Double aortic arch is a congenital heart defects,which is related to vascular rings.It accounts for about 0.5％ of the incidence of congenital heart disease and will result in varying degrees of airway compression of the esophagus,such as wheezing breathing,swallowing difficulties,severe respiratory distress or chronic respiratory symptoms.Spiral CT,echocardiography and cardiovascular imaging can diagnose double aortic arch.Double aortic arch is divided into three types,the treatment of which is different and surgery is effective.In recent years,with the improvement of thoracoscopic technique,thoracoscopic surgery has become an effective means of treatment to double aortic arch.This review focuses on the surgical treatment of double aortic arch progress.

Objective To evaluate the effectiveness and safety of acute normovolemic hemodilution(ANH) in the elderly patients undergoing knee arthroplasty.Methods Thirty ASA Ⅰ～Ⅱ patients of both sexes,aged between 65～75 years undergoing elective knee arthroplasty were enrolled in this study.The hemodynamic status,hemostasis,arterial blood gas and hematocrit were monitored at before anesthesia(T1),after anesthesia(T2),after hemodilution(T3),the start of operation(T4),the end of operation(T5),24 hours after operation(T6),48 hours after operation(T7).Results The vital signs were fairly stable during preoperative in both groups.In both groups compared with time point T1 CVP was significantly elevated at point T3 and point T4.The increase in CVP was significantly higher in group Ⅱ than that in group Ⅰ(P

Objective To identify the nutritional risks of the hospitalized children with congenital heart disease (CHD) during perioperative period and the relationship between nutrition risks and the clinical outcomes.Methods Totally 780 CHD children (522 cases of ventricular septal defect,133 cases of atrial septal defect,70 cases of tetralogy of fallot,and 55 of patent ductus arteriosus) were recruited.The STRONGkids (Screening Tool for Risk on Nutritional Status and Growth) was used to analyze the nutritional risks of CHD children and to identify the nutritional risks of these children at different ages.Also,the potential effect of pulmonary hypertension on malnutrition and effects of the possible nutritional risks on the clinical outcomes were analyzed.Results Of these 780 CHD children,260 (33.3％) were found to be with high and moderate nutritional risks.The incidences of these risks were 49.2％ (187/380) in the 0-1-year-old group,which was significantly higher than that in the 1-3-year-old group (26.2％,60/229) (x2 =25.174,P ＜0.001) and the ＞ 3-year-old group (7.6％,13/171) (x2 =36.029,P ＜ 0.001).Both pulmonary hypertension and malnutrition showed synergic effects on the clinical nutritional risk,and higher nutrition risks were associated with poorer clinical outcomes.Conclusions STRONGkids can effective evaluate the nutritional risks of CHD children during the perioperative period and thus can inform the standardized nutrition support.

Animals ; Drugs, Chinese Herbal ; pharmacology ; Female ; Heart Failure ; drug therapy ; physiopathology ; Hemodynamics ; Male ; Myocardial Ischemia ; drug therapy ; physiopathology ; Phytotherapy ; Rats ; Rats, Wistar ; Rhodiola

Abstract: The coronavirus disease 2019 (COVID-19) has become a global public health problem due to its highly contagious nature. This article aims to discuss the current situation of traditional Chinese medicine in the prevention and treatment of COVID-19, and to provide a basis for traditional Chinese medicine research and scientific and standardized treatment of COVID-19.In this article, the etiology, pathogenesis, treatment plan and research progress were summarized, analyzed and concluded by retrieving and reviewing the literature and clinical reports related to the prevention and treatment of COVID-19 with traditional Chinese medicine. Traditional Chinese medicine has obvious effects in the prevention and treatment of COVID-19, improvement of clinical symptoms, and control of disease progression, which had the unique advantages of mild curative efficacy and safety. It has important practical significance in relieving patients' early symptoms and reducing the incidence of progression from mild to severe, and had great potential for development in the treatment of COVID-19. The traditional Chinese medicine intervention and the formulation of diagnosis and treatment plans for the COVID-19 need to be continuously optimized and improved. Scientific and rational application of traditional Chinese medicine to prevent and treat COVID-19, optimization diagnosis and treatment programs, and in-depth exploration of pharmacological mechanisms, especially the provide reference for early intervention of new coronavirus pneumonia by traditional Chinese medicine, the control of disease progression in the middle stage, and improve prognosis in the late stage with Western medicine.

Changes in behaviour relevant to the vestibular system were studied in Long-Evans rats which were fertilized, born and housed in 2 acceleration of gravity for 4 months and thereafter exposed to 1 acceleration of gravity, and expression of Fos protein in the brain stem was examined. Data from the hypergravity rats were compared respectively with those from the rotation group and the labyrinthectomized group. Static and locomotion modes of the hypergravity rats were changed, tension of extensor was enhanced and the abilities in locomotion equalization and orientation in swimming and air-righting response were reduced. The adaptation process varied with different behaviours. The time for recovery of the ability of orientating in swimming was the longest, taking more than 1 month. The Fos protein expression provides a useful tool for mapping brain functional activities after sensory stimulation, showing a low basal level in normal and labyrinthectomized groups. The hypergravity rats, on the other hand, exhibited more Fos-positive cells in the superior colliculus, inferior colliculus, periaqueductal gray, raphe dorsal nucleus and solitary nucleus. In contrast, the inferior olivary nuclei, locus coeruleus and vestibular nuclei were not strongly labeled. These spatial patterns of Fos expression suggest that a decrease in gravity-inertial force may activate a neural pathway different from the vestibulo-olivar pathways activated by an increase in gravity-inertial force.

Objective To investigate the clinical application of mobile ICU in long distance inter-hospital transportation of critically ill children.Methods The clinical data of 467 critically ill children admitted in the mobile ICU for long distance inter-hospital transportation during Jan 2011 to Dec 2013 were studied retrospectively.Results A total of 467 critically ill children were transported from 27 hospitals of the counties and cities around Nanning.Of these 467 cases,295 cases were male and 172 female,with ages from 29 days to 11 years(median age was 10 months) and weights from 2.5 to 40.0 kg(median weight was 8.3 kg).The transport distances were from 68 to 436 km(median distance was 157 km);the transport durations ranged from 1.5 to 13.0 h(median duration was 5.3 h),and the average pediatric clinical illness score was 83±10.Of these 107 cases(22.9%,107/467) who required first aid before transfer,63 cases(58.9%) were treated with endotracheal intubation while 26 cases(24.3%) with anti-shock therapy.All the 467 cases received sustained electrocardiographic,blood pressure,blood oxygen saturation monitoring and rehydration therapy for maintaining stable internal environment during the transportation,with 341 cases(73.0%) of them received sedative or analgesic treatment,185 cases(39.6%) received mechanical ventilation,15 cases(3.2%) received high doses of vascular active drugs.All the critically ill children were admitted to our Critical Care Department through the green channel.The vital signs improved significantly than those before transportation[heart rate:(143±19)times/min vs.(165±24)times/min;mean arterial pressure:(76±5)mmHg vs.(71±4)mmHg,1mmHg=0.133 kPa;SpO2:(95±2)% vs (92±2)%;pH:7.37±0.04 vs 7.34±0.03;lactate:(2.5±0.2)mmol/L vs (2.8±0.3) mmol/L].There were significant differences between before and after the transportation(P＜0.01,respectively).Conclusion Mobile ICU is propitious to treat the critically ill children energetically and effectively in long distance inter-hospital transportation and ensures the safety.It is worth promoting.

Objective To study the imaging features of Kimura disease to improve diagnostic ability prior to surgery.Methods The clinical manifestations and CT and MR findings of 11 patients with histologically confirmed Kimura disease were retrospectively analyzed.All 11 tumors originated from (or involved)the parotid region in 7 cases, the maxillofacial region in 2 cases, the palate in one case and the groin in one case.Clinically, the lesions showed asymptomatic tumors with the mean clinical course over 2 years.The increase of cosinophilic granulocyte was found in all 11 cases.Results On CT and MRI,5 patients were single masses and others were muhi-nodular masses.The smallest lesion was 6 mm×3 mm,and the largest lesion was 60 mm × 34 mm.The lesions were almost ill-defined in the subcutaneous tissue,especially 10 locating underlying superficialfascia in head and neck.On CT,the lesions showed homogeneous hypodense to the muscle in 9 patients.The lesions appeared isointeuse signal or slightly hypointense on MR T1WI and slightly hyperinteuse on T2WI in 3 patients.All lesions revealed moderate or marked, and homogeneous or inhomngeneous enhancement.Regional lymph nodes (eight cases in the maxillofacial region and one in the groin) enlarged without necrosis and fusion, and with marked enhancement.Conclusion The clinical and imaging findings of Kimura disease have some characteristics, the diagnosis can be made combined with the laboratory examination.

Objective To characterize the features of Nasopharyngeal non-Hodgkin's lymphoma (NHL) on MR imaging and find the main points to differentiate it from the other nasopharyngeal tumors.Methods The MR images of 41 patients with pathologically and immunohistochemically proven nasopharyngeal NHLs were reviewed retrospectively. Images were assessed by the size, invasive extent,signal intensity of primary nasopharyngeal tumor, and the distribution of cervical lymphadenopethy. The difference of regional tissues invasion and cervical lymphadenopathy distribution between the patients with B-cell NHLs and the patients with T-cell or NK/T-cell NHLs were analyzed by Pearson's Chi-Square test or Fisher's exact test Results Of the 41 patients, 26 patients had mature B-cell lymphoma, two patients with mature T-cell Iymphoma, and thirteen patients showed Nature killer/T-cell lymphoma in nasopharynx. MRI revealed that NHLs of nasopharynx can be showed as thickening of nasopharyngeal mucosa and (or) lumps in nasopharynx, which were slightly hyper-intensity on T2-weighted images, and intermediate signal intensity (similar to muscle) on T1 -weighted images, with mild or moderated enhancement following contrast medium administration. Twenty four cases had symmetrical disease of all walls of nasopharynx, and 17 cases had unsymmetrical tumor. Of all cases, 5 cases had superficial ulcerations, 9 cases had exceed nasoharynx invasion spreads superficially along the mucosa, 23 cases had invasion of lingual and (or) palatine tonsils,20 cases showed invasion of parapharygeal muscles, 12 cases suffered from skull base bone infiltration,25 cases had retropaharyngeal lymphadenopathy, and 27 cases had cervical lymhadenopathy. Patient with nasopharyngeal Nature killer/T-cell lymphoma had a higher incidence of exceed nasopharynx invasion,parapharyngeal structures invasion, and superficial ulcerations (the cases were 8, 11, 4 in patient with T-cell or N K/T-cell lymphoma, and 4, 10, 1 in patients with B-cell lymphoma, respectively). Patients with nasopharyngeal B-cell lymphoma had a higher incidence of inasion of lingual and (or) palatine tonsils.Conclusions Nasopharyngeal NHL is a homogeneous tumor that tends to diffusely involve all walls of the nasopharynx and spread in an exophytic fashion to fill the airway, rather than infiltrating into the deep tissues. Different pathological types of nasopharyngeal NHLs have some different appearance on MRI between each other. A large tumor in nasopharynx that fills the nasopharynx cavity, with no or minimal invasion into deep structures, but with invasion extend down into the lingual and(or)palatine tonsils, may suggest the diagnosis of nasopharyneal NHL.

BACKGROUND:The electrospinning technique has been used to prepare biological scaffolds to simulate nano-fiber structure of extracelular matrix; therefore, widespread attention has been paid to the electrospinning technique in the field of regenerative medicine and tissue engineering. OBJECTIVE: To review the articles about increasing electrospun nanofiber scaffold porosity, enlarging pore diameter, promoting cel infiltration with related technologies, in order to discover the most practical and economical technology. METHODS:The first author retrieved CNKI database, Wanfang database and PubMed with the keywords of “cel infiltration, 3D scaffold, electrospinning” in Chinese and English, respectively. Literature retrieval period was from January 2004 to October 2014. RESULTS AND CONCLUSION:Electrospinning technology is the most effective method for preparation of nanofiber scaffolds. Electrospinning scaffolds as tissue engineering scaffolds have become an issue of concern in the basic research year by year. However, the internal nano-scale pore of nanofiber scaffolds limits the cels to grow on the surface, so recent research has been focused on highly porous three-dimensional structure which can promote the permeable growth of cels instead of two-dimensional scaffolds. Several techniques have been used, which go from the adjustment of materials and speed of electrospinning to the applications of various kinds of complicated machines. However, the existing researches are stil not mature and stable, the majority of which are applied onlyin vitro as cel implantation or subcutaneous implantation in smal animals. The above-mentioned methods stil need long-term comparative studies to confirm the feasibility in the tissue-engineered repair of organs.