Objective To explore the feasibility of one-stage operation in periappendicural abscess.Methods The clinical data of 111 patients with periappendicural absecess from 1990 to 2007 were analyzed retrospectively.Results A1l operation were successful.the rate of wound infection was 7.2%(8/111),there was no operative death and no severe complication occurred.Conclusion Timely and appropriate one-stage operation in early periappendicural absecess is safe and feasible.

BACKGROUND:The endothelial dysfunction is the pathogenesis of arteriosclerotic disease, the quantity and function of endothelial progenitor cells are decreased within the cycle, leading to a poor capacity of neovascularizatio, the efficacy of stem celltransplantation alone is unclear, the combination of cytokines and gene-modified stem cells is the hotspot.
OBJECTIVE:To observe the effect of stromal cel-derived factor-1 on the neovascularization after endothelial progenitor cells transplantation.
METHODS:Unilateral hindlimb ischemia model was established in 20 athymic nude mice, and the mice were randomly divided into four groups:combined group (intravenous endothelial progenitor cells+intramuscular stromal cel-derived factor-1), endothelial progenitor cells group (intravenous injection of endothelial progenitor cells), stromal cel-derived factor-1 group (intramuscular injection of stromal cel-derived factor-1), and blank control group (intramuscular M199). The skin temperature of ischemic hindlimbs and survival of animals after transplantation were observed. The ratio of capil ary/skeletal muscle fiber was counted. The expression of CD31 and endothelial nitric oxide synthase were detected.
RESULTS AND CONCLUSION:The fluorescence-labeled endothelial cells were embedded in ischemic hindlimb muscles after celltransplantation. Of the 20 nude mice, two mice died. The rate of ischemic hindlimb reserving was respectively 80%, 75%, 20%and 0 in combined group, endothelial progenitor cells group, stromal cel-derived factor-1 group, and blank control group. The capil ary/muscle fiber ratio in combined group and endothelial progenitor cells group was higher than that of blank control group (P<0.01). The combined group was greater than endothelial progenitor cells group, and endothelial progenitor cells group was greater than stromal cel-derived factor-1 group (P<0.05). The capil ary density in combined group and endothelial progenitor cells group were higher than that in blank control group (P<0.01), and stromal cel-derived factor-1 group was also more than blank control group (P<0.05). The combined group was greater than endothelial progenitor cells group, and endothelial progenitor cells group was greater than stromal cel-derived factor-1 group (P<0.05). The positive rate of endothelial nitric oxide synthase was 73.33%and 53.33%in combined group and endothelial progenitor cells group respectively (P>0.05). Endothelial progenitor cells can migrate to ischemic tissues, endothelial progenitor cells transplantation can promote neovascularization, and stromal cel-derived factor-1 augments the neovascularization after celltransplantation, in which endothelial nitric oxide synthase is involved.

90%).The expression of CXCR4 receptor was 74.8%.The migration cells of control,10,20 and 50 ?g/L were 3.5,7.4,24.9 and 28.0,respectively.The migration activity was significantly higher in SDF-1 group than that of control group(P

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 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 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 evaluate percutaneous transluminal renal angioplasty ( PTRA) and stenting for the treatment of renal artery stenosis (RAS). Method From Feb 2003 through Jun 2005, 19 consecutive RAS patients received interventional therapy including PTRA and/or stents in 12 cases, aortorenal bypass procedures in 4 cases, nephrectomy in 1, and angiography in 2 cases. Among the 12 PTRA and/or stenting cases, stent was deployed in 10 cases, and 2 patients received PTRA only. Results All patients had hypertension preoperatively ( mean blood pressure 172/98 mmHg). Serum creatinine concentration was greater than 1.5 mg/dL in one patient. There was no perioperative mortality nor major complications. Technical success was achieved in 11 patients (91.7%). During follow-up, mean blood pressure was 156/88 mmHg. Hypertension was improved in 8 patients (66. 7% ). Renal function was stable except one patient with renal insufficiency. Restenosis was found in one patient (8.3%). Conclusion PTRA and/or stent is safe, effective for the treatment of RAS in appropriately selected patients.

Objective To investigate the role of network platform for treatment and rescue of acute and severe cerebrovascular diseases in improving treatment level of patients with acute ischemic stroke.Methods The differences of number of patients accepted venous thrombolysis, number of patients accepted emergency intravascular interventional treatment, and time from admission to intravenous thrombolysis (door to needle time [DNT]) were analyzed in patients with acute ischemic stroke admitted to our hospital in the first year (2016) and the second and third years (2017 and 2018) of construction of network platform for treatment and rescue of acute and severe cerebrovascular diseases in Yunfu city. The National Institutes of Health Stroke Scale (NIHSS) scores were compared in 120 patients selected randomly from online referral (study group,n=60) and non-online referral (control group,n=60) within the same time periods in 2018.Results In 2017 and 2018, the number of patients accepted intravenous thrombolysis was 85 and 103, respectively, and the rate of intravenous thrombolysis was 9.92％ and 9.83％; they were all significantly larger/higher than those in 2016 (n=50, 6.97％,P<0.05). In 2017 and 2018, the number of patients accepted emergency endovascular treatment was 56 and 129, respectively, and the emergency endovascular treatment rate was 6.53％ and 12.31％; they were all higher than those in 2016 (n=44 and 6.14％), and the differences between those in 2018 and 2016 were statistically significant (P<0.05). The DNT ([82.00±18.75] min in 2017 and [77.00±32.17] min in 2018) was significantly shorter than that in 2016 ([109.00±30.58] min,P<0.05). The NIHSS scores of the study group and control group were 4.70±3.64 and 8.90±5.62, respectively, after one week of treatment, both of which were lower than those before treatment (14.30±6.29 and 13.60±6.37); and after treatment, the NIHSS scores of the treatment group were statistically lower than those of the control group (P<0.05). Conclusion Construction and effective operation of network platform for treatment and rescue of acute and severe cerebrovascular diseases is an effective guarantee to improve the success rate of treatment for patients with acute ischemic stroke.

Objective:To investigate the efficacy and safety of liposomal amphotericin B (L-AmB) for the salvage treatment of invasive fungal disease (IFD) in patients with hematological diseases.Methods:Data were retrospectively collected from 80 patients with hematological issues treated with L-AmB between June 2023 and December 2023 after failure of previous antifungal therapy. Baseline patient information, clinical efficacy, and factors affecting the efficacy of L-AmB were analyzed by logistic regression. Moreover, adverse effects associated with L-AmB were evaluated.Results:Among the 80 patients, 9 (11.2%) had proven IFD, 43 (53.8%) had probable IFD, and 28 (35.0%) had possible IFD. The efficacy rate of L-AmB salvage therapy for IFD was 77.5%, with a median daily dose of 3 (range: 1-5) mg·kg -1·d -1 and a median dosing course of 14 (range: 8-25) days. Multivariate logistic regression analysis showed that the disease remission status ( OR=4.337, 95% CI 1.167-16.122, P=0.029) and duration of medication ( OR=1.127, 95% CI 1.029-1.234, P=0.010) were independent factors affecting the efficacy of L-AmB. The incidence of infusion reactions associated with L-AmB, including fever and chills, was 5.0%. The incidence of hypokalemia was 28.8% (predominantly grades 1-2), and the incidence of nephrotoxicity was 11.3% (predominantly grades 1-2) . Conclusion:L-AmB is safe and effective in the treatment of patients with IFD who are intolerant to or who have experienced no effect of previous antifungal therapy, with a low rate of adverse reactions.

Objective:To analyze the efficacy and safety of CLAG regimen (cladribine, cytarabine, granulocyte colony-stimulating factor) in treatment of relapsed/refractory acute myeloid leukemia (AML).Methods:The clinical data of 30 patients with relapsed/refractory AML who were admitted to Suzhou Hongci Blood Disease Hospital from January 2018 to February 2021 were retrospectively analyzed, and the efficacy and adverse reactions were observed.Results:Among 30 patients, 1 patient was not evaluated for efficacy due to treatment-related death. Among the 29 evaluable patients, 17 patients (58.6%) achieved complete remission (CR), 5 patients (17.3%) achieved partial remission (PR) and 7 patients (24.1%) had no remission (NR). One patient in low-medium-risk group achieved CR; the CR rate in medium-risk group was higher than that in high-risk group [68.8% (11/16) vs. 41.7% (5/12)], but the difference was not statistically significant ( P = 0.250). Seven patients with M 5 achieved CR. Five patients with positive MLL gene rearrangement achieved CR. Among 6 patients with extramedullary invasion of leukemia cells, 4 patients achieved CR, and among them 3 patients with central nervous system invasion achieved CR. Among 6 patients with cladribine 3.5 mg·m -2·d -1×5 d, 1 patient died of infection after chemotherapy, 1 patient had NR, and the rest achieved CR. Among 24 patients with cladribine 5 mg·m -2·d -1×5 d, the CR rate in patients with cytarabine 2 g·m -2·d -1×5 d was higher than that in patients with cytarabine 1 g·m -2·d -1×5 d [70.0% (7/10) vs. 42.9% (6/14)], but the difference was not statistically significant ( P = 0.240). All patients developed grade Ⅳ myelosuppression after chemotherapy. 12 patients underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT) after CR, and 9 patients were still alive. Conclusions:CLAG regimen is effective and well tolerated in the treatment of relapsed/refractory AML. In order to improve the prognosis, allo-HSCT should be performed as soon as possible after CR.