2.Treatment of Acute Limb Arterial Embolism and Influencing Factors of Its Prognosis
Yukui MA ; Jichun ZHAO ; Bin HUANG ; Zhi HU
Chinese Journal of Bases and Clinics in General Surgery 2003;0(06):-
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
3.Intraoperative internal carotid artery shunt in the resection of carotid body tumors (CBT)
Jichun ZHAO ; Yukui MA ; Bin HUANG ; Yi YANG ; Guojun ZENG
Chinese Journal of General Surgery 2010;25(7):533-535
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.
4. Long-term efficacy of autologous hematopoietic stem cell transplantation in systemic sclerosis patients
Xiaocong HUO ; Mei LAN ; Yangming TANG ; Xinxiang HUANG ; Yukui HUANG ; Jing LEI ; Yonggan LI ; Xia ZHU ; Xuejun LI ; Jinying LIN
Chinese Journal of Rheumatology 2019;23(10):673-678
Objective:
To observe the long-term efficacy and safety of autologous hematopoietic stem cell transplantation (AHSCT) for systemic sclerosis (SSc) patients.
Methods:
Between May 2007 and June 2009,4 patients with SSc were enrolled in the study. Peripheral blood stem cells were mobilized with cyclopho-sphamide (CTX) followed by granulocyte colony stimulating factor (G-CSF). Conditioning was performed with i.v. cyclophosphamide 50 mg·kg-1·d-1 for 4 days. The results of the modified Rodnan skin score (mRSS), thoracic high-resolution computer tomography and pulmonary function were collected after transplantation.
Results:
There was an improvement in mRSS, lung function and HRCT in the six months after AHSCT. Within six month to one year after transplantation, one patient had sustained and two patients recurred. After active treatments two patients were improved again. During the follow-up of 8.7 (4.1-9.8) years, three patients were stable and one patient died. Infection and hepatic function injury were the major complications. There was not transplant-related mortality.
Conclusion
AHSCT with CTX as a pre-conditioning regimen is safe and effective for SSc. The efficacy for patients with short course, rapid progress and edema is significant. However, long-term efficacy is poor, and long-term maintenance treatment is needed.
5.The application of three-dimensional printing abdominal aortic aneurysm improve the teaching effect for the residents in vascular surgery department
Zhoupeng WU ; Ding YUAN ; Jichun ZHAO ; Yukui MA ; Bin HUANG ; Yi YANG ; Fei XIONG ; Guojun ZENG ; Xiyang CHEN ; Tiehao WANG ; Xiaojiong DU
Chinese Journal of Medical Education Research 2018;17(6):611-615
Objective To evaluate 3D printing abdominal aortic aneurysm model in analysis of clinical teaching effect for standardized resident doctors in vascular surgery department. Methods 48 resi-dents in vascular surgery department in our hospital from December 2016 to September 2017 were seleeected and randomly divided into control group and the experimental group. The traditional vascular surgical anatomy atlas, ultrasound, CT abdominal blood vessel 3D reconstruction, digital subtraction, video and so on were used by 24 residents in the control group, while in the experimental group, on the basis of the traditional teaching, abdominal aortic aneurysm model of 3D printing, true aortic coated stent delivery system were increased. After the teaching, the theory of evaluation (abdominal vascular anatomical features, morphological characteristics and classification of AAA, measurement of various parameters and key points of operation in the EVAR) and satisfaction questionnaire were adopted to evaluate the effect of two kinds of teaching methods. SPSS 19.0 was used to conduct t test on two groups of physician evaluation data. Results The results of theoretical assessment showed that there was no significant difference between the control group and the experimental group in the abdominal vascular anatomical features, the morphological features and the classification of the experimental group (P>0.05) in the examination of the common AAA cases and the complicated AAA cases. However, the experimental group was higher than the control group in the mea-surement of the parameters of EVAR, and the score of the operation points and the total score, and the difference was statistically significant (t=2.283, t=2.263, P<0.05). The results of the questionnaire showed that the students' satisfaction scores on the teaching satisfaction of the normal and complex AAA cases were better than those of the control group, and the difference was statistically significant (P<0.05). Conclusion The 3D printing model can increase the understanding and mastery of the anatomy and treat-ment of abdominal aortic aneurysm and improve its learning enthusiasm for vascular surgery. We should make full use of the advantages of 3D printing technology on the basis of retaining the advantages of tradi-tional teaching methods and means, and further enhance the teaching effect.