Objective:To examine the efficacy and experience of staged and segmented two hybrid surgeries for total repair of Debakey type Ⅰ aortic dissection (TIAD).Methods:This study was a retrospective case series. The clinic data of 10 patients with acute TIAD who were admitted to the Department of Cardiac Surgery, Second Hospital of Lanzhou University or the First People′s Hospital of Lanzhou, between January 2016 and August 2022, were retrospectively studied. Ten patients underwent hybrid surgeries in two hospitalizations (stages), including 7 males and 3 females with an age of (60±7) years (range: 49 to 71 years). In stage 1, the first type Ⅱ hybrid arch repair was performed to treat the ascending, total arch, and descending thoracic aorta for acute TIAD without circulatory arrest. In stage 2, the second hybrid surgery including infrarenal abdominal aorta replacement, visceral arteries bypass and endovascular thoracoabdominal aortic repair was performed to treat residual thoracoabdominal aortic dissection after the first hybrid operation (segmented). Basic data, preoperative concomitant diseases, high-risk factors, surgical approaches and postoperative complications of all important organs, as well as CT imaging were analyzed.Results:There was no death in the 20 hybrid surgical procedures. In stage 1 type Ⅱ hybrid surgery, 4 cases underwent reconstruction of the aortic sinutubular junction, while Bentall and David surgery was performed for 3 cases, respectively. A patient received coronary artery bypass grafting. Then all patients were sequentially treated with arch debranching and thoracic aortic endovascular repair. Postoperative complications included renal insufficiency (4/10), hemofiltration (1/10), hypoxemia (4/10), neurologic event (1/10) and type Ⅱ endoleak (1/10). Complete false lumen thrombosis occurred in 9/10 of the patients. All complications recovered successfully at discharge and the average hospital stay was (21±4) days (range: 16 to 28 days) in the first hospitalization. At stage 2, the second hybrid surgery was successfully performed in all patients. No paraplegia, hepatic or renal insufficiency, or endoleak occurred. However, branch graft embolism of the left renal artery was found in one patient 3 days after laparotomy, as well as of superior mesenteric artery in another. Superior mesenteric artery occlusion was successfully treated by endovascular recanalization. Complete false lumen thrombosis occurred in all patients. Although all patients had different degrees of intestinal dysfunction, they were gradually relieved at discharge, and the average hospital stay was (19±2)days (range:16 to 21 days) in the second hospitalization. During follow-up, CT angiography showed aortic remodeling in all patients.Conclusion:Staged and segmented two hybrid surgeries are safe and feasible for total repair of Debakey type Ⅰ aortic dissection and are associated with acceptable early and midterm outcomes.

Objective:To analyze the treatment outcomes and prognoses of children with head and neck non-parameningeal rhabdomyosarcoma (HNnPM RMS).Methods:A retrospective analysis was performed on the clinical data of children with HNnPM RMS admitted to Beijing Children′s Hospital from September 2012 to September 2022. The clinical features, comprehensive treatment modes and prognoses of the patients were analyzed. The overall survival rate (OS) and event free survival rate (EFS) were calculated using the Kaplan-Meier method, and univariate analysis was performed using the Log-rank test.Results:A total of 70 children were included in this study, 38 males and 32 females, with a median age of 47 months (2-210 months). Pathological subtypes including the embryonal in 27 cases, the alveolar in 36 cases and the spindle cell and sclerosing in 7 cases. Thirty children (83.3%) with alveolar type were positive for FOXO1 gene fusion. All 70 children underwent chemotherapy, including 38 with neoadjuvant chemotherapy and 32 with adjuvant chemotherapy. Sixty of 70 children underwent surgery, of whom, 10 underwent two or more surgeries. There were 63 children underwent radiotherapy, including 54 with intensity-modulated radiation therapy, 4 with particle implantation and 5 with proton therapy. The median follow-up was 45 (5-113) months, the 5-year OS was 73.2%, and the 5-year EFS was 57.7%. Univariate analysis showed lymph node metastasis ( χ2=5.022, P=0.025), distant metastasis ( χ2=8.258, P=0.004), and high Intergroup Rhabdomyosarcoma Study (IRS) group ( χ2=9.859, P=0.029) as risk factors for poor prognosis. Before June 2016, the 5-year OS based on BCH-RMS-2006 scheme was 63.6%, and after 2016, the 5-year OS based on CCCG-RMS-2016 scheme was 79.6%. Conclusion:Multidisciplinary combined standardized treatment can offer good treatment outcome and prognosis for children with HNnPM RMS. Local control is a key to the efficacy of comprehensive treatment.

Objective:To examine the efficacy and experience of staged and segmented two hybrid surgeries for total repair of Debakey type Ⅰ aortic dissection (TIAD).Methods:This study was a retrospective case series. The clinic data of 10 patients with acute TIAD who were admitted to the Department of Cardiac Surgery, Second Hospital of Lanzhou University or the First People′s Hospital of Lanzhou, between January 2016 and August 2022, were retrospectively studied. Ten patients underwent hybrid surgeries in two hospitalizations (stages), including 7 males and 3 females with an age of (60±7) years (range: 49 to 71 years). In stage 1, the first type Ⅱ hybrid arch repair was performed to treat the ascending, total arch, and descending thoracic aorta for acute TIAD without circulatory arrest. In stage 2, the second hybrid surgery including infrarenal abdominal aorta replacement, visceral arteries bypass and endovascular thoracoabdominal aortic repair was performed to treat residual thoracoabdominal aortic dissection after the first hybrid operation (segmented). Basic data, preoperative concomitant diseases, high-risk factors, surgical approaches and postoperative complications of all important organs, as well as CT imaging were analyzed.Results:There was no death in the 20 hybrid surgical procedures. In stage 1 type Ⅱ hybrid surgery, 4 cases underwent reconstruction of the aortic sinutubular junction, while Bentall and David surgery was performed for 3 cases, respectively. A patient received coronary artery bypass grafting. Then all patients were sequentially treated with arch debranching and thoracic aortic endovascular repair. Postoperative complications included renal insufficiency (4/10), hemofiltration (1/10), hypoxemia (4/10), neurologic event (1/10) and type Ⅱ endoleak (1/10). Complete false lumen thrombosis occurred in 9/10 of the patients. All complications recovered successfully at discharge and the average hospital stay was (21±4) days (range: 16 to 28 days) in the first hospitalization. At stage 2, the second hybrid surgery was successfully performed in all patients. No paraplegia, hepatic or renal insufficiency, or endoleak occurred. However, branch graft embolism of the left renal artery was found in one patient 3 days after laparotomy, as well as of superior mesenteric artery in another. Superior mesenteric artery occlusion was successfully treated by endovascular recanalization. Complete false lumen thrombosis occurred in all patients. Although all patients had different degrees of intestinal dysfunction, they were gradually relieved at discharge, and the average hospital stay was (19±2)days (range:16 to 21 days) in the second hospitalization. During follow-up, CT angiography showed aortic remodeling in all patients.Conclusion:Staged and segmented two hybrid surgeries are safe and feasible for total repair of Debakey type Ⅰ aortic dissection and are associated with acceptable early and midterm outcomes.

AIM:To investigate the role of anti-miR-21 oligonucleotide ( AMO) in the anti-leukemic activity of decitabine (DCA) in vitro.METHODS:AMO and scramble oligonucleotide (SCR) were constructed and transfected into HL-60 cells.The miR-21 expression was analyzed by real-time PCR to identify the transfection efficiency .The cells were treated with DCA at gradient concentrations (0.5, 2.0 and 4.0 μmol/L) for 48 h.The mRNA expression of human period circadian protein 3 (hPer3) was detected by real-time PCR.The early apoptotic rates were determined by flow cy-tometry with Annexin V/PI staining.Mean fluorescence intensities ( MFI) of CD117 and CD11b were also measured by flow cytometry.RESULTS:The miR-21 relative expression level in AMO group was significantly lower than that in blank group and SCR group (P<0.01).IC50 of DCA in AMO group was significantly lower than that in blank group and SCR group (P<0.01).With the same concentration of DCA, the early apoptotic rate, the mRNA expression of hPer3 and the MFI of CD11b in AMO group were significantly higher than those in blank group and SCR group (P<0.01).The MFI of CD117 in AMO group were significantly lower than those in blank group and SCR group ( P<0.01 ) .CONCLUSION:Activation of hPer3 expression plays an important role in enhanced anti-leukemic activity of decitabine by AMO in vitro.

ObjectiveTo investigate the clinical efficacy of combined traditional Chinese and western medicine for treatment of patients with deep venous thrombosis(DVT)in lower extremity.Methods A retrospective study was conducted. Forty patients with DVT admitted into Mindong Hospital Affiliated to Fujian Medical University were randomly divided into control and treatment groups, 20 cases in each group. Conventional therapy was given in both groups. The patients in control group were hypodermically injected with low molecular heparin 3.075 kU, and orally took warfarin sodium; the former injection was terminated on the 3rd day, and afterwards warfarin was solely administered. On the basis of the treatment in the control group, the patients in treatment group were additionally treated with Huoxue Tongmai decoction(ingredients: peach kernel 15 g, red paeonia 15 g, honeysuckle flower 15 g, rhizoma alismatis 12 g, semen coicis 30 g, semen plantaginis 9 g, suberect spatholobus stem 12 g, radix scrophulariae 9 g, pawpaw 12 g, radix achyranthis bidentatae 12 g), the formula could be modified in accordance with patients' symptoms and signs, and Jiangjun powder was applied at the lesion externally(ingredients of the powder: rhubarb 250 g, mirabilite 200 g, flour 100 g, vinegar 500 g were mixed to form a smooth paste), once a day, 30 days constituting a therapeutic course and totally 2 courses being taken. The perimeter of the affected limb, visual analogy score(VAS), revascularization rate, curative effect and adverse reaction were observed before and after treatment and compared between the two groups.Results The total effective rate in treatment group was higher than that in control group〔90.0%(18/20) vs. 70.0%(14/20),P<0.05〕. After treatment, the perimeter of the affected limb in both groups was significantly smaller than that before treatment, the decrease in treatment group being more marked〔the upper leg(cm):46.21±4.80 vs. 53.18±4.45, the lower leg(cm): 32.57±4.26 vs. 36.21±5.01, bothP<0.05〕. TheVAS scores were significantly decreased in both groups after treatment for 1 month, they reached the valley values after treatment for 2 months, the degree of descent being more significant in the treatment group(2.24±0.58 vs. 3.36±0.61,P<0.01). The revascularization rate of the treatment group after treatment was higher than that of the control group〔85.0%(17/20) vs. 70.0%(14/20),P<0.05〕.ConclusionThe combined treatment of traditional Chinese and western medicine was obviously superior to the sole western medicine for treatment of patients with DVT.

Objective To explore the clinical characteristics and surgical treatment of gastric cancer in elderly patients.Methods The clinical data of 431 patients older than 70 years with gastric cancer from 1984 to 1998 were analyzed retrospectively.Results The main clinical manifestations were upper abdominal pain,distension or upset,loss of appetite and weight.The patients with clinicalⅢ,Ⅳ stage accounted for 64.2 percent.Pathological findings showed no specificity.Radical gastrectomy was performed in 215 cases(49.9%),and palliative resection was done in 122 ones(28.3%).The operative mortality and postoperative complication rate were 5.1%and 25.5%in the patients respectively.The 5-year survival rate was 29.5%in the patients with surgery,53.2%with radical gastrectomy and 10.7%with palliative resection.There were significant differences in 5-year survival rate between the radical and palliative groups.Conclusions The majority of elderly patients are clinical Ⅲ,Ⅳ stages and their operative complication rate is high.The key to increase the survival rate and life quality of elderly patients with gastric cancer is early diagnoses,strong perioperative management and suitable radical surgery.

Objective To investigate the effects of intensive training and on the activity of daily living (ADL) and motor function in cerebral infarction patients. Methods 52 cerebral infarction patients with early rehabilitation were divided into an experiment group (n=26) and a control group (n=26). All patients were treated with the conventional training. Meanwhile, the patients in the experimental group were also treated with intensive training. The Modified Barthels Index (MBI) and brief-style Fugl-Meyer assessment (FMA) were used to evaluate the ADL and motor function before and 1 month after treatment. Results The scores of MBI and FMA were significantly different between the two groups 1 month after treatment (P＜0.05). Conclusion Intensive training can improve the ADL and motor function more than conventional training in cerebral infarction patients.

BACKGROUND: Although the sternohyoid muscular valves are traditionally used as reparative material for functional reconstruction after partial laryngectomy, the late-term results are not so satisfactory.OBJECTIVE: To investigate the efficacy of using external layer mucoperiosteum valve of thyroid cartilage to repair the wound surface and reconstruct vocal function.DESIGN: A self-controlled observational trial using the patients as subjects.SETTING: Department of otolaryngology of a municipal hospital.PARTICIPANTS: A total of 57 patients with laryngocarcinoma were selected from the Department of Otolaryngology, Shantou Second People' s Hospital, from June 1998 to May 2004. Among them, there were 56 men and 1 woman who were aged 37 to 78 years with the average age of 60. 38 years and whose disease duration was two months to one year with the average of five months.METHODS: In the 57 patients with laryngocarcinoma, their external layer mucoperiosteum valves of thyroid cartilages in the affected side were preserved and inverted into laryngeal cavities, which were used to cover the wound surface and rebuild the vocal fold.MAIN OUTCOME MEASURES: The final outcome indices: changes in the symtoms and function and Karnofsky scores before and after treatment. Risk indices: adverse events and side effects.RESULTS: The operations on the 57 patients were successful. The incidence of respiratory tract obstruction and hoarseness in the patients before operation was 38.9% and 98. 1%, but 1.9% and 96. 3% after treatment. Karnofsky score was 40 and 70 before and after treatment, respectively. No complications of pharyngeal stricture occurred in the near and long term.CONCLUSION: Vertical partial laryngectomy and laryngeal reconstruction with mucoperiosteum valve are easy to operate. The recovery of the wound surface is good, phonation efficacy is satisfacory, and respiratory function is not affected. The treatment has low incidence of complications and satisfactory long-term results.

Objective To investigate the role of loss of heterozygosity (LOH) of SMAD2 and its relationship with clinicopathological parameters of primary gastric carcinoma. Methods Fifty cases of primary gastric carcinoma were monitored by polymerase chain reaction -single strand conformation polymorphism (PCR- SSCP) and silver staining to detect SMAD2 LOH. Results The incidence of LOH was 40.0%(22/45) at D18S450 and 33.3%(16/48)at D18S460 . LOH occurred in SMAD2 was 55.1%(27/49).The rate of SMAD2 LOH was 72.0% (18/25) in primary gastric carcinoma with lymph node metastasis , which was significantly higher than that in without lymph node metastasis (P

Objective:To study the expression of D-amino acid oxidase(DAO) in gastric cancer cells and gastric mucosa cells. Methods:The expression of DAO was detected in seven gastric cancer cell lines and a normal gastric mucosa cell line GES-1 by real-time quantitative PCR and in tumor tissues and normal gastric mucous tissues of 46 patients with gastric cancer by RT-PCR.The liver and kidney tissues of nude mouse acted as positive controls.Results:DAO was expressed in the liver and kidney tissues of nude mouse,and DAO expression in kidney tissue was higher than that in liver tissue.DAO was not detected in seven gastric cancer cell lines and the normal gastric mucosa cell line GES-1.Except one tumor tissue sample,DAO was not detected in other gastric cancer tissues and all normal mucosa tissues.Conclusion:DAO was not expressed in gastric cancer cells and gastric mucosa cells.The nutritional treatment of D-Met in place of L-Met could avoid the disadvantage of methionine starvation to important organs,such as liver and kidney.