ObjectiveTo evaluate axillofemoral bypass(AxFB) for the treatment of chronic severe lower limb ischemia. Method Consecutive AxFB performed in Anzhen Hospital from January 1995 to November 2002 was retrospectively analysed, with 31 patients of aortoiliac occlusive disease undergoing axillobifemoral bypass (AxBFB) and 32 axillounifemoral bypass(AxUFB) respectively. Result On discharge, rest pain disappeared in 44 cases and intermittent claudication in 19 cases, with average ankle/brachial index changing from preoperative 0.18(0～0.49) to postoperative 0.68(0.29～1.04). Rate of limbs salvage was 87.4%, amputation rate was 7.9%. Three cases died with a perioperative mortality of 4.8%. The patency rate of 1,3,5 years were 93.2%,79.8% and 64.1%, respectively. Conclusion AxFB for aortoiliac occlusive disease is considered to be acceptable procedure in high-risk patients with poor femoral run-off and chronic critical lower limb ischemia.

Objective To evaluate the treatment for acute embolism in the extremities and define the primary factors affecting the prognosis. Methods From December 1984 to December 2006,536 patients with acute embolism of extremities were treated. Embolectomy with Forgarty catheters were performed in 507 cases, including salvage surgery in 34 cases and conservative therapy in 29 cases. Results The cure rate, mortality and amputation rate were 76.68%,9.51% and 10.26% respectively. Embolism recurred in 11.7% cases. Cardiopulmonary (27.5% ) and renal failure ( 25.5% ) were main causes of death during perioperative period. No bleeding nor other major complications occurred in 221 patients with atrial fibrillation who routinely received wafarine under proper monitoring. About 25.6% patients underwent heart valves surgery during hospitalization or within one year after discharge. Conclusions Patients suffering from acute embolism of the extremities should receive combination treatment. The main factors affecting the prognosis include time and degree of ischemia, and ischemia-reperfusion injury. Anticoagulant and etiologic treatment should be adopted in those with cardiogenic embolus and atrial fibrillation.

Objective To assess the efficiency,safety and indications of permanent inferior vena cava filters (VCF) placement for prevention of pulmonary embolism in cases of deep vein thrombosis (DVT). Method In this study 71 cases were treated with permanent inferior vena cava filters by way of the internal jugular vein and the common femoral vein. Cavography was performed routinely before inserting the VCF to confirm no thrombosis in IVC and access veins. The insertion site for filters is the subrenal vena cava. Results The procedure was successful in all cases. There was no case of symptomatic PE occurred during 1～41 months of follow-up. There were 2 cases of IVC thrombosis at the site of insertion and 5 cases of filter tilting less than 15?. There were no other complications. Conclusion Permanent IVC filter placement is an effective method for preventing fatal PE due to DVT. Imaging of the vena cava and access vein by venous ultrasound and cavography, strict anticoagulation therapy after VCF insertion are key to perform VCF placement, provide protection from recurrent life-threatening PE and reduce complications. The filter placement indications should be strict.

This study was aimed to observe the influence of water-solubility nipponica saponin on activation of TNF-α+IL-17-induced rat fibroblast-like synovial cell line RSC-364 cellular model nuclear transcription factor NF-κB pathway as well as TNF-α, IL-1, ICAM-1, MMP-2, MMP-3 secretion. IL-17+ TNF-α were used for stimulating RSC-364 to establish rheumatoid arthritis (RA) cellular model. Water-solubility nipponica saponin in different con-centrations was used for intervention. The influence of water-solubility nipponica saponin in different concentrations on cell viability was detected by semi-quantitative RT-PCR method. Changes in the level of TNF-α, IL-1, ICAM-1, MMP-2, and MMP-3 of culture supernatant were detected by ELISA. The results showed that the activation of NF-κB p65 in RSC-364 stimulated by TNF-α+ IL-17 can be inhibited by water-solubility nipponica saponin ac-cording to its concentration. It improved IκB-α expression, and inhibited TNF-α, IL-1, ICAM-1, MMP-2 and MMP-3 secretion. It was concluded that water-solubility nipponica saponin can inhibit the activation of NF-κB pathway, hinder the secretion and activation of multiple downstream genes, which may be its effect in inhibiting syn-ovial inflammation in RA.

Objective To investigate the expression of gene Fmr1 in rats cortex, hippocampus and hypothalamus areas after the rapid eyes movement ( REM ) sleep deprivation .Methods Using the modified multiple platform method (MMPM), 126 rats were randomly and averagely divided into three groups , the normal control group ( CC), the environmental control group (TC) and the sleep deprivation group (SD).Each group was detected on day 1, day 2, day 3, day 5, day 7, and day 9, and the sample tissues were extracted from 7 rats at each time point.Immunohistochemistry and RT-PCR were operated to analysis the expression of gene Fmr 1.Results The expressions of gene Fmr1 were increased gradually in the cortex and thalamus of the SD group after 3 days ( P <0.05 ) , and the expressions in the CC and TC groups had no significant difference (P >0.05).The expressions of gene Fmr1 were decreased gradually in hippocampus for SD after 3 days ( P <0.05 ) , and that in the CC and TC groups had no significant difference ( P >0.05 ) . Conclusion The expressions of gene Fmr 1 were increased gradually in the cortex and thalamus but decreased in the hippocampus in the SD group after 3 days.

Objective To summarize our surgical experience on 187 patients undergoing open repair of abdominal aortic aneurysms (AAAs). Methods Data of 187 patients with infrarenal AAA who were treated electively with open repair between January 1992 and February, 2004 were retrospectively reviewed. Results One patient (0.54%) died perioperatively due to ventricular premature beat, ventricular fibrillation 6 hours after. The mean duration of operative procedure was 3.8 hours. The mean blood loss was 445 ml. Perioperative complications included heart failure in 17 cases, respiratory failure in 8, acute myocardial infarction in 2, cerebral infarction in 1, and acute renal failure in 3. The 1? 3? 5-year survival rate was 97.0%? 84.6% and 78.3%, respectively. Conclusion The aneurysm diameter is not the absolute operative indication. Risk factors for open operation of AAA are old age, severe cardial, pulmonary diseases and renal desfunction. Open surgery is still the treatment of choice for AAA.

Objective To explore the effects of chlorhexidine aeetate and trielosan on inhibition of microorganism adhesion on soft denture-lining materials. Methods Silicone rubber soft denture- lining material and resin soft denture-lining material were soaked in 0. 2% chlorhexidine acetate and 0. 1% trielosan for 5 minutes. Then the colony numbers of three different microorganisms (streptococcus mutans, actinomyces viscosus, candida albicans) adhering to soft denture-lining materials were counted. Results The colony numbers of candida albicans were (121.0±7. 0) × 105 cfu/ml in resin soft denture-lining material and (208. 8±8. 6) × 105cfu/ml in silicone rubber soft denture-lining material (P<0. 05). But there were no differences in colony numbers of streptococcus mutans and actinomyces viseosus. After soaked in chlorhexidine acetate and triclosan, the colony numbers of streptococcus mutans were significantly reduced to (87.1±4. 3)× 105cfu/ml, (61.6± 7.9) × 105cfu/ml, (42.1±8.2) × 105cfu/ml and (21.3±4.3)× 105cfu/ml, and the colony numbers of candida albicans were significantly reduced to (11.6±3.6) × 105cfu/ml, (11.1±3. 7) × 105cfu/ml, (41.6±3.0) × 105cfu/ml and (44. 6±4.1)× 105cfu/ml(all P<0. 01). However, chlorhexidine acetate and triclosan had no effects on actinomyces viscosus. There were no significant differences in the action effects between the two detergents (P>0. 05). Conclusions Chlorhexidine acetate and trielosan can effectively inhibit the adhesion of microorganism on denture-lining materials, which are useful in clinic.

OBJECTIVE:To compare pharmacoeconomic and effect of Xueshuantong for injection and Ginkgo leaf extract and dipyridamole injection in the treatment of ischemic stroke. METHODS:Retrospective study was conducted. Totally 404 inpatients with ischemic stroke were divided into Xueshuantong group(271 cases)and ginkgo leaf extract and dipyridamole group(133 cas-es) according to clinical treatment programs. Based on the conventional treatment,patients in 2 groups were given Xueshuantong for injection and ginkgo leaf extract and dipyridamole injection,respectively. The average treatment course was 10 d. Cost-minimi-zation analysis was performed with the determination index of total effective rate. RESULTS:The total effective rates in Xueshuan-tong group and ginkgo leaf extract and dipyridamole group were 90.77% and 88.72%,respectively,the difference was not statisti-cally significant(P>0.05). The costs in 2 groups were 12 860.21 yuan and 13 155.40 yuan,respectively,and xueshuantong group had lower than ginkgo leaf extract and dipyridamde group. CONCLUSIONS:Both Xueshuantong for injection and Ginkgo leaf ex-tract and dipyridamole injection are effective in the treatment of ischemic stroke. However,the economy of Xueshuantong for injec-tion is superior to the other one.

Objective To sum up the experience in the management of acute infrarenal abdominal aorta occlusion. Methods We retrospectively analyzed 34 cases of acute infrarenal abdominal aorta occlusion treated during a period of 18 years. Cell saver was used intraoperatively in five cases.Results Twelve cases died postoperatively in this group (35 3%), with acute post operative renal failure, metabolic acidosis and hyperkalemia being the main causes of death. No acute renal failure and metabolic acidosis occurred in all cases treated by cell saver during operation. Limbs were salvaged in 36 out of 44 extremities of patients surviving the surgical procedure. ConclusionsPrompt diagnosis, proper surgery and correct management of post operative complications are necessary to decrease mortality. Perioperative application of cell saver is recommended to eliminate metabolic wastes from the body.

Objective To investigate the map and pattern of blood oxygen level dependent(BOLD)signal changes correlated to interictal epileptiform discharges(IEDs)with EEG-fMRI in patients with partial epilepsy and then to explore the pathophysiological mechanisms of epileptic discharges and their effect on brain function in partial epilepsy.Methods Through the method of EEG-fMRI,2 patients with parial epilepsy were studied.The relationship between the regions of BOLD signal changes linked to IEDs and the electroelinical localization of epileptogenic zone in patients with partial epilepsy were investigated.Results The epileptogenic areas localized by electroclinical findings in the 2 patients all showed maximal activation and 2 sites of significant activation were found in 1 of the 2 patients;Weak activation were also manifested in the opposite side corresponding to lesions.Conclusions IED-linked BOLD response in patients with partial epilepsy is mainly in epileptogenic zones and weak activation can also be seen in the corresponding contralateral areas of epileptogenic zoiles.Activation areas ale well concordant with epileptogenie areas localized by electroclinical findings.