+PR+SD)was 72.4%.The major adverse events were myelosuppression ranging from grade Ⅰto Ⅲ, hand-foot syndrome,disgusting and the damage of liver function .Some patients displayed the damage of liver function.The median time to progress ( mTTP) was 6.9 months.The median 1-year survival rate was 64.3%. Conclusion The combination of Gemcitabine and S -1 capsule is an effective and well -tolerated method for the patients with advanced esophageal cancer .

Objective To investigate the effect of hypertension and hyperuricemia (HUA) on renal function.Method Total 1 209 subjects undergoing health check up from December 2000 to December 2002 and 45 patients with renal disorders were enrolled in the study.The blood pressure,height,weight,renal function and liver function were measured; and the glomerular filtration rate (GFR) was calculated.The GFR in patients with hypertension,HUA and hypertension with HUA was compared.Results The incidence of hypertension in HUA group and non-HUA was 23.9％ (58/243) and 13.9％ (134/966),respectively (x2 =14.52,P =0.000).GFR in HUA with hypertension,HUA and hypertension groups were (69.1 ± 30.5),(82.8 ± 25.3) and (90.1 ± 21.7) ml · min-1 · (1.73 m2)-1,respectively (P ＜ 0.01).Logistic regression analysis showed that the risk factors for GFR were UA,systolic pressure and age.After 5 years of follow up,GFR in hypertension group was significantly decreased from (90.7 ± 18.1) to (85.6 ± 17.6)ml·min-1 · (1.73 m2)-1m,in HUA group from (86.3±10.9) to(62.1 ±8.2) and inHUAwith hypertension group from (77.9 ± 18.9) to (49.3 ±9.8) ml · min-1 · (1.73 m2)-1,UA and age were the long-term factors that affect GFR (P ＜ 0.05).Conclusions Both hyperuricemia and hypertension can impair the kidney function,if hypertension is complicated with hyperurecemia the effect is more marked.

Objective To investigate the effect of aspirin on the incidence of thromboembolism in hypertensive patients associated with paroxysmal atrial fibrillation.MethodsFour hundred hypertensive patients with paroxysmal atrial fibrillation (mean age 59 years) free of thromboembolic events were randomized assigned to receive aspirin (0.3 g/d) or placebo. Cerebral thromboembolism,including transient ischemic attack and embolism of peripheral arteries were defined as primary outcomes. Event-free survival curves were estimated by Kaplan-Meier curve. Results During 3.6 years follow-up,primary outcomes occurred in 61 patients (4.3% per year). Aspirin significantly reduced the incidence of primary outcome as compared with placebo group( 9.0% vs 21.5%,P

OBJECTIVE To learn about the factors affecting the quality of the air in operating-rooms and discuss the methods of improving their air quality.METHODS The dynamic and static air bacteriology between laminar air flow operating-room and normal operating-room of a fertiary care level hospital of grade Ⅰ in Changchun were observed.RESULTS The passing rate of samples for air static bacteriology between two types of operating rooms at the begining of selective operations(T0) was without difference.At the begining of emergency operations,there was a disparity.The total number of bacteria in normal operating-room increased with the operating-time,but in the laminar flow operating-room,the total number of bacteria increased in fluctuations during the(T2) time(60 ming since operation begain),and descended dramatically during the(T3) time(90 min since operation).CONCLUSIONS The emergency and operation-time are the main factors affecting the air quality in operating-room and the cleaning air-condition could improve the air quality.

4 h,and for class Ⅰ and class Ⅱ operation.