Objective To discuss the application of bare-stent“chimney”technique in treating aortic dissection associated with left common carotid rupture, and to evaluate its therapeutic effect. Methods The clinical data of 7 patients with aortic dissection accompanied with left common carotid rupture, who were admitted to Qinghai Provincial People’s Hospital during the period from February 2012 to March 2014 to receive endovascular isolation operation treatment with bare-stent “chimney” technique, were retrospectively analyzed. When the rupture of aortic dissection was occluded with covered-stent, the left common carotid rupture was isolated with “chimney”bare-stent to reconstruct the blood flow of left common carotid artery. CT angiography was performed 2 weeks after the operation to check if there was any complication such as endoleak, stent migration, etc. Results The technical success rate of endovascular isolation operation was 100%. No type I endoleak occurred. The patients were followed up for 1-13 months, the covered stent in the aorta was in good position, and the “chimney” bare-stent in the left common carotid artery was patent. No complications such as endoleak, stent migration, etc. occurred. Conclusion Bare-stent“chimney”technology can provide treatment opportunity for the patients suffering from left common carotid artery rupture accompanied by aortic dissection; the rupture can be completely obstructed and the blood flow can be reconstructed. The short-term effect is satisfactory, although the long-term effect needs to be further studied.

Objective To research the running status of dual-referral in a township of Dongguan city.Methods Hospitals and community health service centers in C town were selected as the research sites.The dual-referral system implementation situatidn in local area was understood by the questionnaire survey on the patients and medical personnel.Results About 44.4％ of patients understood the dual-referral system in local region.However,82.1％ of patients had no the dual-referral experience.The majority of doctors had the experience of upward referral patients and downward referral patients,but their number only accounted for below 10.0 ％ of diagnosis and treatment patients.When the proportion of community reimbursement increased by 20.0％,for the question of whether or not to go to the community first,57.6 ％ of patients expressed willingness,32.7 ％ of patients expressed unwillingness,and 9.7 ％ of patients expressed no influence on own willingness.Conclusion The understand degree of the patients in C township on dual-referral is in the low side.The links of upward transfer and downward transfer of dual referral are insufficient smooth.