50%) rate of 11.6%.Conclusions Endovascular stent placement is a safe and effective procedure and may be selected as the first choice for severe subclavian arterial occlusion.Short-term follow-up shows a satisfactory clinical outcome.

Objective To construct expression vectors of human ribosomal protein S 3(RPS3) and RPS3Ser209 mutant in orcler to investigate the effect of RPS3Ser209 mutant on NF-κB signaling pathway and DNA binding capacity .Methods The vector RPS3-myc was amplified by polymerase chain reaction ( PCR) from the human liver cDNA and subcloned into pcDNA-3.1myc-HisB.RPS3S209A represented mutant RPS3 expression vectors, in which the designated amino acid was mutated to an alanine residue .Dual luciferase reporter gene assay was used to detect the NF-κB transcription activity in HEK293 cells,immunofluorescence to detect RPS3 location, and EMSA to examine NF-κB DNA-binding activity.Results The expression vectors of RPS3-myc and RPS3S209A-myc were constructed.Compared with wild-type RPS3,the nucleus translocation, transactivation activity of NF-κB and DNA binding ability of RPS3S290A were reduced significantly .Conclu-sion The impact of RPS3 on NF-κB signaling pathway depend on its serine 209.

Objective To investigate the safety and medium-and long-term effects of endovascular stenting,axilloaxillary bypass (AAB),carotid-subclavian bypass (CSB) in patients of subclavian arterial occlusion.Method From 2001 to 2013,311 consecutive patients with subclavian arteriosclerosis obliterans were treated with endovascular stenting (n =191),axilloaxillary bypass (n =96) or carotidsubclavian bypass(n =32).We collected patients' medical data,calculated patency of the graft or stent with life-table method and compared patency between three approaches with Log-rank.Results The incidence of perioperative complications was 4.1％ in the stenting group vs.11.5％ in AAB group vs.18.7％ in CSB group.There was significant statistical differences between the stenting group and bypass group about the incidence of perioperative complications.The primary patency rates at 1,3 and 5 years were 90.3％,84％,81.6％ in stenting group vs.95.3％,92.6％,88.9％ for AAB group vs.100％,96.4％,96.4％ for CSB group.There was significant statistical differences between the stenting group and bypass group about the primary patency rates.Conclusions Both endovascular stenting and extrathoracic surgical bypass are safe and effective treatments for subclavian arteriosclerosis obliterans.However,effect of extrathoracic surgical bypass is more durable in the medium-and long-term.

Objective To evaluate the POSSUM scoring system as preoperative risk assessment approaches for lower extremity arteriosclerosis obliterans (LEASO).Methods A retrospective study was undertaken in 108 patients ( 120 limbs) diagnosed as long segment LEASO from January 2008 to October 2010,in which,67 patients (74 limbs) receiving percutaneous transluminal stent (PTS) treatment were included into PTS group,and 41 patients (46 limbs) undergoing femoral artery to popliteal artery bypass treatment into bypass group.Rutherford classification was used to evaluate degree of chronic ischemia for lower limb and ankle/brachial index (ABI) for the treatment results in these two groups.The score of POSSUM,physiological score and physiological score without age interference were calculated respectively to estimate the risks for operations in two groups.Results The chronic ischemia conditions for two groups were similar (P =0.543 ).Postoperative follow-up was done for 9 - 15 months,there were no difference between two groups for limb salvage ( P =0.556 ) and patency rate ( P =0.632 ).Risk evaluation for patients: POSSUM score for the PTS group (33 ± 7 ) was similar with that of bypass group ( 32 ± 6 ) ( P =0.369 ) ; Physiological score of POSSUM for PTS group ( 24 ± 7 ) was more than that of bypass group ( 22 ±7) (P =0.033) ; Physiological score without age interference in PTS group (22 ±6)was higher than that of bypass group ( 19 ± 6) (P =0.035).Condusious The physiological score of POSSUM could assess the health status of patients with LEASO,which is more useful for pre-vascular surgery evaluations.

Objective To investigate the effect of arterial bypass for subclavian artery occlusive disease. MethodsIn this study, 30 patients with subclavian artery occlusive disease received arterial bypass from Jan 1994 to Jan 2004. Occlusive lesions were documented preoperatively by arteriography. Patency was determined during follow up by Duplex ultrasound. ResultAll 30 patients undergoing bypass procedure were with blood pressure differences of less than 10mmHg between the treated and the healthy arms. The ratio of healthy/diseased side of the mean blood pressure index increased from 0 66?0 11 preoperatively to 0 99?0 09 postoperatively( P

Objective To investigate the effect of early inflamation on the efficacy of gene(LacZ gene)(transfer) to vein graft by adenovirus vector.Methods The liquid containing adenovirus vector was infused through external carotid vein and the segment of carotid vein was resected.The veins were inflated naturally.After 30min incubation,the veins were transplanted into carotid artery in experimental group,and the(circulation) was restored in control group.The veins with transferred gene were collected on day 3,day 14 and day 21.The mark gene expression in the veins was studied with X-Gal stain and activities of ?-galactase were measured.ICAM-1 and VCAM-1 expressions were observed by immunohistochemistry stain in transgenic veins.Results The activities of ?-galactase in mark gene expressed for 14 days was decreased and in 21 day nearly disappearred.VCAM-1 and ICAM-1 expression upregulated after day 3 in transplanted veins and there was leucocyte infiltration and shedding of endothelial cells with endothelial disruption.On the other hand,there was no expression of VCAM-1 and ICAM-1 in control group veins and integrity of endothelium was intact.The positive ECs expressed mark gene was obviously reduced in transplanted veins compared to control group.But the number of positive SMCs were not significently different between to two groups.(Conclusions) The inflammation of vein grafts in early stage of transplantation may be the cause of(endotheliocyte) damage and is related to rapid depression of gene expression.

Objective To evaluate the outcome of composite sequential bypass in treatment of chronic lower extremity ischemia.Methods The clinical data of 25 patients with chronic lower limb ischemia who underwent composite sequential bypass reconstruction,in a 3-year period,were retropectively analyzed.The composite vessel consisted of PTFE vassular prosthesis and autologous vein.The proximal end of PTFE was anastomosed to the common femoral artery,and the distal end to the isolated popliteal artery.The autologous vein exited from the lower end of PTFE vessel and was anastomosed to the tibial or peroneal artery in the leg.Results The venous reconstructions had the inflow taken from the distal PTFE artery(above knee in 5 and below knee in 20).The outflow involved the peroneal artery in 12(48%),the posterior tibial artery in 8(32%),and the anterior tibial artery in 5(20%).Primary patency,secondary patency and limb salvage were 61%,68% and 73% at 3 year,respectively.Conclusions Composite sequential reconstruction using an isolated popliteal segment as supporting point for the distal reconstruction has high long-term patency rate and good effect of limb savage,it is an acceptable option in patients presenting with serious limb ischemia without enough venous conduit for distal bypass.

Objective To assess the early diagnosis of acute mesenteric artery embolism and the clinical outcome of embolectomy.Methods The clinical data of 21 patients with superior mesenteric artery embolism between 1999 and 2005 were retrospectively analyzed.The patients were divided into two groups according to the operation time interval after onset of symptoms.Group I(n=9): patients were operated on in the first 6 hours after onset of symptoms;group II(n=12): patients were operated on more than 6 hours after onset.Urokinase administration directly into the superior mesenteric artery was an additional procedure during the embolectomy,and postoperative heparin anticoagalation was used in all patients.Results The circulation of the intestine returned to normal in 12 patients(all of the 9 patients in group I and 3 patients in group II) 30 minutes after embolectomy and administration of urokinase.Segmental intestinal resection was necessary in 4 patients and extended intestinal resection in 5 patients in group II.The motality of group II was 41.6% and 0 in group I.Conclusions Early recognition and prompt treatment can reduce the incidence of bowel necrosis and mortality rate of patients with superior mesentevic artery embolism.

Objective To investigate the effect and safety of autologons bone margow-mononuclear cell (BM-MNC)transplantation after the bone marrow stimulation in patients with thromboangiitis obliterans (TAO).Methods The bone marrows of 12 patients were stimulated by an injection of the recombinant human granuloeyte-macmphage colony-stimulatory factor(GCSF)for 3-5 days.150-200 ml bone marrow was drown from the iliac spine and the autologous BM-MNC were obtained in each patients.Fifteen lower limbs of 12 patients received implantation of the autologous BM-MNC by an intramuscular iniecdon.A series of subjective indexes(including improvement of pain and cold sensation)and objeetive indexes [including increase of ankle braehial index(ABI),transcutaneons oxygen pressure(TcPO2)and improvement of foot skin ulcer] were used to evaluate the effects.Results The outcomes were evaluated after 2 months of transplantation.The pain-relief rate and the cold feeling improvement rate were 86.7%(13/15)and 93.3%(14/15)respectively.The ABI were 0.38 ±0.05 vs.0.61 ±0.14(P<0.05)before transplantation and 2 months after transplantation respectively.increased in 66.7%(10/15)limbs.The TcPO2 of the ischemic legs increased from(27.47±2.85)mm Hg to(43.53 ±8.38)mm Hg(t=-7.03,P<0.05)after the transplantation,and the improvement rate of TcPO2 was 93.3%(14/15).Skin ulcers in improved in 8/9 limbs.Twelve patients were followed up for all average period of 10 months.The patients'symptoms improved in 80.0%(12/15)limbs,as to the objective index the ABI was0.57±0.13,TcPO2 was(42.07 ±7.81)mm Hg,which improved significandy compared to before treatment(t=-5.33,-7.80,Ps<0.05).skin ulcer healing rate was 66.7%(6/9).The ischemic symptoms in 2 patients were not relieved.There WBS no mortality and high level amputation in all subjects.The complications,such as proliferative retinopathy,malitpmnt tumor,myocardial infarction,stroke or hemangioma were not found in any patients.Conclusion In patients with TAO,intramuscular transplantation of autologous BM-MNC after the bone marrow stimulation has advantages of less bone marrow aspiration,more mononuclear cell content and relatively high safety.It may be a new and effective method to alleviate symptoms and accelerate the healing of skin ulcer.

Objective To evaluate vascular surgery and interventional technique applied in Takayasu's arteritis. Methods Data of 26 patients of Takayasu's arteritis admitted between January 2006 and December 2009 were retrospectively analyzed. The sex ratio(M/F) was 1: 4. 2, age averaged at (27±15)y. There were 16 cases of type Ⅰ , 7 cases of type Ⅱ and 3 cases of type Ⅲ according to Lupi-Herrera classification. 25 patients received surgery including 16 patients undergoing pecutaneous transluminal angioplasty operations, 9 patients doing traditional bypass surgery, and one patient was treated conservatively. Results 23 case-times of percutaneous transluminal angioplasty (PTA) were performed in 16 patients, including 12 cases of balloon angioplasty and 4 cases of stent angioplasty. Four significantly stenotic and occluded carotid arteries were revascularized successfully in 5 patients. Thrombosis of the carotid artery was found in one patient after balloon angioplasty. There were 4 patients in which repeated PTA treatment up to a total of 11 times were needed to guarantee vessel patency. Open surgery succeeded in 9 patients, and clinical symptoms were relieved in all cases during peri-operative period. 22 patients were followed up for 12 -46 months,one patient died of cerebral hemorrhage 3 months post-operation, one patient was found pseudoaneurysm at anastomotic stoma, and 2 patients suffered from anastomotic restenosis.Conclusions Vascular surgery played important role in the therapy of Takayasu's arteritis. PTA can be used repeatedly. Surgical bypass operation is difficult in technology, and can be used in cases that fail to response to PTA or in patients with severe cerebral ischemia.