Objective To explore the clinical characteristics of reperfusion arrhythmias (RA) in patients with ST segment el‐evation myocardial infarction(STEMI) after percutaneous coronary intervention (PCI) .Methods A total of 148 STEMI patients undergoing emergency PCI in our hospital from January 2010 to December 2014 were selected and divided into the RA group (71 cases) and non‐RA group (NRA group ,77 cases) according to whether RA occurring during PCI .The RA situation was observed . The relation between the infarct related artery and RA was analyzed ,the fall back situation of elevated ST segment was observed , the levels of cardiac troponin I (TnI) and creatine kinase isoenzyme MB (CK‐MB) and echocardiographic findings were compared between the two groups .Results The incidence rate of bradyarrhythmias in the left anterior descending coronary artery was signifi‐cantly lower than that in the right coronary artery and left circumflex artery ,while tachyarrhythmias in the left anterior descending coronary artery was higher than that in right coronary artery and left circumflex artery ,the differences were statistically significant (P<0 .05) .The opening time window and CK‐MB peak reaching time in the RA group were earlier than those in the NRA group , the fall amplitude of ST segment ,highest TnI and highest CK‐MB level in the RA group were higher tha those in the NRA group , the differences were statistically significant (P< 0 .05);among 48 cases of tachyarrhythmias ,tachyarrhythmia in 17 cases disap‐peared after intravenous drip or injection of lidocaine and which in 31 cases spontaneously disappeared without treatment ;among 23 cases of bradyarrhythmia ,bradyarrhythmia in 16 cases was controlled by intravenous injection of atropine ,which in 3 cases was con‐trolled within 1 week after placing temporary pacemaker and which in 4 cases was spontaneously disappeared without treatment . The incidence rate of main adverse events in the RA group was 2 .8% ,which was lower than 11 .7% in the NRA group ,the left ventricular ejection fraction in the RA group was significantly higher than that in the NRA group ,the end diastolic diameter and end systolic diameter of the left ventricle were significantly lower than those in the NRA group ,and the differences were statistically significant (P<0 .05) .Conclusion The incidence of RA in the patients with STEMI is higher ,which needs to adopt various effec‐tive methods to actively treat .

Objective: To explore antitumor responses induced by recombinant vaccinia viruses expressing a p53 antigenic peptide (rVV-p53M) and enhanced effect of recombinant vaccinia viruses expressing costimulatory molecule B7 (rVVB7). Methods: A 135 Cys to Tyr point mutation p53-transduced P815 mastocytoma (P815-mp53) was used as an experimental tumor and the p53 protein as the model of tumor associated antigen． rVV-p53M and rVV-B7 were used as vaccine to test their induction of CTL and antitumor immunity. Results: Immunization of BABL/c mice with rVV-p53M could elicit specific CTLs, which could specifically lyse P815-mp53 cells. Immunization of mice with rVV-p53M could survive a part of mice challenged with 1×106 P815-mp53. Treatment with rVV-p53M could significantly prolong the survival oftumor-bearing mice. Admixture at 1:1 ratio of rVV-p53 M and rVV-B7 could enhance antitumor responses induced by rVV-p53M. Conclusion: Immunization with recombinant vaceinia virus expressing antigenic peptide is a useful alternative to peptide-based vaccine. Costimulatory molecule B7 can enhance antigenic peptide to induce antitumor responses.

Objective: This study was aimed to explore antitumor responses induced by recombinant vaccinia viruses expressing a point mutant p53 (rVV-p53FL) and enhancive effects of recombinant vaccinia viruses expressing costimulatory molecule B7 (rVV-B7). Methods: A 135 Cys to Tyr point mutant p53 protein was used as the model of tumor associated antigen. rVV-of3FL and rVV-B7 were used as vaccines to test their induction of CTLs and antitumor immunity. Results: Immunization BABL/c mice with rVV-p53FL could elicited specific CD8+ CTLs that could effecively lyse P815-mp53 cells, a transfectant of the murine P815 mastocytoma containing the mutant p53 gene. Treatment with rVV-p53FL could survive a part of mice challenged with 1 ? 106 P815-mp53. Treatment with rVV-p53FL could significantly prolong survival of tumor-bearing force. Admixture at 1: 1 ratio of rVV-p53FL and rVV-B7 could enhance therapeutic antitumor effects of rVV-p53FL. ~Conclusion: Mutant P53 over-expressed in tumor cells can render cells targets for specific CTLs generated by immunization with mutant p53 protein based vaccine. Costimulatory molecule H7 can enhance tumor-associated antigen inducing antitumor responses.

Objective: To explore antitumor responses induced by recombinant vaccinia viruses expressing a p53 antigenic peptide (rVV p53 M) and enhanced effect of recombinant vaccinia viruses expressing costimulatory molecule B7 (rVV B7). Methods: A 135 Cys to Tyr point mutation p53 transduced P815 mastocytoma (P815 mp53) was used as an experimental tumor and the p53 protein as the model of tumor associated antigen. rVV p53 M and rVV B7 were used as vaccine to test their induction of CTL and antitumor immunity. Results: Immunization of BABL/c mice with rVV p53 M could elicit specific CTLs, which could specifically lyse P815 mp53 cells. Immunization of mice with rVV p53 M could survive a part of mice challenged with 1?10 6 P815 mp53. Treatment with rVV p53 M could significantly prolong the survival of tumor bearing mice. Admixture at 1∶1 ratio of rVV p53 M and rVV B7 could enhance antitumor responses induced by rVV p53 M. Conclusion: Immunization with recombinant vaccinia virus expressing antigenic peptide is a useful alternative to peptide based vaccine. Costimulatory molecule B7 can enhance antigenic peptide to induce antitumor responses.

BACKGROUND:Studies addressing coronary heart disease are largely dependent on the establishment of myocardial infarction animal models. It is very important that exploring a safe method with easy operation, less damage, long time survival and high survival rate for myocardial infarction animal model OBJECTIVE:To compare the pros and cons of two kinds of thoracotomy anterior descending coronary artery ligation to do myocardial infarction animal model. METHODS: Thirty healthy male New Zealand white rabbits were randomly divided into three groups: control, median sternotomy incision, and left sternal incision. The anterior descending coronary artery was ligated after thoracotomy. The operation time, amount of intraoperative bleeding, postoperative food intake, and recovery time of eating were monitored during the surgery and within 24 hours after the surgery. And myocardial enzyme indexes were also monitored within 24 hours after the surgery. Rabbits were detected with ultrasonic echocardiogram at 4 weeks. RESULTS AND CONCLUSION:Different levels of ST segment elevation appeared in median sternotomy and left sternal incision groups by echocardiogram. The success rate of modeling was 70% in median sternotomy incision group, and 80% in left sternal incision group. Within 24 hours post-surgery, the myocardial enzyme indexes in the two groups were significantly increased compared with before surgery (P < 0.05). At 4 weeks, the left ventricular ejection fraction and the left ventricular shortening fraction were significantly decreased when compared to before surgery (P< 0.05). The operation time was shorter, the amount of bleeding was less, the time of eating recovery was less and the amount of eating was much in median sternotomy group than in left sternal incision, with significant differences between he two groups (P < 0.05). The median sternotomy incision for the ligation of anterior descending coronary artery is better than the left sternal incision to establish myocardial infarction models.

Objective To assess the results of emergency endovascular stent-grafting for patients with acute Stanford type B aortic dissection(type B AAD)within 24 hours of onset.Methods Between June 2007 and October 2008,30 patients with acute type B aortic dissection underwent emergency endOVascular stent-grafting within 24 hours of presentation.Under general anesthesia,stent-graft was deploved at the proper position of first tear entry through femoral artery under X-ray monitering.Follow-up by CT was performed 1 w,1 m ,3 m,6 m,1 y postoperatively to observe the efficacy and complications such as endoleak,migration and fracture of stent-graft. Result The technical success rate was 100%;13.4%(4 cases) endoleak rate was identified immediately after deployment.Follow up was made between 1 month to 19 months,averaging at(12±8)months,3.3%type-1 endoleak Was observed after 6 months;One patient died within 30 days possibly of dissection rupture;One patient died of acute liver failure during the follow-up. Conclusion Endovascular repair with stent-graft within 24 hours of presentation was effectivefor the treatment of acute type B aortic dissection.

Objective:To investigate the clinical characteristics and potential predisposing factors of the external cervical resorption(ECR).Methods:22 ECR cases with 38 affected teeth from 2016 to 2022 were retrospectively reviwed.Descriptive analysis combined with single factor analysis was used to study the clinical characteristics and influencing factors of ECR.Results:Maxillary anterior teeth(34.2％)were the most affected by ECR.Univariate analysis showed that ECR was more commonly noted in teeth without percussion pain and palpation pain,the probing depth of the periodontal pocket was greater than 3mm,with pulp activity reaction,without forma-tion of abscess and/or sinus tract,and without periapical lesions.There were statistically significant differences in percussion tender-ness,palpation tenderness and probing depth among the different Heithersary stages(P＜0.05).In the advanced cases,deep periodon-tal pockets and abscess formation were observed.The most common related dental factors of ECR were orthodontic treatment(15.87％)and dental traumatic injury(28.57％).Conclusion:ECR affected teeth often lack of clinical signs and symptoms.Radiology is the key to early diagnosis.

Objective:To explore the extending design and anatomical basis of pedicled gracilis musculocutaneous flaps in perineal reconstruction.Methods:On six female cadavers (age ranged from 27 to 52 years old, 41.2 on average), bilateral gracilis flaps were designed, raised and transferred in the standard surgical manner and tunneled under the adductor longus muscle. Measured the distance from the tip of 12 flaps to the bilateral anterior superior iliac spine (ASIS). The myocutaneous flaps were then transferred and the distances from the tip of flaps to the ASIS were measured again. The paired sample t test (double tail) was used to compare the data measured by the two transfer method.Results:Cadaveric dissection revealed that in 6 corpses, bilateral profunda artery muscular branches all courses between the longus adductor and mangus adductor muscles, the pedicle length of 12 gracilis musculocutaneous flaps was(7.84±0.71) cm. In the standard surgical manner group, after transferring, the distance from the tip of flaps to the ipsilateral ASIS was (9.23±0.95) cm, ranged from 6.9 cm to 10.5 cm, the distance from the tip of flaps to the contralateral ASIS was(11.45±2.27) cm, ranged from 7.5 cm to 14.8 cm. In the tunnelled under the adductor longus muscle extension design group, after transferring, the distance from the tip of flaps to the ipsilateral ASIS was (4.52±1.18) cm, ranged from 2.7 cm to 6.5 cm, the distance from the tip of flaps to the contralateral ASIS was (8.92 ±1.82) cm, ranged from 4.8 cm to 11.7 cm. Compared with the standard surgical manner group, tunneling the flap under the adductor longus muscle to the ipsilateral side increased the reach by 3.5 cm to 7.3 cm, (4.71±1.14) cm, to contralateral side increased the reach by 0.9 cm to 4.1 cm, (2.53±0.89) cm. The distance to the ipsilateral anterior superior iliac spine measured by the two method , t=13.194, P<0.001, and the distance to the contralateral anterior superior iliac spine, t=9.057, P<0.001. The difference was statistically significant. The tunneled under the adductor longus muscle extension design group can increase the reach of reconstructive scope by 3.62 cm on average. The additional increasing length of tunneled under the adductor longus muscle method is 46.2%(3.62/7.84) of the average vascular pedicle length. Conclusions:Cadaveric dissection result have shown that tunneling of the gracilis musculocutaneous flap in a novel extension design way can enlengthen the pedicle length, increase its reach across the perineum.

Objective:To explore the extending design and anatomical basis of pedicled gracilis musculocutaneous flaps in perineal reconstruction.Methods:On six female cadavers (age ranged from 27 to 52 years old, 41.2 on average), bilateral gracilis flaps were designed, raised and transferred in the standard surgical manner and tunneled under the adductor longus muscle. Measured the distance from the tip of 12 flaps to the bilateral anterior superior iliac spine (ASIS). The myocutaneous flaps were then transferred and the distances from the tip of flaps to the ASIS were measured again. The paired sample t test (double tail) was used to compare the data measured by the two transfer method.Results:Cadaveric dissection revealed that in 6 corpses, bilateral profunda artery muscular branches all courses between the longus adductor and mangus adductor muscles, the pedicle length of 12 gracilis musculocutaneous flaps was(7.84±0.71) cm. In the standard surgical manner group, after transferring, the distance from the tip of flaps to the ipsilateral ASIS was (9.23±0.95) cm, ranged from 6.9 cm to 10.5 cm, the distance from the tip of flaps to the contralateral ASIS was(11.45±2.27) cm, ranged from 7.5 cm to 14.8 cm. In the tunnelled under the adductor longus muscle extension design group, after transferring, the distance from the tip of flaps to the ipsilateral ASIS was (4.52±1.18) cm, ranged from 2.7 cm to 6.5 cm, the distance from the tip of flaps to the contralateral ASIS was (8.92 ±1.82) cm, ranged from 4.8 cm to 11.7 cm. Compared with the standard surgical manner group, tunneling the flap under the adductor longus muscle to the ipsilateral side increased the reach by 3.5 cm to 7.3 cm, (4.71±1.14) cm, to contralateral side increased the reach by 0.9 cm to 4.1 cm, (2.53±0.89) cm. The distance to the ipsilateral anterior superior iliac spine measured by the two method , t=13.194, P<0.001, and the distance to the contralateral anterior superior iliac spine, t=9.057, P<0.001. The difference was statistically significant. The tunneled under the adductor longus muscle extension design group can increase the reach of reconstructive scope by 3.62 cm on average. The additional increasing length of tunneled under the adductor longus muscle method is 46.2%(3.62/7.84) of the average vascular pedicle length. Conclusions:Cadaveric dissection result have shown that tunneling of the gracilis musculocutaneous flap in a novel extension design way can enlengthen the pedicle length, increase its reach across the perineum.

Objective:To explore the selection and effects of flap/myocutaneous flap repair methods for the defect after perineum tumor resection.Methods:From January 2011 to February 2017, 31 patients with vulvar tumor who were admitted to Hunan Cancer Hospital underwent repair of wound after tumor resection with various flaps/myocutaneous flaps. The patients were composed of 5 males and 26 females, aged 39-76 years, with 27 vulvar cancer and 4 Paget′s disease in primary diseases. The size of defects after vulvar tumor radical resection ranged from 8.0 cm×4.5 cm to 27.5 cm×24.0 cm. According to the theory of perforasome, the defects were repaired by the external pudendal artery perforator flap, deep inferior epigastric artery perforator flap, rectus abdominis myocutaneous flap, anterolateral thigh flap, internal pudendal artery perforator flap, gracilis myocutaneous flap, and profunda artery perforator flap based on the specific size and location of perineum and groin where the defect was located. According to the blood supply zone of flap, totally 17 local translocation flaps, 18 axial flaps/myocutaneous flaps, and 7 V-Y advancement flaps were resected, with an area of 7.0 cm×4.0 cm to 21.0 cm×13.0 cm. All the flaps/myocutaneous flaps were transferred in pedicled fashion, and the donor sites were closed without tension. The number of flaps/myocutaneous flaps, wound closure, flaps/myocutaneous flaps survival, and follow-up were observed and recorded.Results:Altogether 42 flaps/myocutaneous flaps were harvested in 31 patients. Two flaps/myocutaneous flaps were used in 11 cases for large circular defect repair. All the defects achieved tension-free primary closure. The blood supply of 32 flaps/myocutaneous flaps was good, while insufficient blood supply was noted in the other 10 flaps/myocutaneous flaps. Seventeen flaps/myocutaneous flaps survived smoothly. Wound dehiscence occurred in 5 flaps/myocutaneous flaps 8 to 14 days postoperatively, which was healed with dressing change. Temporary congestion was noted in 7 flaps/myocutaneous flaps 2 to 5 days postoperatively, which recovered without special treatment. Three flaps/myocutaneous flaps had infection 7 to 15 days postoperatively, two of which recovered after dressing change, while the other one had partial necrosis and received debridement and direct closure. Two flaps/myocutaneous flaps were totally necrotic 8 to 15 days postoperatively, which were repaired with pedicled rectus abdominis myocutaneous flap after debridement. Seven flaps/myocutaneous flaps had partial necrosis 7 to 20 days postoperatively and were healed after dressing change. Twenty-four patients were followed up for 9-38 months. The color of flaps/myocutaneous flaps was similar to that of the surrounding skin, the shape of vulva was natural, the movement of hip joint was not limited, the function of micturition and defecation was not affected, and tumor recurrence was noted in 3 patients.Conclusions:For the complicated large defect after perineum tumor resection, the flexible application of different forms of flaps/myocutaneous flaps to repair according to different areas regains the appearance and function. However, there are many complications, so it is necessary to further strengthen the postoperative care.