Objectives To evaluate the effect of endovascular treatment for spontaneous isolated dissection of the superior mesenteric artery (SIDSMA).Methods There were 41 men and 7 women patients, aged at 32-78 years.46 patients presented with abdominal pain and 3 patients was asymptomatic.The SIDSMA was diagnosed by computed tomography angiography(CTA).Results In the 45 symptomatic patients, one was treated by laparotomy, SMA thrombectomy and necrotic bowel resection.44 patients underwent endovasular treatment, among them 2 patients failed endovasular procedure.The other 42 patients underwent successful intravascular remolding.3 asymptomatic patients underwwent conservative treatment.During the mean (17 ± 4)month follow-up period, computed tomography angiography showed patent true lumen in all the 42 patients.The 2 patients in which the endovascular intervention failed remain symptomatic of recurrent abdominal pain and digestive dysfunction.Conclusions The endovascular interventional therapy is safe and effective for SIDSMA.

Objective:To develop a self-directed learning feedback system for patients with post-stroke dysphagia (PSD) and analyze its effectiveness.Methods:From November 2022 to July 2023, convenience sampling was used to select 108 PSD patients from the Neurological Disease Center of Taiyuan Central Hospital as the research subject. The patients were divided into a control group and an experimental group using a random number table method, with 54 cases in each group. The control group received routine nursing upon discharge, while the experimental group was treated intervention measures through the self-directed learning feedback system. The self-efficacy, quality of life, swallowing function, and psychological status of two groups of patients were compared before intervention and one and three months after intervention, respectively.Results:A total of 52 patients in the experimental group and 50 patients in the control group completed the study. Repeated measures analysis of variance showed that the self-efficacy and quality of life scores of both groups improved with the extension of intervention time, and the self-efficacy and quality of life scores of the experimental group were higher than those of the control group at one and three months after intervention, with statistical differences ( P<0.01). After one and three months of intervention, the severity scores of dysphagia in the experimental group were lower than those in the control group, and the differences were statistically significant ( P<0.01). As the intervention time extended, the psychological status scores of the experimental group were lower than those of the control group at different time periods, and the differences were statistically significant ( P<0.05) . Conclusions:The application of self-directed learning feedback system in the rehabilitation of PSD patients at home can improve their self-efficacy, quality of life and swallowing function, and relieve negative emotions, which is worthy of further promotion.

Objective To investigate the clinical efficacy of dot matrix laser combined with subcutaneous separation in the treatment of depressed acne scar.Methods A total of 86 patients with depressed acne scar admitted to the Second Affiliated Hospital of Nanchang University from February 2022 to August 2023 were selected and divided into dot matrix group and combined group according to random number table method,with 43 cases in each group.The patients in dot matrix group were treated with dot matrix laser,and the patients in combined group were treated with dot matrix laser combined with subcutaneous separation.The visual analogue scale(VAS)score,echelle d'evaluation clinique des cicatrices d'acne(ECCA)score,pigmentation area,scar area,treatment satisfaction and adverse reactions were compared between two groups.Results There was no significant difference in VAS scores between two groups after the first treatment and the second treatment(P>0.05).Three months after treatment,the ECCA score of combined group was significantly lower than that of dot matrix group,and the pigmentation area and scar area were significantly smaller than those of dot matrix group(P<0.05).The total satisfaction of patients in combined group was significantly higher than that in dot matrix group(χ2=4.746,P=0.029).There was no significant difference in the occurrence of adverse reactions between two groups(χ2=0.453,P=0.501).Conclusion Dot matrix laser combined with subcutaneous separation in the treatment of depressed acne scar can effectively promote scar repair,reduce skin pigmentation area and scar area,and do not increase pain,with good safety and high patient satisfaction.

OBJECTIVE: To analyze the efficacy of integrated minimally invasive surgery for iliac vein compression syndrome with varicose veins of lower extremities. METHODS: From January 2017 to January 2018, 11 patients with iliac vein compression syndrome accompanied by varicose veins of lower extremities underwent left iliac vein stent implantation and radiofrequency thermal ablation of lower extremity veins in the First Affiliated Hospital of Zhejiang University School of Medicine. The left iliac vein stent was implanted through the puncture point approach of the main great saphenous vein, and then radiofrequency thermal ablation of the main saphenous vein was performed. Rivaroxaban and aspirin were administered from the day of surgery for 6 months and 12 months, respectively. After discharge, patients were followed up for more than 6 months. The lower extremity veins, iliac veins were reexamined by Doppler ultrasound or CT angiography at 2 weeks, 2 months and 6 months after surgery. RESULTS: The operations were successfully performed in 11 patients, and no complication was observed during the operation. The rates of soreness and swelling remission, pigmentation and skin quality improvement, and the iliac vein stent patency were 100%. No varicose vein recurrence, iliofemoral vein thrombosis and pulmonary embolism were found. CONCLUSIONS Integrated minimally invasive surgery is safe, effective and less invasive for iliac vein compression syndrome with varicose veins of lower extremities.
Humans ; Lower Extremity ; surgery ; May-Thurner Syndrome ; complications ; surgery ; Minimally Invasive Surgical Procedures ; standards ; Radiofrequency Ablation ; Saphenous Vein ; surgery ; Treatment Outcome ; Varicose Veins ; complications ; surgery

Heart failure with high prevalence is the endpoint of many cardiovascular diseases. Once diagnosed， patients usually need lifelong medication， which seriously affects their quality of life. The drugs commonly used to treat heart failure include angiotensin-converting enzyme inhibitors， beta-blockers， aldosterone receptor antagonists， and diuretics. However， the long-term use of those drugs can lead to side effects such as hypotension， depletion of body fluid， and electrolyte imbalance and even increase mortality. According to the theory of traditional Chinese medicine （TCM）， Qi deficiency and blood stagnation is the major cause of heart failure and when Qi is not moving， blood is not flowing. Therefore， the TCM clinical treatment of heart failure uses the Chinese medicinal materials which replenish Qi， activate blood， and dispell stasis to treat both internal cause and external symptoms. Recent studies have demonstrated that Chinese herbal medicines such as Astragali Radix， Ginseng Radix et Rhizoma， Notoginseng Radix et Rhizoma， Salviae Miltiorrhizae Radix et Rhizoma， Angelicae Sinensis Radix， as well as the compound formulas such as Buyang Huanwutang， Simiao Yongantang， Qili Qiangxin capsules， and Qishen Yiqi drops， play a significant role in the prevention and treatment of heart failure via replenishing Qi， activating blood， and dispelling stasis. Inhibition of oxidative stress and inflammatory responses， mitigation of myocardial fibrosis， improvement of calcium cycling， and protection of mitochondrial function represent the key mechanisms for the treatment of heart failure with Chinese medicinal materials. Focusing on the pathogenic mechanisms and signaling pathways of heart failure， this paper systematically describes the pharmacological effects， molecular mechanisms， and research progress in the clinical application of Chinese medicinal herbs with effects of replenishing Qi， activating blood， and dispelling stasis and their compound formulas in the prevention and treatment of heart failure， aiming to provide scientific evidence for the development and clinical use of anti-heart failure Chinese medicinal materials.

Circadian rhythm disruption is a universal phenomenon that is associated with a combination of internal and external factors, with internal factors referring to disturbances in the intrinsic regulatory mechanisms of sleep-wake behavior, and external factors including changes in sleep habits, severe sleep deprivation, shift work, social jet lag, prolonged exposure to nighttime light, and late nighttime eating. Shift work, as a common occupational factor, can lead to disruption of the central/ peripheral biological clock which regulates the expression of almost the entire genome, and the disruption of the biological clock can lead to genetic variants, hormonal secretion abnormalities, insulin resistance, oxidative stress, and systemic inflammation, which are risk factors for obesity. In the context of rapid advancement of global economy and industrialization, the prevalence of simple obesity in the traditional cognitive category is increasing in a linear trend, while the incidence of abdominal obesity, which is closely related to metabolic disorders, is also showing an increasing trend. In recent years, the mechanism of circadian rhythm disorder and obesity associated with shift work has attracted much attention, and this article summarized the latest research progress, aiming to provide a basis for the prevention and treatment of obesity caused by circadian rhythm disruption due to shift work.