Chimney stent in acute Stanford type B aortic dissection with insufficient anchorage zone / 中华普通外科杂志

Objective:To investigate the effect of chimney stent for reconstruction of left subclavical artery (LSA) in thoracic endovascular aotic repair (TEVAR) for acute Stanford type B aortic dissection with insufficient anchorage zone and non-thrombotic false lumen.Methods:TEVAR with chimney stent for LSA in 39 cases of acute Stanford type B aortic dissection with insufficient anchorage zone and non-thrombotic false lumen was done from Feb 2013 to Jan 2021.Results:Covered chimney stents was used in 11 cases and bare chimney stents in 28 cases. There was no postoperative stroke, left upper limb ischemia, paraplegia, hemiplegia and death. No stent migration, reverse tear and dissection rupture were observed. One bare stent was obstructed after 18 months, and all the remaining stents were patent during follow-up. The rate of immediate type Ⅰa endoleak in covered chimney stent group and bare chimney stent group were 0(0/11) and 32.1%(9/28) respectively ( P=0.04). The distance from proximal tear to LSA in covered chimney stent group, endoleak subgroup and non-endoleak subgroup in bare chimney stent were (5.1±2.3)mm, (14.4±5.2)mm and (7.8±7.0)mm respectively ( P<0.05). False lumen thrombosis was formed in endoleak subgroup 2-8 weeks after operation, and endoleak disappeared. Conclusions:There is a correlation between immediate type Ⅰa endoleak in bare chimney stent for LSA and the distance from proximal tear to LSA, covered chimney stent can reduce the incidence of immediate type Ⅰa endoleak in TEVAR for acute Stanford type B aortic dissection with insufficient anchorage zone and non-thrombotic false lumen.

Relationship between illness perceptions and health behavior of patients with lower extremity arterial disease / 现代临床护理

Objectives To explore the relationship between illness perceptions and health behavior in the subjects. Methods Revised illness perception questionnaire and health promoting lifestyle profileⅡ (HPLPⅡ) were used to measure 101 patients′illness perception and health behavior between the groups. Results The HPLPⅡscore of LEAD was(2.17 ± 0.29) with the score of dimension. The course of disease, prognosis and perception of emotion were negatively related to health behaviour; personal control and primaty congtion of drsease were postively related to health behaviour (all P<0.01). Conclusion Medical personnel should pay attention to the relationship between illness perceptions and health behavior in patients with LEAD and effective measures should be taken to improve the patients′illness perceptions, promote their choices and persistence in health behavior and improve the quality of life.

The correlation analysis of self- management behavior with self- efficacy of patients with lower extremity arterial disease / 中国实用护理杂志

Objective To investigate the relationships between patients′self- management behaviors and self- efficacy with lower extremity arterial disease, and supply evidence for effective management and intervention of lower extremity arterial disease for clinical medical workers. Methods In August 2014 to January 2015,a total of 110 cases of hospitalized patients with lower extremity arterial disease of two hospitals′vascular surgery from Guangzhou completed questionnaires, including the General Information Questionnaire, Chronic Disease Self- management Behavior - Chinese version, Chronic Disease Self- efficacy -Chinese version. Results The total score of self- management behavior of patients with lower extremity arterial disease ranged from 0 to 69, with an average score of 18.93 ± 6.79, the overall level was not high. Self- efficacy score ranged from 6 to 60, with an average score of 32.25 ± 9.65, the overall level was moderate. Self -management behavior was positively correlated with self- efficacy and its dimensions, and negatively correlated with the dimensions of communication with doctors and Common disease management. Conclusions The clinical staff should strengthen education and guidance of self- management behaviors in patients with lower extremity arterial disease, promote the level of self- management behaviors and self- efficacy, improve the confidence of disease treatment and prevention, in order to achieve the purpose of health promotion.

Endovenous radiofrequency ablation in combination with TriVex for treatment of chronic venous insufficiency of the lower extremity / 中华普通外科杂志

objective To evaluate the therapeutic efficacy of endovenous radiofrequency ablation in combination with TriVex for the treatment of chronic venous insufficiency (CVI)of the lower extremity.Methods One hundred and fifty CVI cases(150 limbs)were randomly assigned to Group A(75 limbs)and Group B(75 limbs).Patients in Group A were treated with greater saphenous vein radiofrequency ablation procedures in combination with TriVex.Patients in Grpup B were treated with greater saphenous vein traditional stripping operation in combination with TriVex.The short-term results in hospital and patient self-assessment for the operation at postoperative 4 week were compared with each other:The changes of CEAP classification and venous clinical severity score(VCSS)were compared. Results Operation time was(67±11)min in Group A versus(69-4-9)min in Group B(P＞0.05).Postoperative pain,average hospital stay in Group A were significantly less and shorter than in Group B(P ＜0.05).The scores of selfassessment for the operation were(11.21±2.00)in Group A versus(10.52±2.08)in Group B(P＜0.05).The change of CEAP classification and VCSS were statistically significant after operation in both groups(P＜0.01).The VCSS decreased 4.6 ±2.5 in Group A versus 4.3±2.7 in Grpup B(P＞0.05).Conclusions Endovenous radiofrequency ablation in combination with TriVex for treatment of CVI are effective,less traumatic,of fast recovery.CEAP classification and VCSS are useful tools for assessing outcomes after the operation.

Exploration of Ways to Train Young Surgical Teachers' Teaching Ability / 中华医学教育探索杂志

Aim: Exploration of ways to train young surgical teachers' teaching ability Method: organizing medical training courses;establishing expert training commission;establishing subject teaching group to give guidance;Improving the estimating quality systems of internet education.Result:To relieve the tension of the shortage of teachers caused by enlarged enrollment and heavy teaching tasks in order to adapt to the current rapid development of medical education Conclusion:Pertinent training will be an effective way to improve the young teachers' teaching consciousness,mental diathesis and ability.

Micro-invasive Surgery in Treatment of Varicose Vein in Lower Limbs / 中国医师杂志

Objective To investigate the skills and effects of TriVex system and to discuss its indications and complications in the treatment of varicose vein in lower limbs.Methods The TriVex system operation was underwent in 106 lower limbs with varicose vein.Sixteen of them showed thrombophlebitis while 38 of them showed chronic ulcer and pigmentation.The lower limbs with perforating vein were treated with subfascial endoscopic perforator vein surgery(SEPS) and limbs with deep insufficient vein valve underwent endoscopic valve repair.Results The therapeutic effect of TriVex system was satisfactory and none of them had soft tissue infection.Hematoma occurred in 12 lower limbs(11.2%).Pigmentation and skin petechia disappeared in 3 weeks after operation.Chronic ulcer healed and ankle pigment reduced in 38 limbs.Hematoma,petechia and numbness were the common complications in the patients with varicose vein in lower limbs.Conclusion It was effective,cosmetic and micro invasive to use the TriVex system in the treatment of thrombophlebitis and varicose vein with chronic ulcer.Adept operation skill can minimize the postoperative complications but the long-term effects of this new technique still needed follow-up studies.

Angioscopic externally valve suture repair in the treatment of femoral superficial vein insufficiency / 中国普通外科杂志

ObjectiveTo evaluate the feasibility of angioscopically external valve suture repair. MethodAngioscope was introduced through the terminal great sapherous to the first venous valve of superficial femoral vein. With general femoral vein, deep femoral vein, superficial femoral vein blocked, heparin-contained NS was used to establish water column, and video-guided angioscopy demonstrates the valve′s shape and its degree of defect and deformation. Twelve patients with primary deep venous insufficiency underwent video-valvuloplasty.ResultsPostoperative phlebography showed disappearance of reflux in 9 cases, and significantly reduced reflux in 3 cases. There was no morbidity postoperatively. Conclusion Angioscopic external suture valve repair is safe and effective in the treatment of femoral superficial venous insufficiency.