Objective To evaluate catheter-directed thromlysis (CDT) through three different approaches in combination with intervention for acute deep venous thrombosis (DVT) of the lower extremities. Methods In this study 137 acute DVT cases were enrolled. CDT was performed through small saphenous veins in 107 cases,through the great saphenous veins in 21 and through popliteal veins in 9.Iliac vein balloon dilation was performed in 66 cases,and stents were placed in 60 cases. Results The limb edema reduction rates between small saphenous vein group and great saphenous vein group and popliteal vein group were of no significant difference (82.3％ ±7.6％ vs 81.6％ ±6.0％ vs 83.9％ ±6.1％,P＞0.05).The difference of rates of thrombolysis ( 63.5 ％ ± 7.7％ vs 66.9％ ± 8.4％ vs 66.1％ ± 2.7％ )between the 3 groups was not statistically significant (P ＞ 0.05 ). The mean time required for the cannulation was shorter in great saphenous vein group than the other two groups [ (7.3 ± 0.3 ) min vs (20.8 ± 1.1 ) min and (15.7 ±0.6) min,P ＜ 0.05 ].There were 12 cases complicating incision bleeding during thrombolysis in small saphenous vein group,in this group there were 5 cases complicating phlebitis and 8 complicating saphenous nerve injury.The complication rates in great saphenous vein group was lower (P ＜ 0.05).Follow-up made in 112 cases for 3 -25 months.There were 97 cases without limb edema.While test by venography or color Doppler,89 cases showed venous patency and rethrombosis developed in 8 cases. Conclusions Catheter-directed thrombolysis with iliac venous intervention was an effective method for the treatment of acute deep venous thrombosis.CDT through great saphenous vein is easier with less complications.

Objective To investigate the features and risk factors associated with lymph node metastasis in colorectal neuroendocrine neoplasm.Methods Clinical and pathological data of 63 patients with colorectal neuroendocrine neoplasm treated in Yinzhou People's Hospital between June 1997 to December 2012,were analyzed retrospectively.Comparisons of categorical data and univariate analysis of risk factors of lymph node metastasis were conducted by x2 test,multivariate analysis was conducted by Logistic regression analysis.Results Of the 63 patients the rate of regional lymph node metastasis was 30％ (19/63) with 58％ limited to para-intestinal lymph nodes in 11 cases,26％ limited to mesenteric lymph nodes in 5 cases,and 16％ limited to mesenteric root central lymph nodes in 3 cases.No metastasis exceeding central lymph nodes was observed.According to univariate analysis,tumor size,depth of invasion,ulceration in mucous membrane,invasion of lymphatic vessel and pathological grading suggested by WHO were related to regional lymph node metastasis (P ＜ 0.01).Multivariate regression analysis revealed that tumor size,invasion of lymphatic vessel and pathological grading were independent risk factors for lymph node metastasis in colorectal neuroendocrine neoplasm (P ＜ 0.05).Conclusions Colorectal neuroendocrine neoplasm with larger tumor size,invasion of lymphatic vessel or higher grade (G2,G3) has high risk of regional lymph node metastasis.