Objective To compare the clinical efficacy of typeⅡhybrid surgery versus Sun’s surgery in treating acute Stanford A aortic dissection. Methods A retrospective analysis was conducted on the clinical data of patients with acute Stanford A aortic dissection who were treated at the Central Hospital of Wuhan affiliated to Tongji Medical College, Huazhong University of Science and Technology from 2016 to 2022. According to the surgical method, patients were divided into a typeⅡhybrid group and a Sun’s surgery group, and the clinical efficacy of the two groups was compared. Results A total of 52 patients were included, with 22 in the typeⅡhybrid surgery group and 30 in the Sun’s surgery group. The typeⅡhybrid group consisted of 18 males and 4 females, with an average age of (58.18±6.00) years, while the Sun’s surgery group consisted of 22 males and 8 females, with an average age of (53.03±11.89) years. All surgeries were successfully completed. There were 4 (13.3%) perioperative deaths in the Sun’s surgery group, including 2 patients of multiple organ failure, 1 patient of paraplegia, and 1 patient of uncontrollable postoperative bleeding. There was 1 (4.5%) perioperative death in the typeⅡhybrid surgery group, who was suspected of acute coronary syndrome and took a loading dose of dual antiplatelet drugs preoperatively. The patient underwent secondary thoracotomy for hemostasis, was re-cannulated during the operation, and finally died of circulatory failure after implantation of intra-aortic balloon pumping. There was no statistical difference in perioperative mortality between the two groups (P=0.381). Compared with the Sun’s surgery group, the typeⅡhybrid surgery group had shorter cardiopulmonary bypass time [153.00 (135.00, 185.25) min vs. 182.50 (166.50, 196.75) min, P=0.013], aortic cross-clamping time [77.00 (70.50, 92.00) min vs. 102.50 (93.50, 109.75) min, P<0.001], postoperative ICU stay [4.00 (2.83, 6.00) days vs. 8.00 (6.38, 11.78) days, P<0.001], postoperative ventilator support time [72.00 (29.50, 93.25) h vs. 87.65 (39.13, 139.13) h, P=0.138], less intraoperative blood loss [(1586.82±209.41) mL vs. (1 806.00±292.62) mL, P=0.004], postoperative 24 h drainage volume [612.50 (507.50, 762.50) mL vs. 687.50 (518.75, 993.75) mL, P=0.409], and shorter postoperative hospital stay [18.00 (13.00, 20.25) days vs. 22.00 (17.00, 29.25) days, P=0.013]. There was no statistically significant difference in the incidence of other early postoperative complications such as secondary thoracotomy for hemostasis, tracheotomy, renal dysfunction requiring dialysis, stroke, and paraplegia between the two groups (P>0.05). Conclusion For patients with acute Stanford A aortic dissection, typeⅡhybrid surgery is safe and effective; compared with traditional Sun’s surgery, typeⅡhybrid surgery has relatively less trauma, lower incidence of complications, satisfactory short-term results, and further research is needed on long-term prognosis.

Objective     To analyze the clinical effect of hybrid surgery on complex type B aortic dissection in 5 years. Methods     A retrospective analysis of 47 patients with complex type B aortic dissection in the Central Hospital of Wuhan affiliated to Tongji Medical College of Huazhong University of Science and Technology from 2014 to 2017 was conducted, including 42 males and 5 females with an average age of 54.9±11.2 years. Twenty-one patients underwent the left common carotid artery to the left subclavian artery bypass (a bypass group), and 26 patients underwent the left common carotid artery to the left subclavian artery transposition (a transposition group). Results     All patients accepted hybrid surgery successfully. There was no statistical difference in arterial occlusion time or intraoperative blood loss between the two groups (P>0.05). The 5-year follow-up rate was 100.0% (47/47). During the follow-up period, 12 (25.5%) patients developed complications, including 5 (10.6%) patients of endoleak, 5 (10.6%) patients of hoarseness, 2 (4.3%) patients of stroke/dizziness. There was no patient of left upper limb weakness, paraplegia or retrograde aotic dissection. The reconstructed left subclavian artery remained patent in 46 (97.9%) patients. The overall 5-year survival rate was 100.0%. Conclusion     The long-term therapeutic outcome of hybrid surgery for the treatment of complex type B aortic dissection is satisfying. In 5 years, the rebuilt left subclavian artery has a remarkable patency rate. Endoleak and hoarseness are the most common surgical complications.

Kommerell's diverticulum is a rare congenital abnormal aortic development. The diverticulum can occur in both left and right aortic arches, from which an aberrant subclavian artery rises to the contralateral side. Only a small number of patients with Kommerell's diverticulum present symptoms. Dysphagia, dyspnea, chest discomfort and upper extremity blood pressure difference are common in adult patients. The risk of aortic dissection or aortic aneurysm rupture is higher in such patients than that in patients with normal aorta. Early surgical intervention is recommended to improve the prognosis. Treatment options include open surgical repair, hybrid operation and total endovascular repair. The choice of surgical method depends on the specific anatomy of patients, the patients' state and the preference of surgeons. This paper reviewed and summarized the surgical methods and early results of the treatment of Kommerell's diverticulum reported in the literature from 2015 to 2020.

As the key features of tumor, metastasis has multiple mechanisms and could cause poor survival. Accumulated evidences indicate that platelet plays an important role in tumor metastasis. Platelet count had become a significant indicator for predicting tumor prognosis,and antiplatelet therapy is an effective way for tumor treatment. Here, the recent advancements of the relationship between platelets and tumor metastasis are reviewed.

Toll-like receptor 5 (TLR5) is responsible for the recognition of bacterial flagellin in vertebrates. In the present study, the first TLR5 gene in duck was cloned. The open reading frame (ORF) of duck TLR5 (dTLR5) cDNA is 2580 bp and encodes a polypeptide of 859 amino acids. We also cloned partial sequences of myeloid differentiation factor 88, 2'-5'-oligoadenylate synthetase (OAS), and myxovirus resistance (Mx) genes from duck. dTLR5 mRNA was highly expressed in the bursa of Fabricius, spleen, trachea, lung, jejunum, rectum, and skin; moderately expressed in the muscular and glandular tissues, duodenum, ileum, caecum, and pancreas; and minimally expressed in the heart, liver, kidney, and muscle. DF-1 or HeLa cells transfected with DNA constructs encoding dTLR5 can activate NF-kappaB leading to the activation of interleukin-6 (IL-6) promoter. When we challenged ducks with a Herts33 Newcastle disease virus (NDV), mRNA transcription of the antiviral molecules Mx, Double stranded RNA activated protein kinase (PKR), and OAS was up-regulated in the liver, lung, and spleen 1 and 2 days post-inoculation.
2',5'-Oligoadenylate Synthetase/genetics/metabolism ; Animals ; Cell Line ; *Cloning, Molecular ; Ducks ; Gene Expression Regulation/*physiology ; Humans ; Immunity, Innate ; Myeloid Differentiation Factor 88/genetics/metabolism ; Myxovirus Resistance Proteins/genetics/metabolism ; Newcastle Disease/metabolism ; Newcastle disease virus/classification ; RNA, Messenger/genetics/metabolism ; Species Specificity ; Toll-Like Receptor 5/genetics/*metabolism

Objective To explore the changes of deceleration capacity of rate (DC) and analyze its correlation with heart rate variability (HRV) and other factors in patients with coronary heart disease. Methods One hundred and twenty-nine patients with coronary heart disease (coronary heart disease group) and 109 healthy people (control group) were enrolled in this study. DC and HRV parameters were measured by using digitized 24 h Holter. The correlation between DC and HRV parameters, other factors were analyzed. Results The levels of DC, SDNN, SDANN, SDNNi, PNN50, TP, LF, HF, AC in coronary heart disease group were significantly lower than those in control group:(5.64±1.67) ms vs. (6.71±1.47) ms, (106.60±20.53) ms vs. (138.82±31.22) ms, (96.94±20.06) ms vs. (127.47±31.87) ms,(28.53±14.75) ms vs. (52.24±14.65) ms, 87.72%vs. 103.86%,(1 967.10±966.16) ms2/Hz vs. (2 846.70±1 443.41) ms2/Hz,(326.43±195.35) ms2/Hz vs.(457.64±254.30) ms2/Hz, 85.88 vs. 106.39, (-6.18±2.15) ms vs. (-7.00±2.51) ms, P<0.05 or<0.01. DC was correlated with SDNNi, PNN50,TP,LF, HF, AC both in total population or in coronary heart disease group and control group by using multiple linear correlation analysis ( r=0.586, 0.356, 0.531, 0.563, 0.435,-0.433, P<0.01). After removing confounders, DC was correlated with age, SDNNi, rMSSD, PNN50 and AC (P<0.01). Conclusions DC decreases in patients with coronary heart disease and is strong correlativity with HRV parameters. DC could be used for quantitative detection of autonomic nervous function.

Objective:To detect the serum level of microRNA-146b (miR-146b)in patients with viral myocarditis,and prelimi-narily explore its clinical significance.Methods:Forty patients with viral myocarditis and forty healthy controls were enrolled in the study.The serum level of miR-146b was detected with reverse transcription-polymerase chain reaction (RT-PCR).The level of cardiac troponin T (cTnT)in the serum of patients with viral myocarditis was detected with electrochemical lumines-cence method.The relationship between miR-146b and cTnT level was statistically analyzed.Results:Compared with the ser-um level of miR-146b (1 .35±0.42)in healthy controls,the serum level of miR-146b(1 .85 ±0.68)in the patients with viral myocarditis increased significantly(t=3.957,P <0.01).The serum level of miR-146b was positively correlated with the level of cTnT in the patients with viral myocarditis (r=0.635,P <0.05).Conclusions:The serum level of miR-146b in the patients with viral myocarditis increased,and it was correlated with the severity of myocardial injury.It indicates that miR-146b may be involved in the pathogenesis of viral myocarditis.

Objective To explore the correlation between cystatin C (Cys C) and intima-media thickness of carotid artery (CIMT) in patients with hypertension.Methods One hundred and one patients with hypertension (hypertension group) and 54 healthy people (control group) were enrolled in this study.The level of serum Cys C was measured and CIMT was detected by B ultrasound.The correlation between Cys C and CIMT was analyzed.Results The level of Cys C and CIMT in hypertension group were significantly higher than those in control group [(0.92 ±0.21) mg/L vs.(0.85 ±0.20) mg/L,(0.91 ±0.16) mm vs.(0.65 ± 0.15) mm] (P ＜ 0.05 or ＜ 0.01).Multiple linear correlation analysis showed that Cys C and CIMT was positively correlated in total population or hypertension group or control group (r =0.412,0.443,0.315,P ＜0.01).Conclusion Serum Cys C is associated with the degree of hypertension arteriosclerosis,and Cys C may be involved in atherosclerosis.

Objective To study the effects and safety of levocarnitine and shuxuetong in treatment of the patients with chronic renal failure.Methods 94 patients with chronic renal failure were selected as research object,and they were randomly divided into group A(levocarnitine and shuxuetong group) 47 cases and group B(shuxuetong group) 47 cases.Group A were treated with levocarnitine oral solution and shuxuetong,and group B were treated with shuxuetong,then the percentage of effectiveness,incidence of adverse reactions of group A and group B and serum BUN,Scr,Hcy were analyzed.Results The percentage of effectiveness of group A was higher than that of group B,but the incidence of adverse reactions of the two groups had no difference,and the serum BUN,Scr,Hcy of group A and group B before the treatment had no differences(P＞0.05),those of group A and group B after treatment were compared there were significant differences(all P＜0.05).Conclusion The effects of levocarnitine oral solution and shuxuetong in treatment of patients with chronic renal failure were better.