ObjectiveTo improve the therapies for recurrent arterial embolism of the extremities. MethodsFrom Dec. 1984 to Dec. 1997, 35 patients of recurrent embolism of the extremities were treated,results were compared to that of 248 patients with first onset.ResultsThe recurrent cases accounted for 12.4% of the disease.One year recurrence developed in 63% of the 35 cases.32 cases suffered from second arterial embolism and 3 cases had third onset with a total of 42 limbs.The rates of cure,mortality and amputation were respectively 54.3%,22.9%, and 2.9% in the recurrent group,compared to 72.6%,10.1%,and 14.9% in the control group.There were statistically significant differences of cure,mortality and amputation rates between the two groups(? 2test, P

Type Ⅰ congenital biliary dilatation is a congenital biliary duct defect disease.It is also called congenital choledochocele cyst (CCC).Endoscopic ultrasonography (EUS),magnetic resonance cholangiopacreatography (MRCP) and endoscopic retrograde cholangiopancreatography (ERCP) are very important for the diagnosis.Operation is generally regaded as the best choose.It is recommended that cholecystectomy + choledochal cyst excision + hepatic duct jejunum Roux-Y anastomosis is the chief therapeutic method.This article reviews the pathogenesis,classifications,diagnosis and treatment of the disease.

Objective To investigate the related factors affecting prognosis of patients with colorectal cancer undergoing palliative resection.Methods The clinical data of 345 patients with colorectal cancer who underwent palliative resection at the First Affiliated Hospital of Guangxi Medical University between January 2007 and December 2011 were retrospectively analyzed.Patients selected the emergent operations or restrictive operation based on the conditions of patients,and then received chemotherapy,radiotherapy and biotherapy.Chemotherapy regimens included FOLFOX4 (5-FU/CF + oxaliplatin) regimen,XELOX (capecitabine + oxaliplatin) regimen and FOLFIRI (5-FU + CF + irinotecan) regimen.Biotherapy regimens included molecular targeted therapies using bevacizumab and cetuximab.The follow-up was applied to patients by outpatient examination,telephone interview and correspondence once every 3 months up to March 1,2014.The survival curve was drawn by the Kaplan-Meier method.The survival rate was analyzed using the Log rank test.The multivariate analysis was done using the COX regression model.Results Of the 1 930 patients,345 patients received palliative resection with a percentage rate of 17.876％.Among the 345 patients,104 patients received emergent operations and others received restrictive operations.After operation,178 patients received adjuvant treatment,FOLFOX4 regimens were done on 85 patients,XELOX regimens on 32 patients,FOLFIRI regimens on 20 patients,radiotherapy on 17 patients and molecular targeted therapies on 24 patients.Seven patients died in the perioperative period and other patients were followed up for 3.0-82.0 months with a median time of 14.0 months.The 1-,3-and 5-year survival rates and the mean survival time were 49.57％,11.88％,6.38％ and 22.6 months,respectively.The results of univariate analysis showed that the CEA levels,bowel obstruction,primary tumor resection,peritoneal implantation,distal metastasis,lymph node metastasis,tumor differentiation,postoperative adjuvant therapy were related factors affecting the prognosis of patients undergoing palliative resection (x2=3.742,18.795,37.641,13.470,4.228,5.835,4.108,6.875,P ＜0.05).The results of multivariate analysis showed that the bowel obstruction,without primary tumor resection,peritoneal implantation,low-differentiation of tumor and without postoperative adjuvant therapy were the independent risk factors affecting the prognosis of patients undergoing palliative resection (RR =1.674,2.273,1.947,1.582,1.342,95％ confidence interval:1.193-2.485,1.646-4.376,1.497-3.587,1.184-2.382,1.032-2.074,P ＜ 0.05).Conclusion The low-differentiation of tumor,peritoneal implantation,bowel obstruction,without primary tumor resection and without postoperative adjuvant therapy are the independent risk factors affecting the prognosis of patients with colorectal cancer undergoing palliative resection.

2016.0 ng/L group (n=85) and followed up for average 371 days (90-540 d).Cardiac death or decompensated heart failure(HF) readmission were counted as advease events end-point for the purpose of this analysis.Results At follow up,76 patients had the cardiac events (26 patients died from cardiovascular causes and 50 patients being rehospitalization).No differences in admission NT-proBNP between patients with and without cardiovascular events.However,patients with high pre-discharge NT-proBNP(3872.0 vs 1306.0 ng/L,P

To explore the impact of middle and low dose atorvastatin on peripheral endothelial progenitor cells (EPCs) in patients with acute myocardial ischemia injury via investigating EPC proliferation, migration, differentiation and secretion of cytokines. Method: A total of 80 patients with acute ST-segment elevation myocardial infarction (STEMI) were randomly divided into 2 groups: Observation group, the patients received atorvastatin 40 mg and Control group, the patients received atorvastatin 20 mg. n=40 in each group. The number of circulating EPC, EPC proliferation ability and the secretion of cytokines before and at different time points after drug therapy were examined by means of MTT, flow cytometry and ELISA. Results: The number of EPC was obviously increased with greatly changed migration ability within 2 weeks atorvastatin treatment in both groups. The secretion of cytokines presented that the contents of VEGF, bFGF, CXCR were elevating first followed by reducing thereafter, while the content of SIRT1was continuously increasing during the period of treating. The above parameters were similar between 2 groups. Conclusion: Middle and low dose atorvastatin could effectively improve EPC proliferation and migration, increase the expressions of CXCR4, VEGF, bFGF and SIRT1 in STEMI patients.

Objective To explore the method of 3D reconstruction of major blood vessels around the pancreas with Myrian system and its clinical significance.Methods By making use of the data from 64-slice CT of GE,the main arteries,portal vein,spleen vein,superior mesenteric vein and inferior mesenteric vein of 60 pancreases were 3D reconstructed with Myrian system.Vessel length and some other data were also recorded.Results The main arteries and veins were reconstructed.The length of portal vein was (46.37 ± 11.48)mm.The length of postpancreas trunk was (34.88±9.13)mm.The angle between portal vein and spleen vein was acute angle in 17 cases (28.33％),right angle in 11 cases (18.33％) and obtuse angle in 32 cases (53.33％).The inferior mesenteric vein fed into spleen vein in 19 cases (31.67％),superior mesenteric vein in 34 cases (56.67％) and conjunction point between spleen vein and superior mesenteric vein in 7 cases (11.67％).Conclusion Myrian system can be used to reconstruct the 3D structure of blood vessels around the pancreas with high reconstruction rates.This method can also be used in feasibility analysis of clinical operations and reduce the risk of bleeding caused by unknown distribution of blood vessels around the pancreas during operation.

Objective To evaluate the effects of anatomic and extra-anatomic reconstruction in cases of aortoiliac occlusion on perioperative morbidity and mortality. Methods Clinical data of 382 cases were retrospectively analyzed with reference to perioperative morbidity and mortality by Logistic regression. Results One hundred and twenty- six patients were enrolled into analysis. Impact factors included lower extremities necrosis(OR 0. 13 95% CI 0. 33 - 0. 36,P=0.005), simultaneous distal reconstruction (OR 11.29 95% CI 1.25 - 102.53,P =0.012). Perioperative complications developed in 13. 5% cases. Goldman cardiac risk(OR 26. 83 95% CI 4. 85 - 49. 54,P =0. 001),age (OR 37. 13 95% CI 3. 29 -48. 53,P = 0. 003),renal dysfunction(OR 5. 71 95% CI 1. 25 -25. 02, P = 0. 024) and surgical modality (OR 0. 03 95% CI 0. 002 - 0. 34, P =0. 005) were identified as risk factors. Perioperative mortality was 8. 7%. Goldman cardiac risk (OR 23. 86 95% CI 3. 90 - 45. 99,P =0. 032),age(OR 65. 56 95% CI 4.88-87.64, P =0.002) and surgical modality(OR 0.02 95% CI 0. 001 -0.262, P=0.005) were among factors predicting perioperative death. Conclusions Age over 70 years, renal dysfunction, intermediate or higher Goldman cardiac risk, moderate or severe emphysema are risk factors of perioperative mortality and morbitity of aortoiliac reconstruction. Extra-anatomic reconstruction should be considered against the risk factors in poor risk patients.

ObjectiveTo evaluate the efficacy of axillo-axillary bypass grafting for the treatment of contralateral arterial ischemia of upper limb. Method 53 cases underwent axillo-axillary artery PTFE graft bypass among those there were 46 cases of subclavian artery occlusion and 3 cases of subclavian artery aneurysm and 4 cases of trauma. Preoperatively 33 cases suffered from a symptom of extremity ischemia and 18 cases with subclavian artery blood steal. Result Good results were achieved in all cases without any complications. Doppler test showed the gradient of bilateral brachial pressure artery was less 10 mmHg in all cases. ConclusionAxillo-axillary artery PTFE graft bypass is an effective method for subclavian artery reconstruction with less trauma and complications. It is especially suitable for the elders with concomitant heart brain and lung diseases. It is also applicable for cases in which the subclavian arteries are not easily accessible due to artery aneurysm and artery trauma.

Objectives To study the diagnosis, treatment and prognosis of acute peripheral artery injury, and ways to improve the treatment. Methods Clinical data of 211 cases of acute peripheral arterial injuries admitted between January 1988 and June 2002 in Anzhen hospital were analyzed retrospectively. Of the 211 cases,73 cases were with blunt injuries, 99 penetrating injuries, 37 iatrogenic injuries, 2 gunshot injuries. Management procedures included arterial primary or patch repair in 28 cases, ligation alone in 17, end-to-end anastomosis in 41, interposition reverse saphenous vein graft in 37, interposition prosthetic graft in 29, thrombectomy in 14, excision of pseudoanurysm in 36, interventional thrombolytise in 2, ultrosonic-guided packing in 2, conservative management in 2. One hundred and ninety-two patients were cured,10 patients amputed, 4 patients died respectively.Results Ratio of cure,amputation,and mortality was 90.1%,4.74%,1.8% respectively.Amputation rate in blunt injuries was significantly higher than that in penetrarting injuries (P

Objective The purpose of the study was to investigate the correlation in incidence and severity between peripheral arterial disease(PAD) and coronary artery disease and stroke in Chinese people,in order to assess the essentiality of Ankle Brachial Index(ABI) examination for all the patients.Methods Patients hospitalized to Departments of Cardiology,Neurology and Vascular Diseases from March 2006 to December 2007 were enrolled.ABI was measured,and the disease history was collected.Ejection fraction(EF),coronary arteriography and ultrasound examination of the cervical artery were recorded to analyze the relationship between them and ABI.The prevalence of decreased ABI was calculated.Results In 132 patients hospitalized in the Department of Cardiology,the prevalence of ABI