Objective To determine the distribution of flurbiprofen axetil in the muscle tissue in the surgical field after intravenous administration in rats. Methods Forty pathogen-free male SD rats weighing 240-260 g were randomly divided into 5 groups (n=8 each) : Ⅰ control group (group C) and Ⅱ-Ⅴ flurbiprofen groups received iv flurbiprofen axetil 2, 4, 8, 16 mg/kg respectively (group F_1, F_2, F_3, F_4). An 1 cm long incision was made in the right plantar surface from the heel to the toes according to the method described by Brennen under isoflurane anesthesia. The muscle was cut through in the incision but not severed. Flurbiprofen axetil was injected iv via the vein in the tail at 20 min after plantar incision was made in group Ⅱ-Ⅴ . At 2 h after iv flurbiprofen axetil administration, the animals were anesthetized with intraperitoneal 3% pentobarbital 100 mg/kg. The muscles of both hindpaws were dissected, homogenized and centrifuged. The supernatant was separated for determination of flurbiprofen content (by RP-HPLC) and PGE_2 content ( by ELISA). Results The flurbiprofen content in the muscle of hindpaw on the operated side was significantly increased dose-dependently compared with that on the non-operated side and was significantly higher than that on the non-operated side. The flurbiprofen content in the muscle of hindpaw on the non-operated side was significantly higher in group F_4 than in the other 4 groups. There was no significant difference in the flurbiprofen content in the paw muscle on the non-operated side among group C, F_1 F_2 and F_3. The PGF_2 content was significantly higher in the hindpaw muscle on the operated side than that on the non-operated side, and was significantly decreased by flurbiprofen dose-dependently. Conclusion The content of flurbiprofen is significantly higher in the muscle tissue in the surgical field after iv administration than that on the non-operated side, indicating that flurbiprofen axtei has target-analgesic effect.

Objective To study target-distribution of flurbiprofen axetil in operative incision tissue in incision-induced rats. Methods Thirty-two-250 g-weight rats were randomly divided into 4 groups. The incision pain model was established by being operated according to Brennan's method. Two hours after vena caudalis injection, all the rats were anesthetized deeply by pentobarbital sodium-perito injection 100 mg/kg,muscles of both hind paws were dissected, homogenated, centrifuged and supernatant fluids were dissociate. The concentration of flurbiprofen were detected by reversed phase high peformance liquid chromatography(RP-HPLC). Results In these groups of different dosage, the concentration of flurbiprofen in operative incision notably increased compared to that in the non-operative incision, especially in group K16. The concentration of flurbiprofen in operative incision of different dosage increased in dose-dependent manner. The difference of concentration of flurbiprofen in non-operative incisions of K2, K4, K8 was statistically insignificant, but the concentration of flurbiprofen in non-operative incision of K6 increased compared to that of K2, K4 and K8. Conclusion The distribution of flurbiprofen axeti in operative incision was targeted. When rats were injected flurbiprofen axetil at 16 mg/kg by vena caudalis, The concentration of flurbiprofen in the non-operative incision increased notably.

Objective To investigate the effect of flow management of cerebral perfusion during aortic arch surgery on the neurological complication.Methods From March 2007 to November 2011,189 patients underwent aortic arch surgery with hypothermic circulatory arrest plus antegrade cerebral perfusion in our department.The clinical data were analyzed retrospectively.According to the different methods of cerebral perfusion flow nanagement,patients were divided into two groups.Single pump with double limb (to the lower body and brain) perfusion was used in group A (96 patients),based on natural distribution of petfusion flow without control.Modified flow management was used in group B (93 patients).A magnetic flow sensor probes was installed on the brain perfusion limb to monitor and control the cerebral perfusion flow precisely (10 ml · kg-1 · min-1).Postoperative neurological complications were compared between two groups.Results There was no significant difference between the two groups in CPB time,aortic clamping time and circulatory arreating time.However,the morbidity of postoperative neurological complications in group B was much lower than that in group A (1.1％ vs 5.2％,P ＜0.05).Conclusion When performing antegrade cerebral perfusion during aortic arch surgery,precisely control of cerebral perfusion flow can reduce the morbidity of postoperative neurological complications effectively.

The study summarizes the clinical experience of surgical treatments of various types of thoracic aneurysm and aortic dissection. Clinical data of 122 patients with thoracic aneurysm and aortic dissection during July 2005 to July 2008 were retrospectively analyzed. The elective operations were performed in 107 patients while emergency surgery was done in 15 cases. Different surgical strategies were employed on the basis of diseased region, including simple ascending aortic replacement (n=3), aortic root replacement (n=43), hemi-arch replacement /total arch replacement+elephant trunk technique (n=32), thoracic/thoracoabdominal aortic replacement (n=8) and endovascular repair (n=36). In this series, there is 4 cases of perioperative death due to massive cerebral hemorrhage (n=1), respiratory failure (n=1) and multiple organ dysfunction syndrome (MODS) (n=2). Three cases developed post-operative massive cerebral infarction and the relatives of the patients abandoned treatment. Instant success rate of endovascular repair was 100%. The intimal rupture was sealed. Blood flow was unobstructed in true lumen and no false lumen was visualized. It was concluded that aggressive surgery should be considered in the patients with thoracic aneurysm and aortic dissection. Surgical procedures should vary with the location and the nature of the lesions.
Aneurysm, Dissecting/*surgery ; Aortic Aneurysm, Thoracic/*surgery ; Retrospective Studies ; Vascular Surgical Procedures/methods ; Young Adult

The study summarizes the clinical experience of surgical treatments of various types of thoracic aneurysm and aortic dissection.Clinical data of 122 patients with thoracic aneurysm and aortic dissection during July 2005 to July 2008 were retrospectively analyzed.The elective operations were performed in 107 patients while emergency surgery was done in 15 cases.Different surgical strategies were employed on the basis of diseased region,including simple ascending aortic replacement (n=3),aortic root replacement (n=43),hemi-arch replacement/total arch replacement + elephant trunk technique (n=32),thoracic/thoracoabdominal aortic replacement (n=8) and endovascular repair (n=36).In this series,there is 4 cases of perioperative death due to massive cerebral hemorrhage (n=1),respiratory failure (n=1) and multiple organ dysfunction syndrome (MODS) (n=2).Three cases developed post-operative massive cerebral infarction and the relatives of the patients abandoned treatment.Instant success rate of endovascular repair was 100%.The intimal rupture was sealed.Blood flow was unobstructed in true lumen and no false lumen was visualized.It was concluded that aggressive surgery should be considered in the patients with thoracic aneurysm and aortic dissection.Surgical procedures should vary with the location and the nature of the lesions.

Objective:Since December 2019, novel coronavirus infection has occurred in Hubei province and spread throughout the country quickly. This new crown viral pneumonia was named as coronavirus disease of 2019 (COVID-19) by WHO. However, at present, there is a high incidence of acute aortic dissection in winter and spring. How to prevent the spread of the epidemic and choose the appropriate treatment is an important topic for the patients with acute aortic dissection.Methods:From January 16, 2020 to February 26, 2020, a total of 37 of acute aortic dissection operations were carried out in several cardiovascular surgery centers in Hubei Province. There were 18 cases of Stanford type A aortic dissection and 19 cases of Stanford type B aortic dissection. There were 10 cases (55.55%) with ascending aorta replacement and 7 cases (38.89%) with Bentall procedure for aortic root surgery, and total arch replacement with stented elephant trunk implantation were performed in 14 cases (77.8%). In 19 patients with Stanford type B aortic dissection, thoracic endovascular aortic repair was performed, with the left subclavian artery chimney technique in 2 cases.Results:No deaths occurred within 30 days of hospitalization. Preoperative nucleic acid testing excluded 7 cases of novel coronavirus infection, and 3 suspected cases underwent emergency surgery. the three-level protective standard was adopted in the majority of the surgeries(62.2%, 23/37), and 11 patients were negative in the reexamination of viral nucleic acid after the operation.Conclusion:During the epidemic period, patients with acute aortic dissection should be carefully identified with actife COVID-19 before surgery. The treatment principles-" prevention and control of pneumonia epidemic should be emphasized, conservative medical management should be taken in the comfirmed cases, the selective operation should be delayed as far as possible, and the operation should be reasonable performed in critical cases" should be followed, which can save patients' lives to the greatest extent and prevent the spread of the virus.