1.Expression and clinical significance of VEGF, ENS and MVD in atherosclerosis plaque of femoral artery in patients with atherosclerosis obliterans
Xin MU ; Shaokui LIU ; Xiaomei WANG ; Jun HONG ; Nan CHU ; Shiyi CHEN
Clinical Medicine of China 2011;27(6):582-584
Objective To investigate the relationship between the expressions of VEGF,ENS, MVD and arteriosclerosis (AS) plaque in atherosclerosis obliterans (ASO) patients. Methods Immunohistochemical staining was used to determine the expression of VEGF, ENS and MVD value in the atherosclerosis plaque of ASO patients hospitalized from October 2007 to August 2010 in our hospital (n =30),and the femoral arterials of control were collected from 22 amputation after traumatic injury. Results The expressions of VEGF (2. 24 ±0.31 vs. 1.87 ±0.27,t =3.58),ENS (1.84 ±0.41 vs. 1. 56 ±0. 38, t =2.09) and MVD value (8.79 ±2.46 slip/HP vs. 6. 05 ±1.68 slip/HP, t =3.64) were significantly higher in the AS plaque of ASO patient than control (P <0.01 or P < 0. 05). We found positive correlations between the expression of VEGF, VEGF/ENS with MVD (r = 0. 391, P < 0. 01; r =0. 583, P < 0. 05) , while negative correlation between the expression of ENS with MVD (r=-0. 328,P <0. 05). Conclusion VEGF promotes the angiogenesis in atherosclerosis plaque,while ENS shows opposite effect The comprehensive performance of them is promoting angiogenesis.
2.A preliminary study on the construction and standardization of procedures for ambulatory joint arthroplasty surgery
Ning WANG ; Xiangpeng KONG ; Zhendong ZHANG ; Shaokui NAN ; Haifeng LI ; Wei CHAI
Chinese Journal of Orthopaedics 2024;44(21):1401-1408
Objective:To investigate the safety and effectiveness of ambulatory joint arthroplasty and to establish a standardized procedure for outpatient joint replacement surgery.Methods:The clinical data from patients who underwent joint replacement surgery at the Orthopaedics Department of the General Hospital of PLA Fourth Medical Center between April 2023 and January 2024 were retrospectively analyzed. After screening and evaluation, fifty-nine patients who met specific criteria were enrolled for elective ambulatory surgery, including unicompartmental knee arthroplasty (UKA), total knee arthroplasty (TKA), and total hip arthroplasty (THA). For comparison, a 1∶1 matched control group was created from patients who underwent primary joint arthroplasty with routine hospitalization during the same period, matched by gender and surgical procedure. Functional outcomes were assessed pre- and post-operatively using the visual analogue scale (VAS), Harris hip score (HHS), and American Knee Society score (KSS). Postoperative complications, post-discharge complications, unplanned 90-day readmissions, and reoperations were analyzed.Results:The ambulatory surgery group had an average age of 62.0±6.5 years (range 53-76 years), which was significantly younger than the inpatient group at 66.2±8.3 years (range 46-81 years; t=3.707, P=0.002). No significant differences were observed in demographics such as body mass index (BMI) and American Society of Anesthesiologists (ASA) classification ( P>0.05). The incidence of complications, including nausea, vomiting, and severe pain, was similar between groups, with no statistically significant difference (χ 2=0.083, P=0.752). One case of unplanned emergency treatment occurred in the day-surgery group, but post-discharge complication rates did not significantly differ between the groups (3 cases vs. 1 case, P=0.473). The rate of delayed discharge in the ambulatory surgery group was 9%, primarily due to acute complications such as nausea, vomiting, severe pain, and poor patient compliance. VAS scores were lower in the ambulatory group compared to the conventional group within two weeks post-surgery, showing a statistically significant difference ( P<0.05). At one week post-surgery, the Harris hip score of ambulatory patients was significantly improved compared to the inpatient group ( t=7.362, P=0.027). The KSS knee score and KSS function score also showed significant improvement at two weeks post-surgery in the ambulatory group ( P<0.05). Cost-benefit analysis indicated that the hospitalization cost for ambulatory UKA (19.5±0.42 k CNY, excluding prosthesis costs) was approximately 3,000 CNY less than that for conventional surgery (22.5±0.41 k CNY), a statistically significant difference ( t=3.699, P=0.001). Conclusion:Ambulatory joint arthroplasty is a safe and effective option for selected patients, with manageable short-term postoperative complications. This outpatient surgery model promotes early recovery of joint function and provides effective pain management. Ambulatory UKA, in particular, offers enhanced cost-effectiveness, reduced length of stay, and faster bed turnover, making it a valuable approach for wider adoption.