Objective To evaluate catheter-directed thromlysis (CDT) through three different approaches in combination with intervention for acute deep venous thrombosis (DVT) of the lower extremities. Methods In this study 137 acute DVT cases were enrolled. CDT was performed through small saphenous veins in 107 cases,through the great saphenous veins in 21 and through popliteal veins in 9.Iliac vein balloon dilation was performed in 66 cases,and stents were placed in 60 cases. Results The limb edema reduction rates between small saphenous vein group and great saphenous vein group and popliteal vein group were of no significant difference (82.3％ ±7.6％ vs 81.6％ ±6.0％ vs 83.9％ ±6.1％,P＞0.05).The difference of rates of thrombolysis ( 63.5 ％ ± 7.7％ vs 66.9％ ± 8.4％ vs 66.1％ ± 2.7％ )between the 3 groups was not statistically significant (P ＞ 0.05 ). The mean time required for the cannulation was shorter in great saphenous vein group than the other two groups [ (7.3 ± 0.3 ) min vs (20.8 ± 1.1 ) min and (15.7 ±0.6) min,P ＜ 0.05 ].There were 12 cases complicating incision bleeding during thrombolysis in small saphenous vein group,in this group there were 5 cases complicating phlebitis and 8 complicating saphenous nerve injury.The complication rates in great saphenous vein group was lower (P ＜ 0.05).Follow-up made in 112 cases for 3 -25 months.There were 97 cases without limb edema.While test by venography or color Doppler,89 cases showed venous patency and rethrombosis developed in 8 cases. Conclusions Catheter-directed thrombolysis with iliac venous intervention was an effective method for the treatment of acute deep venous thrombosis.CDT through great saphenous vein is easier with less complications.

Objective To investigate the correlations on hepatitis B virus (HBV) preS1‐antigen (pre‐S1Ag) with HBV‐DNA , HBV markers(HBV M) and liver function in the patients with hepatitis B .Methods The markers ,preS1‐Ag ,HBV‐DNA and liver function were determined by CLIA and PCR in 905 patients with hepatitis B (HBV infection group ) and 100 healthy persons (healthy control group) .Results Among 905 samples ,the positive rates of preS1‐Ag and HBV DNA were 68 .51% (620/905) and 67 .96% (615/905) ,there was no statistically significant difference between them (χ2 =30 .064 ,P>0 .05);the positive rates of pre‐S1Ag in 570 patients with HBeAg positive were 85 .08% (485/570) ,which was significantly higher than 40 .30% (135/335) in 335 patients with HBeAg negative ,the difference was statistically significant (χ2 =108 .881 ,P<0 .01) .The abnormal rates of ALT and AST in the Pre‐S1 Ag positive and negative groups were 53 .22% ,25 .96% and 51 .29% ,32 .98% ,respectively ,the differences be‐tween them were statistically significant (χ2ALT =53 .148 ,P<0 .001 ,χ2AST =66 .635 ,P<0 .001) .Conclusion Pre‐S1Ag is a reliable index of the HBV infection and duplication and is highly correlated with HBV‐DNA positive ,which is important supplement and strengthening and can provide more timely and reliable experiment basis for guiding the clinical treatment .

ObjectiveTo explore the causes of recurrence of Budd Chiari syndrome after radical resection and the key points of second surgery. Methods Venography was performed in 11 relapsing cases. The diseased IVC segment was resected and replaced with artificial vascular graft in 4 cases, membranectomy and thrombectomy were performed in 2 cases. Thrombectomy with artificial vascular patch cavoplasty in 4 cases, incision of the stenotic IVC and right hepatic venoplasty and IVC venoplasty with artificial vascular patch repairing was performed in 1 case. Result The mortality rate was zero. Acute heart failure occurred in 2 cases and thoracic hemorrhea in 2 cases. Symptoms disappeared or improved in all cases. Patients were followed up from 6 to 68 months, with excellent results in 9 cases and fair in 2 cases. Conclusion There were some factors influcing the long term results of the surgery including distal free length from diseased IVC, thrombus clearance, material and size of the patch used for venoplasty.

Objective To examine the Criterion-related validity of the competency model of armed police sergeant.Methods 513 armed police soldiers were evaluated by 2 leaders with competency model of armed police sergeant.5 equidistant grades rating method was used.The list of excellent soldiers were collected.Results ( 1 ) There were significant differences on 17 items of competency scores between excellent soldier group and average soldier group (P ＜ 0.05 ), except for one item of competency.Furthermore, there were significant differences on 4 factor scores and sum scores between excellent soldier group and average soldier group (P ＜ 0.05 ).( 2 ) The predictive probability were 72.6 % (A) ,71.3% (B) predicting excellent soldiers by the sum scores of competency model.Conclusion The Criterion-related validity of the competency model of armed police sergeant is acceptable.It can be used in the selecting and training of armed police sergeant.

Objective To study the short-and long-term results for Cockett syndrome caused acute deep vein thrombosis (DVT) of the lower extremity by surgical thrombectomy or catheter-directed thrombolysis.Methods One hundred and two Cockett syndrome caused acute DVT cases were treated by surgical thrombectomy or catheter-directed thrombolysis (CDT) from Jan 2006 to Dec 2011.There were 52 patients treated by CDT (group A),and 50 cases by surgical thrombectomy (group B).All patients received warfarin treatment after operation.Results There were no significant differences in general clinical characteristics between the two groups.The limb edema reduction rates between the two groups were of no significant difference(83％ ± 6％ vs.82％ ± 8％ P ＞ 0.05).The venous patency were basically the same (64.6％ ± 6.7％ vs.65.3％ ± 7.2％,P ＞ 0.05).The mean time required was shorter in group A than in group B[(30.5 ±6.7) min vs.(97.5 ±23.6) min,P ＜0.01].The average hospital stay was shorter [(9.8±5.4) d vs.(17.7 ±8.2) d,P＜0.01],and morbidity was less[13.4％ vs.42％,P＜0.01].Eighty six patients were followed up.The circunference difference of thigh,the score of vein patency between the two groups were of no significant difference (P ＞ 0.05).Conclusions Compared with surgical group,patients in CDT group have shorter hospital stay,less complication and similar long and shortterm results.

Objective To evaluate the surgical and interventional therapy in patients with acute superior mesenteric vein thrombosis.Methods In this series,31 acute superior mesenteric vein thrombosis(SMVT) cases were reviewed from Oct 2006 to Feb 2012.According to varied clinical presence,patients received superior mesenteric vein thrombectomy with necrotic bowel resection or indirected catheter thrombolysis through superior mesenteric artery.Results 6 of 9 cases undergoing surgery were cured and other 3 still complained abdominal distension when discharged for not being able to bear anticoagulation and thrombolysis after operation due to alimentary tract hemorrhage,and residual thrombus was shown in superior veins by venography.17 of 22 treated by interventional therapy gained obvious relief within 72 hours after intervention,others gained symptomatic relief in 5-7 days.Indirected catheter thrombolysis were interrupted in 2 due to alimentary tract hemorrhage.One patient was shifted to surgery 48 hours after catheter thrombolysis due to deterioration.Mean duration of follow-up after hospital discharge was (19 ± 5) months in 25 cases,20 had no abdominal distension and pain,3 with postcibal abdominal distension.Conclusions Indirected thrombolytic therapy by way of the superior mesenteric artery is a technically simple,safe and effective therapy for patients with acute SMVT.

Objective To investigate the correlation between the liver fibrosis markers laminin(LN),hyaluronan acid(HA),col-lagen Ⅳ(CⅣ)and procollagen type Ⅲ N-terminal peptide(PⅢNP)with the replication of hepatitis B virus(HBV)DNA in the pa-tients with chronic HBV in Lanzhou.Methods Real-time PCR and chemiluminescent immunoassay(CLIA)were used to quantita-tively measure serum HBV-DNA and liver fibrosis markers in 724 cases of HBV infection in Lanzhou with the different clinical classifications and the natural history stage as the background.Results The values of the liver fibrosis indicators and HBV-DNA level in all clinical types were higher than normal levels,and reached to maximum in the liver cirrhosis goup;CⅣ and PⅢNp were highest in the HBeAg (+)CHB group;according to the hepatitis B natural history stage,the PⅢNP and CⅣ values reached the peak value in the immune clearance phase,moreover the CⅣmean value in the HBeAg and HBV-DNA (+)group was higher than that in the HBV-DNA and HBeAg (-)group.4 indicators in the HBeAg (+)CHB group were higher than those in the HBeAg (-)CHB group,but only HA had statistical difference(P <0.01 ).Conclusion There is certain correlation between CⅣ with HBV-DNA and HBV-M,indicating that which can indirectly reflect the degree of liver damage and viral replication level.

This study was aimed to explore the features of clustered regularly interspaced short palindromic repeats (CRISPR) structures in Shigella by using bioinformatics. We used bioinformatics methods, including BLAST, alignment and RNA structure prediction, to analyze the CRISPR structures of Shigella genomes. The results showed that the CRISPRs existed in the four groups of Shigella, and the flanking sequences of upstream CRISPRs could be classified into the same group with those of the downstream. We also found some relatively conserved palindromic motifs in the leader sequences. Repeat sequences had the same group with corresponding flanking sequences, and could be classified into two different types by their RNA secondary structures, which contain "stem" and "ring". Some spacers were found to homologize with part sequences of plasmids or phages. The study indicated that there were correlations between repeat sequences and flanking sequences, and the repeats might act as a kind of recognition mechanism to mediate the interaction between foreign genetic elements and Cas proteins.
Base Sequence ; Clustered Regularly Interspaced Short Palindromic Repeats ; Computational Biology ; Genome, Bacterial ; Plasmids ; Shigella ; genetics

Objective To discuss a new method of interventional and surgical therapy for the lower extremity postthrombotic syndrome (PTS). Methods 35 PTS cases were enrolled in our group. Dilation and stent placement in stenosis of iliac veins were performed in all cases, then temporary femoral arteriovenous fistula was established. After two weeks, 15 cases with varicosity underwent high ligation of the great saphenous vein and stripping, 5 cases with leg ulcers (ulcers diameter>3 cm) underwent skingrafting. After operation, patients took warfarin orally for 6 months and wear elastic compression stockings. Results Procedures were successful in all cases. Thrombectomy extracted only a few old thrombus. Before discharge, limb swelling subsided in 26 cases while 4 remain light swelling and 5 had no obviously relief. Twenty-six cases were followed-up for 3～24 monthes. Limb swelling subsided in 22 cases but still exist in 4. Limb ulcers were healed in 11 cases and the area of pigmentation were diminished. Limb ulcer recurred 12 months after skingrafting and healed finaly after perforator veins clipping with second skingrafting. Color Doppler was used in follow-up to check the potency of affected deep veins, good outcome was found in 20 cases and rough intima with stenosis of iliac veins was found in 2, no flow signal in 4. Conclusions Stenosis of iliac veins in PTS are common, the pathological changes could be treated by interveional method combined with temporary arteriovenous fistula. The degree of recanalization of femoral-popliteal veins determined the results.

Objective To explore the appropriate method for mechanical thrombectomy, selection of vena cava filter and its duration in place. Method Fifty-five cases of severe acute deep vein thrombosis of the lower limbs were enrolled. Vena cava filter was first placed, then thrombectomy was performed with Amplatz thrombectomy device (ATD). The iliac vein lesions were dilated by balloon followed by temporary arterivenous fistula construction. Result Procedures were all successful in 52 cases, iliac vein stenosis was found in 47 cases and dilated by balloon. Permanent vena cava filters were placed in 20 cases while temporary in 32 cases. Fifty cases were followed-up for 3～30 monthes. Tumefaction disappeared in 46 cases leaving no after thrombosis syndrome. Conclusion This comprehensive modality is effective, less traumatic and of quick recovery. During the procedure, possible residual thrombi should always be under close attention and stenosis in iliac veins be confirmed by repeated venography. In most cases, placing a temporary vena cava filter was the best choice.