Objective To study the diagnosis and operation timing of acute mesenteric ischemia(AMI).Methods A retrospective analysis based on the clinical characteristics,the methods of diagnosis and treatment,and operative results of 21 patients with AMI admitted in our hospital from January 1997 to December 2007 was performed.Results The diagnosis were certified by color doppler ultrasonography in five cases,spiral CT in eleven cases,DSA in two cases,and abdominal exploration in three cases.One case was cured by anticoagulation /thrombolytic therapy;and one case was confirmed with selective vascular angiography and cured by urokinase perfusion via the catheter;after removing the thrombus followed by anticoagulation /thrombolytic via Fogarty balloon catheter,ischemia of intestine completely recovered in three cases,partial small bowel resection were performed in eight cases,"second-look" operation in two cases,and subtotal small bowel resection in six cases.Three cases developed short-gut syndrome and three cases died after operation.Conclusions Imageological examination is essential for diagnosis of doubtful cases of AMI,and adequate treatments and timely selection of operation are critical to attain early diagnosis and good results.

Objective To evaluate the evidence and recommendations of the relevant clinical practice guidelines for the prevention and treatment of stroke published in the last five years. Methods The stroke and guideline-related key words and free words domestic computer retrieval platforms(China biomedical literature database,CNKI,and Yimaitong etc.),as well as foreign platforms(PubMed,NGC,GIN,etc.) were retrieved.The retrieval time limit ranged from January 2012 to May 2017.Appraisal of Guidelines for Research and Evaluation Ⅱ(AGREE Ⅱ)was used to assess the quality of the guidelines. Results A total of 9 490 documents were retrieved preliminarily and finally 16 articles were included. The average scoring rates of the 16 guidelines in the 6 fields of AGREE Ⅱ,including the scope and purpose,participants,rigor of the formulation,clarity of expression,applicability,and independence of the editors were 66.3%, 27.4%,23.0%,53.9%,18.8%,and 0%,respectively.The different guidelines all recommend that internal endarterectomy or carotid balloon dilatation and carotid artery stenting are used to extracranial carotid stenosis,while the treatment of vertebral artery stenting is recommended for extracranial vertebral artery stenosis.However,the intravascular interventional therapy is not recommended for intracranial arterial stenosis.The perioperative period of ischemic stroke intravascular intervention need to pay attention to the application of anti-platelet aggregation,anticoagulation,blood pressure,blood glucose,blood lipid management,and postoperative monitoring. For postoperative stent restenosis,especially after vertebral artery stenting,the guidelines recommend using drug-eluting stents,however,the dosage of heparin in intraoperative anticoagulation is still controversial.The intracranial aneurysm guidelines are more recommended for interventional therapy.The cerebral hemorrhage in different regions is recommended for different surgical procedures. Conclusions The guidelines in this field can reflect the key problems in clinical practice and keep up with the international concept.However,the quality of the methodology of the guidelines development needs to be improved. Some of them need to be updated and the recommendations should refer more evidence of the Chinese population.