Objective To summarize the treatment experience and strategies of patients with acute type A aortic dissection involving coronary arteries in order to improve the efficacy of such patients.Methods Between March 2013 and April 2016,we recruited 37 patients with coronary involvement caused by acute type A aortic dissection,26 men,11 women;mean age (49.7 ± 10.4) years.All procedures were done on an emergency basis within 24 hours after the patient's arrival.Results Acute type A aortic dissection with coronary involvement is a more complex operation associated with high in-hospital mortality(18.9％,7/37) and low short-term survival(64.9％,13/37).There were 9 patients underwent coronary artery bypass graft after completion of the root procedure because of ventricular wall motion abnormality(7 patients) and new ST-segment elevation (2 patients) during weaning from cardiopulmonary bypass.Four of them were survival during follow-up due to the success from rescue coronary artery bypass graft.Conclusion Acute type A aortic dissection with coronary involvement is associated with high in-hospital mortality and low short-term survival.If patients suffered abnormal ventricular wall motion or new ST-segment elevation during weaning from cardiopulmonary bypass,rescue coronary artery bypass graft is essential to salvage these critically ill patients.

Objective To compare the changes of some blood indices after treatment of intertro-chanteric fractures with conventional and minimally invasive dynamic hip scres (DHS) internal fixation so as to understand the influence of minimally invasive technique on physiology of the organism. Meth-ods The elderly patients with intertrochanteric fractures in our department from July 2004 to May 2006 were divided randomly into two groups, ie, conventional DHS internal fixation group(Conventional group, 52 patients)and the minimally invasive DHS internal fixation group(Minimal invasion group, 54 patients). A comparison was done on data including white blood cells (WBC), hemoglobin (Hb), e-rythrocyte sedimentation rate (ESR). C reactive protein (CRP) and creatine kinase (CK) as well as re-cessive blood loss. Results The indices including transfusion, blood loss, recessive blood loss, ESR and CK in minimal invasion group showed less changes compared with conventional group. With statistical difference. But WBC and CRP showed no statisfical difference between both groups. Conclusion Minimally invasive DHS internal fvtation carl reduce operative trauma during treatment of intertrochanterie fractures in the elderly.