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 review the diagnosis and treatment of interstitial pregnancy.

METHODSFour cases with complicated interstitial pregnancy were diagnosed and treated from January, 2004 to June, 2007 at the Affiliated Obstetrics and Gynecology Hospital, College of Medicine, Zhejiang University. The clinical data and follow-up records were analyzed retrospectively.

RESULTSAll 4 nulliparous patients were misdiagnosed before operation. The median age was 30 years (25-34 years), and the median duration of amenorrhea was 48 days (37-58 days). The median concentrations of serum beta-hCG were 3245.5 IU/L (282-30729 IU/L). Two patients with interstitial pregnancy had high levels of beta-hCG, and were diagnosed and treated under laparoscopy. Among them one patient was underwent transcervical curettage under laparoscopic guidance,and another underwent laparoscopic salpingotomy. The remained two patients had low levels of beta-hCG, and were diagnosed and treated under hysteroscopy, 50 mg methorexate(MTX)was injected into the implanted sites under hysteroscopic guidance. The levels of serum beta-hCG in 4 patients dropped down quickly, reaching undetected levels at a mean duration of 13 days after operation. Three months postoperatively, ultrasonic examination revealed the normal contour of uterus.

CONCLUSIONSEndoscopic examination is helpful to make a correct diagnosis, and transcervical curettage (or transcatheter chemotherapy) under laparoscopic guidance (or under hysteroscopic guidance) may be a promising approach for young or nulliparous women with interstitial pregnancy who want to maintain future fertility.

Adult ; Chorionic Gonadotropin, beta Subunit, Human ; blood ; Female ; Humans ; Laparoscopy ; Pregnancy ; Pregnancy, Tubal ; diagnosis ; surgery ; Retrospective Studies

OBJECTIVETo investigate the role of p38 mitogen-activated protein kinase (MAPK) signal transduction pathway in the acute lung injury of severely burned rats.

METHODSForty-eight adult healthy rats were randomly divided into three groups: sham group, burn control group, and burn + SB203580 group. A third-degree burns over 30% total body surface area rat model was used and pulmonary capillary permeability, lung water content, pulmonary histology and p38 MAPK activity were measured at 24 hours postburn.

RESULTSBurn trauma resulted in increased pulmonary capillary leakage permeability (42.5 +/- 4.7 vs. 12.1 +/- 1.4, P < 0.01), elevated lung water content (P < 0.05), and worsen histologic condition. There was a significant activation of p38 MAPK at 24 hours postburn compared with control. SB203580 inhibited the activation of p38 MAPK, reduced the pulmonary capillary leakage permeability (24.7 +/- 2.9 vs. 42.5 +/- 4.7, P < 0.01), decreased lung water content, and prevented burn-mediated lung injury.

CONCLUSIONThe activation of p38 MAPK is one important aspect of the signaling event that contributes to burn-induced lung injury.

Animals ; Blotting, Western ; Burns ; enzymology ; physiopathology ; Enzyme Activation ; drug effects ; Enzyme Inhibitors ; pharmacology ; Imidazoles ; pharmacology ; Lung ; pathology ; physiopathology ; Male ; Mitogen-Activated Protein Kinases ; antagonists & inhibitors ; metabolism ; physiology ; Pyridines ; pharmacology ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Respiratory Distress Syndrome, Adult ; enzymology ; physiopathology ; Signal Transduction ; drug effects ; physiology ; p38 Mitogen-Activated Protein Kinases

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 systematically evaluate the effect and safety of Xuezhikang Capsule (XZKC) for adjuvant treatment for coronary heart disease (CHD) patients accompanied with or without dyslipidemia.

METHODSChina National Knowledge Infrastructure (CNKI) Database, Chongqing VIP Database (VIP), Wanfang Data base, Cochrane Library, and Medline (PubMed) were retrieved with the deadline of August 30, 2013. Randomized controlled trials (RCT) of XZKC in treating CHD patients with or without dyslipidemia were all included. Assessment of bias risk for included studies was conducted according to the Cochrane Handbook for Systematic Reviews of Intervention (Version 5.0.2): Criteria for judging risk of bias in the "risk of bias" assessment tool. Review Management (5.1.0) was employed for data statistics. If there was no significant heterogeneity, results from the random-effect model were presented. If the heterogeneity was not substantial, a meta-analysis was not performed and a narrative and qualitative summary was performed instead.

RESULTSA total of 28 RCTs (6,949 patients) were included after screening results. The methodological quality of included trial was generally lower. Results of Metaanalysis showed that XZKC was beneficial for CHD patients in decreasing cardiovascular events: when compared with the basic treatment group, the relative risk (RR) was 0.53 and 95% confidence interval (CI) was [0.35, 0.81]; when compared with the placebo + basic treatment group, RR was 0.52 and 95% CI was [0.42, 0.65]; when compared with the basic treatment group, RR for improving symptoms of angina was 1.20 and 95% CI was [1. 12, 1.30]; when compared with the basic treatment group, RR for improving abnormal ECG was 1.38 and 95% CI was [1.21, 1.57]. Thirteen studies showed that XZKC + basic treatment was obviously superior in lowering total cholesterol (TC) to that of the basic treatment group. Three studies showed that XZKC + basic treatment was obviously superior in lowering total cholesterol (TC) to that of the placebo + basic treatment group. Thirteen studies showed that XZKC + basic treatment was obviously superior in lowering low density lipoprotein cholesterol (LDL-C) to that of the basic treatment group. Three studies showed that XZKC + basic treatment was obviously superior in lowering LDL-C to that of the placebo + basic treatment group. A total of 18 studies describing adverse reactions (ADs) involved 61 ADs in the XZKC + basic treatment group. All suffered from mild symptoms or were improved after treatment. No severe ADs occurred.

CONCLUSIONTreatment of CHD by XZKC might lower the occurrence of cardiovascular events in CHD patients accompanied with or without dyslipidemia, relieve clinical symptoms, improve ECG, lower blood lipid levels, and with less adverse reactions.

Angina Pectoris ; Cardiovascular Diseases ; Combined Modality Therapy ; Confidence Intervals ; Coronary Disease ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Randomized Controlled Trials as Topic