Objective To evaluate the feasibility of endovascular repair for retrograde type A aortic dissection.Method 35 patients of retrograde type A aortic dissection admitted to Peking University People's Hospital from December 2001 to March 2014 were treated with endovascular repair.There were 33 males and 2 females with mean age of 46 ± 9 years.29 were on acute stage,2 on subacute stage and 4 on chronic stage.The entry tear was in the descending thoracic aorta in 32 cases,between the left subclavian artery and the left common carotid artery in one,and between the left common carotid artery and the innominate artery in two.Results Entry closure was achieved in all patients with a covered stent.2 patients died in 30 days postoperatively (5.7％).1 patient with two chimney developed acute renal artery embolized which was infused by false lumin (2.9％).One patient developed transient paraparesis after graft deployment(2.9％).During the follow-up period,the aortic remodeling is perfect,no entry tear was noted in the ascending thoracic aorta.All the endografts for preserving supra-aortic branches were patent.Conclusions The endovascular repair for retrograde type A aortic dissection is feasible and effective.

Objective:To analyze the chemical constituents of the ether extracts from the fruits of 3 species of Chaenomeles . Methods: The chemical constituents were analyzed by GC MS. Results: Sixty one constituents were firstly isolated and identified from the fruits of 3 species of Chaenomeles . Forty compounds in Chaenomeles lagenaria , thirty four compounds in Xuan mugua ( C.lagenaria from Xuanzhou) and 23 compounds in C.sinensis were isolated and identified respectively. There were 10 compounds in all 3 species of Chaenomeles , but their contents were very much different. They were acetic acid, benzaldehyde, n caproic acid, 14 methyl pentadecanoic methyl ester, glycerin, benzoic acid, 6,9 octadecadienoic methyl ester, squalane, stearic acid and oleic eicosyl ester. Conclusion: The composition and content vary with different species and district of Chaenomeles . The result may be useful for the evaluation of Chaenomeles fruits quality. [

Objective To explore the effects of walking in water on surface electromyography (sEMG) of lower limbs and neural func-tion in spinal cord injury (SCI) patients. Methods From June, 2014 to May, 2016, 42 patients with incomplete thoracolumbar SCI were di-vided into control group (n=21) and experimental group (n=21) randomly. All the patients accepted routine rehabilitation, while the experi-mental group accepted extra walking in water. Average electromyography (AEMG) of quadriceps femoris and tibialis anterior muscles was measured, and the motor and sense function was assessed with American Spinal Injury Association (ASIA) Classification before and six weeks after treatment. Results The AEMG (t>5.763, P<0.01) and the scores of motor and sense (t>10.871, P<0.001) increased in both groups after treatment, and increased more in the experimental group than in the control group (t>4.036, P<0.01). Conclusion Walking in water could further improve lower limbs muscle strength and neural function in patients with incomplete thoracolumbar SCI.

OBJECTIVE To investigate deep fungal hospital infection and methods of its decreasing. METHODS Case histories of near 3 years of hospitalized patients from Jan 2002 to Dec 2004 were analyzed according to Diagnosis Standard of Nosocomical Infection under the items,such as the patients,age,underlying disease,sample,strain,and species distribution. RESULTS There were 360 fungus strains belonged to 15 species in all samples;the patients age was 14-94 with 20 kinds of various underlying diseases;the fungi included Candida albicans,and C.tropicalis,accounted for 61.1% and 17.2%,respectively;the samples were sputum,urine,vaginal secretion,BLA,throat swab and pus,which were 42.2%,21.1%,13.9%,8.4%,5.8%,and 3.6%,respectively;the respiratory department,ICU,and urology department were mainly involved. CONCLUSIONS To prevent fungal infection, measures such as hospital′s environment and management including reasonable use of antibiotics play a great role in monitoring hospital fungal infection and its epidemiology.

Objective To determine the renal effects of chronic exercise training and enalapril in uninephrectomized anti-Thy-1 nephritis Wistar rats (Thy-1-Crf). Methods 5-week-old Wistar rats were subjected to uninephrectomy. Anti-Thy-1 nephritis was induced by injecting 200 μg/kg OX-7 intravenously once a week for four times. They were divided into 3 groups: non exercise; moderate exercise with treadmill running(20 m/min, 0 grade-incline for 60 min); moderate exercise with an angiotensin converting enzyme(ACE) inhibitors, enalapril (2 mg/kg/day i.p.) for 8 weeks.Results Exercise did not suppress the increase in proteinuria in Thy-1-Crf. However, enalapril significantly decreased systolic blood pressure(SBP), urinary protein excretion(UpE), and index of glomerular sclerosis (IGS) in Thy-1-Crf. Conclusion The renal protective effects of moderate exercise in models of renal failure differ depending on the etiology of renal failure. It also suggests that enalapril can widen the acceptable range of exercise intensity in Thy-1-Crf.

Objective To investigate the safety, feasibility and results of laparoscopic assisted distal radical gastrectomy for gastric cancer. Methods Twenty-three cases of gastric cancer were subjected to laparoscopic assisted distal radical gastrectomy, D_(1+α)/D_(1+β) lymphadenectomy on 3 cases and D_2 lymphadenectomy on 20 cases. All cases received Billroth I reconstruction. Results Laparoscopic assisted distal radical gastrectomy was carried out in all cases successfully. The mean operative time was (205 ±38 )min, mean blood loss was (105 ± 66) ml and mean number of lymph nodes dissected was 19.7 ± 6.2 each case. The mean postoperative time of recovery of bowel function was (3.5 ±1.2) d,mean postoperative time of liquid intake was (4.9 ±0.9) d and mean hospitalization was (10.2 ± 2.7) d. No postoperative death or anastomotic fistula was found. Postoperative upper gastrointestinal bleeding occurred in 1 case and was cured by conservative treatment. Follow-up for 1-12 months revealed no recurrence or metastasis. Conclusions Laparoscopic assisted distal radical gastrectomy is a safe and feasible procedure with satisfactory short-term outcomes.Moreover,the short-term outcomes may be improved if the patients are treated under the notion of fast track surgery.

Objective To evaluate iliac artery rupture during endovascular treatment of aorto-iliac disease and treatment with covered stent.Methods From November 2008 to August 2014,iliac artery rupture happened in 8 patients of 225 patients of aorto-iliac artery disease admitted to our hospital.Clinical data of the 8 patients were analyzed retrospectively.Four were of intraoperative rupture and four were of delayed rupture.The aorto-iliac diease of all the 8 patients were TSAC D.Direct placement of a covered stent was performed in all the cases,except for one patient who refused further treatment.Results All of the procedures finally achieved technical success and all patients become hemodynamically stable.One patient was complicated with heart failure who died of multiple organ dysfunction syndrome.Another one died of aspiration.5 patients were followed up from 9-52 moths,average 9-52 moths without recurrence.Conclusions Iliac artery rupture is a serious and life-threatening complication in the endovascular treatment of aorto-iliac disease.Covered stent provided a safe and effective treatment for iliac perforations.

Objective To investigate the clinical features of spontaneous isolated superior mesenteric artery dissection (SISMAD), and to discuss its interventional therapy. Methods The clinical data of 10 patients with SISMAD, who were admitted to authors' hospital to receive interventional treatment during the period from January 2006 to June 2014, were retrospectively analyzed. All the 10 patients were males, aged 44-66 years with a mean of (53±8) years. Clinically, all patients presented with acute-onset abdominal pain or pain around umbilicus, as the effect of conservative treatment was poor, implantation of self-expandable bare stent was carried out. Results Successful implantation of self-expandable bare stent was accomplished in all 10 patients;only one stent was used in 7 patients and 2 stents were used in 3 patients. The blood in the true lumen of superior mesenteric artery (SMA) restored and the residual stenosis extent was less than 15%. The technical success rate was 100%. The abdominal pain was relieved in 8 patients on the operative day after treatment, and in 2 patients the abdominal pain was relieved in 2 days after treatment. All the patients were followed up for 7-71 months (mean of 36 months) and the follow-up rate was 100%. After the treatment patients had no symptoms of abdominal discomfort. Contrast-enhanced CT scan performed at 6, 12 and 24 months after the treatment showed that SMA and stent was patent and no aneurysmal dilatation was observed. Conclusion For the treatment of SISMAD endovascular implantation of self-expandable bare stent is clinically safe and feasible, and its long-term effect is satisfactory.

Objective Because of the major trauma from thoracotomy , postoperative pain may arouse patients'psychological and physiological stress response and hence affected the treatment outcome and functional recovery seriously .We retrospectively studied the correlation between the staging of pain and nursing interference to investigate the effect of nursing interference on the pain intensity after thoracic surgery . Methods Five hundred and eighty cases of patients surviving thoracotomy between December 2013 and March 2014 in Nanjing Jingling Hospital were reviewed .Correlations between comfortable nursing measures such as effective analgesia , postural care , catheter care , environmental interventions , psychological intervention and the standard assessment of pain were analysed according to postoperative pain stage . Results With comprehensive nursing interference , the highest pain score occurred in the first 24 hour (2.89 ±0.39).The score was reduced gradually to 2.25 ±0.90 in stage Ⅱ, 1.58 ±0.57 in stage Ⅲ and 1.06 ±0.24 in stage Ⅳrespectively . Conclusion Comprehensive nursing interference according to pain staging may relieve pain effectively after thoracotomy .

Objective:To report a rare type of aortic arch aneurysm. Methods: Three cases of aortic arch aneurysm derived from the fourth aortic arch were retrospectively analyzed. The pathogenesis and treatment of this type of aortic arch aneurysm were investigated. Results:Most of the aneurysm body was located in the Z2 zone, which was the stem from the fourth aortic arch in the embryonic development period. All of the 3 cases could not be explained by common etiology. We speculated that the cause might be developmental anomaly of the fourth aortic arch. All the 3 aortic arch aneurysms were totally ex-cluded with a covered stent. The technical success rate was 100%. Endoleak of typeⅠwas seen in one case, which was resolved in a later open surgery. During the follow-up, no type of complications was found. Conclusion:To the best of our knowledge, this is the first report of this type of aortic arch aneurysm. The cause may be developmental anomaly of the fourth aortic arch. Endovascular treatment of this type of aortic arch aneurysm is feasible.