2.Deep venous thrombosis after greater saphenous vein ligation and stripping
Dianning DONG ; Xuejun WU ; Shiyi ZHANG ; Zhenyue ZHONG ; Xing JIN
Chinese Journal of General Surgery 2012;27(3):187-189
Objective To report deep venous thrombosis (DVT) after greater saphenous vein ligation and stripping and to evaluate diagnosis,treatment and prophylaxis. Methods The clinical characteristics, diagnosis and treatment of 12 inpatients with postoperative DVT were analyzed retrospectively. Results Of these 12 cases there were 7 cases of central type DVT,2 cases of peripheral DVT,and 3 cases of mixed type DVT.Secondary pulmonary embolism was complicated in 2 cases.Clinical symptoms in these 10 cases of proximal DVT were all severe.Catheter-directed thrombolysis(CDT) through the ipsilateral popliteal vein with protective(IV)CF was applied for these 10 cases.Of 10 cases,femoral vein was found ligated in 1 case,which was repaired under open surgery. Residual greater saphenous vein thrombus extending into deep vein was proved and managed by successful thrombolectomy in one case.Cockett syndrome were found as the causes in the other 8 cases,6 cases were treated with balloon dilatation angioplasty and endovascular stenting of the iliac vein.The 2 cases of with distal DVT were treated by anticoagulation therapy.All patients were cured. Conclusions Cockett syndrome,femoral vein injury and too long residual greater saphenous vein are common causes of DVT after greater saphenous vein ligation and tripping.Careful selection of cases,correct diagnosis,standard operative manipulation,early ambulation were all important in the prevention of DVT after great saphenous vein varix procedure.
3.Clinical value of D-dimer testing in diagnosis of patients with deep vein thrombosis of the lower extremity
Mengtao WU ; Xing JIN ; Liang XU ; Xihong FAN
Chinese Journal of General Surgery 1994;0(05):-
Objective To discuss the clinical value of D-dimer(DD) testing in diagnosis of patients with deep vein thrombosis(DVT) of the lower extremity.Methods An analysis retrospectively was made on the changes of DD testing in 106 cases of DVT at different periods after onset and different clinical stages of DVT,and DD testing in 99 patients with primary deep venous insufficiency(PDVI) as control group.(Results) DD was higher in the acute stage of DVT,and gradually decreased with time in chronic DVT,and was negative in the patients with PDVI;the positive rate was up to 85.7% in the distal DVT.Conclusions The DD testing can be used as one of the methods for diagnosis,prediction and prognosis of acute DVT,especially for diagnosis of distal DVT.
4.Imaging diagnosis and surgical treatment of popliteal artery entrapment syndrome
Maohua WANG ; Xuejun WU ; Xing JIN ; Jingyong ZHANG ; Hai ZHONG
Chinese Journal of General Surgery 2011;26(7):593-595
Objective To summarize the experience on imaging diagnosis and surgical treatment for popliteal artery entrapment syndrome (PAES). Methods From 2004 to 2010, 11 patients (12 limbs) diagnosed as PAES by CTA and MR ( A) underwent surgery. There were 11 patients with a mean age of (28 ±19) years, eight patients were male, three patients were female. Two patients were found to have bilateral involvement. Intermittent claudication was the most frequent presenting symptom. Six limbs were type Ⅰ , three limbs were type Ⅱ , three limbs were type Ⅲ , one limb was type Ⅳ. The preoperative mean ABI was 0.47 ± 0. 27. Results Popliteal artery exploration surgery or peripopliteal artery lysis was performed in 12 limbs, and this procedure was combined with a great saphenous vein bypass graft in seven limb because of arterial occlusion or aneurysm. After a median follow-up of ( 19 ± 20) months (0 month to 6 years) , the mean ABI improved to 0. 81 ±0. 30, which was significantly higher than that of preoperation( P < 0.05),one patient died of pulmonary embolism one day after operation, one patient (one limb) had popliteal artery thrombosis after operation. Intermittent claudication symptoms disappeared in all other patients. Conclusions Timely imaging diagnosis and surgical intervention is very important for patients of PAES.
5.The Function and Clinical Application of The Non-structural Protein of The Type A Influenza Virus
Jinhua SUN ; Mingfu WU ; Mingwei XING ; Miao JIN ; Junwei WANG
Progress in Biochemistry and Biophysics 2006;0(08):-
The first research on the NS1 protein as the non-structural protein of the type A influenza virus was emphasized on the considering of its depressant effect on the composition of the protein of host cell.And now,with deep research,the evolution of its genes and the antigenicity of its protein have been explained.The NS1 protein of influenza virus has the association with the apoptosis induced by the influenza virus,the regulating function of apoptosis has the direct correlation with possibility of producing interference and the cell line infected by influenza virus.The NS1 protein restrained to producing the interferon by infected cell.The NS1 protein plays an important role on the host anti-viral cytokine responses,it possesses nagitive regulation for interferon's antiviral activity,most observation indicated nagitive regulation might associate with the virulence of influenza virus.Furthermore NS1 protein as an inspection antigen to differentiate and diagnose the poultry which was immunized or naturally infected has a very wide prospect,because the traditional vaccine was used extensively.
6.Intracranial pressure monitoring for guiding high coronary craniotomy for clearance of bilateral frontal contusions in 79 cases
Xuehai WU ; Liang GAO ; Jin HU ; Yi JIN ; Xing WU ; Liangfu ZHOU
Chinese Journal of Trauma 2013;(2):103-106
Objective To improve treatment success rate and prognosis for patients with bifrontal contusions by intracranial pressure monitoring.Methods A retrospective analysis was conducted on 79 cases of bifrontal contusions admitted between October 2004 and April 2012.The patients were divided into intracranial pressure monitoring group (n =40) and group without intracranial pressure monitoring (n =39),according to the treatments.Significance of high coronary craniotomy timing,surgical strategy and intracranial pressure monitoring in the diagnosis,treatment and prognosis was analyzed.Results The intracranial pressure monitoring group showed a significantly shorter period concerning osmotic dehydration [(14.24 ± 7.93) days vs (21.61 ± 11.97)days,P<0.01],ICU stay [(14.38 ±7.56)days vs (24.71-± 17.94)days,P<0.01] and total hospital stay [(17.20 ±8.09)days vs (33.92 ± 21.70)days,P<0.01] as well as a better GOS [(4.15 ± 1.22) points vs (3.69 ± 1.56) points,P < 0.05],as compared with group without intracranial pressure monitoring.Conclusions Craniotomy,especially decompressive craniectomy,is one of the most important treatment means to control cranial pressure and ensure cerebral perfusion pressure in patients with bifrontal contusions (in particular the moderate and severe ones).Besides,intracranial pressure monitoring is conducive to selection of surgery timing and is instructive to combined treatment,such as osmotherapy,intracranial pressure controlling and assurance of cerebral perfusion pressure.
7.Design and Functional Investigation of a Novel Anti-coagulative Fusion Protein by Hirudin With a Recognizing Sequence of FXa
Jin-Yang NIU ; Chun-Na DONG ; Ji-De JIN ; Bing-Xing SHI ; Zu-Ze WU ;
China Biotechnology 2006;0(04):-
Hirudin (HV) is known as the most potent and specific inhibitor of thrombin. Although hirudin has many advantages , it has the bleeding side effect and this is the great shortage of hiudin for clinical application. In order to alleviate bleeding side effect of hirudin, fusion protein, named as FHV (fusion hirudin linked with FXa recognition peptide) was designed. The fusion protein gene ( fhv) was cloned into plasmid pPIC9K. FHV engineered Pichia pastoris containing high copies was chosen for fermentation and purification at 30 L fermentor scale, finally, FHV with purity of above 97% was obtained. To investigate the function of FHV in vivo, mouse tail thrombosis model was used. In the mice thrombus tail model induced by carrageenan, FHV decreased the length of tail thrombus significantly, similar to that of HV control, and had no obvious effects on the TT, PT and APTT. In conclusion, FHV is constructed and expressed in yeast. FHV fusion proteins is obtained by fermentation and purification. FHV has antithrombotic effects not influencing IT, PT and APTT after administration immediately in animal models. Therefore, FHV is a promising anticoagulant and antithrombotic drug.
8.Long-circulating liposomal daptomycin enhances protection against systemic methicillin-resistant Staphylococcus aureus infection with improved therapeutic potential.
Xing-Liang HUANG ; Jin WU ; Ting-Ting SU ; Yan-Hong LI ; Zhang-Bao CHEN ; Chong LI
Acta Pharmaceutica Sinica 2014;49(5):701-710
In the face of escalating problems with pathogen control, the development of proper formulations of existing antibiotics is as important as the development of novel antibiotics. Daptomycin is a lipopeptide antibiotic with potent activity against Gram-positive bacteria. Currently, only injectable solution of daptomycin has been approved for clinical use. In the present study, the formulation of PEGylated liposomal daptomycin (PLD) was prepared and optimized, and its efficacy against methicillin-resistant Staphylococcus aureus (MRSA252) strains was investigated. The obtained PLD had a mean vesicle diameter of (111.5 +/- 15.4) nm and a mean percent drug loading of (5.81 +/- 0.19) % with high storage stability. Potent activity of PLD against MRSA was demonstrated in vitro with a more sustained effect than that of conventional liposomal daptomycin and daptomycin solution. In addition, intravenous administration of a single dose (equal to human use) of PLD significantly increased the survival of mice in a MRSA252 systemic infection model compared with other formulations. Drug distribution in the lung was significantly enhanced following administration of PLD, and no measurable tissue lesions or pathological changes were detected during PLD treatment. Taken together, PEGylated liposomes loaded with daptomycin may represent a promising approach to reduce MRSA252 infections, especially those involving bloodstream dissemination, such as hematogenous pulmonary infection.
Animals
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Anti-Bacterial Agents
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pharmacology
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Daptomycin
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pharmacology
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Liposomes
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Methicillin-Resistant Staphylococcus aureus
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drug effects
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Mice
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Staphylococcal Infections
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drug therapy
9.Transcatheter arterial embolism for postpartum hemorrhage
Yan SUN ; Gongpu WANG ; Yang LIU ; Xiangqian KONG ; Xing JIN ; Xuejun WU ; Hai YUAN
Chinese Journal of General Practitioners 2012;11(5):364-366
We reviewed the clinical data of 24 patients with postpartum hemorrhage undergoing transcatheter arterial embolism from March 2009 to September 2011.Twenty out of 24 patients underwent uterine artery embolism,while other 4 underwent internal iliac artery embolism.The hemorrhage reduced markedly 2 to 9 min after arterial embolism in all patients,except 2 who underwent secondary embolism due to the intermittent postoperative hemorrhage. The postoperative complications included low fever and discomfort in lower abdomen.Nineteen patients were followed up for a mean period of ( 17.3 ± 1.1 ) months,no recurrent hemorrhage was observed after discharge.The normal menstrual cycle recovered 4 to 6 months after operation.Three patients underwent pregnancy successfully after discharge.The results indicate that transcatheter arterial embolism is safe and effective in the treatment of postpartum hemorrhage and it should be recommended as a feasible choice in clinical practice.
10.Effect of urgent carotid endarterectomy on operative risk and benefit
Yongjun YANG ; Xing JIN ; Xuejun WU ; Jie LI ; Ruihua WANG ; Basian HERTERT
Chinese Journal of Current Advances in General Surgery 2008;11(5):380-385
Objectives:The time of Carotid intervention for recently symptomatic,severe carotid stenosis which cause a transient ischemic attack or minor stroke is still a controversial issue.Early studies showed that carotid endarterectomy (CEA) caused a high risk if performed within days follow an acute ischemic stroke.However,The National Stroke Strategy posted by UK Department of Health advocated that this situation should be regarded as an emergency procedure,and carotid intervention should ideally be performed within 48 hours.We designed this study to discuss the effect of urgent CEA on operative risk and benefit.Methods: we analyze 12 urgent CEA with primary closure performed during 1996 to 1998.All 12 patients were underwent CEA within 2 weeks,and 2 of them within 2 days.Operative risks and overall benefit from surgery were discussed in relation to the time from the last symptomatic event to CEA.Results: 2 urgent CEA performed in 2 days are recovery uneventful.1 of 12 patients,who underwent urgent CEA within 2 weeks,occurred restenosis after 3 months follow up.No 30-day perioperative recurrent TIA,stroke and death.Conclusions:CEA performed within 2 weeks is feasible and reliable procedure in preventing recurrent TIA and stroke after presenting manifestations.The future aim is to perform CEA within 48 hours after TIA or stroke symptoms.