Objective This report is to compare the difference outcome between total arch replacement and hemi-arch replacement for Stanford type A aortic dissection.Methods The subjects were 208 consecutive patients,including 121 who received total arch replacement(group A) and 87 who had hemi-arch replacement(group B) for Stanford type A aortic dissection from August 2001 to July 2013 in Nanjing Hospital Affiliated to Nanjing Medical University.The cardiopulmonary bypass (CPB) time,average cross-clamping time,selective cerebral perfusion(SCP) time,complications,in-hospital mortality and follow-up after surgery were retrospectively compared between the A and B groups.Results The age,sex ratio,preoperative complications do not show a significant difference between the A and B groups.The CPB time [(247.68± 58.65) min vs (212.68±60.75) min,P =0.000],cross-clamping time[(154.85±45.96) min vs(137.83± 38.91) min,P =0.000] and SCP time [(36.98± 10.62) min vs(29.85± 13.46) min,P =0.000] of group A are all longer than group B.The incidence of postoperative complications(14.0％ vs 10.3％,P =0.619) and in-hospital mortality(9.1％ vs 8.0％,P =0.791) between the A and B groups do not have a significant difference.The mean time of follow-up differed significantly between two groups [(21.86± 18.89) months vs(61.23± 38.57) months,P =0.000] and did not differ in the rate of follow-up(94.5％ vs 96.3％,P =0.585).The rate of false lumen thrombosed at the proximal descending aorta showed a significant difference between the twogroups(91.8％ vs 23.8％,P =0.000),but the rate of secondary surgical intervention (0 vs 2.3 ％,P =0.095) and follow-up death (6.4％ vs 6.3 ％,P =0.975) do not.Conclusion For the Stanford type A aortic dissection patients,surgery is the only treatment that can save lives.Total arch replacement need more time in CPB,cross-clamping and SCP,but the complications,in-hospital mortality and follow-up death do not show a significant difference compared with hemi-arch replacement,and higher rate of false lumen thrombosed have been showed in total arch replacement.

AIM:To investigate the effects of resveratrol ( Res) on the proliferation of ARPE-19 cells and to ex-plore the possible mechanisms.METHODS:After ARPE-19 cells were treated with Res at concentrations of 0, 50, 100, 150, 200 and 300 μmol/L for 24 h, 48 h and 72 h, the effects of Res on the proliferation of the cells were tested by CCK-8 assay.The ARPE-19 cells were treated with Res at concentrations of 0, 100, 150 and 200 μmol/L for 48 h.The effects of Res on the cell cycle and apoptosis were detected by flow cytometry with Annexin V-FITC/PI staining.The protein expression of proliferating cell nuclear antigen (PCNA) was detected by immunofluorescent assay.The mRNA expression of PCNA, P21 and P27 was determined by real-time PCR.RESULTS:The results of CCK-8 assay showed that Res inhibited the prolifera-tion of ARPE-19 cells in a time-and dose-dependent manner.The treatment with Res for 48 h resulted in an arrest of cell cycle at S phase without increasing cell apoptosis.Res inhibited the protein expression of PCNA in ARPE-19 cells.The re-sults of real-time PCR showed that Res increased the mRNA expression of P21 and P27, and decreased the mRNA expres-sion of PCNA.CONCLUSION: Res inhibits the proliferation of ARPE-19 cells and induces the cell cycle arrest at S phase.The mechanism may be related to up-regulation of P21 and P27, and down-regulation of PCNA.