Objective To review the surgical managements of patients with traumatic false aneu- rysms in the extremities.Methods From January 1990 to April 2006,17 patients with traumatic false aneurysms in the extremities were admitted into our hospital.Fourteen patients were treated by vascular repair including vascular repair in seven cases,end to end anastomosis in one,synthetic grafting in one, autogenous vein grafting in one,and direct ligation in four.Three patients were treated nonoperatively, but with local compressive dressing.Results There were no deaths or gangrenes in all cases.The clinical manifestations vanished after the treatment.The mean follow-up period was 13.2 months.The function of the injured extremities recovered satisfactorily.Conclusion Different types of traumatic false aneurysms should be managed by different therapeutic procedures after the diagnoses is made.

Death ; Hematoma, Subdural/etiology* ; Humans ; Syphilis, Congenital/complications*

Animals ; Brain ; drug effects ; metabolism ; Carbon Dioxide ; metabolism ; Chronic Disease ; Curcumin ; pharmacology ; Disease Models, Animal ; Fas Ligand Protein ; metabolism ; Hypoxia ; metabolism ; Male ; Oxygen ; metabolism ; Rats ; Rats, Sprague-Dawley ; fas Receptor ; metabolism

OBJECTIVETo evaluate the intervention effect of diet, exercise and Jiangtang Bushen Recipe (JBR, a Chinese herbal recipe) in preventing the progress of patients with impaired glucose tolerance (IGT) to diabetes mellitus (DM) type 2.

METHODSFifty-one patients with IGT, with their diagnosis conformed to the diagnosis standard of WHO, 1999, were randomly divided into the control group (n = 26) and the TCM group (n = 25). Patients in the control group attended to the educational course for DM and received dietotherapy and kinetotherapy, and to those in the TCM group, under these treatments, JBR was given additionally. Oral glucose tolerance test (OGTT), body weight index (BWI), levels of blood lipids and fasting insulin of all the patients were examined after 3 months, 6 months and 12 months of treatment. The total observation time was 1 year.

RESULTSExcept the 6 cases out of the 51 patients (11.7%), on whom the observation discontinued, in the control group, as compared with before treatment, levels of fasting insulin and fasting blood glucose after treatment were not changed significantly (P > 0.05), also insignificant difference was shown in levels of total cholesterol (TC) and triglyceride (TG), though the two indexes lowered slightly after treatment (P > 0.05), but significant difference was shown in comparison of OGTT/2 h, blood glucose and BWI (P < 0.05). While in the TCM group, fasting blood glucose was changed insignificantly (P > 0.05), but there was significant difference in comparison of fasting insulin, TC, BWI, OGTT/2 h and plasma glucose levels (P < 0.01) respectively before and after treatment. At the end of the study, the cumulative cases with conversion to diabetes were 3 (13.6%) in the control group, and 1 (4.3%) in the TCM group, chi 2 test showed insignificant difference in comparison of diabetes conversion rate between the two groups (P > 0.05), however, the TCM group showed a better year conversion rate of normal glucose tolerance than that in the control group (chi 2 = 8.31, P < 0.01).

CONCLUSIONTCM intervention is possibly effective in delaying the conversion of IGT to DM type 2, and plays integrative effeciency in impelling IGT patients to health. The favorable education and treatment of DM controlling, including dieto- and kineto-therapy may also be advantageous in IGT intervention, but could not be effective in blocking the advance of IGT.

Adult ; Aged ; Combined Modality Therapy ; Diabetes Mellitus, Type 2 ; prevention & control ; Drugs, Chinese Herbal ; therapeutic use ; Exercise ; Female ; Follow-Up Studies ; Glucose Intolerance ; drug therapy ; Glucose Tolerance Test ; Humans ; Male ; Middle Aged ; Phytotherapy

OBJECTIVETo investigate the mechanism of how curcumin improves pulmonary vascular remodeling associated with chronic pulmonary arterial hypertension.

METHODSThe model of chromic hypoxia hypercapniapulmoary remodeling was made. Twenty-four male rats were randomly divided into 4 groups (n = 6): group I (normoxia control group), group II (hypxia and hypercapnia model group), group II (disodium cromoglycate control group), group IV (curcumin treated group). The last 3 group rats were put in a hypoxia cabin where the concentrate of O2 was 8% - 11% and the concentrate of CO2 was 3% - 5%, for 8 h a day and lasting 4 w in total. Group III rats were intraperitoneally injected with disodium cromoglycate (20 mg/kg) and group IV rats were administrated with curcumin by gavage (150 mg/kg). The morphological changes of pulmonary vessel walls and the ultrastructure of mast cells were observed by the optics microscope and the transmission electron microscope. Mast cells and its degranulation state were measured by toluidine blue staining and immunohistochemistry. Data were expressed as means ± SD (standard deviation) and analyzed with SPSS17.0 software.

RESULTS(1) By optics microscopy observation, the value of WA/TA was significantly higher in II group than other groups (P < 0.05). (2) Electron microscope showed that the endothelial cells of pulmonary arterioles in III and IV group were near to I group and the proliferation of pulmonary arterial media smooth cell layer and collagen fibers in adventitia was much lighter than those in II group. The membrane of mast cells was more intact in I, III, IV group than II group. (3) The number of mast cells, the degranulation rate of master cells and the number of positive tryptase stained cells in II group were significantly more than those in other groups. (P < 0.05).

CONCLUSIONCurcumin may inhibit the remodeling of pulmonary vessel induced by chronic hypoxia hypercapnia by mast cell regulation.

Animals ; Cell Degranulation ; Curcumin ; pharmacology ; Hypercapnia ; physiopathology ; Hypertension, Pulmonary ; drug therapy ; Hypoxia ; physiopathology ; Lung ; pathology ; Male ; Mast Cells ; physiology ; ultrastructure ; Pulmonary Artery ; drug effects ; Rats ; Rats, Sprague-Dawley ; Vascular Remodeling ; drug effects

Objective:To evaluate the safety and effectiveness of one-stop hybrid therapy for triple-vessel coronary disease.Methods:Totally 34 patients with triple vessel coronary disease were treated by off-pump coronary artery bypass graft (OPCAB)combined with percutaneous coronary intervention(PCI)from Jan.2011 to Jun.2014.All 34 patients received PCI firstly,46 stents implanted in coronary arteries,and then OPCAB were performed,41 distal anastomosis were completed. Results:The one-stop hybrid procedure was successful in all patients.Selective coronary angiography immediately after one-stop hybrid procedure showed that grafts and stents were unobstructed.There was no death during the operation and perioperative period,no episodes of angina attack,no cardio-cerebrovascular events,no bleeding postoperatively and second exploratory thoracotomy.All patients remained free from angina,cardiac function improved significantly and no patient need medical intervention during the(36 ± 8)months follow-up period.Conclusions:One-stop hybrid cardiac surgery provides a reasonable,feasible,and safe alternative for treating patients with coronary artery triple-vessel lesions,and it has good prognosis.

OBJECTIVETo evaluate the clinical outcome of surgical venous thrombectomy and simultaneous stenting in patients with acute, symptomatic iliofemoral deep venous thrombosis (DVT).

METHODSFrom October 2008 to December 2010, a total of 15 patients with acute symptomatic DVT underwent combined surgical venous thrombectomy and endovascular stenting in ipsilateral iliac vein. There were 6 male and 9 female patients, with a mean age of 57.4 years (ranging from 36 to 71 years). All patients underwent Duplex ultrasonography for diagnosis of DVT. The location of thrombosis was femoro-ilio-caval vein in 2 cases, bilateral iliac vein in 1 case and left iliofemoral vein in 12 cases. All patients had leg swelling and 12 cases had severe leg pain. The mean time of symptomatic DVT occurring at operation was 3.3 d. The factors related to DVT were operation in 6 cases, DVT reoccur in 2 cases. Coexist diseases were digestive tract bleeding in 1 case, gastric ulcer in 1 case, hypertension in 3 cases and 1 case had cerebral infarction. The inferior vena cava filter was inserted before thrombectomy, iliac vein compression and residual stenosis were treated with a self-expandable stent after thrombectomy.

RESULTSIntraoperative venography showed severe venous stenosis in all patients including 80% of iliac vein compression syndrome, 18 self-expandable stents were inserted successfully, the procedural successful rate was 100%, the 30-day mortality rate was 0.One case was suffered from hematoma at incision after operation. 3 patients were lost during follow-up. Median follow-up was 10.3 months (ranging from 2 to 26 months). There was no case of re-thrombosis. Leg pain was disappeared in all cases and only 2 patients showed slight leg swelling after excise.

CONCLUSIONCombined surgical thrombectomy and endovascular treatment for patients with acute symptomatic iliofemoral venous thrombosis is an effective and safe technique with low morbidity and good clinical results.

Adult ; Aged ; Angioplasty, Balloon ; Female ; Humans ; Male ; Middle Aged ; Thrombectomy ; Vena Cava Filters ; Venous Thrombosis ; surgery

OBJECTIVETo study the effects of methionine and choline on the expression levels of CaMKII and CREB mRNA and proteins in hippocampus of rats exposed to lead.

METHODSMale SD rats were divided into five groups. (1) control group, (2) group exposed to lead+2 by drinking water with 0.40 g/L lead acetate, (3) group exposed to methionine and choline (1:1, 400 mg/kg), (4) group exposed to 0.40 g/L lead acetate plus methionine and choline (1:1, 100 mg/kg), (5) group exposed to 0.40 g/L lead acetate plus methionine and choline (1:1, 400 mg/kg). In 8 weeks after exposure, all rats were killed. Then CREB mRNA and CaMK II mRNA expression levels in hippocampus were detected by real-time PCR, CREB and CaMK II protein expression levels in hippocampus were measured by western blot assay.

RESULTSThe expression levels (0.743 ± 0.185 and 0.729 ± 0.199) of CaMKII mRNA and CREB mRNA in the hippocampus of lead group were significantly lower than those (0.950 ± 0.238 and 0.901 ± 0.232) of control group (P < 0.05), also the expression levels (0.271 ± 0.045 and 0.212 ± 0.058) of CREB protein and pCREB protein in the hippocampus of lead group were significantly lower than those (0.319 ± 0.058 and 0.506 ± 0.125) of control group (P < 0.05). The expression levels (1.014 ± 0.210 and 1.126 ± 0.379) of CaMKII mRNA and the expression levels (1.029 ± 0.335 and 0.932 ± 0.251) of CREB mRNA in the hippocampus of 2 groups exposed to lead acetate plus methionine and choline were significantly higher than those of lead group (P < 0.05). The expression levels (0.407 ± 0.951 and 0.563 ± 0.178) of CREB protein and pCREB protein in the hippocampus of group exposed to lead acetate plus 400 mg/kg methionine and choline were significantly higher than those of lead group (P < 0.05).

CONCLUSIONMethionine and choline could decrease the inhibition effects of lead on the expression of CaMKII and CREB mRNA or CREB and pCREB proteins in the hippocampus of rats.

Animals ; Calcium-Calmodulin-Dependent Protein Kinase Type 2 ; metabolism ; Choline ; pharmacology ; Cyclic AMP Response Element-Binding Protein ; metabolism ; Hippocampus ; drug effects ; metabolism ; Lead ; toxicity ; Male ; Methionine ; pharmacology ; RNA, Messenger ; genetics ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo summarize the therapeutic experience and analyse the clinical effects of anatomical plate and combined external fixator for the treatment of elderly intertrochanteric hip fractures.

METHODSFrom Oct.2006 to Jun.2009, 42 patients with intertrochanteric hip fractures were treated. Among them, 19 patients were treated with combined external fixator, included 7 males and 12 females, aged from 71 to 103 years old; according to Evans classification there were 3 of type 1, 5 of type II, 6 of type III, 5 of type IV. The other 23 patients were treated with anatomical plate, included 9 males and 14 females, aged from 73 to 97 years old; there were 5 of type I , 4 of type II, 10 of type II, 2 of type IV, 2 of type V. Comparisons and statistical analysis were made on operation time, blood loss during operation, hospitalization time, the time of loaded walking, fracture healing time and therapeutic effect.

RESULTSAll the patients were followed up for 6 to 15 months with an average of 8.6 months. In combined external fixator group, the average operation time was (29.368 +/- 3.253) min, the average blood loss during operation was (30.526 +/- 5.242) ml, the average hospitalization time was (4.368 +/- 1.165) d, the average time of loaded walking was (14.526 +/- 1.867) weeks, the fracture healing time was (14.632 +/- 2.798) weeks; in the anatomical plate group above-mentioned indexes were (58.987 +/- 8.600) min, (256.090 +/- 30.112) ml, (13.783 +/- 1.976) d, (11.391+/- 1.644) weeks, (11.391 +/- 2.327) weeks,respectively; and there were significant differences between two groups (P<0.05). According to Harris score criterion, the scores of combined external fixator group was (86.368 0 +/- 3.640) scores,and the scores of anatomical plate group was (86.435 +/- 4.198) scores; there were no significant differences between two groups (P>0.05).

CONCLUSIONThe effect of combined external fixator and anatomical plate for the elderly intertrochanteric hip fractures are both satisfactory and each has its own merits. Combined external fixator has advantages such as fewer complications and operative injuries than that of anatomical plate and is more suitable for the weaker with elderly intertrochanteric hip fractures.

Aged ; Aged, 80 and over ; Bone Plates ; Female ; Follow-Up Studies ; Fracture Fixation ; adverse effects ; instrumentation ; methods ; Hip Fractures ; physiopathology ; surgery ; Humans ; Male ; Postoperative Complications ; Retrospective Studies ; Treatment Outcome ; Weight-Bearing

OBJECTIVETo detect the level of transforming growth factor-beta1 (TGF-beta1), TGF-beta2, vascular endothelial growth factor (VEGF) and platelet-derived growth factor receptor-alpha (PDGFRalpha) in plasma and peripheral blood leukocytes in a hereditary hemorrhagic telangiectasia type 2 (HHT-2) family, and explore the implication of angiogenesis related proteins in HHT-2 pathogenesis.

METHODSThe diagnosis of the HHT-2 patient was based on clinical features and further confirmed by determining a C1231T mutation of activin receptor-like kinase 1 (ALK1) gene. Five other new members in this family were evaluated with ALK1 gene screening and clinical manifestation. Plasma level of TGF-beta1, TGF-beta2 or VEGF was measured by ELISA, and the expression of PDGFRalpha,TGF-beta1, and VEGF in peripheral blood leukocytes by flow cytometry combined with direct or indirect immunofluorescence.

RESULTSNo C1231T mutation was detected in exon 8 of ALK1 gene in the 5 new members. Plasma TGF-beta1 and TGF-beta2 concentration in 3 affected HHT case was (16 954 +/- 3 709) ng/L and (11 548 +/- 2 611) ng/L, respectively, compared with that of normal control, the difference was not significant (P > 0.05). VEGF concentration in the 3 HHT patients, 6 unaffected family members and 6 normal controls was (179.2 +/- 22.0) microg/L, (149.8 +/- 22.7) microg/L and (132.9 +/- 21.0) microg/ L, respectively. Plasma VEGF level in HHT patients was significantly higher than that in normal subjects (P < 0.025). Peripheral leukocyte PDGFRalpha and VEGF in HHT patients and unaffected family members were markedly higher than that of normal control (P < 0.05 and P < 0.02), while TGF-beta1 distribution was similar in HHT patients and normal subjects.

CONCLUSIONCompared with normal controls there is no difference in plasma TGF-beta1 concentration on peripheral leukocytes of HHT patients. Plasma VEGF concentration or leukocytes VEGF expression in HHT is significantly higher than that of normal subjects. Leukocytes PDGFRalpha expression in HHT is significantly higher than that of normal control. These changes may be associated with a compensable mechanism in HHT.

Adolescent ; Adult ; Aged ; Child, Preschool ; Female ; Granulocytes ; metabolism ; Humans ; Leukocytes, Mononuclear ; metabolism ; Male ; Middle Aged ; Pedigree ; Receptor, Platelet-Derived Growth Factor alpha ; blood ; Telangiectasia, Hereditary Hemorrhagic ; blood ; Transforming Growth Factor beta ; blood ; Vascular Endothelial Growth Factor A ; blood