Objective To summarize experiences in treatment of traumatic aortic rupture. Methods Between July 2001 and December 2008, 17 patients with acute traumatic aortic rupture were treated in our department. One patient died of hemorrhagic shock one hour after admission before opera-tion. Nine patients underwent thoracotomy under general anesthesia with double lumen endotracheal tube and normothermic femoral-femoral partial cardiopulmonary bypass, with bypass time for 35-139 minutes and aortic clamping time for 25-87 minutes. Successful operation was performed in seven patients inclu-ding one treated with simple repair and the other six with partial replacement of thoracic aorta with artifi-cial vascular graft. The other seven patients underwent endovascular repair and received stent grafts at the site of thoracic injury via right lilac-femoral artery under general or local anesthesia. Results One pa-tient free from operation was died of hemorrhagic shock. Of nine patients treated with thoracotomy, two patients died of hemorrhagic shock during operation and the other seven survived, with operation time ran-ging from 100 to 180 minutes. Seven survivors were followed-up for 2-6 years, with no death during fol-low-up period. Seven patients in endovascular repair group recovered, wiht operation time ranging from 50 to 70 minutes. All these seven patients were followed up for 3-14 months, which showed no death. Reex-amined CT in six patients showed no mediastinal hematoma or leakage of contrast medium from the aorta isthmus at 2-5 months after operation. Conclusions Endovascular repair is simple, safe and effective for traumatic aortic rupture. The selection of thoracotomy and endovascular repair is based on following conditions: the combined injuries of patients, the equipments of hospital and the skills of operators.

Objective To review reoperation on blood vessel prosthesis occlusion after arterial bypass graft in lower limbs. Method The treatment effect of 21 patients with reoperation on blood vessel prothesis occlusion after arterial bypass graft in lower limbs was analyzed retrospectively. Results All the cases were followed up 6-36 (12 ±3) months. The limb salvage rate was 71.4%(15/21) ,the amputation rate was 28.6% (6/21). All 9 limbs that underwent revascularization from deep femoral artery reserved. Conclusions Endomembrane hyperplasy, occlusion of the inflow and outflow tracts are the major reasons for the occlusion of blood vessel prosthesis after arterial bypass graft in lower limbs. Appropriate procedures should be based on careful consideration of the occlusion reasons. Profundaplasty is an effective therapy for those who are treated by reoperation on blood vessel prosthesis occlusion in lower limbs.

Objective To evaluate the clinical effect of the endovascular treatment of iliac vein compression syndrome.Methods Thirty-three patients with iliac vein compression syndrome were treated with endovascular treatment.Of which,edema and varicose vein of the left lower extremity in 29 patients,complicated with acute deep vein thrombosis of left lower extremity in 3 patients,post deep venous thrombosis syndrome in 1 patient.Balloon dilatation and stent implantation were performed in all 33 patients.The diameter of balloon was 10-12 mm,diameter 12-14 mm Bard self expandable stent.Five patients with varicose vein and ulcer of left lower extremity were treated with two stage operation.Results The diagnosis was confirmed by left lower extremity deep veins angiography.There was no death patient,and no hematoma of hematoma locus.Follow-up for 3-30 months,the rate of follow-up was 100％(33/33).The edema of the lower extremity was markedly reduced or disappeared in 28 patients.Color Doppler ultrasound and left lower extremity angiography showed that the stent was unobstructed,no stent occlusion and new onset thrombosis cases.Conclusion Endovascular treatment is safe,effective with few complications,and is the first choice for the treatment of iliac vein compression syndrome.

Objective To assess the effect of alprostadil on accelerating early recovery of renal transplant patients with delayed graft function.Methods A randomized control clinical trial was designed in renal recipients with delayed graft function(DGF)who were administered with 50μg alprostadil each day after the operation.The effects of alprostadil were compared with the control group which included 14 recipients with DGF to determine the influences of alprostadil on urine,serum creatinine(SCr).Under Doppler ultrasound,the renal blood flow resistance-indexes(RI)were measured.The rates of acute renal graft rejection(AR)were also calculated in both groups,and the 1year patient/graft survival rates were compared between the two groups.Results Urine was significantly higher in alprostadil-treated group than in control group(P ＜ 0.05).On the contrary,SCr and RI were significantly lower in alprostadil-treated group than in control group(P ＜ 0.05).No significant differences were found between the two groups in AR rate(6.25％ vs 7.14％)and the 1-year patient/graft survival rates(P ＞ 0.05).Conclusion The application of alprostadil in renal recipients with DGF had beneficial effects on accelerating recovery of renal graft function.

Objective To investigate the effects of different abstinent duration on brain functional network of heroin addicts at resting state.Methods Sixteen heroin addicts during protracted abstinence for 11-13 months (PA12 group) and twenty heroin addicts during protracted abstinence for 5-7 months (PA6 group) were recruited in the resting-state functional MRI study.Graph theoretical methods were applied to construct topological organization of whole brain network and nodes betweenness of the networks in all subjects,and the between-group differences were analyzed.The correlation of the node betweenness with the abstinence duration was conducted.Results There was no significant difference (P＞0.05) in the small world characteristic (γ≈1,λ》1) between two groups.Compared with the PA6 group,the PA12 group demonstrated significantly decreased nodal betweenness in regions of left parahippocampal gyrus,left precentral gyrus,and significantly enhanced nodal betweenness in regions of the left cuneus,left temporal and right middle occipital gyrus (all P＜0.05).Moreover,the betweenness of the left precentral gyrus (r =-0.52,P =0.001) and parahippocampal gyrus (r=-0.49,P=0.002) were negatively related with the abstinence duration,the betweenness of the right middle occipital was positively correlated with the abstinence duration (r=0.49,P=0.003).Conclusion The brain network small world topology of heroin addicts tend to be stable after 5-7 months of abstinence.Long-term abstinence may minimize the addicfs memory of drugs and potential drug seeking behavior,and recover addicts' visual spatial attention function.

PurposeHeroin addiction is a chronic and recurrent functional brain disease, there are some functional changes in specific brain regions, but the network character remains unclear. The aim of this paper is to explore the network character of brain resting-state functional network in heroin addicts, to identify the potential neuromechanism of heroin addiction from the perspective of brain network.Materials and Methods Thirty heroin addicts (HA group) and twenty-nine healthy controls (control group) underwent resting-state functional MRI scanning using GE 3.0T MRI scanner. The brain functional networks were constructed based on graph theory, the small-world properties and node properties were calculated and compared between the two groups, the correlation between the total dosage of heroin and node degree was analyzed.Results Compared with control group, the small world characteristics of HA group was altered with statistically significant difference (P<0.05, corrected by false discovery rate); the node degrees in orbit frontal regions increased, while those in occipital brain regions decreased (P<0.05, corrected by false discovery rate). No correlation was found in HA group between node degree and the total dosage of heroin.Conclusion These results suggest that topology of functional brain networks were altered in heroin addicts which tends to random networks; increased motivational driving to the salience of drug and decreased visuospatial attention in heroin addicts may provide a strategy for identifying the neuromechanism of heroin addiction.

Objective To investigate the efficacy and the course of desensitization treatment in bronchial asthma with positive specific IgE to dust mite in children. Methods A total of 105 children with bronchial asthma with positive specific IgE to dermatophagoides farinae allergens were randomized into the observation group and the control group. Children in the control group were treated to continue anti-asthma according to the routine of prevention and treatment children with asthma. Chinldren in the observation group were treated by dermatophagoides farinae drops in addition to the treatment of children in the control group. The recurrence of asthma was compared between two groups at 25 weeks post-treatment. At 25 weeks post-treatment , children in the observation group was randomly divided into the observation groupⅠand group Ⅱ. Children in the observation groupⅠreceived continuous treatment except for desensitization treatment. Children in the observation group II received the sublingual immunotherapy with dermatophagoides farinae drops (No.4) for 1 year in addition to the treatment in the observation groupⅠ. The recurrence of asthma was also compared between the two sub-groups. Results The rate and times of recurrence of asthma were lower in the observation group than those in the control group(P < 0.05), with no significant differences between the observation groupⅠand groupⅡ (P > 0.05). Conclusion The recurrent rate and frequency of asthma could be reduced by the sublingual immunotherapy with dermatophagoides farinae drops in children with asthma of positive specific IgE to dust mite. The course of treatment may be half year long.

Objective To explore the relationship between therapeutic dosage of ultrasound ablation in treatment of uterine fibroids and imaging characteristics of bloody supply of uterine fibroids by color Doppler ultrasound imaging. Methods One hundred and forty-two patients with 168 fibroids were treated by ultrasound ablation. Before treatment, bloody supply of fibroids were classified into grade 0 -4 by ultrasonography. Three patients lost follow-up with contrast MRI exam within 1 month after treatment, so 165 fibroids were enrolled in this study. Bloody supplies were 9 fibroids in grade 0, 34 fibroids in grade 1, 35 fibroids in grade 2, 55 fibroids in grade 3 and 32 fibroids in grade 4. After 1 month treatment, the treated area without blood supply and ratio of ablation were measured by contrast MRI to evaluate the efficacy of thermal ablation and compare status of blood supple based different therapeutic dosage. According to International Reditherapy for Society ( SIR ) standard, adverse effect and score of pain were evaluated. Results ( 1) Ratio of ablation based; ratios of ablation were 79% in grade 0, 89% in grade 1, 92% in grade 2, 86% in grade 3, 71% in grade 4. It reached statistical difference when blood supply of grade 0 compared with those of grade 2 and 3 (P ＜ 0. 05 ) and blood supply of grade 4 compared with those of grade 1, 2, 3 ( P ＜ 0. 05). (2) Factor of energy efficiency:factor of energy efficiency were 13.19 J/mm3 in degree 0, 9. 54 J/mm3 in degree 1, 12. 91 J/mm3 in degree 2, 17. 83 J/mm3 in degree 3 and 28. 10 J/mm in degree 4. Factor of energy of ablation in degree 4 was significantly higher than those in degree 1, 2 and 3 blood supply (P ＜ 0. 05). It exhibit the positive relationship between blood supply and factor of energy of ablation ( r = 0. 354 ,P ＜ 0. 01). ( 3 ) Score of pain and adverse effect: nearly 85% ( 120/142 ) patients could tolerate this treatment very well. Those scores of pain were in range of 0 to 4. All patients did not extend their hospitalization and C to F of SIR standard was not recorded. Conclusion blood supply of myoma measured by ultrasound could predict dosage of ultrasound ablation, it could help select indicated well patients.

Objective To explore the changes and effect of functional connectivity(FC) of reward network in chronic heroin addicts(HA) using resting-state fMRl(rs-fMRI). Methods rs-fMRI was performed on 26 chronic heroin addicts(HA group) and 25 matched normal volunteers(control group).The rs-fMRI data were proceeded by usingrs-fMRI(DPARSF) software on Matlab 2009a. Bilateral nucleus accumbens(Nacc) were set as ROIs. Then the mean time series of ROI were compared with other voxels within the brain by the rs-fMRI data analysis toolkit(REST). Intra-and inter-group analysis was performed with single sample and two sample t test respectively.The association of intensity of FC in brain regions and the duration/doses of heroin consumption was investigated. Results In HA group, positiveresting-state FC compared with the ROIs was found in frontal gyms, dorsal striatum, thalamus and pons, while temporal lobe, negative found in part of parietal cortex and occipital cortex, part of dorsal lateral prefrontal cortex and cerebellum. Within control group, positive FC compared with the ROIs was found in frontal gyms, dorsal striatum, thalamus, hippocampal gyrus and pons, occipital cortex, negative FC with ROIs found in part of dorsal lateral prefrontal cortex and cerebellum(P<0.005, voxels>26). Compared with the control group,the FC between the right Nacc and the bilateral calcarinegyrus, left middle occipital gyrus(voxel numbe r=31,28,47;t=3.99, 3.74,3.74;and P<0.005,respectively)were significantly increased in the HA group.The FC between the left Nacc and left fusiform gyrus and right precuneus(voxel number=40,26;t=3.77,3.57;and P<0.005, respectively)were significantly increased, while between the left Nacc and left dorsal medial/lateral prefrontal cortex and bilateral dorsal anterior cingulate(voxel number=98;t=-4.14;and P<0.005)were significantly decreased in the HA group. There was no corrlation between the abnormal FC and the duration/doses of heroin consumption in HA group(P>0.05). Conclusion The abnormal interaction between Nacc and the regions involved in cognitive control and visual spatial attention may contribute to the heroin addiction.

OBJECTIVE: To evaluate the role of transforming growth factor-β1 (TGF-β1) and connective tissue growth factor (CTGF) in the pathogenesis of pulmonary artery hypertension, we observed the dynamic expression of TGF-β1 and CTGF in rats with high blood flow. METHODS: Fifty adult male SD rats were randomly divided into 5 groups: a sham group (group S) and groups with right pneumonectomy for 1, 2, 4 and 6 weeks (PE1, PE2, PE4 and PE6 group), 10 rats per group. The mean pulmonary arterial pressure (mPAP), vessel morphometry and right ventricle hypertrophy index (RVHI) were measured. TGF-β1 and CTGF protein expression in the lung tissues were determined with immunohistochemistry and Western blot. The expression of TGF-β1 mRNA and CTGF mRNA in the lung tissues was evaluated by RT-PCR. RESULTS: Compared with group S, the mPAP and RVHI in the rats were significantly increased in group PE1, PE2, PE4, and PE6 (P<0.05); the indicators of vascular remodeling [(MA+PMA)%, RMT, and RMA] were markedly elevated in group PE4 and PE6 (P<0.05), but not in group PE1 and PE2. Immunohistochemical staining of TGF-β1 and CTGF were more prominent in all of the right pneumonectomy groups than in the sham group. Western blot showed that the level of TGF-β1 protein was significantly increased in all of the right pneumonectomy groups (P<0.01), and the peak was observed in group PE2, whereas the level of CTGF protein was markedly elevated in group PE4 and PE6 (P<0.05), but no change was noticed in group PE1 and PE2. Compare to group S, the mRNA level of TGF-β1 was dramatically increased in all right pneumonectomy groups (P<0.01), peaked at group PE2, and remained high in group PE4 and PE6. In contrast, the elevation of mRNA level of CTGF was not significant in group PE1, but group PE2, PE4 and PE6 demonstrated significant mRNA level of CTGF (P<0.01). Correlation analysis showed that the protein and mRNA levels of CTGF were positively correlated with RMT and RMA ( r=0.743, r=0.906; P<0.05), while no correlation between the protein and mRNA level of TGF-β1 with RMT or RMA. There was no correlation between the mRNA level of TGF-β1 and CTGF. CONCLUSION TGF-β1 and CTGF play a role in the pathogenesis of increased pulmonary blood flow-induced pulmonary hypertension.
Animals ; Connective Tissue Growth Factor ; metabolism ; Hypertension, Pulmonary ; metabolism ; Lung ; metabolism ; Male ; Pulmonary Artery ; RNA, Messenger ; Rats ; Rats, Sprague-Dawley ; Transforming Growth Factor beta1 ; metabolism