Objective To report deep venous thrombosis (DVT) after greater saphenous vein ligation and stripping and to evaluate diagnosis,treatment and prophylaxis. Methods The clinical characteristics, diagnosis and treatment of 12 inpatients with postoperative DVT were analyzed retrospectively. Results Of these 12 cases there were 7 cases of central type DVT,2 cases of peripheral DVT,and 3 cases of mixed type DVT.Secondary pulmonary embolism was complicated in 2 cases.Clinical symptoms in these 10 cases of proximal DVT were all severe.Catheter-directed thrombolysis(CDT) through the ipsilateral popliteal vein with protective(IV)CF was applied for these 10 cases.Of 10 cases,femoral vein was found ligated in 1 case,which was repaired under open surgery. Residual greater saphenous vein thrombus extending into deep vein was proved and managed by successful thrombolectomy in one case.Cockett syndrome were found as the causes in the other 8 cases,6 cases were treated with balloon dilatation angioplasty and endovascular stenting of the iliac vein.The 2 cases of with distal DVT were treated by anticoagulation therapy.All patients were cured. Conclusions Cockett syndrome,femoral vein injury and too long residual greater saphenous vein are common causes of DVT after greater saphenous vein ligation and tripping.Careful selection of cases,correct diagnosis,standard operative manipulation,early ambulation were all important in the prevention of DVT after great saphenous vein varix procedure.

OBJECTIVEThis study is conducted to explore new methods to perform surface biomodification of titanium implants and improve osteogenic efficiency.

METHODSAn RGD peptide and chitosan (CS) were combined by acylation reaction, forming RGD-CS. An RGD-CS/pDNA complex was subsequently prepared using a complex coacervation method and grafted on a pure titanium surface after physical and biochemical treatments were performed. The chemical structural characteristics of RGD-CS were evaluated using an infrared spectrometer and an elemental analyzer. The shape of this complex was then assessed by gel electrophoresis combined with atomic force microscopy. The grafting effect of this complex on the titanium surface was detected by EB staining.

RESULTSCS and RGD peptides were coupled by an amide bond. The RGD-CS/pDNA complex was completely composited at N/P > or = 2. Atomic force microscopy results showed that the morphology of this complex was mainly spherical. EB staining experiments showed that this complex was successfully grafted on the titanium plate.

CONCLUSIONRGD peptide-modified CS can be used as a titanium implant surface plasmid package carrier of pDNA.

Chitosan ; Dental Implants ; Microscopy, Atomic Force ; Oligopeptides ; Plasmids ; Titanium

Objective To study the treatment of multilevel atherosclerotic occlusive disease of the lower(extremity).Methods From March 2004 to January 2006,intraoperative iliac balloon angioplasty and stenting combined with simultaneous vascular bypass and profundoplasty were performed on 24 limbs in 21 patients(suffering) from lower extremity multilevel atherosclerotic occlusive disease.In 24 limbs iliac balloon angioplasty and stent placement were performed with simultaneous profundoplasty in 12 limbs and femoro-popliteal bypass in 14 limbs.Results Surgical procedures were technically successful in all patients.There were no severe postoperative morbidity or mortality.Before-operative vs postoperative ABI was 0.24?0.13 vs 0.63?(0.18)(P

ObjectiveTo evaluate the effect of varicose vein of lower limbs treated by intravenous laser treatment .MethodIntravenous laser apparatus combin ation with operation was used to treat the varicose vein of the lower extremi ties in 98 patients(all 118 legs).The change of symptoms and signs were recorded and compared before and after operation by using venous ultrasonagraphy and pa thological examination to evaluate the treatment effect.ResultsIn the 84 followed up patieats (104 compromised legs),dull,heaviness were rel ieved completely after operation in 87 legs(83.7%),decreased in 11 legs(10.6%); skin pigmentation obviously decreased in 37 of 44 legs(84.1%);superficial varic ose vein disappeared in all the patients.No blood flow signal was detected in 10 1 legs(97.1%) and slow blood flow in 3 legs(2.9%) were detected by ultrasounogr aphy.Pathological examination revealed various degeneration and necrosis in ful l layers of the vessels;and smooth muscle cells were disrupted,cell nucleus bec ame pyknotic, the internal and external elastic laminar were ruptured and no inflammatory cell infiltration in the lumen and wall of the vessels were seen .ConclusionsIntravenous laser treatment is an ideal method in the treatment of varicose vein of lower extremities .

Objective To evaluate the endovascular treatment of diffuse aortoiliac occlusive diseases. Methods Thirty-two patients underwent endovascular treatment in which rest pain was found in 84.38%, foot local gangrene in 15.62%. Mean age was 69.7 years (range, 52 years to 81 years) and 71.9% was male. Trans Atlantic Inter-Society Consensus C and D disease was respectively in 40.6% and 59.4% patients. Mean length of vasculopathy was (14.6 ± 1.2) cm (range, 4.5 cm to 19.5 cm) All patients had prohibitive risk for open revascularization. With the approach from femoral artery or brachial artery, combined techniques, such as recanahzation, balloon dilation, stent placement and concomitant common femoral endarterectomy were used. Results Technical success was achieved in twenty-nine patients(90.63%). The complication rate was 3.45%. Clinical status was markedly improved in eight cases (27.59%) and moderately improved in twenty-one cases(72.41%). Mean postoperative ABI was 0.73 ± 0.12, mean preoperative ABI was 0.32 ± 0.09. Significant differences were seen between postoperative ABI and preoperative ABI(P<0.05). Mean time of follow-up was (13.9±6.2) months. At 6 months, primary patency was 81.82% and secondary patency was 89.09%. At 12 months, primary patency was 63.64% and secondary patency was 80.18%. Conclusion Combined multiple endovascular technique is a safe and effective method in the treatment of poor risk diffuse aortoiliac occlusive diseases.

Objective: To assess plantar arch index (AI) and prevalence of flat feet in school-age children (7-12 years old) in Shanghai and evaluate the relationship between flat feet with age, gender, weight status (BMI) and occurring sides, and to provide a reference for the prevention of flatfeet. Methods: Three-dimensional foot measuring instruments were used to measure bilateral foot length, medial arch height, AI and arch height ratio (AHR) in school-age children in Shanghai. Statistical analysis of these foot parameters was performed. Results: A total of 3 226 children between aged 7 and 12 in Shanghai were measured with AI of (0.27±0.05) and AHR of (3.02±1.89). Prevalence of flat feet in the group of 7 to 12 year old children was 56.1%. Prevalence of flatfeet decreased significantly with age: 72.6% at 7 years old and 37.9% at 12 years old. Boys had a significantly greater risk for flat feet than girls: the prevalence of flat feet was 62.9% for boys and 47.8% for girls (OR=1.81, 95%CI=1.57-2.10). This risk was independent of age but related to gender. The risk of flat feet in boys was always higher than that in girls at every age. For children aged 7-8, being overweight was not significantly related to the occurrence of flat feet. However, for children aged 9-12 who were overweight were more likely to have flat feet than those of normal weight. The OR increased with age: from 1.44 (95%CI=1.03-2.03) at 9 to 2.96 (95%CI=1.68-5.23) at 12. There was no difference on which side flat feet would occur (χ2=0.95，P=0.33). Conclusion This finding shows that prevalence of flat feet is influenced by age, gender and weight status. AI and prevalence of flat feet in children aged 7-12 decreases with age, and boys have significantly higher prevalence of flat feet than girls. Overweight children aged 9 or older have a higher risk of flat feet.

OBJECTIVETo investigate the effect of cetylpyridinium chloride buccal tablets on halitosis induced by oral conditions.

METHODSWith Porphyromonas gingivalis, Prevotella intermedia and Fusobacterium nucleatum as the testing bacteria, the minimal inhibitory concentration (MIC) of cetylpyridinium chloride buccal tablets was determined using minute amount serial dilution test. The production of volatile sulfur compounds (VSCs) was measured using sulfide detector halimeter in the anaerobic bacteria culture at 4 and 8 h after addition of the tablets. The effect of the tablets in suppressing odor production by mouth-borne halitosis bacteria was assessed using cysteine challenge test in healthy volunteers, and the effectiveness was evaluated by measuring the reduction in VSCs production and the duration of the effect.

RESULTSCetylpyridinium chloride buccal tablets inhibited the growth of all the 3 bacteria. The tablets obviously inhibited VSCs production by the 3 bacteria with a effect similar to chlorhexidine. Compared with distilled water gargle, the buccal tablets significantly reduced cysteine-induced VSCs production level in the healthy volunteers (P<0.05), and the effect lasted for 230 min.

CONCLUSIONCetylpyridinium chloride tablets can obviously suppress bacteria responsible for oral halitosis and produce good effects in the treatment of halitosis induced by oral conditions.

Cetylpyridinium ; therapeutic use ; Fusobacterium nucleatum ; drug effects ; Halitosis ; drug therapy ; Humans ; Microbial Sensitivity Tests ; Porphyromonas gingivalis ; drug effects ; Prevotella intermedia ; drug effects ; Sulfur Compounds ; analysis ; Tablets ; Volatile Organic Compounds ; analysis

ObjectiveTo explore the distribution of traditional Chinese medicine （TCM） syndromes of alopecia areata （AA）， and to provide reference for TCM clinical syndrome differentiation and classification of AA. MethodsAA patients who visited the specialized hairiness clinic of Beijing China-Japan Friendship Hospital were included. A questionnaire was developed including general information of the patients， history of hair loss （onset time， triggers and exacerbating factors， disease progression）， current symptoms （symptoms and signs）， medical history， personal history， family history， and hair microscopy examination results. The factor analysis and cluster analysis were used to determine the syndrome elements and to summarize the syndrome types. ResultsA total of 600 patients with AA were included， including 218 males （36.33%） and 382 females （63.67%）. Totally， 128 patients （21.33%） had a family history of hair loss， and 326 patients （54.33%） had a previous related underlying disease. The leading triggering and exacerbating factors of AA were tension and anxiety， accounting for 335 cases （55.83%） and 285 cases （47.50%）， respectively. The top 10 symptoms involved among patients were scalp oil， anxiety， irritability， dreaminess， fatigue， itching， tension， weakness and dandruff. The factor analysis showed that the factor rotation converged after 9 iterations， and finally obtained 12 common factors and 34 variables， with a cumulative contribution rate of 58.59%. In terms of disease location of AA， the main syndrome elements were liver， spleen and kidney， and the disease nature syndrome elements were mainly dampness-heat， qi stagnation， yin deficiency， qi deficiency， and blood deficiency. The clustering analysis of the 12 common factors showed that TCM syndromes could be summarized into four categories： internal retention of damp-heat， liver-kidney deficiency， qi and blood deficiency， and liver constraint and spleen deficiency. There were significant differences in the distribution of TCM syndromes in patients of different ages and genders （P＜0.001）. ConclusionThe main disease location of AA is in the liver， spleen， and kidney， with the liver being the key. The disease mechanism of AA is a deficiency-excess complex， initially manifested as excess and later becoming deficiency. The TCM syndromes mainly include four types which are internal retention of damp-heat， liver-kidney deficiency， qi and blood deficiency， and liver constraint and spleen deficiency.

The lateral hypothalamic area (LHA) plays a pivotal role in regulating consciousness transition, in which orexinergic neurons, GABAergic neurons, and melanin-concentrating hormone neurons are involved. Glutamatergic neurons have a large population in the LHA, but their anesthesia-related effect has not been explored. Here, we found that genetic ablation of LHA glutamatergic neurons shortened the induction time and prolonged the recovery time of isoflurane anesthesia in mice. In contrast, chemogenetic activation of LHA glutamatergic neurons increased the time to anesthesia and decreased the time to recovery. Optogenetic activation of LHA glutamatergic neurons during the maintenance of anesthesia reduced the burst suppression pattern of the electroencephalogram (EEG) and shifted EEG features to an arousal pattern. Photostimulation of LHA glutamatergic projections to the lateral habenula (LHb) also facilitated the emergence from anesthesia and the transition of anesthesia depth to a lighter level. Collectively, LHA glutamatergic neurons and their projections to the LHb regulate anesthetic potency and EEG features.