Objective To evaluate the curative effect of interventional therapy in treating arteriosclerosis obliterans (ASO),and to discuss the related factors that may affect the postoperative recurrence.Methods The clinical data of 137 patients with lower extremity ASO (184 affected limbs in total),who were treated with interventional management during the period from January 2011 to October 2014,were retrospectively analyzed.After the treatment,the patients were followed up for 18 months.The arterial patency was checked up periodically,and the related factors that might induce recurrence were analyzed.Results The technical success rates for diseased iliac artery,femoral popliteal artery and infrapopliteal artery were 97.4％,92.5％ and 88.6％ respectively,while the technical success rates for TASC Ⅱ A,B,C and D type lesions were 97.4％,96.1％,89.7％ and 87.0％ respectively.Follow-up check-ups showed that the arterial patency rate of infrapopliteal artery was lower than that of iliac femoral artery and popliteal artery (P＜0.05),the restenosis rate of TASC Ⅱ C and D type lesions was higher than that of TASC Ⅱ A and B type lesions (P＜0.05).Multivariate Cox regression analysis indicated that diabetes mellitus,smoking and hyperlipidemia were the independent risk factors that could affect postoperative recurrence.Conclusion For the treatment of lower extremity ASO,interventional therapy is safe and effective.The postoperative restenosis rate is related to the location and type of the diseased arteries.Effective control of blood sugar level,smoking cessation and lipid-lowering measures can help reducc thc incidence of postoperative recurrence.

Objective Retrospectively investigate the application of anterolateral thigh flow-through flap in reconstruction of the extremities,to estimate its role and characteriscts.Methods From March,2010 to January,2016,anterolateral thigh flow-through flap was performed for reconstruction of the extremities in 87 patients (56 males,and 31 females).Patient ages ranged from 13 to 68 years,average of 34.4 years.Of all cases,there were 37 legs,21 ankles or foots,1 arm,19 forearms,and 9 hands.The role and result of anterolateral thigh flow-through flap was analyzed retrospectively.Results The result showed that when anterolateral thigh flow-through flap was transferred,which simutaneously played various roles as follows:①rebuilding main vascular defect,to revascularise the distal limb.② preserving recipient vessels,to prevent flow impaired.③rebulding recepient vessel defect.④ protecting vascular anastomosis and preserving recipient flow simultaneously.⑤avoiding the dilemma of end-to-side anastomosis when recipient vessels is deep.⑥ balancing blood flow,the blood supply of the flap was more stable.⑦ linking another tissue in a series fashion,to achieve complex reconstruction.Vascular compromise occurred in 3 cases after surgery,total necrosis occurred in 1 case and partial necrosis in 1 case after reexploration.One case presented deep infection and secondary with renal failure,and received amputation.Local infection presented in 3 cases,wound dehiscence in 2 cases.All the other flaps survivled uneventfully,and its texture and color was normal.In donor site,local infection occurred in 1 case,wound dehiscence in 2 cases.Conclusion Anterolateral thigh flow-through flap has function of many sided reconstruction,which is able to play a vital role in reconstruction of the extremities.

BACKGROUND: Rat models induced by unilateral nephrectomy combined with adriamycin are widely used in screening anti-drugs of glomerular sclerosis. However, few reports concerning this method on inducing rabbit model of glomerular sclerosisOBJECTIVE: To establish a rabbit model of glomerular sclerosis, and to observe the renal function and histopathological changes during model preparation. DESIGN, TIME AND SETTING: Randomized controlled animal experiment was performed in Laboratory Animal Center of Kunming General Hospital of Chengdu Military Region between December 2008 and May 2009. MATERIALS: Twenty-five Japanese big-ear rabbits, weighing 1.75-2.25 kg, half males and half females, were selected to establish glomerular sclerosis models, and randomly divided into normal (n=10) and model (n=15) groups. METHODS: The left kidney of rabbits in the model group was removed under anesthetized with 30g/L saline solution of sodium pentobarbital (1 mL/kg). Rabbits in the normal group underwent a similar surgical procedure without kidney removing. At 1 week after operation, 5 mg/kg adriamycin was injected into rabbits in the model group, 3 mg/kg adriamycin was reinjected 2 weeks later. Same volume of physiological saline was injected in the normal group. MAIN OUTCOME MEASURES: The renal blood biochemical indexes were detected prior to and at weeks 4, 6, and 8 after model preparation. One nephridial tissue was harvested from each group to undergo pathological observation at week 8 after the second medication. RESULTS: ①Kidney in the normal group presented slightly white, slightly tough texture with smooth surface. ②Pathological features of focal segmental glomerulosclerosis was showed in the model group under a light microscope, presented as extracellular matrix hyperplasia, mesangial region expansion, renal glomerular capillary wall ball mix adhesion, tubule degeneration, or even interstitial fibrosis, as well as interstitial infiltration of inflammatory cells. ③Compared to the normal group, the total protein and albumin was and decreased, triglyceride, total cholesterol, low density lipoprotein cholesterol, urea nitrogen, and creatinine were significantly increased in the model group. The urine protein content of rabbits in the model group was obviously increased at 4 weeks, gradually reached a platform after 8 weeks, which still greater than that of the normal group. ④SPECT showed that the glomerular filtration rate of the model group was notably decreased (33 mL/min) than the normal group (92.6 mL/min).CONCLUSION: The unilateral nephrectomy combined with adriamycin in rabbits results in the formation of glomerular sclerosis, renal function and 24 h urinary protein is more visible in the phase change.

Surgical robots, as a new means for surgeons, have been gradually applied in orthopedics. Initially, the development of orthopedic robots was stagnant for a long time because of limited techniques available, clumsy equipment, high costs, and low market demands. The recent decade has witnessed rapid growth of artificial intelligence in all walks of life, increasing investment in research and development, reducing manufacture costs and expanding demands for precise and individualized medical treatment so that a wide variety of novel and ingenious robotic systems have been proposed, prototyped, and commercialized in most of the major procedures in orthopedic surgery, including knee and hip replacements, cruciate ligaments surgery, spine surgery, corrective osteotomy, bone tumor surgery, and trauma surgery. This review depicts the history of development and future prospects in application of surgical robots in the field of orthopedics.

Limb (digit) replantation is the primary treatment in salvage of severed traumatic limbs (digits). It is vital to improve the success rate of limb (digit) salvage and the function recovery. Once a human limb (digit) is separated from the body, blood circulation stops and normal physiological metabolism are disrupted, hence result in a series of physiological and pathological changes such as cell degeneration and tissue necrosis, which greatly affect the therapeutic effect of limb (digit) replantation. Therefore, how to scientifically minimise the metabolism of tissues in a severed limb (digit) and mitigate the subsequent ischaemia-reperfusion injury to improve the success rate of limb (digit) replantation is a hot issue in the field of limb (digit) replantation. In this article, a review of current status and progress of existing limb (digit) preservation methods are presented. Through an extensive search and analysis of literatures, the advantages and disadvantages of current limb (digit) preservation methods are summarised in the hope that it will provide a reference for clinical preservation of severed limbs (digit) .

Objective To assess preliminary clinical efficacy of digital assisted technology in double skin paddle anterolateral thigh flap reconstructing degloved injury of forefoot or midfoot.Methods From March 2013 to December 2015,eight patients with degloved injury of forefoot or midfoot were retrospectively analyzed by case series study.They were seven males and one female,with age range of 18-51 years (mean,34.5 years).The foot skin defect area ranged from 18 cm × 12 cm to 13 cm × 10 cm.All patients underwent computed tomography angiography (CTA) in lower extremities preoperatively.The CTA data were entered into Mimics 15.0 software in DICOM format.Based on perforating condition of descending branch of lateral fenoral circunflex artery and the size of foot defect,one thigh was chosen for three dimensional reconstruction of anterolateral thigh flap.The flap size ranged from 24 cm× 9 cm to 19 cm × 7 cm.All reconstructive surgeries were performed secondarily.Patients were all at Ⅱ stage recovery.The survival of flaps and healing status of flap donor sites were observed in one month after surgery.The number of debulking flaps was recorded.The appearance of flaps,shoe wearing,gait and related complications were recorded.Results The follow-up was 10-21 months (mean,15.5 months.All flaps survived uneventfully,and all donor sites were sutured directly.Three patients had twice debulking procedures,three patients had one debulking procedure,and two patients had no debulking.At the last visit in follow-up,the color and texture of flaps were good.All patients were able to wear shoes normally,two patients remained mild abnormal gait,and one patient presented superficial ulcer at the medial of the forefoot.Conclusions Double skin paddle anterolateral thigh flap for reconstruction of degloved injury of forefoot or midfoot can prompt wound healing and decrease complications.Digital assisted technology is an excellent supplementary method in double skin paddle anterolateral thigh flap for reconstruction of degloved injury of foot,which makes precise preoperative planning and intraoperative accurate cutting.

Objective To discuss the clinical value of benefiting Qi and activating blood circulation on crit-ical limb ischemia(CLI)of lower extremity arteriosclerosis obliterans(ASO)after intervention. Methods Totally 43 patients with CLI were randomly divided into treatment group and control group. Patients in control group re-ceived basic treatment and interventional therapy,and those in treatment group additional benefiting Qi and activat-ing blood circulation for 6 months.The ankle brachial index(ABI),clinical symptoms and patency rate of vascular in 1 month,3 months and 6 months after angioplasty were analyzed and compared. Results ABI in treatment group 1 month,3 months and 6 months after angioplasty was increased when compared with that in control group (P<0.05),and the incidence rate of claudication and rest pain was significantly lower than that in control group 3 months and 6 months later(P<0.05).The patency rate of vessels in treatment group was higher than that of con-trol group and there was significant difference between the two groups(P < 0.05). Conclusions Benefiting Qi to activating blood circulation could improve the clinical efficacy and reduce the degree of restenosis in patients with CLI.