Objective To investigate the influence of the hematoma involving the aortic arch in endovascular aortic repair of complicated type B intramural aortic hematoma. Methods A total of 69 patients[58men; mean age(58.1±8.9)years; range 38-77]underwent endovascular repair between February 2011 and June 2015 were retrospectively reviewed. Patients with hematoma involving about the left subclavian artery level were categorized as group A(n=28) and patients without hematoma involvement to the aortic arch were categorized as group B (n=41). Results All the patients were treated with coverd aortic stents. The success rate was 97.1％ with complete isolation of lesion in 67 patients. The average follow-up period was(19.6±14.1)months. During perioperative period, no procedure related deaths was recorded. Perioperative complications include paraplegia in 1case(1.4％) in group B and stent graft-induced new entry in 2 cases(2.9％) in group A. During the follow-up period 1 case in group A within 1 month and another 1 case in group B within 1 year developed new entries at proximal end of stents. 1 case (1.4％) in group B had asymptomatic type Ⅰ endoleak 2 years after TEVAR. Conclusions Type B aortic intramural hematoma with arch involvement is not a risk factor of stent-induced new entry in perioperative period after endovascular treatment and further studies are needed. Strict control of blood pressure is essential for the prevention of stent-related complications.

Purpose To investigate the features of 64-slice spiral computerized tomography (CT) on collateral circulation of pancreatic portal hypertension (PPH).Material and Methods the abdominal CT images of 52 patients with PPH confirmed by pathology the Affiliated Hospital of Southwest Medical University from August 2013 to May 2015 were analyzed retrospectively.The collateral circulations of portal vein were recorded.Results There were 21 (40.4％) patients with isolated splenic vein occlusion (ISVO),and 32 (59.6％) patients with non isolated splenic vein occlusion (NISVO) in the total 52 patients.There was no significant difference in the occurrence rate between ISVO and NISVO (x2=1.92,P＞0.05).The main collateral pathways of PPH were pathway Type Ⅰ (28 patients)and pathway Type Ⅲ (22 patients),and 2 patients belonged to pathway Type Ⅱ.The patients in pathway Type Ⅰ or Ⅲ were significantly more than patients in pathway Type Ⅱ(P＜0.01).There were 92.3％ (48/52) of patients with gastroepiploic varicosity,which is significantly higher than other varicose veins (P＜0.001).The significant difference was found between the patients (21.2％) with gastric fundus varicosity and the patients (1.9％)with inferior segment esophageal varices (x2=9.42,P＜0.01).The patients with gastric fundus varicosity and right superior colic varicosity in NISVO were more than those in ISVO (x2=4.15,7.44,P＜0.05).Conclusion For PPH patients,the valuable features of collateral circulation can be revealed by multi-slices CT.

Primary lesions unknown metastatic cancer ( CUP) is a class of histopathologically confirmed metastases. However,a variety of clinical diagnosis and treatment can not clear the primary tumor. The identifica-tion of tumor primary site is the first step in the diagnosis of CUP. The histopathology,immunohistochemistry and PET /CT are commonly used clinical diagnosis and treatment. Gene expression profiling technique is a new meth-od for the diagnosis of primary tumor in recent years. It has high diagnostic accuracy,sensitivity and specificity, and is expected to achieve individual treatment of patients with CUP.

OBJECTIVETo develop an HPLC method for simultaneous determination of four major alkaloids in Lindera aggregate.

METHODThe analysis was carried out on an Agilent ZORBAX SB-C18 column (4.6 mm x 250 mm, 5 microm) with gradient elution using acetonitrile-water (containing 0. 15% diethylamine, adjusted to pH = 3.0 with acetic acid) as mobile phase. Flow rate was 1.0 mL x min(-1) and the detection wavelength was at 289 nm.

RESULTThe calibration curves were linear over the range of 0.428-8.560 microg for boldine, 2.122-31.83 microg for norboldine, 0.760-15.20 microg for reticuline and 0.020 4-0.400 8 microg for linderegatine, respectively. The average recoveries were 99.18% for boldine, 101.0% for norboldine, 100.3% for reticuline and 99.17% for linderegatine, respectively. with RSD not more than 3.0%.

CONCLUSIONThe described method is reliable and convenient and could be used for the quality control of Lindera aggregate.

Alkaloids ; analysis ; Chromatography, High Pressure Liquid ; methods ; Lindera ; chemistry

Objective To explore the aortic remodeling after thoracic endovascular aortic repair for acute type stanford B aortic dissection. Methods Retrospective analysis the clinical data of 51 patients who diagnosed with acute type B aortic dis-section and received TEVAR between September 2015 and August 2016. The maximal diameters of false and true lumen were measured directly at the level of primary tear entry, the level of the bronchial bifurcation,and the level of the celiac trunk and the the lower edge of left renal artery,changes in diameter were evaluated between the preoperative and postoperative CT scan. Results The marked change in the true lumen dilatation and false lumen regression trend at the level of primary tear entry after thoracic endovascular repair(1 month vs 1 year, P<0. 05), while the changes of its diameter above level were not obvious af-ter thoracic endovascular repair(3 months vs 6 months, P>0. 05). the true lumen dilatation and false lumen regression trend at the level of the bronchial bifurcation along with time. The true lumen dilatation is a process of slow change at the level of the celiac trunk and the lower edge of left renal artery after TEVAR, and the false lumen changed not obviously. Conclusion En-dografting is effective for acute type B aortic dissection which can promote positive descending aortic remodeling changes,but it has no significant effect on abdominal aortic remodeling.

OBJECTIVETo evaluate safety and immunogenicity of inactivated hepatitis A vaccine in HBsAg carriers and healthy children.

METHODSOne hundred and twenty-one healthy children and ten HBsAg carriers, aged 1-10 years HAV susceptible were enrolled in the study. The inactivated hepatitis A vaccine was produced by Tangshan Biogenetic Company. The dosage of the vaccine was 1000 U/Dosage and 500 U/Dosage. The vaccination schedule was six month apart for two injections. The serum anti-HAV level was detected with EIA at one month after first injection and at one and six month after the booster injection, respectively.

RESULTSThe anti-HAV appeared in all the children. One month after the booster injection, the serum anti-HAV level in children vaccinated 500 U/Dosage was 4684.9 mIU and 4535.6 mIU, respectively and in the children vaccinated 1000 U/Dosage, 5399.8 mIU and 7347.1 mIU, respectively. The anti-HAV level was not statistically different between the two groups of children. There was no adverse reaction after the vaccination. The anti-HAV level was still high one year after first injection.

CONCLUSIONSThe data indicated that the safety and immunogenicity of the domestic inactivated hepatitis A vaccine were excellent in both groups of children.

Child ; Child, Preschool ; Hepatitis A Antibodies ; blood ; Hepatitis A Vaccines ; immunology ; Hepatitis B Surface Antigens ; blood ; Humans ; Immunization ; Infant ; Vaccines, Inactivated ; immunology

Objective:To analyze the clinical features and surgical outcomes of petrous bone cholesteatomas (PBCs).Methods:Data from 39 PBCs patients treated in the Department of Otorhinolaryngology, Xijing Hospital from September 2011 to December 2017 were reviewed retrospectively, including 23 males, 16 femals, aged 12-71 years old, with the median age of 37. Clinical classifications, surgical methods, facial and hearing function, and intraoperative and postoperative complications were made summary analysis.Results:In this study, five patients were congenital PBCs and 34 patients were acquired PBCs. The common clinical symptoms were hearing loss (100%, 39/39), ear discharge/pus (89.7%, 35/39) and facial paralysis (46.2%, 18/39). According to Sanna′s classification, 14 cases were supralabyrinthine, including three cases underwent transcochlear (TC) approach, six cases underwent transotic (TO) approach and five underwent translabyrinthine (TL) approach. 10 cases were infralabyrinthine, including eight cases underwent subtotal petrosectomy, one case underwent TO approach and one underwent TL approach.10 cases were massive, including seven cases underwent TC approach, three cases underwent TO approach. Five cases were infralabyrinthine-apical, including two cases underwent TC approach, two cases underwent TO approach, and one case underwent endoscope assisted infratemporal fossa type B. The degree of facial nerve (FN) dysfunction from high to low was massive (6/10), supralabyrinthine (8/14), infralabyrinthine-apical (2/5) and infralabyrinthine (2/10). 19 cases involved in facial nerve operation, three cases underwent FN decompression, four cases underwent FN rerouting, four cases underwent nerve grafting, and one case underwent facial-hypoglossal anastomosis. Preoperative FN involvement in 18 cases, and the FN function was improved in 14 cases after surgery. The improved rate of postoperative FN function was 77.8%. The bone conducted hearing retained 50.0% (14/28) postoperatively. Five cases with cerebrospinal fluid leak were managed by inserting free muscle plugs and cavity obliteration. Two cases with the cholesteatomas matrix involved the sigmoid sinus and the jugular bulb, and occlusion of the sigmoid sinus was performed. Postoperatively, two patients presented with synkinesis. The patients were followed up for 40 to 115 months, and there was no recurrence.Conclusions:There are no specific clinical manifestations for PBCs, thus, it is difficult in early diagnosis and treatment. According to Sanna′s classification, preoperative FN and hearing function, the best surgical approach should be selected with minimal recurrences and perioperative morbidity.

Objectives The function of the semicircular canal receptors and the pathway of the vestibulo-ocular reflex (VOR) can be diagnosed with the clinical head impulse test.The aim of the study was to investigate the horizontal VOR by means of video head impulse test in peripheral vestibular disorders.Methods Using the vHIT,we examined horizontal semicircular canal VOR in a group of 55 patients and a control group of 20 healthy subjects.The group of patients included 10 cases of vestibular neuritis (VN),6 cases of vestibular schwannoma (VS),12 cases of Meniere's disease (MD),and 15 cases of bilateral vestibulopathy (BV),as well as 13 cases of idiopathic sudden hearing loss with vertigo(ISHL).Results Instantaneous gains of 40 ms,60 ms and 80 ms of horizontal VOR were 0.88 ± 0.17,0.94 ± 0.13 and 0.96 ±0.13,respectively.Regression gain at 60 ms was 0.99 ± 0.11,and asymmetry was 5.6 ± 3.5.Normal range of 60 ms instantaneous gain was ＞ 0.73,normal range of regression gain was ＞ 0.80.AbnormalvHIT was found in VS (100％),VN (90.9％),BV (86.7％),MD (40.0％) and ISHL (38.5％).Three conditions of refixation saccades occurred in cases with abnormal VOR:isolated covert saccades (12.5％),isolated overt saccades (45.0％) and the combination of overt and covert saccades (42.5％).Conclusions The vHIT detects abnormal VOR changes in the combination of gain assessment and refixation saccades.Since isolated covert saccades in VOR changes can only be seen with vHIT,peripheral vestibular disorders are likely to be misdiagnosed with the HIT.

Objective To explore the influence of different initial intimal tear positions on abdominal branch perfusion in Stanford B aortic dissection.Methods CTA data of 130 patients with Stanford B aortic dissection were reviewed retrospectively.The involved aortic branches (celiac trunk,superior mesenteric artery,bilateral renal artery) were classified into different types according to the degree of ischemia and perfusion damage,and their relationship with different initial intimal tear positions were also analyzed.Results There were 542 branches in 130 patients,in which 465 branches (465/542,85.79％) were ischemic,including 337 branches (337/542,62.18％) of dynamic ischemia and 128 branches (128/542,23.62％) of static ischemia,77 branches (77/542,14.21％) without ischemia.In ischemic branches,the perfusion in 69 (69/542,12.73 ％) of them were impaired and those of the other 396 branches (396/542,73.06 ％) were unimpaired.In all of the 69 branches of impaired perfusion,37 branches (37/69,53.62％) were dynamic ischemia and 32 branches (32/69,46.38％) were static ischemia,and the difference was no statistically significant (x2 =3.077,P =0.215).Furthermore,no significant impact was found in initial intimal tear positions on ischemic patterns (dynamic and static) or perfusion patterns (unimpaired and impaired;x2 =1.352,0.776,P=0.509,0.678).Conclusion Initial intimal tear positions has no significant impact on ischemia pattern or perfusion pattern of abdominal aortic branches.The evaluation of abdominal aortic branches is helpful for guiding surgery.