Objective To evaluate the effectiveness of venous external valvuloplasty in treatmeant of moderate or severe incompetent deep venous valve.Methods 54 patients with moderate and severe primary incompetent deep venous valve underwent anterograde and retrograde venous angiography of lower limbs, the angiography showed that reflux degree were 2～4grade. 54 patients were divided into two groups.The first group patients(n=32) without serious injured free margin of venous valve leaves were treated by venous external valvuloplasty,the other group patients with serious injured free margin of valve leaves(n=22),were other treatment.Results The showed excellent curative effect,were obtained better effect 29(90.6%) of the 32 cases were 3(9.4%) of 32 cases.The symptoms of all patients were disappearance and ulcer were close up. The colour Doppler ultrasonography had shown that blood was not flow backwards in the vein.Conclusions The authors believe that the good results may be expected in the opration of venous external valvuloplasty in patients with moderate and severe primary incompetent deep venous valve whose free margin of valve leaves were not serious injured .

ObjectiveTo evaluate superselective hepatic artery angiography and embolization in the diagnosis and treatment of massive hemobilia. Methods Eight patients with massive hemobilia were admitted from March 1993 to July 2001.All underwent emergent superselective right or left hepatic artery angiography, with the diagnosis being established, and embolization of the hepatic artery branch proximal to the bleeding point. Results Two out of the 8 patients received second embolization for recurrent bleeding, and the bleeding stopped immediately after the embolization in all 8 patients. All patients were alive and without bleeding recurrence at follow up from 2 months to 7 years. Conclusion Superselective hepatic artery angiography and embolization is an effective method in the diagnosis and treatment for massive hemobilia.

Objective　To study the diagnosis, treatment and prognosis of hepatolithiasis combined with cholangiocarcinoma. Methods　The clinical, pathological and follow-up data of 17 cases of hepatolithiasis combined with cholangiocarcinoma were retrospectively analysed. Results　The results showed that the incidence of cholangiocarcinoma in hepatolithiasis was 5% in this series. 17.6% of the patients were diagnosed as cholangiocarcinoma preoperatively. Tumor occurring in intrahepatic ducts was 88.2% and in hepatic porta ducts 11.8%. Nine cases were well-differentiated adenocarcinomas. Only 7(41.2%) cases were radically resected and their average survival time was 26.0 months. Eight(47.1%) patients underwent internal drainage with average survival time 12.4 months. 2(11.7%) cases subject to external drainage with survival time 3.6 months. Conclusions　If patients with hepatolithiasis have a long history of recurrent cholangitis, weight-loss in a short period, progressive jaundice or intractable abdominal pain, the possiblility of combined with cholangiocarcinoma should be considered. Resection of the tumor has a better prognosis than that of tumor unresected; and the prognosis of internal drainage is better than that of external drainage.

Objective To observe the effects of selenium extracellular polysaccharide of Porphyridium sp(Se-PSP) on the growth and apoptosis of BEL-7402 tumor cell line.Methods The Se-PSP was obtained from a sort of culture medium with some selenous acid solution.In vitro,human tumor cells were cultured in sorts of PSP or Se-PSP liquors with different concentrations,and the result of which was determined by MTT,Focus apoptosis assay and DNA fragmentation.Results and Conclusion Se-PSP(80mg?L-1) displayed strong growth inhibitory effects against BEL-7402 human cancer cell line,and induced the apoptosis of BEL-7402 cells.

Objective To investigate the analgesic efficacy and safety of parecoxib-sodium in patients undergoing laparoscopic cholecystectomy. Methods Ninety patients received laparoscopic cholecystectomy were divided into parecoxib-sodium group,flurbiprofen group and control group by random digits table, 30 cases in each group, all patients received the drug by vein 30 minutes before surgery. The postoperative pain intensity (VAS score), satisfaction of patients, changes of blood coagulation function and maximum agglutination rate (MAR) of platelet agglutination test before and after treatment and the incidence of postoperative adverse reaction were observed and compared. Results Pestoperative VAS scores and psychiatric symptoms at different time in parecoxib-sodium group and flurbiprofen group were significantly lower than those in control group (P ＜ 0.05), analgesic satisfaction rate were 93.3% (28/30) in parecoxibsodium group and 90.0% (27/30) in flurbiprofen group, which were significantly higher than that in control group [20.0%(6/30)] (P＜0.05). There were no significant difference in blood coagulation function and MAR before and after treatment among three groups (P ＞ 0.05). Conclusion Parecoxib-sodium displays significant analgesic effects and low rate of adverse events for the patients undergoing laparoscopic cholecystectomy, it is worthy of clinical application.

Objective     To share the clinical experience of video-assisted thoracoscopic surgery (VATS) anatomic basal segmentectomy by single-direction method. Methods     The clinical data of 352 patients who underwent VATS anatomic basal segmentectomy in West China Hospital between April 2015 and April 2021 were retrospectively reviewed, including 96 males and 256 females with a median age of 50 (range, 26-81) years. All basal segmentectomies were performed under thoracoscopy, through the interlobar fissure or inferior pulmonary ligament approach, and following the strategy of single-direction and the method of "stem-branch". Results    All patients underwent basal segmentectomy successfully (49 patients of uniportal procedure, 3 patients of biportal procedure and 300 patients of triportal procedure) without addition of incisions or conversion to thoracotomy and lobectomy. The median operation time was 118 (range, 45-340) min, median intraoperative blood loss was 20 (range, 5-500) mL, median drainage time was 2 (range, 1-22) d and median postoperative hospital stay was 4 (range, 2-24) d. The postoperative complications included pneumonia in 6 patients, prolonged drainage (air leakage duration>5 d or drainage duration>7 d) in 18 patients, cerebral infarction in 1 patient and other complications in 2 patients. All patients were treated well and discharged without main complaints. No perioperative death happened. Conclusion    VATS anatomic basal segmentectomy is feasible and safe. It can be performed in a simple manner following the strategy of single-direction.

Objective To study the protective effects of DADLE on pulmonary function in rats with sepsis and the mechanism.Methods Seventy-two SD rats were randomly divided into sham operated group(SO),septic group(SEP),and DADLEtreated group (DADLE).Sepsis model was induced by cecal ligation and puncture(CLP).In SO group,the abdomen was opened without any other treatment.In DADLE-treated group,DADLE(0.5 mg/ml) was administerd at a dose of 5 ml/kg by intravenous injection after CLP.Rats were sacrificed at the 2nd,6th and 10th h after CLP.Arterial blood was collected for blood gas analysis.The wet-to-dry lung weight ratio was measured,and the levels of TNF-a and IL-6 in blood were detected.The levels of MPO,MDA and ATP in lung tissue were determined.The pathologic changes of the lungs were examined under a light microscope.Results As compared with SEP group,PaCO_2,and PaO_2 were significantly increased(P<0.05),while the wet-to-dry ratio and levels of serum TNF-a and IL-6 were significantly reduced(P<0.05),and levels of MPO and MDA were significantly reduced(P<0.05) and content of ATP in lung tissue was significantly increased (P<0.05)in DADLE group.More severe pathological changes were found in SEP group than in DADLE group.Conclusion DADLE has pulmonary protective effects in rats with sepsis.

Objective To study the protective effect of δ opioid receptor agonist DADLE(D-Ala2-D-Leu5-enkephalin)on mitochondrial respiratory function in a rat model of sepsis. Methods Sixty SD rats were randomly divided in to sham operated group (SO), septic group (SEP), and DADLE group (DADLE), each of 20 cases. Sepsis model was produced by cecal ligation and puncture (CLP). In SO group,the abdomen was opened without any other treatment. In DADLE group, DADLE (0.5 mg/mL) was administer at a dose of 5 mL/kg by intra-peritoneal injection after CLP. All rats were sacrificed 8 hours after CLP. ALT and AST in blood were determined. Mitochondrial respiratory function was evaluated by the clark oxygen eletrode. The levels of ATP, ADP, AMP were determined by high performance liquid chromatogra phy (HPLC). Results RCR and ADP/O in DADLE group were much higher than that in SEP group (P<0.05). ATP in DADLE groups were much higher than SEP group (P<0.05), while ALT and AST of DADLE group were significantly lower than SEP group (P<0.05). Conclusion DADLE can protect mitochondrial respiratory function and improve the hepatocellular energy metabolism in sepsis.

Objective To investigate the feasibility and technique of using the anterolateral thigh perforator flap pedicled with the lateral branch of the lateral circumflex femoral artery (LBLCFA) to repair soft tissue defect of extremities.Methods Eighty-six cases of anterolateral thigh perforator flap transplantation were performed from May,2014 to May,2018.A total of 37 cases of soft tissue defect of extremities were treated by anterolateral thigh perforator flap used the LBLCFA as vascular pedicle,of which there were 19 cases of upper limbs and 18 of lower limbs.There were 27 cases of defects caused by trauma,and 10 by soft tissue tumor resection.The flaps were designed centering around the point proximal to the midpoint of the iliac-patellar line.The dimensions of soft tissue defect were from 9.0 cm×6.0 cm to 26.0 cm×10.0 cm,and the flap were from 10.0 cm×7.0 cm to 27.0 cm×11.0 cm.The length of vascular pedicle ranged of 7.0-13.0 cm,with an average of 11.5 cm.The donor sites were directly sutured.All of the patients were followed-up regularly in the outpatient department.Results All the flaps survived and the donor sites were primarily healed.Of these 37 cases,2 trauma patients and 2 patients treated with local radiotherapy had poor wound healing,but still healed after multiple dressing changes.All the patients were followed-up for 3-26 months,with an average of 13 months.The texture,color and elasticity of the flap were similar to the surrounding tissue of the recipient sites,while only a linear scar remained at the donor sites.Ten tumor patients were treated with routine radiotherapy and chemotherapy after the repairation;there was no tumor recurrence during the follow-up period.Conclusion The LBLCFA gives off a relatively large and thick perforator proximal 5.0-7.0 cm of the iliacpatellar line,which locates in the upper lateral side,travels parallel to the vastus lateralis,and give off the skin and muscular perforators.The lateral branch can be used as pedicle to make into perforator flap or chimeric flap,which provides a novel selection of vascular pedicel for anterolateral thigh perforator flap.When the descending branch does not provide a thick and large perforator,the LBLCFA has important practical value and is worth utilizing in the clinic.

Objective:To investigate the application and surgical effect of lobed anterolateral femoral chimeric perforator flap in repairing the complex soft tissue defects of limbs.Methods:Clinical materials of 52 cases with complex soft tissue defects of limbs were retrospectively reviewed from October 2013 to October 2020. Thirty-two males and 20 females were reviewed, and the age of them ranged from 6 to 65(mean 39) years old. The injuries include 17 cases of traffic accidents, 15 machine crush injuries, 12 engineering accidents, and 8 extensive resection of malignant tumors. The size of soft tissue defects ranged from 26.0 cm×10.0 cm to 35.0 cm×15.0 cm. Lobed anterolateral thigh chimeric perforator flaps or lobed Flow-through chimeric perforator flaps were designed according to the soft tissue defects and blood circulation of the distal extremities. Start from 8-month post-operation, upper limb function was assessed according to the Upper Limb Function Assessment Standard of Hand Surgery Branch of Chinese Medical Association and Disability of arm shoulder and hand(DASH) score scale, and Fugl-Meyer score system was used to evaluate the lower limb function. Long-term follow-up was conducted through WeChat video call and outpatient clinic evaluation.Results:All flaps survived. One patient with crush injury got delayed wound healing due to deep hemaetoma after surgery, and the rest were healed at the first stage. All the cases entered followed-up, ranged from 6 to 20(mean 8) months. The appearance of the flaps was satisfactory, and the color of the flaps has no significant difference compared with the recipient area. No recurrence of tumor was reported during the follow-up period. According to the Upper Limb Function Assessment Standard of Hand Surgery Branch of Chinese Medical Association, there were 21 excellent cases and 8 good cases, and the total excellent and good rate was 100%. The DASH score of upper limbs ranges from 11.5 to 45.1(mean 25.4±13.7), and the Fugl-Meyer score of lower limbs range from 18.6 to 31.8(mean 26.2±11.2) at the last follow-up.Conclusion:The complex soft tissue defect of limbs is a common complication caused by high-energy trauma, which is difficult to repair. The lobed anterolateral thigh chimeric perforator flap through a Decompose-Combine and arrange method for reconstruction, which is flexible in flap design. A variety of tissue flaps can be obtained by anastomosing only one group of blood vessels. It is an ideal choice for repairment of complex soft tissue defects of limbs.