Postoperative complications of endovascular repair of abdominal aortic aneurysms in poor-risk patients / 中华普通外科杂志

Objective To review the complications after endovascular aneurysm repair (EVAR) of high-risk abdominal aortic aneurysms in our medical center.Methods Fifty eight elective high-risk EVAR cases from January 2008 to December 2013 were analyzed retrospectively.Results The technical success rate was 96.6％ (56 of 58 patients).The overall complication rate in perioperative period was 32.8％ (19/58).Eleven systemic complications (19.0％),16 primary endoleaks (27.6％),7 access of site complications(12.1％) were observed.The follow-up rate was 86.2％ (51/58).During the follow up period,the mortality was 7.8％ (4/51),the re-intervention rate was 7.8％ (4/51).The overall complication rate was 29.4％ (15/51),including systemic complications (2/51),secondary endoleak (9.8％) and graft-related complications (11.8％,6/51).Conclusions Endoleak,graft-related complications continue to be the main causes of re-intervention in high-risk aneurysm patients after EVAR.

Pulmonary embolism after greater saphenous vein ligation and stripping / 中华普通外科杂志

Objective To analyze characteristics and prophylaxis of pulmonary embolism (PE) after greater saphenous vein ligation and stripping.Methods We retrospectively analyzed the clinical characteristics and treatment of 11 inpatients with postoperative PE in Anhui Provincial Hospital and other hospitals from January 2008 to June 2013.Results In this group 6 patients died after failed cardiopulmonary resuscitation (CPR) and other treatments,the mortality was 54.5％.5 patients recovered after anticoagulation,thrombolysis and other treatments.During the process of thrombolysis,floating thrombus was found within the femoral vein in 2 patients and inferior vena cava filter was implanted.After 8-25 months follow-up,all 5 patients were free of difficulty of breathing,chest tightness,chest pain and other symptoms.Among many clinical manifestations,dyspnea (90.9％) was the most common,other clinical manifestations included chest pain (27.3％),syncope (18.2％),sudden death (18.2％).There was no typical triad of dyspnea,chest pain and hemoptysis in these patients.Conclusions Early diagnosis and early treatment of PE are most important to decrease mortality and to improve the prognosis of patients suffering from postoperative PE.

Dual role of dendritic cells in the pathological mechanism of atherosclerosis / 国际外科学杂志

Atherosclerosis is a chronic inflammatory immune disease,which is one of the causes of human lower limb disability.Dendritic cells are the most powerful professional antigen presenting cell in immune system,and dendritic cells have the dual role of immunogenicity and tolerability.As a professional antigen presenting cell,the immunogenicity of dendritic cells present self abnormal antigen and course immune system disorder,which may be one role of dendritic cells participate in atherosclerosis.However,the tolerability of dendritic cells can course the generation of immune tolerance,which makes dendritic cells exert a regulatory role in atherosclerosis.This paper makes an introduction about how dendritic cells are involved and play a regulatory role in the pathogenesis of atherosderosis.

Subintimal angioplasty true lumen re-entry technology in the treatment of lower limb atherosclerosis obliterans / 国际外科学杂志

Subintimal angioplasty had been widely used in the intervention of lower extremity arterial obliterans disease in recent years.True lumen re-entry is the key to subintimal angioplasty.This comprehensive exposition of the true lumen re-entry can improve the chances of ultrasound and subintimal arterial flossing with antegraderetrograde intervention and catheter systems and other emerging technologies in the application of subintimal angioplasty,and various types of technology advantages and disadvantages.

SDF-1 combined with peripheral blood endothelial progenitor cells transplantation for the treatment of hindlimb ischemia in nude mice / 中华普通外科杂志

Objective To explore the effect of stromal cell-derived factor-1 ( SDF-1 ) in combination with transplantation of peripheral blood endothelial progenitor cells (EPCs) for the treatment of nude mice hindlimb ischemia. Methods Hindlimb ischemia model was established in nude mice, mice were then divided into five groups randomly: ischemic control group, peripheral blood EPCs transplantation group, SDF-1 local application group, SDF-1 combined with EPCs group, SDF-1 combined with AMD3100 treated EPCs group. Local CD34+VEGFR+ cells in the hind gastrocnemius were detected at day 3,7 after transplantation. The intensity of neovasculorization were evaluated at day 28. Results The double-positive cells number of control group, EPCs group, SDF-1 group, SDF-1 + EPCs group, SDF-1 + AMD3100 EPCs group were 0.00 ±0.00,5. 30 ±0.65,0.00 ±0.00,10. 31 ±0. 63,1. 86 ±0. 17 at day 3 and 0. 00 ±0. 00, 7.05 ±0. 18,0. 00 ±0. 00,11. 81 ±0. 53,2. 83 ±0. 48 at day 7. The number of new capillaries were 3. 00 ± 0.13,6.15 ± 0. 04,6. 20 ± 0. 10,10. 65 ± 0.08,6. 21 ±0. 08 at day 28. SDF-1 increased the CD34 + VEGFR+ cells (P ＜0. 05) and the number of new vessels (P ＜0.05). SDF-1 combined EPCs further increased the number of new vessels (P ＜ 0. 05 ). Conclusions SDF-1 enhances blood vessel formation and promotes angiogenesis by promoting EPCs homing, which could be blocked by AMD3100.

Research contents and performance evaluation of tissue engineered blood vessels / 国际外科学杂志

Cardiovascular disease is a frequently-occurring disease of human society, each year many patients in need of vascular graft surgery. The emergency and application of tissue engineered blood vessels, in particular the application of nanomaterials, will hopefully solve the problem of vascular sources. Here this article reviews the research contents and performance evaluation of tissue engineered blood vessels.

Endothelial progenitor cells in the treatment of lower extremity ischemic disease / 国际外科学杂志

With the population aging, diet changing and incveasing risk factors on vascular disease, the lower extremity ischemic disease has become a frequently occurring disease of older person, and it is the main reason for amputation disability. In the 21st century the stem cells transplantation is one of the most advanced technologies and has been applied quickly to clinical therapy, regarded as a radical treatment of lower extremity ischemic disease. Endothelial progenitor cells have gradually become a new direction and a new research focus because of its unique biological characteristics in the treatment of this disease. This article focuses on endothelial progenitor cells in treating extremity ischemia lesions on the theoretical basis and research developments.

Endothelial progenitor cells and vascular restenosis after interventional treatment / 国际外科学杂志

Restenosis after interventional treatment is the major factor infheneing the result of percutaneous transluminal angioplasty, and it is a hot and difficult research in recent years. Endothelial progenitor cells are a class of proliferation and able to differentiate into vascular endothelial precursor cells, and take part in the repair and angiogenesis after endothelial injury-intimate. It is expected to play an important role in the prevention of vascular restenosis after interventional treatment. In this article, we reviewed the endothelial progenitor cell research overview and advances of prevention of restenosis after interventional therapy in recent years.

The effect of TFPI-2 gene on apoptosis of pancreatic cancer cell / 中国癌症杂志

Background and purpose: TFPI-2 is a new serine proteinase inhibitor,it is related to many tumors.In this study,the effect of TFPI-2 gene on cell proliferation and apoptosis of human pancreatic cancer cell line Panc-1 were investigated.Methods:The growth curve was drawn for the 3 groups,Panc-1-TFPI-2、Panc-1-V and Panc-1.DNA strand breaks were used to detect the apoptosis of the 3 groups,and the change of cell cycle and apoptosis index was evaluated by flow cytometry.Results:Compared with nontransfected cells,the growth of Panc-1 cell transfected with TFPI-2 was inhibited significantly.The transfected cells showed a significant increase in G1/G0 phase.The apoptosis of Panc-1-TFPI-2 cell could be identified by DNA strand breaks and flow cytometry in comparison with the control group.The apoptosis index of the Panc-1-TFPI-2 cell(6.9?0.5)% was higher than the group Panc-1-V and group Panc-1[(3.0?0.4)% and(3.5?0.4)%]P

Percutaneous Transluminal Angioplasty and Stent Placement for the Treatment of Long Segmental Atherosclerotic Occlusive Disease of Lower Limb / 医学研究杂志

Objective To evaluate the clinical effects of endovascular angioplasty and stenting for the treatment of TASC B,C arteriosclerotic occlusion(ASO) of lower extremity.Methods After the identification of the occlusion by angiography via femoral artery access by Seldinger method,the occluded arteries (mean length 7.5cm; range 1~20 cm) in 40 patients(47limbs) were treated by percutaneous transluminal angioplasty and stent placement. Results The primary recanalization was successful in 45 of 47 limbs. The technical successful rate was 96%. Thirty one self-expanding stents were deployed. PTA without stent placememt was performed in 16 limbs(of them,11 were blow knee).The ankle brachial pressure index (ABI) increased from (0.36?0.14) preoperatively to (0.82?0.15) on the 7th postoperative day. All patients were follow-uped for 1 to 48 months. Stents were occluded in 4 patients. Restenosis was observed in 1 limbs. All of the rest remained patent in the follow-up period.Conclusion Endovascular angioplasty and stenting can be an effective method for the treatment of long segmental (including below-knee) arteriosclerotic occlusion of lower extremities.

Effect of Recombinant Tissue Factor Pathway Inhibitor 2 Gene on The Invasion of Human Pancreatic Cancer in Vitro and in Vivo / 中国普外基础与临床杂志

Objective To investigate the invasion ability of Panc-1 cells in vivo and in vitro after being transfected with tissue factor pathway inhibitor 2 gene(TFPI-2).Methods The expression vector pEGFP-C1-TFPI-2 was transfected into human pancreatic cancer line Panc-1 cells by using liposome.TFPI-2 mRNA and protein of transfected and nontransfected cells were detected by reverse transcription-polymerase chain reaction(RT-PCR)and Western blot respectively.The tumor cells invasive behavior of transfected(Panc-1-TFPI-2)and nontransfected(Panc-1-V and Panc-1-P)cells were assessed in vitro through Boyden Chamber method.The transfected and nontransfected cells were implanted into nude mice to observe its growth and metastasis in vivo.Results Expressions of mRNA and protein of TFPI-2 were confirmed in transfected cells.After TFPI-2 transfection,the number of Panc-1-TFPI-2,Panc-1-V and Panc-1-P cells passing through membrane of Boyden Chamber were 24.4?3.5,61.3?4.1 and 60.2?3.9,respectively.The number of TFPI-2-expressing cells to traverse a Matrigel-coated membrane was obviously decreased compared with that of non-expressing cells,the invasion ability was lower than that before transfection in vitro.The subcutaneous tumor volume of the Panc-1-TFPI-2 group was(438.0?69.8)mm3,the Panc-1-V group was(852.0?102.9)mm3 and the Panc-1-P group was(831.0?78.1)mm3,P

An experimental study on the role of CTLA4Ig gene transfected DCs in the induction of immune tolerance / 中华器官移植杂志

Objective To investigate the possibility of DCs transfected with CTLA4Ig cDNA by retrovirus vector to induce antigen specific hyporesponsiveness.Methods The modified DCs(CTLA4Ig-DCs) were prepared by transferring the DCs from cultured rat BM cells with the constructed retro-virus CTLA4Ig vector.The CTLA4Ig gene expression was detected on the prepared DCs by RT-PCR and Dot-ELISA methods.The influence of the modified DCs on mixed lymphocyte reaction(MLR) intensity was determined by T cell proliferation.Results The CTLA4Ig gene could be transferred successfully to DCs by retrovirus vector,which was confirmed by RT-PCR and Dot-ELISA methods.As compared with control group,DCsRev could significantly and antigen-specifically inhibit MLR in vitro in a dose-and time-dependent manner.The number of DCRev from 10~(3) to 10~(4) could reach the maximal inhibition by(69.12 %).On the other hand,the inhibition capacity of DCsRev was increased from(48 h) to 12 h prior to adding stimulating cells and the maximal inhibition was(98.3 %) at(12 h).Analysis of T cell proliferation revealed that donor-specific inhibition could be induced by DCsRev in an ex-vivo model.But this kind of inhibition was not lifetime.Conclusions The CTLA4Ig gene could be transferred successfully to DCs by retrovirus vector.This kind of DCs lost capacity of stimulating MLR,and could inhibit T cell proliferation,which might be responsible for the antigen-specific suppression induced by DCsRev.

Clinical significance of spontaneous shunt of omentorenopexy in the treatment of portal hypertension / 中国普通外科杂志

0.05 ). The rate of hypertensive gastropathy, compared with PCDV (66.74%), was significantly attenuated in patiens who underwent PCDV+ORP (22.78%, P

Single balloon dilatation and placement of stent in the treatment of Budd Chiari syndrome / 临床外科杂志

Objective To evaluate single balloon dilatation and placenment of the stent for the treatment of Budd Chiari Syndrome.Methods Thirty four patients with Budd Chiari Syndrome underwent covagraphy catheterized through superior and inferior vena cava (IVC) simultaneously and single balloon dilatation of IVC and placement of metallic stents.Results Puncture and dilatation were successful in 33 patients.The obstructed segments of IVC were dilated to 10～20 mm in diameter.Nine metallic stents were placed in 9 cases. The caval pressure below obstruction were reduced from(2.71?0.78) kPa to(1.98?0.85) kPa in average.Conclusions Covagraphy catheterized through superior and inferior vena cava (IVC)simultaneously reveals the site and length of the obstruction clearly.Insertion of large single balloon is technically simple and dilatation is definite.Restenosis in segmental type may be prevented by stent insertion.