Aspirex mechanical thrombectomy system in the treatment of acute iliofemoral deep vein thrombosis / 中华普通外科杂志

Objective:To evaluate percutaneous mechanical thrombectomy (PMT) using Aspirex device for treating acute iliofemoral deep vein thrombosis (IFDVT).Methods:The clinical and follow-up data of 68 patients with IFDVT at our institution from Jan 2019 to Jun 2021 was retrospectively analyzed.Results:Twenty-six patients who had received PMT combined with auxiliary catheter directed thrombolysis (CDT) were included into group A, and 42 patients received CDT alone were into group B.The final thrombus clearance rates were more than 50%, and the clinical efficacy of thrombolysis was achieved. Group A associated a significant reduction in lysis duration and UK dosage and hospital days and degree of detumescence after 24 h compared with group B,and all aforementioned differences were statistically significant. Hospitalization costs in group A were more than group B. At one year follow-up, there were no significant differences between the two groups in the cumulative prevalence post-thrombotic syndrome (PTS) and the Villalta score and primary patency (92.0% vs. 90.0% , χ2=0.059, P=0.807). Conclusions:The application of PMT using the Aspirex device for acute IFDVT was safe and effective, which could accelerate the clearance of thrombus, and reduce UK dosage, lysis duration, hospital days. However, it increased the hospitalization costs.

Diagnosis and surgical treatment of patients with femoral vein compression from synovial cyst of hip joint / 中华普通外科杂志

Objective To investigate the diagnosis,treatment and outcomes of femoral vein compression by the synovial cyst of the hip joint.Methods A retrospective study was performed on 13 patients with femoral vein compression from the hip joint synovial cyst between March 2010 and June 2017.Results All the patients received Doppler ultrasound exam.Five (38％) patients received CT.Eight (61.6％) patients received MRI.Surgeries were performed and successful in 12 cases,the synovial cysts were completely removed.All postoperative pathologic results were confirmed as synovial cyst.The median follow-up time was 24 months without recurrence.One patient treated by percutaneous needle aspiration suffered from early cyst recurrence one month after the procedure.Conclusions Surgical excision is the preferred treatment method,postoperative symptoms improve significantly without cyst recurrence.

Isolated calf deep vein thrombosis / 中华普通外科杂志

Objective To analyze the clinical features and risk factors of isolated calf deep vein thrombosis (ICDVT).Methods Age,gender,locations,clinical symptoms,and risk factors of the hospitalized patients who diagnosed with ICDVT in the Department of Vascular Surgery,the First Affiliated Hospital of Zhengzhou University in 2015 were retrospectively analyzed.Results 122 hospitalized ICDVT patients were enrolled,accounting for 25.7％ of the patients with lower extremity deep vein thrombosis.Among them,41 cases (33.6％) were male,81 cases(66.4％) were female.The average age was 56.41 ±13.87 years.49 cases (40.0％) had left lower limb ICDVT,39 cases (32.0％) had right lower limb ICDVT;34 cases (28.0％) had both two lower limbs involved.Muscular calf vein thrombosis accounted for 77.9％ (95 cases).76 cases (62.3％) were painful.91 cases (74.6％) had swelling.Common risk factors included age (≥ 45 years) (85.2％),deficiency of natural anticoagulants (83.0％),surgery (45.9％) and malignant tumors (28.7％).Conclusions Pain and swelling were the main clinical symptoms of ICDVT.Age ≥ 45 years,deficiency of natural anticoagulants,surgery,and malignancy were main risk factors of ICDVT.

Effect of N-acetylcysteine on the liver function and mRNA and protein expressions of NF-KB in brain-dead BA-Ma mini pigs / 中华创伤杂志

Objective To investigate the effects of N-acetylcysteine (NAC) pretreatment on the liver function and mRNA and protein expressions of nuclear factor-KB (NF-KB) in brain-dead BA-Ma mini pigs. Methods The brain-dead model was established by increasing intracranial pressure by a modi-fied, slow and intermittent way. A total of 15 BA-Ma mini pigs were randomly and equally divided into three groups (five in each group), ie, control group (Group C) : treated only with opening and closing abdomen after anesthesia; group without NAC treatment (group B): brain-dead models without use of NAC; NAC treatment group (Group N): 1 and 12 hours after establishment of brain-dead models, 200 mg/kg NAC was added into 100 ml normal saline and intravenously transfused. Levels of ALT and AST in serum as well as TNF-α, IL-1β and IL-6 were determined at 3,6,12, 18,24 hours after brain death. The changes of liver tissues were observed by HE staining under a light microscope, the uhrastruc-rural changes of liver tissues observed under electron microscope, the expression of NF-KB detected by immnohistochemistry and change of NF-KB mRNA by RT-PCR. Results (1) Compared with Group C, serum ALT and AST began to increase at 12 hours after brain death, but IL-1β, IL-6 and TNF-α be-gan to increase three hours after brain death in Groups B and N. mRNA and protein expressions of NF-KB in Groups B and N began to increase six hours after brain death, when Group B increased more sharply than Group N, with statistical difference (P<0.05). (2) At 12 hours after brain death, injury of liver cells in Group B was severer than that in Group N. Conclusion NAC can inhibit the mRNA and pro-tein expressions of NF-KB, decrease the release of inflammatory factors and hence protect the hepatic structure and function during brain death.