Adult ; Female ; Femoral Fractures ; surgery ; Fracture Fixation ; methods ; Humans ; Knee Injuries ; surgery ; Male ; Middle Aged ; Tibial Fractures ; surgery

OBJECTIVETo analyze the molecular characteristics of the newly isolated two Japanese encephalitis virus strains (JEV) in Wuhan.

METHODSThe mosquitoes were collected in Wuhan from April to October in 2009. The envelope (E) protein gene of JEV was detected using RT-PCR and sequenced. Sequence comparisons and phylogenetic analysis were conducted using DNAstar and MegAlign.

RESULTSTwo Japanese encephalitis virus (JEV) strains (WHJX09-9, WHJX09-10) were isolated from Culex tritaeniorhynchus among 16 mosquito pools and identified as genotype I. The result showed that the homology of the two strains was 98. 9% in nucleotides and 100% in deduced amines. The comparison between the new genotype 1 JEV strains and live attenuated vaccine strain SA14-14-2 in E gene showed that the homology of nucleotide sequence was 87.4% and 87.9%, the homology of amino acid was 96.9% (total 15 amino acid were different) in E gene. The mutation sites of amino acid distributed among three different coding domain, but no antigen binding site and neurotoxin-involved site of amino acid were changed.

CONCLUSIONWuhan had appeared a new genotype of JEV which was different from the former strain isolated in Wuhan, the new JEV strains still had neurotoxicity but had high homology with the vaccine strains adopted in Wuhan. The vaccine could still be adopted to prevent Japanese encephalitis if steps were take to eradicate mosquitos at the same time. laboratory surveillance were also an important task to build an early-warning mechanism against JEV.

Amino Acid Sequence ; Animals ; Cell Line ; China ; Culicidae ; virology ; Encephalitis Virus, Japanese ; chemistry ; classification ; genetics ; isolation & purification ; Genotype ; Insect Vectors ; virology ; Molecular Sequence Data ; Phylogeny ; Sequence Alignment ; Viral Envelope Proteins ; chemistry ; genetics

OBJECTIVETo investigate the methods and effects of secondary intervention for mid-long term complications of endovascular repair (EVR) in aortic diseases.

METHODSFrom May 1999 to Jun 2007, 21 patients with mid-long term complications after EVR were treated in our center. Of these cases, 15 cases received first EVR for abdominal aortic aneurysm (AAA), 3 cases for thoracic aortic aneurysm (TAA) and 3 cases for aortic dissection (TAD). The mid-long term complications included 11 cases of type I endoleak, 4 cases of type II endoleak, 2 cases of type III endoleak and 4 cases of migration of stent grafts. Proximal or distal extensions were used for type I and III endoleak in 9 cases. Fenestrated, scallop and bifurcated stent grafts were used to reconstruct the aortic arch in 3 cases. Emboli technique was used in treating type II endoleak. Thrombectomy and bypass technique were used in 4 cases with stent graft limb occlusion. One ruptured AAA accepted open surgery.

RESULTSSecondary endovascular technique were undergone in 20 (95.2%) cases. One case died in 30 days after the secondary intervention and endoleak remained after the secondary operation in 5 cases. Three cases died of the secondary intervention.

CONCLUSIONSEndoleak and limb occlusion were the chief mid-long complications after EVR. Secondary endovascular technique can be used in most cases and carries great challenges in aortic arch lesions.

Adult ; Aged ; Aged, 80 and over ; Aortic Diseases ; surgery ; Blood Vessel Prosthesis Implantation ; adverse effects ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Postoperative Complications ; etiology ; therapy ; Retrospective Studies ; Stents ; adverse effects ; Treatment Outcome

OBJECTIVETo review the experience of hybrid conventional open and endovascular treatment of thoracoabdominal aortic aneurysm (TAAA), and evaluate the immediate and long term outcomes.

METHODSFrom September 1998 to October 2008, 15 TAAA patients were treated by hybrid-procedures. The mean patient age was 58.7 years (ranged from 44 to 72 years). The aneurysms were Crawford type I in 2, type II in 8, type III in 2, type IV in 3. The median aneurysms diameter was (67.5 +/- 7.5) mm (ranged from 55 to 82 mm). Patients were followed up before dismissal, 3, 6, 12 months later, and annually thereafter.

RESULTSTwo patients were antegrade revascularization, the others were retrograde revascularization. Mean operation time was (8.1 +/- 1.4) h (ranged from 6.8 to 12.7 h), mean blood loss was (956.7 +/- 80.1) ml (ranged from 750 to 3,000 ml). Two patients died during perioperative time, no paraplegia. During follow up revealed shrinkage of aneurysm, no graft migration and paraplegia, but 1 died for acute myocardial infarct.

CONCLUSIONSHybrid treatment is a safe and effective option for treatment of TAAA. Immediate and mid-term outcomes are favorable, but long-term surveillance is indefinite.

Adult ; Aged ; Aortic Aneurysm, Abdominal ; surgery ; Aortic Aneurysm, Thoracic ; surgery ; Blood Vessel Prosthesis Implantation ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo determine the safety and efficacy of total percutaneous endovascular abdominal aortic aneurysm repair using the Perclose ProGlide suture-mediated closure system.

METHODSFrom May 2008 to April 2010, 36 abdominal aortic aneurysm patients were undergone total percutaneous endovascular repair. There were 30 male and 6 female patients with a mean age of 68 years. Endografts used included 3 Endurant endografts, 13 Talent endografts, and 20 Zenith endografts. Prior to insertion of the introducer sheath, two ProGlides were pre-set to 18 to 24 F access sites and one to 14 to 16 F access sites. At last, suture the arteriotomy by tying down knots of the ProGlide following removal of the sheath. Technical success, complications, and procedure and access closure times were evaluated. Follow-up protocol consisted of computed tomography angiograms performed at 3, 6, 9, 12 months, and annually thereafter.

RESULTSTwenty patients were operated under local anesthesia and 16 patients under general anesthesia. A total of 68 femoral arteries were closed with 128 devices. Thirty-eight vessels were with 2 devices, while 8 arteries required 3 devices and 2 arteries required 4 devices for hemostasis and an additional 20 vessels only required a single device. Sixty-three (63/68, 92.6%) vessels were closed successfully. Two vessels converted to open closure. Three vessels complicated with hematomas without surgical procedure. The mean follow-up was (12±3) months. There was one asymptomatic femoral artery dissection 3 months after operation.

CONCLUSIONSTotal percutaneous endovascular abdominal aortic aneurysm repair is safe and effective. But it should be performed at hybrid operating room where can convert to open procedure if necessary.

Aged ; Aged, 80 and over ; Aortic Aneurysm, Abdominal ; surgery ; Blood Vessel Prosthesis Implantation ; instrumentation ; methods ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Suture Techniques ; instrumentation ; Treatment Outcome

OBJECTIVETo study the changes of body composition in females patients with human immunodeficiency virus (HIV)-related lipodystrophy (LD) syndrome (HIV-LD).

METHODSTotally 25 female patients who were treated in our hospital from January 2002 to December 2009 were divided into LD group and non-LD group based on the existence of LD. All these patients were receiving highly active antiretroviral therapy (HAART). In addition, 12 healthy women were set as the controls. Total and regional body composition were measured by dual X-ray absorptiometry in all three groups.

RESULTSThe fat mass (FM) was correlated negatively with the duration of HAART (r=-0.431, P=0.029). Multiple linear regression analysis showed that FM had positive correlation with weight and negative correlation with lean mass (LM) (r = - 0. 973, P =0. 000). Total, trunk and leg FM were significantly lower in LD patients than that in controls (P <0.05).Meanwhile, total, trunk and leg bone mineral contents were statistically lower in LD patients than that in controls (P <0. 05). Lumbar bone mineral density of LD patients was lower than that of non-LD patients and controls, and there was significant difference between LD patients and controls (P = 0. 001). LM of LD patients was higher than that of non-LD patients but without statistical difference (P > 0. 05).

CONCLUSIONSThe peripheral and central FM and bone mineral contents remarkably decrease in female patients with HIV-LD. How-ever, HIV-LD patients tend to have higher LM than non-LD patients. .

Adipose Tissue ; metabolism ; Adult ; Body Composition ; physiology ; Bone Density ; physiology ; Female ; HIV-Associated Lipodystrophy Syndrome ; metabolism ; Humans ; Middle Aged ; Young Adult

Objective To compare the effects and complications between neuroendoscope-assisted and conventional shunt methods in patients with hydrocephalus,Methods The data of 299 patients with hydrocephalus admitted to our hospital from June 2002 and June 2009 were analyzed.Among these patients,98 adopted neuroendscope:78 were performed ventriculoperitoneal shunt(EVPS)combined with endoscopic third ventriculostomy(ETV)and the other 20 with obstructive hydrocephalus were performed ETV only.The other 201 patients adopt conventional operation:VPS was employed in 196 and ventriculoatrial shunt was performed in 5.We compared shunt effectiveness by calculating the pre-and post-operative ventricular indexes,shunt failure rates and complication rates during the follow-up between the 2 groups.Results No difference in etiology of hydrocephalus or clinical characteristics between the 2 groups was found.Compared with the conventional shunt group,neuroendscope-assisted group enjoyed a longer operative time,a higher surgery cost,a lower clogging incidence rote and a higher precision rote of putting the tube(P<0.05).Conclusion Applying of neuroendoscope is a very good option in treating patients with various kinds of hydrocephalus with good long-term follow-up results.

OBJECTIVETo investigate the treatment strategies of peripheral arterial aneurysms.

METHODSThirty-five cases were reviewed from July 1998 to December 2007, and 28 cases were male, 7 cases were female. Eleven cases were popliteal artery aneurysms, 15 cases were femoral artery aneurysms, 4 cases were extracranial carotid aneurysms and 5 cases were subclavian artery aneurysms. All cases had either open procedures or endovascular procedures.

RESULTSSurgical open procedures were performed on 24 cases, and endovascular procedures were performed on 11 cases. The perioperative complication rate were 16.7% (4/24) and 0% for open and endovascular groups respectively. The average follow-up time was 41 months (7 months to 8 years). The accumulative five year patency were 61% and 48% for surgical grafts and stent grafts respectively. Two cases died of diseases and one had stroke during follow-up.

CONCLUSIONSSurgical open repair is still standard procedure for most peripheral arterial aneurysms and endovascular repair may have its own advantage for high risk patients.

Adult ; Aged ; Aged, 80 and over ; Aneurysm ; surgery ; Blood Vessel Prosthesis Implantation ; Endovascular Procedures ; Female ; Humans ; Male ; Middle Aged ; Peripheral Vascular Diseases ; surgery ; Retrospective Studies

Adult ; Female ; Humans ; Kidney Neoplasms ; diagnostic imaging ; metabolism ; Neuroectodermal Tumors ; diagnostic imaging ; metabolism ; Radiography ; Young Adult

OBJECTIVETo evaluate immediate- and median-term outcomes from subintimal recanalization of superficial femoral arteries (SFA) chronic total occlusions (CTO) with the Outback LTD catheter.

METHODSFrom January 2010 to May 2011, 35 legs in 30 patients with CTO of the SFA and proximal popliteal artery were treated by Outback LTD catheter. There were 20 male and 10 female patients. The mean age of the patients was 68 years. Clinical presentation was severe intermittent claudication (Rutherford category 3, 10/35, 28.6%), rest pain (Rutherford category 4, 13/35, 37.1%), and minor ulceration (Rutherford category 5, 12/35, 34.3%). In all cases, the true lumen could not be entered by using standard antegrade catheter and guide wire techniques. Technical success, complications, procedure times, clinical outcomes and cumulative patency rates in follow-up were evaluated.

RESULTSMedian lesion length was (210 ± 15) mm. Recanalization of the arterial occlusion was successful in 34 of 35 treated lesions (97.1%). None of the 30 patients showed any procedure-related complications during or after treatment. The mean follow-up was (7.2 ± 0.3) months. Cumulative primary patency rates after 3, 6, and 12 months were 90.9%, 84.8% and 50.6%. Three minor toe amputations and one major below-the-knee amputation were observed in patients with critical limb ischemia.

CONCLUSIONSThe Outback LTD catheter is a safe and effective device to recanalize challenging superficial femoral arteries CTO. The technique could reduce radiation exposure time and raise the technique success rate.

Aged ; Aged, 80 and over ; Angioplasty, Balloon ; instrumentation ; methods ; Arterial Occlusive Diseases ; surgery ; Catheters ; Female ; Femoral Artery ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome