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 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 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 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 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 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.

AIM: To investigate the expression of adhes i on molecules in human hepatocellular carcinoma (HCC), and analyze the correlatio n between the expression of adhesion molecules and chemosensitivity. METHODS: The surgical and needle specimens from 64 patients were tested by the ATP-TCA. The expression of adhesion molecules and multi-drug resi stance genes (MDR) of tumor tis sues of 64 cases and adjacent tissues of 12 cases of HCC were detected with RT-P CR. RESULTS: The expression level of E-cadherin, ICAM-1, CD 44, CD 44V, ? 5, ? 1 in liver cancer tissues was 1.24?0.54, 0.96?0.3 7, 0.62?0 .73, 0.86?0.33, 0.97?0.49, 1.41?0.24, respectively. There was a signif icant difference between CD 44 and E-cadherin, ? 1. The expression levels of MD R 1, MRP, GST-?, LRP, TOPO II mRNA in liver cancer tissues were 1.17?0.47, 1 .59?0.33, 1.18?0.48, 1.03?0.48, 1.00?0.31, respectively. The express ion level of adhesion molecule mRNA had positive Spearman correlation with the expression level of MDR mRNA. ICAM-1, ? 5 had positive Spearman correlation w ith MDR 1. E-cadherin and CD 44 had negative Spearman correlation with MDR 1. E-cadherin had negative Spearman correlation with MRP. ICAM-1 had positive Spearman correlation with LRP. E-cadherin and CD 44 had negative Spearman c orrelation with LRP. CONCLUSION: The expression levels of adhesion molecule mRNA ha ve correlation with the effect of chemotherapy and the expression of MDR genes .

Objective To analyze the cost of capsule endoscopy in diagnosing small bowel bleeding and to compare it with traditional diagnostic methods.Methods The patients suspected with small bowel bleeding were divided into group A(n=58,collected during 1998 to 2005)diagnosed with traditional processes and group B (n=93,collected during 2002 to January 2005)diagnosed with capsule endoscopy.The diagnostic yield,specific treatments,examination costs and other accumulated costs of two groups was compared.The examination cost ratio and the integration cost ratio were evaluated.The sensitivity analysis was performed.Results The diagnostic yield of small bowel bleeding in group A and group B were 22.4%(13/58) and 86%(80/93),respectively.The total of examination costs were 133 750 RMB and 790 500 RMB,respectively.The examination costs in group B(RMB 9881.3/each) was slightly lower than group A(RMB 10 288.5/each).Furthermore,as the diagnostic yield of group B was significantly higher than group A(P=0.001).The specific treatments based on the results of the diagnosis was 37.4% higher in group B(49.5%) than group A(12.1%).That means the cost of repeat- ed consultations,emergencies room visit,examinations,supporting treatments and hospitalizations in group B were significantly decreased.After the adjustment,the cost in group B(RMB 9881/patient) was lower than group A(16 361.5 RMB in one month—97 424.0 over 5 years/patient).The total cost of each patient in group A was 6480.2—87 542.7 RMB more than group B,which represented 1.7—9.9 folds increase.Conclusions The patients who suspected with small bowel bleeding and had a negative results of gastroscopy and colonoscopy were recommended to have capsule endoscopy which yields early diagnosis and less cost.

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.