Objective To study the long-term result of thrombectomy and thrombolysis for acute mixed deep vein thrombosis(DVT)of the lower extremity. Methods Clinical data of 142 patients treated for acute mixed DVT from September,1991 to June,2005 were reviewed.There were 77 patients treated by thrombectomy.Among these 77 patients there were 49 patients whose common iliac vein was occluded or stenosis.All the 77 patients received territorial transfusion with urokinase and hepafin after operation.The other 65 cases were treated by systemic thrombolysis with urokinase and heparin. Results Two weeks after thrombectomy or thrombolysis,the circumference difference between bilateral limbs was occlusive from (4.3±2.2)cm to(0.6±0.5)cm in thrombectomy group,and from(3.9±2.5)cm to(1.6±0.9)cmin thrombolysis group(t=-8.346,P=0.000).Patients were followed up for an average of(49±42)months.The circumference difference between bilateral limbs was reduced to(0.5±0.4)cm in thrombectomy group and(1.4±1.3)cm in thrombolysis group respectively(t=-5.764,P=0.000).The sequela morbidity in thrombectomy group was less than that in thrombolysis group(P＜0.05).The morbidity of edema,pigmentation,and ulcer was 29.9%,15.6%,0%in thrombectomy group and 50.8%,84.6%,6.2%in thrombolysis group.In thrombectomy group,89.6%veins regained patency and 72.7%valves had normal function compared with that in thrombolysis group 30.8%and 9.2%(Z=-8.502.P=0.000).The cure rate was 70.1%in thrombectomy group and 30.8%in thrombolysis group (Z=-4.740.P=0.000).Mortality rate was 3.9%in thrombectomy group,while there was no inhospital death in thrombolysis group. Conclusions For the treatment of acute mixed DVT.especially in protecting the normal valve function,thrombectomy was significantly superior to that of thrombolysis except for causing some mortality.

Objective To study the causes, prevention and treatment of secondary thrombosis after vena cava filter placement. Methods We summarized the clinical experience regarding 7 cases of secondary thrombosis of the inferior vena cava from December 2001 to June 2004 in this hospital. Results Two patients underwent thrombectomy, 1 patient received interventional thrombolytic therapy, and the rest of 4 patients received conservative treatment. All the treatment had obtained good results. No pulmonary embolism took place in the study. Conclusions Thrombosis secondary to filtration can be completely prevented by adhering strictly to the indications of filter placement and conducting supplementary anticoagulation therapy. Interventional therapy is the first choice for the treatment of secondary thrombosis after filter placement.

Objective To summarize the experience of fluoroscopy-guided chemical thoracic sympathectomy(CTS) for the treatment of Raynaud's phenomenon.Methods A series of 73 cases of Raynaud's phenomenon(141 upper limbs) treated with CTS from March 2001 to September 2005 in this hospital was chronologically divided into two groups: the Group A between March 2001 and December 2002 and the Group B between January 2003 and September 2005.In the Group A,under the guidance of X-ray fluoroscopy,a needle was punctured through the back skin to the second or the third thoracic sympathetic ganglion beside the thoracic vertebrae and 2 ml of 5% phenol was injected.In the Group B,when the needlepoint reached the rear edge of target thoracic vertebra,2~3 ml of anesthetic was injected.Then the needle was advanced sequentially untill the needlepoint reached the sympathetic ganglion.Other manipulation was the same with the Group A. Results The incidence of pneumothorax in the Group A(28.4%,19/67) exceeded greatly that in the Group B(4.1%,3/74)(?~2=15.773,P=0.000).The effective rate in the Group A(77.6%,52/67) was much lower than that in the Group B(97.3%,72/74)(?~2=12.851,P=0.000).Between the two groups,differences of the incidence of axilla pain(Group A,2 limbs;Group B,5 limbs)(?~2=0.411,P=0.521),bradycardia(Group A,1 case;Group B,nil)(?~2=0.002,P=0.967),and Horner's syndrome(Group A,1 case;Group B,1 case)(?~2=0.000,P=1.000) were not statistically significant.Conclusions Pneumothorax is a common complication of chemical thoracic sympathectomy.Improvement of procedure can reduce the incidence of pneumothorax and increase the effective rate.

Objective:To evaluate the effects of Er,Cr:YSGG laser on the root surface of periodontally involved teeth and healthy teeth,concerning the microstructure and the roughness.Methods:Eight freshly extracted teeth due to severe periodontitis and eight freshly extracted teeth due to orthodontic rea-sons or being third molar were chosen in this study.The root surface of each tooth was divided into four areas,and received four treatment methods:no treatment (control group );root planing with Gracey scaler for 30 seconds;irradiation by the lower power Er,Cr:YSGG laser;irradiation by the higher power Er,Cr:YSGG laser.Four periodontally involved teeth and four healthy teeth were used for the evaluation of microstructure using scanning electron microscope (SEM).The other four periodontitis teeth and four healthy teeth were used for the evaluation of roughness (Ra value )using 3 D profiler.Results:Smear layer was found on the teeth scaled by Gracey scaler,while the teeth irradiated by Er,Cr:YSGG laser demonstrated a melting surface with less smear layer.In the periodontitis teeth irradiated by the higher power,opening dentinal tubules could be observed.For the periodontally involved teeth,the Ra values of groups 1 to 4 were (237.4 ±20.0)nm,(1 35.7 ±1 1 .9)nm (P=0.01 ),(463.6 ±49.3)nm (P<0.001 )and (486.0 ±59.0)nm (P<0.001 )respectively.For the healthy teeth,the Ra values of groups 1 to 4 were (1 91 .4 ±44.5)nm,(1 31 .6 ±21 .5)nm (P=0.482),(463.7 ±34.6)nm (P<0.001 )and (470.3 ±1 21 .3)nm (P<0.001 )respectively.Conclusion:Er,Cr:YSGG laser can affect the microstructure of the cementum of the periodontitis teeth and healthy teeth.Irradiation by the Er,Cr:YSGG laser resulted in a melting surface with less smear layer and increased the roughness in the surface of root.

0.05). Neuralgia of the lower limb was complicated in 3 (8%)cases. 31 cases were followed up from 3 months to 9 years. 24 out of the 26 patients experincing immediate post-CLS relief remained asymptomatic, and 2 suffered symptom deterioration necessitating major amputation. ConclusionsCLS is a simple procedure with less complication offering an alternative for the treatment of lower limb ischemia.

Objective To evaluate the complicatio ns after thrombectomy for deep vein thrombosis (DVT) of the lower extremity. Methods Thrombectomy was under taken for 143 patients using Fogarty catheter, then local thrombolysis and antic oagulation was undertaken by a indwelling catheter in the great saphenous vein. Results The total recurren ce rate of DVT was 12.6%(18/143), whereas the early recurrence rate without loc al thrombolysis and anticoagulation was 29.8%(14/47). The recurrence rate was 1 8.9%(14/74) against the background of Cockett syndrome, and 5.8%(4/69) withou t Cockett syndrome. Other complications included lymphatic fistula in 4 cases (2 .8%), pulmonary embolism, vena cava thrombosis, massive haemorrhage, and incisi onal infection in one each, death ensued in 3 (2.1%). ConclusionsThe recurrence rate of DVT could be low ered by management of the stenosis or occlusion of common iliac vein and local thrombolysis and anticoagulation. Thrombectomy should be the first choice of the rapy for DVT.

BACKGROUND:LARS artificial ligament was designed by Laboureau from France using polyethylene terephthalates with the anatomic structure of human ligament and mechanical principle of weight.This ligament is not only accorded with physiological structure of normal anterior cruciate ligament,but also significantly elevates anti-torque,can resist repetitive twist,bend and excessive traction.OBJECTIVE:To summarize characteristics of clinical application of LARS artificial ligament in transplant reconstruction following acute anterior cruciate ligament of knee joint injury.METHODS:A total of 23 patients with acute anterior cruciate ligament injury,comprising 17 males and 6 females,aged 21-54 years,were selected.Time-from injury to surgery was 3 days to 3 weeks.Polyethylene terephthalatas LARS artificial ligament made in France was used to reconstruct damaged ligament.The transplant was evaluated before and after implantation according to Lysholm knee joint criteria.RESULTS AND CONCLUSION:Following 11.2 months (10-14 months) of follow-up,unstable symptoms of affected knees of all 23 cases disappeared.Anterior and posterior drawer tests were negative,with good joint function.Average extension and flexion degree was 0°-120°.In accordance with Lysholm knee joint score,significant difference was found from (40.34±4.00) points preoperatively to (90.21±4.00) points postoperatively (P<0.01).They could do common athletic activities at about 2 months following surgery.In some cases,magnetic resonance examination demonstrated that residue ligament gradually grew into artificial ligament,which gradually became thicker.Above-mentioned results have verified that under an arthroscope,reconstruction of anterior cruciate ligament using polyethylene terephthalates LARS artificial ligament showed simple operation and small wound,which may lead to immediate stability,early rehabilitation exercises.Simultaneously,interlacing of residue ligament and artificial ligament keeps the nerve conduction pathway of propdoceptive sense,which prevents joint function limitation greatly.Moreover,short-term outcomes are satisfactory.

SUMMARY Tuberculous aneurysm of the aorta is a very rare disorder. There have been only 50 reported cases of tuberculous aneurysm since 1895 till now, of which 88% were false aneurysms with majority being single in number. And only four were found to have multiple tuberculous aneurysms. The mean ages of the patients were 50?16 years. Treatment of tuberculous aortic aneurysm must be a combined medical and surgical approach. Once tuberculous aneurysm is identified, surgery must be performed promptly. The size of the aneurysm does not influence the need for surgery. A 70-year-old male with intermittent episodes of abdominal pain after receiving an inappropriate antitubercular therapy for pulmonary tuberculosis was diagnosed as multiple false tubercular aneurysm of abdominal aorta. An aneurysm of base 3.3 cm and greatest diameter 5 cm?6 cm was seen just above the opening of Coeliac trunk. Also at the dorsal aspect of abdominal aorta and superior mesenteric artery junction and ventral aspect of renal artery false aneurysms were seen, each with the size of 1 cm in diameter. Apart from antitubercular and antimicrobial treatment, first line surgery Endovascular Exclusion of Abdominal Aortic Aneurysm was performed for ruptured false abdominal aortic aneurysm. Even before the second line surgery, smaller abdominal aortic aneurysms got ruptured and the patient ’s party gave up further treatment. Finally the patient died of gastrointestinal haemorrhage.

60 years)group and younger(≤60)group. Analysis of the pathogenesis of DVT in the 2 groups was made and the relationship of DVT and CS (between) the 2 groups was compared. There were 43 patients in elder group and 46 in younger group. All (patients) were treated by thrombectomy. Results There were 25 (58.1%) patients with concomitant CS in elder group and 37 (80.4%) in younger group. There was a significant difference between the two groups (?~2=5.2274, P

Objective To analyze retrospectively the effect on patency of arterial bypasses combined with arteriovenous fistulae in patients with poor run-off. MethodsA retrospective analysis was made based on twenty-six patients with severe lower extremity arteries ischemia and poor run-off, undergoing arterial bypasses combined with arteriovenous fustulae. ResultsAmong the 28 diseased extremities in 26 patients,14 cases received bypass combined with deep arteriovenous fistulae(saphenous vein),and twelve underwent operations combined with superficial arteriovenous fistulae(popliteal vein,tibialis posterior vein).The short term patency rates in these two groups were both 78.6%.The two year′s patency of the bypasses combined with deep fistulae was 78.6%,that of combined with superficial fistula was 57.1%.ConclusionsArtery bypasses combined with arterovenous fistulae could improve the patency rates of the synthetic grafts in patients with severe lower extremity arteries ischemia and poor run-off.