Clinical Observation on Wagner 2-3 Diabetic Foot Ulcer Treated by TCM External Treatment Scheme for Euriching Pus for Tissue Growth / 中国实验方剂学杂志

ObjectiveTo observe the clinical efficacy and safety of traditional Chinese medicine （TCM） external therapeutic protocol of enriching pus for tissue growth （EPTG） in the treatment of Wagner 2-3 diabetic foot ulcer. MethodThe randomized controlled trial （RCT） design was adopted. Patients receiving basic treatment were divided into the EPTG group and the control group （debridement and change of nano-silver medical antibacterial dressing）. Ulcer healing rate， ulcer area， ulcer depth， TCM symptom score， visual analogue scale（VAS）， transcutaneous partial pressure of oxygen， wound blood flow， inflammatory factors ［C-reactive protein （CRP）， interleukin-6 （IL-6）， and tumor necrosis factor-α （TNF-α）］， growth factors ［vascular endothelial growth factor （VEGF）， transforming growth factor-β1 （TGF-β1）， and fibroblast growth factor-β （FGF-β）］， adverse events， and outcome events of the two groups before and after treatment were observed. ResultCompared with the conditions before treatment， the ulcer healing rate， ulcer area， ulcer depth， TCM symptom score， VAS score， transcutaneous partial pressure of oxygen， wound blood flow， CRP， IL-6， TNF-α， VEGF， TGF-β1， and FGF-β were significantly improved （P<0.01）. In terms of the improvement in the ulcer healing rate， ulcer area， ulcer depth， VAS score， transcutaneous partial pressure of oxygen， wound blood flow， CRP， IL-6， TNF-α， VEGF， TGF-β1， and FGF-β， the EPTG group was superior to the control group （P<0.01）. There were no statistically significant differences in adverse events and outcome events between the two groups. ConclusionThe TCM external therapeutic protocol of EPTG is safe and effective in the treatment of Wagner 2-3 diabetic foot ulcer. It can greatly reduce the area and depth of diabetic foot ulcer， improve the ulcer healing rate and TCM symptom score， relieve the pain of patients， and improve the microcirculatory blood supply in the local ulcer. Its mechanism of action may be related to the reduction of the local inflammatory response of the wound and the improvement of the proliferation of fibroblasts and vascular endothelial cells.

Analysis on the Correlation between TCM Syndromes and Inflammatory Reaction and Body Temperature Changes of Acute and Subacute Deep Vein Thrombosis / 中国中医药信息杂志

Objective To investigate the correlation between inflammatory cells, body temperature changes, and TCM syndromes of deep venous thrombosis (DVT) patients in acute and subacute phases. Methods The data of age, gender, body temperature, blood routine, venous ultrasonography, and four diagnostic information of 130 DVT patients in acute and subcute phases were collected and analyzed in a cross-sectional study. The correlation between inflammatory cells and the changes of body temperature and TCM syndromes were analyzed. Results Among 130 DVT patients, 37 patients had damp-heat syndrome, 64 patients had blood stasis and dampness syndrome, and 29 patients had qi stagnation syndrome. Neutrophils increased most obviously in blood stasis and dampness syndrome (P<0.05), which had close correlation with the skin redness (OR=1.287, 95%CI: 9.412-21.247). The mononuclear cells increased most obviously in the damp-heat syndrome, which has close correlation with nouhof (OR=7.364, 95%CI:1.189–45.603), high skin temperature (OR=6.683, 95%CI:1.791–24.938), skin tightness (OR=6.107, 95%CI:1.423–26.203) and weakness (OR=3.302, 95%CI: 1.002–9.169). The temperature rising was the most common in the damp-heat syndrome, and the increase of mononuclear cells was the most common one. Conclusion DVT is often accompanied with elevated levels of inflammatory cells and body temperature. Damp-heat syndrome has close correlation with body temperature and mononuclear cells increasing. Dampness and blood stasis syndrome and neutrophils are closely related.

Progress in opioid receptor and opioids for the treatment of cancer pain / 肿瘤研究与临床

Cancer pain is the most important factor affecting the cancer patients' quality of life, and the approach to relieve and control cancer pain is becoming the focus. Pain mechanism research can offer solutions to pain treatment, such as blocking the happening and conduction of analgesia. The earliest μ, κ, σopioid receptors were found in the research of morphine and opioid peptides, especially μ receptor's leading role in pain treatment. Currently, μ opioid agonist is basically used in clinical pain treatment. Morphine, the third level drug, is still the classic pain therapy drugs. Novel drugs such as fentanyl transdermal and controlled-release oxycodone provide new ideas for the pain ease. Opioid combined with non-opioid drugs, the change of opioid drugs delivery way and joint application of controlled release drug and relievers, have dramatically reduced opioid drugs' side effects.

The combination of dexmedetomidine and propofol for sedation in pediatric patients undergoing regional anesthesia / 中国基层医药

Objective To evaluate the effectiveness and safety of the combination of dexmedetomidine and propofol for sedation in pediatrics undergoing regional anesthesia.Methods Forty-eight children aged 2 -6 years old,scheduled for elective surgery under regional anesthesia,were randomly divided into the two groups.The dexme-detomidine plus propofol group(group DP,n=24)received an infusion over 10 minutes of dexmedetomidine 0.7μg/kg and propofol 1.0 to 2.5 mg/kg bolus for induction,then an infusion of dexmedetomidine 0.5μg·kg-1·h-1 and propofol 100-300μg·kg-1·min-1 for maintenance.The propofol group(group P,n=24)received a propofol 1.0 to 2.5mg/kg bolus for induction,then an infusion of propofol 150 -300μg·kg-1 ·min-1 for maintenance.If body movement was detected during surgery,a bolus of propofol 1 .0mg/kg was administered in both groups,and if there was another body movement within three minutes of the propofol bolus,a bolus of ketamine 1 .0mg/kg was adminis-tered.Hemodynamic data,respiratory rate,and oxygen saturation were recorded by researchers blinded to the study drugs.Recovery time and the primary outcome were evaluated by a modified Aldrete score.The occurrence of adverse events and the amount of supplemental ketamine used were also recorded.Results The consumption of propofol in the group DP was (149.00 ±24.93)μg·kg-1·min-1,and in the group P was (217.00 ±17.90)μg·kg-1· min-1.The propofol consumption was significant lower that in group DP(t=117.94,P=0.00).The needs for sup-plemental ketamine bolus in the group DP was 0.50(1.00)/case,and it was 2.00(1.00)/case in group P.The need for supplemental ketamine was less in group DP(Z=-4.48,P=0.00).Hypopnea occurred in 5 cases in group P, and 0 in group DP.The incidence of hypopnea was more in group P(χ2 =5.58,P=0.03).In group DP,the mean arterial pressure and heart rate at discharge were respectively (74.96 ±5.69)mmHg and (101.17 ±9.65)bpm,and their baseline values were (81.13 ±7.23)mmHg and (112.00 ±13.65)bpm.Both mean arterial pressure and heart rate in the group DP remained decreased at discharge(t=10.78,P=0.00;t=10.08,P=0.00;respectively).The discharge time of the group DP was (40.91 ±10.90)min and it was(39.67 ±14.95)min in group P.There was no significant difference in the discharge time(t=0.11,P=0.74).Conclusion The combination of dexmedetomidine and propofol can provide appropriate depth of sedation in pediatric patients undergoing regional anesthesia.

Release of L-EK in cerebrospinal fluid induced by intrathecal HEK293 cells modified with human preproenkephalin gene and the analgesic efficacy of L-EK for bone cancer pain / 中华麻醉学杂志

Objective To evaluate the release of leucine-enkephalin (L-EK) in the cerebrospinal fluid induced by intrathecal human embryonic kidney (HEK293) cells modified with human preproenkephalin (hPPE)gene and the analgesic efficacy of L-EK for bone cancer pain.Methods Forty CIBP female Sprague-Dawley rats were randomized into transplantation (CIBP+ hPPE/HEK293,n =20) and control (CIBP + HEK293,n =20)groups using a random number table.At 1 day before inoculation of cancer cells (T1,baseline) and 8,15,21,25,32 and 35 days after inoculation (T2-7),thermal paw withdrawal latency (TWL) was measured,and the number of licking/biting the claw on the transplantated side and degree of hindlimb limping during free activities were recorded.After observation at T4,10 rats were chosen from each group and sacrificed and the cerebrospinal fluid of rats was collected in an ice bath for detection of hPPE expression using radioimmunoassay.Results Compared with control group,TWL was significantly prolonged,the concentration of L-EK in the cerebrospinal fluid was increased,and the number of licking/biting the claw on the transplantated side and degree of hindlimb limping during free activities were decreased at T4-7 in transplantation group.Conclusion Intrathecal HEK293 cells modified with hPPE gene can continuously secrete L-EK and mitigate bone cancer pain.

Construction of human embryonic kidney cells exhibiting human preproenkephalin gene expression / 中华麻醉学杂志

ObjectiveTo construct human embryonic kidney cells (HEK293) modified with human preproenkephalin (hPPE) gene.MethodshPPE gene fragments were obtained from recombinant plasmid pcDNA3.1( + )/hPPE by using restriction endonuelease Hind Ⅲ and Not Ⅰ.Homologous recombination of lentivirus and hPPE gene was produced by using recombinant DNA technology.HEK293 cells were then transfected with the recombinant lentivirus vectors.The expression of hPPE gene in HEK293 cells was detected by Western blot.ResultsThe results of DNA sequencing indicated that the positive clone of recombinant lentivirus was completely consistent with sequencing of hPPE in Genebank.The titer of the concentrated virus was 2.07 × 108 TU/ml.GFP fluorescence was not seen in HEK293 cells transfected with the lentiviral vector under fluorescence microscope.A strong fluorescence was seen in HEK293 cells transfected with Ubc-GFP-L.V.empty viral vector.Positive expression of hPPE was demonstrated in HEK293 cells transfected with lentiviral vector by Western blot.Conclusion HEK293 cells modified with hPPE gene were successfully constructed and the target gene hPPE was stably expressed in HEK293 cells.

Endovascular treatment for TASC Ⅱ C/D femoropopliteal arterial disease / 中华普通外科杂志

ObjectiveTo evaluate endovascular stenting for TASC TASC Ⅱ C/D femoropopliteal arterial disease.MethodsBetween January 2008 and June 2011,Endovascular treatments of 51 limbs TASC Ⅱ C/D femoropopliteal artery occlusions in 46 patients(27 male and 19 female) were retrospectively reviewed.Mean age was (70 ± 8 ) years ( range,52 years to 88 years).Severe intermittent claudication,rest pain,minor tissue defect and foot ulceration or gangrene were in 29 limbs,12 limbs,6 limbs and 4 limbs,respectively. Technical success rate,ankle brachial index (ABI),complication rate, and cumulative primary patency rate were evaluated. ResultsTechnical success rate was 90.2％.93 stents were placed in 46 limbs of the 42 patients.Postoperative ABI was increased in all patients.42 patients(46 lower limbs) were followed up for a mean period of 14.6 months.Primary,assisted-primary,and cumulative patency rates at 6 months were 81.0％,88.1％ and 90.5％.Primary,assisted-primary,and cumulative patency rates at 12 months were 66.7％,71.8％ and 79.5％ respectively. ConclusionsEndovascular treatment of TASC Ⅱ C/D femoropopliteal arterial lesions is microinvasive,safe and effective.

Endovascular angioplasty for extracranial vertebral artery stenosis caused by atherosclerosis / 中华普通外科杂志

Objectives To evaluate the safety and efficacy of endovascular angioplasty for extracranial vertebral artery ( VA ) stenosis caused by atherosclerosis. Methods We analyzed retrospectively data of the 24 patients with extracranial vertebral artery stenosis who had been placed endovascular angioplasty from April 2006 to March 2010. According to Mori classification, there were 21 type A and 3 type B among all cases.The artery stenosis rate was 60％ -95％ , the average was 79％ ± 10％. Results Twenty-four balloon mounted stents were placed, the successful rate was 100％. Postoperatively the stenosis rate decreased to 4％ ± 6％. Patients were followed up from 3 to 36 months, the average was 22 months. Symptomes disappeared in 15 out of 17 patients. Postoperative restenosis on the treatment site with transient brain ischemia occurred in one patient. The symptoms in another patient of multiple cerebral infarction with ataxia and episodic vertigo were not relieved, although the patient didn't suffer from apoplectic seizure after the intervention. Postoperative color Doppler ultrasound revealed an over 50％ residual stenosis in 5 patients. The postoperative restenosis rate was 20. 8％. According to Malek scoring, 22 patients were scored 1 point, 1 patient scored 2 and one scored 4. Conclusions Endovascular angioplasty with stent placement is a safe and effective treatment. The restenosis rate could be futher reduced by technology improvement.

A rat model of tibia cancer pain produced by MADB-106 mammary gland carcinoma cells / 肿瘤研究与临床

Objective To establish a tibial cancer pain model with MADB-106 mammary gland carcinoma cell line and to conduct therapeutic research through the behavior pain, X-ray, histological observation of the model. MethodsA rat model of bone cancer pain was established by intra-tibial inoculations of MADB-106 rat mamnary gland carcinoma cells in SD rats. Spontaneous pain was assessed by the reflection of spontaneous paw withdraw, move-evoked pain was observed by the extent of lower extremity claudication when the rats walked and heat hyperalgesia was evaluated by using a thermal dolorimeter. The structural damage of the bone was monitored by X-ray and histology.ResultsThe model group spontaneously withdrawed their paws (14.42±1.24) times on the 15th day after operation (P ＜0.001), (18.33±1.37) times on the 22nd day (P ＜0.001), (21.25±1.54) times on the 25th day (P ＜0.001). The radiant pain thresholds of the model group was (1 1.86±1.63) s on the 15th day after operation (P ＜0.001), (8.38±1.05) s on the 22nd day (P ＜0.001), (7.47±1.25) times on the 25th day (P ＜0.001). The move-evoked pain score of the model group was (1.25±0.62) on the 15th day after operation (P ＜0.001), (2.00±0.95) on the 22nd day (P ＜0.001), (2.33±1.07)on the 25th day (P ＜0.001). The results showed that rats of the model group displayed the gradual development of spontaneous pain, heat hyperalgesia and move-evoked pain on the 15-25 days after injection of the tumor cells. The X-ray of the tibia showed clear bone destruction. The histology of the bone showed the bone marrow cavity was full of tumor cells and the cortical bone had been destroyed. ConclusionThe bone cancer model has been built well and it will be useful to evaluate the therapy of cancer pain after two weeks.

The biological significance of endothelial progenitor cells in angiogenesis and vascular tissue engineering / 基础医学与临床

Endothelial progenitor cells (EPCs) can differentiate into mature endothelial cells and participate in postnatal vascular regeneration and impaired endothelium repair.Rearches in recent years on use of EPCs as seed cells in promoting angiogenesis,maintaining the integrity of endothelial function and constructing tissue engineered blood vessels are reviewed.

Endovascular revision of graft-related stenoses / 中华普通外科杂志

Objective To evaluate the safety and efficacy of endovascular intervention to revise peripheral bypass problems through prosthetic approach.Methods Among 17 cases undergoing graft bypass anastomotic stenosis and graft thrombosis was identifled in 16 cases(inflow or outflow obstructive lesions in 10),inflow obstructive lessions in 1(without anastomotic and graft thrombosis).All revision procedures were taken under local anesthesia,16 patients were treated by means of surgical thrombectomy followed by endovascular intervention through prosthesis itself in addition to one who had no thrombectomy.The graft patency and clinical outcome were observed.Resuits Thirteen stents were implanted in 13patients with distal anastomotic stenosis and 1 with proximal anastomotic stenosis including 10 stentings/PTAs in iliac popliteal,posterior tibial or anterior tibial arteries.One stent was implanted in 1 patient with common femoral stenosis.Stenting were not used(abandoned)in 2 patients,of which one underwent a foot amputation and calf gangrene occurred a week later,and the other had a redo of grafting.Follow-up time is 1-35 months.with an average of 12±4 months.One had a below-knee amputation two months after intervention,the other had symptoms recurred and treated with a redo 3 months afterwards.the third died of myocardial infarction six months later.Grafts remained patent in the rest 13 patients at follow-up.Conclusions Endovascular intervention through prosthesis is a safe and effective method,which offers an alternative means to treat anastomotic stenosis.inflow or outflow obstructive lesions.

Bacterial Distribution and Antimicrobial Resistance of Nosocomial Infection in Ningxia:Monitoring by Ningxia Hui Autonomous Region Nosocomial Infection Surveillance System / 中华医院感染学杂志

OBJECTIVE To observe bacterial distribution and drug resistance in Ningxia.METHODS The patients with nosocomial infection mornitored by Ningxia Hui Autonomous Region Nosocomial Infection Surveillance System from Jan 2003 to Dec 2007 were analyzed and summarized.RESULTS Amomg 3276 isolates,1752 strains(53.48%) were Gram-negative bacilli,1471 strains(44.9%) were Gram-positive cocci and,53(1.62%) fungi.The most common pathogens were Escherichia coli(909),Staphylococcus aureus(509),S.epidermidis(260),Enterococcus faecalis(258),and Pseudomonas aeruginosa(206).Most of them were multidrug resistant.Most strains of Gram-negative bacilli were highly susceptible to imipenem,while most strains of Gram-positive cocci were highly susceptible to vancomycin.CONCLUSIONS Most pathogens of nosocomial infection are multidrug resistant,the resistance detection of bacteria has an important significance to clinical treatment and infection control.

Experience in the treatment of arterial embolism of the extremities, report of 536 cases / 中华普通外科杂志

Objective To evaluate the treatment for acute embolism in the extremities and define the primary factors affecting the prognosis. Methods From December 1984 to December 2006,536 patients with acute embolism of extremities were treated. Embolectomy with Forgarty catheters were performed in 507 cases, including salvage surgery in 34 cases and conservative therapy in 29 cases. Results The cure rate, mortality and amputation rate were 76.68%,9.51% and 10.26% respectively. Embolism recurred in 11.7% cases. Cardiopulmonary (27.5% ) and renal failure ( 25.5% ) were main causes of death during perioperative period. No bleeding nor other major complications occurred in 221 patients with atrial fibrillation who routinely received wafarine under proper monitoring. About 25.6% patients underwent heart valves surgery during hospitalization or within one year after discharge. Conclusions Patients suffering from acute embolism of the extremities should receive combination treatment. The main factors affecting the prognosis include time and degree of ischemia, and ischemia-reperfusion injury. Anticoagulant and etiologic treatment should be adopted in those with cardiogenic embolus and atrial fibrillation.

The management and prevention of acute abdominal aortic occlusion and myonephropathic metabolic syndrome / 中华胸心血管外科杂志

Objective: To summarize the experience in the management of acute abdominal aortic occlusion and myonephropathic metabolic syndrome. Methods: Thirty two cases of acute abdominal aortic occlusion treated between Aug. 1987 and Aug. 2003 in this department were analyzed retrospectively. Results: There were 11 deaths in surgical group (36 6%), mainly due to acute renal failure, metabolic acidosis and hyperkalemia postoperatively. Conclusion: Acute abdominal aortic occlusion is a potentially lethal disease, which would lead to limb. Early diagnosis and surgical restoration of aortic circulation might be helpful decrease the morbidity and mortality. The effective management of myonephropathic metabolic syndrome (MNMS), a common and severe complication of AAO would have a great impact on the therapeutic outcome. However, the mechanism, prevention and treatment of this syndrome further study.

Transiently expressed muscle nicotinic acetylcholinereceptors in HEK293 cells / 中国药理学通报

Aim Expressing muscle acetylcholin e receptors in mammallian cells using receptor clone technique.Methods The cDNA coding for the ?,?,?, ?,?-subunits of the mouse muscle nAC hR in pSP65, pSP64,pBS SK(-) are subcloned into pcDNA3.1+ by gene recobinant technique and then transfect HEK293 cells using lipofection technique.The ?-n AChR and ?-nAChR are transiently expressed in HEK293 cells membrane. Recording the response of transfected HEK293 cells to acetylcholine by using the whole- cell clamp technique.Results Transfected HEK293 cells may produ ce a inward current as appling acetylcholine.The current values are acctylcholin e-concentration-dependent.Conclusion ?-nAChR or ?-nAChR i s expressed successfully in HEK293 cells.

The treatment of acute infrarenal abdominal aorta occlusion / 中国普通外科杂志

Objective To sum up the experience in the management of acute infrarenal abdominal aorta occlusion. Methods We retrospectively analyzed 34 cases of acute infrarenal abdominal aorta occlusion treated during a period of 18 years. Cell saver was used intraoperatively in five cases.Results Twelve cases died postoperatively in this group (35 3%), with acute post operative renal failure, metabolic acidosis and hyperkalemia being the main causes of death. No acute renal failure and metabolic acidosis occurred in all cases treated by cell saver during operation. Limbs were salvaged in 36 out of 44 extremities of patients surviving the surgical procedure. ConclusionsPrompt diagnosis, proper surgery and correct management of post operative complications are necessary to decrease mortality. Perioperative application of cell saver is recommended to eliminate metabolic wastes from the body.

Axillofemoral bypass for the treatment of chronic severe lower limb ischemia / 中国普通外科杂志

ObjectiveTo evaluate axillofemoral bypass(AxFB) for the treatment of chronic severe lower limb ischemia. Method Consecutive AxFB performed in Anzhen Hospital from January 1995 to November 2002 was retrospectively analysed, with 31 patients of aortoiliac occlusive disease undergoing axillobifemoral bypass (AxBFB) and 32 axillounifemoral bypass(AxUFB) respectively. Result On discharge, rest pain disappeared in 44 cases and intermittent claudication in 19 cases, with average ankle/brachial index changing from preoperative 0.18(0～0.49) to postoperative 0.68(0.29～1.04). Rate of limbs salvage was 87.4%, amputation rate was 7.9%. Three cases died with a perioperative mortality of 4.8%. The patency rate of 1,3,5 years were 93.2%,79.8% and 64.1%, respectively. Conclusion AxFB for aortoiliac occlusive disease is considered to be acceptable procedure in high-risk patients with poor femoral run-off and chronic critical lower limb ischemia.

Diagnosis and treatment of acute lower extremity arterial injury:experience of 125 cases / 中国普通外科杂志

Objective To sum up the experience in the diagnosis and management of acute lower extremity arterial injury.Methods Between Jan 1988 and Feb 2004,125 cases of lower limb arterial injuries were admitted and undergoing surgery, including gunshot in 3 cases, blunt trauma in 56 and stabbing in 66 cases. Associated injuries included bony injury in 36 cases, nerve injury in 11 cases, and vein injury in 23 cases. Arterial primary or patch repair was performed in 28 cases, end-to-end anastomosis in 37 cases, saphenous vein graft used in 32 cases, prosthetic graft bypass in 23 cases, thrombectomy in 2 cases and blood vessel ligation in 3 cases.Results Limb salvage rate was 85.6% and patient survival of 98.4%. Massive bleeding and multiple organ failure caused mortality in one each. The rate of amputation is 10.4%(13/125), with preoperative gangrene being present in 8 cases.Conclusion Lower extremity arterial injury carries a high amputation rate. The use of Doppler scanner is helpful for early diagnosis. An ankle/brachial index of less than 1 in the affected limb was considered as a positive sign of arterial injury. Prompt revascularization and early fasciectomy are important to reduce amputation rate and mortality.

Experience in the management of extensive small bowel necrosis from acute superior mesenteric arterial embolism: report of 7 cases / 中国普通外科杂志

Objective To summarize our experience in the management of extensive small bowel necrosis from acute superior mesenteric arterial (SMA) embolism. MethodsSeven cases with extensive small bowel necrosis from acute SMA embolism were treated from 1991 to 1999. Results In this group small bowel of 28～ 30 cm and 70～90 cm were remained respectively in 3 and 4 cases after surgery. Two patients died of septic shock while the other 5 developed short or ultra short bowel syndrome and were finally cured by means of combined intravenous nutrition and oral feeding. 5 patients were followed up for 18～36 months, all are in good health. Conclusions Timely diagnosis and prompt operation are important to elevated survival rate. SMA embolectomy helps in preserving living intestine. For patients with short or ultra short bowel syndrome, comprehensive measures of intravenous nutrition and stepwise oral feeding in combination can quickly restore digestive and absorptive function of the residual intestine.

Surgical management for ruptured aortoiliac artery / 中国普通外科杂志

Objective To evaluate surgical therapy for ruptured aortoiliac artery. Method Between Apr 1984 and Dec 2003, 23 patients of ruptured aortoiliac artery were admitted with ruptured aortoiliac artery aneurysm in 18 cases and traumatic artery rupture in 5 patients. Two patients were treated with direct vascular repair and 21 patients underwent prosthetic grafts replacement. Result Four cases died perioperatively including 2 patients dying of acute renal failure, one of upper gastrointestinal heamorrhage caused by stress ulcer at 48 h after operation, and one of respiratory failure in 72 h. Conclusion Based on the etiology emergency operations should be performed on patients of ruptured aortoiliac artery by repairing or prosthetic grafts replacement.