Genomic epidemiology of Vibrio parahaemolyticus from acute diarrheal patients in Shenzhen City from 2013 to 2021 / 中华预防医学杂志

Objective: To characterize the prevalence and genomic epidemiology of Vibrio parahaemolyticus from acute diarrheal patients in Shenzhen City from 2013 to 2021. Methods: Based on the Shenzhen Infectious Diarrhea Surveillance System, acute diarrheal patients were actively monitored in sentinel hospitals from 2013 to 2021. Whole-genome sequencing (WGS) of Vibrio parahaemolyticus isolates was performed, and the genomic population structure, serotypes, virulence genes and multilocus sequence typing were analyzed. Outbreak clusters from 2019 to 2021 were explored based on single-nucleotide polymorphism analysis. Results: A total of 48 623 acute diarrhea cases were monitored in 15 sentinel hospitals from 2013 to 2021, and 1 135 Vibrio parahaemolyticus strains were isolated, with a positive isolation rate of 2.3%. Qualified whole-genome sequencing data of 852 isolates were obtained. Eighty-nine serotypes, 21 known ST types and 5 new ST types were identified by sequence analysis, and 93.2% of strains were detected with toxin profile of tdh+trh-. 8 clonal groups (CGs) were captured, with CG3 as the absolute predominance, followed by CG189. The CG3 group was dominated by O3:K6 serotype and ST3 sequence type, while CG189 group was mainly O4:KUT, O4:K8 serotypes and ST189a and ST189 type. A total of 13 clusters were identified, containing 154 cases. About 30 outbreak clusters with 29 outbreak clusters caused by CG3 strains from 2019 to 2021. Conclusion: Vibrio parahaemolyticus is a major pathogen of acute infectious diarrhea in Shenzhen City, with diverse population structures. CG3 and CG189 have been prevalent and predominant in Shenzhen City for a long time. Scattered outbreaks and persistent sources of contamination ignored by traditional methods could be captured by WGS analysis. Tracing the source of epidemic clone groups and taking precise prevention and control measures are expected to significantly reduce the burden of diarrhea diseases caused by Vibrio parahaemolyticus infection in Shenzhen City.

Value of different scoring models in predicting the survival of patients with liver cirrhosis after transjugular intrahepatic portosystemic shunt / 临床肝胆病杂志

Objective To compare the value of Child-Pugh score, Model for End-Stage Liver Disease (MELD) score, MELD combined with serum sodium concentration (MELD-Na) score, CLIF Consortium Acute Decompensation (CLIF-C AD) score, and Freiburg index of post-transjugular intrahepatic portosystemic shunt (TIPS) survival (FIPS) score in predicting the survival of patients undergoing TIPS. Methods A retrospective analysis was performed for the clinical data of 447 patients with liver cirrhosis who underwent TIPS in several hospitals in southwest China, among whom there were 306 patients in the survival group and 62 in the death group. The scores of the above five models were calculated, and a survival analysis was performed based on these models. The independent samples t -test was used for comparison of normally distributed continuous data between groups, and the non-parametric Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups; the Pearson chi-square test was used for comparison of categorical data between groups; a multivariate Cox regression analysis was used for correction analysis of known influencing factors with statistical significance which were not included in the scoring models; the Kaplan-Meier method was used to evaluate the discriminatory ability of each model in identifying risks in the surgical population, and the log-rank test was used for analysis. The area under the receiver operating characteristic curve (AUC), C-index at different time points, and calibration curve were used to evaluate the predictive ability of each scoring model. Results Compared with the death group, the survival group had significantly lower age ( Z =2.884, P < 0.05), higher albumin ( t =3.577, P < 0.05), and Na + ( Z =-3.756, P < 0.05) and significantly lower proportion of patients with alcoholic cirrhosis ( χ 2 =22.674, P < 0.05), aspartate aminotransferase ( Z =2.141, P < 0.05), prothrombin time ( Z =2.486, P < 0.05), international normalized ratio ( Z =2.429, P < 0.05), total bilirubin ( Z =3.754, P < 0.05), severity of ascites ( χ 2 =14.186, P < 0.05), and scores of the five models (all P < 0.05). Survival analysis showed that all scoring models effectively stratified the prognostic risk of the patients undergoing TIPS. Comparison of the C-index of each scoring model at different time points showed that Child-Pugh score had the strongest ability in predicting postoperative survival, followed by MELD-Na score, MELD score, and CLIF-C AD score, and FIPS score had a relatively poor predictive ability; in addition, the prediction efficiency of each score gradually decreased over time. Child-Pugh score had the largest AUC of 0.832 in predicting 1-year survival rate after surgery, and MELD-Na score had the largest AUC of 0.726 in predicting 3-year survival rate after surgery, but FIPS score had a poor ability in predicting 1- and 3-year survival rates. Conclusion All five scoring models can predict the survival of patients with liver cirrhosis after TIPS and can provide effective stratification of prognostic risk for such patients. Child-Pugh score has a better ability in predicting short-term survival, while MELD-Na score has a better ability in predicting long-term survival, but FIPS score has a relatively poor predictive ability in predicting both short-term and long-term survival.

Review of traditional Chinese medicines in ameliorating neuropsychiatric diseases by improving the levels of monoamine neurotransmitters via gut microbiota regulation / 中国中药杂志

The degeneration of monoaminergic system and the reduction of monoamine neurotransmitters(MNTs) are associated with the occurrence of a variety of neuropsychiatric diseases, becoming the key indicators for clinical diagnosis and treatment. Recent studies suggested gut microbiota could influence the occurrence, development, and treatment of neuropsychiatric diseases by directly or indirectly regulating the synthesis and metabolism of MNTs. Rich clinical experience has been accumulated in the amelioration and treatment of neuropsychiatric diseases by traditional Chinese medicines. The traditional oral administration method demonstrates obvious advantages in regulating gut microbiota. It provides a new idea for explaining the pharmacodynamic material basis and mechanism of traditional Chinese medicines in ameliorating neuropsychiatric disease by improving the levels of MNTs via gut microbiota regulation. Focusing on three common neuropsychiatric diseases including Alzheimer's disease, Parkinson's disease, and major depression, we summarized the pathways of gut microbiota in regulating the levels of MNTs and the paradigms of traditional Chinese medicines in ameliorating neuropsychiatric diseases via the "bacteria-gut-brain axis", aiming to provide ideas for the development of drugs and treatment schemes.

Advances in application of regulatory T cells in transplant immune tolerance: from basic to clinical research / 器官移植

Regulatory T cells (Treg) are important inhibitory immune cells to establish immune tolerance, which play a pivotal role in regulating excessive immune response and autoimmune diseases of the host. Previous studies related to transplant immune tolerance have confirmed that increasing the number of Treg in vivo or enhancing the function of Treg serve as a therapeutic strategy to induce transplant immune tolerance. At present, Treg-based induction methods for transplant immune tolerance include adoptive infusion of Treg, in vivo amplification of Treg and utilization of antigen-specific Treg. In this article, the characteristics and mechanism of Treg, the latest research progress on basic experiments and clinical practice of Treg related to transplant immune tolerance at home and abroad were reviewed, and future challenges and development of Treg therapy were prospected, aiming to unravel the significance and application prospect of Treg in transplant immune tolerance, explore the advantages and limitations of Treg therapeutic strategies, and provide reference and evidence for subsequent research in this field.

The repellent effect of tea tree oil emulsion on leeches / 药学学报

Leech bites usually lead to more bleeding, and dermal tissue is damaged to form lifelong scars. If leeches enter the body cavity, it will be more dangerous. Therefore, there is an urgent need to develop effective repellents. In this study, oil in water (O/W) emulsion of tea tree oil was prepared with tea tree oil as the main ingredient, and konjac glucomannan (KGM), ethyl cellulose (EC) as the main excipients. The filter-paper ring method and repellent test in water were used to evaluate the repellent effects on leeches. The animal experiments were approved by the Ethics Committee of Academy of Military Medical Sciences and were conducted in accordance with relevant guidelines and regulations. The activities of acetylcholinesterase (AchE), glutathione S-transferase (GST) and carboxylesterase (CarE) in vivo were measured to clarify the repellent mechanisms. The results showed that a uniform and stable tea tree oil emulsion was successfully prepared, which has excellent hydrophilicity and can effectively repel leeches. The tea tree oil emulsion has a good repellent effect on leeches, which can avoid the volatilization of tea tree oil and prolong the effective repelling time. The novel formulation of tea tree oil provides a new idea for repelling effects with long time and high efficiency based on similar essential oil.

Anti-FGF-2 nanobody inhibits rat corneal angiogenesis induced by alkali burn / 中国临床药理学与治疗学

AIM: To investigate the possible use of anti-FGF-2 nanobody for the treatment of pathological neovascularization. METHODS: SD rats were divided into a sham operation group, a control group (3 mm diameter circular filter paper soaked with 1 mol/L NaOH solution was applied to the central part of the cornea of rats for 30 s to prepare the rat model of alkali-burn angiogenesis) and a treatment group (treated with a drop of 3 mg/mL anti-FGF-2 nanobody 7 days after the operation. Repeat application 3x/day for 14 days). Corneal angiogenesis was measured by stereoscopic microscopy and CD31 immunohistochemical staining. The mRNA and protein expression levels of VEGF and FGF-2 were detected by quantitative fluorescence PCR (qPCR), enzyme-linked immunosorbent assay (ELISA) and immunohistochemistry.RESULTS: (1) Blood vessel: The area of the treatment group was significantly reduced compared with the model group, and the vascular lumen was narrower (P0.05); (3) Expression levels of VEGF mRNA and protein: The treatment group was significantly higher than the model group (P<0.05). In addition, the expression of VEGF also increased significantly in the continuous administration of the sham operation group. CONCLUSION: Anti-FGF-2 nanobody can be used for the treatment of angiogenesis. However, the expressions of VEGF will compensatorily increase after blocking FGF-2 in normal or pathological rats.

Review of key contents published in Chinese Journal of Trauma in 2019 / 中华创伤杂志

There published 186 papers in Chinese Journal of Trauma in 2019. The yearly monographic topic was concentrated in spine and spinal cord injuries, involving 54 papers covering basic, clinical and rehabilitative studies. The columns mainly included Forum for Academician, Consensus and Guidelines, Trauma Center Construction, Special Monograph for 70th Anniversary of the Founding of People's Republic of China, Spine and Spinal Cord Injuries, Posttraumatic Bone Infection, Trauma Nursing and Basically Scientific Research. The authors introduce the key contents so as to help readers deepen their understanding of the publication and academic orientation of the Chinese Journal of Trauma.

Research Progress on Chemical Constituents and Pharmacological Effects of Piperis Fructus / 中国实验方剂学杂志

Piperis Fructus is the dried nearly ripe or ripe fruit of Piperaceae, which is an important spice material and a traditional Chinese medicine (TCM), it is widely used in the world. It is recorded to possess the efficacy of warming spleen and stomach for dispelling cold, depressing Qi and dissolving phlegm. Piperis Fructus mainly contains amide alkaloids with piperine as the main ingredient and volatile oil dominated by monoterpenoids and sesquiterpenoids, which have a wide range of biological activities, such as anti-cancer, anti-oxidation, anti-inflammatory, etc. By referring to relevant papers at home and abroad, the researches on chemical compositions from different parts and pharmacological effects of Piperis Fructus in recent 5 years were summarized and analyzed. It was found that Piperis Fructus has great potential for drug development as a TCM with homology of medicine and food, which can provide a reference for further research and comprehensive utilization of Piperis Fructus.

Review of key contents published in Chinese Journal of Trauma in 2019 / 中华创伤杂志

There published 186 papers in Chinese Journal of Trauma in 2019.The yearly monographic topic was concentrated in spine and spinal cord injuries,involving 54 papers covering basic,clinical and rehabilitative studies.The columns mainly included Forum for Academician,Consensus and Guidelines,Trauma Center Construction,Special Monograph for 70th Anniversary of the Founding of People's Republic of China,Spine and Spinal Cord Injuries,Posttraumatic Bone Infection,Trauma Nursing and Basically Scientific Research.The authors introduce the key contents so as to help readers deepen their understanding of the publication and academic orientation of the Chinese Journal of Trauma.

Review of the main papers published in Chinese Journal of Trauma in 2018 / 中华创伤杂志

There published papers in Chinese Journal of Trauma in 2018.The yearly monographic topic is concentrated in sports injury.The author reviews the main research progress of papers from following aspects:Forum for Academician,Expert Consensus,Innovation and Contention,Military Medicine,Monographic Topic,Trauma Nursing,Basically Scientific Research so as to facilitate the readers' understanding of the journal.

Design and implementation of infusion monitoring system based on improved capacitance detection method / 医疗卫生装备

Objective To design a high-performance, reliable and practical wireless infusion monitoring system to realize automated infusion monitoring.Methods The system was composed of an infusion monitor,an intelligent gateway and a host computer, which used AD7746 chip to monitor the electric capacity, I2C serial bus for capacity-related data readback, CC2530 SCM for difference calculation and infusion state determination, and ZigBee technology to execute wireless data transmission at real time.Results The system carried out multi-node monitoring on volume and velocity at real time,and the acquired data were accurate and reliable.Conclusion The system gains advantages over the traditional ways in practicability and reliability when used for infusion monitoring.

The value of HDL particles,the concordance of HDL-C and apoA-Ⅰ in assessing the severity of coronary artery disease / 实用医学杂志

Objective The study was to analyze the relationship between HDL particles,the level of HDL-C and the concordance of HDL-C and apoA-Ⅰand the degree of coronary stenosis,then to explore their values in predicting coronary artery disease.Methods 591 patients were collected for coronary angiography,and calculated Gensini score respectively.HDL particles and the level of HDL-C,apoA-Ⅰwere analyzed in coronary artery disease (CAD)group and non-CAD group,stable angina pectoris(SAP)group and acute coronary syndrome(ACS)group and four groups divided by quartile of Gensini score(A,B,C,D).To investigate the relationship between the con-cordance of HDL-C and apoA-Ⅰand the severity of coronary artery disease,HDL-C,apoA-Ⅰwere divided into low and high group according to the 50 percentile,then pair wise combination was done into four groups. Results Compared with non-CAD group,HDL particles,the level of HDL-C,apoA-Ⅰwere significantly reduced in CAD group(P<0.001).Compared with SAP group,similar results were found in ACS group.HDL particles,the level of HDL-C,apoA-Ⅰwere decreased gradually in A,B,C,D group(P<0.001).The concordance of HDL-C and apoA-Ⅰwas related to the risk of CAD(P<0.001).The area under curve(AUC)of HDL particles was higher than that of HDL-C,the concordance of HDL-C and apoA-Ⅰ.Conclusions HDL particles,HDL-C,the concordance of HDL-C and apoA-Ⅰwere related to coronary stenosis.The value of HDL particles in predicting CAD risk was su-perior to that of HDL-C,the concordance of HDL-C and apoA-Ⅰ.

Diagnosis related groups technology as used in hospital management / 中华医院管理杂志

The diagnosis related groups( DRGs) method is applied in hospital management at both hospital and clinical department level. This technology enabled us to evaluate hospital medical services in general, objectively evaluate discipline development, and formulate individualized discipline guidelines, supporting scientific distribution of hospital resources. At the department level, the technology supported clinical departments in their discipline construction and quality management. The application of DRGs can improve fine management of hospitals.

Effect and mechanism study of PSRC1 overexpression on foam cell formation of RAW264.7 / 实用医学杂志

Objective To investigate the effect and potential mechanism of PSRC1 overexpression on foam cell formation of oxidized low-density lipoprotein(ox-LDL)-induced RAW264.7. Method After 48-h treat-ment of 100 μg/ml ox-LDL,changes of the accumulation of cholesterol esters in two groups was detected by oil red O staining.The protein expression of SR-AⅠand LDLR was detected by Western blot assay.Besides,ELISA was used to detect levels of IL-6 and TNF-α.Result The accumulation of cholesterol esters was lower in Ad-PSRC1 group than that in Ad-GFP group(P<0.05). The protein expression of SR-AⅠand LDLR was decreased signifi-cantly(P<0.05),and levels of the secreted IL-6 and TNF-α were also significantly decreased(P<0.05).Con-clusion Our data indicates that PSRC1 overexpression suppresses the formation of foam cells through improving lipid metabolism and down-regulating inflammatory cytokine IL-6 and TNF-α in macrophages.

Risk factors associated with the severity of pulmonary embolism in patients with acute deep venous thrombosis of lower extremities / 中华外科杂志

<p><b>OBJECTIVE</b>To identify the risk factors associated with the severity of pulmonary embolism among patients with deep venous thrombosis of lower extremities.</p><p><b>METHODS</b>This prospective study enrolled 208 patients with acute deep venous thrombosis to screen for pulmonary embolism between July 2010 and July 2012 in Beijing Shijitan Hospital. There were 101 male and 107 female patients, with a mean age of (59 ± 16) years. Gender, age, extension, side of lower extremities of deep venous thrombosis was analyzed by χ² test. Ordinal Logistic regression was used to determine risk factors associated with severity of pulmonary embolism.</p><p><b>RESULTS</b>There were 83 patients with iliofemoral deep venous thrombosis, 102 patients with femoropopliteal and 23 patients with calf deep venous thrombosis. Pulmonary embolism was detected in 70 patients with the incidence of 33.7%. Pulmonary embolism was significantly correlated with extension (χ² = 17.286, P = 0.004) and sides (χ² = 15.602, P = 0.008) of deep venous thrombosis, not with age (χ² = 7.099, P = 0.260), gender (χ² = 7.014, P = 0.067), thrombotic risk factors (χ² = 3.335, P = 0.345) in univariate analysis. Results of multivariate ordinal logistic regression showed that iliofemoral vein thrombosis (OR = 6.172, 95% CI: 1.590 to 23.975, P = 0.009) and bilateral venous thrombosis (OR = 7.140, 95% CI: 2.406 to 24.730, P = 0.001) are associated with more serious pulmonary embolism.</p><p><b>CONCLUSIONS</b>Incidence of pulmonary embolism is still high in patients with deep venous thrombosis. Extensive iliofemoral and bilateral vein thrombosis may increase risk of severity of pulmonary embolism. Clinicians should pay more attention to these high-risk patients.</p>

Correlation Study on Chinese Medical Syndrome Types of Chronic Atrophic Gastritis Patients, Hp, and IL-1β Polymorphism / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To explore the correlation between Chinese medical (CM) syndrome types of chronic atrophic gastritis (CAG) patients and Helicobacter pylori (Hp) infection, polymorphisms of IL-1B, and IL-1β.</p><p><b>METHODS</b>Totally 192 CAG patients and 202 healthy subjects (as the healthy control group) were recruited in this case-control study. The Hp infection was tested by 13C-urea breath test and colloidal gold-labeled assay (GICA). The concentration of peripheral blood IL-1β was measured by ELISA. The polymorphisms of IL-1B gene in the promoter region were analyzed using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP).</p><p><b>RESULTS</b>Pi-Wei weakness syndrome (PWWS) was dominant in CAG patients (31.77%, 61/192 cases). The Hp infection ratio in CAG patients was 53.65% (103/192 cases), of which, Pi-Wei damp-heat syndrome(PWDHS, 64.86%, 24/37 cases) and Gan-Wei disharmony syndrome (GWDS, 66.67%, 24/36 cases) were dominant. Compared with the health control group, the plasma concentration of IL-1β was obviously elevated in CAG patients with PWDHS, GWDS, and static blood obstructing collaterals syndrome (SBOCS) (all P < 0.05). Additionally, there was no difference in the distribution of polymorphisms in the promoter region of IL-1 B gene between the CAG patients and the healthy control group (P > 0.05).</p><p><b>CONCLUSIONS</b>The incidence risk of CAG was not associated with IL-1B polymorphism. But CM syndrome types of CAG patients was associated with Hp infection and peripheral blood IL-1β levels.</p>

Changes of serum enzymes in acute mesenteric vasculopathy / 中华普通外科杂志

Objective To study changes of serum enzymes among acute mesenteric vasculopathy (AMV) and several surgical acute abdomens for early diagnosis of acute mesenteric vasculopathy.Methods Rabbit models were established for acute mesenteric artery ischemia,acute mesenteric venous ischemia,acute mechanical ileus,acute strangulated intestinal obstruction,acute gastric perforation,acute pancreatitis,sham group,blank control group.Serum enzymes were tested after 0,1,3,6,9 h.Result Compared with blank control,acute mesenteric vasculopathy experienced significantly alterations of the serum enzymes.ALT (alanine aminotransferase),ALP (alkaline phosphatase),r-GT (glutamyl transferthe enzyme) were significantly higher after mesenteric veins blocked 3 hours,LDH (lactate dehydrogenase) was significantly higher after mesenteric venous blocked 6 hours (P ＜ 0.05).ALT was significantly higher after mesenteric artery blocked 6 hours (P ＜ 0.05).Elevated ALT were statistically different in acute mesenteric vasculopathy compared with blank control,sham group,gastric perforation,mechanical ileus,and strangulated intestinal obstruction (all P ＜ 0.05) ; r-GT level was statistically different between acute mesenteric artery ischemia and acute mesenteric venous ischemia.Conclusions Mesurements of serum enzymes level are helpful to make early diagnosis of acute mesenteric vasculopathy.

The clinical significance of ultrasound guided biopsy of peritoneum in diagnosis of unexplained ascites / 重庆医学

Objective To investigate the clinical significance of ultrasound guided biopsy of peritoneum in diagnosis of unex-plained ascites .Methods A total of 95 patients with unexplained ascites after conventional examination were collected ,then under-went ultrasound inspection which showed thickened peritoneum and the relations to surrounding tissues around the planned perito-neum puncture point ,and conducted the peritoneal biopsy .Results A total of 95 were successfully biopsied with 2 -4 peritoneal tissues .Pathological examination showed that 37 cases (38 .9% ) were diagnosed as peritoneal metastatic carcinoma ,41 cases (43 . 1% ) with peritoneal tuberculosis ,5 cases (5 .2% ) with peritoneal mesothelioma ,1 case (1 .1% ) with eosinophilic granuloma ,4 ca-ses (4 .2% ) with fibrous hyperplasia ,and 7 cases (7 .4% ) with chronic inflammatory cell infiltration .The positive rate of ultra-sound guided peritoneal biopsy was 88 .4% .Conclusion The ultrasound guided biopsy of peritoneum is of clinically great signifi-cance in diagnosis of unexplained ascites .

A prospective randomized control clinical trial about clopidogrel combined with warfarin versus clopidogrel alone in the prevention of restenosis after femoral-popliteal artery angioplasty / 中华外科杂志

<p><b>OBJECTIVE</b>Using two antithrombotic treatment (clopidogrel vs. clopidogrel combined warfarin) strategies after femoral-popliteal artery angioplasty prospectively, to evaluate which strategy is more effective for the restenosis prevention.</p><p><b>METHODS</b>Totally 50 patients referred for endovascular treatment (including the percutaneous transluminal angioplasty (PTA) and stent implantation) of the superficial femoral artery and popliteal artery from January 2008 to May 2009 were randomly divided into clopidogrel group (group A, 25 cases, 30 limbs) and clopidogrel plus warfarin group (group B, 25 cases, 33 limbs) before operation. Clinical outcomes and restenosis rate of the target lesions were evaluated at 3, 6 and 12 months after operation.</p><p><b>RESULTS</b>Totally 88 patients were screened for participation in the study, 56 patients were included after the follow-up of 12 months. At 3 months, the rates of restenosis were 16.7% in group A and 18.2% in group B (χ² = 0.025, P = 0.874). At 6 months, the accumulated restenosis rates were 36.7% in group A and 36.4% in group B (χ² = 0.001, P = 0.98). At 12 months, the accumulated restenosis rates were 53.3% in group A and 42.4% in group B (χ² = 0.75, P = 0.387). Analysis for the critical limb ischemia sub-group showed that follow-up of 12 months, the accumulated restenosis rate was 8/10 in group A and 6/12 in group B (χ² = 1.023, P = 0.312).</p><p><b>CONCLUSION</b>The clopidogrel alone treatment for PTA or PTA plus stent implantation of femoral popliteal artery has no statistically significant difference in comparison with the clopidogrel combined warfarin treatment in terms of the cumulative vascular restenosis rate at 3, 6, 12 months postoperatively.</p>

Endovascular treatment for critical limb ischemia in patients with TASC C/D femoropopliteal lesions / 中华普通外科杂志

Objectives To assess outcomes of endovascular treatment for critical limb ischemia in patients with TASC C and D femoropopliteal lesions.Methods Between January 2009 and January 2012,patients with critical limb ischemia for TASC Ⅱ C or D lesions underwent endovascular treatment.Patients demographic,pre-and post- procedure ABI,primary patency rate,limb salvage at 1,3,6,12,24 months were reviewed.Results There were 58 males,38 females, mean age was (76 ± 10 ) years,with Rutherford Ⅳ in 68 limbs,Ⅴ in 23 limbs,Ⅵ in 5 limbs.Successful rate of procedure for target lesions was 94.80％,angioplasty alone was performed in 13 limbs,stent in 80 patients,thromblysis assisted angioplasty and stent in 8 limbs.Stents of popliteal artery were implanted in 47 limbs.Major complication rate was 19.80％,two patients died within 30 days.Mean ABIs were 0.25 ±0.17 and 0.76 ±0.23 before and after procedure.Mean time of follow up was (12 ± 6) months.Primary patency rates and limbs salvage rate were 94.79％ and 95.83％,93.73％ and 95.83％,88.01％ and 93.42％,78.34％ and 93.42％,68.38％ and 83.04％ on 1,3,6,12,24 months respectively.Conclusions Patients with critical limb ischemia caused by TASC C/D lesions often suffer from significant comorbid medical conditions.Endovascular procedure has a high risk of morbidity and restenosis,but short term limb salvage rate is satisfactory.