Advance in comprehensive treatment of liver metastasis of gastric cancer / 国际肿瘤学杂志

Gastric cancer is one of the most common malignant tumors of digestive system, which has the characteristics of strong heterogeneity, rapid progress and poor prognosis. Liver metastasis of gastric cancer is the main cause of death of advanced gastric cancer. At present, the clinical treatment of gastric cancer mainly includes systematic treatment (systemic chemotherapy, targeted treatment, immunotherapy), surgical resection, interventional treatment and radiotherapy, but the therapeutic effects are not good, and liver metastasis of gastric cancer is lack of standardized treatment strategy. At present, the multi-disciplinary comprehensive treatment mode has been widely used in the diagnosis and treatment of malignant tumors, and has achieved good results. According to the clinical characteristics and surgical accessibility of liver metastasis of gastric cancer, the Chinese Gastrointestinal Surgery Expert Group divides it into three clinical types: resectable type, potential resectable type and non-resectable type. All kinds of clinical types of patients need multidisciplinary comprehensive treatment cooperation group experts to discuss and formulate individualized treatment plan.

CT-guided versus ultrasound-guided percutaneous lung puncture biopsy in the diagnosis of peripheral pulmonary masses: a Meta-analysis / 肿瘤研究与临床

Objective@#To systematically evaluate the efficacy and safety of CT-guided percutaneous lung puncture biopsy versus ultrasound-guided percutaneous lung puncture biopsy.@*Methods@#Relevant domestic and foreign related databases such as PubMed, Web of Science, Cochrane Library, OVID, China Biology Medicine, VIP, Wanfang and CNKI databases were searched, the randomized controlled trial about the applications of CT-guided and ultrasound-guided percutaneous lung puncture biopsy were collected. After extracting the relevant data, a Meta-analysis was performed using RevMan 5.2 and Stata softwares.@*Results@#Ten studies met the inclusion criteria, with a total sample size of 1 158 cases, of which 635 were CT-guided puncture biopsy and 523 were ultrasound-guided puncture biopsy. Meta-analysis showed that the difference of the success rate between the CT-guided group and the ultrasound-guided group was not statistically significant [97.48% (619/635) vs. 96.56% (505/523), RR= 1.01, 95% CI 0.99-1.03, P= 0.360]; the puncture diagnosis rate in the CT-guided group was lower than in the ultrasound-guided group, and the difference was statistically significant [92.44% (619/635) vs. 96.56% (505/523), RR= 0.97, 95% CI 0.94-0.99, P= 0.007]. The total incidence of complications after puncture in the CT-guided group was higher than that in the ultrasound-guided group, and the difference was statistically significant [14.49% (92/635) vs. 9.56% (50/523), RR= 1.56, 95% CI 1.11-2.19, P= 0.010]; the incidence of pneumothorax after puncture in the CT-guided group was higher than that in the ultrasound-guided group, and the difference was statistically significant [11.50%(73/635) vs. 6.31% (33/523), RR= 1.77, 95% CI 1.17-2.68, P= 0.007]; the difference of the incidence of bleeding after puncture between the CT-guided group and the ultrasound-guided group was not statistically significant [2.99% (19/635) vs. 3.25% (17/523), RR= 1.08, 95% CI 0.59-1.98, P= 0.800].@*Conclusions@#Both CT-guided and ultrasound-guided percutaneous lung puncture biopsy have good clinical diagnostic value. However, for the intrapulmonary masses shown by ultrasound, the ultrasound-guided lung puncture biopsy has a shorter operation time, lower cost, and higher safety.

CT-guided versus ultrasound-guided percutaneous lung puncture biopsy in the diagnosis of peripheral pulmonary masses: a Meta-analysis / 肿瘤研究与临床

Objective:To systematically evaluate the efficacy and safety of CT-guided percutaneous lung puncture biopsy versus ultrasound-guided percutaneous lung puncture biopsy.Methods:Relevant domestic and foreign related databases such as PubMed, Web of Science, Cochrane Library, OVID, China Biology Medicine, VIP, Wanfang and CNKI databases were searched, the randomized controlled trial about the applications of CT-guided and ultrasound-guided percutaneous lung puncture biopsy were collected. After extracting the relevant data, a Meta-analysis was performed using RevMan 5.2 and Stata softwares.Results:Ten studies met the inclusion criteria, with a total sample size of 1 158 cases, of which 635 were CT-guided puncture biopsy and 523 were ultrasound-guided puncture biopsy. Meta-analysis showed that the difference of the success rate between the CT-guided group and the ultrasound-guided group was not statistically significant [97.48% (619/635) vs. 96.56% (505/523), RR= 1.01, 95% CI 0.99-1.03, P= 0.360]; the puncture diagnosis rate in the CT-guided group was lower than in the ultrasound-guided group, and the difference was statistically significant [92.44% (619/635) vs. 96.56% (505/523), RR= 0.97, 95% CI 0.94-0.99, P= 0.007]. The total incidence of complications after puncture in the CT-guided group was higher than that in the ultrasound-guided group, and the difference was statistically significant [14.49% (92/635) vs. 9.56% (50/523), RR= 1.56, 95% CI 1.11-2.19, P= 0.010]; the incidence of pneumothorax after puncture in the CT-guided group was higher than that in the ultrasound-guided group, and the difference was statistically significant [11.50%(73/635) vs. 6.31% (33/523), RR= 1.77, 95% CI 1.17-2.68, P= 0.007]; the difference of the incidence of bleeding after puncture between the CT-guided group and the ultrasound-guided group was not statistically significant [2.99% (19/635) vs. 3.25% (17/523), RR= 1.08, 95% CI 0.59-1.98, P= 0.800]. Conclusions:Both CT-guided and ultrasound-guided percutaneous lung puncture biopsy have good clinical diagnostic value. However, for the intrapulmonary masses shown by ultrasound, the ultrasound-guided lung puncture biopsy has a shorter operation time, lower cost, and higher safety.

DoubleGJstentplacementinthetreatmentoflowerureteralstricturesandobstruction / 实用放射学杂志

Objective Toevaluatetheinterventionaltherapeuticefficacyoflowerureteralstricturesandobstructionbyimplantation of"doubleGJ"stentsbytheguidewiretrackwithtwowaysjointofpercutaneousnephrocentesisandurethra.Methods 45caseswith malignanttumoroflowerureteralstrictureorobstructionweretreatedwithballooncatheterdilatation,andthenthe"doubleJ"tube wasimplantedusingpercutaneousnephrostomyandurethradoublepathguidedwireorbit.Postoperativeurinevolume,renalfunction, colordopplerultrasoundandCTfollowGupwereobservedandreviewedfor3－12monthsaftersurgery.Results Thesuccessfulrate oftheoperationwas100%(45/45),withtheureteralobstructionrelievedandtheclinicalsymptomsimproved.After7days,renal functionfullyrecoveredtonormalin39patients,andsignificantlyimprovedin6patients.Conclusion Implantationof "doubleGJ"stentsbytheguidewiretrackwithpercutaneousnephrocentesisandtransurethraldoublepathisasimple,effectiveandminimallyinvasive treatmentformalignantureteralstrictureandobstruction.

Determination of Four Kinds of Organic Residual Solvents in Imatinib Mesylate by Capillary Gas Chromatography / 医药导报

Objective To establish a method for simultaneous determination of petroleum ether (60-90 ℃),ethyl acetate,ethanol and pyridineas residual organic solvents in imatinib mesylate API. Methods Capillary gas chromatography was adopted.The determination was performed on DB-WAX capillary column with FID detector.The injector temperature was 180 ℃and the temperature of FID was 200 ℃ by temperature programming with nitrogen serving as carrier gas at a flow rate of 5 mL·min-1.The injection volume was 1 μL.With N,N-dimethylformamide(DMF) serving as solvent,four kinds of organic solvent residues in the samples were calculated by external standard method. Results The four kinds of organic solvent were completely separated under the established chromatographic condition.A good linearity was obtained in the concentration ranges of them (r=0.999 8-0.999 9).The sampling precisions (RSDs) were less than 2.0%(n=5).The average recovery rates of ethyl acetate,ethanol and pyridine were 97%-101%and that of petroleum ether was 88.7%(RSD<2.0%,n=5).The limits of detection for them were 0.58,0.42,0.18 and 0.61 ng respectively(S/N=3:1).The limits of quantification for them were 1.8,2.1,0.5 and 2.5 ng,respectively (S/N=10:1). Conclusion The method is simple,sensitive,accurate and reliable.

Advances of the effects of antibody heterogeneity on the function and metabolism of monoclonal antibody drugs / 中国药科大学学报

Antibody drugs often show "heterogeneity",including the related isomers differing from one another in glycosylation,charge or molecular size.Most of these isomers come from post-translational modifications,such as aggregation,degradation,glycosylation,oxidation,deamidation or disulfide misfolding,of the recombinant protein in the "cell factories".These modifications not only influence the quality,safety and efficacy of the antibodies,but also serve as an important indication of product quality throughout the whole process of antibody production.This paper reviews the relationship between glycoslation,charge and size heterogeneities of monoclonal antibodies and drug efficacy,safety,pharmacokinetics as well as immunogenicity,contributing to a better understanding of the relationship between antibody structure and function.It will provide some support and guidance for the research and development of antibody drugs,especially biosimilars.

Determination of 18β-isomer in Magnesium Isoglycyrrhizinate by HPLC / 医药导报

Objective To establish a HPLC method for determination of 18β-isomer in magnesium isoglycyrrhizinate. Methods The determination was performed by Agilent Extend-C18 column ( 4. 6 mm × 250 mm, 5 μm ) . Mobile phase consisted of 0. 1 mol·L-1 potassium dihydrogen phosphate buffer solution ( adjusted to pH 7. 0 with potassium hydroxide )-acetonitrile (80︰20) at the flow rate of 1.0 mL·min-1. The column temperature was 30 ℃, and the detection wavelength was set at 250 nm. Results The resolution of magnesium isoglycyrrhizinate and 18β-isomer was greater than 2.0. The linear range of them was 0.41-2.46μg·mL-1( r=0.9998) , the detection limit was 0.21 ng, and the average recovery were 100.2%,99.1%, 110.2%,RSD were 0.9%,0.1%,0.2%(n=3). Conclusion The method is simple and accurate, and can be used for determination of 18β-isomer in magnesium isoglycyrrhizinate.

Determination of 18β-isomer in Magnesium Isoglycyrrhizinate by HPLC / 医药导报

Objective To establish a HPLC method for determination of 18β-isomer in magnesium isoglycyrrhizinate. Methods The determination was performed by Agilent Extend-C18 column ( 4. 6 mm × 250 mm, 5 μm ) . Mobile phase consisted of 0. 1 mol·L-1 potassium dihydrogen phosphate buffer solution ( adjusted to pH 7. 0 with potassium hydroxide )-acetonitrile (80︰20) at the flow rate of 1.0 mL·min-1. The column temperature was 30 ℃, and the detection wavelength was set at 250 nm. Results The resolution of magnesium isoglycyrrhizinate and 18β-isomer was greater than 2.0. The linear range of them was 0.41-2.46μg·mL-1( r=0.9998) , the detection limit was 0.21 ng, and the average recovery were 100.2%,99.1%, 110.2%,RSD were 0.9%,0.1%,0.2%(n=3). Conclusion The method is simple and accurate, and can be used for determination of 18β-isomer in magnesium isoglycyrrhizinate.

The repair of blunt popliteal artery injuries with two-points approach vascular stenting technique / 介入放射学杂志

Objective To explore the clinical effect of two-points approach vascular stenting technique (via both the femoral artery and posterior tibial artery of the affected side) in repairing blunt popliteal artery injuries.Methods The clinical data of eleven patients with blunt popliteal arterial injuries,who were treated with two-points approach vascular stenting technique during the period from March 2011 to March 2015 as single-approach stenting repair failed,were retrospectively analyzed.First,antegrade puncture of the femoral artery on the affected side with subsequent angiography was performed to evaluate the arterial injury,when the attempt to push the guide-wire to pass the injured arterial segment by twisting manipulation failed the puncture of posterior tibial artery was immediately carried out,then,a 4-French single-bend catheter together with a goose neck snare was inserted.Guide-wire capture technique was used to gasp the guide-wire in the injured artery segment,and then the guide-wire was pulled to pass through the injured artery segment.In this way,the guide-wire working circle was reliably established,and along the guide-wire the vascular stent was inserted and delivered to the right site to repair the injured artery.A 6-French guiding catheter was inserted to perform thrombus aspiration for eliminating the distal outflow obstruction caused by thrombus.Thrombolytic therapy with small dose of urokinase through a indwelling catheter was employed for the treatment of peripheral arterial thrombosis.Results The technical success rate was 100％.Angiography revealed that partial transection of artery was detected in 7 patients,and complete transection of artery in 4 patients.A total of 16 stents were implanted.No perioperative mortality or procedure-related complication occurred.All patients were followed up for 13-24 months,with a mean of (18.7±3.8) months.In-stent thrombosis occurred in 2 patients,which was treated with thrombolytic therapy and the blood flow recovered;severe in-stent stenosis (＞70％) was seen in 3 patients,in whom the blood flow returned to normal after balloon dilation therapy;mild in-stent stenosis (＜30％) was found in 6 patients,and no special treatment was given.During the follow-up period,no stent fracture,deformation,or displacement was seen,and no patient needed to have an amputation surgery.Conclusion In treating blunt popliteal artery injuries,two-points approach vascular stenting technique can effectively reduce the operation time,rapidly recover the blood flow of the injured popliteal artery,and shorten the time of limb ischemia.This technique has very satisfactory clinical shortterm effect.

Endovascular treatment for closed articular artery injuries / 中华普通外科杂志

Objective To explore the efficacy of endovascular treatment for closed articular artery injuries.Methods The clinical data of 13 patients from Jan 2010 to Dec 2014 treated for closed articular artery injuries were analyzed retrospectively.The location,severity and extent of arterial injury were confirmed by intraoperative arteriography.The diameter and length of the injured arteries were measured.The guidewire was sent to the lesion site and working wire pathway was established.When the guidewire was difficult to pass through the lesion site,femoral and posterior tibial or radial artery may be used to establish working wire pathway.The stent or stent-graft was implanted through the contralateral femoral artery or distal end of ipsilateral artery.Results Intraoperative angiography confirmed intimal injury (n =2),partial transection (n =5),complete transection (n =5) and arteriovenous fistula (n =1).Eighteen stents or stent-grafts were implanted.Treatment was successful in all patients without peiropeartive death and procedure-related complications.All were followed up for 15 to 48 months and the mean follow-up was (30 ± 11) months.Three patients with stent lumen stenosis less than 50％ as showed by angiography.There was no stent fracture,displacement,or deformation.Conclusions Endovascular treatment for closed articular artery injuries is of less invasion,shorter operative time and quick postoperative recovery.

Interventional Treatment of Post-thrombosis Syndrome / 中国微创外科杂志

Objective To investigate the clinical effect and value of interventional therapy for post-thrombosis syndrome (PTS).Methods Clinical data of 91 patients with PTS who had received interventional therapy were retrospectively analyzed.The patients were in prone position in surgery.We selected puncture approach of popliteal vein and established a working guidewire channel, and then performed balloon dilatation and stent placement.Results The technical success rate was 98.9% (90/91), with complete recanalization of the stenosis or occluded vessel and restoration of the normal blood flow.There was 1 case of failure to traverse the left common iliac vein segment, but the collateral circulation was rich enough to compensate.The 90 patients were followed up for 6-30 months, with a mean of (18.5±2.3) months.The 6, 12, and 24-month patency rates were 93.3% (84/90), 81.3% (61/75), and 71.4%(20/28), respectively.No stent migration or ulcer recurrence occurred in the 90 patients during the follow-ups.Conclusion For the treatment of PTS, endovascular treatment has high technical success rate.With satisfactory clinical effect, this therapy is safe and effective.

Efficacy of endovascular interventional minimally invasive techniques in treatment of acute brachial artery injury / 中华创伤杂志

Objective To evaluate the efficacy of endovascular interventional minimally invasive techniques in treatment of acute brachial artery injury.Methods A retrospective case series study was designed to analyzed data of 16 cases (11 males and 5 females) sustaining acute brachial artery injury treated from March 2011 to August 2016.Mean age was 47.9 years (range,27-66 years).Left upper extremity vascular injury occurred in 7 cases and right upper extremity vascular injury occurred in 9.There were 13 cases of arterial intima injury and 3 of arterial pseudoaneurysm.All patients underwent endovascular therapy including stent implantation and balloon dilatation.Angiography was used to evaluate the repair of brachial artery and the operation time was recorded.Improvements of distal limb arterial pulse and limb ischemic symptoms were observed,and the patients who were followed up with stent lumen stenosis more than 50％ received endovascular treatment again.Results The procedures was successful in all patients,with operation time of 30-75 minutes (mean,45 minutes).After the insertion of a stent,recovered brachial artery blood flow and disappeared pseudoaneurysm were observed on angiography,without occurrence of stent stenosis or contrast extravasation.Symptoms of local pain and numbness were alleviated,and blood supply of the distal brachial artery was improved after operation.All patients were followed up for 3-36 months(mean,16.7 months).The false aneurysm did not recur.Two cases of stent stenosis more than 50％ had a second balloon dilation procedure and the blood flow returned to normal.Stent patency was found in 14 cases with stent stenosis of less than 50％.During the follow-up period,no ischemic necrosis,displacement of the stent or stent fracture were found.Conclusion For acute brachial artery injury,endovascular management exhibits higher technical success rate and good clinical outcome with a low incidence of complications.

Endovascular Repair of Blunt Popliteal Arterial Injuries

OBJECTIVE: To evaluate the feasibility and effectiveness of endovascular repair for blunt popliteal arterial injuries. MATERIALS AND METHODS: A retrospective analysis of seven patients with clinical suspicion of popliteal arterial injuries that were confirmed by arteriography was performed from September 2009 to July 2014. Clinical data included demographics, mechanism of injury, type of injury, location of injury, concomitant injuries, time of endovascular procedures, time interval from trauma to blood flow restoration, instrument utilized, and follow-up. All patients were male (mean age of 35.9 ± 10.3 years). The type of lesion involved intimal injury (n = 1), partial transection (n = 2), complete transection (n = 2), arteriovenous fistula (n = 1), and pseudoaneurysm (n = 1). All patients underwent endovascular repair of blunt popliteal arterial injuries. RESULTS: Technical success rate was 100%. Intimal injury was treated with a bare-metal stent. Pseudoaneurysm and popliteal artery transections were treated with bare-metal stents. Arteriovenous fistula was treated with bare-metal stent and coils. No perioperative death and procedure-related complication occurred. The average follow-up was 20.9 ± 2.3 months (range 18-24 months). One patient underwent intra-arterial thrombolysis due to stent thrombosis at 18 months after the procedure. All limbs were salvaged. Stent migration, deformation, or fracture was not found during the follow-up. CONCLUSION: Endovascular repair seems to be a viable approach for patients with blunt popliteal arterial injuries, especially on an emergency basis. Endovascular repair may be effective in the short-term. Further studies are required to evaluate the long-term efficacy of endovascular repair.

Erratum: Endovascular Repair of Blunt Popliteal Arterial Injuries

The publisher and authors would like to draw the reader's attention to an error in the following article. Endovascular Repair of Blunt Popliteal Arterial Injuries. Korean J Radiol 2016;17(5):789-796.

Percutaneous transhepatic various interventional technique for treatment of common bile duct stones / 实用放射学杂志

Objective To explore the effect and application value of percutaneous transhepatic various interventional technique for treatment of common bile duct stones.Methods 46 patients with common bile duct stones were treated.All patients were treated by percutaneous transhepatic cholangiopancreatography in order to confirm the number and location and size of the stones.Place me-chanical lithotripsy net according to the size of stones.Then percutaneous transhepatic balloon dilation.Postoperatively biliary tract was drained for 2 weeks.Results 45 operations were successful,The successful rate was 97.83%.Complete stone removal was obtained with one session in 41 patients and two sessions in 4 cases,respectively.There was no serious complications occurred during the operation. There was no perforation and bleeding,but hyperamylasemia occurred in 3 patients and acute pancreatitis occurred in 1 patient and bile perito-nitis occurred in 2 patients.Conclusion Percutaneous transhepatic various interventional technique can keep the function of papillary sphincter and is a valuable methed for patients suffering from common bile duct stones with a high successful rate and safety.

Implantation of double-J stent via the guide-wire track for the treatment of ureteral stricture and obstruction / 介入放射学杂志

Objective To explore the technique of implantation of double-J stent via the guide-wire track, which was established through percutaneous renal puncturing, for the treatment of ureteral stricture and obstruction, and to evaluate its therapeutic effect. Methods A total of 75 patients with ureteral stricture or obstruction, who failed to respond to cystoscopic catheterization, were enrolled in this study. The lesions included benign stricture(n=60) and malignant stricture(n=15). Ureteral guide-wire track was established through percutaneous renal puncturing, which was followed by the dilatation of the stricture with balloon catheter and subsequent implantation of double-J stent via the guide-wire track. After the double-J stent was removed, the patients were followed up for 3 months to five years. Results The success rate of the procedure was 98.7%(74/75). Technical failure occurred in one patient with benign ureteral stricture. The cure rate was 70.7%(53/75), the improvement rate was 26.7%(20/75), and no improvement was seen in one case (1.35%). The total effective rate was 97.3%(73/75). Conclusion For the treatment of ureteral stricture and obstruction, the implantation of double-J stent via the guide-wire track, which is established through percutaneous renal puncturing, is a safe and effective method.

Mid-and long-term result of endovascular therapy for lower extremity deep venous thrombosis / 中华普通外科杂志

Objective To evaluate the mid-term and long-term result of mechanical aspiration thrombectomy or combined with balloon thrombectomy,venoplasty and catheter-directed thrombolysis therapy for lower extremity deep venous thrombosis.Methods Clinical data of 1 068 admitted patients were analysed retrospectively from January 2000 to June 2010.Among these patients,271 cases were treated by thrombectomy only,537 cases received thrombectomy with arterial catheter-directed thrombolysis,260 cases were treated by thrombectomy with dorsalis pedis vein thrombolysis,492 patients with stenosis or obstruction of iliac vein underwent venoplasty treatment.Results After 36 month follow-up edema,pigmentation and chronic ulcers were 10.26％,7.28％,1.55％ respectively.The patency without reflux,patency with reflux,residual thrombus,occlusion rate of the iliofemoral vein were 84.25％,8.95％,4.3％,2.5％ respectively; The patency,residual thrombus and occlusion rate of popliteal vein were 93.32％,5.49％,1.19％.Iliac vein stent patency rate was 92.28％.Conclusions Endovascular treatment for lower extremity deep venous thrombosis was a reasonable therapy with a satisfactory mid-term and long-term result,protecting venous valve function and reducing the morbidity of post-thrombotic syndrome.

Clinical effect comparison of mechanical aspiration thrombectomy versus thrombolysis for acute lower extremity deep venous thrombosis of mixed type / 国际外科学杂志

Objective To compare the clinical effect of manual aspiration thrombectomy versus systemic thrombolysis for acute lower extremity deep venous thrombosis of mixed type.Methods The clinical data of 380 patients with acute lower extremity deep venous thrombosis of nixed type was analyzed retrospectively,who were classified into two groups according to treatment methods.Group A (229 cases):the ipsilateral femoral vein was accessed under local anesthesia,a 12-14 F sheath was introduced via a guide wire to aspirate iliofenoral thrombus.As for the femoropopliteal thrombus,a Fogarty balloon catheter was introduced to pull thrombus to iliac vein,then mechanical aspiration thrombectomy was performed.One hundred and thirteen patients with stenosis or occlusion of comnon iliac vein were treated with adjunctive PTA and stenting.As for the residual thrombus bclow popliteal vein,a small dose urokinase vas given to thrombolysis and heparin anticoagulation after procedure.Group B(151 cases) were treated by systemic thrombolysis and anticoagulation with heparin.Results The swelling and pain of affected limbs of group A began to relief after operation immediately,but these times of group B was 3-7 days after operation.The thrombus was eliminated completely(Grade Ⅰ):goup A was better than group B (63.32％ vs 37.09％) (x2 =20.53,P =0.002).Conclusions The manual aspiration thrombectomy was superior to simple systemic thrombolysis in treating acute lower extremity deep venous thrombosis of mixed type,especially in protecting the normal valve function that was better than thrombolysis,aspiration thrombectomy with adjunctive iliac vein angioplasty was a more reasonable method to treat acute LEDVT.

Impact of obesity on long-term survival after aortic valve replacement with small prosthesis / 中华胸心血管外科杂志

Objective This study was designed to evaluate the effect of obesity on late survival after aortic valve replacement(AVR) in patients with implantation of small aortic prosthesis(size≤21).Methods From January 1998 through December 2008,307 patients in a single center in china underwent primary AVR with smaller prosthesis survive the 30 days of surgery.Patients were defined as normal if body mass index (BM1) ＜ 24.0 kg/m2,as overweight if BMI 24.0-27.9 kg/m2,and as obesity if BMI≥28.0 kg/m2.Data of New York Heart Association(NYHA) Functional class,effective orifice area index (EOAI),left ventricular mass index(LVMI),left ventricular ejection fraction(LVEF) were got at the 3rd month(M),6th M,1 st year(Y),3rd Y,5th Y,8th Y after operation respectively.Results At multivariable analysis,obesity was independent factor of later mortality [hazard ratio (HR):1.62 ; P =0.01].Obesity group and overweight group had poor survival (P ＜0.001)and higher proportion of NYHA Function Ⅲ/Ⅳ (P ＜ 0.01) in long-term compared to normal group.EOAI were lower and LVMI were higher in obesity group and overweight group,but LVEF have no significant difference.Conclusion Obesity is associated with increased late mortality after AVR in patients with implantation of small aortic prosthesis.Obesity and overweight may also affect the NYHA function in long term.EOAI should be improved where possible as it may reduce late mortality and improve life quality in such patients.

PTAS treatment for lower extremity atherosclerotic occlusive diseases / 中国介入影像与治疗学

Objective To estimate the clinical effect and application value of percutaneous transluminal angioplasty and stenting (PTAS) on patients with lower extremity atherosclerotic occlusive disease (LEAOD). Methods Percutaneous transluminal angioplasty (PAT) and PATS were performed on 127 patients with diabetic lower limb arteriosclerosis. Results Total achievement ratio was 97.64% (124/127). PTAS was failed in 3 patients, clinical symptoms disappeared or improved in 124 patients. The average ankle brachial index (ABI) before and after operation was 0.35 (0.11-0.58) and 0.87 (0.67-1.06), respectively. The difference in ABI before and after operation was significant (P<0.05). During 3-60 months following-up, arteria iliaca remained open in 53 patients, and no recurrence of clinical symptom was found. At 6, 12, 36 and 60 months after operation, the encumbered superficial femoral artery kept smooth bloodstream with a proportion of 97.78%, 91.11%, 84.44%, 75.56% in 45 patients in upper 2/3 segment and 89.66%, 79.31%, 72.41%, 65.52% in 29 patients in infer 1/3 segment, respectively. Conclusion Long-term vessel recanalization can be obtained effectively and haemodynamics index be remarkably improved with PTA and PTAS in LEAOD patients.