Objective To observe the clinical value of doppler ultrasound in evaluation of the treatment outcome of alcoholic liver disease.Methods 212 patients with alcoholic liver disease were selected.Ultrasound and liver function tests were applied before and after treatment,and temperance and medicines were applied for treating.The effects were used to observe the senlitivity of ultrasound applied in evaluation the treatment outcome of alcoholic liver disease.Results Of 212 cases,95 cases were diagnosed as alcoholic fatty liver disease by ultrasound before treatment,and the detection rate before treatment was 96.70％.51 cases were diagnosed as alcoholic hepatitis and 59 cases were alcoholic cirrhosis.After treatment,there were 37 cases had abnormal ultrasound images in 43 patients with alcoholic liver disease,and the detection rate was 86.04％.And 9 cases were diagnosed as alcoholic fatty liver disease by ultrasound,12 cases were diagnosed as alcoholic hepatitis and 16 cases were alcoholic cirrhosis.Conclusion It was noninvasive,cheap,convenient and repeated by using doppler ultrasound,and it was conducive to grasp the change of the condition of the patients for doctors.Ultrasound could be chosen as the preferred method for diagnosis of alcoholic liver disease.

Objective: To evaluate the surgical results of aortic regurgitation caused by aortitis. Methods: Results: Between 1990 and 2002, 20 patients with aortic regurgitation caused by aortitis underwent surgery. The surgical procedures included aortic valve replacement in 12 patients and aortic root replacement in 8 (Bentall type operation in 5, Cabrol type operative in 2, and David type operation in one). Conclusion: There was no operative death. The follow-up duration ranged from 2 to 61 months (mean, 24 months). Postoperative perivalvular leakage and/or detachment of the prosthetic valve occurred in 7 patients after aortic valve replacement. 7 patients required re-operation, and 3 patients underwent third operation due to perivalvular leakage. There were 4 later deaths (20%). Conclusion: The timing for the operation, selection of operative procedure, and preoperative control of active inflammation were essential for successful treatment of aortic regurgitation caused by aortitis.

Objective To summarize the methods and results of surgical treatment of coarctation of the aorta associated with aortic dissection.Methods Analyzed the clinical data of 10 patients with aortic coarctation associated type B aortic dissection who underwent one-stage surgical repair between 2011 and 2013 in Anzhen Hospital.There were 7 males and 3 females with the age ranged from 23 to 56 years,average at 41.2 years.All patients were diagnosed by UCG and CTA.There are three key points to determine the operation method,diameter of the aortic arch and descending aorta,and the extent of dissection.Descending thoracic aortic replacement with short stented elephant trunk was performed in 3 patients,thoracic and abdominal aortic replacement in 1 patient,ascending-abdominal aorta bypass with arch or descending aortic ligature in 3 patients.Results One hospital death occurred(10％).There was no severe surgical complication.No death or reoperation occurred during follow up period.Conclusion Aortic coarctation associated type B aortic dissection is a rare and complex disease.Surgical treatment is an effective and safe method for the disease.

Objective To observe the clinical effect of Biafine cream to prevent acute irradiation-induced dermal injury. Methods 104 patients who had to accept radiotherapy were randomized into two groups:treatment group(56 cases) was give Biafine cream application since the first radiotherapy session while the other 48 served as control without this medication when general and health education program was given. Results Dermal toxic rate and degree in the treatment group were obviously lower than those of the control group, with the difference between the two groups significant. Conclusions Biafine cream can effectively prevent acute irradiation-induced dermal injury. It can alleviate the patients' suffering and improve their quality of life, so as to ensure uneventful radiotherapy .

Objective To analyze the short-term results of endovascular aortic repair (EVAR)for patients with acute type B aortic dissection and chronic renal insufficiency (CRI ).Methods Between February 2009 and December 2012,EVAR was performed in 30 patients with acute type B aortic dissection and CRI (CRI group).Consecutive 30 patients with acute type B aortic dissection whose renal function was normal during the same period was chosen as the control group (non-CRI group).All patients were within 14 days after onset,in which Marfan syndrome was excluded and diagnosis made by computed tomographic angiography (CTA) before the procedure.In 57 patients,EVAR was performed under looal anesthesia and associated procedures included insertion of a chimney stent in the left subclavian artery in 2 case and a bare metal stent in the renl artery in 2,In 3 patients,EVAR was done following right axillary artery-to-left axillary and left subclavian artery bypass with a Y-shaped graft under general anesthesia.Follow-up regimen included renal function and CTA at I month and 1 year postoperatively.Results Compared to the non-CRI group,patients in the CRI grup was significantly younger [ (44.7±13.2) years versus (53.7±16.2)years,P ＜0.05)and had a higher rate of perioperative complications (cerebrospinal ischemia,deterioration of renal dysfunction,and gastroenteral dysfunction) (16.7％ versus 3.3％,P ＜0.05 ),all of which resolved after surgical or medical treatment.One patient in CRI group was readmitted at 6 months for a redo EVAR to treat a new tear distal to the stent.At 1 month and I year postoperatively,no patients suffered from deterioration ofthe renal function,and their CTAs detected no apparent device deformation,alteration and endoleak,with remsrkable improvement in the blood supply of the aortic trie lumen and branches.Conchusion Satisfactory short-term results can be achieved with EVAR for patients with acute type B aortic dissection and CRI.At I month and 1 year postoperatively,no mortality or morbidity occumed such as endoleak,aortic rupture,neurologic and abdominal ischermia.

Objective To summarized the experience of simultaneous aortic operation and coroanry artery bypass graft (CABG).Methods Ninety seven patients who underwent combined aortic operation and CABG were reviewed from January 2009 to December 2011.All patients are divided into four groups according to etiology,63 aortic aneurysm,other 25 aortic dissection,7 coarctation of aorta or occlusion of main branch,and the other two aortic ulcer.Mean age of all patients is(57.6 ±9.5) years.The rate of preoperational diagnosis of coronary disease (CAD) were respectively 93.7％ (59/63),40.0％(10/25),100.0％,100.0％.The patients made the preoperative diagnosis of CAD were performed selective simultaneous CABG with aortic procedures.The others without diagnosis of CAD had to receive urgent CABG during the aortic procedures.Results The aortic procedures with simultaneous urgent CABG had signilicant higher mortality than with selective CABG,16.7％,3.8％,Fisher's exact test P =0.078.Conclusion Selective simultaneous CABG with aortic procedures is safely.In aortic surgery,patients with risk factors of CAD should undergo preoperative coronary artery angiography or spiral computed tomography.

Objective To summarize our clinical experience and results of intraoperative stented elephant trunk technique on Stanford type B dissection.Methods From March 2009 to December 2011,24 patients of Stanford type B aortic dissection with insufficient anchored zone or the left subclavian artery involvement underwent intraoperative stented elephant trunk technique in Beijing AnZhen Hospital.Of these patients,20 were male and 4 female,with a mean age of (50.6 ± 9.8) years,(36-77 years).Associated with hypertension in 20 cases,aortic root aneurysm in 1 case,aortic insufficiency in 2 cases,mitral insufficiency in 1 case,coarctation of the aorta in 1 case; 14 cases had a history of smoking.The postoperative internal fistula after descending thoracic aortic stent-graft occurred in 4 cases.Results 24 patients of Stanford type B aortic dissection with insufficient anchored zone or the left subclavian artery involvement underwent intraoperative stented elephant trunk technique.Concomitant procedures included the bypass from the left subclavian artery to the left common carotid artery in 5 cases,aortic valve replacement and ascending aortic plasty in 3 cases,left subclavian artery reconstruction in 2 cases,double valve replacement in 1 cases,the bypass from ascending aorta to descending aorta each in one.The times of cardiopulmonary bypass and selective cerebral perfusion averaged (163.1 ±48.6) min and (29.1 ± 12.4) min,respectively.There was no in-hospital mortality.Complications occurred in 2 patients (2/24,8.3％),including respiratory insufficiency and mediastinal bleeding requiring reoperation,each in one.No paraplegia or stroke occurred postoperatively.Follow-up was available in 23 patients (23/24,95.8％).During the follow-up,type Ⅰ endoleak occurred in 2 patient and needed surgical repair.One patient underwent endovascular aortic repair due to pseudoaneurysm of the distal end of the stent.The complete thrombosis ratio of the false lumen was 86.4％ (20/24).Conclusion The intraoperative stented elephant trunk technique was safe and feasible for Stanford type B aortic dissection with insufficient anchored zone or the left subclavian.artery involvement,a low rate of morbidity and mortality were achieved.The long-term results need the further follow-up.

Objective To identify the risk factors for postoperative spinal cord injury in Stanford type A aortic dissection patients.Methods 210 Stanford type A aortic dissection(TAAD) patients underwent Sun's procedure in Beijing Aortic Disease Center during July 2014 to March 2015.14 patients had spinal cord injury after surgery.Clinical data and computed tomography angiography(CTA) imaging of aorta were retrospectively analyzed and multi-logistic regression analysis was performed to identify risk factors for spinal cord injury post operation.Results 14 out of 210(6.7％) patients had transient or permanent spinal cord injury after surgery.Univariate analysis showed only false lumen derived intercostal arteries at eighth thoracic vertebral level (T8) to first lumbar vertebral level (L1) was significantly associated with post-surgery spinal cord injury (P =0.000).Multi-logistic regression analysis showed that false lumen derived intercostal arteries (P =0.000) and age (P =0.016) were significantly associated with postoperative spinal cord injury.Conclusion Major intercostal arteries derived from false lumen and rapid thrombogenesis in false lumen are the major risk factors for postoperative spinal cord injury in Stanford type A aortic dissection patients.

Objective The purpose of the study was to assess the distal aorta changes and prognosis after total arch replacement combined with stented elephant trunk implantation(Sun's procedure) for Marfan patients with Stanford type A aortic dissection involving the aortic arch.Methods Between February 2009 and February 2014,47 Marfan patients (38 males,9 females) with Stanford type A aortic dissection involving the aortic arch underwent Sun's procedure.Mean ages(32.43 ± 7.96) years(ranged from 19 to 50 years).According to whether the growth rate of the distal aortic diameter is more than 5 mm/year or not after the first year,the data it was divided into the improve group(29 cases) and the progressive group(18 cases).The residual false lumen thrombosis and the diameter of the distal aorta were evaluated by CT date.Results All patients were survived and discharged after Sun's procedure.The mean follow-up period was 1 years.The survival rate was 97.9％ (46/47) and 1 patients died.The total recover of the distal aorta was achieved in12 patients(25.5％) after procedure.The reoperation of total thoracoabdominal aortic replacement rate of the distal aorta was 8.5％ (4/47) and the reoperation interval was(9.88 ±2.84) month(6-12 month).Complete thrombus formation around the stented elephant trunk was observed in 85.1％ (40 of 47).The annual rate of growth of the distal aorta were:the descending aorta segment of stented elephant trunk (0.00 s3.41) mm,the diaphragm level(1.14 ±2.20)mm,the renal artery level(0.97 ±2.15)mm.Complete thrombus formation around the stented elephant trunk of theprogressive group was lower thanthe improvegroup(72.2％ vs 93.1％,P =0.089).The reoperation rate of total thoracoabdominal aortic replacement surgery of the progressive group was higher than the improve group(22.2％ vs 0,P =0.017).The incidence of aortic rupture risk of the progressive group was higher than the improve group (5.6％ vs 0,P =0.383).The diameter of the distal aorta after Sun's procedure of the progressive group was higher than the improve group after 1 year:the descending aorta segment of stented elephant trunk end(40.17 ±7.09) mm vs (27.86 ±6.77)mm(P ＜0.001),the diaphragm level(42.17 ±9.91)mm vs(27.48 ±7.14) mm(P ＜0.001),the renal artery level (38.22 ± 6.90) mm vs(24.00 ± 6.18) mm (P ＜ 0.001),the difference was statistically significant.Conclusion Using Sun's procedure for Marfan patients with Stanford type A aortic dissection involving the aortic arch would promote false lumen thrombosis of stented elephant trunk and aortic remodeling and delay the time interval of the reoperation.The Marfan patients in progressive group which the diameter of the distal aortic growth rate was more than 5mm/year,should be actively carry out rigorous monitoring of the distal aorta and prevention of aortic rupture risk events.