Objective:To compare drug-coated balloon (DCB) and standard angioplasty balloon (SAB) in the treatment of postoperative in-stent restenosis (ISR) in patients with arteriosclerosis obliterans (ASO) of the lower extremity.Methods:From Jan 2017 to Dec 2018, 43 ISR patients after percutaneous transluminal angioplasty for ASO of the lower extremity at our hospital were enrolled.Patients were divided into 2 groups with 18 patients treated by DCB and 25 by SAB. The patients were followed up for 6~12 months.Results:There was no significant difference in the incidence of complications between DCB group and SAB group ( P>0.05).Compared with that in SAB group, the plasma level of ET-1 in DCB group was lower while NO was higher at 6, 24 h and 2 weeks after surgery ( P<0.05), there was no significant difference in P-selectin ( P>0.05). The ABI values in both groups increased, and that in DCB group were higher than SAB group at 6 and 12 months after surgery ( P<0.05). The lumen loss in DCB group at 6 and 12 months after surgery was significantly lower ( P<0.05). At 6 and 12 months, the primary patency of target lesions in the DCB group was 100.00% and 88.89%, which was higher than the 72.00% and 52.00% in the SAB group ( P<0.05); the CD-TLR rate in the DCB group was 11.11%, which was lower than 48.00% in the SAB group ( P<0.05). Conclusion:DCB comes with lower postoperative ISR in ASO patients of the lower extremity.

Objective To investigate the efficacy and safety of exsanguination band used in the lower extremity varicose vein operation.Methods A total of 158 cases of lower extremities varicose veins in this hospital served as the research subjects.All cases underwent the high ligation of great saphenous vein combined with punctate stripping operation.Among them,117 cases intraoperatively used the exsanguination band for blocking the lower limb blood flow (observation group),41 cases did not use the exsanguination band (control group).Then the intraoperative bleeding volume,operation time,pain degree and postoperative complications were observed in the two groups.Results Compared with the control group,the operation time,intraoperative blood loss,hematoma score,prothrombin time (PT) and fibrinogen (FIB) in the observation group were significantly decreased (P＜0.05),while activated partial thrombin time (APTT) and thrombin time (TT) were significantly increased(P＜0.05).The lower limb blood flow occlusion time in the observation group was 45-62 min with an average of (46.68-5.53) min.The sensory score and pain score at postoperative 2 weeks had no statistical difference between the two groups (P＞0.05).No arterial abnormalities and no obvious ischemic injury were found in the injured limbs of 2 groups.Conclusion Applying the exsanguination band for transiently blocking the blood flow can effectively shorten the operation time,reduces the intraoperative bleeding amount and decreases the subcutaneous hematoma formation risk with high safety.

Objective To investigate the risk factors for multiple organ dysfunction syndrome(MODS)in elderly patients with severe stroke.Methods A total of 112 elderly severe stroke pa-tients admitted to our hospital from January 2020 to December 2022 were recruited prospectively,and then according to the results of sequential organ failure assessment(SOFA)within 14 d after admission,they were divided into MODS group(n=38)and non-MODS group(n=74).Based on their clinical outcomes,they were also assigned into survival group(n=-33)and death group(n=79).General clinical data,acute physiology,chronic health evaluationⅡ(APACHEⅡ)score,Glas-gow coma scale(GCS)score,and head computed tomography parameters were collected.Logistic regression analysis was used to analyze the risk factors of MODS.Results The MODS group had significantly larger proportions of stroke/hemorrhage,chronic obstructive pulmonary disease,cor-onary heart disease and smoking,higher NIHSS and APACHE Ⅱ scores,elevated ratios of multi-vessel disease,urinary tract infection,venous thrombosis,hemorrhage,epilepsy and myocardial in-farction,more patients using acute mechanical ventilation and osmotic therapy,and increased hos-pital mortality,but lower GCS score when compared with the non-MODS group(P＜0.05,P＜0.01).Binary logistic regression analysis showed that NIHSS score,APACHE Ⅱ score,and mul-tivessel disease were independent risk factors for MODS(OR=1.124,95％CI:1.121-1.163,P=0.015;OR=1.265,95％CI:1.296-1.426,P=0.001;OR=2.532,95％CI:1.126-5.013,P=0.026).The MODS score and APACHE Ⅱ score were significantly higher in the death group than the survival group(P＜0.05).Conclusion Elderly severe stroke patients are prone to MODS during the acute period.