[Brachiocephalic artery-sparing aortic arch repair combined with stent-graft elephant trunk technique for Stanford type A aortic dissection: analysis of 23 cases].

OBJECTIVE: To assess the clinical outcomes of brachiocephalic artery-sparing aortic arch repair combined with stent-graft elephant trunk technique for treatment of Stanford type A aortic dissection. METHODS: Twenty-three patients with Stanford type A aortic dissection requiring arch replacement underwent brachiocephalic artery-sparing aortic arch repair combined with stent-graft elephant trunk technique. The operations were performed within 72 h (20 cases) or 3-14 days (3 cases) after the onset of aortic dissection. RESULTS: There was no perioperative death in these cases. The mean extracorporeal circulation time was 209∓52 min, the aortic cross clamp time was 85∓21 min, and the mean chest tube output within the first 24 h after the operation was 570∓263 mL; none of the patients required chest reopening for management of bleeding. Postoperative acute renal failure requiring hemodialysis occurred in 3 cases, transient neurologic dysfunction in 2 cases, paraplegia in case and hematosepsis in 1 case. No such complications as permanent neurologic deficit or postoperative visceral malperfusion occurred in these cases. All the patients survived and were discharged from hospital without experiencing severe complications in the follow-up for 6-18 months. CONCLUSION: Brachiocephalic artery-sparing aortic arch repair combined with stent-graft elephant trunk technique is a safe and simple procedure with controllable bleeding and can serve as an optional procedure for aortic arch replacement.

[Spatial evolution of land use intensity and landscape pattern response of the typical basins in Guizhou Province, China]. / è´µå·žå ¸åž‹åå­åœŸåœ°åˆ©ç”¨å¼ºåº¦ç©ºé—´æ¼”å˜åŠæ™¯è§‚æ ¼å±€å“åº”.

Based on the small scale characteristics of the basin, which is a kind of special landform influenced by the human activities obviously in Karst mountain area, the system grid method and the semivariogram model were used to analyze the 15 basins which belonged to three types in the territory of Guizhou Province to reveal the general pattern of spatial evolution of land use intensity and the mutual relationship with the landscape pattern change of the typical basins in the Karst mountainous area of Guizhou Province in 2005, 2010 and 2015. The results showed that the dynamic spatial evolution of land use intensity and response mode of landscape pattern showed obvious difference under the different basin types. In general, with the decrease of economic level of the basins from high to low, the land use intensity decreased in the form of a gradient. At the level of microcosmic evolution, the land use intensity of basins in the center of the cities and counties descended first and then ascended in the form of concentric band around the periphery of the center in the basin, and the spatial evolution trend of this kind of basin exhibited a stable and expanded form. The land use intensity of basins surrounding cities and towns, with a high intensity center, that could either increase or decrease, exhibited a fluctuating spatial evolution trend. The land use intensity of remote basins was basically stable, even slightly weakened and its space evolution was stable and debilitating. Because of the divergence of dominant function of the basins, there were five different modes of response between the change of land use intensity and landscape pattern of basins. During the study period, the spatial evolution of land use intensity of these 3 basin types was driven by natural and human factors. The interaction among various factors formed the typical characteristics of the land use intensity spatial evolution type of different basins.

[Ultrafiltration with different membranes and respiratory function after cardiopulmonary bypass].

OBJECTIVE: To investigate the protective effect of ultrafiltration on pulmonary function after cardiopulmonary bypass (CPB) by comparing two different membranes used in the ultrafiltration. METHODS: Thirty patients undergoing cardiac surgery with CPB were randomly divided into adsorption group (n=15) and control group (n=15), and in the former group, AN69 membrane was used for ultra-infiltration, with polysulfone (PS) membrane adopted in the control group during CPB. Plateau airway pressure (P(Plateau)), peak airway pressure (P(Peak)), static pulmonary compliance (Cst), dynamic pulmonary compliance (Cdyn) and respiratory index (RI) were measured or calculated before and 5, 60, 120, and 240 min after CPB in each group respectively. RESULTS: During the period of 5 to 240 min after CPB, the increase in P(Plateau), P(Peak), RI and decrease in Cst and Cdyn were much more obvious and lasted for longer time in the adsorption group than in the control group (P<0.05). No operative death or hemoglobinuria occurred in these cases. CONCLUSION: Ultrafiltration with AN69 membrane more effectively reduces CPB-induced lung injury and improves the postoperative respiratory function than with PS membrane.