Gastrointestinal hemorrhage from angiodysplasiamay may be associated with degenerative aortic valve stenosis , the associated of the two conditions termed Heyde ’ s syndrome.Gastrointestinal angiodysplasia and aortic valve stenosis areboth chronic degenerative diseases, and the incidence rate increased with age.Degenerative aortic stenosis can enhance high molec-ular weight polymer damage, which subsequently increases the risk of gastrointestinal bleeding.Aortic valve replacement is considered as the first-line treatment for patients with severe aortic stenosis , and can effectively improve the outcomes of hemor-rhagic angiodysplasia and acquired coagulopathy .However, the substantial connection between aortic valve stenosis and gastro-intestinal bleeding remains unclear, and the clinical diagnosis and treatment of this syndrome need more evidences.Herein, we will review the knowledge of epidemiology, pathogenesis and clinical diagnosis and treatment of Heyde’ s syndrome.

Objective To evaluate and compare the therapeutic results of subclavian artery angioplasty and stenting in patients with aortoarerteritis and atherosclerosis. Methods 13 cases (9 males and 4 females; age, 28-69 years) of subclavian artery stenotic occlusive disease were performed with PTA and stent. Results Six patients had aortoarerteritis, 7 had atherosclerosis lesions. Twelve of 13 stenoses could be successfully angioplasty ( n =6) and stenting ( n =6) . The one failure was due to the inability to cross the lesion with the guidewrie. Compared with atherosclerosis, higher balloon inflation pressure was required to dilate the lesions of aortoarerteritis. 12 patients were asymptomatic after PTA and stent implatation. Patients were follow up for 3-24 months and clinical examination demonstrated patency of the vessels with PTA and stents. Conclusion Subclavian PTA and stent implatation is safe and good clinical result as in aortoarerteritis as in atherosclerosis.

Objective To approach the cause and treatment of complications during and after catheter closure of ventricular septal defect(VSD).Methods Catheter closure of ventricular septal defect was attempted in 415 patients.Among them,74 patients with complications were retrospectively analyzed.Results The overall complication rate was 17.83%(74/415).The complications during procedure were seen in 13.98%(58/415) which included arrhythmias in 11 patient,aortic regurgitation in 15 patients,residual shunt in 26 patients,displacement of closure device in 1 patients,cardiac temponade in 1 patient,tricuspid valve injury in 1 patient,mitral valve injury in 1 patient,iatrogenic VSD in 1 patient and respiratory complication in 1 patient.The complications after procedure were noted in 4.19% of the patients(16/382),including arrhythmias in 8 patients,LV enlargement in 2 patients,thrombus fomation in femoral artery in 2 patients,Ⅲ?AVB in 2 patients whom required temporary and permanent pacemaker implantation,respectively,headache in 4 patients,haemolysis due to residual shunting in 2 patients,tricuspid valve injury in 1 patient and puncture site bleeding in 1 patient.There was no death recorded in our study.Conclusion The incidence of complications during and after catheter closure of ventricular septal defect was relatively low but careful long term follow-up is necessary for the monitor of delayed complications.

Objective To approach the cause and treatment of complications during and immediately after percutaneous balloon mitral valvuloplasty. Methods One thousand three hundred and eleven patients with mitral stenosis were treated by percutaneous transseptal balloon mitral valvuloplasty. Among them, 42 patients with complications were retrospectively analyzed. Results The overall complications rate was 3.2% (42/1 311) including atrial fibrillation 0.8%(10/1 311), acute pericardial tamponade 0.31%(4/1 311), severe mitral insufficiency 0.46% (6/1 311), femoral arterial venous fistula 0.69% (9/1 311), acute pulmonary edema and iatrogenic atrial septal defect 0.23%(3/1 311), respectively. Coronary air embolism, arterial thrombosis and transient cerebrovascular accident was 0.15%(2/1 311) for every other one. Balloon rupture was 0.08%(1/1 311).Conclusions The complications of percutaneous balloon mitral valvuloplasty rarely occur. It is a safe and efficient nonsurgical method for treating rheumatic mitral stenosis.

Objective To evaluate the feasibility and effectiveness of endoluminal grafting for the treatment of abdominal aortic aneurysms in high-risk patients with serious co-morbidities.Methods Endoluminal stent grafting was performed in fifty-one patients(45 males and 6 females,with a mean age of 71.6±7.5 years)with abdominal aortic aneurysms.Of all the patients,21(37.7%)were high-risk surgical candidates because of associated co-morbidities.These patients were classified in grade Ⅱ and Ⅲ according to the criteria assigned by the"Society for Vascular Surgery"and"International Society for Cardiovascular Surgery".Based on the preoperative CT and DSA findings,the appropriate stent was selected for every patient.Post-operative clinical observation and CT scan were regularly carried out,the occurrence of complications and the morphological changes of the aneurysms were observed.The results were evaluated and analyzed.Results Primary technical success was achieved in all patients(100%).No death occurred during the procedure or in 30 days after the procedure.An average follow-up period of(29.1±20.5)months was made.Minor endoleak was noted on CT scans in 10 patients,and the endoleak disappeared in 5 patients during the follow-up period.One patient died from unknown cause.The total mortality rate was 2.0%(1/51).The major complications rate was 9.8%(5/51),including stent thrombosis(n=2),thrombosis at femoral artery(n=1),lymphatic fistula at femoral incision(n=1) and stent dislocation(n=1).Conclusion Endoluminal stent grafting is a safe and feasible technique for the treatment of abdominal aortic aneurysms with excellent medium-term results.This technique is especially suitable for the patients with high surgical risk.

This article presents several common problems.of medical injection pump through one case of ESD troubleshooting. Expounds the causes of the problem and provides solutions.
Equipment and Supplies ; Injections ; instrumentation ; Static Electricity

Objective To provide anatomical evidence for the repair of wounds of finger distal phalanx,espe-cially for the recovery of feeling. Methods 10 samples of fresh adult hand were dissected under microscope. The course,branches,distribution and external diameter of nerves and blood vessels in finger distal phalanx and morpho-logical relationship between nerves and vessels were measured. Results Proper palmar digital nerves mostly step over digital arteries at section starts of distal finger arterial arcades and go to finger pulps and latero-backs. Their thinks di-vide into 2 branches. Transverse diameters of interior and exterior branches are 0.8 ～ 1.2 mm and 0.9 ～ 1.4 mm re-spectively at liner semilunaris levels. Distributionsof left and right branches are reciprocal chiasmas. Conclusion Finger nerve mostly ramifies to finger pulp,finger tip and finger back at the level of phalangette bottom. Its branches are lower and thinner than concomitant arteries. The suitable anatomy region for anastomosis of nerves and blood ves-sels is the middle1/3 section from the distal interphalangeal joint to the nail during replanation of amputated finger pa-ratelum.

0.05). Conclusions HF could not only relax cerebral vessels, reduce the CVR and enhance the CBF, but also dilate the femoral vessels of CVS dogs. Nevertheless, the latter action was much weaker. Furthermore, there was no relationship between effects of HF on vascular relaxation and contraction activity and the blood vessel endothelium.

Objective To analyze the safety and efficacy of endovascular aortic repair (EVAR) for abdominal aortic aneurysm(AAA) with hostile aortic proximal landing anatomy. Methods The clinical and imaging data of 147 AAA patients [135 males, (68.7 ± 8.9) years old, range 43-85 years old] with hostile aortic proximal landing anatomy treated by EVAR from January 2012 to December 2014 in our center were retrospectively analyzed. The range of maximum aneurysm diameter was 45-100 mm; the length range of proximal aneurysm neck was 7-32 mm;the width range of proximal aneurysm neck was 15-30 mm, and the infrarenal angulation was 10°-90° . In addition, there were atherosclerotic changes in the proximal neck in 43 cases. Follow-up protocol consisted of evaluation of clinical symptoms and cTA at 3, 6 and 12 months and annually thereafter. Results The technical success rate was 100%. Different procedures were adopted among patients, with 113 cases of EVAR, 3 cases of fenestrated EVAR and 24 cases of chimney EVAR. The intra-operative type Ia endoleak was observed in 32 cases, in which 25 of them were successfully treated by balloon angioplasty and the other 9 patients were treated with Cuff extension. During the mean follow-up period of 18 months (6-42 months), the accumulative survival rate was 98.0%(144/147),the patency rate of stents was 99.3%(146/147), and the thrombosis rate of aneurysm was 97.3%(143/147). Two patients died because of aneurysm rupture, and another case died of unknown reason. Two patients underwent secondary intervention successfully for the treatment of thrombosis formation and lumen occlusion in unilateral iliac stent in 1 case, and type Ⅲ endoleak in another case. No other complications such as misplace of stent grafts, no bilateral limb ischemia and stent infection were observed during follow-up. Conclusions EVAR is a safe and effective option to treat AAA with hostile aortic proximal landing anatomy. Choosing the most suitable stent-graft, the combination of various interventional techniques and close postoperative follow-up are the key points for successful treatment.