Type B aortic dissection is a life-threatening aortic disease.With the development of clinical classification and diagnostic method,the mortality of type B aortic dissection has been greatly decreased.In respect of treatment,endovascular repair due to minimally invasive advantages become the first choice for the treatment of complicated type B aortic dissection.For non-complicated type B aortic dissection,endovascular repair also gradually replace drug treatment,and showed good efficacy.Open surgery is only available for patients who ate not suitable for endovascular repair or repair failure or patients with connective tissue disease.

Background The use of adaptive optics (AO) system in ophthalmic clinic and basic studies has increased in recent years.However,there are few reports on the stability of ocular aberrations after correction.Objective This study was to analyze the stability of aberration after correction by observing the repeatability of ocular aberration measurements.Methods Forty-one postgraduate school students and volunteers who meet the conditions were included from February to April 2014.The Zernike aberration coefficients including astigmatism (Z2-2,Z22),defocus (Z02),trefoil (Z33,Z3-3),coma (Z3-1,Z13),spherical aberration (Z40) and the value of root mean square (RMS) including 3rd-order to 7th-order aberrations,total higher-order aberrations (HOAs) and total ocular aberrations (TOAs) were measured by using AO system.The repeatability and stability of these data after corrected with AO system were analyzed.The repeatability was evaluated by ANOVA,within-subject standard deviation (Sw),repeatability (r) and intra-class correlation coefficients (ICC).The stability was evaluated by the nonparametric Friedman's rank test.Results AO system showed excellent repeatability on Z2-2,Z22,Z20 and TOA RMS (ICC＞ 0.9),good repeatability on Z13,Z33,Z3-3,Z40,3rd-order RMS,4th-order RMS,HOA RMS (ICC ＞ 0.75),poor repeatability on Z3-1,5th-order RMS,6th-order RMS,7th-order RMS (ICC ＜ 0.75).Repeatability (2.77 Sw) values ranged from 0.009 mm (7th-order RMS) to 0.163 mm (Z31).After low-order ocular aberrations were corrected,It was founded that Z2-2,Z22 reached stable state at the 4th second;Z02 was stable at the 6th second;Z3-3 and Z33 reached stable state at the 4th second and third second,separately;Z13 was stable from 3rd-second to 9th-second,Z3-1 was stable at the 4th-second.Z40 and HOA RMS were stable at the third second and fifth second,respectively.The Z2-2,Z02,Z22,Z3-3,Z3-1,Z33,Z40 and HOA RMS were significantly different among different time points before and after low-order aberrations correction (all at P ＜ 0.05).Z2-2,Z22,Z20 reached stable state at the 4th-second,3rd-second and 5th-second,respectively;Z3-3,Z33 reached stable state at the 2nd-second and 3rd-second,respectively;Z3-1and Z40 reached stable state at the 2nd-second;HOA RMS reached stable state at the 5th-second.Conclusions After correcting the human ocular aberration,different aberrations can reach stable state at different time.The time of Z02,Z22,Z3-3,Z3-1,Z40reaching stable state after 2nd-order to 5th-order ocular aberrations correction was earlier than those of lower-order aberrations correction.

To detect furaltadone metabolite 3-amino-5-morpholinomethyl-2-oxazolidinone ( AMOZ ) in fish sample, an Eu3+ labeling time-resolved fluoroimmunoassay ( TRFIA ) was developed. The effects of experimental conditions including AMOZA-OVA concentration, dilution of antibody, and reaction time on the sensitivity of TRFIA were explored. The results showed that the optimized assay conditions were as follows:the AMOZA-OVA concentration was 0. 25 μg/mL; the antibody was diluted 5í104 folds, and the competitive reaction time was 50 min. Under optimal conditions, the method showed a detection limit of 0. 01 ng/mL, an IC50 of 0. 26 ng/mL and a linear range (IC20-IC80) of 0. 025-2. 83 ng/mL. The recoveries of AMOZ in fish at three spiked levels ranged from 78 . 0% to 86 . 0%, and the relative standard deviations were less than 15%. Good correlation between the ic-TRFIA and high performance liquid chromatography-tandem mass spectrometry was obtained for spiked food samples. The proposed ic-TRFIA method was suited for the determination of AMOZ residue in food samples.

To assess the efficacy and outcome of endovascular aortic repair (EVAR for the treatment of primary infected aortic aneurysms (PIAAs).Methods The clinical data of 15 consecutive patients presenting with PIAA from Apr 2010 to Apr 2018 were retrospectively reviewed.Results 10 were male out of 15 patients ranging from 55 to 80 years old.The aneurysms were located in thoracoabdominal aorta in 1 case,abdominal aorta in 10 cases and left common iliac artery in 4 cases.Positive microbial cultures were reported in 13 patients,including Salmonella species in 12 and Streptococcus in 1.Eleven patients received preoperative antibiotics therapy before elective EVAR for more than 1 week.Four patients underwent emergency EVAR due to ruptured aneurysms.Postoperative antibiotic therapy was given for at least six months.There was no death within 30 days.Mean follow-up time was 44.6 months.Infection relapsed in 6 patients during follow-up.Infection-related death occurred in 3 cases.3 of them were healed.Conclusions EVAR combined with aggressive antibiotic strategy is feasible for the treatment of PIAAs,particularly in high-risk surgical patients or in the acute setting of rupture.

Objective:To evaluate the efficacy and safety of physician-modified fenestration TEVAR for treating type B aortic dissection with unhealthy or short anchoring zone.Methods:Clinical data of patients with type B aortic dissection who received TEVAR for left subclavian artery fenesration from May 2016 to Dec 2018 were analyzed prospectively.Results:The technical success rate was 93.2%. One case was converted into chimney stenting. One case suffered type Ⅰendoleak. One case had type Ⅲ endoleak. There were no deaths or neurological complications during the perioperative period, and the mean hospital stay was 9.2 (5-26) days. The median follow-up time was 30 (12-42) months. One case developed type Ⅰ endoleak during follow-up. No retrograde dissection occurred and all LSA stents remained patent.Conclusion:Physician-modified fenestration TEVAR is safe and effective for the treatment of type B aortic dissection with unhealthy or short anchoring zone.

Objective To evaluate fenestrated endovascular aortic repair (FEVAR) using physician-modified stent-grafts (PMSGs) for thoraco-abdominal aortic lesions.Methods Seven cases of thoraco-abdominal aortic lesions (1 type Ⅲ thoraco-abdominal aortic aneurysm,1 type Ⅳ thoraco-abdominal aortic aneurysm,4 chronic thoraco-abdominal aortic dissection and 1 type Ⅰ endoleak after EVAR due to abdominal aortic aneurysm) were treated with FEVAR from Nov 2016 to Nov 2017.Results FEVAR was performed successfully in all cases.Type Ⅱ and Ⅲ endoleak occurred in 4 cases.One died of acute myocardial infarction 2 days postoperatively.Renal dysfunction deterioration occurred in one case of chronic dissection and improved after the medical treatment.Renal subcapsular hematoma was found in 2 cases postoperatively,and resolved after conservative therapy.Mean follow-up period was 7.2 months,target vessel patency was identified in 5 of the 6 cases.Conclusions FEVAR using PMSGs is a viable alternative to treat thoraco-abdominal aortic lesions.

Objective To evaluate fenestrated thoracic endovascular aortic repair (f-TEVAR) using fenestrated stent graft on table in zone 0 and zone 1 for aortic arch diseases.Methods 13 patients undergoing f-TEVAR by using physician modified fenestrated stent grafts (PMSGs) on table in zone 0 and zone 1 for aortic arch diseases between Nov 2015 and Mar 2018 were retrospectively reviewed.Results The median age was 59 years(range,33-81 years).PMSGs were deployed from Z0 in 5 patients and Z1 in remaining 8 patients.All but 3 patients underwent elective procedure.The technical success rate was 92.3％.Overall mortality was 7.7％ (1/13).There were no perioperative neurologic complications and paraplegia.One patient suffering from acute left leg ischemia and renal failure recovered after openembolectomy and dialysis.Median length of stay was 9.0 days (range,4-35 days).12 patients were survival at a median follow-up of 11.5 months (range,1.0-19.0 months).Retrograde dissection occurred in one patient and resolved after open repair.During follow up,all target vessels remained patent,with no fenestration-related type Ⅰ or Ⅲ endoleaks.Conclusions f-TEVAR using modified fenestrated stent grafts on table in Z0 and Z1 is feasible for the treatment of aortic arch diseases.

Objective To analyze the clinicopathological features and lymph node metastases characteristics of intrahepatic cholangiocarcinoma (ICC).Methods The retrospective case-control study was conducted.The clinicopathological data of 1 321 ICC patients who were admitted to 12 hospitals from April 2007 to November 2017 were collected,including 182 in the Eastern Hepatobiliary Surgery Hospital of the Second Military Medical University,173 in the First Affiliated Hospital of Xi'an Jiaotong University,156 in the First Hospital Affiliated to Army Medical University (Third Military Medical University),139 in the Cancer Center of Sun Yatsen University,128 in the Zhongshan Hospital of Fudan University,113 in the Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine,109 in the First Affiliated Hospital of Dalian Medical University,84 in the Tianjin Medical University Cancer Institute and Hospital,65 in the First Affiliated Hospital of Zhengzhou University,62 in the Affiliated Hospital of North Sichuan Medical College,58 in the Affiliated Drum Tower Hospital of Nanjing University Medical School and 52 in the Second Affiliated Hospital of Zhejiang University School of Medicine.Treatment planning was respectively determined by comprehensive hospitals according to clinical features and results of related examinations.Surgical procedures were performed based on the results of intraoperative examinations and patients' conditions.Observation indicators:(1) laboratory examination and treatment situations;(2) relationship between clinicopathological features and primary tumor location and diameter;(3) diagnosis of lymph node dissection and metastases;(4) relationship between clinicopathological features and lymph node metastases.Measurement data with normal distribution were represented as x±s,and comparison between groups was done by the t test.Measurement data with skewed distribution were described as M (range).Comparison of count data were analyzed using the chi-square test.Results (1) Laboratory examination and treatment situations:of 1 321 patients,cases and percentages of positive hepatitis B virus (HBV),positive serum alpha-fetoprotein (AFP) (＞ 20 μg/L),positive serum carcinoembryonic antigen (CEA) (＞ 5 μg/L),positive serum alanine transaminase (ALT) (＞75 U/L),positive serum CA19-9 (＞37 U/mL) and positive serum total bilirubin (TBil) (＞20 μmol/L) were respectively 202,80,329,207,590,300 and 15.586％ (202/1 296),7.339％(80/1 090),26.299％ (329/1 251),16.587％ (207/1 248),49.789％(590/1 185),24.000％ (300/1 250).Of 1 321 patients,1 206 underwent surgery,including 904 with hepatectomy,193 with transcatheter arterial chemoembolization (TACE),72 with percutaneous transhepatic biliary drainage (PTBD),3 with endoscopic retrograde cholangiopancreatography (ERCP),3 with PTBD + ERCP and 31 with other treatments;115 had missing registration of surgical procedures.(2) Relationship between clinicopathological features and primary tumor location and diameter:① Relationship between clinicopathological features and primary tumor location:cases with CA19-9 level ≤ 37 U/mL,38-200 U/mL and ＞ 200 U/mL were respectively 227,91,146 with primary tumor located in left liver and 282,134,137 with primary tumor located in right liver.Cases combined with hepatitis and intrahepatic bile duct stone were respectively 67,73 with primary tumor in left liver and 111,47 with primary tumor in right liver,with statistically significant differences in above indictors (x2 =6.710,5.656,12.534,P＜0.05).The results of further analysis showed that incidence age of ICC was (63± 10)years old in patients with hepatitis and (59± 10) years old in patients without hepatitis,with statistically significant differences (t =4.840,P＜0.05).② Relationship between clinicopathological features and primary tumor diameter:cases with primary tumor diameter ≤ 3 cm,with 3 cm ＜ primary tumor diameter ≤ 5 cm and with primary tumor diameter ＞ 5 cm were respectively 159,250,229 with CEA level ≤ 5 pg/L and 40,65,95 with CEA level ＞ 5 μg/L and 165,258,286 with ALT level ≤ 75 U/L and 34,57,36 with ALT level ＞ 75 U/L and 148,242,281 with TBil level ≤ 20 μmol/L and 51,73,43 with TBil level ＞ 20 μmol/L,and 37,70 and 131 patients had satellite loci of tumor,with statistically significant differences in above indictors (x2=8.669,6.637,15.129,34.746,P＜0.05).(3) Diagnosis of lymph node dissection and metastases:of 904 patients with hepatectomy,346 received lymph node dissection,total number,number in each patient and median number of lymph node dissected were respectively 1 894.0,5.5 and 4.0 (range,1.0-26.0);157 had lymph node metastases,with a rate of lymph node metastasis of 45.376％ (157/346),number and number in each patient of positive lymph node were respectively 393.0 and 2.5.Of 346 patients with lymph node dissection,114 had lymph node metastasis by preoperative imaging examination,postoperative pathological examinations confirmed 64 with lymph node metastasis and 50 without lymph node metastasis;232 didn't have lymph node metastasis by preoperative imaging examination,postoperative pathological examinations confirmed 93 with lymph node metastasis and 139 without lymph node metastasis.The sensitivity,specificity and diagnostic accuracy by imaging examination were respectively 40.8％,73.5％ and 58.7％.(4) Relationship between clinicopathological characteristics and lymph node metastases:lymph node metastasis rate was respectively 51.397％ (92/179) in patients with primary tumor located in left liver,39.103％ (61/156) in patients with primary tumor located in right liver,34.615％(18/52) in patients with primary tumor diameter ≤ 3 cm,42.500％(51/120) in patients with 3 cm ＜ primary tumor diameter ≤ 5 cm,52.980％(80/151) in patients with primary tumor diameter ＞ 5 cm,48.790％(121/248) in patients with CEA ≤ 5 μg/L,59.302％ (51/86) in patients with CEA ＞ 5 μg/L,40.234％ (103/256) in patients with TBil ≤ 20 μmol/L,35.106％ (33/94) in patients with TBil ＞ 20 μmol/L,with statistically significant differences in above indictors (x2 =5.078,6.262,9.456,5.156,P ＜ 0.05).Conclusions The related etiological factors may be different due to different primary location of ICC.Primary tumor in left liver is significantly associated with intrahepatic bile duct stone of left liver,and primary tumor in right liver is associated with combined hepatitis,while combined hepatitis could lead early occurrence of ICC.At present,there is a low rate of lymph node dissection in ICC patients and a high lymph node metastasis rate in patients receiving lymph node dissection.Lymph node metastasis is associated with primary tumor location and diameter,levels of CEA and TBil.Lymph node metastasis rate in left liver is higher than that in right liver,and is getting higher with increased primary tumor diameter.

【Objective】 To investigate the status of blood donation of pregnant women's family members, so as to recruit their family members and establish potential blood donation team. 【Methods】 Questionnaire survey was carried out among family members of pregnant women who participated in blood preparation plan by random sampling. 【Results】 The motivations of self-efficacy, internal reward, severity and stress of blood donors were significantly higher than those of non-donors, but non-donors concerned more about negative feelings of phlebotomy(P<0.05). People with rare blood type, low age, high income, weak negative motivation and strong positive motivation had stronger blood donation intention and higher probability of blood donation behavior(P<0.05). 【Conclusion】 It is necessary to expand blood sources through multiple channels by organizing publicity activities around targeted groups, such as establishing channels for blood donation reservation, taking the lead role of the donated crowd, so as to build up a recruitment team for voluntary blood donation.