With the development of gene technology,it is gradually possible and much better for genetic modification of bone marrow stem cells in treatment of hindlimb ischemia. Gene modification of cells prior to their transplantation, especially stem cells, enhances their survival and increases their function in cell therapy. But this treatment is only used for the experimental stage. Here, we review the current uses of gene-modified bone marrow stem cells in vascular disease.

Objective To evaluate the early clinical efficacy of subfascial endoscopic perforator vein surgery (SEPS) in the treatment of chronic venous insufficiency (CVI) of lower limbs. Methods A retrospective study was carried out in 26 patients (34 legs) with CVI treated by SEPS. Results The number of incompetent perforating veins ligated per limb ranged 1～5 (mean, 3 5). The postoperative clinical score (2.48?0.25) was significantly lower than the preoperative score (6.54?0.93) ( t =21.497, P

Objective To investigate the protective effects of ulinastatin(UTI)on ischemia-reperfusion(I/R)injury(SMIRI)of skeletal muscle in rats.Method Twenty-four male SD rats randomly were divided into three groups in equal number:control group(Group C)rats underwent anesthetization without ischemia;the ischemia-reperfusion injury group(Group I/R)rats underwent ischemia and reperfusion,0.5 ml normal saline (N.S)was infused upon extermal jngular vein prior to reperfusion;ulinstatin group(Group U)underwent ischemia and reperfusion,and 0.5 ml UTI(5×104 U/kg)Was infused at the same time.The skeletal muscle injury model was induced by a rubber band tourniquet applied to the left root of the hind limb for 4 hours and reperfusion for 4 hours.At the end of study,the expression of TNF-α mRNA of skeletal muscle was determined by reverse transcription-polymerase chain reaction(RT-PCR);enzyme-linked immun-osorbent assay(ELISA)were performed for plasma level of TNF-α;the plasma concentrations of lactate dehydrogenase(LDH),creatine kinase (CK),malondialdehyde(MDA),myeloperoxidase(MPO)activity and MDA in skeletal muscle were measured by colorimetry respectively.The oedema degree was quantified by calculating the wet/dry weight ratio of skeletal muscle.Structural changes of skeletal muscle were also observed histologically and ultrastructurally.The statistical difference was analyzed with One-way ANOVA by SPSS version 10.0 Software for windows.Results The level of plasma TNF-α,TNF-α mRNA expression in skeletal muscle in group I/R were significantly higher than those in Group C(P＜0.01),while those in Group U were significantly lower than those in Group I/R(P＜O.01).The plasma concentrations of LDH,CK,MDA and the MPO activity,W/D of skeletal muscle varied in those groups were likewise in comparinson between groups(P＜0.05).The histologic changes of skeletal muscle tissue under light and electronic microscopy were slingter in Group U than in group I/R.Conclusions UTI can inhibit the production of inflammatory factors and MDA,and suppress the MPO activity,showing protective effects against ischemia-reperfusion injury of skeletal muscle of rats.

Objective:To evaluate the efficacy of dual intervention for the treatment of acute pulmonary embolism(PE) in patients with deep venous thrombosis(DVT) of lower limbs.Methods:Twenty five patients of DVT with PE were treated with combination of transcatheter thrombolysis and inferior vena cava filter placement.Results:All the filter procedures and catheter were successfully performed,without any complication.The clinical symptoms were markedly improved in all patients.Twenty three cases were followed up for 3-36 months after dual intervention,and no complications of interventional treatment or recurrent PE was found.Conclusion:The inferior vena cava filter placement is an effect method in preventing PE.Dual interventional procedures is a superior and effective method for managing the patients with PE.

Objective To explore the significance of LDH and ?2-m concentration in CSF in differentiating viral meningitis from purulent meningitis in pediartic patients.Methods Kinetic method was performed to detect the LDH concentration in CSF in 45 patients with purulent meningitis and 49 patients with viral meningitis and 22 healthy children of control group respectively.On the other hand,radioimmunoassay(RIA)was used to detect the concentration of ?2-m.Results The concentrations of LDH in CSF in purulent meningitis group(26.15?12.17)U/L were higher than that in viral meningitis group(8.76?4.94)U/L significantly(P

Objective:To investigate the mechanism of Salvia Miltiorrhizae(SM) on protecting the renal injury of rats with obstructive jaundice.Methods:The 36 rats were randomly divided into control group,obstructive jaundice group and SM treated group.The renal injury of rats model with obstructive jaundice was established by ligating common bile duct.In the SM treated group,SM (2.0g/ d) was given through abdominal cavity.Animals were killed at the 7th,14th,21st and 28th day after operation respectively.The malondialdehyde (MDA) and superoxide dismutase (SOD) activity content of serum and renal tissue were determined,and the changes of renal function and histopathology were observed.Results:Comparing with non treated group,the serum and renal tissue SOD activity were markedly increased,and the MDA were obviously decreased(P

Objective To explore the clinical significance of retrograde access for the interventional treatment of lower extremity arterial occlusive diseases when the occluded segment of lower extremity artery could not be reached through antegrade access.Methods Twenty-seven cases (male 17,female 10; age range 32-89 years ) were retrospectively investigated, including 18 with lower limb arteriosclerosis obliterans,7 with diabetic foot and 2 with thromboangiitis obliterans.According to the Fontaine staging,6 cases were classified as Fontaine Ⅱ,11were classified as Fontaine Ⅲ and 10 were classified as Fontaine Ⅳ.All cases underwent endovascular operation through antegrade access first with an attempt to cross the occlusive segment,but in vain.So retrograde access was tried via puncture of pedis dorsalis or posterior tibial artery or exposure of lateral branches of posterior tibial artery,peroneal artery or dorsal artery by open surgery,which followed by Percutaneous transluminal angiography and (or) stenting.Results The operation through retrograde access was successful in all cases with obvious improvement of ischemic symptoms.Hematoma at the puncture site occurred in 3 patients,and paresthesia of toes occurred in 1after dorsalis pedis arteriotomy.No severe perioperative complication occurred.The average ankle brachial index increased from 0.37 ± 0.11preoperatively to 0.85 ± 0.12 postoperatively.Conclusions Retrograde access could be used as an alternative strategy in lower extremity arterial occlusive diseases when the occluded segment could not reach through antegrade access.

OBJECTIVE:To observe clinical efficacy and safety of citalopram in the treatment of depression patients after lung cancer operation. METHODS:114 depression patients after lung cancer operation were selected and randomly divided into observa-tion group and control group (n=57). Control group was given routine treatment as nutrition support and electrolyte balance,but had no anti-depression drugs;observation group was given Citalopram tablet 20 mg orally,qd. Two groups were treated for 6 weeks. Clinical efficacy,HAMD and HAMA scores,each score and total score of SF-36 were observed before and after treatment. The occurrence of ADR was recorded. RESULTS:The total effective rate of observation group was 87.72%,which was significant-ly higher than that that of control group(71.93%),with statistical significance(P<0.05);there was no statistical significance in HAMA score,HAMD score,each score and total score of SF-36 between 2 groups before treatment(P>0.05);HAMA score and HAMD score of 2 groups decreased significantly after treatment,the observation group was lower than the control group;each score and total score of SF-36 increased significantly,the observation group was higher than the control group,with statistical sig-nificance(P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Citalopram is effective and safe for depression af-ter lung cancer operation,can improve mental state and quality of life.

Objective:To systematically evaluate the intelligence-assisted endoscopic diagnosis system based on deep learning (DL-IEDS) for early cancer of the upper digestive tract.Methods:Literature on the value of DL-IEDS for diagnosis of early cancer of the upper digestive tract was searched in English (PubMed, Embase, Web of Science and Cochrane Library)and Chinese databases (Sinomed, CNKI, Wanfang and VIP). The quality of literatures was evaluated according to Quality Assessment of Diagnostic Accuracy Studies-2. The Rev Man 5.3, Meta-Disc 1.4 and Stata 15.1 were used for the meta-analysis.Results:Eight studies were included with a total of 9 675 images (including 2 748 images of early cancer). Meta-analysis results showed that the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and comprehensive diagnostic ratio of DL-IEDS in the diagnosis of early cancer of the upper digestive tract were 0.920, 0.874, 6.824, 0.103 and 71.109, respectively. The area under the curve (AUC) of summary receiver operating characteristics was 0.958 7. Five studies reported the results of DL-IEDS in the diagnosis of early gastric cancer, and the combined analysis showed that the pooled sensitivity and specificity were 0.840 and 0.845 respectively, and the AUC was 0.919. Four studies reported the accuracy rate of endoscopic experts and endoscopic novices in diagnosing early upper gastrointestinal cancer, and results showed that the pooled sensitivity, specificity and AUC were 0.693, 0.892 and 0.892 3, and 0.586, 0.860 and 0.754 5, respectively. Compared with endoscopy experts, the AUC of DL-IEDS in diagnosis of early upper gastrointestinal cancer showed no statistically significant difference ( Z=1.510, P=0.131), while compared with endoscopy novices, the difference was statistically significant ( Z=6.841, P<0.001). Conclusion:The DL-IEDS has high diagnostic accuracy for early upper digestive tract cancer, and can significantly improve the diagnostic ability of endoscopy novices.

Liver fibrosis and cirrhosis are the common outcomes of various chronic liver diseases after progression， and studies have shown that liver fibrosis and early liver cirrhosis can be reversed. Compound traditional Chinese medicine prescriptions have a marked therapeutic effect in reversing liver fibrosis and early liver cirrhosis， and their mechanism of action remains unclear. By reviewing related articles in China and globally， this article summarizes the six main phenotypic mechanisms involved in the efficacy of compound traditional Chinese medicine prescriptions， i.e.， inhibiting liver inflammation and regulating liver immune response， regulating hepatic stellate cell activation and extracellular matrix （ECM） generation， promoting ECM degradation， reversing hepatic sinusoidal capillarization， regulating hepatocyte regeneration， and regulating gut microbiota， and in addition， this article also analyzes the advances and shortcomings in current studies on each phenotype. Future studies on compound traditional Chinese medicine prescriptions should focus on experimental exploration and rescue experiments to verify the above phenotypes and further explore the upstream and downstream signaling pathways with a marked effect. This article aims to help clarify the direction and ideas of studies on the therapeutic mechanism of compound traditional Chinese medicine prescriptions， in order to provide a basis for clarifying the scientific essence of compound traditional Chinese medicine prescriptions.