Objective To explore the diagnosis and Fogarty catheter embolectomy operation management of acute arterial embolism in the extremities.Methods The clinical data of 87 cases of acute arterial embolism in the extremities treated by Fogarty catheter was ana- lyzed retrospectively,Results All cases were diagnosed through asking patient history and symptom,physical examination and the check of color Doppler while the results were proved by operation.No one case received vasography.After operation,78 cases blood stream of limb had been resumed and cure rate of 87.6% was achieved while 4 cases improved(4.5%),and no occurrence of ischemic necrosis and amputated ex- tremity.5 cases(5.6%)received amputation at the relative level and there were 2 cases(2.3%)of perioperative death.Those cases who re- ceived operations within 48 hours from the time of morbidity achieved cure rate of 100%,while those cases more than 48 hours achieved cure rate of 47.6%,improvement rate of 19.0%,amputation rate of 23.8% and mortality of 9.6%.Conclusion First,Ultrasound Doppler exami- nation should be taken for avoidance of misdiagnosis when acute extremity arterial embolism is suspected.Second,The key Intraarterial embo- lectomy using Fogarty catheter is an effective method for the treatment of acute arterial embolism in the extremities,is significant in application,Third,as soon as the diagnosis is established,embolectomy with Forgarty catheter must be carried out to avoid clot extension and necrosis of the extremity.Satisfactory therapeutic efficacy can be got,if the patient receive operation within 48 hours from onset.

Objective To study the effect of vascular endothelial growth factor (VEGF) containing fibrin glue(FG) on re-endotheliazation, cell proliferation and intimal hyperplasia in a canine model of carotid artery endothelium injury. MethodsThe effect of FG/VEGF/heparin versus FG alone treatment was evaluated at the time point of 10, 30, and 90 days by measuring the intima/media (I/M) ratio and cell proliferation by BrdU incorporation using immunohistochemistry. EC coverage was determined by SEM. ResultsCompared with normal saline control, FG/VEGF/heparin treatment significantly increased EC coverage at day 10 and at day 30 (P

Objective To evaluate the clinical effects of autogenous vein grafting for the treatment of atherosclerotic occlusion of the lower limbs. Methods Ninety cases of segemental atherosclerotic occlusion of the lower limbs underwent autogenous vein graft bridging procedures from Jan 2002 to Feb 2005 in our hospital. The immediate surgical results were compared with symptoms of pre-operation, and the long-term patency rate was evaluated. Results Total symptom relief was achieved in 87 cases, with the limbs pain disappearing, skin temperature going up, and the refractory ulcer tending to heal. There was a significant difference in ABI, perioperatively increasing from 0. 38?0. 11 to 0. 85?0. 18(P

Objective To discuss the diagnosis, selection of type of operation, and prevention and treatment of perioperative complications of abdominal aortic aneurysm (AAA). Methods The clinical data of 96 (patients) who underwent open surgical treatment of AAA, at Xijing Hospital between January, 1990 and June, 2004 were retrospectively reviewed. Among those, 82 patients with infrarenal AAA underwent aneurysmectomy and graft repair. 12 cases were treated by aneurysmal wrapping with Dacron. In 2 patients with suprarenal false AAA, lateral aneurysmectomy and repair was performed. Results The distance between renal artery and the neck of the aneurysm was determined by arteriography, MRA or EBT. Ninty-three patients were cured, and three cases died, with an operative mortality of 3.1%(3/96). The operative mortality was 50.0%(2/4) in 4 cases who had urgent operation because of ruptured AAA, while the operative mortality rate of the cases undergoing elective surgical repair was 1.1%(1/92, P

Objective:To observe the changing characteristics of pharmacokinetic and pharmacodynamic (PK-PD) parameters of vancomycin in critical patients under different drug regimens and to further explore the influencing factors.Methods:The clinical data of patients who treated with vancomycin and recorded by steady-state through concentration (C min) admitted to intensive care unit (ICU) of Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2011 to December 2018 were analyzed retrospectively. The patients were divided into three groups according to the dosing interval (groups of q12 h, q8 h and q6 h respectively) and C min was collected. The serum concentration of vancomycin before (0 hour) and 1, 2, 4, 6, 8, 12 and 24 hours after administration were estimated by JPKD Ver 3.1. Area under the curve (AUC 0-24 h) was estimated by trapezoidal area method. Minimum inhibitory concentration (MIC) of pathogenic microorganisms in the same period was retrieved, thus AUC 0-24 h/MIC was calculated. Results:285 patients with 529 records of C min were enrolled in the study, including 375 data in q12 h group, 121 data in q8 h group and 33 data in q6 h group. After unifying daily dose by JPKD Ver 3.1, the C min (10-20 mg/L) reaching rate of q12 h group, q8 h group, q6 h group were 35.7%, 43.8% and 60.6%, respectively, while only q12 h group was statistically significant compared with q6 h group ( P < 0.01). q6 h group and q8 h group showed higher C min than q12 h group (mg/L: 13.8±5.2, 13.5±7.3 vs. 11.4±7.9, both P < 0.05) and lower peak concentration (C max) than q12 h group (mg/L: 19.4±5.3, 21.5±7.3 vs. 23.9±8.1, both P < 0.05). However, there was no significant difference in terms of percentage of PD target (AUC 0-24 h/MIC≥400) among the three groups (q12 h group, q8 h group, q6 h group were 38.1%, 41.3%, 45.5%, P > 0.05). Multiple linear regression analysis showed that creatinine clearance (CCr) and vancomycin clearance (CLvancomycin) were the main influencing factors of vancomycin PD parameters such as C min and AUC 0-24 h/MIC ( r values of CCr were -0.391, -0.424, and rvalues of CLvancomycin were -0.673, -0.663, all P < 0.01), and were negatively correlated with age ( r values were -0.432 and -0.488, respectively, both P < 0.01). Conclusions:At the same daily dose, C min can be increased and C max can be decreased by increasing the frequency of vancomycin administration, thus minimize the fluctuation of vancomycin serum concentration, but AUC 0-24 h/MIC is not affected. Vancomycin administration regimen in severe patients should be optimized according to CCr, CLvancomycin and age.