Subclavian artery occlusion is a common peripheral artery occlusion disease of various causes,with incidence of 1.9％.The most common symptoms are dizziness,ataxia,and hemiplegia that are caused by subclavian steal syndrome.Surgery is the only therapeutic method for symptomatic patients.Open surgery remains an important role despite of the rapid progress in endovascular surgery.Main surgical method includes carotid-subclavian transposition (CST),carotid-subclavian bypass (CSB) and axillary-axillary bypass.Each one is suitable for different lesions and anatomies.Both the effectiveness and safety have been testified.

To observe the clinical efficacy of treatment of infantile brachia plexus injuries with three cooperative therapies of Tuina, Acupuncture and Acupoint injection, which have the function of clearing the meridians. Methods: The affected neck and arm were relaxed with Tuina techniques of one-thumb meditation, grasping and kneading. The points of Jiaji (Ex-B 2) on the neck, Jianjing (GB 21), Futu (LI 18), Jiquan (HT 1), Jianyu (LI 15), Quchi (LI 11), ect were pressed with one thumb. The points of Jiaji (Ex-B 2) on the neck, Tianchuang (SI 16), Futu (LI 18), Jiquan (HT 1), Quchi (LI 11), Waiguan (TE 5), Yangchi (TE 4), Hegu (LI 4)and the corresponding points were inserted with filiform needles and reinforcing-reducing method. The points of Jianyu (LI 15), Jianliao (TE 14), Quchi (LI 11), Shousanli (LI 10),Waiguan (TE 5), Yangchi (TE 4), Hegu (LI 4) were injected with Methylcobalamin injection.The treatment was given once every other day. Results: Of 35 cases, 22 cases were cured, 9 cases greatly improved and 4 cases improved. Conclusion: Three Therapies of Clearing Meridians have a good clinical efficacy for treating infantile brachia plexus injuries.

Objective To study the effect of early pulmonary surfactant (PS) treatment on oxygenation in neonates with acute respiratory distress syndrome (ARDS). Methods Clinical data of neonates with ARDS were retrospectively analyzed. All neonates with ARDS were divided into control group and treatment group. Neonates in treatment group were given PS at a dose of 70-100 mg/kg through the endotracheal tube. Results Among 64 neonates with ARDS, 18 neonates in treatment group were treated with PS, while other interventions were same with 46 neonates in control group. The PaO2/FiO2 and ventilation efifciency index were statistically higher in treatment group than those in control group at 6 h, 12 h, 24 h and 48 h (P<0.05). The oxygenation index and respiratory index were statistically lower in treatment group than those in control group at the same time points (P<0.05). Compared with control group, the treatment group also had a signiifcantly shorter duration of assisted ventilation and oxygen treatment (P<0.05). Conclusions Early treatment with PS in neonates with ARDS could improve the pulmonary compliance and oxygenation, and reduce the duration of assisted ventilation and oxygen treatment, and thus yield better prognosis.

Objective To study the oxygenation of the pulmonary surfactant replacement therapy for acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) in neonates.Methods Ninetyeight eligible neonates with ALI and ARDS were divided into two groups,treatment group (n =30) and control group(n =68).Thirty infants in treatment group were injected with pulmonary surfactant 70 ～ 100 mg/kg via tracheal intubation.The rest of the treatment measures were same in treatment and control group.Results There were no differences between the two groups in gender,gestational age,birth weight and ALI/ARDS.After the pulmonary surfactant replacement therapy for ALl and ARDS,the PaO2/FiO2 and ventilator efficiency index were higher in treatment group than that in control group at 6 h,12 h,24 h,48 h;the oxygenation index and respiratory index were shorter in treatment group than that in control group at the same time.The differences at all time points were statistically significant (P ＜ 0.05).The treatment group also had a significantly shorter duration of assisted ventilation[(66 ± 13) h vs (80 ± 18) h,(82 ±26) h vs (101 ±36) h] and oxygen treatment time [(86±13) h vs (104± 16) h,(103 ±25) h vs (125 ±29) h] (P ＜0.05).Conclusion The application of the pulmonary surfactant replacement treatment in neonates with ALI and ARDS could improve rapidly in dynamic compliance and oxygenation,decrease duration of assisted ventilation and supplemental oxygen administration,thus yield better prognosis.

Carotid Arteries ; diagnostic imaging ; surgery ; Feasibility Studies ; Head and Neck Neoplasms ; blood supply ; diagnostic imaging ; surgery ; Humans ; Radionuclide Imaging

AIM: To observe the expression of COX-2 in rat corneal neovascularization (CNV) and its relationship to CNV, and to explore the inhibition of Celecoxib, a COX-2 inhibitor, to CNV.METHODS: The distribution and quantification of COX-2and VEGF was detected by immunohistochemistry. Expression of COX-2 and VEGF mRNA was quantified by RT-PCR.The difference in protein and mRNA expressions of COX-2and VEGF was analyzed to find the correlation between them.RESULTS: Expression of activated COX-2 and VEGF protein and mRNA in CNV had a dynamic change. VEGF and COX-2co-localized. Compared with the control group, expression of both protein, mRNA of COX-2 and VEGF in experimental group Ⅱ and Ⅲ had significant difference (P＜0.05), indicating the correlation between COX-2 and VEGF, while that in experimental group I had no statistical difference (P＞0.05).CONCLUSION: COX-2 expression was up-regulated in inflammatory CNV. COX-2 modulates the expression of VEGF,playing a very important role in CNV. Celecoxib inhibit COX-2expression so as to hold back the CNV.

Background Recurrence of pterygium is a common complication after the surgical excision of pterygium,and this procedure is related to cell proliferation,inflammation and neovascularization.Researches determined that rosiglitazone can suppress inflammation and neovaseularization and inhibit proliferation,hut few studies concerning the effect of rosiglitazone on pterygium were performed. Objective The aim of this study was to investigate the effect of peroxisome proliferator-activated receptor γ agonist on the proliferation and apoptosis of human pterygium fibroblasts(HPFs)in culture and search for a new drug to prevent and cure the recurrence after pterygium surgery. Methods Human pterygium samples were obtained during surgery and HPFs were cultured and purified using an explant method and 0.25%trypsin digestion,respectively.The identity of cultured HPFs was confirmed by immunohistochemistry using anti-vimentin and keratin antibodies.Rosiglitazone with the concentrations of 0(control),5,10,25,50,75,100,150,200,400μmol/L was then added in the culture medium for 12,24 or 72 hours.1%DMSO was used as blank control.The MTT method was used to assay the biologic effects of rosiglitazone on HPFs.Cell cycle distribution and apoptosis of HPFs after rosiglitazone treatment were studied by flow cytometic analysis.The expression of proliferating cell nuclear antigen(PCNA)mRNA in HPFs was detected by real-time PCR. Result Cultured HPFs radially migrated outward from the pterygium block,and then grew in long fusiform shape,showing positive response for vimentin and negative for keratin.The HPFs became round and thin with loose distribution after the addition of rosiglitazone.Following 25-125 μmol/L rosiglitazone administration for 12,48 or 72 hours,the A490 value of HPFs significantly declined with the increase of dosage(F=158.312,P=0.006)and lapse of time(F=1.924,P=0.135).Following the treatment of 25,75 or 125 μmol/L rosiglitazone for 24 hours,the number of HPFs in G0/G1 phase was markedly elevated;while the cell numbers in S phase decreased significantly in comparison with the control group(P＜0.05).The apoptotic rate of HPFs in the 25,75 and 125 μmol/L rosiglitazone groups significantly increased with the increase of rosiglitazone concentration(P＜0.05).Real-time PCR revealed that after 24 hours of rosiglitazone treatment,the expression of PCNA mRNA in HPFs was suppressed in a dose-dependent manner(F=3244.329,P＜0.05). Conclusion Rosiglitazone inhibits HPFs proliferation,arrests their cell cycle progression in G0/G1 phase,induces apoptosis of HPFs and depresses the synthesis of PCNA in a dose-and time-dependent manner.

Inflammation is a common ocular surface disease.Glucocorticoid drugs are effective on the ocular surface inflammation,but their long-term and massive application is prone to serious side effects.Nonsteroidal antiinflammatory drugs (NSAIDs) have anti-inflammatory,anti-allergic,analgesic effects.The topical application of NSAIDs for the prevention and treatment of ocular inflammatory disease is much safer than that of glucocorticoid.Therefore,NSAIDs have more and more concerns in the treatment of ocular surface inflammation in recent years.Although NSAID has good anti-inflammatory effectiveness and less adverse effects,it should be correctly administered.During the treatment process of inflammatory ocular surface diseases,the combination of NSAIDs with glucocorticoid drug can strengthen the curative effect and reduce the adverse reactions.

Objective: To discuss the effects of different joint line heights on patellofemoral joint (PFJ) contact pressure at different knee flexion angels in human cadaveric total knee arthroplasty. Methods: Seven normal fresh-frozen human cadaveric knees with intact joint cartilage were tested on an Instron 8501 testing machine with a load of 30 kg. The load of quadriceps tendon was adjusted to balance the specimen at the desired angles. Total knee arthroplasty were performed with femurs of increased lengths (i. e. the heights of joint line were +2 mm, +4 mm, and +6 mm) and tibial plateaus of different heights. The peak PFJ contact pressure was measured with Fuji pressure-sensitive film before and after total knee arthroplasty. Results: After total knee arthroplasty, at knee flexion angles of 60°, 90° and 120°, the peak contact pressures of lateral PFJ facet were significantly higher when the heights of joint line were +4 mm and +6 mm than those when the heights of joint line were 0 and +2 mm (P<0.05); at knee flexion angles of 30°, 60°, 90° and 120° the peak contact pressure of medial PFJ facet were significantly higher when the heights of joint line were +6 mm than those when the heights of joint line were 0, +2 mm, and +4 mm (P<0.05). Conclusion: The peak PFJ contact pressure increases if the height of joint line is elevated by more than 4 mm in total knee arthroplasty, so the variation of joint line should be controled within 4 mm in total knee arthroplasty.

Cardiovascular Diseases ; prevention & control ; Cerebrovascular Disorders ; prevention & control ; Humans ; Medicine, Chinese Traditional ; methods