The character and application status of interventional thrombectomy devices for acute ischemic stroke (AIS) are briefly introduced and the development trend is also analyzed.
Brain Ischemia ; drug therapy ; surgery ; Humans ; Stroke ; drug therapy ; surgery ; Thrombectomy ; instrumentation ; Thrombolytic Therapy ; instrumentation

OBJECTIVETo examine the outcome of damage control surgery (DCS) in patients with acute mesenteric ischemia (AMI).

METHODSClinical data of 15 consecutive AMI cases treated with DCS from May 2001 to March 2009 at the Research Institute of General Surgery, Jinling Hospital were retrospectively analyzed. Eleven patients had acute superior mesenteric vein thrombosis (MVT) on admission, and 4 suffered from acute mesenteric arterial embolism/thrombosis (MAE/MAT). The staged damage control approach included immediate resection of the involved bowel (but no attempts to restore gastrointestinal continuity), open thrombectomy, transfer of the patients to ICU for resuscitation, and thrombolysis prior to the planned definitive reconstructive procedure.

RESULTSOf 15 patients, 10 (66.7%) survived. The mean remnant small bowel length was (209.0+/-53.8) cm (120 to 280 cm). None of the survived patients was parenteral nutrition-dependent. Of the 5 deaths, 2 died of recurrence of thrombosis and necrosis of the remaining bowel,1 of massive gastrointestinal bleeding. One patient abandoned treatment intra-operatively, and another with total small bowel resection abandoned treatment postoperatively.

CONCLUSIONSDamage control approach improves the survival of patients with AMI. Thrombectomy and thrombolysis are necessary for AMI management to prevent progression or further development of the thrombosis.

Acute Disease ; Adult ; Female ; Humans ; Intraoperative Complications ; Ischemia ; surgery ; therapy ; Male ; Mesenteric Vascular Occlusion ; surgery ; therapy ; Mesentery ; surgery ; Middle Aged ; Retrospective Studies ; Thrombectomy ; Thrombolytic Therapy

Diabetes Complications ; drug therapy ; surgery ; therapy ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Ischemia ; drug therapy ; etiology ; surgery ; therapy ; Lower Extremity ; blood supply

Coronary revascularization (CRV), mainly by means of percutaneous coronary intervention or coronary artery bypass graft surgery, has been developed nowadays to rescue patients with myocardial ischemia. Nevertheless, the recurrent angina after coronary revascularization (RACR) remains a concernful problem in clinical practice, its management is still a real challenge to physicians. Therefore, the prevention and treatment of RACR become vital for keeping the benefits of CRV. The common causes of RACR and the adoptable integrative medical approaches for its diagnosis and treatment were discussed in this paper.
Angina Pectoris ; etiology ; surgery ; therapy ; Angioplasty, Balloon, Coronary ; Combined Modality Therapy ; Coronary Artery Bypass ; Coronary Restenosis ; prevention & control ; surgery ; therapy ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Myocardial Ischemia ; surgery ; therapy ; Percutaneous Coronary Intervention ; Phytotherapy

Priapism is defined as abnormal prolonged penile erection occurring beyond or unrelated to sexual interest. The disorder is enigmatic yet devastating because of its elusive etiology, irreversible erectile tissue damage, and resultant erectile dysfunction (ED). Current management strategies suffer from a poor understanding of the pathophysiology, especially at the molecular level. The traditional treatments are based more on empirical rather than evidence-based knowledge. The outcomes for restoration of normal erectile function are poor, especially for stuttering priapism. Therefore, it is critical to understand priapism from a molecular level, to formulate treatment strategies and to establish rational prevention strategies for high-risk populations, such as sickle cell disease (SCD) patients and cases of the stuttering variant. This review focuses on the recent advances at the molecular level in priapism and penile erection, and applies the recent knowledge to the treatment of stuttering priapism.
Hormones ; therapeutic use ; Humans ; Ischemia ; complications ; Male ; Penile Prosthesis ; Penis ; blood supply ; Priapism ; drug therapy ; etiology ; surgery ; Recurrence

OBJECTIVE To investigate the etiology, prevention and treatment of colon ischemia after operation for abdominal aortic aneurysm (AAA). METHOD Seven of 140 cases complicated with colon ischemia who had received AAA operation were analyzed retrospectively. RESULTS Three cases underwent emergency operation. The seven cases were subjected to removal of AAA, implantation of prosthesis, and ligation of the inferior mesenteric artery. Two cases had the ligation of the bilateral internal iliac artery (IIA). Epilateral IIA was ligated in 2 cases. Bowel resection was carried out in 3 cases, 1 of which received reconstruction of the inferior mesenteric artery (IMA). Three cases received conservative therapy, but died from multiply organ failure. CONCLUSION Correct prevention and management of colon ischemia can effectively reduce the operative morbidity of AAA patients.
Aged ; Aged, 80 and over ; Aortic Aneurysm, Abdominal ; surgery ; Colon ; blood supply ; Humans ; Ischemia ; etiology ; prevention & control ; therapy ; Male ; Mesenteric Artery, Inferior ; surgery ; Middle Aged ; Postoperative Complications ; etiology

By searching relevant data from the PubMed database, Chinese National Knowledge Infrastructure (CNKI) database and Wanfang database, a comprehensive analysis and review regarding acupuncture for cerebral ischemia reperfusion injury (CIRI) in recent 10 years were performed. The results showed that acupuncture could inhibit the inflammatory reaction, reduce oxidative stress injury, restrain brain edema formation, inhibit apoptosis, promote neural and vascular regeneration, etc. Acupuncture methods used included electroacupuncture, scalp acupuncture, eye acupuncture and "consciousness-restoring resuscitation needling", etc. The existing problem was that the intervention action of acupuncture was mainly focused on inhibiting inflammatory reaction and oxidative stress injury, and the study on apoptosis and neural and vascular regeneration was needed. It is suggested that from the aspect of multiple target points, the intervention mechanism of acupuncture for CIRI should be systemically studied in the future, which could provide new idea for clinical diagnosis and treatment on ischemic cerebrovascular diseases.
Acupuncture Therapy ; history ; Animals ; Apoptosis ; Brain Ischemia ; history ; surgery ; History, 21st Century ; Humans ; Oxidative Stress ; PubMed ; Reperfusion Injury ; etiology ; history ; physiopathology ; therapy

BACKGROUNDTakayasu's arteritis (TA) is a chronic idiopathic inflammatory disease that affects large and medium size arteries. The brachiocephalic trunk is the most frequently involved site in TA, and multi-vessel lesions are common. Surgical treatment includes vessel reconstruction surgery and percutaneous transluminal angioplasty (PTA). Herein, we report our preliminary experience with surgical treatment of cerebral ischemia caused by cervical arterial lesions due to TA.

METHODSFrom January 2000 to December 2007, 38 patients with cerebral ischemia caused by cervical arterial occlusive lesions due to TA were treated surgically. There were three males and 35 females, with an age range of 15 - 42 years (mean 26.5 years). All patients had operative repairs undertaken. Twenty eight patients received bypass operation and 10 patients received percutaneous transluminal angioplasty. One case with coronary stenosis received coronary artery bypass simultaneously. Patients were followed up for 11 months to eight years.

RESULTSThere were no peri-operative deaths in cerebrovascular reconstruction patients. Symptoms of cerebral ischemia were improved or cured in 25 of 38 patients. There was a low incidence of cerebral reperfusion syndrome. Two patients died at five and seven years after surgery due to heart failure. Another 8 patients (20%) required further surgery for stenosis (5 patients) or anastomotic aneurysms (3 patients). Percutaneous transluminal angioplasty was performed successfully for treatment of aortic and renal lesions. Repeated angioplasty for revascularization was performed in six PTA cases with restenosis after 5 - 24 months.

CONCLUSIONSWhen cerebral perfusion has potential to be affected by TA, a definitive corrective procedure is advised when the patient is relatively stable. Although the recurrence rate is very high, percutaneous transluminal angioplasty is the first choice procedure. Bypass operation is optimal for brachiocephalic-vessel involvement in TA. Cerebral reperfusion syndrome can be avoided by careful selection of the operation method and improved post-operative treatment.

Adolescent ; Adult ; Arteritis ; drug therapy ; Brachiocephalic Trunk ; pathology ; surgery ; Brain Ischemia ; etiology ; pathology ; surgery ; Cerebral Revascularization ; methods ; Female ; Humans ; Male ; Methylprednisolone ; therapeutic use ; Takayasu Arteritis ; complications ; pathology ; surgery ; Treatment Outcome ; Young Adult

Adipose stem cells (ASCs) are a type of adult stem cells that share common characteristics with typical mesenchymal stem cells. In the last decade, ASCs have been shown to be a useful cell resource for tissue regeneration. The major role of regenerative medicine in this century is based on cell therapy in which ASCs hold a key position. Active research on this new type of adult stem cell has been ongoing and these cells now have several clinical applications, including fat grafting, overcoming wound healing difficulties, recovery from local tissue ischemia, and scar remodeling. The application of cultured cells will increase the efficiency of cell therapy. However, the use of cultured stem cells is strictly controlled by government regulation to ensure patient safety. Government regulation is a factor that can limit more versatile clinical application of ASCs. In this review, current clinical applications of ASCs in plastic surgery are introduced. Future stem cell applications in clinical field including culturing and banking of ASCs are also discussed in this review.
Adipose Tissue/*cytology ; Cicatrix/prevention & control ; Humans ; Ischemia/therapy ; *Mesenchymal Stem Cell Transplantation ; Mesenchymal Stromal Cells/*cytology ; Surgery, Plastic ; Tissue Engineering ; Wound Healing

OBJECTIVETo explore the effects and action mechanism of electroacupuncture (EA) pretreatment on rats with transient cerebral ischemia/reperfusion.

METHODSA total of 144 healthy SD male rats were randomly divided into a sham operation group (group S), an ischemia/reperfusion group (group I/R) and an EA pretreatment group (group EA), 48 rats in each one. The model of cerebral ischemia/reperfusion was established by using 4-vessel occlusion method in the group I/R; after 5 min of cerebral ischemia, the reperfusion was performed. The group EA was treated with EA at "Dazhui" (GV 14) and "Baihui" (GV 20) 5 days before model establishment, 30 min per time, once a day. In group S, bilateral foramen alares were exposed without burning on the vertebral arteries, and bilateral common carotid arteries were unfolded and not occluded. The rats in the group I/R and group EA were sacrificed 6 h, 12 h, 24 h and 48 h after reperfusion and those in the group S were sacrificed at corresponding time to collect hippocampus example. The Western-blot method was used to measure the expression of glucose-regulated protein 78 (GRP 78), and HE staining method was used to count the number of surviving neurons, and TUNEL method was used to measure the number of apoptotic neurons.

RESULTSCompare with the group S, the number of surviving neurons in hippocampus was reduced at each reperfusion time point and the number of apoptotic neurons was increased (all P<0.05) in the group I/R and the group EA; the expression of GRP 78 at each reperfusion time point in group I/R and group EA was increased (P<0.05). Compared with the group I/R, the number of surviving neurons in hippocampus was increased at each reperfusion time point and the number of apoptotic neurons was reduced in the group EA (P<0.05); the expression of GRP 78 at each reperfusion time point was further increased (P<0.05).

CONCLUSIONThe electroacupuncture pretreatment has obvious cerebral protection on rats with ischemia/reperfusion, which is related with further increasing the expression of GRP 78 in ischemia area, leading to relieved endoplasmic reticulum stress.

Animals ; Brain Ischemia ; genetics ; metabolism ; surgery ; therapy ; Electroacupuncture ; Heat-Shock Proteins ; genetics ; metabolism ; Hippocampus ; metabolism ; Humans ; Male ; Rats ; Rats, Sprague-Dawley ; Reperfusion