Objective To study the expression and clinical significance of vascular endothelial growth factor(VEGF)and soluble vascular cell adhesion molecule-1(sVCAM-1)in children with Henoch-Schonlein purpura(HSP).Methods The levels of plasma VEGF and sVCAM-1 were measured in 58 children with HSP and 23 normal children by enzyme-linked immunosorbent assay(ELISA),respectively.Results The plasma levels of VEGF and sVCAM-1 of HSP children at acute stage were significantely higher than those of HSP children at the remission stage and those of the controls(Pa

To investigate the influence of Anxin granules combined with tirofiban on acute myocardial infarction (AMI) Patients after elective percutaneous coronary intervention (PCI). One hundred and twenty AMI patients were randomly divided into treatment group and control group. The patients in the two groups were all given Tirofiban 30mins before PCI . The treatment group was added Anxin granules 30 mins before and after PCI. Tissue factor (TF) and von willebrand factor (vWF) were tested at 6 hours after operation. Syndromatology alteration of traditional Chinese medicine (TCM) and bleeding complications were observed at 4 weeks after operation. Both TF and vWF at 6 hours after operation of the treatment group was lower than the control group significantly (P < 0.01), while the condition of myocardial ischemia at 90 mins after operation of the treatment group was better than control group with significance. The syndromatology alteration of TCM especially spontaneous perspiration and hypodynamia of the treatment group were improved significantly compared to control group 4 weeks after operation. All patients in both groups had no bleeding complications and thrombopenia. The study suggests that Anxin granules combined with tirofiba can improve the clinical efficacy and the endothelial function of AMI patients after PCI with no increase in bleeding events.
Aged ; Angioplasty, Balloon, Coronary ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Middle Aged ; Myocardial Infarction ; complications ; metabolism ; surgery ; Postoperative Hemorrhage ; drug therapy ; etiology ; metabolism ; prevention & control ; Thromboplastin ; metabolism ; von Willebrand Factor ; metabolism

OBJECTIVETo study the anatomical characteristics about ascending aortic and aortic arch in Chinese population by CT.

METHODSFrom September 2006 to September 2007, 388 patients free of current known aortic pathology undergone thoracic aorta CTA. The diameter of ascending aorta, aortic arch, and branch vessels of aortic arch were measured respectively by AW4.2 work station. The data base about all the measurements was set up. The CHISS statistical software was used to analysis data.

RESULTSThe aortic diameter above coronary artery (CA), the level at origin of and brachiocephalic trunk (BCT), the halfway of the ascending aorta, the level at origin of left common carotid artery (LCCA), the level at origin of left subclavian artery (LSA) and the level at distal of origin of LSA respectively were (34 +/- 5) mm, (34 +/- 5) mm, (33 +/- 4) mm, (30 +/- 4) mm, (28 +/- 3) mm and (26 +/- 3) mm. The diameters of two level between the origin of BCT and right subclavian artery (RSA) were (13.1 +/- 1.9) mm and (12.8 +/- 2.3) mm. Diameters of two level at LCCA were (8.7 +/- 1.5) mm and (7.9 +/- 1.0) mm. The diameters of two level between the origin of LSA and left vertebral artery were (10.7 +/- 1.7) mm and (9.3 +/- 1.3) mm. The aortic lumina length between the origin of CA and BCT was (5.3 +/- 1.2) cm, the aortic lumina length between the origin of BCT and LCCA was (1.3 +/- 0.4) cm, the lumen length between origin of BCT and RSA was (4.1 +/- 0.8) cm, the lumen length between origin of LSA and left vertebral artery was (3.8 +/- 0.8) cm. The distance between the wall of BCT and LCCA was (0.4 +/- 0.2) cm, the distance between the wall of LCCA and LSA was (0.7 +/- 0.6) cm.

CONCLUSIONSModular branched stent-graft system is fit for most part of the Chinese. The size fit for human could be got on this basic.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Aorta ; anatomy & histology ; Aorta, Thoracic ; anatomy & histology ; diagnostic imaging ; Aortography ; Blood Vessel Prosthesis ; Brachiocephalic Trunk ; anatomy & histology ; diagnostic imaging ; Carotid Artery, Common ; anatomy & histology ; diagnostic imaging ; Female ; Humans ; Male ; Middle Aged ; Prosthesis Design ; Subclavian Artery ; anatomy & histology ; diagnostic imaging ; Tomography, X-Ray Computed ; Young Adult

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

OBJECTIVESTo review the dilatation of the proximal neck in abdominal aortic aneurysm (AAA) after endovascular repair (EVR), and to analyze the factors contributed to these changes.

METHODSFrom January 1997 to January 2007, a total of 45 patients treated by EVR met the inclusion criteria. There were 44 male and 1 female patients, with an average age of (69 ± 17) years. The patients were all asymptomatic abdominal aortic aneurysm, combined hypertension in 37 cases, coronary heart disease in 40 cases. All the patients had the complete preoperative enhanced CT information, and accepted more than 6 months of regular enhanced CT follow-up (1, 3, 6, 12 months after surgery and annually thereafter). The proximal aneurysm neck diameter increase was determined by CT, increase over 2 mm as having change, less than 2 mm as no change.

RESULTSThe average follow-up interval was (34 ± 25) months (ranging from 9 to 100 months). The mean preoperative proximal neck diameter was (21.5 ± 2.3) mm, and (22.4 ± 2.4) mm one month after operation and (24.0 ± 2.8) mm at the latest follow-up. The increase of proximal neck diameter was detected in 71.1%. The oversizing percentage was 19% ± 6%. The incidence of proximal neck over-sizing stent-graft in diameter was 6.7%. The incidence of no dilation at proximal neck diameter was 97.4%, 68.6%, 39.3% and 3.3% at 16, 24, 36 and 96 months postoperatively respectively. The stent-graft migration was detected in 22.2% patients, and the migration distance was (7.0 ± 1.3) mm (ranging from 0 to 9.5 mm). There were no case which the migration oversized 10 mm or need to reintervention.

CONCLUSIONSThe more oversizing percentage, the more dilatation in the proximal neck. The stent-graft migration and the dilatation of the proximal neck might have effect on each other.

Aged ; Aged, 80 and over ; Aortic Aneurysm, Abdominal ; pathology ; surgery ; Blood Vessel Prosthesis Implantation ; Dilatation, Pathologic ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Stents

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

OBJECTIVE To illuminate the adenoid bacteria distribution in children with adenoid hypertrophy. METHODS PubMed, Embash, Medline, CNKI, VIP Information and Wanfang data were searched for studies on the adenoid bacteria distribution and adenoid hypertrophy. Random effects meta-analysis was used to pool data. RESULTS Nine studies were included in this meta analysis. The pooled detection rates of haemophilus influenza, staphylococcus aureus and streptococcus pneumonia were 0.21 (95%CI, 0.09-0.32), 0.14 (95%CI, 0.09-0.20) and 0.15 (95%CI , 0.08-0.22) respectively. CONCLUSION Haemophilus influenzae, staphylococcus aureus, and streptococcus pneumoniae are three main kinds of pathogenic bacteria of adenoid hypertrophy in children.

OBJECTIVETo determine the infective status and natural distribution of Xinjiang hemorrhagic fever (XHF; Crimean-Congo hemorrhagic fever, CCHF) in ticks, rodents and livestock in the Tarim Basin.

METHODSThe pathogenic materials of ticks or rodents' viscera and blood samples of sheep were inoculated into sucking mouse of 24 to 48-hour old. Materials with typical clinic symptoms were identified with RPHA and IFA. RT-PCR was taken to detect special S gene segment of Crimean-Congo hemorrhagic fever virus (CCHFV) in the objective material.

RESULTSAll the samples of ticks, rodents' viscera and blood samples of sheep from 21 counties (cities) in the Tarim Basin were divided into 422 groups and inoculated into sucking mouse at laboratory. 49 materials with typical clinic symptoms were obtained. The morbidity rate with typical clinic XHF was high in Bachu, Yuli, Yutian and Ruoqiang. There were 43 samples identified with RPHA with 6 positive samples and positive rate of 1.4%. The materials with positive RPHA were found in Yuli, Luntai and Yutian. 42 samples were identified with IFA and 13 positive samples with the positive rate of 3.1%. The positive materials of IFA were found in Bachu, Yuli, Minfeng, Luntai and Yutian. 32 samples were detected with RT-PCR and there were 31 samples with special S gene segment of CCHFV (329- 548 nt). The positive materials was widely distributed in Aksu, Awat, Bachu, Luopu, Yuli, Minfeng, Qiemo, Ruoqiang, Luntai and Yutian. The highest infective rate was in Hyalomma asiaticum kozlovi, and followed by sheep. S gene segment was detected in viscera of M. meridianus.

CONCLUSIONXHF relied on the river in the southern part of Xinjiang and distributed in the areas with Populus euphratica shrub in desert and oasis in the Tarim Basin. The main vector and host were Hyalomma asiaticum kozlovi. Livestock such as sheep, camel, L. yarkandensis, M. meridianus and Euchoreutes naso could serve as the deposited host of XHF.

Animals ; Animals, Domestic ; virology ; China ; epidemiology ; Hemorrhagic Fever Virus, Crimean-Congo ; genetics ; isolation & purification ; Hemorrhagic Fever, Crimean ; epidemiology ; transmission ; Humans ; Morbidity ; Polymerase Chain Reaction ; Rodentia ; virology ; Ticks ; virology

OBJECTIVETo describe observation of availability of catheter-directed foam sclerotherapy for the great saphenous vein varicosis.

METHODSA selective series of 30 patients of vein varicosis were treated with foam sclerotherapy using a standard technique for foam delivery from April 2008 to August 2008. Patients were treated with 1% polidocanol foam through a catheter, which was inserted percutaneously over a guidewire in the great saphenous vein (GSV). All successfully treated patients were examined by colour duplex two weeks after the procedure.

RESULTSThirty patients with an insufficiency reflux of the GSV were treated with the catheter-directed foam sclerotherapy. Primary technical success was achieved in all the patients. The concentrations (1.0%) and doses (6 to 8 ml) of polidocanol was mainly we used. Five patients experienced transient scotomas and developed segmental phlebitis of a collateral vein. The intervention was well tolerated in all patients without the occurrence of serious side effects. In 27 of the 30 treated patients (90%), a closure of the GSV was found at control visits 2 weeks, 3 months after treatment.

CONCLUSIONThe use of an endovascular catheter inserted percutaneously over a guidewire is feasible in most patients and has resulted in high primary occlusion rates.

Adult ; Aged ; Aged, 80 and over ; Catheterization, Peripheral ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Saphenous Vein ; Sclerosing Solutions ; administration & dosage ; therapeutic use ; Sclerotherapy ; methods ; Treatment Outcome ; Varicose Veins ; therapy