Objective To evaluate the mid-term outcomes of endovascular repair of descending thoracic aortic aneurysm(DTAA) in high-risk patients.Methods Twenty four patients with DTAA received stent-grafts implantation between January 2001 and July 2007 and their clinical data were retrospectively analyzed.All patients were considered high-risk for open surgical repair due to the location or rupture of the aneurysm,high age and severe comorbidities.Spiral computed tomography angiography and 3-dimentional reconstructions were performed at 1,3,6 and 12 months postoperatively and thereafter every year.Results The primary operational success rate was 100%.There were 2 deaths(8.3%) during perioperative period due to multiorgan failure and acute myocardial infarction respectively.Two(8.3%) patients had severe post-operational complications(1 stroke and 1 acute renal insufficiency).Eleven cases of type Ⅰ(46%) endoleak were detected immediately after the operation and among them,the endoleak disappeared after balloon dilatation in 3 cases while the other 8 patients were treated conservatively.Follow-up of 1 to 60 months(mean 18.6?4.2 months) was completed in 19 patients(79.2%).Stent displacement with type Ⅰ endoleake was found in 1 patient at 4 years after the operation and delayed type Ⅲ endoleak occured in another patient at 2 years post-operation.Both patients received endovacular repair again and the endoleaks were closed successfully.One patient died of colon cancer during the follow up.Complete thrombosis of the thoracic aneurysm sac and no stent migration or endoleak was found on the followup CT at 3 months after the operation in all the patients.The decrease in maximal aneurysm diameter was 0-18 mm(mean 6.3?3.1 mm).The prosthetic vascular grafts implanted in 4 patients with preliminary carotid subclavian bypass surgery were patent during the follow-up period.Conclusion Treatment of descending thoracic aortic aneurysm in high-risk patients with endovascular approach showed acceptable early mortality and morbidity and may be considered as a treatment alternative for carefully selected patients.

This paper introduces the principles of an Environmental Temperature Supervising Network System, explain its hardware and software structure and the function of network system. The whole system is proved stable and reliable by experiment. It may have some profit in the market and great future in the application.

Objective To discuss the clinical significance of vancomycin plasma concentration monitoring and its relationship with adverse reactions in treatment of elderly patients. Methods The clinical records of 32 patients aged over 70 years admitted in the Emergency Medical Department of Sichuan Provincial People's Hospital were collected. Based on the diagnosis and laboratory examinations on admission, the patients were treated with cefoperazone+sulbactam or moxifloxacin, while in patients with severe infections, intravenous drip of carbapenem antibacterial drugs were given. After treatment for 3-5 days, when no effective results were obtained, according to the pathogenic results achieved from cultures of blood, sputum, secretions, catheter, etc, the corresponding treatment was given. If the infection was caused by positive bacteria mainly methicillin-resistant Staphylococcus aureus (MRSA) sensitive to vancomycin, the original antibiotic was replaced by vancomycin or vancomycin combined with other antibiotic; intravenous drip of vancomycin 1 g in 250 mL normal saline was given, once in 12 hours, with a speed of 10 mg/min or not over 15 mg/min. The function of liver and kidney, and auditory impairment were observed, and the correlation between vancomycin plasma concentration and adverse reactions was analyzed. Results The total incidence of adverse reactions in elderly patients with different serum vancomycin trough concentrations was 37.50%(12/32) in which the highest incidence was kidney damage 18.75%(6/32) followed by the hearing loss 9.38%(3/32) and liver damage 9.38%(3/32). There were no statistical significant differences in the rates of adverse reactions among the different vancomycin trough concentrations (<10, 10-20,>20 mg/L) and [37.50%(6/16), 38.46%(5/13), 33.33%(1/3), all P>0.05], that meant along with the increase of vancomycin concentration, no tendency of increment of adverse reactions was seen. Of the 32 cases, there were 13 treated by vancomycin combined with other antibiotic, the combination rate being 40.63%. There were 2 cases of hepatic impairment (11.83%), 1 case of renal impairment (7.69%) and none hearing damage in patients treated with combination of antibiotic therapy. Therefore no correlation was concluded between the occurrence of adverse reactions and the combination therapy ( r=0.15, P>0.05). Conclusions In elderly patients over the age of 70 years, there is a higher incidence of kidney damage in the application of vancomycin. Thus, the monitoring of vancomycin plasma concentration in elderly patients has instructive significance in its clinical use.

OBJECTIVE: To evaluate and compare outcomes effects of Chinese recognition materials in post-lingually deafened patients with cochlear implant. METHOD: Thirty-two post-lingually deafened cochlear implant users participated in the study. Each one of them was given a series of speech recognition tests including the speech recognition score of monosyllable words, spondee words, Chinese BKB sentences and MHINT in quiet, as well as speech recognition threshold of HOPE corpus in babble noise. Speech recognition scores and thresholds were compared among these test materials using histograms , scatter diagrams and statistical methods. RESULT: Recognition scores for spondee words, Chinese BKB sentences and MHINT were affected by ceiling effects, with 1,14 and 4 cases scored 100% respectivelty. Meanwhile, 17, 26 and 14 cases scored more than 85% correspondingly. On the other hand, speech recognition scores for monosyllable words in quiet and speech recognition threshold for HOPE corpus in babble noise were not affected. CONCLUSION For a considerable part of post-lingually deafened patients using cochlear implant, some Chinese speech recognition materials have demonstrated different degrees of ceiling effects. While speech recognition scores for monosyllable words in quiet and recognition threshold for HOPE corpus in noise can evaluate the performance of speech recognition abilitymore objectively.
Cochlear Implantation ; Cochlear Implants ; Humans ; Language ; Noise ; Speech Perception ; Treatment Outcome

OBJECTIVE: Small diameter vascular grafts (＜ 6 mm) are used predominantly in revascularization and reconstructive procedures. The small diameter vascular grafts already used in our clinical practice include autologous veins or arteries, polyethylene terephthalate (Dacron) and expanded polytetrafluoroethylene (ePTFE) synthetic vascular grafts. Unfortunately these vascular grafts all have some disadvantages that prohibit their uses. Therefore search for ideal small diameter vascular grafts has become the focus in recent years.DATA SOURCES: A computer-based online search of Pubmed database was undertaken to identify the articles about small diameter vascular grafts published in English between January 1990 and January 2007 with the key words of "prosthetic graft, vascular bypass graft, small diameter vascular graft, tissue engineering".STUDY SELECTION: The data were selected firstly to choose the full-text of articles met the criteria. Inclusion criteria: ① Articles about biological vascular grafts; ②Articles about synthetic vascular grafts; ③Articles about small diameter tissue engineering blood vessels. Exclusion criteria: Repetitive or analogical articles or case reports.DATA EXTRACTION: Totally 113 articles on small diameter vascular grafts were collected and 41 met the inclusive criteria after eliminated the repetitive or similar studies or case reports.DATA SYNTHESIS : Although biological vascular grafts have the outstanding advantages, such as superior long-term patency, relatively resistant to infection, minimal thromboembolism, etc., they also have predominant disadvantages of limited availability, durability and aneurysm formation. Dacron and ePTFE are currently the standard synthetic vascular grafts in the vascular bypass surgery, but their immediate or long-term patency rates are relatively poor due to compliance mismatch, thrombogenicity and poor haemodynamics, especially when they are used in small diameter revascularization and reconstructive procedures. Thus, various modifications have been applied to Dacron and ePTFE grafts to improve their function. In recent two decades, the emergence of tissue-engineering technology has made the development of a novel biologically viable vascular substitute feasible, and it may prove to be the ultimate solution for better small-diameter vascular grafting.CONCLUCTION: So far there is no completely biodegradable small diameter vascular graft suitable for the arterial circulation in humans. Construction of an ideal small-diameter vascular graft will require an interdisciplinary effort requiring critical contributions from biologists, engineers, and clinicians, with strong collaborations among these 3 fields being crucial to success.

Objective: To observe the controlled hypotension effects of nicardipine in 2 different ways for spinal tumor operalion. Methods: Twenty-four adult patients, scheduled for selective spinal tumor operation, were randomly divided into 2 groups. In groupⅠ(n=12), the nicardipine was infused at a rate of 10 μg*kg-1*min-1 and the infusion continued until MAP was at the level of 7.33-8.66 kPa, and then the rate was decreased to 1 μg*kg-1*min-1. In Group Ⅱ(n=12), nicardipine was given 0.01-0.02 mg/kg as the load dose, then infused at 1-2 μg*kg-1*min-1. Results: During the period of controlled hypotension, cardiac index(CI) increased significantly, other hemodynamic variables were stable and no hypertension rebound occurred in both groups. Reaching time of target blood pressure in groupⅡ was shorter than that in groupⅠ（P＜0.05）. The dose required to obtain target blood pressure in group Ⅱwas less than that in group Ⅰ（P＜0.05）. BP recovery time from discontinuing nicardipine infusion to pre-hypotension level,bleeding volume and transfusion volume were similar between 2 groups（P＞0.05）.During mass bleeding,　serious arrhythmia and oliguria did not occur in any case. Conclusion: Controlled hypotension with nicardipine is rapid, stable and easily controlled without hypertension rebound. Nicardipine has considerable protective effects on heart and kidney during mass bleeding. The method of bolus injection followed with intravenous infusion is more suitable to clinical application.

Objective: To observe the inhibitory effect of scopolamine(Spm) and chlopromazine (Clo) on withdrawal syndromes in morphine dependent rats. Methods: The intensity of withdrawal syndromes on the model of morphine dependent rats was recorded after single or muiltiple subcutaneous administration(sc) of Spm and Clo at different doses. Results: Withdrawal syndromes were markedly decreased when single Spm 1 mg/kg and Clo 0.5 mg/kg combined with morphine were injected (P<0.05). Spm+Clo(sc) had much stronger effects on inhibiting withdrawal syndromes after intraperitoneal (ip) naloxone in morphine dependent rats (P<0.01). Conclusion: Spm can act on Ach-receptor and relieve morphine withdrawal syndromes. Clo may have a synergistic action with Spm via α2-receptor in the locus coeruleus of the rat brain stem.

Objective To research the therapeutic effect of vitamin E in prevention and treatment of anemia in premature children.Methods We investigated 90 cases of premature children admitted to the neonatal ward of our hospital from December 2010 to December 2011.According to hospital successively order these premature were randomly divided into control group (Group A),high-dose group (Group B),low-dose group (Group A).Group A including 30 cases,subcutaneous injection of erythropoietin(EPO) from the 7th days after admission,750IU/kg weekly for 3 times,for 4 weeks.At the same time,plus iron 6mg/(kg·d).On the basis of the above-mentioned control treatment,oral administration of different doses of vitamin E was in the treatment group,for 4 weeks.Group B including 30 cases was given vitamin E 15mg/(kg·d).Group C including 30 cases was given vitamin E 2.5mg/(kg· d).The changes of each group during the treatment in hematocrit (Hct),hemoglobin(Hb),red blood cell(RBC),reticulocyte(Ret) and the changes of serum concentrations of vitamin E before and after treatment were observed.Results Hct,Hb,RBC,Ret in group B,group C patients were both improved.The improvement of the indicators was better than that of group A (P ＜ 0.05).There was no significant difference between the improvement of each index of Group B and Group C(P ＞ 0.05).Serum concentrations of vitamin E after treatment in group B and group C patients were significantly higher and the difference was statistically significant(P ＜ 0.05).Serum concentration of vitamin E in group A didn't increase obviously.Conclusion Additional small doses of VitE should be given during EPO prevention of anemia in premature children.

Objective To discuss the treatment strategy of knee dislocation and to evaluate its outcome.Methods Thirty-six patients with unilateral knee dislocation treated with individualized protocol were studied retrospectively,including 22 males and 14 females with an average age of 35 years (range,19-72 years).There were 30 acute and 6 chronic knee dislocations.According to the modified Schenck's classification of knee dislocation,there were 7 KD- Ⅰ and 23 KD-Ⅲ cases in the acute category,and all 6 chronic cases were KD-Ⅲ.Seven acute KD- Ⅰ and 6 chronic KD-Ⅲ cases underwent one-stage arthroscopic surgery.In 23 acute KD-Ⅲ cases,2 were treated conservatively with splint or brace due to advanced age,18 with staged surgery,3 with one-stage surgery due to concomitant vascular and nerve injury.Functional and clinical evaluation was conducted at final follow-up.Results All 36 patients were followed up for an average of 27 months (range,18-36 months).The Lysholm score (82.0±11.4),Tegner score (5.5±1.3),and knee range of motion (118.3°±19.2°) at final follow-up showed a statistically significant improvement compared with preoperative results (P＜O.O1).Eight (23.5％) patients had residual knee instability:posterior drawer test and Sag sign were positive (++ or +++) in 8 knees,valgus instability (++) in 1 and varus instability (+++) in 1.The remaining 28 knees were stable.Conclusion Special attention should be paid to rotational knee dislocation with single cruciate ligament rupture.Properly individualized treatment plan is the key to optimal outcome.Arthroscopic surgery can lead to successful outcome.Early one-stage arthroscopic surgery is recommended for acute KD-Ⅰ and chronic KD-Ⅲ dislocation,staged arthroscopic surgery for acute KD-Ⅲ dislocation.

Objective To observe the influencing factors of recurrence and metastasis for postoperative breast cancer high-risk population, and TCM regimen of syndrome differentiation and treatment was used to validate its significance for the prevention of recurrence and metastasis. Methods The influencing factors of recurrence and metastasis of 178 postoperative breast cancer high-risk cases with positive hormone receptor were studied. The recurrence and metastasis, disease-free survival and accumulative points of TCM symptoms of integrated group (with TCM syndrome differentiation and endocrine therapy) and western medicine group (with endocrine therapy) were compared. Results Lymph node metastasis, cancer staging and TCM therapy had influence on the disease-free survival rate of postoperative breast cancer high-risk patients. TCM therapy was the independent prognostic factor for disease-free survival. 3-year recurrence and metastasis rate was lower in integrated group than that in western medicine group, with statistical difference (P=0.03). The total accumulative points of TCM symptoms in both two groups decreased after treated for 3 and 6 months, integrated group showed greater significance. TCM therapy was better for the treatment of irritability, hot flash and perspiration, good for spontaneous perspiration and insomnia, but poor in dry mouth, bitter taste in mouth and fatigue. Conclusion Lymph node metastasis, cancer staging and TCM therapy are main influencing factors for recurrence and metastasis. TCM therapy with regimen of syndrome differentiation and treatment can reduce 3-year recurrence and metastasis rate, improve TCM symptoms, especially is significant for the improvement of irritability, hot flash and perspiration.