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BACKGROUND:The anterior cruciate ligament has unique nonlinear mechanical properties under a complex physiological loading environment.Elastin is an important contributor to the mechanical properties of the anterior cruciate ligament,but its mechanical response to the anterior cruciate ligament under axial tension is not clear. OBJECTIVE:To quantitatively analyze the effect of elastin on the tensile mechanical response of the anterior cruciate ligament. METHODS:Elastase solution and control buffer were prepared.The porcine anterior cruciate ligament samples were prepared into small-size samples and randomly soaked in 0,0.1,1.0,2.0,5.0,and 10.0 U/mL elastase solution for 6 hours,and other small samples of the same size were soaked in 2 U/mL elastase solution for 0,1,3,6,9,and 12 hours.To determine suitable soaking conditions for elastin-targeted enzymes and verify the digestive effect,histological staining was used to compare the effects of enzyme treatment on tissue structure and composition.The ligament samples were randomly divided into elastase-treated group and PBS group,and immersed in 2 U/mL elastase solution and PBS buffer for 6 hours,respectively.A mechanical tensile test was performed before and after immersion. RESULTS AND CONCLUSION:(1)The biochemical results showed that being treated in 2 U/mL elastase solution for 6 hours could reduce the elastin content by 31.1%,and had no significant effect on other mechanical-related components in the tissue.(2)The histological results showed that elastase was able to penetrate the tissue,and the loose degree of tissue increased after treatment.(3)In the mechanical results before and after treatment,the mechanical properties of the PBS group decreased significantly,only the low-tension elastic modulus increased significantly and the initial length increased significantly in the elastase-treated group.(4)The intergroup comparison results showed that there was no significant difference between the two groups in pre-treatment,but the low-tension elastic modulus,initial slopes,saturated slopes,and initial length of the elastase-treated group after treatment were significantly higher than those in the PBS group.(5)These results suggest that elastin degradation significantly affects the biomechanical properties of the anterior cruciate ligament and further complements our understanding of the structure-function relationship of the anterior cruciate ligament.
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Objective:To study the prevalence and distribution of adult thyroid diseases in urban and rural areas of Hebei Province.Methods:A multi-stage stratified cluster sampling method was used to select Renqiu City and Licun Town, Luquan City of Hebei Province as the urban and rural survey sites, respectively. Questionnaire survey, physical examination and thyroid B ultrasound examination were conducted on local permanent residents (≥ 5 years of residencies) over 18 years old. The fasting venous blood sample was collected to determine the serum thyroid function indicaters.Results:A total of 2 650 adults were surveyed, including 1 393 urban residents and 1 257 rural residents (1 357 males and 1 293 females). A total of 435 patients with thyroid diseases were diagnosed, the detection rate was 16.42%. There were seven thyroid diseases, including subclinical hypothyroidism (60.92%, 265/435), Hashimoto's thyroiditis (34.02%, 148/435), hypothyroidism (4.83%, 21/435), simple goiter (3.22%, 14/435), hyperthyroidism (2.53%, 11/435), subclinical hyperthyroidism (2.53%, 11/435), and thyroid cancer (1.84%, 8/435). The detection rates of thyroid diseases in urban and rural areas were 21.18% (295/1 393) and 11.14% (140/1 257), respectively. The detection rates of thyroid diseases in males and females were 11.42% (155/1 357) and 21.66% (280/1 293), respectively. The detection rates of thyroid diseases in 18-< 30, 30-< 40, 40-< 50, 50-< 60 and ≥60 years old were 13.46% (91/676), 14.81% (81/547), 15.42% (89/577), 20.94% (85/406) and 20.05% (89/444), respectively. There were statistically significant differences between different areas, gender and age groups (χ 2 = 48.54, 50.53, 14.68, P < 0.05). Conclusions:The detection rate of subclinical hypothyroidism in adults in urban and rural areas of Hebei Province is relatively high, followed by Hashimoto's thyroiditis. Attention should be paid to the screening, evaluation, and intervention of thyroid function among urban female populations.
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The 82nd American Diabetes Association Academic Meeting was held in New Orleans, U. S.A. on June 3, 2022. The meeting had both in-person and virtual activities, encompassed the advances in diabetes study, prevention, and management, including the latest research results of Chinese researchers. This summary highlights the important research findings, including congress awards, drug research progress, management of complications/comorbidities, update of guideline/consensus, and progress of other metabolic diseases, with an aim to provide reference for diabetes management in China.
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Objective:To study the relationship between fasting glucose (FPG) and gene polymorphisms of adiponectin (ADIPOQ), interleukin 6 (IL-6) and tumor necrosis factor-alpha (TNF-α) in early pregnancy and insulin resistance in patients with gestational diabetes mellitus (GDM).Methods:Sixty patients diagnosed with GDM within 24 -28 weeks from January 2022 to August 2022 in the Affiliated Hospital of Jining Medical University were selected as the GDM group, and another 60 healthy pregnant women were taken as the normal control group. The fasting insulin (FINS), FPG levels and the homeostatic model assessment insulin resistance index (HOMA-IR) and other clinical data were detected at 8 -12 weeks of pregnancy. Meanwhile, polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to detect the polymorphisms of ADIPOQ gene at S0100622 locus, IL-6 gene at S01006318 locus, TNF- α gene at S01009718. Receiver operating characteristics(ROC) curve was used to evaluate the diagnostic performance of FPG combined with polymorphisms of ADIPOQ, IL6 and TNF-α in predicting GDM in early pregnancy.Results:The body mass index (BMI), early pregnancy FPG, mid pregnancy FPG, 75 g oral glucose tolerance test (OGTT) 1 h blood glucose, OGTT 2 h blood glucose, glycosylated hemoglobin (HbA 1c), FINS and HOMA-IR in the GDM group were higher than those in the normal control group: (27.1 ± 2.6) kg/m 2 vs. (25.6 ± 2.5) kg/m 2, (4.7 ± 1.3) mmol/L vs. (4.1 ± 1.5) mmol/L, (5.5 ± 1.3) mmol/L vs. (4.2 ± 1.2) mmol/L, (6.3 ± 1.5) mmol/L vs. (5.5 ± 1.7) mmol/L, (6.0 ± 1.5) mmol/L vs. (5.2 ± 1.4) mmol/L, (5.8 ± 0.7)% vs. (5.2 ± 0.6)%, (6.4 ± 1.1) mU/L vs. (5.2 ± 1.2) mU/L, 1.5 ± 0.6 vs. 1.0 ± 0.7, there were statistical differences ( P<0.05). According to the risk assessment of genotype, the high-risk rate in the GDM group was 88.33% (53/60), while the normal control group was 56.67% (34/60), there was statistical difference ( χ2 = 17.67, P<0.05). In GDM group, the HOMA-IR with ADIPOQ gene S0100622 locus TG genotype was higher than that with TT genotype: 6.58 ± 0.89 vs. 4.98 ± 0.58; the HOMA-IR with IL-6 gene S01006318 locus CG genotype was higher than CC and GG genotype: 8.13 ± 1.31 vs. 6.53 ± 0.81, 4.85 ± 0.54, the HOMA-IR with TNF-αgene S01009718 locus AG genotype was higher than GG genotype: 6.31 ± 1.04 vs. 5.16 ± 0.82, there were statistical differences ( P<0.05). Logistic regression analysis showed that age>35 years, previous diabetes history, BMI, TG genotype at S0100622 locus of ADIPOQ gene, CG genotype at S01006318 locus of IL-6 gene, AG genotype at S01009718 locus TNF- α gene were risk factors for the onset of GDM ( P<0.05). The results of ROC curve analysis showed that the area under the curve (AUC) of FPG for predicting GDM onset was 0.737, with a specificity of 83.50%; FPG combined with ADIPOQ, IL-6, TNF- α genetic risk assessment predicted with AUC of 0.921 and a specificity of 86.80%. Conclusions:ADIPOQ gene TG genotype at S0100622 locus, IL-6 gene CG genotype at S01006318 locus, TNF- α gene AG genotype at the S01009718 locus has a certain correlation with the onset of GDM, which can predict the onset of GDM and is associated with perioperative insulin resistance in patients. Early FPG testing combined with genetic screening has practical clinical guiding significance in reducing adverse pregnancy outcomes for mothers and infants.
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Objective:To summarize the clinical experience in treating acute superior mesenteric artery embolization with intestinal necrosis.Methods:Clinical data, surgical methods, complications and 30-day follow-up of patients with acute superior mesenteric artery embolization and intestinal necrosis admitted at Xijing Hospital of Air Force Military Medical University from Jan 2008 to Dec 2020 were retrospectively analyzed.Results:A total of 46 patients were included. The 30-day overall mortality rate was 19.6%, and that of those treated by enterostomy after enterectomy was 12.1%, and that was 38.5% in those undergoing primary entero-anastomosis after enterectomy. Univariate analysis showed that rebound pain was positive ( P=0.025), MAP was higher than 105mmHg ( P=0.04), heart rate was less than 120 beats/min ( P=0.04), and Fullen intestinal ischemia grade ( P=0.03) was significantly related to survival rates. Conclusions:Rebound pain, MAP, heart rate, Fullen grade, and surgical methods significantly affect the prognosis of patients. More patients survive with intestinal resection and enterostomy than those with intestinal resection and immediate anastomosis.
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Objective:To study the role of the Administration Research Fund in promoting the high-quality development of hospitals.Methods:This study conducted a comprehensive analysis of all projects funded by the Administration Research Fund in terms of the quantity of applying and granting, the specialties or the fields involved, the heads of projects, the outputs of the projects, and the trends and characteristics of the selected topics, further, analyzed and evaluated the role played by the projects in promoting hospital development through questionnaires and in-depth interviews.Results:Since the establishment of the fund, a total of 113 projects have been funded (204 have been declared). Encompassing a wide range of professions or fields. More than 80% of the project leaders were from administrative departments, showing the characteristics of high education and youthfulness.Conclusions:The Administration Research Fund reached its goal at the time of establishment and formed a stable influence. The selection of project topics revolved around the aspects of continuous improvement in hospital development and presented a certain pattern, which can promote the growth of management cadres and is one of the important ways to promote hospital development. It is recommended to further improve the quality of administration research projects by strengthening the whole process of management, setting up project guidelines, and improving the review mechanism.
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Objective:To summarize our experience in 13 cases of intestinal autotransplantation (IATx) after resection of lesions involving the roots of mesenteric vessels.Methods:The clinical data of 13 patients undergoing IATx in Xijing hospital were retrospectively analyzed. The etiology, surgical procedure and complications were analyzed. The patients were followed up by telephone and regular evaluations.Results:All 13 cases of IATx were successfully completed. For 12 patients who were diagnosed with tumors involving the mesenteric roots, the tumors were removed for cure intent avoiding massive intestinal resection. Pancreaticoduodenectomy was carried out simultaneously in 11 cases. The postoperative complication rate was 85% (11/13). The autograft was resected in 1 patient on the 1st postoperative day due to necrosis from mesenteric thrombosis, leading to short bowel syndrome. One-year survival was 69% (9/13). Among 4 deaths, 1 patient died of liver metastasis, and another died of liver and lung metastases. Five patients were alive 2 years postoperatively.Conclusion:IATx while-technically challenging, avoiding short small bowel syndrome in properly selected patients after resection of lesions especially benign ones involving the roots of mesenteric vessels that were traditionally considered to be "unresectable".
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Objective:To investigate the clinical effect of the first dorsal metatarsal-dorsal phalangeal artery flap in repairing large area of soft tissue defect on the palmar side of finger.Methods:From February, 2016 to June, 2018, 11 fingers of 11 patients (7 males and 4 females, aged 19-46 years old with an average of 32.5 years old) with large area of soft tissue defect on the palmar side of the finger were repaired with the first dorsal metatarsal-dorsal phalangeal artery flap. These included 3 with the first dorsal metatarsal-first dorsal phalangeal artery blood supply, and 8 with the first dorsal metatarsal-second dorsal phalangeal artery blood supply. In which 3 with retained finger pulp was for repairing the defects and bridging arteries, including 1 flexor tendon defect repaired by the extensor digitorum brevis tendon of the second toe with the flap. The type of blood vessel was Gilbert I detected by CDU before surgery. The area of the flaps was from 1.5 cm×5.0 cm to 3.0 cm×8.0 cm. The donor area of the flaps was compressed with full thickness skin grafts of the shank. The follow-up data was collected by outpatient clinic visits and telephone interviews.Results:All the 11 flaps survived and were followed-up for an average of 14 months, ranged from 6 months to 24 months. The colour and texture of the flaps were good. Sensing of temperature, pain and touch restored, without swelling. Function of the fingers was well restored. The range of motion of distal and proximal interphalangeal joints was closed to normal. The TPD of the flaps was 5-11 mm, with an average of 8 mm. Ten had primary wound healing in the donor sites of foot. One case had necrosis of the proximal toe of the skin graft and healed after dressing change. Long-term follow-up of the skin grafting area was wear-resistant, and does not hinder walking without rupture.Conclusion:Application of the first dorsal metatarsal-dorsal toe artery flap to repair large area of soft tissue defect on the palmar side of finger has number of advantages such as it, covers the wound and carry the tendons, bridges the arteries at the same time, plus delivers satisfactory outcome.
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Objective:To investigate risk factors of nerve injury after carotid body tumor resection.Methods:From 1991 to 2016, the clinical data of patients with neurologic complications after resection of carotid body tumor was retrospectively analyzed. Logistic regression analysis was used to investigate the risk factors of nerve injury.Results:A total of 132 patients with 142 tumors underwent surgery. 45 patients (46 sides) suffered nerve injury, including 4 strokes and 44 nerve injuries. After active rehabilitation, 18 cases were left with permanent nerve injury, and the 4 patients with strokes regained self-care ability. By multivariate regression analysis, high-lying tumors ( OR=4.345, P=0.005), Shamblin Ⅲ tumor ( OR=4.382, P=0.047) increase the risks of postoperative nerve injury. Resection of high-lying tumors carried a higher risk of developing permanent nerve injury ( OR=7.290, P=0.001). Conclusions:Neurologic complication could be alleviated by rehabilitation. Intraoperative abrupt rupture of carotid artery is the leading cause of stroke. Shamblin Ⅲ and high-lying tumor are the predictors of postoperative nerve injury.
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External attentional focus strategy (EFs) is wildly used for athletes and healthy people to learn motor skills, and is also useful for motor function rehabilitation in patients with neurological disorders. This paper reviewed the concept, theoretical basis and application of EFs in stroke rehabilitation, which is effective on motor function. However, the timing of intervention remains to be further clarified.
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OBJECTIVE@#To develop an automated chimeric analysis and reporting platform based on short tandem repeat (STR) and capillary electrophoresis methods for allogeneic hematopoietic stem cell transplantation (allo-HSCT) so as to improve work efficiency.@*METHODS@#Apache, MySQL, PHP and HTML5 were used to build the database and interface. The STR locus geno typing and chimeric analysis logic and flow were set up on the basis of STR rules and capillary electrophoresis. STR genotyping and 194 times of chimeric testing data of 100 patients after allo-HSCT were used to test the platform for automatic STR locus genotyping, chimeric calculation and report generation.@*RESULTS@#The established platform could realize the functions of STR locus customization, STR genotype determination, automatic chimeric analysis, and detection information database management, which can automatically generate an integrated report including multiple sequential chimeric results and trend graphs for the same patient and can be accessed and used simultaneously by different users through different browser interfaces. The results of automated analysis by the platform are completely consistent with that of manual analysis by experienced technicians, and the possibility of manual analysis error is reduced through automation. The time required for automatic analysis using this platform is approximately 1/6-1/5 of manual analysis.@*CONCLUSION@#The automatic analysis platform built in this study is operation stable and reliable in analysis results, which can improve work efficiency and report connotation, thus worthing popularized and applicable.
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Humans , Electrophoresis, Capillary , Genotype , Hematopoietic Stem Cell Transplantation , Microsatellite Repeats , Tissue DonorsABSTRACT
To evaluate the impact of admission diagnosis on seizure outcome in patients with autoimmune epilepsy (AE). Methods: We conducted a retrospective study on 40 AE patients at Department of Neurology, Xiangya Hospital, Central South University from Jan. 1st, 2017 to Nov. 21st, 2018. According to their admission diagnosis, these patients were further assigned into 2 groups: An AE diagnosed group and an AE undiagnosed group. Demographic data, clinical characteristics, cerebrospinal fluid (CSF), electroencephalogram, and brain imaging were compared between the 2 groups. Favorable seizure outcome was defined as >50% reduction of seizure frequency at the first follow-up. The impact of admission diagnosis on seizure outcome of AE patients was analyzed. Results: The ages of 40 AE patients were (33.23±16.41) years, comprising 19 males and 21 females. No significant difference was found between the AE diagnosed group and the AE undiagnosed group in gender, age, central nervous system-specific Ab profile, CSF, and brain imaging. Duration of symptom onset to Ab detection was significantly longer in the AE undiagnosed group than that in the AE diagnosed group (P<0.01). Duration of symptom onset to immunotherapy was also significantly longer in the AE undiagnosed group than that in the AE diagnosed group (P<0.001). There were more patients with favorable seizure outcome in the AE diagnosed group than the AE undiagnosed group (P<0.05). Conclusion: Admission diagnosis for patients with AE is associated with seizure outcome after immunotherapy. For adult-onset epilepsy or epilepsy with unknown etiology, the diagnosis of AE should be considered. Early diagnosis of AE and prompt initiation of immunosuppressive treatment are crucial to increase the likelihood of achieving favorable seizure outcome.
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Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Electroencephalography , Epilepsy , Immunotherapy , Retrospective Studies , SeizuresABSTRACT
Whole body vibration training (WBVT) is a new kind of therapeutic exercise, which can improve musculoskeletal function and motor performance by transferring vibration stimulation to the body to affect neuromuscular activity. In this paper, the clinical efficacy, mechanism and parameter setting of WBVT in the treatment of chronic ankle instability were introduced through a systematic review of relevant literatures, so as to provide theoretical basis for the clinical application of this technique.
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Objective To investigate whether a 3D printed model of the contrlateral healthy distal radius, especially its articular accuracy, helps anatomical reduction and precise reconstruction of the fractured distal radius. Methods The CT data of bilateral radii were collected from 15 normal volunteers ( 11 males and 4 females with an average age of 22. 8 years ) between November and December 2016. After 3D reconstruction of the bilateral distal 1/3 radii, solid 3D models of left radius were mirrored and generated by 3D printing. The data of right radii ( reference group ) were compared with the data of the solid 3D models of left radius acquired through a 3D scanner ( test group ) using deviation analysis. Results The maximum volume difference between the 3D printed model and the contralateral radius was 6. 86％. The average volume of the reference group was 19, 165. 82 ± 3, 250. 50 mm3 and that of the test group 19, 310. 65 ± 3, 305. 15 mm3, showing no statistically significant difference between the 2 groups ( t= -0. 941, P=0. 363 ) . The maximum surface area difference was 3. 84％ between the 2 groups. The average surface area of the reference group was 5, 075. 80 ± 549. 34 mm2 and that of the test group 5, 139. 43 ± 572. 48 mm2, showing a signifi-cant difference ( t= -2. 451, P=0. 028 ) . The 3D deviation analysis showed a mean positive deviation of 0. 37 ± 0. 10 mm and a mean negative deviation of 0. 30 ± 0. 07 mm. The maximum mean square root was 0. 65. The 3D deviation was distributed mainly within 1 mm interval, with a distribution frequency of 96. 27％. Conclusions A 3D printed model prepared by high precision equipment is accurate enough to guide reconstruction of distal radius fractures in adults. In the treatment of complex fractures of the distal radius, a 3D printed model of the contralateral healthy distal radius can be used as a reference to achieve anatomical reduction and precise reconstruction of the fractured distal radius.
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This paper reviewed that high-intensity interval training (HIT) is effective on cardiorespiratory fitness and walking ability, but limited in quality of life in stroke paitents. More researches are needed to explore the differences from HIT to low and moderate intensi-ty continuous training .
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Expanded polytetrafluoroethylene (ePTFE) polymers do not support endothelialization because of nonconductive characteristics towards cellular attachment. Inner surface modification of the grafts can improve endothelialization and increase the long-term patency rate of the ePTFE vascular grafts. Here we reported a method of inner-surface modification of ePTFE vascular graft with extracellular matrix (ECM) and CD34 monoclonal antibodies (CD34 mAb) to stimulate the adhesion and proliferation of circulating endothelial progenitor cells on ePTFE graft to enhance graft endothelialization. The inner surface of ECM-coated ePTFE grafts were linked with CD34 mAb in the presence of 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide/N-hydroxysuccinimide (EDC/NHS) solution and the physicochemical properties, surface morphology, biocompatibility, and hemocompatibility of the grafts were studied. The hydrophilicity of CD34 mAb-coated graft inner surface was significantly improved. Fourier transform infrared spectroscopy analysis confirmed ECM and CD34 mAb cross-linking in the ePTFE vascular grafts with our method. Scanning electron microscopy analysis showed protein layer covering uniformly on the inner surface of the modified grafts. The cell-counting kit-8 (CCK-8) assay confirmed that the modified graft has no obvious cytotoxicity. The modified graft showed a low hemolytic rate (0.9%) in the direct contact hemolysis test, suggesting the modification improved hemocompatibility of biopolymers. The modification also decreased adhesion of platelets, while significantly increased the adhesion of endothelial cells on the grafts. We conclude that our method enables ePTFE polymers modification with ECM and CD34 mAb, facilitates endothelialization, and inhibits platelet adhesion on the grafts, thus may increase the long-term patency rate of the prosthetic bypass grafts.
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Antibodies , Antibodies, Monoclonal , Biopolymers , Blood Platelets , Endothelial Cells , Endothelial Progenitor Cells , Extracellular Matrix , Hemolysis , Hydrophobic and Hydrophilic Interactions , Methods , Microscopy, Electron, Scanning , Polymers , Polytetrafluoroethylene , Spectroscopy, Fourier Transform Infrared , Surface Properties , TransplantsABSTRACT
Peanut yield and quality are seriously affected by pod rot pathogens worldwide, especially in China in recent years. The goals of this study are to analyze the structure of fungal communities of peanut pod rot in soil in three peanut cultivars and the correlation of pod rot with environmental variables using 454 pyrosequencing. A total of 46,723 internal transcribed spacer high-quality sequences were obtained and grouped into 1,706 operational taxonomic units at the 97% similarity cut-off level. The coverage, rank abundance, and the Chao 1 and Shannon diversity indices of the operational taxonomic units were analyzed. Members of the phylum Ascomycota were dominant, such as Fusarium, Chaetomium, Alternaria, and Sordariomycetes, followed by Basidiomycota. The results of the heatmap and redundancy analysis revealed significant variation in the composition of the fungal community among the three cultivar samples. The environmental conditions in different peanut cultivars may also influence on the structure of the fungal community. The results of this study suggest that the causal agent of peanut pod rot may be more complex, and cultivars and environmental conditions are both important contributors to the community structure of peanut pod rot fungi.
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Alternaria , Arachis , Ascomycota , Basidiomycota , Chaetomium , China , Fungi , Fusarium , SoilABSTRACT
Objective To discusses the role of suboccipital retrosigmoid approach in surgical treatment of cerebellopontine angle meningiomas.Methods The clinical data of 32 patients with cerebellopontine angle meningiomas,underwent microsurgery through suboccipital retrosigmoid approach in our hospital from January 1998 and December 2014,were analyzed retrospectively.The treatment efficacy was analyzed.Results In these 32 patients,all of them received tumor removal.After the operation and during the follow-up,the preoperative symptoms and signs disappeared in 22 patients,and relieved in 7.The cranial nerve deficit was unchanged in 3;new neurological deficit was presented in 5,and 8 months-3 years follow up showed that excepted for two patients with permanent damage,the other 3 patents got recovery within 3-6 months of follow up.No tumor recurrence was noted.Conclusion Suboccipital retrosigmoid approach offers excellent exposure to cerebellopontine angle region in surgical treatment of cerebellopontine angle meningiomas,enjoying tiny operational trauma,quick recovery and few complications.
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Objective To explore the effect of targeted surveillance on the control of nosocomial infection in neonatal intensive care unit (NICU).MethodsThe nosocomial infection rates were retrospectively analyzed after continuous improvement of targeted surveillance in NICU from January 2013 to June 2015.ResultsDuring the research period, 59 cases has nosocomial infection in 1011 case who were selected in accordance with inclusion criteria, nosocomial infection rate is 5.8% and daily infection rate is 3.5%. On semiannual basis, the daily infection rates decreased from 8% in the ifrst half of 2013 to 2.2% in the ifrst half of 2015. The ventilator associated pneumonia cases/1000 ventilator days decreased from 12.8‰ to 0‰ from the ifrst half of 2013 to the ifrst half of 2015. The central ventral indwelling catheter related bloodstream infection cases/1000 central ventral indwelling catheter days decreased from 4.5‰ to 0‰ from the ifrst half of 20133 to the ifrst half of 2015. The differences were statistically significant (P all?
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<p><b>OBJECTIVE</b>To summarize the experience of endovascular repairing aortic arch disease hybrid with supra-arch debranching procedures.</p><p><b>METHODS</b>It was a retrospective study. From January 2002 to December 2014, 42 high risk patients with aortic arch disease were treated by supra-arch debranching hybrid with subsequent endovascular repair in the First Affiliated Hospital of Sun Yat-sen University. There were 39 male and 3 female patients with a mean age of (53±13) years (ranging from 34 to 80 years). Of the 42 patients, 7 were thoracic aortic aneurysm, 20 were Stanford type B aortic dissection and 15 were Stanford type A aortic dissection. After the supra-aortic debranching technique, simultaneous (n=16) or staged (n=26, mean interval (7±3) days) endovascular repair were performed. Fisher exact test was used to compare the in-hospital mortality of ascending aorta based debranching and non-ascending aorta based debranching.</p><p><b>RESULTS</b>Technical success rate was 81.0% (34/42). The overall 30-day complication rate was 31.0% (13/42), including 3 cerebral stroke (7.1%), 8 endoleak (19.0%, including 6 type I endoleak and 2 type II endoleak), 1 circulatory failure, 1 aorto-tracheal fistula. The 30-day mortality was 9.5% (4/42), 2 died of cerebral stroke, 1 died of circulatory failure, 1 died of aorto-tracheal fistula. The in-hospital mortality of ascending aorta based debranching group was obviously higher than that of the non-ascending aorta based debranching group (4/16 vs. 0, P=0.02). The median time of follow-up was 64.8 (2 to 156.9) months. CT scanning was performed at 1, 3 months after surgery and annually thereafter. The overall survival rate was 76.6%. During the follow-up period, there was 4 deaths, and 2 of them were aortic artery related (5.3%). There were 4 de novo complications during the follow-up period, 1 stroke attributed to bypass occlusion was cured by medical treatment, 2 pseudoaneurysm was successfully treated with open surgery, 1 stent-graft induced new distal entry tear was successfully treated with a tapered stent-graft, there was no new endoleak during follow up period, 3 type I endoleak disappeared spontaneously, and 1 type II endoleak disappeared after secondary intervention.</p><p><b>CONCLUSIONS</b>Endovascular repair of aortic arch disease hybrid with supra-arch debranching procedure is low invasive with favorable long-term outcomes. It is suitable for high risk patients of poor general condition with little tolerance to aortic arch replacement. The in-hospital mortality is higher in the ascending aorta based debranching group than in the non-ascending aorta based debranching group. Stroke is a critical fatal complication and should be attached attention.</p>