Objective To analyze the risk factors associated with respiratory dysfunction (ARD) in patients with DeBakey type Ⅰ aortic dissection after operation and provide the measures for prevention and treatment.Methods Retrospectively analyzed the clinical data of DeBakey Ⅰ type aortic dissection 18 patients under deep hypothermic cardiopulmonary bypass from September 2008 to March 2012 in the application of the three-branch type aortic arch endovascular stent.Recorded age,sex,preoperative complication,with or without perfusion badness syndrome,cardiopulmonary bypass time and aortic cross-clamping time.Monitoring preoperative and postoperative blood gas analysis,chest X-ray,ventilator parameters,intraoperative and postoperative blood transfusion.The single factor analysis of the risk factors associated with postoperative ARD was analyzed.Results No patient died in peroperative period.Five patients (27.8％) was in perfusion badness syndrome preoperative,8 patients (44.4％) was in ARD postoperative.Three patients (16.7％) occurred within 72 h and 5 patients (27.8％) occurred within 48 h.Three patients (16.7％) performed incision of tracheal for the duration of mechanical ventilation for more than 7 d.Correlation factor analysis showed that BMI (P =0.047),cireulatory arrest time (P =0.035) had correlation with postoperative ARD.Conclusions ARD is a common complication during perioperative.It can be correctable by pay full attention to the risk factors,and the prognosis is good.

This article analyzes the characteristics of lymph node metastasis in proximal advanced gastric cancer,in order to guide the extent of stomach resection (proximal or total gastrectomy) and the resection of spleen or splenic preservation. The metastasis of lymph node in proximal advanced gastric cancer has certain characteristics, which can provide a significant guidance for lymphadenectomy. Total gastrectomy plus splenectomy is a feasible radical surgery for proximal advanced gastric cancer, because of the requirement of lymphadenectomy.

Objective To study the significance of serum IL-17 level in patients with acute coronary syndrome (ACS ) before and after rosuvastatin treatment .Methods Forty-eight ACS patients served as group A and 30 stable angina pectoris patients served as group B in this study .T heir blood-lipid level and serum hs-CRP and myocardial enzyme levels were measured and the number of coronary artery branches with lesions was calculated .Their association with serum IL-17 level was analyzed .Patients in group A were treated with rosuvastatin .The serum IL-17 levels were compared in two groups before and 4 weeks after rosuvastatin treatment .Results The serum IL-17 level was significantly higher in group A than in group B before rosuvastatin treatment (34.41 ± 6 .37 ng/L vs 15 .18 ± 3 .11 ng/L ,P<0 .05) and significantly lower in group A 4 weeks after rosuvastatin treatment than before rosuvastatin treatment (16 .71 ± 4 .72 ng/L vs 34 .41 ± 6.37 ng/L ,P<0 .05) .No significant difference was found in serum IL-17 level between the two groups after rosuvastatin treatment (P>0 .05) .Multivariate regression analysis showed that the serum hs-CRP and troponin level and the number of coronary artery branches with lesions were positively related with the serum IL-17 level (P=0 .012 ,0 .008 ,0 .000) .Conclusion Serum IL-17 level in ACS patients can partly reflect the severity of ACS .Early treatment of ACS with rosuvas-tatin can reduce the inflammatory reactions and serum IL-17 level ,and is of great significance in stabilizing the coronary plaques and reducing the incidence of ACS .

Objective To investigate and analyze the reference ranges of the common parameters of venous blood cell analysis a ‐mong healthy adults in Kunshan City .Methods The analytical results of venous blood cells from 2 456 healthy adults were selected and the ten indicators of red blood cell ,hemoglobin ,mean corpuscular volume ,mean corpuscular hemoglobin concentration ,mean corpuscular hemoglobin ,hematocrit ,white blood cell ,lymphocytes percentage ,neatrophilic granulocyte percentage ,blood platelet were statistically analyzed by adopting the SPSS 19 .0 software .Results The commonly used 10 parameters of blood cells showed a skewed distribution ,the Mann‐Whitney U tests showed that the gender difference in 10 parameters was statistically significant (P<0 .05) ;the WBC count was slightly higher than that reported by other literature ,the other 9 parameters were close to those reported by the majority of related literature .Conclusion The commonly used parameters of blood cell analysis are influenced by the region , gender ,environment ,living condition and detection instrument ,and it is necessary to establish the reference ranges for each labora‐tory .

Objective To summarize efficacy of surgical treatment of acute extradural hematoma. Methods The clinical data of 67 acute extradural hematoma(combined skull fracture) surgery cases were retrospectively analyzed from January 2006 to December 2009. Results Cerebral hernia and the time from the formation of cerebral hernia to operation affacted the prognosis of acute extradural hematoma severely. It was controversial that removal of skull bone or not after cerebral hernia. Conclusions The timely diagnosis and operation of acute extradural hematoma was positive correlation to the prognosis. The simple removal of skull bone impacted limitedly on the prognosis of patients with GCS 3.

Objective Summarize anterior open tension-free inguinal hemiorrhaphy, especially application experience and understanding in the 952 cases of day surgery, and clarify the advantages. Method During December 2004 - June 2007, we treated 952 Patients of inguinal hernia and femoral hernia,using local anesthesia, tension-free, in the form of day surgery. And the resulte were compare to traditional hemiorrhaphy, tension-free hemiorrhaphy of hospital in all aspects. Results Patients in this group were all cured.Intraoperative and postoperative pain was mild.All patients should be used only a small amount of postoperative oral analgesics, and no urinary retention. They got out of bed immediately after surgery, and they recorered fast ,with less complications. They could be discharged home in surgical day (2 h later). Af ter 18 months follow-up, only 2 cases recurrence. Conclusions (1) Compared with the traditional hemiorrhaphy and ambulatory tension-free hemiorrhaphy, tension-free during the day has lots of advantages, such as easier method, wider surgical indications, faster postoperative recovery, shorter hospital stay, less complications and lower recurrence rate;(2)Tension-free hernion'haphy day surgery is safe，feasible，and has obvi-ous advantages.

Objective To investigate the effect of preoperative pravastatin preconditioning on myocardial ischemia-repedusion(I／R)injury in patients undergoing cardiac valve replacement with cardiopulmonary bypass (CPB).Methods Sixty ASA Ⅱ orⅢpatients of both sexes aged 18-64 yr undergoing cardiac valve replacement under CPB were randomly divided into 4 groups(n=15 each)：control group(group C)and 3 pravastatin groups receiving oral pravastatin 10，20 and 40 mg respectively every night for 7 days before operation(group P1-3).The number of patients receiving dopamine(≥5 μg·kg-1·min-1)and adrenaline was recorded from the termination of CPB to the end of operation，from the end of operation to 12 h after operation，during 12-24 h after operation and during 24-48 h after operation.Venous blood samples were taken from central venous line for measurement of plasme cTnI and CK-MB concentrations at 7 days before operation，before induction of anesthesia，at opening of the aorta and at 2，24 and 48 h after opening of aorta.Results The number of patients receiving dopamine and adrenaline was significantly less in group P3 than in group C(P<0.05).Plasma CK-MB and cTnI concentrations were significantly lower in group P3 than in group C(P<0.05).Conclusion Preconditioning with oral pravastatin(40mg／d for 7 consecutive days)can protect myocardium against I／R injury in patients undergoing cardiac valve replacement with CPB.

Morphology and microstructure of five herbal .medicines of the Bidens genus (Compositae )inChina were studied, and their resource utilization discussed. They are B. bipinnata, B.biternata, B. parviflora, B. tripartita and B. frondosa.

Objective To report a rare case of M3r subtype of acute promyelocytic leukemia (APL)with 3'-end of RARα (3'RARα) submicroscopic deletion, and the characters of morphologic, cytogenetic,molecular genetic and molecular biology studies. Methods Chromosomes of bone marrow (BM) cells were prepared with direct method and short-term culture method, and R-banding technique was used for karyotypic analysis. Fluorescence in situ hybridization (FISH) assays were performed on fixed BM cells using the following specific DNA probes: CEP X/Y alpha satellite DNA probe, LSI PML-RARα dual-color dual-fusion and LSI RARα dual-color break apart probes. A quantitative real-time reverse-transcription polymerase chain reaction (RT-PCR) was performed to detect the PML-RARα transcript. A multiplex nested RT-PCR was also performed, which may simultaneously detect the fusion genes derived from 29 chromosomal aberrations in acute leukemia including PML-RARα, PLZF-RARα and NPM-RARα fusion transcripts. Results R-banding analysis revealed a karyotype of 45,X,-Y[6]/46,XY[8], FISH using CEP X/Y probe further confirmed Y-chromosome loss. FISH analysis with RARα dual-color break apart probe demonstrated a deletion of the entire 3'-end of one allele of RARα gene. Cytogenetic, FISH and RT-PCR analyses showed no PML-RARα,PLZF-RARα, NPM-RARα, NuMA-RARα and STAT5b-RARα rearrangements. Conclusion A new RARαrearrangement involving 3'RARα submicroscopic deletion in APL without X-RARα fusion has been identified.FISH analysis with RARα dual-color break apart probe is a useful method for characterization of this abnormality, but its molecular consequences remain to be elucidated.

Interventional pulmonary procedures performed by flexible bronchoscopy has been widely used in the adult clinics.However,pediatric interventional pulmonary procedures are different from adult in anesthesia methods,equipment,technology and so on.At present.it is more limited.This review showed the experiences of pediatric bronchoscopy in Taipei Veterans General Hospital of Taiwan,China.