This study is to evaluate the effect of sequence arterial reconstruction on lower extremity arteriosclerotic occlusion. 36 patients underwent bypass operation. Among them,1 case died of acute renal failure, and 1 case died of acute myocardial infarction. The arterial reconstructive patency rate was 100% after operation, and was 89 2% and 70 2% 2 and 5 years after operation respectively. It is suggsted sequence arterial reconstruction is safe and effective for lower extremity arteriosclerotic occlusion. The key to the successful operation lies in the patent inflow and outflow of the arterial reconstruction. Biocomposite graft in combination with common ostium technique would be helpful.

In order to have better understanding of the etiology and treatment of the endoleak after endovascular graft exclusion for abdominal aortic aneurysms, experiences with the treatment of endoleak in 38 cases received EVGE for AAAs were reviewed.Among them, 4 cases were complicated with endoleak. Type Ⅰ endoleak occurred in two cases, type Ⅱ in one case, and type Ⅲ in one case. One case was converted to open surgery, the other three cases were kept under observation. The results showed that DSA is a useful in the diagnosis of endoleak.The endoleak can be sealed by stretching the graft and inserting an extension or another stent graft and embolizing collateral vessel.

This paper presents a general review on characteristics and development trends of new-style field first-aid medical equipment. It shows that first-aid medical equipment has new characteristics involving multi-functions, flexibility, application of advanced technology, etc., and has new development trends such as multiple functions, higher efficiency to be used in war and intellectualized control for self-aid and buddy-aid.

To study the effects of astragaloside Ⅳ, which was obtained from Astragalus membranaceus Bge., on myocardiac dynamics and cardiac function on normal and cardiac depressant rat. Methods　Left ventricular pressure (LVP) and differential value of dp/dt were recorded by left ventricular catherization to observe the effect of 1 mg/kg iv astragaloside Ⅳ on normal and cardiac depressant rat induced by iv 0.75 mg/kg of Propanolol. Results　Astragaloside Ⅳ decreased heart rate slightly, and showed inotropic activity by increasing dp/dtmax significantly, with improvement of cardiac diastolic function. It shortened the time constant (T) and caused no obvious change on the tension time index (TTI) in normal rat. These results suggested that astragaloside Ⅳ did not increase cardiac oxygen consumption while exerting its inotropic effect. Conclusion　Astragaloside Ⅳ can improve both cardiac systolic and diastolic functions, and may be used as a candidate for the treatment of cardiac disfunction.

Object To study the effects of astragaloside Ⅳ, which was obtained from Astragalus membranaceus Bge., on myocardiac dynamics and cardiac function on normal and cardiac depressant rat Methods Left ventricular pressure (LVP) and differential value of dp/dt were recorded by left ventricular catherization to observe the effect of 1 mg/kg iv astragaloside Ⅳ on normal and cardiac depressant rat induced by iv 0 75 mg/kg of Propanolol Results Astragaloside Ⅳ decreased heart rate slightly, and showed inotropic activity by increasing dp/dt max significantly, with improvement of cardiac diastolic function It shortened the time constant (T) and caused no obvious change on the tension time index (TTI) in normal rat These results suggested that astragaloside Ⅳ did not increase cardiac oxygen consumption while exerting its inotropic effect Conclusion Astragaloside Ⅳ can improve both cardiac systolic and diastolic functions, and may be used as a candidate for the treatment of cardiac disfunction

Objective To evaluate the benefits and the risk of pulmonary embolism between walking exercises and bed rest in the acute stage of deep venous thrombosis (DVT). Methods From February 2008 to March 2009,40 acute primary DVT patients were arbitrarily randomized into controlled group and experimental group,with 20 cases in each group,who were hospitalized within seven days of onset.Patients in controlled group underwent bed rest for 7-10 days,wearing elastic stockings.While patients in experimental group were early (1-2 days after admission) off bed walking about 600-1200 m every day with elastic stockings for 7-10 days.During the process patients in both group received regular anticoagulation treatment,and continued warfarin anticoagulation therapy after out of hospital for at least 6 months.The clinical characteristics of the two groups were comparable.Primary end points were the reduction of pain assessed daily with the Visual Analogue Scale (VAS),the reduction of leg circumference at thigh,and cumulative pulmonary embolism incidences of two groups in three months. Results Symptoms in all patients of the two groups were improved,but the pain level showed a statistically significant reduction starting after the third day(58 ±8) mm in the experiment group and after the fifth day (58 ± 13) mm in the controlled group.The leg circumferences of the two groups after 7 days were statistically significantly different (P ＜ 0.05),the cumulative pulmonary embolism incidences of the two groups for 3 months were not statistically significantly different. Conclusion Mobile patients with acute DVT should be encouraged to walk with medical compression stockings.The rate of resolution of pain and swelling is significantly faster when the patient ambulates with compression.The quality of life significantly improved.The risk of pulmonary embolism does not significantly increase by this approach.

Objective To observe the long-term efficacy of human fibrin sealant (FS) in the treatment of proximal type Ⅰ endoleak after endovascular aneurysm repair (EVAR) in abdominal aortic aneurysm (AAA).Methods The clinical data of 104 AAA patients with proximal type Ⅰ endoleak receiving EVAR + FS in Changhai Hospital from 2003 to 2012 was retrospectively analyzed,among those 77 cases were with less than 15 mm proximal neck,21 cases with greater than 60 degrees proximal neck angulation,37 cases with severe calcification or thrombosis in proximal neck.After failure of conventional endoleak therapy FS was injected through AAA catheter and long-term efficacy was evaluated by CTA during the follow-up.Results Intra-sac pressure decreased significantly after FS injection.Three patients (2.9％)died perioperatively.Postoperative 1'-,3' and 5 year survival rate was 91.8％,80.6％ and 60.2％respectively.Maximum diameter of AAA decreased from (58.78 ± 13.41) mm to (52.6-± 12.2) mm.There was no FS injection related complications.Conclusion Intra-sac injection of FS is an effective,economical and safe method for treating post-EVAR endoleak,especially for AAA with relatively short and twisted aneurysm neck.

Objective:To examine the effectiveness of thin struct bare stents for the treatment of spontaneous isolated dissection of the superior mesenteric artery (SIDSMA).Methods:The data of 32 patients admitted to First Hospital of Jiaxing (20 cases) and Jinling Hospital (12 cases) with SIDSMA from January 2016 to January 2021 were retrospectively analyzed. There were 27 males and 5 females, aging (54.8±9.4) years (range: 36 to 75 years). All patients were treated with thin struct bare stents. Controllable spring coils were used to fulfill the false lumen in 2 cases. Symptoms, vascular remodeling pattern at the SIDSMA lesion, and patency of the stents were observed during follow-up.Results:The surgical success rate was 100%. According to the length of the lesions and stents, the number of stents implanted was 1 in 17 cases, 2 in 11 cases and 3 in 4 cases. The angiography showed that blood flow in the stent was smooth. The numerical rating scale for abdominal pain decreased from 6.1±1.5 (range: 4 to 10) preoperatively to 1.0 (1.0) (range: 0 to 3) 1 hour postoperatively ( W=528, P<0.01). The compression rate of the true lumen of the superior mesenteric artery decreased from (92.3±6.7)% (range: 25% to 94%) preoperatively to 0.8 (1.2)% (range: 0 to 3.2%) 1 month postoperatively ( W=528, P<0.01). The primary patency rate of CT angiography at 1 month postoperatively was 100%. The vascular remodeling rate was (92.3±6.7)% (range: 80% to 100%). All patients were followed for (46.3±17.0) months (range: 24 to 76 months). The cumulative patency rates in 1, 2 and 5 years were all 100%. Conclusion:The use of thin struct bare stents for SIDSMA could obtained the expected safety and efficacy.

Objective:To examine the effectiveness of thin struct bare stents for the treatment of spontaneous isolated dissection of the superior mesenteric artery (SIDSMA).Methods:The data of 32 patients admitted to First Hospital of Jiaxing (20 cases) and Jinling Hospital (12 cases) with SIDSMA from January 2016 to January 2021 were retrospectively analyzed. There were 27 males and 5 females, aging (54.8±9.4) years (range: 36 to 75 years). All patients were treated with thin struct bare stents. Controllable spring coils were used to fulfill the false lumen in 2 cases. Symptoms, vascular remodeling pattern at the SIDSMA lesion, and patency of the stents were observed during follow-up.Results:The surgical success rate was 100%. According to the length of the lesions and stents, the number of stents implanted was 1 in 17 cases, 2 in 11 cases and 3 in 4 cases. The angiography showed that blood flow in the stent was smooth. The numerical rating scale for abdominal pain decreased from 6.1±1.5 (range: 4 to 10) preoperatively to 1.0 (1.0) (range: 0 to 3) 1 hour postoperatively ( W=528, P<0.01). The compression rate of the true lumen of the superior mesenteric artery decreased from (92.3±6.7)% (range: 25% to 94%) preoperatively to 0.8 (1.2)% (range: 0 to 3.2%) 1 month postoperatively ( W=528, P<0.01). The primary patency rate of CT angiography at 1 month postoperatively was 100%. The vascular remodeling rate was (92.3±6.7)% (range: 80% to 100%). All patients were followed for (46.3±17.0) months (range: 24 to 76 months). The cumulative patency rates in 1, 2 and 5 years were all 100%. Conclusion:The use of thin struct bare stents for SIDSMA could obtained the expected safety and efficacy.

Since 2000 Dorros et al. reported the first case of type A aortic dissection (TAAD) treated with an endovascular repair, surgeons explored a novel treatment option for TAAD gradually. The application of endovascular repair for TAAD highlights some points below which should pay attention to because of the special anatomic location and morphological characteristics of ascending aorta: (1) customized treatment strategy based on the characteristics of patients; (2) pre-operation evaluation; (3) selection of the stent and delivery system; (4) selection of the access sites; (5) preservation of the coronary artery flow, aortic valve function and perfusion of the branch vessels; (6) accurate location of stent-graft; (7) mid-term and long-term follow-up. In a word, it's helpful to avoid misunderstanding in treatment and improve the safety of operation by grasping the indication and the technical points and making the customized treatment strategy based on the characteristics of patients.
Aneurysm, Dissecting ; surgery ; Aorta ; pathology ; surgery ; Aortic Aneurysm ; surgery ; Blood Vessel Prosthesis Implantation ; Endovascular Procedures ; Humans ; Stents