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.

Objective To evaluate endovascular aortic repair for retrograde Stanford type A aortic dissection with an entry tear in the descending aorta.Methods From April 2006 to Dec 2012,31 patients with retrograde type A aortic dissection were treated with endovascular technique.22 patients had pleural effusion,14 patients had patent false lumen in the ascending aorta.Emergency operation was performed in 2 patients with acute right renal artery and right common iliac artery ischemia respectively.29 patients received endovascular treatment after 3 weeks conservative treatment.Chimney technique was used in 3 patients.Results All procedures were technically successful without severe complications.Ascending aorta recovered 1-3 months after operation.Pleural effusion subsided 3 days to 3 weeks after endovascular treatment.During follow-up of (31 ± 18) months,no severe complications developed,all the stent-grafts placed by chimney technique were patent.Conclusions Endovascular aortic repair can be used in the treatment of retrograde Stanford type A aortic dissection.Chimney technique can be used to reconstruct supra-aortic branches.

Objective] To summarize the experiences of Professor Shu Qijin and to introduce his frequently used traditional Chinese medicine(TCM) herbal-pairs for treating lung cancer. [Methods] Professor Shu's experience and the treatment principles on herbal-pairs were summarized by attending the process of his diagnosis and treatment for lung cancer patients and his medical records. [Results] Shu treated that lung cancer by traditional Chinese medicine belongs to the multi-target therapy, drug although short, lung disease is also complex. However, the drug for lung cancer a target in strong, if properly combined, can hold simplification, observant insight. For advanced lung cancer patients with Qi deficiency symptoms, Shu used common heterophylla-Astragalus, Codonopsis-white atractylodes rhizome, Radix Glehniae, Ophiopogon japonicus, medicine of Fuzheng anticancer; sputum is a poison stasis, Shu divided common diffusa-sheliugu, Lobelia chinensis, Scutellaria barbata, Taxus chinensis var. mairei, Polygonum cuspidatum root medicine for detoxification Sanjie; blood stasis, Shu used common trigonous, rhizome, notoginseng, radix paeoniae rubra, etc. drug for promoting blood circulation and removing blood stasis. Anyway, Shu permited the treatment of lung cancer, on the basis of dialectical argumentation, discerning the pathogeny, disease location, disease, illness and mastering five flavors of the four properties of traditional Chinese medicine(TCM), rising and sinking, using the following drugs, clinical addition and subtraction, herbal prescription has better clinical efficacy, and attached with the case of a post-mortem. [Conclusions]Medicine of precise curative effect is determined by Shu and the mechanism of medication has higher clinical value,it is worth in-depth study and application.

Objective To observe the effect of elevated local sheer stress of abdominal aota on its caliber and wall expression of MMP-9,and analyse the action of high shear stress on arterial remodling.Methods Forty-eight SD rats were randomly divided into 4 experiment and 4 comparison groups.An infra-renal aortocaval fistula was constructed by needle puncture using a 0.4mm needle in the experiment groups.The aorta proximal to the fistula was harvested after 1 d,7 d,14 d and 28 d respectively,while sham operation was done in the comparison groups.The diameter and wall thickness of the aorta were measured after fistula was made and before harvest.The level of change of MMP-9 was observed by immunohistochemistry.Results The diameter of aorta proxinal to the fistula was enlarged in the 1d group(P

Objective To explore ideal treatment strategy for hemangioma and vascular malformations.Methods The clinical data of 863 cases of hemangioma and vascular malformation were analyzed retrospectively.There were 414 male and 449 female patients,The ages ranged from 2 weeks to 55 years.Among these cases,742 were hemangioma while 121 were vascular malformation.The different treatment methods were selected based on the type,location,and extent of the lesion and the patient′s individnal situation.Seven hundred and forty-six patients underwent surgical treatment,89 patients underwent operation combined with sclerotherapy,and 28 patients received embolization of feeding arteries with or without operation.Results Early postoperative results showed that 772 cases(89.46%) were cured,78 cases(9.04%) markedly improved and 13 cases(1.5%) improved.A total of 620 cases were followed up for 0.5-3.0y,of which,556 cases(89.68%) were cured,51 cases(8.23%) markedly improvod,and 13 cases(2.09%) had improved.Conclusions Operation is ideal strategy for the limited disease focus,while non-surgical treatment is necessary for patients with extensive and deep lesions or who are not fit for surgical treatment.Combining surgical treatment and non-surgical treatment can achieve better therapeutic efficiency.

The tissue engineering technology that developed in the 1980s brings a hope for the regeneration of human organs. It is feasible to construct by-pass vessels, which have no immune resistance but are capable of anticoagulation. At present, a huge number of researches have provided the necessary basis for the construction. However, there are still some difficulties on the points of induction and proliferation of endothelial cells, development of new materials for scaffold and co-culture of seed cells in scaffold. These difficulties have become the bottle neck of tissue engineered blood vessels. The tissue engineering vessels are nowadays absent in clinical practice. With the progress in researches of tissue engineering, it is strongly believed that human organs and tissues can be constructed using tissue engineering technology, thus satisfying the donors of organ transplantation.

Pulmonary cavitary lesions in children consist of a group of heterogeneous diseases, mainly caused by infections, and their imaging manifestations can be similar.It is clinically difficult to distinguish them from other lesions such as bullae, cyst, and emphysema.Some scholars have advanced a concept about thin wall(4 mm or less) and thick wall(more than 4mm).People tried to make this distinction by defining cyst as a thin wall and cavity as a thick wall, but there are considerable overlaps between the two categories in etiology and pathophysiology.They are sometimes difficult to distinguish for imageology, and it is still necessary to find the cause of the disease based on the characteristics.This review divides etiology into two categories: infectious and non-infectious etiology.Combined with chest imaging examination, the purpose is to analyze and summarize the features of pulmonary cavitary lesions in children, and provide a diagnostic idea for differentiating various pulmonary cavities to guide clinical treatment.

Objective To evaluate surgical management of ruptured abdominal aortic aneurysm (RAAA).Methods Clinical data of 36 RAAA patients undergoing emergent graft replacement or endovascular aortic repair (EVAR) from May 2002 to July 2013 were retrospectively analyzed.25 and 21 patients were associated with hypertension and chronic obstructive pulmonary disease respectively.33 patients were treated with graft replacement.3 patients received endovascular treatment and 1 patient converted to open surgery.Results Perioperative death occurred in 3 patients including severe hemorrhagic shock in 1 patient,cardiac arrest in 1 patient and multiple organ failure in 1 patient.During follow up for 3 to 61 months,no operation related complication,such as artificial graft infection happened.Conclusions Emergent operation including open surgery and EVAR is crucial for RAAA treatment.Early diagnosis,excellent operative techniques and effective perioperative management are measures conducive to lowering the mortality rate of RAAA.

Humans ; Larynx ; surgery ; Neurilemmoma ; surgery

Acupuncture Points ; Acupuncture Therapy ; history ; China ; History, Ancient ; Humans ; Medicine in Literature ; Meridians