With more and more attention and investment on acupuncture scientific researches, considerable outcomes and achievements has been acquired, but the shortcoming of low transformation rate of acupuncture research achievements is gradually exposed. Nowadays there is no related report on this problem, so based on achievement translational research in other areas and practical situation of acupuncture, the existing problems and solutions are analyzed. As a result, the existing problems include (1) the research content is mainly basic research and clinical research but less acupuncture device research, leading to limited transformation efficiency; (2) the evaluation system and transformation pattern are still needed to be perfect. The solutions are (1) to properly evaluate the research achievements of acupuncture, (2) to advocate the concept and method of translational medicine, (3) to reform the policy and system, and (4) to establish valid platforms covering research, outcomes and transformation.
Acupuncture ; economics ; legislation & jurisprudence ; manpower ; Biomedical Research ; Biotechnology ; economics ; legislation & jurisprudence ; manpower ; China ; Humans ; Technology Transfer

Objective To evaluate endovascular management for isolated iliac artery aneurysm (IIAA). Methods From May 1997 to Jan 2006, 15 IIAA cases underwent endovascular treatment, including 12 true aneurysms and 3 psudoaneurysms. There were 9 common iliac artery aneurysms (CIAA), 3 internal iliac artery aneurysms (IIAA) , and 3 external iliac artery aneurysms (EIAA). The average diameter was (5. 97?1. 49) cm (3. 5-9. 0 cm). IIAA was treated with metallic coils and CIAA/EIAA by stent-grafts. Results Unilateral internal iliac artery was preserved in 14 cases, and bilateral internal arteries were preserved in one case. Postoperative endoleak was found in 2 cases. There was no other major complications nor mortality. One case suffered buttock claudication because of internal iliac artery exclusion. The operation time was 1. 9?1. 1 h, blood loss was 126. 7?70. 1 ml. Patients were up and about after 2. 1?1. 1 d, hospital stay was 5.5?4.7 d. Conclusions Endovascular treatment is safe and effective for isolated iliac artery aneurysm. Internal iliac artery preservation and prevention of endoleak is of great importance.

Objective To evaluate the feasibility of chimney technique during thoracic endovascular aneurysm repair(TEVAR) in aortic arch lesions. Methods The stent-graft was deployed covering super arch branch artery in arch lesions in case there was not enough landing zone. A chimney stent was put in the super arch branch artery. We retrospectively analyzed the data of this group, aiming at summarizing the indications, methods, results and complications of chimney technique. Results From August 2004 to August 2009, 27 aortic arch lesions were treated by TEVAR with chimney stent, male/female ratio was 25/2, average age was 67. 2 ±3. 8 years, including3 chimney stents for innominate artery, 11 chimney stents for left common carotid artery and 13 chimney stent for left subclavian artery. Type I endoleaks were encountered in 18. 5% (5/27) of this group by final angiogram. Left common carotid artery dissection was caused by puncture in one case. One patient died of respiratory failure. There was no postoperative stroke nor bleeding. Discharged patients were followed up from 3 to 60 months, averaging at 16. 8 months. There was one death from MI 4 years later. There was minor stroke and left subclavian artery chimney stent occlusion in one each cases during the follow-up. All endoleaks were sealed without stent migration. Conclusion Chimney technique improves the length of landing zone and decreases effectively the endoleak rate.

OBJECTIVETo investigate the methods and effects of secondary intervention for mid-long term complications of endovascular repair (EVR) in aortic diseases.

METHODSFrom May 1999 to Jun 2007, 21 patients with mid-long term complications after EVR were treated in our center. Of these cases, 15 cases received first EVR for abdominal aortic aneurysm (AAA), 3 cases for thoracic aortic aneurysm (TAA) and 3 cases for aortic dissection (TAD). The mid-long term complications included 11 cases of type I endoleak, 4 cases of type II endoleak, 2 cases of type III endoleak and 4 cases of migration of stent grafts. Proximal or distal extensions were used for type I and III endoleak in 9 cases. Fenestrated, scallop and bifurcated stent grafts were used to reconstruct the aortic arch in 3 cases. Emboli technique was used in treating type II endoleak. Thrombectomy and bypass technique were used in 4 cases with stent graft limb occlusion. One ruptured AAA accepted open surgery.

RESULTSSecondary endovascular technique were undergone in 20 (95.2%) cases. One case died in 30 days after the secondary intervention and endoleak remained after the secondary operation in 5 cases. Three cases died of the secondary intervention.

CONCLUSIONSEndoleak and limb occlusion were the chief mid-long complications after EVR. Secondary endovascular technique can be used in most cases and carries great challenges in aortic arch lesions.

Adult ; Aged ; Aged, 80 and over ; Aortic Diseases ; surgery ; Blood Vessel Prosthesis Implantation ; adverse effects ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Postoperative Complications ; etiology ; therapy ; Retrospective Studies ; Stents ; adverse effects ; Treatment Outcome

The cardiovascular circulation feedback control treatment instrument (CFCTI) is an automatic feedback control treatment system, which has the function of monitoring, alarming, trouble self-diagnosis and testing on the line in the closed loop. The instrument is designed based on the successful clinical experiences and the data are inputted into the computer in real-time through a pressure sensor and A/D card. User interface window is set up for the doctor's choosing different medicine. The orders are outputted to control the dose of medicine through the transfusion system. The response to medicine is updated continually. CFCTI can avoid the man-made errors and the long interval of sampling. Its reliability and accuracy in rescuing the critical patients are much higher than the traditional methods.
Automation ; instrumentation ; Cardiovascular System ; Feedback ; Medication Systems

Behcet Syndrome ; Humans ; Thrombosis ; Vasculitis ; Venous Thrombosis ; Warfarin

Objective: To analyze associations of MRI-lesions and clinical features with disability in patients with multiple sclerosis (MS) in Shanghai, China. Methods: We studied patients with MS, identified from a survey in Shanghai, whose sites of lesions in the CNS was based on the MRI examinations. Associations between MRI-lesions, various clinical variables and the severity of disability were analyzed with univariate and multivariate logistic regression analysis. Results: There were 210 patients in this study. The disability of the patients with lesions confined to the spinal cord was significantly more severe than those with lesions in the brain (p < 0.008). Current age (OR: 1.041, 95% CI: 1.007~1.077), MS duration (OR: 1.082, 95% CI: 1.011~1.159) and MRI-lesions in the spinal cord (OR: 2.441, 95% CI: 1.039~5.737) were significantly associated with severity of disability on multivariate logistic regression analysis. Conclusion: MRI-lesions in the spinal cord, older age, a longer MS duration were significantly associated with a more severe disability in this MS study in Shanghai China.

BACKGROUNDAs an alternative to open aneurysm repair, endovascular aortic repair (EVAR) has been applied to ruptured abdominal aortic aneurysm (rAAA). The aim of this study was to evaluate the immediate and long-term outcomes of EVAR for rAAA.

METHODSFrom July 1997 to September 2007, 20 men and six women with rAAA (median age, 68 years) were treated with EVAR. Most patients with suspected rAAA underwent emergency computed tomographic angiography (CTA). The procedure was performed under general or local anesthesia. Endovascular clamping was attempted in hemodynamically unstable patients. Bifurcated endografts and aorto-uni-iliac (AUI) endografts with crossover bypass were used. Patients had CT scan prior to discharge, 3, 6, 12 months after discharge, and annually thereafter.

RESULTSTime between diagnosis and EVAR ranged from 1 hour to 5 days. EVAR was performed under general anesthesia in 21 patients, and under local anesthesia in five patients. Endovascular aortic clamping was performed in four patients. There was no conversion to open surgery during EVAR. Stent-graft insertion was successful in all patients. One patient died during EVAR from acute myocardial infarction. Ten patients had systolic blood pressure < 80 mm Hg. Eleven patients received a blood transfusion. Mean aneurysm size was (47 +/- 12) mm. Mean ICU stay was (8 +/- 3) days, mean hospital stay (18+/- 6) days, and mean procedure time (120 +/- 32) minutes. The 30-day mortality was 23% (6/26 patients), and major morbidity 35% (9/26 patients). Early endoleak occurred in 8/26 patients (31%). The mean follow-up was (18 +/- 7) months. No patient demonstrated migration of the stent-graft.

CONCLUSIONSEVAR is a safe and effective option for treatment of acute rAAA, independent of the patient's general condition. Immediate and mid-term outcomes are favorable, but long-term outcome is unknown. Multi-center studies are necessary to establish the role of EVAR for rAAA.

Aged ; Aged, 80 and over ; Aortic Aneurysm, Abdominal ; mortality ; therapy ; Blood Vessel Prosthesis Implantation ; adverse effects ; methods ; Female ; Humans ; Intensive Care Units ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo investigate the treatments of left subclavian artery (LSA) in endovascular repair (EVR) of thoracic aortic aneurysm (TAA) and thoracic aortic dissection (TAD).

METHODSIn 54 TAD or TAA cases, all of the proximal landing zone (PLZ) were less than 15 mm and only the LSA was needed to be treated in EVR, the following methods and techniques were used in the treatments of LSA: complete cover, partial cover, endovascular reconstruction following complete cover, surgical reconstruction before complete cover.

RESULTSDSA was used to evaluate the condition of cerebral circulation in all cases. Forty left subclavian arteries were covered completely. Ten were covered completely after right subclavian artery (RSA)-LSA or left common carotid artery (LCCA)-LSA bypass. PTA and stent in LSA was done in 3 cases. In 1 case, LSA was covered completely first, and then the graft was punctured and bare stent was fixed after inflation by cutting balloon. All of the ancillary techniques were enforced successfully. No severe complications were found in brain and upper extremity. The proximal endoleak rate was 17% (9/54). In the 40 cases whose LSA were not reconstructed, the primary left subclavian steal syndrome (LSSS) happened in 8 cases (20%) and the primary average systolic pressure of left brachial artery was 63 +/- 24 mm Hg.

CONCLUSIONSEVR can be enforced safely and efficiently in TAA and TAD with short PLZ by some ancillary endovascular or surgical techniques. The methods to treat the LSA depend on the condition of the cerebral circulation.

Adult ; Aged ; Aged, 80 and over ; Aneurysm, Dissecting ; surgery ; Aortic Aneurysm, Thoracic ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Subclavian Artery ; surgery

OBJECTIVETo design and manufacture a modular branched stent-graft system of endovascular reconstruction of the aortic arch in canine, and to investigate the feasibility of endovascular repair.

METHODSAfter the length and the diameter of ascending aorta, aortic arch and super-arch branched vessel measurement, a modular branched stent-graft system, including two pieces bifurcated stent-graft and one piece straight stent-graft, was designed and manufactured. Under X-ray fluorescope, these three modulars were accessed from right subclavian, left subclavian and femoral artery respectively and connected one by one to reconstruct the aortic arch. The shape and structure of stent-grafts, haemodynamics in aortic arch and endoleak were observed.

RESULTSEight of ten operations were completed successfully. Two dogs died of obstruction of coronary artery and artery rupture of left subclavian respectively during operation. In the eight successful cases, two proximal type I endoleaks were observed, and no other type endoleak occurred. The shape and the localization of stent-grafts were fine, and the coronary artery and carotid artery were unobstructed.

CONCLUSIONIt is feasible to reconstruct aortic arch of canine by modular branched stent-graft, and it is significant to direct the research of reconstruction of human aortic arch.

Animals ; Aorta, Thoracic ; surgery ; Blood Vessel Prosthesis ; Dogs ; Feasibility Studies ; Male ; Prosthesis Design ; Stents