Objective To introduce a new septorhinoplastic method for twisted nose, humped nose and hawk nose as well as deviation of nasal septum, and to evaluate its operative method and effect. Methods The incision of cleft between lateral nasal cartilage and greater alar cartilage was employed in all patients. The method of unilateral mucoperiosteal flap osteotomy was used to correct nasal pyramid deformity, and swinging-door operation was performed to correct the deviation of nasal septum simultaneously. Results The operative results of 36 cases were effective and satisfactory. Postoperative follow-up ranged from one year to fifteen years. Based on the results of follow-up in the 32 cases, no recurrence and complications were found in all the cases. Conclusion This new method for septorhinoplasty avoids the detachment and move of nasal bone and nasal septum cartilage and injury of nasal mucoperiosteum, and maintains the blood supply of nasal bone and nasal septum cartilage. It corrects extero-nasal deformity as well as deviation of nasal septum. The operation is effective in nose aesthetic and ventilatory function.

ObjectiveTo study the treament of arterial occlusion of lower extrimities. MethodsSeventy-three cases(78 limbs) of chronic ischemia o f lower extremities were diagnosed as artroial occlusion by color u ltrasounography, DSA or MRA. Arterial bypass using grafting,endarterectomy and percuteneous transluminal angioplasty (PTA) were used for the artery segmental occlusion in 44 limbs. Venous arterialization and reconstruc tion of profunda femoris were performed for extensive occlusion in 29 limbs. ResultsAll the cases showed satisfactory r esults 6 months to 8 years after operation except 8 limbs (segmenta l occlusion in 3 limbs and extensive occlusion in 5 limbs) were amputated. ConclusionsThe key points of improvement of the therapeu tic effects of the arteral occlusion of lowe extremity lie on the cho ice of the therapeutic methods accoding to the results of DSA or MRA.

Objective To explore the mediating effects of rumination and its subtypes on the relationship between negative life events and depressive symptoms in treatment-naive depressed patients.Methods Sixty-two treatment-naive depressed patients completed the center for epidemiologic studies depression scale (CESD),rumination response scale (RRS),and life event scale (LES).Results ① The scores of CESD were positively correlated with total score of RRS,brooding score of RRS,and negative LES score (NLES) in depressed patients (r=0.66,P＜ 0.01;r =0.50,P＜ 0.01;r =0.51,P＜ 0.01).The total score of RRS and brooding score of RRS were positively correlated with NLES(r=0.45,P＜0.01;r=0.47,P＜0.01).② The total score of RRS played a mediating role between NLES and CESD (indirect effect=0.12,95％ CI =0.04 ～ 0.23).③The brooding of RRS played a mediating role between NLES and CESD (indirect effect =0.07,95％ CI=0.02～0.15).Conclusion The RRS and the brooding of RRS exert mediation effects on the relationship between NLES and CESD in patients with depression.

Objective To investigate the management of acute limb ischemia.Methods The clinical data of 28 patients with acute limb ischemia were retrospectively analyzed.Four patients with arterial embolism underwent embolectomy.one patient with pseudoaneurysm underwent false aneurysm resection and revascularization with PTFE,23 patieuts wiht arterial occlusive disease were treated by multiple means such as embolectomy,bypass,primary amputation,endovascular interventions,and pharmacologic therapy(n=23).Results The 5 patients with arterial embolism or pseudoaneurysm were all treated successfully.In the 23 patients with arterial occlusive disease,5(21.7%) were treated successfully,12(52.2%) were improved,and 6(26.1%) had ineffective treatment.No inpatient died,but 4 patients underwent amputation.During follow-up of 6-45 months,there were 4 deaths and other 5 amputations.Conclusions Proper intervention of patients with acute limb ischemia should be chosen according to clinical evaluation of the illness,and includes embolectomy and revascularization,to get limb or life salvage.

Objective To explore the treatment of thromboangitis obliterans (TAO) of lower extremities.Methods From March 1994 to February 2009,24 cases (26 limbs) affected by chronic ischemia were diagnosed as TAO by Doppler ultrasound and DSA,CTA or MRA.According to the different levels of the extensive and diffuse arterial occlusion,the revascularization was performed in the ways:19 cases (21 limbs) underwent venous arterialization,3 cases (3 limbs) underwent endovascular therapy,and 2 cases (2 limbs) underwent thrombectomy.ResultsAfter the venous arterialization,19 cases (21 limbs) were followed up for 1 to 14.5 years.Apart from the 5 limbs amputation (23.8%),the postoperative results of the most limbs were satisfactory (61.9%).The ABI before therapy (0.38?0.11) was significantly lower than that 6 months after therapy (0.79?0.08),P

Objective To observe and investigate the therapeutic effect of thalidomide on gastrointestinal bleeding of angiodysplasia.Methods Eighteen patients with recurrent gastrointestinal bleeding of angiodysplasia were treated with thalidomide 100 mg daily for 4 months.Median follow-up time was 16.7 months.The changes of clinical setting and serum.vascular endothelial growth factor(VEGF)and tumor necrosis faetor-α(TNF-α)level between pre-therapy and post-therapy were compared.Results The clinical setting of patients in post therapy was significantly better than that in pre-therapy.The overall symptom score,the median bleeding frequency and median transfusion volume of patients after therapy was significantly lower than those before the therapy[(15.000±3.630)vs(5.330±3.325),(11.220±6.404)vs(1.000±1.237),(1422.22±1556.601)ml vs(100.00±240.098)ml,respectively,all P＜0.01],while median hemoglobin was obviously higher than that before the therapy[(5.950±1.656)g/ml vs(9.533±2.278)g/ml,P＜0.01].Serum VEGF and TNF-α levels decreased obviously after the therapy(118 pg/ml vs 58 pg/ml,116 pg/ml vs 34 pg/ml,P＜0.01).Conclusions Thalidomide can suppress the serum VEGF and TNF-α levels of the patients with recurrent gastrointestinal bleeding of angiodysplasia,then play a significantly role in preventing the rebleeding in patients with recurrent gastrointestinal bleeding of angiodysplasia.

Objective To investigate the mechanism and effect of thalidomide on gastrointestinal bleeding of angiodysplasia. Methods The endothelial cells of human umbilical vein were cultured in vitro to exponential phase of growth, then were divided into blank control, solvent control and different concentrations (10- 100 μg/ml) of thalidomide incubated with or without basic fibroblast growth factor (bFGF). The cell proliferation was measured by MTT assay 72 h after stimulation. The expressions of vascular endothelial growth factor (VEGF) and tumor necrosis factor-α (TNF-α) were detected by ELISA and real-time PCR, respectively. Results The proliferation of endothelial cells of human umbilical vein was inhibited by thalidomide (≥40 μg/ml) both in presence or absence of bFGF. The expression of VEGF could be inhibited by 20 μg/ml of thalidomide in the absence of bFGF and 10 μg/ml in the presence of hFGF. No expression of TNF-α was detected. Conclusions The in vitro study reveals that thalidomide can inhibit the proliferation and the expression of VEGF, which may treat gastrointestinal bleeding of angiodysplasia by suppressing the angiogenesis.

Objective To evaluate pigtail catheter mashing thrombosis combined with catheter directed thrombolysis in the treatment of acute iliofemoral venous thrombosis complicated by Cockett syndrome in the left lower limbs.Method Data of 137 cases of acute iliofemoral venous thrombosis complicated with Cockett syndrome in left lower limb by interventional therapy from January 2007 to October 2012 were analyzed retrospectively.Inferior vena cava filters were placed in all of the patients.Patients were divided into two groups:Group A (n =81) treated with catheter directed thrombolysis only,Group B (n =56) treated with pigtail catheter mashing thrombosis combined with catheter directed thrombolysis.After operation,patients were treated by anticoagulation with urokinase and heparin calcium,and then warfarin for 6 to 1 2 months.Results The thrombolysis time in group B was significantly shorter than that in group A (P ＜0.01),the dosage of urokinase was significantly less than that in group A(P ＜ 0.01).The venous patency score in group B after therapy was significantly better than in group A (P ＜ 0.01).121 patients were followed up for 10-60 months.There were no pulmonary embolism.Conclusions Pigtail catheter mashing thrombosis combined with catheter directed thrombolysis in the treatment of acute iliofemoral venous thrombosis complicated with Cockett syndrome in left lower limb can improve thrombolytic efficiency,shorten thrombolysis time,reduce the use of urokinase.

Objective To evaluate a thrombolytic system of portal vein port-catheter kit (PC) in the treatment of portal vein thrombosis (PVT). Methods In this study, 42 PVT patients with liver cirrhosis and portal hypertension after splenectomy from 2005 to 2007 were divided into two groups. In group A (20 eases) thrombolysis was administered through the PC device. Urokinase at the dosage of 1000 U?kg-1?h-1 was given for a consecutive 3 -6 days through the PC, and then the therapy was converted to 100 AxaIU/kg of low molecular heparin twice a day for 7 days subcutaneously. In group B, the thrombolysis was performed on 22 patients through peripheral veins. The therapy was same as in group A except for that the urokinase dosage was doubled. The complete thrombolysis rate, the effective thrombolysis rate, the time of thrombolysis, the long-term recurrence rate and the incidence of complication were compared between the two groups. Results The complete thrombolysis rate and the effective thrombolysis rate in group A were 75%, 90% respectively, compared with that of 41%, 59% respectively in group B. The significant differences in the complete thrombolysis rate, the effective thrombolysis rate, the time of thrombolysis and the incidence of complication were found between the two groups, while the thrombolysis recurrence rate had no significant difference between the two groups. Conclusion PC regime is an effective and safe method for the treatment of portal vein thrombosis.

Objective To determine the effect of community family visit on patients with metabolic syndrome.Methods According to the diagnostic criteria set up by the Diabetes Society of the Chinese Medical Association 220 patients with metabolic syndrome were equally divided into two groups:family visit group and control group.The family visit group was followed up by full-time medical staff regularly,while not interfering with the control group.After one year before and after the intervention,the relevant indicators were compared between the two groups.Results The levels of SBP,DBP,TG,TC,LDL-ch,24-hour urine protein were lowered markedly by intervention (P＜0.05).HDL-ch increased compared to the previous (t= 7.921,P＜0.05),but body mass index were not significantly changed.Before and after the intervention the levels of SBP,DBP,TG were ideal This was followed by significant improvement of fasting plasma glucose (FPG),two hours after meal blood glucose (2 hPG),TC,HDL set standards,24-hour urine protein body mass index.Compared with the control group,the family visit group showed siguificant improvement of related indicators except body mass index and TC.Condusion Intervention by family visit is effective in improving the vales of metabolic syndrome.