Objective To investigate the causes of and preventive measures for complications following the placement of permanent inferior vena cava filter (VCF). Methods A total of 71 patients, with proven diagnosis of lower limb deep vein thrombosis (DVT) by Doppler ultrasonography, underwent the placement of permanent VCF from December 1999 to June 2003. Forty of the patients were acute lower limb DVT. Cavography was performed routinely during operation to confirm no thrombosis in inferior vena cava and access veins. The insertion site of filters was below the renal veins. Four types of permanent VCF were used: Titan-Greenfield filters, Simon-Nitinol filters, LGM filters and TrapEase filters. Anticoagulation treatments were used in all the cases post-VCF insertion. Results The placement of VCFs was successfully accomplished in all the cases in the study. Follow- up observations for 1～41 months revealed vena cava thrombosis at the site of insertion in 2 cases and filter tilting less than 15? in 5 cases. There were no events of filter migration, filter fracture, vessel wall perforation, filter embolism or access vein thrombosis, as well as pulmonary embolism (PE). Conclusions Different types of VCFs have different kinds of complications and their incidence rates. Preoperative ultrasonography and intraoperative cavography should be performed to evaluate the vena cava and access vein. Careful surgical management and strict anticoagulation therapy are the key to the successful VCF placement and the prevention of PE or other complications.

Vena cava filters (VCF) are extensively used in the prevention of pulmonary embolism, whose performances are closely linked to their structures. As cardiovascular interventional devices,VCFs have to be micro-invasive and have minimized adverse effects. This paper reviewed recent development of vena cava filters and discusses the relationship between their performances and structures.

OBJECTIVE:To investigate the direction of examination reform of licensed pharmacists,and to provide a basis for setting up the courses for pharmaceutical major in higher vocational college. METHODS:By the method of literature analysis and comprehensive analysis,examination points and their distribution,the 7th edition of Pharmacy Expertise (Ⅱ) was analyzed in-depth in terms of the change of exam outline,score distribution and the contents of test papers,correlation between teaching ma-terials and scores of test papers,key and difficult points. RESULTS:The exam outline of the 7th edition of Pharmacy Expertise (Ⅱ)was changed from 7 systems into 16 chapters;each chapter contained 3 parts:pharmacological action and clinical evaluation, medication monitoring and clinical application of commonly used drugs;there were most examination points in pharmacological ac-tion and clinical evaluation which were important points. The quantity of test questions was reduced,but choice questions were add-ed,mainly on medication monitoring. The 5th,8th,10th chapters accounted for the most points in the test papers,and ratios of page numbers to points in chapters 1-2,4,9,and 14-16 were all lower than average level. The pharmacological action and clinical evaluation were key points,and the clinical application of commonly used drugs were difficult pints,which emphasized on practi-cal skills in pharmaceutical care. CONCLUSIONS:Licensed pharmacist examination is closely related to clinical practice,which re-flects the characteristics ofexamination based on practiceandpriority to practice,and provides reference for setting up pharma-cy courses.

ObjectiveTo evaluate the result of in situ great saphenouse vein bypass for the treatment of lower limb ischemia.MethodsFrom 1995 to 2000, 34 patients with femoro popliteal artery occlusive disease underwent in situ great saphenouse vein bypass using self made valvulotome in our hospital.The distal anastomosis was made on above knee popliteal artery in 3 cases, below knee popliteal artery in 16 cases, posterior tibial artery in 11 cases and anterior tibial artery in 4 cases, respectively.ResultsOn discharge, the rest pain disappeared in 26 cases and intermittent claudication disappeared in 7 cases, with average ankle/brachial index changing from 0 34(0～0 52) preoperatively to 0 78(0 48～1 2) postoperatively.The cumulative patency rate at 6,12,24,36 and 48 monthes were 91 18%?88 14%?84 99%?80 52%?80 52%,respectively.ConclusionIn situ great saphenouse vein bypass is effective for the treatment of lower limb arterial ischemia. The vein valve was disrupted successfully with self made valvulotome.

Objectives To study the diagnosis, treatment and prognosis of acute peripheral artery injury, and ways to improve the treatment. Methods Clinical data of 211 cases of acute peripheral arterial injuries admitted between January 1988 and June 2002 in Anzhen hospital were analyzed retrospectively. Of the 211 cases,73 cases were with blunt injuries, 99 penetrating injuries, 37 iatrogenic injuries, 2 gunshot injuries. Management procedures included arterial primary or patch repair in 28 cases, ligation alone in 17, end-to-end anastomosis in 41, interposition reverse saphenous vein graft in 37, interposition prosthetic graft in 29, thrombectomy in 14, excision of pseudoanurysm in 36, interventional thrombolytise in 2, ultrosonic-guided packing in 2, conservative management in 2. One hundred and ninety-two patients were cured,10 patients amputed, 4 patients died respectively.Results Ratio of cure,amputation,and mortality was 90.1%,4.74%,1.8% respectively.Amputation rate in blunt injuries was significantly higher than that in penetrarting injuries (P

0.05, but there was a larger deviation with Model 930.

Berberine is the main active ingredients in Coptis.The content determination of berberine can provide the basis for its quality evaluation.Relevant provessinal literatures about determination methods of berberine were summarized,and the main methods included TLC,UV, HPLC,HPEC,fluorescence,and so on.HPLC was the most widely used method because of its high separation efficiency,specificity and sensitivity.

ObjectiveTo evaluate axillofemoral bypass(AxFB) for the treatment of chronic severe lower limb ischemia. Method Consecutive AxFB performed in Anzhen Hospital from January 1995 to November 2002 was retrospectively analysed, with 31 patients of aortoiliac occlusive disease undergoing axillobifemoral bypass (AxBFB) and 32 axillounifemoral bypass(AxUFB) respectively. Result On discharge, rest pain disappeared in 44 cases and intermittent claudication in 19 cases, with average ankle/brachial index changing from preoperative 0.18(0～0.49) to postoperative 0.68(0.29～1.04). Rate of limbs salvage was 87.4%, amputation rate was 7.9%. Three cases died with a perioperative mortality of 4.8%. The patency rate of 1,3,5 years were 93.2%,79.8% and 64.1%, respectively. Conclusion AxFB for aortoiliac occlusive disease is considered to be acceptable procedure in high-risk patients with poor femoral run-off and chronic critical lower limb ischemia.

Objective To investigate the effects of dexmedetomidine on oxidative stress response after operation in patients with acute craniocerebral trauma. Methods Sixty patients who underwent intracranial hematoma and decompressive craniectomy within 24 h after acute craniocerebral trauma,were randomly divided into midazolam group and dexmedetomidine group(n=30). All patients were maintained seda-tion for 12 h after operation. Mean arterial blood pressure (MAP),heart rate (HR),blood glucose,S-100B protein (S-100B),malond-ia1ehyde(MDA) and superoxide dismutase (SOD) were recorded at the end of operation(T0),3 h(T1),6 h(T2),12 h(T3) after opera-tion. Results Postoperative MAP, HR and blood glucose were stability in two groups. MAP, HR and blood glucose of dexmedetomidine group were lower than those of midazolam group(P<0. 05). The serum concentrations of S-100B and MDA gradually reduced,and the serum levels of SOD gradually increased at T1 ~T3 in two groups. Compared with midazolam group, these changes were significantly higher in dexmedetomidine group(P<0. 05). Conclusion Dexmedetomidine can protect the brain by maintaining haemodynamic stability and attenu-ating oxidative stress response after operation in patients with acute craniocerebral trauma.

Objective To evaluate the treatment for acute embolism in the extremities and define the primary factors affecting the prognosis. Methods From December 1984 to December 2006,536 patients with acute embolism of extremities were treated. Embolectomy with Forgarty catheters were performed in 507 cases, including salvage surgery in 34 cases and conservative therapy in 29 cases. Results The cure rate, mortality and amputation rate were 76.68%,9.51% and 10.26% respectively. Embolism recurred in 11.7% cases. Cardiopulmonary (27.5% ) and renal failure ( 25.5% ) were main causes of death during perioperative period. No bleeding nor other major complications occurred in 221 patients with atrial fibrillation who routinely received wafarine under proper monitoring. About 25.6% patients underwent heart valves surgery during hospitalization or within one year after discharge. Conclusions Patients suffering from acute embolism of the extremities should receive combination treatment. The main factors affecting the prognosis include time and degree of ischemia, and ischemia-reperfusion injury. Anticoagulant and etiologic treatment should be adopted in those with cardiogenic embolus and atrial fibrillation.