1.The surgical treatment of varicose veins of lower extremity with primary deep venous insufficiency
Chinese Journal of General Surgery 1993;0(01):-
0.05). ConclusionsWhen varicose veins of the lower extremity with deep vein insufficiency exists, patients should undergo high ligation and stripping of the great saphenous vein, additional correction of the deep vein reflux provides no further effect.
2.Application and progress of surgical nutrition
Chinese Journal of General Surgery 2001;0(08):-
Nutrition support is extensively used in many clinical fields. The rest energy requirement in Chinese is only 5021~5858kJ/d.In our country 40% to 50% of hospitalized patients need nutrition support.In nutrition support,attention should be paied to :(1)The energy giving to the patient should be appropriate;(2)hormone resistance;(3)immunonut rition.
3.Medical rescue and emergency management of natural disasters
Guoxiang ZHAO ; Shengyong WANG
Chinese Journal of Disease Control & Prevention 2008;0(05):-
China is one of the countries with most serious natural disasters lose all over the world.Natural disasters are a public emergency.Human society can't avoid the natural disasters today,so the global target of a struggle is to reduce the loss of natural disasters.The natural disasters loss will be reduced to a minimum,once the system is established of medical rescue and emergency management by the government.
4.Pre-occlusion and Stump Pressure of the Internal Carotid Artery in Carotid Endarterectomy
Guojun ZHAI ; Jun ZHAO ; Guoxiang DONG
Chinese Journal of Minimally Invasive Surgery 2005;0(12):-
Objective To investigate the value of the pre-occusion and stump pressure(SP)of the internal carotid artery in carotid endarterectomy(CEA).Methods During Januray 2007 to January 2009,12 patients with carotid arterial stenosis underwent CEA in our deparment.With cervical plexus block,we performed pre-occlusion test and measured the stump pressure(SP)by using vascular shunt selectively.The patients were monitored with clear consciousness during the whole procedure of CEA.The data of postoperative complications and results of pre-occlusion and SP as well as the follow-up were analyzed afterwards.Results During the operaion,three patients had transient increase of heart rate and blood pressure.The lowest SP was detected in two patients,who had moderate or severe stenosis of the contralateral carotid artery complicated with lesions in the vertebral basilar artery.Two patients showed positive results in pre-occusion test,and vascular shunt was used in four cases.After the operaion,one patients developed hyperperfusion syndrome.Nine patients showed improvement of symptoms of dizziness and decreased eyesight.This series were followed up for a mean of 11 months(ranged from 1 to 26 months).During the period,two of the patients showed re-stenosis of the carotid artery;none of them had cerebral infarction.Conclusions Cervical plexus block combined with pre-occusion test ensures the safty and effectiveness of minimally invasive carotid endarterectomy.We recommend selective vascular shunt according to the results of pre-occlusion test,SP,and the severity of the lesions in the contralateral carotid artery and vertebral basilar artery.
5.Long-term results of electrocoagulation for 426 cases of varicose veins of the lower extremities
Tianrun LI ; Guoxiang DONG ; Jun ZHAO
Chinese Journal of Minimally Invasive Surgery 2005;0(11):-
Objective To assess long-term outcomes of electrocoagulation for treating varicose veins of the lower extremities. Methods A retrospective review was made on clinical data of 426 cases of varicose veins of the lower extremities treatd by electrocoagulation from October 1996 to October 2001.Postoperative follow-ups were carried out with clinic checkups or questionnaires.Results Of the 426 cases,follow-ups for 4~9 years(mean,5.8 years) were completed in 364 cases(500 limbs) and a loss to follow-up was encountered in 62 cases,the follow-up rate being 85.4%.The cumulative rate of recurrent varicose veins was 10.4%(52/500),in which the recurrent varicose veins were cured with sclerosing agents in 50 limbs and with re-operations in 2 limbs.The relief rate of sensation of heaviness and tension was 95.1%(309/325).Accompanying venous ulcers in 20 limbs healed up within 2~8 weeks.The incidences of subcutaneous hematoma and saphenous nerve injury were 0.8%(5/594) and 1.2%((7/594),) respectively.Skin burns happened in 5 limbs(0.8%,5/594). Conclusions Electrocoagulation for varicose veins of the lower extremities is proved to be a novel minimally invasive method,with advantages of safety,effectiveness,low costs,and short hospital stay.
6.Chemical thoracic sympathectomy for Raynaud's phenomenon: Report of 73 cases
Jun ZHAO ; Guoxiang DONG ; Jingyuan LUAN
Chinese Journal of Minimally Invasive Surgery 2005;0(11):-
Objective To summarize the experience of fluoroscopy-guided chemical thoracic sympathectomy(CTS) for the treatment of Raynaud's phenomenon.Methods A series of 73 cases of Raynaud's phenomenon(141 upper limbs) treated with CTS from March 2001 to September 2005 in this hospital was chronologically divided into two groups: the Group A between March 2001 and December 2002 and the Group B between January 2003 and September 2005.In the Group A,under the guidance of X-ray fluoroscopy,a needle was punctured through the back skin to the second or the third thoracic sympathetic ganglion beside the thoracic vertebrae and 2 ml of 5% phenol was injected.In the Group B,when the needlepoint reached the rear edge of target thoracic vertebra,2~3 ml of anesthetic was injected.Then the needle was advanced sequentially untill the needlepoint reached the sympathetic ganglion.Other manipulation was the same with the Group A. Results The incidence of pneumothorax in the Group A(28.4%,19/67) exceeded greatly that in the Group B(4.1%,3/74)(?~2=15.773,P=0.000).The effective rate in the Group A(77.6%,52/67) was much lower than that in the Group B(97.3%,72/74)(?~2=12.851,P=0.000).Between the two groups,differences of the incidence of axilla pain(Group A,2 limbs;Group B,5 limbs)(?~2=0.411,P=0.521),bradycardia(Group A,1 case;Group B,nil)(?~2=0.002,P=0.967),and Horner's syndrome(Group A,1 case;Group B,1 case)(?~2=0.000,P=1.000) were not statistically significant.Conclusions Pneumothorax is a common complication of chemical thoracic sympathectomy.Improvement of procedure can reduce the incidence of pneumothorax and increase the effective rate.
7.Effects of electrode shape on electrocoagulation results for varicose veins
Tianrun LI ; Guoxiang DONG ; Jun ZHAO
Chinese Journal of Minimally Invasive Surgery 2001;0(04):-
Objective To compare electrocoagulation effects of three types of electrodes for varicose veins.Methods Twelve dogs(24 veins in hind limbs)were randomly divided into 3 groups with 4 dogs in each group:columnar electrode group,circular electrode group,and radial electrode group.Each dog's long saphenous veins were high ligated and electrocoagulated.The activated partial thromboplastin time(APTT)was measured and pathological examinations(HE and Weigert)were performed immediately following operation and on the 7th and the 14th postoperative day,respectively.The destruction depth and extent,residual vessels,and skin burn after electrocoagulation were compared among the three groups.Results One case of skin burn on the left hind limb occurred in the columnar electrode group.Immediately following the operation,the number of vessels that were destroyed beyond 50% of perimeter in the radial electrode group was 8,which was significantly higher than that in the columnar electrode group(3 vessels)and the circular electrode group(4 vessels)(Fisher's exact test,P=0.013 and 0.038),and the number of vessels that were destroyed deep to the meddle membrane in the radial electrode group was 1,which was significantly lower than that in the columnar electrode group(7 vessels)and the circular electrode group(6 vessels)(Fisher's exact test,P=0.005 and 0.020).On the 7th day after operation,there was no statistical difference among the 3 groups in the number of vessels with remnant area above 50% of the perimeter(?2=5.371,P=0.068).On the 14th day after operation,the number of vessels with remnant area above 50% of the perimeter in the radial electrode group(1 vessel)was significantly lower than that in the columnar electrode group(7 vessels)and the circular electrode group(6 vessels)(Fisher's exact test,P=0.005 and 0.020).There was no statistical difference among 3 groups in APTT immediately following operation and on the 7th and the 14th postoperative day(P=0.905,0.871,and 0.865).Conclusions Compared with the other two catheters,radial electrode has the largest destroyed area,the smallest remnant area of the vessel,and the lowest risk of skin burn.
8.Clinical application of Tempofilter Ⅱ temporary caval filter
Jun ZHAO ; Jingfu LI ; Guoxiang DONG
Chinese Journal of Minimally Invasive Surgery 2005;0(07):-
Objective To summarize the clinical application of the Tempofilter Ⅱ temporary caval filter.Methods The Tempofilter Ⅱ temporary caval filter was employed in 24 patients from April 2002 to August 2006.Before the implantation,we performed color ultrasonography to detect the extent of thrombus and the situation of inferior vena cava,renal vein,and access vein(right internal jugular vein).Under the guidance of color ultrasonography and X-ray fluoroscopy(free of contrast agent),the temporary filter was placed in the inferior vena cava distal of the renal vein orifice through a guide wire by using the Seldinger technique.Results The filter was successfully implanted and removed in all the 24 patients.The duration of placement was 5 days~6 weeks(mean,16.8 days).Filter thrombosis occurred in 4 patients at 3 days ~ 2 weeks after operation.The thrombi(
9.Lower extremity deep venous insufficiency and Cockett syndrome.
Guoxiang DONG ; Xuan LI ; Jun ZHAO
Chinese Journal of Practical Surgery 2001;21(5):276-277
Objective This study was To investigate the incidence rate of Cockett syndrome and relationship between Cockett syndrome and varicose veins and deep venous incompetence of the left lower extremities.Methods 73 patients(100 legs) with varicose veins of the lower extremities were investigated by descending deep venography and iliography preoperatively.Results There were 35(47.9%) cases with abnormalities of the left common iliac vein (ALCIV)in all the cases.There were 31 cases with this conditions in the patients with varicose veins of the left or both lower extremity.While in the patients with varicose veins of the only right lower extremity,there were only 4 cases with ALCIV.In contrast,there was a significant difference between groups(χ2=9.8641,P=0.0017).In the patients with ALCIV,14 cases with Ⅲ or Ⅳ grade of deep venous incomptence were found, and only 6 cases with deep venous incompetence in the patients without ALCIV.There was a significant difference(χ2=5.3688,P=0.0205).Conclusion Cockett's syndrome frequently occurs in varicose veins of the left lower extremity.There is a relationship between them.Cockett's syndrome might be one of the causes for the deep venous incompetence of the left leg.
10.Effects of atorvastatin on nitric oxide, endothelin-1 and myocardial function in a rabbit model of acute myocardial infarction and reperfusion
Xianliang LIU ; Xijun ZHAO ; Guoxiang HE
Chinese Journal of Pathophysiology 2010;26(1):75-79
AIM:To evaluate the effects of atorvastatin on nitric oxide(NO),endothelin-1(ET-1)and myocardial no-reflow in a rabbit model of acute myocardial infarction and reperfusion(AMI/R). METHODS:Twenty-four rabbits were randomized into 3 groups:8 in AMI/R group,8 in atorvastatin-treated group(5 mg·kg~(-1)·d~(-1))and 8 in sham-operated group. Animals in the former two groups were subjected to 60 min of coronary occlusion followed by 120 min of reperfusion. Data on haemodynamics were collected. NO in blood sample,and in normal,and in infarcted reflow and no-reflow myocardium were evaluated respectively by nitrate reductase method. The levels of ET-1 in blood sample,and in normal,infarcted reflow and no-reflow myocardium were determined by radioimmunoassay. RESULTS:(1)Compared to the baselines,the heart rate(HR),systolic blood pressure(SBP),diastolic blood pressure(DBP),left ventricular systolic pressure(LVSP),maximal rate of increase and decline in left ventricular pressure(±dp/dt_(max))and cardiac output(CO)in AMI/R and atorvastatin-treated groups were significantly declined,whereas left ventricular end-diastolic pressure(LVEDP)was increased after 60 min of coronary occlusion and 120 min of reperfusion(P<0.05 or P<0.01). However,in atorvastatin-treated group,LVSP,LVEDP,±dp/dt_(max) and CO at the time point of 120 min of reperfusion recovered more significantly than those at the time point of 60 min of coronary occlusion(P<0.01),which was more significant than those in AMI/R group(P<0.05 or P<0.01). Compared to AMI/R group,the SBP and DBP were significantly heigher in atorvastatin-treated group(P<0.01).(2)In atorvastatin-treated group,the levels of ET-1 in blood sample were significantly lower than those in AMI/R group(P<0.01),and the levels of NO were significantly higher(P<0.01). Moreover,the levels of NO or ET-1 in infarcted reflow myocardium were significantly lower than that in AMI/R group(P<0.05 or P<0.01).(3)Atorvastatin could ameliorate myocardial function. CONCLUSION:Atorvastatin is effective in increasing NO and reducing ET-1 in blood plasma and local myocardium,and in protection of endothelial cells. Atorvastatin also has a beneficial effect on improving left ventricular function during acute myocardial infarction and reperfusion in rabbits.