Background : Acute Type A Aortic Dissection (ATAAD) is a severe cardiovascular emergency with complex pathogenic mechanisms. This study aims to explore the cellular heterogeneity and potential mechanisms of ATAAD, as well as evaluate the protective effects of fenofibrate on ATAAD. Methods : We established a mouse model of ATAAD and performed single-cell RNA sequencing analysis on the ascending aorta of normal control, BAPN induced ATAAD, and BAPN+fenofibrate intervention groups. Quality control, data integration, and cell clustering analyses were conducted using the Seurat package. Cell communication, pseudo-time analysis, and characteristic gene analysis were employed to investigate the pathogenesis of ATAAD and the mechanism of fenofibrate action. Results : We identified 10 major cell types, with significantly increased proportions of monocytes and macrophages in the BAPN group. Pathway analysis revealed differential expression of multiple signaling pathways in ATAAD, particularly the specific activation of the SPP1 pathway. We identified 12 macrophage subpopulations, among which the C2 subpopulation (Plekhg5+ and Timd4+) may play a role in maintaining normal aortic function, while the C5 subpopulation (Cxcl3+ and Met+) may be a potential inducer of ATAAD. Following fenofibrate intervention, inflammatory pathway activity decreased, and macrophage subpopulation distribution tended towards normal. Moreover, the expression of the Lyve1 gene in macrophages was significantly associated with favorable prognosis, suggesting its potential as a marker for assessing aortic dissection outcomes. Conclusion : This study elucidates the cellular heterogeneity and potential mechanisms of ATAAD, identifying key macrophage subpopulations and signaling pathways. Fenofibrate may ameliorate the occurrence and progression of ATAAD by modulating macrophage subpopulation distribution and function, thereby improving intimal permeability. These findings lay the foundation for developing novel therapeutic strategies for ATAAD.

In today’s fast paced society, the phenomenon of rest intolerance has emerged as a prevalent psychological concern, which has been shown to pose potential risks to the mental and physical health of many people. However, rest intolerance remains underexplored, particularly among nursing students who face high academic pressure. This study aims to investigate rest intolerance and its associated factors among nursing students using the social ecological model, and to identify central indicators for intervention targets that alleviate this issue through network analysis. This research is a nationwide cross-sectional study using network analysis. From June 23 to September 29, 2024, the Rest Intolerance Scale-8 (RIS-8) was administered to evaluate rest intolerance among 1,878 nursing students in China. Data collection was conducted using stratified and quota sampling methods. Based on the social ecological model, factors potentially associated with rest intolerance were identified and subsequently investigated using random forest classification. In addition, to further elucidate factors associated with rest intolerance, univariate and multivariable generalized linear models were conducted. Finally, network analyses were undertaken to evaluate central indicators of rest intolerance and core factors among nursing students. Central indicators were identified based on their expected influence value. A higher expected influence value signifies a greater importance of the nodes in the network. The network’s stability was assessed using a case-dropping procedure. The self-reported level of rest intolerance indicated a median score of 24 points. The results of the multivariate generalized linear model analysis demonstrated that nursing students exhibiting higher scores of the study variables are associated with increased feelings of rest intolerance, including higher levels of online social networking addiction (β = 0.32; 95

Dysfunctional mechanosensing via focal adhesions (FAs) significantly contributes to thoracic aortic dissection in the β-aminopropionitrile mouse model by triggering FA kinase activation and subsequent Rho/ROCK and mTOR signaling pathways. The present findings indicate that these signaling pathways play distinct roles in ascending vs descending dissections. Specifically, in the ascending aorta, smooth muscle cell FA kinase-Rho/ROCK signaling acts as a beneficial adaptive mechanism to prevent dissections, whereas mTOR signaling is pathogenic and contributes to dissections.

The rapid integration of artificial intelligence (AI) into healthcare has raised important patient privacy concerns, particularly regarding AI-based health monitoring devices. As future healthcare professionals, nursing students will play a critical role in adopting and implementing AI-based health monitoring devices. This study aims to evaluate the level of patient privacy concerns in AI-based health monitoring devices among nursing students and analyze the associated factors. A group of 967 nursing students was extracted from the 2023 Chinese Population Psychology and Behavior Survey (PBICR). The multivariate generalized linear model analysis was used to evaluate the associated factors of the level of patient privacy concerns in AI-based health monitoring devices among nursing students. The mean score of nursing students’ level of patient privacy concerns in AI-based health monitoring devices was 69.00 (50.00,88.00) (range 0-100). Family health [Tertile 2: 35 39 (β = 0.03), Tertile 3: 40 50 (β = 0.03)], anxiety symptoms [Tertile 2: 2 7 (β = 0.07), Tertile 3: 8 21 (β = 0.10)], resilience [Tertile 2: 4 6 (β = 0.02), Tertile 3: 7 8 (β = 0.10)], and with no sibling (β=-0.02) were associated with patient privacy concerns in AI-based health monitoring devices among nursing students. The results of the study indicate that nursing students have certain concerns about AI-based health monitoring devices. The study emphasizes the need for targeted educational programs to mitigate patient privacy concerns and enhance the acceptance of AI-based health monitoring devices in nursing education based on their associated factors. Not applicable.

AimThis systematic review and meta-analysis was to evaluate the relationship between body mass index (BMI) and the clinical outcomes in patients with metastatic colorectal cancer (mCRC) undergoing treatment with bevacizumab plus chemotherapy.MethodsThe search for relevant literature was conducted across PubMed, Embase, Cochrane Library, and Web of Science, with the final search date being October 4, 2023. We utilized the weighted mean differences (WMDs), risk ratios (RRs), or Hazard ratios (HRs) as the metric for effect sizes, which were accompanied by 95% confidence intervals (CIs).ResultsA total of 9 studies were included for analysis. The results indicated that non-obese patients with mCRC undergoing treatment with bevacizumab experienced a reduced overall survival (OS) at the six-month compared to their obese counterparts (RR: 0.97, 95% CI: 0.94 to 1.00, p = 0.047). Furthermore, no significant differences in one-year, two-year, and five-year OS, as well as PFS and median OS, were observed between obese and non-obese mCRC patients undergoing treatment with bevacizumab plus chemotherapy.ConclusionThese findings suggest that obesity may play a role in the short-term OS of patients with mCRC undergoing bevacizumab treatment. The clinical implications of these findings underscore the importance of considering patients’ BMI in the context of mCRC care. This study may also help guide personalized treatment strategies and further research into the interplay between obesity, treatment efficacy, and patient survival in mCRC. However, further investigation is warranted to substantiate the findings of this study.

ObjectiveVeno-arterial extracorporeal membrane oxygenation (VA-ECMO) is a critical support technique for cardiac surgery patients. This study compares the outcomes of femoral artery cannulation vs. combined femoral and axillary artery cannulation in post-cardiotomy VA-ECMO patients. This study aimed to compare the clinical outcomes of critically ill patients post-cardiac surgery under VA-ECMO support using different cannulation strategies. Specifically, the focus was on the impact of femoral artery (FA) cannulation vs. combined femoral artery and axillary artery (FA+AA) cannulation on patient outcomes.MethodsThrough a retrospective analysis, we compared 51 adult patients who underwent cardiac surgery and received VA-ECMO support based on the cannulation strategy employed—FA cannulation in 27 cases vs. FA+AA cannulation in 24 cases.ResultsThe FA+AA group showed significant advantages over the FA group in terms of the incidence of chronic renal failure (CRF) (37.50% vs. 14.81%, p = 0.045), preoperative blood filtration requirement (37.50% vs. 11.11%, p = 0.016), decreased platelet count (82.67 ± 44.95 vs. 147.33 ± 108.79, p = 0.014), and elevated creatinine (Cr) levels (151.80 ± 60.73 vs. 110.26 ± 57.99, p = 0.041), although the two groups had similar 30-day mortality rates (FA group 40.74%, FA+AA group 33.33%). These findings underscore that a combined approach may offer more effective hemodynamic support and better clinical outcomes when selecting an ECMO cannulation strategy.ConclusionDespite the FA+AA group patients presenting with more preoperative risk factors, this group has exhibited lower rates of complications and faster recovery during ECMO treatment. While there has been no significant difference in 30-day mortality rates between the two cannulation strategies, the FA+AA approach may be more effective in reducing complications and improving limb ischemia. These findings highlight the importance of individualized treatment strategies and meticulous monitoring in managing post-cardiac surgery ECMO patients.

Objectives This study aims to develop and internally validate a prediction model, which takes account of multivariable and comprehensive factors to predict the prolonged length of stay (LOS) in patients with lower extremity atherosclerotic disease (LEAD).Design This is a retrospective study.Setting China.Participants, primary and secondary outcomes Data of 1694 patients with LEAD from a retrospective cohort study between January 2014 and November 2021 were analysed. We selected nine variables and created the prediction model using the least absolute shrinkage and selection operator (LASSO) regression model after dividing the dataset into training and test sets in a 7:3 ratio. Prediction model performance was evaluated by calibration, discrimination and Hosmer-Lemeshow test. The effectiveness of clinical utility was estimated using decision curve analysis.Results LASSO regression analysis identified age, gender, systolic blood pressure, Fontaine classification, lesion site, surgery, C reactive protein, prothrombin time international normalised ratio and fibrinogen as significant predictors for predicting prolonged LOS in patients with LEAD. In the training set, the prediction model showed good discrimination using a 500-bootstrap analysis and good calibration with an area under the receiver operating characteristic of 0.750. The Hosmer-Lemeshow goodness of fit test for the training set had a p value of 0.354. The decision curve analysis showed that using the prediction model both in training and tests contributes to clinical value.Conclusion Our prediction model is a valuable tool using easily and routinely obtained clinical variables that could be used to predict prolonged LOS in patients with LEAD and help to better manage these patients in routine clinical practice.

Objective . The study evaluates the safety and efficacy of hypothermic cardiac arrest (HCA) at various temperatures in aortic arch surgeries. Methods . We conducted a literature search in PubMed, Google Scholar, and Embase databases. For single proportion assessments, we employed fixed-effect and random-effect models in the general linear mixture model and the inverse variance model for other computations. We analyzed factors such as age, sex, operation time, and postoperative complications, with subgroup and metaregression analyses. We used funnel plots to depict potential publication bias. Results . Our research incorporated 43 papers with 34,797 cases. HCA temperatures were divided into five groups (A: 30–32°C, B: 28–30°C, C: 26–28°C, D: 24–26°C, and E: <24°C). There is no statistically significant difference in myocardial ischemia time ( P  = 0.90) and isolated cerebral perfusion (ICP) time ( P  = 0.95). Groups A and C have the best performance in avoiding postoperative complications including transient nerve injury (TNI), permanent nerve injury (PNI), renal failure (RF), and mortality occurrence rate. Group A has the lowest occurrence rate in PNI (3%) and mortality (3%). Group C has the lowest RF incidence (5%). Conclusion . Maintaining temperatures of 30–32°C in en bloc anastomosis or 26–28°C during arch replacement with separate grafts can significantly reduce complications including PNI, RF, and in-hospital mortality.

Objectives Homocysteine (Hcy) level has been widely identified as a risk factor associated with adverse outcomes in patients with lower extremity atherosclerotic disease (LEAD). However, there are still some knowledge gaps in research on the association between Hcy level and downstream adverse outcomes, such as length of stay (LOS). This study aims to explore whether and to what extent Hcy level is associated with LOS in patients with LEAD. Design Retrospective cohort study. Setting China. Participants, primary and secondary outcomes We conducted a retrospective cohort study of 748 patients from inpatients with LEAD between January 2014 and November 2021 at the First Hospital of China Medical University in China. We used a slew of generalised linear models to evaluate the association between Hcy level and LOS. Results The patients’ median age was 68 years and 631 (84.36%) were males. A dose–response curve with an inflection point at 22.63 µmol/L was observed between Hcy level and LOS after the adjustment of potential confounders. LOS increased before Hcy level reached the inflection point (β: 0.36; 95% CI: 0.18 to 0.55; p<0.001). Conclusion Our results show that an Hcy level <22.63 µmol/L is associated with increased LOS in patients with LEAD, which was independent of some other risk factors. This might shed light on how Hcy can be used as a key marker in the comprehensive management of patients with LEAD during hospitalisation.

Abstract BackgroundThe thoracic aortic aneurysms especially ascending aortic aneurysms are lethal and tend to be rupture and dissected. The prognosis of untreated aortic aneurysms is worse compared with surgical treatment, however surgical treatment is still a challenging operation with massive trauma and hard to perform on the appropriate time. Medical treatment is mainly to treat the risk factors but not the pathogenesis. With the exploration of the mechanisms of the diseases from onset to development till deterioration or even death leading, the medicine treatment of aortic aneurysms will become more well-targeted and effective.The single cell RNA sequencing is widely used to reveal the function of an individual cell in the context of its microenvironment. After the gene differences study at the cell clusters level, we attempt to obtain the overall differential expression analysis through the algorithm on this basis. This is not only an overall exploration of the mechanism of this disease, but also an attempt to propose a new analytical method to incorporate both local and holistic results from the single-cell sequencing outcome. MethodsAll DEGs are obtained by starting from the processing of the original samples. After ensuring no statistical significance, we extracted gene expression array and finally to the results intersection of the edgeR and DESeq models. The following part is bioinformatics analysis process, including enrichment analysis such as GO analysis and KEGG pathways, the presentation of PPI network, and the target prediction associated with network analysis used to select the hub genes.ResultsBy comparing the gene expression of normal ascending aorta tissue and ascending aorta tissue of ATAA patients, we screened 1390 DEGs, including 526 up-regulated DEGs and 864 down-regulated DEGs. The selected hub genes are: CDC20, CCNB2, BUB1B, BIRC5, PTTG1, ESPL1, PPP1R12B, MYLK, MYL9, MYH14, MYH11. In the classification process using k-means clustering algorithm, MYLK and MYH11 gene showed the characteristics of being in the center and difficult to be classified, indicating that they have a certain pivotal effect. It is consistent with the observation of the characteristics of the small world network. The results obtained by this method is highly compatible with the consensus，and can explain the mechanisms of the aortic aneurysms progressing. ConclusionCDC20, CCNB2, BUB1B, BIRC5, PTTG1, ESPL1 genes as down-regulated hub genes, PPP1R12B, MYLK, MYL9, MYH14, MYH11 were up-regulated hub genes associated with ATAA. MYLK and MYH11 are in the strong group in the consensus of experts. Also, we provided a method to convert single-cell mRNA sequencing results to whole-exome sequencing results, thereby enabling further thinking about molecular pathways of disease at the global and local level in single cell sequencing result.

BACKGROUND:Increasing studies have reported on the prevalence of frailty in patients with peripheral artery disease (PAD). The aim of this systematic review and meta-analysis was to estimate the pooled prevalence of frailty in patients with lower extremity PAD. METHODS:Two authors systematically searched PubMed and Embase databases from their inception to August 8, 2022. Original articles that reported the prevalence of frailty in patients with lower extremity PAD were included. The prevalence of frailty in patients with lower extremity PAD was pooled using a random-effect model. Meta-regression, subgroup, and sensitivity analyses were conducted to explore the heterogeneity. RESULTS:Eighteen studies reported on 17 articles involving 1,726,343 patients with lower extremity PAD were identified. The pooled prevalence of frailty in patients with lower extremity PAD was 49 % (95 % confidence interval [CI] 37-61 %), with significant heterogeneity between studies (I 2 = 100 %, p < 0.001). Multivariable meta-regression showed that only the severity of PAD (coefficient 0.270; 95 % CI 0.017-0.523, p = 0.039) was significantly associated with the heterogeneity. In subgroup analysis, the pooled prevalence of frailty was higher in critical limb ischemia or chronic limb-threatening ischemia (54 %) than all PAD (48 %); the pooled prevalence of frailty was 64 %, 51 %, and 54 % for Modified Frailty Index-5, Modified Frailty Index-11, and Clinical Frailty Scale, respectively. The pooled prevalence of frailty appeared to be lower in male (39 %) than the female patients (47 %). CONCLUSIONS:The prevalence of frailty was higher in patients with lower extremity PAD, suggesting frailty is a common condition. This finding highlights the significance of assessing frailty in patients with lower extremity PAD.

The quadricuspid aortic valve (QAV) is a rare congenital disease with a prevalence of 0. 013-0.043% of cardiac cases. Most patients with QAV are treated with aortic valve replacement. A Type B QAV with dilated ascending aorta of 47.9 mm; combined with severe regurgitation is reported here. In this case, considering the patient's cusps are flexible and reservable, the aortic root was reconstructed utilizing tricuspidization and annular banding technique, and dilated ascending aorta was replaced at the same time.

Background: Obstructive sleep apnoea (OSA) is highly prevalent in patients with Stanford type B aortic dissection (TBAD). Few studies have evaluated the effects of OSA on vascular changes in TBAD patients. This study aimed to explore the effect of OSA on aortic morphological changes in TBAD patients and its relation to late aortic events (LAEs). Methods: This case-control study included 143 TBAD patients. The diameters of different parts of the aorta were measured based on computed tomography angiography (CTA). According to the apnoea-hypopnoea index (AHI), OSA was classified as mild (5 ≤ AHI ≤ 15), moderate (15 < AHI ≤ 30), or severe (AHI > 30). The false lumen (FL) status was evaluated and classified as partially thrombosed, patent, or completely thrombosed. Results: The OSA prevalence in TBAD patients was 64.3%, and image differences related to LAEs between TBAD patients with and without OSA included the maximum aortic diameter at onset (37.3 ± 3.9 vs. 40.3 ± 4.5 mm, p < 0.001), the FL diameter of the proximal descending thoracic aorta (16.0 ± 6.8 vs. 20.3 ± 4.7 mm, p < 0.001), and the proportion of the FL that was partially thrombosed (39.2 vs. 64.1%, p = 0.004). Additionally, in the multivariable analysis of patients with OSA, the risks of an aortic diameter ≥40 mm, a proximal descending aorta FL ≥ 22 mm and a partially thrombosed FL were 4.611 (95% CI: 1.796–11.838, p = 0.001), 2.544 (95% CI: 1.050–6.165, p = 0.039), and 2.565 (95% CI: 1.167–5.637, p = 0.019), respectively, after adjustment for confounding factors. Trend tests showed that the risks of an aortic diameter ≥40 mm and a partially thrombosed FL increased with increasing OSA severity. Conclusions: TBAD patients with moderate to severe OSA have aortic dilatation in different parts of the aorta. OSA is an independent risk factor for multiple imaging signs related to LAEs, suggesting that OSA is an important factor affecting the prognosis of TBAD patients.

基于国内外文献检索及既往病历书写、临床科研经验确定数据结构化节点,通过设计病历书写选择框、逻辑引用、信息系统互联影像、检验系统等方法建立结构化病历模板并在实际临床工作中应用评估,以此设计涵盖多种血管外科疾病的智能化、结构化病历系统,规范临床医师病历书写,提升病历质量,为后期临床科研提供结构化数据支持,并为血管外科专病数据库建设提供了工作基础.

Objective: Animal models are required to explore the mechanisms of and therapy for proximal descending thoracic aortic aneurysm (TAA). This study aimed to establish a reproducible swine model of proximal descending TAA that can further explain the occurrence and progression of proximal descending TAA. Methods: Eighteen Chinese Wuzhishan miniature pigs (30.32 +/- 1.34 kg) were randomized into the elastase group (n = 12) and the control group (n = 6). The elastase group received intra-adventitial injections of elastase (5 mL, 20 mg/mL), and the control group received injections of physiologic saline solution. A 4-cm descending thoracic aortic segment proximal to the left subclavian artery was isolated. The distance between the left subclavian artery and the injection starting point of the descending thoracic aorta was 0.5 cm. Elastic protease was circumferentially injected intra-adventitially into the isolated segment of the aortic wall in the elastase group by a handmade bent syringe. The length of the elastic protease injection was 2 cm. An average of 12 injection points were distributed in this 2-cm aortic segment. Each injection point used about 0.4 mL of elastic protease. The distance between two injection points was about 1.5 cm. All animals underwent digital subtraction angiography preoperatively and 3 weeks after operation. Three weeks after TAA induction, aortas were harvested for biochemical and histologic measurements. Results: All animals in the elastase group developed TAAs. No aneurysms were observed in the control group. The distance between the left subclavian artery and the TAA was 8.00 +/- 4.19 mm. Preoperative and postoperative aortic diameters of the elastase group were 15.42 +/- 0.43 mm and 24.53 +/- 1.41 mm, respectively (P < .0001). Preoperative and postoperative aortic diameters of the control group were 15.31 +/- 0.33 mm and 15.57 +/- 0.40 mm, respectively (P = .5211). The changes of aortic structure and composition included reduction of smooth muscle cells and degradation of elastic fibers. Levels of matrix metalloproteinases 2 and 9 were increased in TAA tissue. Conclusions: This study establisheda reproducible largeanimal model of proximal descending TAA. This model has the same biochemical characteristics as human aneurysms in the aspects of aortic expansion, aortic middle-level degeneration, and changes in the levels of matrix metalloproteinases and provides a platform for further study.

Objective: Mitophagy results in selective clearance of damaged mitochondria. We investigated whether mitophagy was involved in the neuroprotection by inhibiting microRNA (miRNA)-124 on ischemic spinal cords. Methods: Inhibition of miRNA-124 was conducted by intrathecal injection of lentivirus vectors containing antagomiR-124. Spinal cord ischemia was induced in rats by crossclamping the descending aorta just distal to the left subclavian artery for 14 minutes. Hind-limb motor function was assessed with the motor deficit index (MDI). Lumbar spinal cords were harvested for ultrastructural, histologic examinations, and terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick-end labeling staining. Mitophagy was evaluated by expressions of beclin-1 and LC3-II in mitochondria. Expressions of inhibitory member of the apoptosis-stimulating proteins of p53 family, p53, beclin-1, LC3-II, and miRNA-124 were measured by Western blot and quantitative real-time polymerase chain reaction. Mitophagy was inhibited by the antagonist of 3-methyladenine. Results: Compared with control animals, antagomiR-124 significantly inhibited expressions of miRNA-124 (P <. 01) and p53 (P <. 05) and enhanced expressions of inhibitory member of the apoptosis-stimulating proteins of p53 family, becline-1 and LC3-II (P <. 01, respectively) in spinal cords. MDI at 6, 12, 24, and 48 hours after reperfusion were markedly lower in antagomiR-124 group (P <. 01, vs control group, respectively). More motor neurons and less apoptotic cells were detected in lumbar spinal cords of antagomiR-124 group (P <. 01 vs control group). Administration of 3-methyladenine completely abolished enhancements of mitochondrial becline-1 and LC3-II by antagomiR-124 (P < .01 vs antagomiR-124 group) and partially inhibited effects of antagomiR-124 on MDI, number of motor neurons, and apoptotic cells (P <. 01 or <. 05 vs control group and antagomiR-124 group, respectively). Conclusions: Inhibition of miRNA-124 exerts neuroprotection on spinal cords against ischemia-reperfusion injury, possibly by induction of mitophagy and antiapoptotic effects.

OBJECTIVE:To explore the role of microRNA (miR)-30a in the development of aortic dissection. METHODS:Human aortic specimens of aortic dissections and aneurysms were harvested. Aortic specimens from donors for heart transplantation served as controls. Rat aortic vascular smooth muscle cells (VSMCs) were transfected with agomiR-30a or antagomiR-30a, and control cells were incubated with empty vectors. Rats were pretreated with agomiR-30a or antagomiR-30a (5 × 107 transfection units every 3 days for 4 weeks), and empty vectors were infused to controls. Acute aortic dissection was induced by subcutaneous infusion of angiotensin II (1 μg · kg-1 · min-1 for 24 hours). Protein expressions of lysyl oxidase (LOX) and elastin and gene expression of miR-30a were measured in VSMCs and human and rat aortic specimens by Western blot analysis and quantitative real-time polymerase chain reaction. RESULTS:Gene expression of miR-30a was much higher, and protein abundance of LOX and elastin was significantly lower, in the aortic dissection specimens (P < .05 vs controls). Transfection of agomiR-30a markedly decreased the luciferase activity of LOX in VSMCs of wild type, but not of LOX 3'-UTR mutant (P = .002). In cultured VSMCs, transfection of agomiR-30a dramatically enhanced the gene expression of miR-30a and down-regulated the protein abundance of LOX and elastin (P < .05 vs controls). Pretreatment with agomiR-30a in vivo enhanced miR-30a expression and down-regulated the protein abundance of LOX and elastin in rat aortas (P < .05 vs controls). The rate of dissection was significantly higher in rats pretreated with agomiR-30a (P = .003 vs controls). CONCLUSIONS:Overexpression of miR-30a contributes to the development of aortic dissection, possibly by targeting LOX.

目的评价应用近端加长覆膜支架及"改良"无名动脉插管行全弓置换治疗Stanford A型夹层的近期临床效果。方法回顾性分析2012年12月至2015年1月我院收治的21例Stanford A型主动脉夹层患者的临床资料,其中男16例、女5例,平均年龄57岁。21例患者均应用近端加长覆膜支架和我中心自行研制的"改良"无名动脉插管行全弓置换术。结果 21例患者平均手术时间为（187.0±31.1）min,体外循环时间（116.0±32.0）min,主动脉阻断时间（87.0±23.0）min,选择性脑灌注时间（23.0±3.9）min,术后应用呼吸机时间为（19.0±6.0）h,术后ICU停留时间（3.0±0.9）d。所有患者术后恢复良好,无死亡病例,无严重并发症发生。结论应用近端加长覆膜支架及"改良"无名动脉插管行全弓置换术治疗Stanford A型夹层疗效确切、简单安全,近期随访结果满意。