Objective To investigate the perioperative nursing of patients with Stanford type B aortic dissections treated with endovascular graft exclusion.Method The clinical data of 22 cases undergoing thoracic endovascular aortic repair from February 2011 to August 2013 were retrospectively analyzed to summarize the nursing experience.Results Twenty-two patients survived successfully through operation.One case had retrograde type A dissection after operation,another 15 had hyperthermia,and all of them were cured and discharged due to symptomatic treatment.The postoperative 3 months follow-up showed no type I endoleak.Conclusion Preoperative psychological nursing,postoperative blood pressure control,nursing of complications,strengthening instruction of diet and physical activity,are critical for the promotion of early rehabilitation of patients after discharge.

Objective To assess the health risk of heavy metals in rice from key areas in a city.Methods Based on the distribution of pollution sources,34 rice samples were collected in 2012 from key areas of A county,B county and C county.Five kinds of heavy metals were detected.Health risk associated with the five kinds of heavy metals were assessed using USEPA health risk assessment model.Results The total rate of over standard was 52.9% and the mean concentrations of As,Cd,Cr,Hg and Pb were 0.183 mg/kg,0.115 mg/kg,0.049 mg/kg,0.014 mg/kg and 0.247 mg/kg respectively.The total health risk level was 6.12 ×10 -4/a and the health risk levels in A,B and C county were 7.01× 10 -4/a,5.19 ×10 -4/a and 6.20 ×10 -4/a respectively.Conclusion The total health risks of three counties are higher than USEPA recommended level (1×10 -4/a).

Objective To compare the accuracy of double contrast-enhanced ultrasound (DCEUS) and multi-detector row CT (MDCT) in determining the gross classification in patients with gastric carcinoma (GC) preoperatively.Methods 239 patients with GC proved by endoscopic biopsy were included.DCEUS (intravenous microbubbles combined with oral contrast-enhanced ultrasound) and MDCT were performed preoperatively.The diagnostic accuracy of DCEUS and MDCT in determining gross classification was calculated and compared.Results The overall accuracy of DCEUS in determining the gross appearance of GC was higher than that of MDCT (85％ vs.80％,P ＜ 0.05);there was no significant difference in accuracy between DCEUS and MDCT for Borrmann Ⅰ and Ⅳ classification of AGC (x2 =1.175,P =0.323 for type Ⅰ;x2 =2.171,P =0.141 for type Ⅳ);the accuracy of DCEUS for EGC,Borrmann Ⅱ and Ⅲ classification of GC was higher than that of MDCT (x2 =16.307,P =0.000 for EGC;x2 =39.950,P =0.000 for type Ⅱ;x2 =35.770,P =0.000 for type Ⅲ).Conclusion DCEUS is valuable in determining gross typing of gastric adenocarcinoma preoperatively.

Sutureless technique is a recently developed operation as a first-line therapeutic options for total anomalous pulmonary venous connection (TAPVC). It was originally used to relieve postoperative pulmonary venous obstruction after TAPVC repair and shared a favorable safety and efficacy. Sutureless technique has advantage over conventional repair since the sutures will not touch the intima of pulmonary veins, leading to limited intimal hyperplasia and anastomotic stenosis. In recent years, the sutureless technique has been adopted as a prophylactic method to reduce postoperative obstruction. Compared with the conventional surgery, the indications of the sutureless technique are yet unclear, and a variety of improved methods of sutureless technique with satisfactory outcomes have emerged. This paper review the development of the sutureless technique, introduce some improvements of the surgical technique and summarize indications of suturelss technique.

Objective: To investigate the value of tumor perfusion parameter measured by using double contrast-enhanced ultrasound (DCEUS) QontraXt three-dimensional pseudocolor quantitative analysis to the therapeutic effect evaluation of preoperative neoadjuvant chemotherapy (NAC) in advanced gastric cancer (AGC) patients. Methods: Eighty-nine AGC patients underwent 3 cycles of preoperative NAC (XELOX) followed by complete resection of lesion. The DCEUS QontraXt three-dimensional pseudocolor was performed one or two weeks before the NAC and operation were applied, respectively. The peak enhancement (PE), time to peak (TP), sharpness of the bolus (β) and area under the enhancement curve (AUC) of primary gastric tumor were measured by QontraXt three-dimensional pseudocolor quantitative analysis. These DCEUS parameters between respond and non-respond groups before and after NAC therapy were compared. The prediction accuracy of DCEUS to the therapeutic effect evaluation of preoperative NAC was determined by the receive operating characteristic (ROC) curves. Results: Among 89 AGC patients, 52 patients responded to NAC therapy, while 37 patients resisted to NAC therapy. Twelve cases in respond group and 26 cases in non-respond group were mucinous carcinoma. Forty cases in respond group and 11 cases in non-respond group were non-mucinous carcinoma (P<0.05). In responder group, the PE and TP before NAC were (53.7±9.3)% and (14 521±2 667) ms, and (32.2±5.5)% and (17 235±1 898) ms after NAC. The ratio of changes of PE (ΔPE) and TP (ΔTP) were 0.43±0.17 and 0.36±0.14, respectively. In non-respond group, the PE and TP before NAC were (54.4±7.2)% and (13 869±3 247) ms, and (45.3±6.1)% and (15 127±1 423) ms after NAC therapy. The ratio of ΔPE and ΔTP were 0.24±0.20 and 0.22±0.12. The PE and TP after NAC, the ratio of ΔPE and ΔTP were significant different among these two groups (all of P<0.05). The ROC curves showed that the ratio of ΔPE in assessing the respond of gastric cancer patients to NAC was superior compared to other parameters (AUC=0.784, P=0.004). The optimal cut-off value of the ratio of ΔPE was 24% and its sensitivity and specificity to the therapeutic effect evaluation of NAC in gastric cancer were 82.7% and 64.9%. Conclusion DCEUS QontraXt three-dimensional pseudocolor quantitative analysis might be a novel, noninvasive and reliable method to evaluate the therapeutic effect of preoperative NAC in AGC patients.