1.Progress of recurrence of venous thromboembolism in cancer patients
Chengjie WANG ; Hualiang REN ; Biao YUAN ; Chunmin LI
Cancer Research and Clinic 2018;30(6):426-429
Cancer patients complicated with venous thromboembolism (VTE) face treatment problems, very high recurrence rate and bleeding rate. Cancer itself and the antitumor treatment plan are the important factors causing the recurrence. After the relapse, the prognosis of the patients is extremely bad, and more than 50% of the patients died within 1 year. Until now, there is no unified effective treatment plan for the relapse. This paper reviews the recurrence of VTE and the related research progress.
2.Advances in the in-stent restenosis of lower extremity atherosclerotic occlusive disease
Hualiang REN ; Wangde ZHANG ; Chunmin LI
International Journal of Surgery 2017;44(11):788-792
Arteriosclerotic occlussive disease of the lower extremeties has become a common disease of aging society.Interventional technique is the main method of treating this disease,however,in-stent restenosis various and will degenerate itstherapeutic effect significantly and bring big trouble to clinicians.In the last decade,prevention and treatment techniques have emerged on the underlying mechanismofin-stent restenosis.Particularly,great improvement has been made,because of the development of related devices,such as drug coated balloons,cutting balloons,viabahn stentand bioresorbable stent,all of which could reduce the incidence of in-stent restenosisto varying degrees.In this paper,the latest progress of clinical research on the mechanism and treatment of in-stent restenosis is reviewed,particularly,the clinical effects of these newdevices are analyzed and summarized.
3.Effect of debulking therapy by thrombolysis in aorto-iliac artery occlusion
Chunmin LI ; Rui LENG ; Hualiang REN ; Qi WANG ; Wangde ZHANG
Chinese Journal of General Surgery 2019;34(12):1044-1047
Objective To explore the role and clinical efficacy of catheter induced thrombolysis (CDT) debulking method in the treatment of aorto-iliac artery occlusion.Methods A total of 59 patients with aorto-iliac artery occlusion who underwent endovascular treatment between June 2015 and June 2017 were enrolled.Patients were divided into PTA group and CDT group according to the treatment methods received.The PTA group received a balloon-expandable stent placement,and the CDT group underwent thrombolytic therapy for 48 to 72 hours before angiographic evaluation and further PTA treatment.Results In the CDT group,7 cases were still unable to place the stent after thrombolysis,and 20 patients successfully received stenting including 1-stent-placement in 16 patient and 2-stents-placement in 4.In PTA group 32 patients were treated with stents placement including 1-stent-placement in 19 patients,2-stents in 12,3-stents in 1.Follow-up rate was 86.3% within 1 year,the patency rate was 84.21% in the PTA group,and 76.92% in the CDT group.Conclusions CDT is effective method for occlusion of the aortoiliac artery.TASC classification of aorto-iliac arterial occlusion degrades after CDT treatment,thus reducing the use of stenting.
4.Compliance and influencing factors of stretch sock pressure therapy with varicose veins of lower extremities
Kai ZHENG ; Qi WANG ; Chunmin LI ; Wangde ZHANG ; Hualiang REN
Chinese Journal of General Practitioners 2021;20(10):1072-1076
A total of 280 patients with varicose veins of lower extremities who were prescribed stretch socks as pressure therapy in the outpatient clinic of Beijing Chaoyang Hospital from September 2019 to November 2019 were included in the study. Among 280 patients 208 were followed up for one year(74.3%), 139 cases (66.8%) gave up wearing stretch socks and 69 cases (33.2%) insisted to wear. The main reasons for giving up wearing were feeling too tight (23.1%), too much troubles (17.7%), symptom improvement (15.1%), poor effect (10.8%) and so on. The compliance of wearing stretch socks as pressure therapy in outpatients with varicose veins of lower extremities is poor with a variety of reasons, the data may provide a reference for improving clinical compliance in the future.
5.Percutaneous mechanical thrombectomy plus drug coated balloon dilation for the treatment of in-stent restenosis and arterial thrombosis of the lower extremity
Chunmin LI ; Hualiang REN ; Rui LENG ; Renming ZHU ; Wangde ZHANG
Chinese Journal of General Surgery 2020;35(5):389-392
Objective:To evaluate the safety and efficacy of a combination of percutaneous mechanical thrombectomy (PMT) and drug coated balloon(DCB)for the treatment of in-stent restenosis(ISR) and arterial thrombosis of the lower extremity.Methods:The clinical data of 53 patients treated with PMT + DCB were analyzed retrospectively, including 38 cases of ISR and 15 cases of arterial thrombosis. 33 patients were males and the others were females , the mean age was (68.6±9.4) years . Patients were followed at 30 days, 6 months, and 12 months concerning clinical symptoms, calculation of ABIs and duplex ultrasonography.Results:Procedural success was achieved in all 53 patients. One patient died of cardiovascular event perioperatively. 6 operation-related complications occurred including 5 cases of distal embolism during the PMT managed by using 5 F angiography catheter suction and one case of artery perforation during PMT procedure, a balloon was used to cover it. 47 (88.6%) patients completed 12-month follow-up, the TLR was 10.6% (5/47). One patient had the amputation 4 months later; There were 7 cases with arterial restenosis.PMT+ DCB were performed again in 4 cases, 1 case received stent implantation and 2 cases treated by medication.Conclusion:The use of combination of PMT and DCB is a safe and effective method to treat ISR and arterial thrombosis of the lower extremity.
6.Change of Serum Angiopoietin-like Protein 2 and Its Significance in Patients with Arteriosclerotic Occlusion.
Yue LIANG ; Hao NIE ; Hualiang REN ; Fangda LI ; Cui TIAN ; Huihua LI ; Yuehong ZHENG
Acta Academiae Medicinae Sinicae 2017;39(2):188-195
Objective To investigated the changes of angiopoietin-like protein 2(Angptl2) in patients with arteriosclerotic occlusion (ASO). Methods A total of 140 subjects including 75 ASO patients (ASO group) and 65 healthy subjects (control group) were enrolled in this study. Angptl2 and adiponectin were evaluated by using enzyme-linked immunosorbent assay. Biochemical data and high sensitive C reactive protein were measured and recorded as well. Results Compared to the control group,the ASO group presented with significantly higher level of plasma Angptl2 [(13.55±9.17) μg/L vs. (9.04±4.79) μg/L,P=0.010]. Plasma Angptl2 level of critical limb ischemia subjects was significantly higher than that of intermittent claudication subjects [(17.01±10.20)μg/L vs. (10.53±6.97) μg/L,P=0.003]. The best diagnostic cutoff value of Angptl2 was 13.67 μg/L,with a sensitivity of 60.34% and a specificity of 81.25%. In addition,type 2 diabetes mellitus patients with ASO exhibited significantly higher serum Angptl2 levels [(18.67±9.84)μg/L] than those without ASO [(13.01±3.47) μg/L] (P=0.021). In ASO group,serum Angptl2 levels were negatively correlated with ankle brachial index (r=-0.244,P=0.035). Conclusion The plasma level of Angptl2 increases in ASO patients. Its level is remarkably increased when the disease progressions to critical limb ischemia. Angptl2 can be a potential biological marker of disease progression.