The treatment of bleeding wound of solid visceral and the rescue of uncontrollable bleeding are still confronted with difficulties in surgery and first-aid field. Many researchers devote to study in the field of hemostasis, and the novel porous hemostatic agent is one of the hot spot of research about hemostasis. The review focuses on the hemostatic effect, properties, hemostatic mechanism, shortcoming and future trends of three novel porous hemostatic agents such as polysaccharides, zeolite and wollastonite.
Calcium Compounds ; Hemorrhage ; therapy ; Hemostatic Techniques ; Hemostatics ; administration & dosage ; chemistry ; Humans ; Polysaccharides ; Porosity ; Silicates ; Zeolites

OBJECTIVETo introduce the procedure of carotid stenting, and to summary experiences of 55 cases. To study the theory and clinical significance of carotid stenting for carotid artery stenosis.

METHODSFifty-five patients with severe carotid atheromatous stenoses were treated by stent implantation. Fifty-eight stents were implanted. Forty-one of these stents were Wallstent, 14 were Smart stents and 3 were OptiMed stents. Cerebral protection device was furnished for 18 patients.

RESULTSDuring operation, there were 2 cases of small stroke and 2 cases of major stroke. One patient suffered from left eye area deficit, who had a little signs after 3 months. Another patient had consciousness loss and right-side paralysis and had a recovery in consciousness after salvage. The incidence of nervous system complications was 6.9%. Serious stroke rate was 3.5%. The incidence of circulatory system complications was 10.3%. Those patients who received cerebral protection device did not have nervous complication.

CONCLUSIONCarotid stenting is effective for the treatment of carotid artery stenosis. The experienced surgeon can make this procedure safe. The procedure's safety is enhanced by using cerebral protection device.

Aged ; Angioplasty, Balloon ; adverse effects ; methods ; Carotid Stenosis ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Postoperative Complications ; etiology ; prevention & control ; Stents ; Treatment Outcome

OBJECTIVETo evaluate quality of surveillance and emendate rates of birth and death of population of the Three Gorges area.

METHODSData on the two samples collected were designed based on principle of capture-recapture method. An investigation of missing report of birth and death was conducted in 7061 families selected through stratified random sampling method. We collected and registered the data of birth and death in every family investigated and checked with correlative records reported in disease surveillance system of the Three Gorges area. The missing report rates and the 95% confidence intervals of birth rate and death rate were calculated.

RESULTSThe underreporting rates of birth and death were 13.91% and 15.60% and death of infant was 33.33%. The emended birth rate was 8.92 per thousandth and the 95% confidence interval of birth rate was 8.38 per thousandth-9.45 per thousandth. The emended report rate of death was 6.88 per thousandth and the collectivity 95% confidence interval was 6.37%-7.38 per thousandth.

CONCLUSIONResults showed that the quality of birth and death in the disease surveillance reporting system of Three Gorges area was competent to the quality level of the standard set for national disease surveillance system. The birth and death rates of population in the Three Gorges area were under 10.00 per thousandth.

Adolescent ; Adult ; Aged ; Birth Rate ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Infant ; Infant Mortality ; Infant, Newborn ; Male ; Middle Aged ; Mortality ; Population Surveillance ; methods

OBJECTIVETo introduce a new method using calcium phosphate cement/Danshen drug delivery system for treating ischemic necrosis of the femoral head and evaluate its curative effect.

METHODSFrom May 2000 to June 2005, 48 adult patients (54 hips) with ischemic necrosis of the femoral head at Stages I, II and III of antigen reactive cell opsonization (ARCO) were treated with implantation of calcium phosphate cement/Danshen drug delivery system in the involved femoral head. The operation consisted of removal of the necrotic bone under weight-loading cartilage and the implantation of phosphate cement/Danshen drug delivery system, and all manipulations were made percutaneously through a bone tunnel in the trochanter. The functions of the hip joint were evaluated and X-ray films were taken preoperatively and postoperatively.

RESULTSPostoperative follow-up was 45.5 months on average, ranging from 27 to 78 months. According to the evaluation criterion of "Dandong 1995" for therapeutic effect of adult ischemic necrosis of the femoral head, the therapeutic effects were excellent in 33 hips, good in 17, fair in 3 and poor in 1, with the excellent and good rate of 92.6%.

CONCLUSIONSThis method is relatively simple with little invasion. It not only improves the microcirculation of the femoral head by local application of traditional Chinese medicine, but also provides mechanic buttress in the weight-loading area to prevent collapse during repairing, which is beneficial to repair and reconstruction of femoral head. It may be a choice of minimal invasion surgery for ischemic necrosis of the femoral head at Stages I, II and III of ARCO.

Adult ; Aged ; Bone Cements ; Calcium Phosphates ; administration & dosage ; Decompression, Surgical ; Drug Delivery Systems ; Female ; Femur Head ; blood supply ; Femur Head Necrosis ; diagnostic imaging ; therapy ; Humans ; Ischemia ; therapy ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Radiography ; Salvia miltiorrhiza

Objective： This study was designed to establish a method of analyzing DNA content in fresh tumor using fresh cells. Methods： Clinical blood tumor samples were separated to obtain mononuclear cells by Ficoll-Hypaque, solid tumor tissues were made to be single cells by using mechanical method. The purified mononuclear cells and single cells suspensions were divided into two portions. One portion was fixed by ethanol and placed overnight, then measured DNA content by conventional flow cytometric method. The other portion was stained directly by PI （ propidium iodide) dissolved in PIPES (piperazine-Ν ,Ν '-bis[2-ethanesulfonic acid] disodium salt) buffer, then measured DNA content by flow cytometry, the DNA content results were compared with those of fixed cells. Results： There was no obvious difference in the CV（ coefficient of variation) of the peak of G0/G1 cells between fresh and fixed tumor cells from the same type tumor (t-test, P >0.05). Repetition test showed that the results of DNA content analysis using fresh cells were stable. Conclusion： Fresh tumor cells stained by PI dissolved in PIPES buffer could be used for the analysis of clinical tumor propagation and DNA ploidy.

BACKGROUNDEndovascular therapy is a treatment option for localized occlusion of the subclavian artery. In this report the long-term experience with 59 patients is presented.

METHODSBetween June 1998 and September 2008, we used endovascular therapy to treat 61 subclavian arterial obstructive lesions in 59 patients (46 males and 13 females, 34 - 82 years of age with a mean age (61.9 + or - 11.0) years). Twenty patients (34%) had clinical symptoms due to vertebrobasilar insufficiency, 26 (44%) had disabling arm ischemia, and 13 (22%) had both symptoms. We performed all procedures under local anesthesia. The approaches were from the femoral artery (n = 47), brachial artery (n = 1, involving bilateral subclavian disease) or both (n = 11). Sixty stents were implanted. All patients were followed-up at 1, 3, 6, and 12 months post-procedure, and annually thereafter.

RESULTSWe achieved technical success in 58 (95.1%) arteries, all of which were stented. There were three technical failures; two were due to the inability to cross over an occlusion, necessitating the switch to an axillo-axillary bypass, and the third was due to shock after digital subtraction angiography and prior to stenting. Arterial stenosis pre- and post-stenting was (83.6 + or - 10.8)% and (2.5 + or - 12.5)% (P < 0.01). Clinical success was achieved in 55 of the 59 patients (93.4%). Of the four clinical failures, three were technical and the remaining patient had a stent thrombosis. Systolic blood pressure difference between the two brachial arteries was (44.7 + or - 18.5) vs. (2.2 + or - 3.9) mmHg (P < 0.01). Primary patency was 98% at 12 months, 93% at 24 months, and 82% at 5 years. Five patients were lost to follow-up by 12 months post-stenting. Significant recurrent obstruction developed in five patients with resumption of clinical symptoms. The overall survival rate was 98.2% at 12 months, 89.5% at 24 months, and 84.5% at 5 years.

CONCLUSIONSEndovascular therapy for proximal subclavian arterial obstructive lesions is effective and successful. This minimally invasive treatment may be the first choice of treatment for proximal subclavical arterial obstructive lesions.

Adult ; Aged ; Aged, 80 and over ; Arterial Occlusive Diseases ; pathology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Stents ; Subclavian Artery ; pathology ; Subclavian Steal Syndrome ; pathology ; therapy ; Vertebrobasilar Insufficiency ; pathology ; therapy

OBJECTIVETo investigate the effect of endovascular therapy and artery bypass for subclavian artery occlusion disease and to explore a suitable therapeutic procedure.

METHODSThirty-nine patients with subclavian artery occlusive disease received endovascular therapy or arterial bypass from June 1997 to May 2004. Twenty-seven endovascular stenting were performed on 26 patients through the femoral artery (n = 14) or combined brachial artery (n = 12). Retrograde endovascular balloon angioplasty and stent placement were performed on 12 patients. Eight subclavian arteries were punctured with ultrasound localization. On account of unsuccessful stenting, 13 cases received arterial bypass. In addition, endovascular stenting were performed on 9 cases with carotid or vertebrarterial stenoses.

RESULTSThe blood pressure difference was less than 10 mm Hg between the treated and the healthy arms in all 39 patients. The ratio of healthy/diseased side of the mean blood pressure index increased from 0.62 +/- 0.11 preoperatively to 0.98 +/- 0.04 postoperatively (P < 0.01). The mean patency time for endovascular therapy and arterial bypass was (57.6 +/- 3.7) and (60.2 +/- 7.2) months, respectively.

CONCLUSIONSBoth endovascular therapy and arterial bypass have good curative effect for subclavian artery occlusion. Endovascular therapy is the preferred treatment for subclavian artery occlusion with mini-trauma and safety.

Adult ; Aged ; Aged, 80 and over ; Angioplasty, Balloon ; methods ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Stents ; Subclavian Steal Syndrome ; surgery ; therapy ; Treatment Outcome

Objective To understand the health status and potential impact resulted in the second stage of Three Gorges Reservoir Areas sluicing. Methods Data were collected on deaths, prevalence rates of infectious and endemic diseases, as well as on vector surveillance through the project entitled 'Three Gorges Population Health Survey System'. Results The main causes of death in the population living in the Three Gorges Reservoir Areas would include: circulatory system diseases, tumors, respiratory system diseases, injuries/poison and digestive system diseases. The number of deaths caused by the above said five kind of diseases accounted for 90.94% of the total number of deaths. The prevalence rates on Water-born diseases related to the sluicing of reservoir and zoonosis-bome diseases related to the changes of vectors were still low. The indoor and outdoor densities of rodents were 3.11% and 3.16%, both were higher than that in 2006 but lower than the average numbers in the five years prior to the sluicing. The constituent ratio of Apodemus agrarius had constantly risen since 2006. The density of mosquitoes found in livestock barns and human households was higher than that in 2006 but lower than the average number of the five-year studies prior to the sluicing. Conclusion Environment change after the sluicing of the Three Gorges Reservoir Areas did not seem to have obvious impact on the health status of the people living in the areas. However, to strengthen the surveillance on the biological features of the vectors which might have related to the transmission of diseases would be highly recommended.

OBJECTIVETo evaluate the safety and efficacy of endovascular therapy for renal artery stenosis.

METHODSPercutaneous transluminal renal angioplasty with stent (PTRAS) was performed on 33 consecutive patients with severe renal artery stenosis who suffered from poorly controlled hypertension or renal dysfunction. They were subsequently underwent 7 to 49 months clinical follow up for the effect of the procedure on renal function, blood pressure control, mortality.

RESULTSAngiographic success was obtained in 32 (97.0%) of the 33 patients. The mortality was 18.2%. After PTRAS, two (6.1%) died of myocardial infarction within 4 months. Four (12.1%) patients with preoperative serum creatinine (Scr) > or = 177 micromol/L died of uraemia within 17 approximately 28 months. Twelve and twenty-four months after the procedure, systolic and diastolic blood pressure of 26 (78.8%) cases with preoperative Scr < 177 micromol/L significantly decreased (P < 0.05), with less antihypertensive medications taken and satisfactory renal function.

CONCLUSIONFor patients without serious cardiorenal disease, PTRAS has a beneficial effect on blood pressure and renal function. For patients with serious cardiorenal disease or preoperative Scr > or = 177 micromol/L, the mortality is higher. PTRAS should be performed prudently. The preservation of renal function may be enhance by using renal protection device.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Angioplasty, Balloon ; methods ; Female ; Follow-Up Studies ; Humans ; Hypertension, Renovascular ; etiology ; Male ; Middle Aged ; Renal Artery Obstruction ; complications ; therapy ; Renal Insufficiency ; etiology ; Stents ; Treatment Outcome

OBJECTIVETo discuss the options and clinical outcomes of surgical treatment of cervical ossification of the posterior longitudinal ligament (OPLL).

METHODSFrom January 2006 to December 2010, 63 patients of cervical OPLL treated surgically by same team were retrospectively analyzed. There were 49 males, 14 females, with a mean age of 56.2 years (from 38 to 76 years). The duration of symptoms ranged from 2 months to 20 years (mean 3.2 years). The ossified ligament was classified via sagittal and coronal images on CT scan. The cervical curvature was measured. Choice of surgical methods was determined according to the type of ossified ligament and cervical curvature. All complications occurred was recorded. The Japanese Orthopedic Association (JOA) scoring system was used to evaluate the neurological status. The severity of cervical pain was assessed with visual analogue scale (VAS) method. The results of preoperative, postoperative and follow-up were statistically compared with student t test.

RESULTSThe JOA scores of 35 patients performed with anterior approach improved from 9.8 ± 2.3 preoperatively to 11.7 ± 2.1 at final follow-up (t = 3.28, P < 0.05). The VAS sore was significantly decreased at final follow-up compared with preoperative (t = 3.15, P < 0.05). While the JOA scores improved from 10.4 ± 2.7 preoperatively to 12.5 ± 2.3 at final follow-up (t = 3.81, P < 0.05) in 12 patients with laminectomy and from 9.7 ± 2.5 to 11.6 ± 2.6 in 14 patients with laminoplasty (t = 3.56, P < 0.05). The VAS score either in laminectomy or in laminoplasty has not significantly difference between preoperative, 3 month postoperative and final follow-up (P > 0.05). Two patients underwent a combined anterior-posterior approach procedure. Complications in patients included 1 patient of postoperative neurologic deterioration and 2 cases of cerebrospinal fluid leakage in patients with anterior approach, and 2 cases of C(5) nerve palsy in patients with laminectomy.

CONCLUSIONSSurgical options of cervical OPLL should be determined by detailed study of type and range of ossified ligament, as well as the cervical curvature of patients. Good neurological function can be expected in case of appropriate choosing the method for treating the cervical OPLL.

Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Ossification of Posterior Longitudinal Ligament ; surgery ; Retrospective Studies ; Treatment Outcome