Background Patients with chronic lung disease (CLD) are at a significantly increased risk of developing cardiovascular disease (CVD); however, specific risk assessment tools tailored for this high-risk population are currently lacking. This study aimed to develop, validate, and interpret a machine learning model specifically designed to predict the risk of concurrent CVD in patients with CLD. Methods Based on the China Health and Retirement Longitudinal Study (CHARLS) cohort, 2,639 patients with CLD were included. Core features were selected using univariate and multivariate logistic regression. Seven machine learning algorithms were systematically compared. After identifying the optimal model, external validation was conducted using the English Longitudinal Study of Ageing (ELSA) cohort (n = 1,303). The SHapley Additive exPlanations (SHAP) framework was employed to interpret the model’s predictive mechanisms, and an interactive web application was developed based on the optimal model. Results The study ultimately identified 8 core predictors: age, body mass index (BMI), depression score, hypertension, dyslipidemia, impaired instrumental activities of daily living (IADL), and medication history for lung diseases and lipid-lowering drugs. The XGBoost model demonstrated the best performance, achieving Area Under the Curve (AUC) values of 0.838, 0.797, and 0.695 in the training, testing, and external validation sets, respectively, while exhibiting excellent calibration and clinical net benefit. SHAP analysis revealed that hypertension, depression score, and age were the primary contributing variables, and confirmed a significant synergistic amplification effect between lipid metabolism and psychophysical functional indicators. Conclusion The model constructed based on the XGBoost algorithm can accurately and robustly predict CVD risk in patients with CLD. Coupled with SHAP interpretability analysis and the online prediction tool, this study provides reliable digital decision support for CVD risk stratification, early identification, and personalized intervention among patients with CLD in primary care settings.

This study sought to determine the factors linked to depressive symptoms among cancer patients and to establish a machine learning model for identifying those at high risk of such symptoms, with interpretability supported by SHAP. The dataset derived from the 2018 wave of the China Health and Retirement Longitudinal Study (CHARLS) was used, and a total of 466 middle-aged and elderly cancer patients were enrolled. Feature selection was conducted via LASSO regression, and the data were randomly partitioned into training (60%) and test (40%) subsets. Eight machine learning models were built and compared. Their performance was evaluated using the ROC curves, PR curves, Brier score, and decision curve analysis, while SHAP was applied to interpret the model outputs. Seven key features were identified. Among all models, XGBoost achieved the optimal overall performance in the test cohort, presenting an AUC of 0.771, PR-AUC of 0.790, Brier score of 0.1596, and favorable net clinical benefit. SHAP analysis indicated that self-rated health, life satisfaction, and IADL limitation were the most important contributors to model predictions. Subgroup analyses showed stable performance across age and sex strata, with all AUCs above 0.70. Overall, the XGBoost model demonstrated good discrimination and interpretability, suggesting its potential as an auxiliary tool for early warning, further screening, and risk stratification of depressive symptoms in cancer patients.

Limited treatment options and poor prognosis present significant challenges in the treatment of lung squamous cell carcinoma (LUSC). Disulfidptosis impacts cancer progression and prognosis. We developed a prognostic signature using disulfidptosis-related long non-coding RNAs (lncRNAs) to predict the prognosis of LUSC patients. Gene expression matrices and clinical information for LUSC were downloaded from the TCGA database. Co-expression analysis identified 209 disulfidptosis-related lncRNAs. LASSO-Cox regression analysis identified nine key lncRNAs, forming the basis for establishing a prognostic model. The model's validity was confirmed by Kaplan-Meier and ROC curves. Cox regression analysis identified the risk score (RS) as an independent prognostic factor inversely correlated with overall survival. A nomogram based on the RS demonstrated good predictive performance for LUSC patient prognosis. The relationship between RS and immune function was explored using ESTIMATE, CIBERSORT, and ssGSEA algorithms. According to the TIDE database, a negative correlation was found between RS and immune therapy responsiveness. The GDSC database revealed that 49 drugs were beneficial for the low-risk group and 25 drugs for the high-risk group. Silencing C10orf55 expression in SW900 cells reduced invasiveness and migration potential. In summary, this lncRNA model based on TCGA-LUSC data effectively predicts prognosis and assists clinical decision-making.

Background: Numerous studies have shown a strong correlation between disulfidptosis and various cancers. However, the expression and function of RPN1, a crucial gene in disulfidptosis, remain unclear in the context of cancer. Methods: Gene expression and clinical information on lung adenocarcinoma were obtained from The Cancer Genome Atlas (TCGA) and Genotype-Tissue Expression (GTEx) databases. RPN1 expression was analyzed using the Timer2.0 and the Human Protein Atlas (HPA) databases. Prognostic significance was assessed using Cox regression analysis and Kaplan-Meier curves. Genetic mutations and methylation levels were examined using the cBioPortal and UALCAN platforms, respectively. The relationship between RPN1 and tumor mutation burden (TMB) and microsatellite instability (MSI) across different cancer types was analyzed using the Spearman correlation coefficient. The relationship between RPN1 and immune cell infiltration was analyzed using the Timer2.0 database, whereas variations in drug sensitivity were explored using the CellMiner database. Receiver operating characteristic curves validated RPN1's diagnostic potential in glioma, and its correlation with immune checkpoint inhibitors (ICIs) was assessed using Spearman's correlation coefficient. Single-sample gene set enrichment analysis elucidated a link between RPN1 and immune cells and pathways. In addition, a nomogram based on RPN1 was developed to predict patient prognosis. The functional impact of RPN1 on glioma cells was confirmed using scratch and Transwell assays. Result: RPN1 was aberrantly expressed in various cancers and affected patient prognosis. The main mutation type of RPN1 in the cancer was amplified. RPN1 exhibited a positive correlation with myeloid-derived suppressor cells, neutrophils, and macrophages, and a negative correlation with CD8+ T cells and hematopoietic stem cells. RPN1 expression was associated with TMB and MSI in various cancers. The expression of RPN1 affected drug sensitivity in cancer cells. RPN1 was positively correlated with multiple ICIs in gliomas. RPN1 also affected immune cell infiltration into the tumor microenvironment. RPN1 was an independent prognostic factor for gliomas, and the nomogram demonstrated excellent predictive performance. Interference with RPN1 expression reduces the migratory and invasive ability of glioma cells. Conclusion: RPN1 exerts multifaceted effects on different stages of cancer, including immune infiltration, prognosis, and treatment outcomes. RPN1 expression affects the prognosis and immune microenvironment infiltration in patients with glioma, making RPN1 a potential target for the treatment of glioma.

BACKGROUND:The nck-associated protein 1 (NCKAP1) of the disulfidptosis-related gene is essential in programmed cell death. However, a comprehensive analysis of the biological significance of NCKAP1 in pan-cancer is lacking.METHODS:Gene expression matrices and clinical expression information of cancers were obtained from The Cancer Genome Atlas (TCGA) and Genotype Tissue Expression (GTEX) databases. A comprehensive analysis of NCKAP1 expression, biological function, gene mutation, immune cell infiltration, DNA methylation, and drug sensitivity profiles in pan-cancer was performed using the Timer2.0, HPA, GEPIA, STRING, cBioPortal, UALCAN and CellMiner databases. The prognostic value of NCKAP1 was investigated based on COX regression analysis and the Kaplan-Meier(K-M) curves. A nomogram was established to verify the clinical value of NCKAP1 for LUAD. The correlation between NCKAP1 and immune cells and signaling pathways were investigated by single-sample gene set enrichment analysis(ssGSEA). Validation was performed using PCR, Western Blot (WB), and Transwell assays.RESULT:Significant differences in expression levels, mutation levels, and methylation levels of NCKAP1 between tumor and normal samples. NCKAP1 affects the prognosis of various cancers. NCKAP1 is strongly associated with microsatellite instability (MSI) and tumor mutational burden (TMB). The Gene Ontology (GO) and the Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses indicate that NCKAP1 is strongly associated with cell death and tumor immunity. The expression of NCKAP1 affects the sensitivity to various drugs. Moreover, NCKAP1 is an independent predictor of prognosis in LUAD patients. The results of ssGSEA showed that elevated NCKAP1 expression was positively correlated with multiple immune-related signaling pathways. PCR analysis showed that the expression of NCKAP1 was increased in LUAD cells. Transwell invasion assay showed that overexpression of NCKAP1 resulted in enhanced invasion of LUAD cells.CONCLUSIONS:We comprehensively analyzed the relationship between NCKAP1 and pan-cancer and its potential clinical value. NCKAP1 could be a potential immune marker for various cancers (especially LUAD), providing new insights and insights for cancer therapy.

BackgroundThe aim of this study was to assess the impact of preoperative chemotherapy on long-term survival (≥1 month) in patients with thymic epithelial tumors (TETs) and conditions suitable for chemotherapy using data from surveillance, epidemiology, and end-result databases.MethodsThis retrospective study controlled for confounding factors by propensity score matching (PSM), analyzed overall survival (OS) and cancer-specific survival (CSS) by Kaplan-Meier methods, and analyzed factors affecting the prognosis of patients undergoing surgery for thymic epithelial tumors by univariate and multifactorial Cox regression.ResultsA total of 2,451 patients who underwent surgery for TETs were identified from the Surveillance, Epidemiology, and End Results database. Preoperative chemotherapy significantly improved OS and CSS in patients with stage III/IV TETs compared to patients without preoperative chemotherapy. Subgroup analysis showed that patients younger than 60 years of age with TETs, patients with thymic carcinoma, and patients with TETs with multiple cancers were more likely to benefit from preoperative chemotherapy.ConclusionThis study found that preoperative chemotherapy is a viable option for advanced thymoma with favorable overall and cancer-specific survival rates, but patient history and physical condition should be fully considered in conjunction with diagnostic imaging findings to assess patient tolerance to chemotherapy.

BackgroundLung cancer continues to be a problem faced by all of humanity. It is the cancer with the highest morbidity and mortality in the world, and the most common histological type of lung cancer is lung adenocarcinoma (LUAD), accounting for about 40% of lung malignant tumors. This study was conducted to discuss and explore the immune-related biomarkers and pathways during the development and progression of LUAD and their relationship with immunocyte infiltration. MethodsThe cohorts of data used in this study were downloaded from the Gene Expression Complex (GEO) database and the Cancer Genome Atlas Program (TCGA) database. Through the analysis of differential expression analysis, weighted gene co-expression network analysis (WGCNA), and least absolute shrinkage and selection operator(LASSO), selecting the module with the highest correlation with LUAD progression, and then the HUB gene was further determined. The Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and Gene Set Enrichment Analysis (GSEA) were then used to study the function of these genes. Single-sample GSEA (ssGSEA) analysis was used to investigate the penetration of 28 immunocytes and their relationship with HUB genes. Finally, the receiver operating characteristic curve (ROC) was used to evaluate these HUB genes accurately to diagnose LUAD. In addition, additional cohorts were used for external validation. Based on the TCGA database, the effect of the HUB genes on the prognosis of LUAD patients was assessed using the Kaplan-Meier curve. The mRNA levels of some HUB genes in cancer cells and normal cells were analyzed by reverse transcription-quantitative polymerase chain reaction (RT-qPCR). ResultsThe turquoise module with the highest correlation with LUAD was identified among the seven modules obtained with WGCNA. Three hundred fifty-four differential genes were chosen. After LASSO analysis, 12 HUB genes were chosen as candidate biomarkers for LUAD expression. According to the immune infiltration results, CD4 + T cells, B cells, and NK cells were high in LUAD sample tissue. The ROC curve showed that all 12 HUB genes had a high diagnostic value. Finally, the functional enrichment analysis suggested that the HUB gene is mainly related to inflammatory and immune responses. According to the RT-qPCR study, we found that the expression of DPYSL2, OCIAD2, and FABP4 in A549 was higher than BEAS-2B. The expression content of DPYSL2 was lower in H1299 than in BEAS-2B. However, the expression difference of FABP4 and OCIAD2 genes in H1299 lung cancer cells was insignificant, but both showed a trend of increase. ConclusionsThe mechanism of LUAD pathogenesis and progression is closely linked to T cells, B cells, and monocytes. 12 HUB genes(ADAMTS8, CD36, DPYSL2, FABP4, FGFR4, HBA2, OCIAD2, PARP1, PLEKHH2, STX11, TCF21, TNNC1) may participate in the progression of LUAD via immune-related signaling pathways.

Many studies have shown that circular RNA (circRNA) is an important regulator mediating the malignant progression of cancer. However, the role and mechanism of circ-EIF3I in lung cancer (LC) development are still unclear. A total 36 paired LC tumor tissues and adjacent normal tissues were enrolled. The expression of circ-EIF3I, microRNA (miR)-1253, and neuro-oncological ventral antigen 2 (NOVA2) was measured by quantitative real-time PCR. The proliferation, apoptosis, migration, and invasion of LC cells were determined by MTT assay, colony formation assay, flow cytometry, and transwell assay. Dual-luciferase reporter assay was performed to verify the interaction between miR-1253 and circ-EIF3I or NOVA2. The protein levels of NOVA2 and Wnt/β-catenin pathway-related markers were detected by western blot analysis. Xenograft tumor was constructed to explore the function of circ-EIF3I on LC tumor growth. Circ-EIF3I was upregulated in LC tumor tissues and cells. Silenced circ-EIF3I could suppress the proliferation, migration, invasion, and enhance the apoptosis of LC cells in vitro, as well as reduce LC tumor growth in vivo. Circ-EIF3I could sponge miR-1253, and miR-1253 inhibitor overturned the regulation of circ-EIF3I knockdown on LC cell progression. NOVA2 was confirmed to be a target of miR-1253, which could reverse the inhibitory effects of miR-1253 on LC cell progression. Further experiments showed that circ-EIF3I regulated NOVA2 expression by sponging miR-1253. In addition, circ-EIF3I silencing could inhibit the activity of Wnt/β-catenin pathway via regulating the miR-1253/NOVA2 axis. Circ-EIF3I might function as an oncogene in LC, which promoted LC progression by the miR-1253/NOVA2/Wnt/β-catenin network.

38岁女性患者。间断咳嗽、发热1年，咳痰、痰带血丝1周。胸部增强CT及CTA检查示左肺下叶后基底段区见团块状稍混杂低密度影，周围见斑片状密度增高影，内多发血管影和囊状影，其中一较粗大血管(直径约2 cm)与胸主动脉相连。全麻下行单操作孔胸腔镜左肺下叶切除术。手术优先处理变异供血动脉，再单向式法处理下肺静脉、下叶支气管、下肺动脉、斜裂肺组织，完整切除左肺下叶。术后病理示(左肺下叶)部分肺组织纤维化、实性变，肺间质内供血动脉伴粥样硬化斑块形成和胆固醇结晶沉积，符合肺隔离症表现。患者术后症状缓解，顺利出院。随访2个月，患者无不适，复查胸部CT未见明显异常。

目的 观察微创胸腹腔镜联合食管癌根治术的治疗效果.方法 将96例行食管癌根治术的患者根据手术方法分为观察组(n=70)和对照组(n=26),观察组实施胸腹腔镜联合食管癌根治术,对照组应用传统小切口食管癌根治术.比较两组患者的手术一般情况、氧分压、并发症及预后情况.结果 观察组患者手术时间、术中出血量、淋巴结清扫数目、术后住院时间均明显低于对照组(P﹤0.01).术后6、72 h,观察组患者的氧分压均明显高于对照组,差异均有统计学意义(P﹤0.01).观察组患者并发症总发生率为28.57％(20/70),明显低于对照组的61.54％(16/26),差异有统计学意义(χ2=21.489,P=0.000).观察组患者术后淋巴结转移率、复发率、二次手术发生率均明显低于对照组,术后生活质量评分、6个月内生存率均明显高于对照组,差异均有统计学意义(P﹤0.01).结论 微创胸腹腔镜联合食管癌根治术相比传统小切口食管癌根治术具有独特的优势,其安全可靠、微创、恢复快,值得在临床上推广使用.

Objective:To investigate the clinical application of three-dimensional CT bronchovascular reconstruction in double-port thoracoscopic anatomical pulmonary segmentectomy.Methods:Seventy-six patients undergoing double-port thoracoscopic anatomical pulmonary segmentectomy in our hospital from October 2016 to July 2018 were selected. According to whether the patients received preoperative three-dimensional CT bronchovascular reconstruction, they were divided into an unreconstructed group ( n=35) and a reconstructed group ( n=41). There were 22 males and 13 females in the unreconstructed group, with the age of (60.63±9.80) years old; there were 25 males and 16 females in the reconstructed group, with the age of (61.02±10.05) years old. The operative time, intraoperative blood loss, thoracic fluid drainage volume, complications, and postoperative pathological reports of all patients were recorded. Results:Compared with those in the unreconstructed group, the reconstructed group had shorter operation time [(136.22±22.22) min vs.(155.86±21.34) min], less intraoperative blood loss [(97.39±22.34) ml vs.(116.54±23.69) ml], and less postoperative thoracic fluid drainage volume [(789.15±135.45) ml vs.(875.00±150.46) ml], with statistically significant differences (all P<0.05). There was no statistically significant difference in the incidence of postoperative complications between the two groups ( P>0.05). Conclusion:The application of three-dimensional CT bronchovascular reconstruction before surgery can achieve precise pulmonary segmental resection, reduce the operation time, intraoperative blood loss, and postoperative pleural fluid drainage volume, which is suitable for patients undergoing thoracoscopic anatomical pulmonary segmentectomy.

To achieve a deeper understanding of patients who developed esophageal cancer (EC) as a second primary malignancy, which may help guide in clinical practice for these patients in the future. In the primary cohort, EC patients with a prior malignancy were identified from the surveillance, epidemiology, and end result 18 database. The 5 most common types of prior cancers were picked out based on the frequency of occurrence. In addition, Kaplan-Meier and log-rank tests were performed to investigate the survival impacts of prior cancers on EC patients. Besides, a competing-risk model was constructed to explore the relationship between EC-treatment and EC-specific mortality. In the secondary cohort, patients with stage I-III (N0M0) EC from 2004 to 2014 were enrolled. After propensity score matching, univariate and multivariate Cox analyses were developed to determine the prognostic factors for EC patients. A total of 1199 EC patients with a prior cancer were identified in the primary cohort. The 5 most common sites of prior cancers were prostate, female breast, bladder, lung and bronchus, and larynx. Kaplan-Meier analyses revealed that EC patients with prior prostate cancer and bladder cancer had the best overall survival (OS), while those with prior cancers of larynx and lung and bronchus had the worst OS. Fine and Gray competing risks analysis indicated that the administration of surgery was closely associated with better EC-specific survival (P < .001). In the secondary cohort, multivariate Cox analyses found that age at diagnosis, race, tumor grade, tumor extent, nodal status and metastasis stage, histology, and the administration of surgery were prognostic factors for OS and cancer-specific survival in EC patients. Besides, the existence of a prior cancer was an independent prognostic factor for cancer-specific survival. EC remains to be the most important cause of death in EC patients with a prior cancer. EC related treatment should be actively adopted in patients with a prior cancer, as they were more likely to die from EC than the prior cancer. EC patients with a prior cancer had comparable OS than those without.

目的 研究三孔胸腔镜肺癌根治术术后慢性疼痛的发生率并探讨其影响因素.方法 收集某三级甲等医院2018年1月1日-2018年10月31日符合研究要求的胸腔镜下肺癌根治术患者56例.实际完成随访48例.以数字分级评分法评定术后第1-3天,第3个月时患者的疼痛程度.以术后第3个月是否发生术后慢性疼痛(CPSP)为标准,将患者分为两组,即CPSP组,与非CPSP组.并针对10项相关因素进行分析.结果 根据实际完成的随访例数分析年龄,术后1-3天疼痛程度差异有统计学意义(P＜0.05).结论 针对存在统计学差异的相关因素行Logistics回归分析,分析结果显示术后急性期疼痛(P＜0.05)、年龄(P＜0.05)是发生慢性术后疼痛的独立危险因素.

目的 分析胸腔镜下亚肺叶切除术治疗IA期非小细胞肺癌的围手术期临床效果,为IA期非小细胞肺癌患者的外科治疗提供临床依据.方法 回顾性分析2013年1月～2016年1月本院心胸外科收治的75例IA期非小细胞肺癌患者的临床资料,胸腔镜下亚肺叶切除术组36例;肺叶切除术组39例.比较两组患者年龄、手术时间、术中出血量、术后卧床时间、胸管引流时间、术后首日胸液引流量、术后住院时间、术前合并症例数、术后并发症发生率.结果 胸腔镜下亚肺叶切除组与肺叶切除组术后并发症发生率、术后首日胸液引流量和术后住院时间比较差异均无统计学意义.与肺叶切除组比较,亚肺叶切除组患者年龄较大,且术前合并症较多,手术时间短,术中出血量少,术后卧床时间短,术后胸管引流时间短,差异有统计学意义(P<0.05).两组患者在围手术期均无死亡.结论 胸腔镜下亚肺叶切除术与肺叶切除术治疗IA期非小细胞肺癌围手术期内均安全有效,但胸腔镜下亚肺叶切除术对于术前合并基础疾病、年龄较大的非小细胞肺癌患者更有优势,且创伤小,术中出血少,术后卧床时间短,更有利于患者术后快速康复,值得在临床上推广应用.

Objective To explore the effect of full thoracoscopic lobectomy and the traditional thoracotomy lobectomy in the treatment of non-small cell lung cancer. Methods Group selection 62 patients with non small cell lung cancer received in our hospital from January 2014 to December 2015 were divided into observation group and control group, 31 cases in each group. Observation group used total thoracoscopic lobectomy; the control group used thoracotomy. lymph node dissection cases and incidence of adverse reactions of the two groups were compared. Results In the observation group, the number of Hilar and mediastinal lymph node and Mesenchymal lymphadenectomy are (250.1 ± 1.8)and (206.2 ± 4.1) ; The control group (249.3 ± 2.1) and (205.7 ± 9.6);there was no significant difference between two groups (P>0.05); Adverse reactions of the observation group was 6.45% (2/31); in the control group it was 32.26% (10/31).when compared the two groups, there was significant difference (P<0.05). Conclusion The non small cell lung cancer lobectomy for thoracoscopic effect is re-markable, with faster postoperative recovery, less trauma, and adverse reaction rate is low.

目的：探讨心脏瓣膜手术后呼吸衰竭相关的危险因素。方法378例进行心脏瓣膜手术的患者,对其术后呼吸衰竭相关的危险因素进行分析。结果通过观察记录情况显示,378例患者在进行了心脏瓣膜手术后有20例(5.3%)发生了呼吸衰竭的症状,其中7例患者在进入ICU紧急抢救之后恢复正常呼吸,13例患者最终由于呼吸衰竭导致死亡。年龄≥55岁、心功能Ⅳ级、转流时间≥3 h、术后并发症、输血≥2000 ml是术后呼吸衰竭的危险因素(P<0.05)。结论临床研究表明,在术后可以根据术中是否进行了二次体外循环支持与术后氧合指数来进行呼吸衰竭的预测。

目的：探讨再次心脏手术瓣膜置换术的临床效果。方法随机选取2010年2月至2014年12月收治的行人工心脏瓣膜再次置换术患者32例，对患者的临床资料进行回顾性分析。结果32例再次心脏手术瓣膜置换术者中，29例患者术后存活，存活率为90．63％，术后复查显示，其中18例恢复至心功能Ⅰ级，11例恢复至心功能Ⅱ级。结论对生物瓣衰败患者行再次心脏手术瓣膜置换术能够有效促进患者心功能的恢复，术中应谨慎操作，术后密切随访，及时发现并处理心功能异常事件。

目的：对35例同期心脏瓣膜手术和冠状动脉搭桥患者的临床效果进行深入探讨和剖析,以供相关工作人员有所借鉴。方法35例同期心脏瓣膜手术和冠状动脉搭桥患者,对其病况、手术方法、术后临床效果以及患者的满意度进行详细分析。结果35例患者在术后均取得了较好的临床效果,心脏功能均明显得到改善,所有患者中23例非常满意,10例一般满意,2例不满意,总满意度为94.29%。结论对心脏外科手术患者实施同期心脏瓣膜手术和冠状动脉搭桥是极为有效的,且患者对其治疗效果满意度较高,值得在临床推广和应用。

目的 总结三分支主动脉弓覆膜支架治疗Stanford A型主动脉夹层的临床经验.方法 正中开胸,股动脉、右房插管转流,不游离主动脉弓及头臂血管,鼻温18℃,停循环,于无名动脉近端2 cm部分切开升主动脉,直视下置入三分支主动脉弓覆膜支架于主动脉弓和近端降主动脉及三支头臂血管内,行左颈总动脉、右无名动脉气囊导管选择性脑灌注,吻合支架血管近端与升主动脉人工血管,恢复全身灌注.观察并发症及疗效.出院时和3个月复查CT血管造影(CTA).结果 本组无死亡,手术过程顺利,脑及右上肢停循环6～7 min,左上肢及降主动脉停循环25～27 min,心肌血运阻断时间81～96 min,体外循环时间145～190 min.术后64排CTA示1例左锁骨下动脉支架外左侧少量血流流向降主动脉,3个月时消失;术后短暂、轻度精神症状1例;二次开胸止血1例,与血管吻合无关.术后1周及3个月CTA示支架血管位置满意,各头臂血管血流通畅.结论 三分支主动脉弓覆膜支架术中置入治疗A型主动脉夹层具有操作简单、并发症少、临床效果好等优点,值得临床推广应用.