Ultrasound guided popliteal vein catheter thrombolysis for acute lower extremity deep venous thrombosis / 中华普通外科杂志

Objective To evaluate the feasibility and efficacy of ultrasound-guided popliteal vein catheter thrombolysis for acute deep venous thrombosis of the lower extremity.Methods Clinical data were retrospectively analyzed on 120 patients of unilateral acute lower extremity deep vein thrombosis from April 2010 to April 2013.60 cases were included in systemic thrombolytic group; 60 cases into catheter directed thrombolysis group.Thrombolysis rate and limb swelling reduction rate were calculated and compared between the two groups.Results Due to limb swelling rate,in systemic thrombolysis group:Thigh swelling reduction rate was (77 ± 9) ％ ; Leg swelling reduction rate was (70 ± 11) ％,while in catheter directed thrombolys group,that was (87 ± 5) ％,and (80 ± 9) ％,respectively (P ＜ 0.05).The thrombolysis rate in systemic group was (59 ± 14)％,that was (71 ± 13)％ in catheter directed thrombolysis group (P ＜ 0.05).Conclusions Ultrasound guided precutaneous catheter popliteal vein thrombolysis significantly improves the short-term outcome of deep venous thrombosis in terms of leg swelling reduction rate and thrombolysis reduction rate.

Expression and significance of SM22α and α-SMA in varicose veins / 中华普通外科杂志

ObjectiveTo explore the relationship between the expression of smooth muscle 22 alpha ( SM22α),α-smooth muscle actin (α-SMA) and the development of varicose veins of the lower extremities. MethodsWe collected tissues of varicose saphenous vein in the experimental group,and what left over of normal saphenous vein tissues harvested for a coronary bypass operation ( control group).RT-PCR were applied to investigate the expression level of SM22αmRNA and immunohistochemical techniques were applied to investigate the expression level of SM22α and α-SMA protein in normal and varicose veins.ResultsThe expression level of SM22α mRNA in normal and abnormal veins was 0.2614 ±0.1168 and 0.5114 ± 0.1554 respectively ( t =5.020,P ＜ 0.01 ).The immunohistochemical staining showed that signals of SM22α and α-SMA protein existed in the cytoplasm of smooth muscle cells.The integrate optical density (IOD) of SM22α in normal and abnormal veins was 10 055 ± 3584 and 16 226 ± 3378 respectively ( t =4.991,P ＜ 0.01 ).The IOD of α-SMA in normal and abnormal veins was 9746 ± 3903 and 15 371 ± 4318 respectively (t =3.861,P ＜ 0.05 ). ConclusionsSM22α and α-SMA was down-regulated in varicose veins,indicating that the VSMC had transformed the typical contractile phenotype into the typical synthetic phenotype.Phenotype changes of VSMC further promote venous wall remodeling leading to the occurrence of varicose veins.