Objective:To summarize the clinical data of Sun's procedure(total aortic arch replacement with frozen elephant trunk technique) in the treatment of complex aortic arch disease after previous cardiac surgery.Methods:From January 1, 2018 to December 31, 2020, a total of 55 patients underwent resternotomy Sun's procedure in the Aortic Surgery Center of Beijing Anzhen Hospital, including 41 males and 14 females, with a mean age of(45.4±12.7) years old, were retrospectively analyzed. The indications of primary cardiac surgery included type A aortic dissection, aortic root or ascending aortic aneurysm, heart valve surgery, and coronary heart disease. Indications for reoperation included residual aortic dissection larger than 55 mm in diameter, aortic aneurysm dilation, new type A aortic dissection, anastomotic leakage with symptoms, and pseudoaneurysm. All the operations were performed under general anesthesia and median resternotomy, total aortic arch replacement with the stented elephant trunk implantation and were performed by anterograde unilateral or bilateral cerebral perfusion.Results:There was no intraoperative death, and the postoperative mortality was 9.1%(5/55). The causes of death were 2 cases of low cardiac output, 1 case of respiratory failure, 1 case of cerebral complications, and 1 case of gastrointestinal bleeding. Except death, there were 2 cases of postoperative cerebral complications(2/50, 4%), 5 cases of spinal cord injury(transient paraplegia)(5/50, 10%), the median duration of ventilator use was 17 hours(14-42 h). Other postoperative complications included respiratory insufficiency requiring ventilatory support longer than 48 hours(8/50, 16%), renal insufficiency requiring temporary dialysis(2/50, 4%). The follow-up time was(25.9±11.2) months(10-47 months), during which 1 case died due to cerebral complication, 4 cases underwent total thoracoabdominal aorta replacement, and 1 case underwent anastomotic leakage repair.Conclusion:It is safe and effec to perform Sun's procedure(total aortic arch replacement with frozen elephant trunk technique) in the treatment of complex arch disease after previous cardiac surgery.

Blastocystis sp. is a kind of protozoa living in the intestinal tract of human and animals, which will cause intestinal diseases such as diarrhea, abdominal distension and vomiting. This paper was aimed to understand the infection of Blastocystis sp. In golden monkeys and the transmission path in North China. Thirty-seven feces samples from golden monkeys and 116 cockroach samples from Shijiazhuang Zoo were collected from July to October 2019 for PCR analysis of Blastocystis sp. Genetic diversity analysis was further conducted on the samples with positive PCR results. The results showed that the infection rate was 48.7% (18/37) in golden monkeys and 82.8% (96/116) in cockroaches, respectively. The genetic evolution analysis based on small subunit ribosomal RNA demonstrated that three subtypes (ST) of Blastocystis sp. including ST1, ST2, and ST3 existed in the intestinal tract of golden monkeys, while only ST2 was detected in the intestinal tract of cockroaches. This paper may provide supports for the quarantine and control of Blastocystis sp. for the zoo in Northern China.

Objective: To study the effect of postoperative application of tranexamic acid on recovery and prognosis of unilateral total hip arthroplasty. Methods: One hundred and twenty patients who received unilateral total hip arthroplasty in 541st General Hospital of Dongzhen Town from August 2016 to August 2018 were divided into observation group and control group by random number table method, with 60 cases in each group. The control group received intravenous injection of tranexamic acid 10 min before skin incision after anesthesia; on the basis of the control group, the observation group was given tranexamic acid intravenously again 3 h after operation, and the control group was no longer given repeated injection of tranexamic acid. The hemorrhage, hemoglobin (Hb), hematocrit(HCT), hip joint Harris score and complications were compared between the two groups. Results: There was no significant difference in intraoperative blood loss and transfusion between the two groups (P>0.05); the drainage volume, total blood loss, dominant blood loss and recessive blood loss in the observation group were lower than those in the control group [(227.43 ± 20.14) ml vs. (280.91 ± 23.56) ml, (601.01 ± 42.84) ml vs. (667.04 ± 49.21) ml, (281.93 ± 18.50) ml vs. (322.06 ± 21.23) ml, (330.94 ± 21.73) ml vs. (370.03 ± 25.90) ml] (P<0.05). After operation 3 d, the levels of Hb and HCT in observation group were higher than those in control group [(117.07 ± 9.60) g/L vs. (102.19 ± 8.31) g/L, (35.05 ± 2.91)% vs. (32.01 ± 2.77)%] (P<0.05). After operation 2 weeks and 1 month after operation, the hip joint Harris score in observation group was higher than that in control group [(52.03 ± 4.02) scores vs. (48.37 ± 5.05) scores, (67.86 ± 5.29) scores vs. (61.23±5.10) scores] (P<0.05). There was no significant difference in the occurrence of intermuscular venous thrombosis, local hematoma and incision exudation between the two groups(P>0.05). Conclusions On the basis of preoperative application of tranexamic acid, combined postoperative application of tranexamic acid can significantly reduce the blood loss after unilateral total hip arthroplasty, and help the early recovery of joint function, without increasing complications and with high safety.

Objective To explore the effect of self-care agency on the self-perceived burden of patients with permanent bladder fistula. Methods From January 2016 to January 2017,the general data questionnaire,the Self-Perceived Burden Scale(SPBS),the Exercise of Self-Care Agency Scale(ESCA)was used to investigate 388 cases of permanent bladder fistula in 2 hospitals in Lanzhou, Baiyin and Dingxi city, and the results were statistically analyzed. Results The total score of SPBS was (36.01 ± 1.34) points,which was in the middle level.The total score of ESCA was(51.05±10.23)points,which was in low level.The total score of SPBS was negatively correlated with the total score of ESCA and each dimension (r =-0.496--0.168, P<0.01 or 0.05). Stratified regression analysis showed that self-care skills, self-responsibility, self-concept and health knowledge level in self-care ability were important influencing factors (P<0.05). Conclusions Nursing staff can improve the self-care ability, reduce the self-perceived burden,and improve the quality of life of patients.

Objective To retrospectively analyze perioperative and early outcomes after Sun's procedure of type A aortic dissection patients with different tear size ratia.Methods To retrospectively analyze the general information of 120 patients with acute Stanford type A aortic dissectiontreatedin our center from November 2014 to December 2016.Patients were divided into three group according to proximal and distal tear sizeratio(PDTSR):35 patients in Group A(PDTSR≥2),44 patients in Group B (1/2 ＜ PDTSR ＜ 2)and 41 patients in Group C (PDTSR ≤ 1/2).Retrospectively reviewed the data of perioperativeand follow-up period.Results Preoperative mortality was significantly higher in Group A (37.1％ vs.2.3％ vs.2.4％;P ＜ 0.001).Preoperative morbidity higher in Group A,but there was no significant difference.Ventilator support of duration ＞ 5 days in Group A is significantly higher in Group A (P =0.006).Three-month closure rate of false lumen was higher in Group A (85.0％ vs.65.0％ vs.72.7 ％,P =0.263).Proximal tear significantly larger than distal tear was found associated with preoperative death in logistic regression analysis.Conclusion Acute type A aortic dissection patients with larger proximal tear size need more urgent surgery to fix the dissection.Sun's procedure was an effective way to cure type A aortic dissection,while patients with relatively larger distal tears need more strict postoperative follow-up.

Objective The objective of this study was to investigate the miR-345 expression level in non-small cell lung cancer(NSCLC)tissue and its potential clinical significance.Methods Real-time PCR was conducted to evaluate the expression of miR-345 in NSCLC tissues in 98 samples and cell lines.Then the association between tissue miR-345 expression level and clinical outcomes was further analyzed.Results The expression level of miR-345 was significantly decreased in NSCLC tissues and cell lines when compared to the controls(P<0.05).miR-345 expression level in NSCLS tissues was associated with various clinicopathological parameters including LN metastasis(P<0.001),distant metastasis(P=0.028),TNM stage(P=0.004)and grade(P=0.011).In addition,the NSCLC patients in the low miR-345 expression group showed significantly shorter overall survival time than that in the high miR-345expression group(P=0.021).Multivariate analysis showed that the expression of miR-345 was an independent risk factor for NSCLC(HR=3.897,95% CI:2.263~10.440;P=0.012).Conclusion The expression level of miR-345 was decreased in NSCLC tissues as well as cell lines compared with normal controls.Low miR-345 expression in tissues was associated with progression and poor prognosis of NSCLC.These results indicate that miR-345 may be a novel prognostic marker in NSCLC.

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 To identify the risk factors for acute kidney injury (AKI) in overweight patients who underwent surgery for the treatment of acute type A aortic dissection(TAAD).Methods A retrospective study including 108 consecutive overweight patients(body mass index(BMI) ≥24) between January 2010 and May 2013 in Beijing Anzhen Hospital was performed with Sun's procedure of total aortic arch replacement and frozen elephant trunk implantation.AKI was as defined according to Acute Kidney Injury Network (AKIN) criteria based on serum creatinine(sCr) or urine output.Results The mean age of the patients was(43.69 ± 9.66) years.During the postoperative period seventy-two patients(66.7％) developed AKI.The overall postoperative mortality rate was 7.4％,8.3％ in AKI group and 5.6％ in non-AKI group.There is no statistically significant difference between the two groups(P =0.32).A logistic regression analysis was performed to find out the independent risk factors for AKI:elevated preoperative sCr level and postoperative drainage volume.Renal replacement therapy(RRT) was performed in fifteen patients (13.9 ％).Conclusion A higher incidence of AKI (66.7 ％) in overweight patients following acute TAAD was identified.The logistic regression model found out elevated preoperative sCr level and 72 hour drainage volume as the two independent risk factors for AKI in overweight patients.More attention should be paid to prevent AKI in overweight patients following TAAD.

BACKGROUND:Interleukin-12 (IL-12) may function as an immune regulator in the pathogenesis of osteoarticular tuberculosis. OBJECTIVE:To explore the association of single-nucleotide polymorphisms in IL-12A rs568408 G/A and IL-12B rs3212227 A/C with susceptibility to osteoarticular tuberculosis and serum interleukin-12 levels in Guangxi Zhuang population. METHODS:The single-nucleotide polymorphisms in IL-12A rs568408 G/A and IL-12B rs3212227 A/C polymorphisms were detected by polymerase chain reaction-single base extension technique and direct DNA sequencing in 150 patients with osteoarticular tuberculosis (disease group) and 165 healthy individuals (control group) in Guangxi Zhuang population. The genotype and al ele frequencies of IL-12 and the relationship of genotypes to the susceptibility to osteoarticular tuberculosis were analyzed. In addition, the association of genotypes of single-nucleotide polymorphisms in IL-12A rs568408 G/A and IL-12B rs3212227 A/C with serum IL-12 levels were analyzed. RESULTS AND CONCLUSION:There was no significant difference in the genotype and al ele frequencies of IL-12A rs568408 G/A and IL-12B rs3212227 A/C between the disease group and the control group (P>0.05). Moreover, there was no difference in four haplotypes of IL-12 gene between the disease group and the control group (P>0.05). Serum IL-12 levels in subjects with osteoarticular tuberculosis carrying the variant rs568408 GA/AA genotypes and wild-type rs568408 GG genotypes were similar (P>0.05). Similarly, there was no significant difference in serum IL-12 levels between subjects with osteoarticular tuberculosis carrying the variant rs3212227 AC/CC genotypes and wild-type rs3212227 AA genotypes (P>0.05). These findings suggest that the single-nucleotide polymorphisms in IL-12A rs568408 G/A and IL-12B rs3212227 A/C polymorphisms are not associated with susceptibility to osteoarticular tuberculosis in Guangxi Zhuang population.

BACKGROUND:To repair and reconstruct the joint capsule and surrounding ligaments is one of effective methods against displacement and dislocation after total hip arthroplasty. In recent years, anterolateral total hip arthroplasty has been widely used, but little is reported on the anatomic features of the anterolateral hip joint capsule and iliofemoral ligament. OBJECTIVE:To investigate the anatomic features of the anterolateral hip joint capsule and iliofemoral ligaments, thereby providing anatomic evidence for selecting and optimizing the approach for total hip arthroplasty and for clinical practice. METHODS:Thirty adult cadaver hips fixed with formalin were used for this study. The anterolateral hip joint capsule and the iliofemoral ligaments were dissected and anterolateral hip joint capsules were divided into three sections and nine parts. The average thickness of each part and the average height and width of each section were measured. The anterolateral hip joint capsule was observed by its beginning and ending, course, branch and histological features. RESULTS AND CONCLUSION:The anterolateral hip joint capsule was tightly connected with the iliofemoral ligaments to form a complex. The thickness of the capsule was varied. The thinnest parts of the complex were BI and BII. In addition, the average height and width of each section were different. The joint capsule originating from the anterior inferior iliac spine and acetabulum was divided into three branches and fixed on the intertrochanteric line. Understanding of the anterolateral hip joint capsule and iliofemoral ligaments may make for the approach selection, design and optimization of total hip arthroplasty.