Objective To investigate the method of surgical treatment of mixed type Takayasu′s arteritis(TA).Methods Clinical data of 12 cases of TA were retrospectively analyzed.Results All 12 patients were treated with operations,including arterial bypass with prosthesis-graft in 5 cases;percutaneous transluminal angioplasty (PTA) and intraluminal stent implantation in 3 cases;combination of the two methods in 4 cases.All patients were followed up for 3 to 60 months.10 cases of organ ischemia or renal hypertension were very well controlled,2 cases showed restenosis of renal artery and one of them died from cerebrovascular accident.Conclusions Combination of arterial bypass,PTA and intraluminal stent impantation can control the ischemia of the vital organs and reduce the blood pressure of renal hypertension in patients with TA.

Objective To assess on the effect of the different catheterization on patients with oral poisoning gastric lavage systematically and objectively. Methods A computerized search of PubMed, the Cochrane Library, EMBASE, Springer Link, Science Direct,China Biology Medicine (CBM),China National Knowledge Internet(CNKI), Wanfang Data and VIP database was performed for relevant randomized controlled trials (RCTs) which investigated the effects of the oral intubation gastric lavage on patients with oral poisoning relative to nasogastric lavage, retrieval to January 2016, and back into the study of references. According to include and exclude standard to screening literature, literature which met inclusion criteria was selected for quality evaluation and data extraction. Meta-analysis and trial sequential analysis were performed by using Rev-Man 5.3 and TSA soft-ware to estimate the required information size (RIS). Results 13 studies incorporated into Meta-analysis including a total o 1 296 patients. Meta-analysis results showed that the oral intubation gastric lavage group was better than nasogastric lavage in shortening the time of intubation [MD=-9.05, 95% CI(-12.86--5.23), P=0.00], improving the rate of intubation for the first time [MD=1.36, 95% CI (1.14-1.62), P =0.00], mucosal bleeding complication [MD=0.11, 95% CI (0.04-0.64), P=0.010], nausea and vomiting [MD=0.60, 95%CI (0.37-0.98), P=0.04], kinking [MD=0.14, 95% CI (0.02-0.80), P=0.03], reflex cardiac arrest [MD=0.24, 95% CI (0.08-0.71), P=0.01] and asphyxia [MD=0.45, 95% CI (0.26-0.80), P=0.007], the difference were statistically significant. But no significant difference existed in gastric tube fall off. Conclusions The oral intubation gastric lavage could shorten intubation time of patients, improve the first time intubation rate and reduce certain complications. It suggests that the oral intubation be extensively applied to care patients with oral poisoning.

Objective To assess the correlation between magnetic resonance imaging (MRI)and clinical staging of pelvic organ prolapse (POP)by using pubococcygeal line (PCL)and midpubic line (MPL)respectively.And to determine which(MRI)reference line for staging pelvic organ prolapse had the highest agreement with clinical staging.Methods A retrospective study of 32 women with pelvic organ prolapse who underwent dynamic pelvic MRI from Jan 2013 to May 2013 was conducted.One radiologist staged descent on MRI for each pelvic compartment (anterior,middle,posterior),using PCL and MPL lines.Agreement between MRI and clinical staging was estimated respectively.Results Thirty-two women were included.Agreement between clinical and MPL staging was morderate in the anterior (κ=0.44,SE=0.13)and middle compartment (κ=0.46,SE=0.12),but fair in the posterior com-partment (κ=0.23,SE=0.10).Agreement between clinical and PCL staging was poor in all compartments of pelvic.Conclusion MPL appeared more reliable and simple than the PCL for the evaluation of pelvic prolapse on MRI.

The general characteristics, outcomes and risk factors of the patients with aortic dissection (AD) were evaluated in a single medical center. From January 2002 to December 2008, 284 patients with AD were treated and followed-up at our institution, including 105 cases of type A AD and 179 cases of type B AD. The patients in each type were divided into three groups according to management: medical treatment group (A or B), open surgery group (A or B), and stent-graft group (A or B). The characteristics and follow-up outcomes were compared between the groups or subgroups. The results showed that there was significant difference in the prognosis for type A AD between medical treatment group and open surgery group, but there was no significant difference in the prognosis for type B AD between medical treatment group and stent-graft group. Independent risk factors of follow-up mortality for patients with type A AD included a history of atherosclerosis (HR, 3.807; 95% confidence interval [CI], 1.489 to 7.611; P=0.003), in-hospital hypotension/shock (HR, 4.687; 95% CI, 1.846 to 11.900; P=0.001), in-hospital myocardial ischemia or infarction (HR, 3.734; 95% CI, 1.613 to 8.643; P=0.002), pleural effusion (HR, 2.210; 95% CI, 1.080 to 4.521; P=0.030), branch vessel involvement (HR, 2.747; 95% CI, 1.202 to 6.278; P=0.016) and surgical treatment (HR, 0.177; 95% CI, 0.063 to 0.502; P=0.001). And there were insignificant independent predictors for mortality of the patients with type B AD. It was concluded that there were significant differences in characteristics and one year mortality between type A AD and type B AD, but after one year, there was no significant difference in the mortality and complications of them. There were several discordant risk factors of AD, such as female gender, age, thrombus, abrupt onset of pain that were considered as the risk factors in some papers. And there was no definite risk factor of mortality in this study in the patients with type B AD.

OBJECTIVE: By reviewing the clinical material in 23 cases (25 tumors) of carotid body tumors, we concluded our experience in selecting the appropriate diagnostic modality and surgical therapy to facilitate surgical maneuvers and decrease the incidence of postoperative complications. METHOD: From 2003 to 2008, 23 cases of carotid body tumors were admitted and treated in Wuhan Union Hospital. All the 23 cases were operated after determining diagnosis that was deterred by angiography and noninvasive examinations including color Doppler scan, computed tomography angiography and magnetic resonance angiography. RESULT: There was no patient died, no cerebral infarctions, no recurrence after operation. Nervous complications occurred in 5 cases post operatively. CONCLUSION Preoperative angiography is a appropriate diagnostic modality for carotid body tumor, which can shows the supply arteries of the tumor and estimate the structure of the Willis Circle, so that we can judge the possibility to temporarily clamp the carotid artery during the operation to control the hemorrhage and eliminate the postoperative nervous complications.
Adult ; Aged ; Angiography, Digital Subtraction ; Carotid Body Tumor ; diagnosis ; diagnostic imaging ; surgery ; Female ; Humans ; Male ; Middle Aged ; Treatment Outcome

The general characteristics,outcomes and risk factors of the patients with aortic dissection (AD) were evaluated in a single medical center.From January 2002 to December 2008,284 patients with AD were treated and followed-up at our institution,including 105 cases of type A AD and 179 cases of type B AD.The patients in each type were divided into three groups according to management:medical treatment group (A or B),open surgery group (A or B),and stent-graft group (A or B).The characteristics and follow-up outcomes were compared between the groups or subgroups.The results showed that there was significant difference in the prognosis for type A AD between medical treatment group and open surgery group,but there was no significant difference in the prognosis for type B AD between medical treatment group and stent-graft group.Independent risk factors of follow-up mortality for patients with type A AD included a history of atherosclerosis (HR,3.807; 95％ confidence interval [CI],1.489 to 7.611; P=0.003),in-hospital hypotension/shock (HR,4.687; 95％ CI,1.846 to 11.900;P=0.001),in-hospital myocardial ischemia or infarction (HR,3.734; 95％ CI,1.613 to 8.643; P=0.002),pleural effusion (HR,2.210; 95％ CI,1.080 to 4.521; P=0.030),branch vessel involvement (HR,2.747;95％ CI,1.202 to 6.278; P=0.016) and surgical treatment (HR,0.177; 95％ CI,0.063 to 0.502; P=0.001).And there were insignificant independent predictors for mortality of the patients with type BAD.It was concluded that there were significant differences in characteristics and one year mortality between type A AD and type B AD,but after one year,there was no significant difference in the mortality and complications of them.There were several discordant risk factors of AD,such as female gender,age,thrombus,abrupt onset of pain that were considered as the risk factors in some papers.And there was no definite risk factor of mortality in this study in the patients with type B AD.