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Objective:To evaluate the effect of remote endarterectomy in the treatment of complex lower extremity ischemia.Methods:Twenty-one limb ischemic patients underwent remote endarterectomy in Beijing Hospital from Sep 2016 to Feb 2020. Clinical data including general condition, the lesion of lower artery before operation and follow up outcomes were collected. Then the patency rate and limb salvage rate were calculated.Results:The technique success rate was 71.4% (15/21). The 3, 6, 12 month patency rate were 93.3%, 85.6% and 74.1%, respectively. The 1-year limb salvage rate was 93.3% (14/15). In the 6 patients converted to artificial vessel bypass, the 3,6,12 months patency rates were 76.7%, 66.7% and 46.8%, respectively. The 1-year limb salvage rate was 66.7%.Conclusions:Remote endarterectomy of the lower extremity artery is an alternative option in the treatment of complex ischemic lesions of the lower extremity artery, other than artificial vessel bypass.
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Objective To evaluate the efficacy of excimer laser atherectomy (ELA) combined with drug-coated balloon (DCB) in the treatment of lower limb arteriosclerosis obliterans.Methods From Sep 2016 to Dec 2018 42 patients (42 limbs) underwent ELA combined with DCB therapy.Results There were 27 males and 15 females.The mean age was (65.7 ±9.7) years.The average lesion length was (14.3 ±7.5) cm.The technical success rate was 100％ and the remission rate of clinical symptoms was 92.9％.Ankle-brachial index was significantly improved from (0.45 ± 0.15) pre-operation to (0.85 ± 0.13) postoperation (P =0.001).The mean follow-up was 10.9 months.At 3,6,and 12 months follow-up,the primary patency rate was 95.2％,92.8％ and 84.9％.The 1-year limb salvage rate was 95.2％.Conclusion ELA combined with DCB has a good 1-year results as our data reveal.
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Objective To investigate the effect of iso-osmolar contrast media (IOCM) on renal function in elderly patients. Methods The clinical data of 77 patients aged over 65 years undergoing vascular angiography and interventional therapy using IOCM with a dose>100 ml from September 2016 to May 2017 were retrospectively analyzed. Serum creatinine (CRE), urea and uric acid were measured before angiography, within 48 h and 3-7 d after angiography. The incidence of contrast-induced nephropathy (CIN)and the renal function before and after angiography were compared. Results Among the 77 patients, 58 were males and 19 were females, with an average age of (73.8 ± 7.2) years. The mean serum CRE values before and 3-7 days after angiography were (84.55±39.92)μmol/L and (83.87±38.45)μmol/L respectively (t=0.140, P=0.889);the mean serum urea levels were (5.64±2.36) mmol/L and (6.44±3.15) mmol/L (t=3.041,P=0.003);the mean serum uric acid levels were (281.39±85.30)μmol/L and (333.29±89.89)μmol/L (t=7.297, P<0.001), respectively. CIN occurred in 7 patients with an incidence of 9.1％. In 7 patients with CIN, the mean CRE values increased from (135.71±102.41)μmol/L before angiography, to (180.00±100.45)μmol/L within 48 h and (142.86 ± 92.97) μmol/L 3-7 d after angiography (F=9.876,P=0.011); and the uric acid levels progressively decreased from (353.43 ± 86.73)μmol/L before angiography, to (339.14 ± 85.69)μmol/L within 48 h after angiography and (299.57 ± 95.71) μmol/L 3-7 d after angiography (F=5.713,P=0.029). Conclusion In elderly patients, IOCM has relatively mild effect on renal function during vascular angiography or interventional therapy.
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Gallibacterium anatis,a member of the Pasteurellaceae family,constitutes a part of the normal micro-flora of the upper respiratory tract and the lower genital tract in chickens.However,increasing evidence indicate that G.anatis is also associated with a wide range of pathological changes,particularly in the reproductive organs,which leads to decreased egg production,lowered animal welfare and increased mortality.As a recently defined opportunistic pathogen limited focus has been placed on the pathogenesis and putative virulence factors permitting G.anatis to cause disease.One of the most studied virulence determinants is a large RTX-like toxin (GtxA),which has been demonstrated to induce a strong leukotoxic effect on avian macrophages.A number of fimbria of different sizes and shapes,particularly the F17-1ike fimbriaes,appear to be common in a diverse selection of G.anatis strains.The capsular material expressed possibly involved in serum resistance,metalloproteases capable of degrading immunoglobulins,hemagglutinins,and all factors which may promote biofilm formation are likely linked to the virulence of G.anatis.This review summarized the putative virulence factors described for this bacterium to date.
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Objective To investigate the clinical effects of percutaneous trasluminal angioplasty (PTA) for ischemic lesions of below-the-knee(BTK) arteries in elderly patients.Methods Clinical data of 56 elderly patients(the PTA group) with ischemic lesions of BTK arteries who had received PTA treatment were retrospectively analyzed.The ankle brachial index (ABI) and the skin temperature of the affected foot were recorded and analyzed before and after treatment.The clinical effects were compared with those of conservative treatment 31 patients(the control group) had received during the same period.Results PTA was successfully performed in all of the 56 cases.The skin temperature rose,claudication disappeared or the claudication distance increased,rest pain disappeared or lessened,and no severe complications or death occurred in the PTA group.ABI increased from (0.41±0.12) before treatment to(0.63±0.21),(0.65±0.19),(0.67± 0.22),(0.61±0.20),and (0.58±0.18) at 24 hours,1,3,6 and 12 months after treatment,respectively.The skin temperature increased from(28.4±2.1)℃ before treatment to(35.4±2.4)℃,(35.6±2.1)℃,(35.8±2.4)℃,(34.6±2.1)℃ and(34.3±2)℃ at 24 hours,1,3,6 and 12 months after treatment,respectively.There were statistically significant differences in ABI and the skin temperature between before treatment and any time point after treatment(all P＜0.05) and between the PTA group and the control group at any time point after treatment(all P＜0.05).Conclusions PTA is a safe and effective treatment for ischemic lesions of BTK arteries in elderly patients.
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Objective: To explore the peri-operative treatment and 3 years post-operative outcome in patients with rheumatic mitral valve stenosis and small left ventricle. Methods: A total of 152 patients with rheumatic mitral valve stenosis and severe pulmonary hypertension were studied. According to left ventricular end diastolic index (LVEDI) value, the patients were divided into 2 groups: Small left ventricle (Small) group, the patients with LVEDI value≤60 mm, n=67 and Non-small left ventricle (Non-small) group, the patients with LVEDI value>60 mm,n=85. Peri-operative condition and follow-up parameters were compared between 2 groups. Results: Compared with Non-small group, Small group had increased pre-operative CVP, SPAP and decreased LVEDV, LVEDVI and RVEF at admission, all P0.05. There were 52 severe pulmonary hypertension patients received iloprost inhalation, their SPAP was decreased than non-inhalation patients at incision closing; SPAP was lower in Small group inhalation patients than Non-small group inhalation patients, all P0.05. Conclusion: The patients with mitral valve stenosis and small left ventricle had the worse pre-operative condition and higher risk in surgery; peri-operative treatment could improve their cardiac and liver function, but they still had the shorter post-operative median survival time.
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Treatment resistant depression is a common and severe mental disorder associated with significant burden of disease .Most individuals receiving conventional pharmacotheraphy fail to achieve and sustain remission.So this is still one of the difficult challenges for the psychiatrist .Much of the research pro-vided indications that the efficacy of treatment for the disease was not optimistic, but the treatment was still made great progress .The common treatments for this disease included pharmacotherapy,psychotherapy,elec-troconvulsive therapy(ECT),transcranial magnetic stimulation (TMS),magnetic resonance guided focused ultrasound surgery( MRgFUS) ,deep brain stimulation ( DBS) ,aerobic exercise,light therapy and so on.Each therapeutic strategy has its own features, and could be suitable or unsuitable in some situations.The high rates of non-remission with first-line treatment strategies make the combination of antidepressant and non-drug treatments to be the new trend of the treatments for treatment resistant depression in the future.
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<p><b>BACKGROUND AND OBJECTIVE</b>Fast track surgery (FTS) is a systematical method to accelerate the recovery of surgical patients by reducing the physical and mental trauma stress of them. The research is to investigate the feasibility of FTS application in lung cancer surgery.</p><p><b>METHODS</b>A total of 80 cases of lung cancer patients with single leaf lobotomy resection were randomized into two groups. While the experimental group was treated with the conception of FTS, and the control group was treated with the traditional methods. The incident rate of post-operation pain degrees, telecasts, pleural effusion, the post-operation time stay in hospital time and the total cost during hospitalization in two groups were compared respectively.</p><p><b>RESULTS</b>In FTS group: the VAS score of post-operation pain at 1 h, 6 h, 12 h, 24 h and 48 h all significantly decreased compared to the traditional therapy group. The incidence rate of telecast was 10.53%. The incidence rate of pleural effusion was 26.31%. The length of stay after operation was (4 +/- 1) d and the total cost was RMB 15 600 +/- 7 600. In the control group, the above values were 77.78%, 33.33%, 22.22%, (9 +/- 1) d, RMB 23 600 +/- 5 400, respectively. The post operation pain (VAS method) of FTS group was remarkablely below the control group. There has significant difference of the incident rate of telecasts, stay time in hospital and the total cast in two groups (P < 0.05). No significant difference was observed in the incident rate ofpleural effusion.</p><p><b>CONCLUSION</b>The new methods of FTS can apparently accelerates recovery after lung cancer resection, reduces complications, shorten timestay in hospital and cut down the total cost.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Lung Neoplasms , General Surgery , Pulmonary Surgical Procedures , Treatment OutcomeABSTRACT
Object To study on the structure of sapogenins from pod of Gleditsia sinensis Lam Methods Pod of G. sinensis was extracted with solvents and the constituents in the extraction isolated, after hydrolised completely, with the aid of flash chromatography to obtain 2 gledgenins Results The structures of the 2 gledgenins were proved to be 3 hydroxy 12 oleanen 28 oic acid and 3, 16 dihydroxy 12 oleanen 28 oic acid respectively as shown by IR, NMR, MS and crystallographic data The structures were further verified by acylation, methylation and followed by reaction with 3, 5 dinitro benzoyl chloride Conclusion New crystalline derivatives were obtained to provide further evidence of their structures