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Objective To explore the clinical significance of retrograde access for the interventional treatment of lower extremity arterial occlusive diseases when the occluded segment of lower extremity artery could not be reached through antegrade access.Methods Twenty-seven cases (male 17,female 10; age range 32-89 years ) were retrospectively investigated, including 18 with lower limb arteriosclerosis obliterans,7 with diabetic foot and 2 with thromboangiitis obliterans.According to the Fontaine staging,6 cases were classified as Fontaine Ⅱ,11were classified as Fontaine Ⅲ and 10 were classified as Fontaine Ⅳ.All cases underwent endovascular operation through antegrade access first with an attempt to cross the occlusive segment,but in vain.So retrograde access was tried via puncture of pedis dorsalis or posterior tibial artery or exposure of lateral branches of posterior tibial artery,peroneal artery or dorsal artery by open surgery,which followed by Percutaneous transluminal angiography and (or) stenting.Results The operation through retrograde access was successful in all cases with obvious improvement of ischemic symptoms.Hematoma at the puncture site occurred in 3 patients,and paresthesia of toes occurred in 1after dorsalis pedis arteriotomy.No severe perioperative complication occurred.The average ankle brachial index increased from 0.37 ± 0.11preoperatively to 0.85 ± 0.12 postoperatively.Conclusions Retrograde access could be used as an alternative strategy in lower extremity arterial occlusive diseases when the occluded segment could not reach through antegrade access.
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With the development of gene technology,it is gradually possible and much better for genetic modification of bone marrow stem cells in treatment of hindlimb ischemia. Gene modification of cells prior to their transplantation, especially stem cells, enhances their survival and increases their function in cell therapy. But this treatment is only used for the experimental stage. Here, we review the current uses of gene-modified bone marrow stem cells in vascular disease.
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Objective To investigate the protective effects of ulinastatin(UTI)on ischemia-reperfusion(I/R)injury(SMIRI)of skeletal muscle in rats.Method Twenty-four male SD rats randomly were divided into three groups in equal number:control group(Group C)rats underwent anesthetization without ischemia;the ischemia-reperfusion injury group(Group I/R)rats underwent ischemia and reperfusion,0.5 ml normal saline (N.S)was infused upon extermal jngular vein prior to reperfusion;ulinstatin group(Group U)underwent ischemia and reperfusion,and 0.5 ml UTI(5×104 U/kg)Was infused at the same time.The skeletal muscle injury model was induced by a rubber band tourniquet applied to the left root of the hind limb for 4 hours and reperfusion for 4 hours.At the end of study,the expression of TNF-α mRNA of skeletal muscle was determined by reverse transcription-polymerase chain reaction(RT-PCR);enzyme-linked immun-osorbent assay(ELISA)were performed for plasma level of TNF-α;the plasma concentrations of lactate dehydrogenase(LDH),creatine kinase (CK),malondialdehyde(MDA),myeloperoxidase(MPO)activity and MDA in skeletal muscle were measured by colorimetry respectively.The oedema degree was quantified by calculating the wet/dry weight ratio of skeletal muscle.Structural changes of skeletal muscle were also observed histologically and ultrastructurally.The statistical difference was analyzed with One-way ANOVA by SPSS version 10.0 Software for windows.Results The level of plasma TNF-α,TNF-α mRNA expression in skeletal muscle in group I/R were significantly higher than those in Group C(P＜0.01),while those in Group U were significantly lower than those in Group I/R(P＜O.01).The plasma concentrations of LDH,CK,MDA and the MPO activity,W/D of skeletal muscle varied in those groups were likewise in comparinson between groups(P＜0.05).The histologic changes of skeletal muscle tissue under light and electronic microscopy were slingter in Group U than in group I/R.Conclusions UTI can inhibit the production of inflammatory factors and MDA,and suppress the MPO activity,showing protective effects against ischemia-reperfusion injury of skeletal muscle of rats.
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Objective To explore the significance of LDH and ?2-m concentration in CSF in differentiating viral meningitis from purulent meningitis in pediartic patients.Methods Kinetic method was performed to detect the LDH concentration in CSF in 45 patients with purulent meningitis and 49 patients with viral meningitis and 22 healthy children of control group respectively.On the other hand,radioimmunoassay(RIA)was used to detect the concentration of ?2-m.Results The concentrations of LDH in CSF in purulent meningitis group(26.15?12.17)U/L were higher than that in viral meningitis group(8.76?4.94)U/L significantly(P
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Objective To evaluate the early clinical efficacy of subfascial endoscopic perforator vein surgery (SEPS) in the treatment of chronic venous insufficiency (CVI) of lower limbs. Methods A retrospective study was carried out in 26 patients (34 legs) with CVI treated by SEPS. Results The number of incompetent perforating veins ligated per limb ranged 1～5 (mean, 3 5). The postoperative clinical score (2.48?0.25) was significantly lower than the preoperative score (6.54?0.93) ( t =21.497, P
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Objective:To investigate the mechanism of Salvia Miltiorrhizae(SM) on protecting the renal injury of rats with obstructive jaundice.Methods:The 36 rats were randomly divided into control group,obstructive jaundice group and SM treated group.The renal injury of rats model with obstructive jaundice was established by ligating common bile duct.In the SM treated group,SM (2.0g/ d) was given through abdominal cavity.Animals were killed at the 7th,14th,21st and 28th day after operation respectively.The malondialdehyde (MDA) and superoxide dismutase (SOD) activity content of serum and renal tissue were determined,and the changes of renal function and histopathology were observed.Results:Comparing with non treated group,the serum and renal tissue SOD activity were markedly increased,and the MDA were obviously decreased(P
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Objective:To evaluate the efficacy of dual intervention for the treatment of acute pulmonary embolism(PE) in patients with deep venous thrombosis(DVT) of lower limbs.Methods:Twenty five patients of DVT with PE were treated with combination of transcatheter thrombolysis and inferior vena cava filter placement.Results:All the filter procedures and catheter were successfully performed,without any complication.The clinical symptoms were markedly improved in all patients.Twenty three cases were followed up for 3-36 months after dual intervention,and no complications of interventional treatment or recurrent PE was found.Conclusion:The inferior vena cava filter placement is an effect method in preventing PE.Dual interventional procedures is a superior and effective method for managing the patients with PE.