Objective To analyze the causes of misdiagnosis of aorta diseases for simple inferior limb artery thrombo-embolism,and summarize the clinical experience. Methods Retrospective analysis was made on clinical data of 9 eases misdiagnosed aorta disease,including clinical manifestation,misdiagnosis,improper treatment and final definite diagnosis. Results All 9 cases were misdiagnosed as simple inferior limb thrombo-embolism at first.Three cases were treated with emergent thrombectomy using Fogarty catheter.The correct diagnosis Was achieved by 3-dimensional CT angiography (3DCTA) after operation,and the eitiology of other 6 cases were also pmved as aortic disease by 3DCTA before operation.Among 5 cases of acute aorta dissection with iliac-femoral artery involved,2 cases abandoned surgery with one dying the next day and the other lost to follow-up after being discharged.The other 3 cases were treated with endovascular therapy successfully.One case of abdominal aorta anurysm with mural thrombosis defluxion were treated by aneurysm resection.The other 3 caBes of Leriche syndrome with acute aorta terminal filament thrombosis formation were cured by aortoiliac bypass.The limbs ischemia were improved in all cases without perioperative death.Conclusion Aorta diseases can sometimes lead to acute inferior limb ischemia,mimicking limb artery thrombo-embolism.Preoperative imaging especially 3 DCTA helps to establish correct preoperative diagnosis for a successful treatment.

Objective To summarize our experience in treating abdominal aorta saddle embolism(ASE).Methods The clinical data of 21 cases of abdominal ASE were treated with Fogarty catheter and other(methods) during January 2000 to July 2006 were retrospectively assessed.Results After the blood flow was restored by operation,4 died in the postoperative early stage because of sudden cardiac asystole due to(hyperkalemia);in the late stage,6 died of multiple organ dysfunction syndrome socondary from acute renal(failure)(ARF).Eleven patients were cured.Of them,bilateral lower extremites were salvaged in 5 patients;and 6 patients received amputation.Ten patients were followed up,and the blood supply of the salvaged legs was good.Conclusions Early diagnosis and embotism removal are the key points to decrease the mortality and amputation rate of ASE.The intra-operative and post-operative prevention and management of(hyperkalemia) and ARF are important for reduction of mortality.

Objective:To study the effect of ischemic postconditioning(I-postC)on the lung injury following ischemia-reperfusion(I/R)of skeletal muscle in the hind limbs of rats.Methods:The rat model of hind limbs I/R injury was established by subrenal abdominal aorta cross-clamping for 4 hours.Forty-eight rats were divided into 3 groups:I/R group,IPC and I-postC group.Each group received 4 hours of ischemia and then 12 or 24 hours of reperfusion respectively.The tissue morphology,wet-to-dry weight(W/D)ratio,malondialdehyde(MDA)and myeloperoxidase(MPO) of lung tissue were compared.The expression of ICAM-1 mRNA in lung was also studied by RT-PCR or in situ hybridization.The protein product was detected by Western blot.Results:In IPC and I-postC groups,all parameters decreased significantly compared with I/R ischemia group(P

Objective To construct a double luciferase reporter gene vector with PRDM1 gene promoter as target,and establish drug screening cell model in vitro,hope to find small molecule compounds in Chinese herbal medicine library by this model.Methods Total DNA was extracted from 293T cells and it was used for amplifying the fragment contained PRDM1 gene promoter (267 bp/1 257 bp) by PCR.The amplified product was inserted into pGL3-Basic vector.The PCR product and pGL3-PRDM1 vector were verified by sequencing and alignment.The pGL3-PRDM1 and pRL-TK vector were co-transfected into engineer cells.The activity of PRDM1 gene promoter could be assayed by measuring luciferase.The method was optimized by changing ratio of two vectors.Results The highest transfection efficiency and luciferase activity were found in ratio of n(pGL-PRDM1) ∶ n(pRL-TK)=2 ∶1,and with the recombinant luciferase report gene vector contained the length of 1 257 bp amplified fragment transfecting into U266 cells.Moreover,the inductor (5-Aza-CdR) of PRDM1 gene was used for authenticating the method(P＜0.01),the fluoresscence in tensity and promoter activity of PRDM1 gene were enhanced in a dose dependent manner with 5-Aza-CdR.The activity of the promoter of PRDM1 gene was significantly decreased from the concentration of 5 μmol/L of Artemisinid(P＜0.05).The total glucosides of paeoniflorin promoted the promoter activity of PRDM1 gene at a low concentration,and inhibited the promoter activity of PRDM1 gene at a high concentration.Artesunate has no effect on cell proliferation.The effect of total glucosides of paeony on cell proliferation was more complicated.Conclusion A drug selection model targeting PRDM1 gene promoter has been successfully established,and artesunate has been screened to inhibit the promoter activity of PRDM1 gene.

Objective To evaluate the short term results of endovascular laser for the treatment (ELVT) of great saphenous varicosity. Methods Twenty one cases (a total of 27 lower extremities) were enrolled. Treatment included EL combined with ligation and resection of communicating branches. One patient underwent high ligation and resection of the great saphenous vein for the purpose of pathology after ELVT treatment. Result Twenty patients were followed-up for a period of 2～6 months. Color Duplex ultrosonography was conducted 2 weeks,4 weeks,and 6 mos,respectively. Thrombotic obliteration was found in all cases. Pathology study showed perforation of the vein with intimal injury and thrombosis. Conclusion The short term efficacy of EL treatment is definite with insignificant side-effect,and quick patient recovery. The mechanism is related to direct thermal injury of laser to the venous intima resulting in thrombotic obliteration.

Objective To sum up our experience in the diagnosis and management of acute superior mesenteric venous thrombosis (SMVT). Methods We retrospectively reviewed 41 patients treated for acute SMVT admitted in our hospital from Jan 1978 to Aug 2003. Before 1995 (group Ⅰ), a surgery was preformed in patients with suspected acute SMVT. Since Jan 1995 (Group Ⅱ), aggressive medical therapy was immediately delivered, and the patients were subjected to laparatomy with suspected peritonity. Results There were 13 cases in group Ⅰ, and 28 in group Ⅱ. Mortality in group Ⅰ was 38.5%, and that in group Ⅱ was 10.7% (P

Objective To investigate the expression and relationship of early growth response gene-1((Egr-1)),platelet-derived growth factor-B(PDGF-B) and tranforming growth factor(TGF-?_1) in autogenous vein graft in rats,and the role in vein graft intimal hyperplasia(IH).Methods Autogenous vein graft model was(established) in 90 wistar rats.The vein graft samples were harvested at 1,2,6,24 hours,and 3,7,14,28,42 days after surgery.Normal vein was used as control group.Egr-1、PDGF-B,TGF-?_1 mRNA was measured by reverse transcription-PCR and in situ hybridization.Western blotting and immunohistochemistry were used to detect the protein expression of Egr-1,PDGF-B and TGF-?_1. Results Expression of Egr-1,PDGF-B,TGF-?_1 mRNA and protein was not detected in normal vein.In grafting vein,expression level of Egr1mRNA reached a peak at 28days,and the positive rate of Egr-1mRNA was 45%?6%;(PDGF-BmRNA) reached a peak at 14days(48%?6%);a peak of TGF-?_1mRNA was 46%?9% reached at 7days;Egr-1 protein expression reached a peak at 28days, and the positive rate of Egr-1 protein was 40%?9%.PDGF-B protein reached a peak at 28days(45%?4%),TGF-?_1 protein reached a peak at 14days(41%?7%).Conclusions Intimal hyperplasia of vein graft is closely associated withexpression of Egr-1、PDGF-B and TGF-?_1;the activation and expression of PDGF-B and TGF-?_1 may be(modulated) by Egr-1,and they may contribute to increase expression of Egr-1 by feedback.

Objective To evaluate expression of inducible nitric oxide synthase (iNOS) in human abdominal aortic aneurysm (AAA) and to identify its initiation in the oxidative vascular injury. Methods This study included 22 AAA patients and 10 cadaveric normal abdominal aorta. In situ hybridization and immunofluorenscent staining were used to localize iNOS messenger RNA (mRNA) and protein. Double staining with a combination of in situ hybridization and immunofluorenscent staining was used to simultaneously demonstrate iNOS mRNA expression and its cellular localization. The presence of end-product of oxidative injury induced by iNOS was indirectly assessed with immunofluorenscent staining by anti-nitrotyrosine antibody, its cellular localization were assessed by double immunofluorenscent staining. Results In situ hybridization and immunohistochemistry confirmed the presence of iNOS in media and adventitia of AAA in all 22 patients. Specific cell markers identified iNOS mRNA-positive cells were T and B lymphocytes, macrophages, and smooth muscle cells. Positive immunostaining for nitrotyrosine was present in macrophages and smooth muscle cells. Normal abdominal aorta demonstrated virtually no iNOS or nitrotyrosine expression. Conclusion Stimulated expression of iNOS is associated with degeneration of AAA in human beings leading to oxidative tissue and cellular injury in AAA.

Objective To explore the role of heme oxygenase-1 (HO-1) gene expression on murine experimental abdominal aortic aneurysm (AAA).Methods Wistar rats were divided into hemin (experimental group) and saline (control group) group randomly, and experimental AAA model was established by elastase perfusion. The specimen was obtained at postoperative day 7, and the dilatation rate was calculated. In situ hybridization was applied to detect the expression of HO-1 mRNA in aortic wall, while immunohistochemical staining was used to detect the protein expression of ICAM-1 and HO-1. Results In experimental group, the aorta dilation was inhibited and aneurysm was not observed. In experimental group, HO-1 mRNA and protein expression was strengthened (P

ObjectiveTo investigate the expression and significance of p38 mitogen-activated protei n kinase (MAPK) in autogenous vein graft. Methods Autogenous vein graft model was established by transplanting the right jugular vein to infr arenal abdominal aorta in 80 Wistar rats. Ten vein graft samples were harvested 6 hours, 24 hours, 3 days, 7 days, 2 weeks, 4 weeks, 6 weeks and 8 weeks after s urgery,respectively. Reverse transcription-PCR and in situ hybridization,Wester n blot and immunohistochemistry methods were used to detect the expression of pr otein and phosphorylation protein of p38 and p38mRNA. ResultsThe expression of p38 mRNA increased 6 hours after surgery and reached the peak on the second week after surgery (59%?26%),and significantly higher than that on 4,6,8 weeks( P