Objective To explore the relation between lower extremity deep venous thrombosis and knee injury.Methods 100 knee injury patients were operated on in our department.The difference of incidence rates of DVT,the thrombus location and incidence rates of DVT before and after operation in the two groups was compared.There were no fatal pulmonary embolism occurring in either group.Results The incidence rate of DVT in tibial plateau fracture group was 52％,that in patellar fracture was 30％ (P ＜ 0.05).DVT incidence rate of popliteal,pretibial,posterior tibial vein thrombosis in group of tibial plateau fracture was higher than that in group of patellar fracture (P ＜ 0.05),while there was no significant difference in postoperative thrombosis between the two groups(P ＞ 0.05).Conclusions There is a high incidence rate of DVT in knee joint injury.Which is closely related to the position of fracture and limb immobilization.

Objective To investigate the effects of acarbose versus fenofibrate on insulin secretion and insulin resistance in the subjects with impaired glucose tolerance (IGT) and hypertriglyceridemia. Methods Eighty subjects were allocated to acarbose group (28 cases),fenofibrate group (30 cases),and control group (22 cases) without intervention for 3 months,and also divided into elderly (46 cases) and younger groups (34 cases). Fasting blood samples were collected for measuring fasting plasma glucose and lipid.Oral glucose tolerance test (OGTT) were carried out with measurement of plasma insulin and glucose before ad after treatment.Early insulin secretion indexes(△I30/△G30),insulin secretion indexes (HOMA -β) and insulin resistance indexes (HOMA-IR)were calculated. Results After 3-months of treatment,the lipid profile was evidently improved in fenofibrate group. Levels of triglyceride (TG) and total cholesterol (TC) were significantly reduced ( both P ＜ 0.01 ),△I30/△G30 was significantly increased (P ＜ 0.05) and HOMA-IR was decreased (P＜＜0.01).In acarbose group,levels of fasting plasma glucose (FPG),2hours postprandial plasma glucose (2 hPG) and HOMA-IR were reduced (all P＜0.01),△I30/△G30 and HOMA-β were enhanced (P＜0.01 or P＜0.05).No change of above indicators was found in the control group.Compared with fenofibrate group,acarbose group had higher △ I30/△G30 (P＜ 0.05),HOMA-β (P＜ 0.01 ) and lower HOMA-IR ( P ＜ 0.01 ).The improvement of △△I30/△G30 was correlated with the decreasing of plasma FPG,2 hPG and TG(r=0.5812,0.6327,0.3872,P＜0.01),while HOMA-1R was related with the decreasing of plasma 2 hPG,TG and TC(r=0.8126,0.4671,0.2895,P＜ 0.01). HOMA-IR,△I30/△G30 and HOMA-β were lower (P＜0.01) and acarbose improved insulin resistance better (P＜0.05) in the elderly than in the younger with type 2 diabetes. Conclusions Pancreatic β-cell function declines gradually with aging,acarbose may have advantage over fenofibrate in improving early insulin secretion and resistance which was more relieved by diminishing glucotoxity in comparison with lipotoxity.

OBJECTIVETo investigate the risk factors affecting neoplasm recurrence and metastasis following liver transplantation (LT) and liver resection (LR) in patients with hepatocellular carcinoma (HCC) meeting Milan criteria.

METHODSWe retrospectively analyzed the clinical data of 88 patients with HCC meeting Milan criteria undergoing LT or LR in Nanfang Hospital between January, 2006 and December, 2011 and compared the survival rate and recurrence-free survival rate between the two groups. Univariate analysis of 12 variables during peri-operative period was carried out to screen the risk factors affecting neoplasm recurrence and metastasis.

RESULTSThe LT group and HR group had similar 1-, 3-, and 5-year-survival rates (P>0.05), but the LT group showed significantly higher 1-, 3-, and 5-year recurrence-free survival rates (P<0.05). The recurrence rate was much lower in LT group than in LR group (P<0.05). Multivariate analysis identified gender, tumor size, degree of pathological differentiation, and microvascular tumor embolism as independent risk factors affecting the recurrence-free survival rate.

CONCLUSIONPatients with HCC meeting Milan criteria undergoing LT have longer long-term recurrence-free survival. A male patient with a greater tumor size, microvascular tumor embolism, and poorly differentiated carcinoma is more likely to develop neoplasm recurrence and metastasis following the surgery.

Carcinoma, Hepatocellular ; mortality ; pathology ; surgery ; Female ; Hepatectomy ; Humans ; Liver Neoplasms ; mortality ; pathology ; surgery ; Liver Transplantation ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Prognosis ; Retrospective Studies ; Survival Rate ; Treatment Outcome

Objective To investigate methods and results of endovascular treatment in TASC (Ⅱ) D-type femoral artery occlusion. Methods From January 2012 to May 2013, 26 cases (26 branches) of superficial femoral artery occlusion with endovascular treatment of TASC (Ⅱ) D-type superficial femoral artery occlusion were retrospectively reviewed. The effi-cacy was evaluated through ABI, CTA, DSA and symptoms improved. Results 26 branches were treated with endovascular methods. Technical success rate was 80.7%(21/26), including 13 branche with stent implantation, 6 branches with Silver-hawk atherectomy and 2 branches with Viabahn stent implantation. All patients were followed up for a mean period of (10.3 ± 1.2)months, primary patency rates at 6 months were 69.2%in stent group, 66.7%in Silverhawk atherectomy group and 100%in Viabahn stent group. Conclusion Endovascular treatment of TASC (Ⅱ) D-type femoral artery occlusion can lead to satisfactory short term patency rates, and Viabahn stent is the latest treatment.

Objective To investigate the risk factors affecting neoplasm recurrence and metastasis following liver transplantation (LT) and liver resection (LR) in patients with hepatocellular carcinoma (HCC) meeting Milan criteria. Methods We retrospectively analyzed the clinical data of 88 patients with HCC meeting Milan criteria undergoing LT or LR in Nanfang Hospital between January, 2006 and December, 2011 and compared the survival rate and recurrence-free survival rate between the two groups. Univariate analysis of 12 variables during peri-operative period was carried out to screen the risk factors affecting neoplasm recurrence and metastasis. Results The LT group and HR group had similar 1-, 3-, and 5-year-survival rates (P>0.05), but the LT group showed significantly higher 1-, 3-, and 5-year recurrence-free survival rates (P<0.05). The recurrence rate was much lower in LT group than in LR group (P<0.05). Multivariate analysis identified gender, tumor size, degree of pathological differentiation, and microvascular tumor embolism as independent risk factors affecting the recurrence-free survival rate. Conclusions Patients with HCC meeting Milan criteria undergoing LT have longer long-term recurrence-free survival. A male patient with a greater tumor size, microvascular tumor embolism, and poorly differentiated carcinoma is more likely to develop neoplasm recurrence and metastasis following the surgery.

Objective To investigate the risk factors affecting neoplasm recurrence and metastasis following liver transplantation (LT) and liver resection (LR) in patients with hepatocellular carcinoma (HCC) meeting Milan criteria. Methods We retrospectively analyzed the clinical data of 88 patients with HCC meeting Milan criteria undergoing LT or LR in Nanfang Hospital between January, 2006 and December, 2011 and compared the survival rate and recurrence-free survival rate between the two groups. Univariate analysis of 12 variables during peri-operative period was carried out to screen the risk factors affecting neoplasm recurrence and metastasis. Results The LT group and HR group had similar 1-, 3-, and 5-year-survival rates (P>0.05), but the LT group showed significantly higher 1-, 3-, and 5-year recurrence-free survival rates (P<0.05). The recurrence rate was much lower in LT group than in LR group (P<0.05). Multivariate analysis identified gender, tumor size, degree of pathological differentiation, and microvascular tumor embolism as independent risk factors affecting the recurrence-free survival rate. Conclusions Patients with HCC meeting Milan criteria undergoing LT have longer long-term recurrence-free survival. A male patient with a greater tumor size, microvascular tumor embolism, and poorly differentiated carcinoma is more likely to develop neoplasm recurrence and metastasis following the surgery.

Objective To conduct a Meta-analysis for assessing the therapeutic efficacy and safety of doxorubicin-eluting bead transcatheter arterial chemoembolization (DEB-TACE) vs conventional TACE (C-TACE) in the treatment of hepatoeellular carcinoma (HCC).Methods The relevant studies on DEB-TACE and C-TACE for HCC were searched from PubMed,Web of Science and CK1N databases.The tumor responds and adverse events in the selected studies were analyzed with RevMan5.0 statistical software.Moreover,publication bias was assessed by a funnel plot.Results Thirteen studies with 1 325 HCC patients were finally included in this analysis.The tumor response to DEB-TACE was better than that to C-TACE (OR:2.28;95％CI [1.75,2.96];P＜0.001 0).The risk of adverse events in DEB-TACE group was also lower than that in C-TACE group (RR:0.56;95％ CI [0.32,0.97];P=0.04).Conclusion Compared with C-TACE,DEB-TACE is more effective and has lower risk of adverse events in the treatment of HCC.

Objective:To study on the effects of gastrointestinal function and portal vein hemodynamics applicated with abdominal hot compressing with evodiae fructus and crude salt after hepatectomy.Methods:A total of 60 patients who underwent hepatectomy were randomly divided into 2 groups by random number table method, with 30 in each group. The control group was treated with conventional basic western medicine, while the treatment group was treated with medicinal evodiae fructus and crude salt hot compress on abdomen on the basis of the control group. The portal vein diameter (PVD), portal venous flow velocity (PVV), recovery time of main clinical indexes, clinical symptom scores and liver function indexes were dynamically monitored at different observation time points.Results:The scores of abdominal distension, nausea and vomiting in the treatment group were significantly lower than those in the control group 3 days after treatment ( t values were -3.489 and -2.740, respectively, all Ps<0.05). The recovery time of bowel sounds, first exhaust time and first defecation time in the treatment group were significantly earlier than those in the control group ( t values were -3.622, -4.297 and -4.151, respectively, all Ps<0.01). With the extension of treatment time, ALT in 2 groups showed a gradual downward trend ( P<0.05 or P<0.01), DBIL in control group was significantly higher at 3 days after treatment than before ( t=-2.157, P=0.039), and TBIL was significantly lower at 7 days after treatment than before ( t=2.175, P=0.038). The PVD ( t values were 3.528, 2.160) and PVV ( t values were 11.096, 4.264) of the treatment group were significantly higher than those of the control group 3 and 5 days after treatment ( P<0.01 or P<0.05). Conclusion:Early application of abdominal hot compressing with evodiae fructus and crude salt hot compress on abdomen after hepatectomy can improve the portal vein blood circulation and promote the rehabilitation of gastrointestinal function in patients with hepatectomy.

Objective To explore the impact of arterial injury on distal limb blood supply in lower limb trauma. Meth?ods Retrospective analysis of 93 patients with different levels of lower limb arterial injury admitted to our hospital from June 2014 to August 2017. There were 84 males and 9 females aged 43.54±9.90 years (ranging 25-65 years). Revascularization was performed through open reduction. Patients were divided into three groups according to their arterial injury locations. Proximal ves?sels were along the superficial femoral artery, from its beginning to the point where it was divided into the descending genicular ar?tery and direct periosteal branches. Intermediate vessels were from the dividing point on the superficial femoral artery to the popli?teal artery before it was divided into the medial inferior genicular artery. Distal vessels were from the dividing point on the poplite?al artery to the distal end of the peroneal artery. The duration from injury to revascularization in the three groups were 13.67±5.99 h, 11.15±4.43 h, and 11.92±5.48 h, respectively. There was no significant difference between groups (F=1.564, P=0.215). ISS in the three groups were 13.00±3.74, 12.77±3.81, and 11.50±3.99, respectively. There was no significant difference between groups (F=1.445, P=0.241). The following items were compared among the three groups, postoperative creatine kinase, arterial blood lac?tate and limb compartment cut. Results Creatine kinase of the intermediate vascular group was 8 743.15±6 968.48 u/L, proximal vascular group 1 467.67±1 810.27 u/L, distal vascular group 2 893.51±1 304.56 u/L. The data of intermediate vascular group were higher than those of proximal and distal vascular groups with significant difference among the groups (F=22.587,P=0.000). The lactate of the intermediate vascular group was 3.20 ± 1.51 mmol/L, proximal vascular group 1.63 ± 0.46 mmol/L, distal vascular group 1.85±0.69 mmol/L with significant difference among the groups (F=20.612,P=0.000). The compartment cut of the intermedi?ate vascular group was incised in 24, but not in 15. The proximal vascular group was not incised in 18, while 15 was incised and 21 not incised in distal vascular group. The rates of compartment cut were 61.5%, 0 and 41.7%, respectively with significant differ? ences (χ2=19.156, P=0.000). Conclusion In lower limb injuries, the intermediate vascular (from the superficial femoral artery after it is divided into the descending genicular artery and direct periosteal branches to the popliteal artery before it is divided into the medial inferior genicular artery) injury leads to the most severe distal limb ischemia.