Peripheral neuritis is one of the main common diabetes complications. Long-term development of the disease can cause gradual decreasing of nerve function or even muscle atrophy and movement difficulty. The Mongolian medicineErdun-wurile is a commonly used as a tendon-relaxing and collateral-activating medication in the clinical practice. It had good therapeutic effects in the treatment of nervous system diseases. In recent years, it has also been used in the treatment of diabetes complications. This paper provided an overview on clinical reports about Mongolian medicineErdun-wurile in the treatment of diabetic peripheral neuritis.

AIM: The gel vehicle was optimized by release and transdermal resorption of integerrimine in vitro in order to design its anti-cancer transdermal drug delivery system. METHODS: The releasing rate was detected by dissolution Vilia-Chien diffusion cells, nude mouse skin were used as permeation barrier, the concentration of integerrimine in samples was measured by RP-HPLC. RESULTS: Integerrimine releases of three different vehicles conformed to Higuchi equation, the releasing rate of CMC-Na gel is faster than that of HPMC gel, and that of Carbopol gel is the slowest in three, and corresponded with zero kinetic equation. CONCLUSION: HPMC is an drug vehicle of choice.

AIM: The powder characteristic, water and ethanol extraction amount, extraction amount of active ingredient ferulic acid were comparatively studied between crude powder and micronized powder to explore the application of micronization technology to Angelica Sinennsis. METHODS: Angelica Sinennsis powder was characterized by laser diffraction analyzer and scanning electron microscopy, the angle of repose and bulk density were measured, the water and ethanol extraction were quantified by cooled and heated extraction, the active ingredient ferulic acid was detected by RP HPLC after it released from Angelica Sinennsis. RESULTS: The differences of particle characteristic and surface morphology between the crude and superfine powder were significant, however, water and enthanol extraction amount were not increased markedlky, the dissolution amount of ferulic acid was almost the same. CONCLUSION: Pharmaceutical characteristic of Angelica Sinennsis powder is affected by micronization, but its bioavailability is not improved. Micronization technology is not suitable to Angelica Sinennsis.

Objective To investigate the expression of type Ⅲ collagen in abdominal aortic aneurysm tissues and normal aortic tissues. Methods RT PCR and immunohistochemistry were applied to detect the expression of type Ⅲ collagen in abdominal aortic aneurysm (AAA) tissues( n =5) and normal aortic (NA) tissues( n =3) . Results Expression of type Ⅲ collagen was increased in AAA group compared with normal group with AAA/NA= 7 251( P

Objective To compare the clinical efficacy of Rivaroxaban and Warfarin in the treatment of lower extremity deep vein thrombosis.Methods From January to December 2015,51 patients of deep vein thrombosis of the lower limb divided into.Warfarin group (21 cases) and Rivaroxaban group (30 cases).The time of each therapy lasted for 3 months or longer.The characteristics and the change of lower limb venous patency rate in two groups of patients were analyzed to evaluate the curative effect.Results Rivaroxaban group had shorter therapy time than Warfarin group.The lower limb venous patency rate in Rivaroxaban group were higher than that in Warfarin group (85.7％ vs.60％,P ＜0.05).Ultrasonography showed partial patency in 5 mixed thrombus patients of Warfarin group,while complete patency in 2 and partial patency in 3 of Rivaroxaban group.Normalized rate in peripheral venous thrombosis patients of Rivaroxaban group were higher than Warfarin group (84％ vs.25 ％ P ＜ 0.001).Conclusions Rivaraxaban is superior to Warfarin in the complete recanalization of DVT,while safe and reliable.

Objective To study the treatment of a or toiliac occlusive disease and prevention and management of early complications. Methods From Mar 1998 to Mar 2005, 83 aortoiliac arterial occlusion patients were treated with embolectom y by Forgaty catheter as the main therapy for acute occlusion. In cases of chron ic occlusion percutaneous transluminal angioplasty and stenting, prosthesis graf t bypass surgery as well as proximal endovascular procedure combining with dista l arterial reconstructions were adopted on case to case basis. Results There was acute aortoiliac occlus ion in 14 cases, 6 cases (42.9%) suffered from early complications after embole ctomy, with mortality of 7.1%. In chronic aortoiliac occlusion of 69 cases,va rious complications developed in 16 cases(23.2%),of which aortoiliac arteri al stent placement in 17 cases with complications of 23.5%;prosthesis bypass in 23 cases, with complications of 30.4%, and mortality of 4.3%;aortoili ac stenting combining with femoral-popliteal bypass in 29 cases(58 legs)with complications in 5 cases(17.2%). Conclusion The expansion and development of minimally invasive tech niques along with minimal invasive surgery may reduce surgical risks,decrease m obidity and mortality rate.

Objective To evaluate the extra-anatomic bypass surgery for aorto-iliac occlusive disease in the elderly. Methods From January 2005 to December 2008,33 elderly patients/39 limbs (age ranged from 70 to 87 years, mean 76.0 ± 3.0 years) with aortoiliac occlusive disease were retrospectively analyzed. According to Fontaine classification, there were 5 phase Ⅱ b cases (7 limbs), 22 phase Ⅲ cases (26 limbs), and 6 phase Ⅳ cases (6 limbs), all cases were with TASC C, D lesions. Results These 33 cases/39 limbs were tr eated with a variety of bypass, including axillobifemoral bypass (6 cases/12 limbs) ,axillofemoral bypass ( 20 cases/20 limbs ), femorofemoral bypass ( 7 cases/7 limbs ). Intermittent claudication improved in 5 cases, rest pain disappeared in 22 cases, and ulcers healed in 6 cases after operations. The mean ABI increased from 0.29 ± 0.11 to 0.66 ± 0.13 ( t = 2.69, P ＜ 0.05 ). All limbs were salvaged and there was no perioperative mortality within 30 days after operations. Postoperative complication rate was 9.1%. Patients were followed up for a median of 12 ±5 months (range, 6 to 28 months), primary patency rate was 89.7% (35/39), secondary patency rate was 94.9% (37/39), limb salvage rate was 92.3% (36/39). After dischargement the mortality was 6.1% (2/33) with one dying of myocardial infarction and another one of malignant tumor (gastric cancer). Conclusions Extra-anatomic bypass for aorto-iliac occlusive disease in the elderly is feasible, safe and effective, and the cardiopulmonary dysfunctions are the major risk factors for perioperative complications.

Objective To discuss the strategies of prevention and treatment for complications of endovascular therapy in aortoiliac artery occlusive disease.Methods 220 cases who received endovascular interventions with aortoiliac artery occlusive disease were retrospectively reviewed from June 2012 to June 2014.Among these patients,189 cases were males.The age was between 46 to 85yrs and the average age was 64yrs.Results The overall technique success rate was 97.2％.Nine procedure-related major complications requiring additional endovascular or surgical treatment were encountered in 7 patients including 2 acute in-stent thrombosis,1 iliac artery rupture,1 distal embolism,and 5 puncture associated complications (2 acute artery thrombosis,1 arteriovenous fistula,1 hematoma,1 artery dissection).8 cases improved after second endovascular or remedial open surgery,among those 4 cases were managed by endovascular interventions including 2 catheter directed thrombolysis,1 cover-stent implantation and 1 balloon-based angioplasty,4 patients received open surgery including 3 thrombectomies,1 hematoma cleating.After 22 months follow-up,the primary patency,assistant-primary patency and secondary patency was respectively 90.8％,92.1％ and 99.2％.Conclusions More attentions should be paid to the complications of endovascular therapy in aortoiliac artery occlusive disease.Helpful to prevent these complications are a comprehensive evaluation of the lesions,and individualized surgical plan prior to the operations,and a careful intraoperative management.

Objective To evaluate the result of revascularization for lower limb artery ischemia in elder patients. Method During Jan 2006 to Nov 2008, 262 elder patients (60 years old and up), underwent artery revascularization for lower limb arterial ischemia. Mortality, morbidity, primary patency, secondary patency and limb salvage were analyzed. Result There were a total of 323 ischemia limbs in those 262 elder patients undergoing revascalarization, among those 102 limbs underwent artery bypass, 98 limbs underwent endoluminal angioplasty with or without stenting, 67 limbs underwent embolectomy or endarterectomy, 56 limbs underwent open surgery combined with endoluminal treatment due to multiple segment lesions. Operation success rate was 94.7%. Two patients died within 30 days. Perioperative morbidity developed in 15 cases. 245 patients (93.5%) were followed-up from 1 month to 35 months. Mortality was 6.1% (15 cases), primary patency was 80.5%, secondary patency was 92.7% and limb salvage rate was 95.2%. Risk factors analysis showed that history of cardiac disease and elder ages were associated with higher mortality. Diabetes mellitus, critical ischemia and multiple segment lesions were associated with poor long term patency and limb salvage. Conclusion Lower limb ischemia is severe disease related to elder patients' death and amputation. Careful patient selection, detailed pre-operation work-up, meticulous operative technique play crucial roles for a successful arterial reconstruction.

OBJECTIVETo describe a case of Ehlers-Danlos syndrome type IV and its pedigree in China.

METHODSClinical materials of a case of Ehlers-Danlos syndrome type IV and a pedigree of 6 members within 4 generations were analyzed. Dilated internal jugular vein in the proband was removed by operation. The diagnosis, surgical treatment, and postoperative complications were retrospectively reviewed.

RESULTSVessels of the proband in the pedigree were crisp and easily lacinated during the procedure of removing his internal jugular vein. Repeating postoperative hematomas were found though complete stanching was achieved during the operation. The patient was successfully recovered by promptly debridgement and needle sucking. The other 5 members of the pedigree all had the triads of Ehlers-Danlos syndrome.

CONCLUSIONSThough it was of extremely low morbidity rate, the high mortality rate and complication of Ehlers-Danlos syndrome deserve great attention during surgical management, especially in patients with Ehlers-Danlos syndrome type IV. Surgeons should be aware of the ponderance of its complications and combined diseases to avoid fatal intraoperative vascular lascination and incontrollable hemorrhage.

China ; Ehlers-Danlos Syndrome ; genetics ; surgery ; Humans ; Jugular Veins ; surgery ; Male ; Middle Aged ; Pedigree