ABSTRACT
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.
ABSTRACT
OBJECTIVE:To observe the clinical effect and safety of Xuebijing injection in the treatment of moderate and se-vere infection of stage Ⅲ-Ⅳ pressure ulcer. METHODS:A total of 130 cases of moderate and severe infection of stage Ⅲ-Ⅳ pres-sure ulcer admitted to our hospital from Jul. 2011 and Jun. 2016 were randomly divided into observation group and control group, with 65 cases in each group. Control group was treated with 0.5%Iodophor disinfectant to disinfect the sore surface,given wet ster-ile gauze soaked with 0.5% Iodophor disinfectant to compress sore surface for 30 min,and then given Aikangfu absorptive silver ion antibacterial healing dressing to fill wound,changed dressing after 2/3 was soaked. Observation group was additionally given Xuebijing injection 50 mL added into normal saline 100 mL intravenously for 30-40 min,2-3 times a day,for consecutive 7 days,on the basis of control group. Treatment course of both groups lasted for 4 weeks. The clinical efficacy,the score of pres-sure ulcer scale for healing(PUSH),debridement time,the time of local symptom and SIRS disappearance as well as the occur-rence of ADR were compared between 2 groups. RESULTS:The total response rate of observation group(93.85%)was signifi-cantly higher than that of control group (80.00%),and debridement time,the time of local symptom and SIRS disappearance were all significantly shorter than control group,with statistical significance(P0.05). After 1-4 weeks of treatment,PUSH score of 2 groups was de-creased significantly compared to before treatment,and the score of observation group was significantly lower than that of con-trol group,with statistical significance(P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:For moderate and severe infection of stage Ⅲ-Ⅳ pressure ulcer,Xuebijing injection effectively reduces inflammatory exudation,improves the ab-sorption of necrotic tissue,relieves local symptom and systematic inflammatory reaction,promotes the healing of pressure ulcers and has good clinical effect and safety.
ABSTRACT
Objective To investigate the effect of Yunnan Baiyao Plaster on serum related markers levels in the patients with stroke ,to evaluate its improvement effect on the neurological dysfunction and pain and to analyze its effect mechanism .Methods Eighty cases of hemorrhagic stroke treated in the neurosurgical department of our hospital from February 2015 to June 2016 were screened as the research subjects and divided into the control group and observation group according to the random number table method ,40 cases in each group .All subjects were given the routine treatment ,while the observation group received the external use of Yunnan Baiyao Plaster around the head operative incision and drilling ,to give Yunnan white ointment ,with the attaching area of 5 cm × 4 cm ,once daily ,for consecutive 7 d ,meanwhile took oral Yunnan Baiyao Plaster 0 .5 g with warm boiling water ,once daily for consecutive 7 d .The serum markers levels before and after treatment ,neural function defect score ,decline proportion of NIHSS scores and prognostic indicators were compared between the two groups .Results The mean pain value within 1 week in the obser-vation group was lower than that in the control group ,the difference was statistically significant (P 0 .05);after 2 weeks ,ET ,TNF-α and IL-1β levels in the observation group and control group were lower than those before treatment in the intra-group comparison ,while the comparison between the two groups showed that the ob-servation group was lower than the control group ,the difference was statistically significant (P0 .05) .Conclusion The combined treatment of Yunnan Baiyao Plaster in the patients with hemorrhagic stroke conld relieve pain and reduce the neurological deficit ,which might be related to the mechanism of anti-inflammation and analgesia .
ABSTRACT
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.
ABSTRACT
Objective To discuss the clinical value of subintimal angioplasty (SIA) in treating long segment occlusion of superficial femoral artery (SFA) in the elderly,and to observe the follow-up results.Methods Subintimal angioplasty was performed in 66 elderly patients with stage Ⅱ-Ⅳ long segment occlusion of SFA.The improvement of ankle-brachial index (ABI) and the long-term patency rates were observed and analyzed before and after treatment.Results Of 66 elderly patients,the surgery was successfully performed in 64 cases (97 ％).Skin temperature was improved,the claudication disappeared or a claudication distance was prolonged,the rest pain disappeared or relieved,foot infection was under control and turned into the dry gangrene in these patients.SIA was given up in 1 case because the wire failed to return to the true lumen and the distal outflow segment was occluded.One patient underwent bypass grafting instead of SIA because the wire failed to get into the subintimal.The ABI got obvious improvement before and after treatment (0.59±0.16 vs.0.84± 0.21,P＜0.01).The patency rates in 62 patients undergoing SIA at 6,12,24,36 months were 85.5％ (53/62),69.4％ (43/62),54.8％ (34/62) and 48.4％ (30/62) after surgery,and the 3-years limb salvage rate in 62 cases was 96.6％ (60/62).Conclusions Subintimal angioplasty is an effective method for treating long segment occlusion of superficial femoral in elderly patients,and it has the satisfactory long-term follow-up results.
ABSTRACT
Stage assessment is an important part of standardized resident training.After two years of practice and exploration,Liaoning had established the complete examination and evaluation system including the theory test and skill test and this system was future improved through analyzing two years' results and summing up the experiences making it more suitable for residency training in the future.
ABSTRACT
Objective To analyze the protein expression and subcellular distribution of mechanogrowth factor (MGF) in ostcoblasts under stretch stimulation. Methods Cyclic stretching was applied to osteohlasts by a mechanical stretching device. The whole-cell proteins were extracted from controlled and stretched osteoblasts for detecting the protcin expression level of MGF by Western blot and observing the intracellular distribution of MGF by fluorescent immunocytological method. Results Western blot showed significant increase of expression of MGF in osteoblasts under stimulation of cyclic stretching. The level of protein was increased by four folds after 12-hour stretching of osteohlasts, and then declined sharply. Immunofluorescence analysis showed that MGF was mainly distributed in the nuclei of osteoblasts. ConcinsionsUnder the cyclic stimulation, the expression of MGF reaches a short period of peak in osteoblasts, which may be related to the injury of osteoblasts caused by stretching. MGF is mainly distributed in the nuclei of osteoblasts, indicating that MGF may contain nuclear localization signal and modulate the expression of relative genes.
ABSTRACT
Objective To evaluate the clinical significance of implanting an inferior vena cava filter to prevent pulmonary embolism.Methods Reviewed the causality of 180 cases,which was undertaken the ultrasound examination,patients were diagnosed as the deep vein thrombosis,male patients were 128 cases, female patients were 52 cases,median age was 65 years old,all received the transfemora] implantation of inferior vena cava filter implantation.Results All the operations were successfully conducted,filters were placed into inferior vena cava at 1-3 cm inferior of renal vein,without hematoma in the puncture position and thrombosis.One hundred and forty-nine cases (82.8%) were followed up at 1,6,12 months respectively, 55 cases(30.6%)were followed up more than 36 months, no filter drift,deformation and inferior vena perforation complications was observed.There was no fatal pulmonary embolism occurred for all the cases,the inferior vena unobstructed rate was 95.6%.Conclusion Vena cava filter is an effective and safe method which can prevent and cure pulmonary embolism.
ABSTRACT
@#Objective To investigate the effects of estrogen on brain derived neurotrophic factor (BDNF) and neuropeptide Y (NPY) levels in cerebellar cortex of ovariectomized rats. Methods 24 female Wistar rats were randomly divided into three groups: intact (INT) group, ovariectomized (OVX) group, and OVX+estrogen 0.5 mg/kg every day group (E group). Radioimmunoassay (RIA) was used to measure the estrogen content in plasma, and the levels of BDNF and NPY were measured with Immunohistochemistry. Results Compared with the INT group, the plasma estrogen level significantly reduced in OVX group (P<0.001). However, the plasma estrogen level was higher in the E group than that in the OVX group (P<0.001). The BDNF and NPY presented in the Purkinje cell layer,and BDNF also distributed in the molecular layer and granular layer. Compared with that in the INT group, BDNF and NPY positive cells markedly decreased in OVX group, with slight cytosol staining in the cerebellar cortex (P<0.001). The BDNF and NPY positive neurons increased in E group compared with that in the OVX group (P<0.001). Conclusion Estrogen can increase the BDNF and NPY levels in cerebellar cortex of female rats, which may protect the structure and function of cerebellar neurons.
ABSTRACT
Mechano-growth factor (MGF) is one of IGF-1 isoforms. MGF is mechanosensitive and has important functions in muscle hypertrophy, regeneration and nerve injury recovery. In this study, MGF cDNA (330 bp) was cloned from stretched osteoblasts by RT-PCR. In order to avoid prolin residue inhibiting enterokinase cleavage, 9bp of MGF cDNA 5' end sequence was truncated by primer, then the obtained truncated MGF (des(1-3)MGF) cDNA (321 bp) was subcloned in pET32a(+) vector to construct a prokaryotic recombination expression plasmid. Trx/des(1-3)MGF fusion protein, existing in forms of solution, was expressed in transformed Escherichia coli strain BL21(DE3) by IPTG induction at 30 degres C. The supernatant of cell lysates was subjected to ion exchange chromatography and Ni2+ metal affinity chromatography, and the fusion protein was obtained with the purity over 95%. After the fusion protein was cleaved by enterokinase, Trx and des(1-3)MGF was isolated by reverse-phase HPLC. Through these procedures, des(1-3) MGF was obtained with the purity of 98%. The protein molecular mass was conformity to the theoretical value by SDS-PAGE and mass spectrometry analysis. The purified des(1-3)MGF was incubated with MC3T3-E1 for cell proliferation and migration assays. The results show that des(1-3)MGF exhibited more facilitative effects on proliferation and migration of MC3T3-E1 than that of des(1-3)IGF-1.