Objective To investigate pathogenesy and therapeutic prospect of diabetes mellitus accompanied lower limb vascular lesion. Methods Relevant literatures of recent years were reviewed. Results Diabetes mellitus is one of the main risk factor causing peripheral artery disease. The site of vascular lesion often occur in major blood vessel and micrangium. The arterial sclerosis and decreased blood supply in microcirculation are important factors of lower limb ischemia. Lower limb ischemia in patients with diabetes mellitus is a common complication. Medical treatment and surgical treatment are the methods to improve symptoms of the complication. Conclusion Surgical therapy is an effective method for the treatment of diabetes mellitus accompanied lower limb vascular lesion.

Objective To explore the diagnostic methods, therapy and the prognostic factors for the ruptured abdominal aortic aneurysm (RAAA). Methods The clinical data of 23 patients (males 15, females 8, age range 35-78, mean age 65) with RAAA below the level of renal arteries, who were treated with surgery, were collected from April 1999 to December 2005 and were analyzed retrospectively. Seven cases had a history of RAAA, 6 cases had pulsating abdominal masses; 15 cases were diagnosed by emergency Doppler ultrasonic examination or CT. All of the patients underwent emergency surgical operation: The ruptures of the abdominal aorta below the level of renal arteries were obstructed by using clamp ring or using transluminal ballon according to conditions of each patient. The aritficial vascular graft was then taken after the control of hemorrhage. Results There were 9 (39%) patients died within 30 d after the emergency operation. The causes of death included acute renal failure because of hemorrhagic shock (4 cases), multiple organ failure (3 cases), and respiratory-circulatory failure (2 cases). Conclusion Surgery may be an effective treatment for RAAA. The critical step of the operation was to control hemorrhage by obstructing the proximal end of the aortic rupture according to the conditions of each patient. The main postoperative complications and causes of death include acute cardiovascular and cerebrovascular diseases, renal failure and pneumonia.

Objective To investigate the preventions and managements of hepatic artery reconstructions and its complications. Method Seventy-two patients who underwent the reconstruction of hepatic artery in orthotopic liver transplantation (OLT) and were followed up during recent 3 years after OLT were collected and analyzed retrospectively. Results The overall hepatic artery complications rate was 1.4 % (1/72). A pseudoaneurysm at the side of hepatic artery anastomosis was found by angiography and embolized successfully. The patency of hepatic artery toward donor liver was remained. Postoperative Doppler ultrasonography monitoring showed that no hepatic arterial thrombosis and stenosis occurred during 43 months of follow-up after OLT. Six patients died in the hospital after OLT and 6 patients died during the follow-up period. The overall cumulative 1-, 3-year survival rate was 83.3 % and 83.3 % respectively. No death associated with hepatic artery complications occurred. Conclusion Complete evaluation and prompt management perioperatively of hepatic artery reconstruction and its complications may improve the long-term survival of the recipients and grafts after OLT.

BACKGROUND: Ethanol chemical damage method can be used to establish thin endometrium rat model. Expression of proliferation-related proteins is decreased in thin endometrium animal model, which contributes to the study of thin endometrium-related mechanism and provides guidance for clinical treatment. OBJECTIVE:To explore the changes in vimentin and vascular endothelial growth factor expression in rat modelsof high concentrations of ethanol-induced thin endometrium. METHODS: 0.3 mL 95% ethanol was slowly injected in the right uterus of female Sprague-Dawley rats to establish rat models of thin endometrium. An equal volume of physiological saline was injected into the left uterus as control sides. RESULTS AND CONCLUSION:The thickness of endometrium in the injured uterus was significantly thinner than the control ones. Number of glands reduced, structure became disorder, and vimentin and vascular endothelial growth factor expression markedly diminished. These results suggest that 95% ethanol injury can effectively establish rat models of thin endometrium. Proliferation-related protein expression altered in the thin endometrium.

Objective To present and summarize the data concerning the diagnosis and treatment of popliteal aneurysm in our hospital. Methods The data of popliteal aneurysm in our hospital from 1975 to 2004 were reviewed and analyzed. Eleven patients with 11 diseased limbs were treated, including 8 males and 3 females, age from 21 years to 64 years 〔(48.54?13.66) years〕. The combined diseases include syphilis, rheumatic heart disease and chronic obstructire pulmonary disease etc. Ten patients received operations, including endoaneurysmorrhaphy (n=4) and graft bypass after aneurysmal resection (n=6), through posterior approach (n=7) or medial approach (n=3). One patient, combined with advanced syphilis and heart failure, received conservative treatment because of his poor general condition. Results The common clinical manifestations included popliteal pulsating mass, claudication, difficulty in extension of the knee, pain etc. Acute ischemia occurred in 3 limbs. The diameter of popliteal aneurysms varied from 4-13 cm 〔(6.73?2.69) cm〕. There were 3 (27.3) cases of ruptured aneurysms whose diameters were 7 cm, 7 cm and 11 cm respectively. Special examinations included arteriography and Doppler sonography. Pathological results of these patients were pseudoaneurysm (n=3), syphilitic aneurysm (n=3) and atherosclerotic aneurysm (n=4). Two patients were not followed up, and postoperative follow up of the other 8 patients ranged from 18 months to 30 years. In the group of endoaneurysmorrhaphy, postoperative gangrene of the affected limb occurred in one patient, and above-knee amputation was performed. One patient suffered from intermittent claudication in the group of endoaneurysmorrhaphy and of graft bypass respectively. No manifestations of limb ischemia were found in the other 5 patients during the time of follow up. Conclusion General utilization of Doppler sonography in screening high risk patients might be helpful to detect popliteal aneurysm. For symptomatic popliteal aneurysm or asymptomatic popliteal aneurysm with diameter larger than 3 cm, operation is indicated. Asymptomatic popliteal aneurysms no more than 3 cm in diameter could be monitored with care.

Objective To summarize the experience of surgical management of carotid tumors ( CBT ) and application of shunt between common and internal carotid artery intraoperatively. Methods Thirty patients of CBT (mean age:39. 2 ±2. 3 years old,10 male and 20 female, 15 in left, 14 in right and 1 in both sides) who underwent surgical resection, were retrospectively reviewed. The average size of CBT was 4.9 ±0.3 cm. The diagnosis was established by ultrasound, CT, MRI or carotid arteriography. 16 patients underwent surgical resection of CBT, 10 patients underwent additional ligation of external carotid artery, and 4 patients underwent additional intraoperative shunt between common and internal carotid artery. Results Surgical procedures were successfully performeded in all 30 patients with CBT. Intraoperative shunts were successfully used between common and internal carotid artery in 4 patients. The postoperative complications included hoarseness (15) , bucking (11), crooked tongue ( 17) , dyspnea (1), dysphagia(3). There was no hemiplegia and death. Conclusion Surgical resection is the choice of treatment of carotid body tumor. The application of intraoperative shunt between common and internal carotid artery in complicated Shamblin Ⅲ stage is safe and effective.

Objective To present and summarize the data concerning the treatment and prognosis of acute limb arterial embolism in West China Hospital.Methods Forty three patients with 52 limbs of acute arterial embolism were treated in West China Hospital from January 2003 to March 2006.There were 15 males and 28 females,aging from 26 years to 77 years 〔(58.88?13.90) years〕.The diagnosis was based on clinical manifestations and results of color Doppler sonography or DSA.The follow-up ranged from 1 month to 39 months.The following factors,which might influence the prognosis,were analysed through multiple linear regression of SPSS 10.0:age,sex,uper limb or lower limb,location of embolus,ischemic time,clinical categories of acute limb ischemia,history of smoking,atherosclerosis and other combined diseases,pervious history of acute limb arterial embolism,operative or nonoperative treatment,and postoperative complications.Results Clinical categories of acute limb ischemia include:Ⅰ(n=0),Ⅱa(n=16),Ⅱb(n=29),Ⅲ(n=7).The ischemic time varied from 3 h to 2 weeks.The sources of embolus:heart(n=39),vessle(n=7),iatrogenic origin(n=1),unidentidied origin(n=5).The therapies included embolectomy(n=38),catheter-directed thrombolysis(n=2) and medical treatment(n=12).The following postoperative complications occured:compartment syndrome(n=12),respiratory failure(n=3),alkalolsis(n=3),acute renal failure(n=2),wound infection(n=2) and pulmonary infection(n=1).Two patients died of cerebral infarction in hospital and one patient died of heart failure 3 months after discharge.Thirty-eight patients with 45 diseased limbs were followed up.The results were excellent in 13 limbs,good in 15 ones,fair in 8 ones and poor in 9 ones.The statistically significant influencing factors of prognosis include ischemic time,clinical categories of acute limb ischemia and history of smoking(P

Objective To review retrospectively our experience of the diagnosis and surgical treatment in patients with abdominal aortic aneurysm(AAA).Methods The diagnosis and surgical treatment in 72 patients 〔62 men, 10 women; mean age (67.5?9.3) years)〕 with AAA from January 1995 to February 2004 were analyzed. Fifty eight patients with infrarenal AAA and 2 patients with suprarenal AAA underwent elective graft replacement operation; 12 patients with ruptured AAA underwent urgent graft replacement operation. Results Fifty eight patients with infrarenal AAA and 2 patients with suprarenal AAA were cured and 2 patients with infrarenal AAA died of multiple organ failure after elective graft replacement operation, the 30 day mortality rate in patients with infrarenal AAA after elective operation was 3.45%. Seven patients were cured and 5 patients died of multiple organ failure after urgent graft replacement operation, the 30 day mortality rate was 41.67%. Conclusion The elective graft replacement operation in patients with AAA is a safe and effective surgical approach under the improvement of surgical technique and management of perioperative period.

Objective to construct the high titers rat Hes1 adenovirus expression vector (Ad-Hes1).Methods With the rat cDNA as a template,the Hes1 fragment was amplified by PCR,which constructed pShuttle-CMV-Hes1 shuttle plasmid by directly clone.Based on pShuttle-CMV-Hes1,pAdeno-Hes1 virus plasmid was constructed,pAdeno-Hes1 was transfected into 293 cells to package Ad-Hes1,virus titers were determined by modified TCID50.Hes1 was detected by Western blot after Ad-Hes1 infected with H9c2 myocardial cells.Results pShuttle-CMV-Hes1 shuttle plasmid and pAdeno-Hes1 plasmid were constructed successfully,with a general titer of 1.6 × 1011 PFU,Ad-Hes1 can be expressed in H9c2 myocardial cells,and its MOI value was 30.Conclusion Ad-Hes1 is successfully constructedand packaged,thus provide basis for further research on the protection effect of Hes1 on myocardium.

Through the deep study of the surgical relident training of our country,we discover that the self-administration mode of surgery resident team is an effective way of optimizing resident standard training. In this mode,human resources and organization are effectively set up with modern management strategy. And with the characteristic training of the mode,we have got a good training effect.