Background The objective of this study was to assess the clinical safety and efficacy of vena cava filter (VCF) placement,with particular emphasis on the incidence and risk factors of inferior vena cava thrombosis (VCT) after VCF placement.Methods Clinical data of patients with venous thromboembolism (VTE),with or without placement of VCF,were analyzed in a retrospective single-center audit of medical records from January 2005 to June 2009.The collected data included demographics,procedural details,filter type,indications,and complications.Results A total of 168 cases of VTE (82 with VCF; 86 without VCF) were examined.Over a median follow-up of 24.2months,VCT occurred in 18 of 82 patients with VCFs (11 males,7 females,mean age 55.4 years).In 86 patients without VCFs,VCT occurred in only 6 individuals (4 males,2 females) during the study period.VCT was observed more frequently in patients fitted with VCFs than in those without VCFs (22% vs.7.0%).Conclusions The incidence of VCT in patients with VTE after VCF implantation was 22% approximately.Anticoagulation therapy should be continued for all patients with VCF placement,unless there is a specific contraindication.Almost all instances of VCT in patients with VCF implants in our study occurred after stopping anticoagulation treetment.The use of VCFs is increasing,and more trials are needed to confirm their benefit and accurately assess their safety.

Objective: To investigate the effect of electroacupuncture (EA) on rat with diet induced obesity (DIO) and to explore the possible neurochemical mechanisms using the technique of immumohistochemisty. Methods:To establish DIO rat model by feeding the animals with high fat diet for 14 weeks. DIO rats were randomly divided into 4 groups: (1) 2Hz EA group, (2) 100Hz EA group, (3) restrain control group,(4) diet resistance (DR) group,(5) DIO group and (6) normal control group. EA treatment: (1) The acupoints used were Zusanli and Sanyinjiao on both legs. (2) The intensities of stimulation were 0.5, 1.0 and 1.5mA for 10 mins each. EA treatment was administered 3 times per week. Food intake and body weight were measured daily for 4 weeks. (3) The changes of the expression of ? melanocyte stimulating hormone (? MSH) in the hypothalamic arcuate nucleus (ARC) were measured with immunohistochemical semiquantitative analysis. Results: (1) The food intake and body weight of 2 Hz EA group and 100 Hz EA group were decreased significantly compared with the restrain control group and DIO group. (2) The number of ? MSH positive cells in hypothalamic ARC in 2 Hz EA and 100 Hz EA group was significantly higher than that in restrain control group and DIO group. The number of ? MSH positive cells in hypothalamic ARC in DIO group is significantly lower than those in DR group or normal control group. Conclusion: A decrease of ? MSH level in hypothalamus may be associated with diet induced obesity. The therapeutic effect on obesity produced by EA may be accounted for by the stimulation of pro opio melanocortin neurons in hypothalamic ARC to release ? MSH, which inhibits food intake , resulting in a decrease of body weight.

Objective To investigate the change of plasma ghrelin level and explore the related factors of ghrelin alteration in elderly hypertensive patients with psychological distress. Methods A total of 300 elders, who were screened with Hamilton Anxiety Scale (HAMA), Hamilton Rating Scale for Depression (HAMD), and the Symptom Checklist-90 (SCL-90) for psychological stress and somato-psychological manifestations respectively, were divided into hypertension group (n=148) and non-hypertension group (n=152). Their blood samples were collected to measure the plasma level of ghrelin and total cortisol on the same day. Results The incidences of anxiety and depression were 27.7% and 11.7%, respectively, in all the enrolled elders. However, the rates of psychological distress, particularly anxiety, were significantly higher in the hypertensive elders than in the non-hypertensive ones (43.2% vs. 12.5%). Anxiety was positively related to the cortisol level but negatively related to the plasma ghrelin level, and the latter two were negatively correlated with each other. Conclusion Chronic increase of plasma cortisol induced by long-term anxiety can lead to the reduction of ghrelin level, which then adversely affects blood pressure in elders with psychological distress. Therefore, ghrelin might be a selective antihypertensive medicine for hypertensive elders with anxiety.

Objective To evaluate the safety and effectiveness of endoscopic mucosal resection with circumferential incision(EMR-CI)and endoscopic submucosal dissection(ESD)for the rectal neuroendocrine neoplasm(RNEN).Methods Databases such as PubMed,the Cochrane Library,Embase,Web of Science,SinoMed,China National Knowledge Infrastructure(CNKI),Wanfang Data and Weipu database were searched by computer.The retrieval time limit was Nov.22,2022.The Chinese and English literatures on the efficacy of EMR-CI vs ESD in treatment of RNEN patients were collected.According to inclusion and exclusion criteria,the included literatures were screened,extracted data,and evaluated the methodological quality by Newcastle-Ottawa scale(NOS),Meta-analysis was performed using Rev Man 5.3 software.Results Seven clinical control studies were included,including 199 cases in the EMR-CI group and 443 cases in the ESD group.Results of Meta-analysis of validity outcome indicators,there was no significant difference in histological complete resection rate between the EMR-CI group and the ESD group(O(R) = 0.56,95%CI:0.30～1.02,P = 0.060);The endosopic complete resection rate of EMR-CI was similar to that of ESD with no significant difference(O(R) = 0.33,95%CI:0.09～1.17,P = 0.090);The size of lesions removed by EMR-CI was smaller than that of ESD with significant difference(WMD =-0.86,95%CI:-1.33～-0.40,P = 0.000);The time EMR-CI required to remove the lesion was significantly shorter than that of ESD(WMD =-12.48,95%CI:-16.42～-8.54,P = 0.000).The positive rate of horizontal resection margin of EMR-CI was similar to that of ESD,with no significant difference(O(R) = 1.74,95%CI:0.64～4.75,P = 0.280);The positive rate of vertical resection margin was significantly higher than that of ESD(O(R) = 2.41,95%CI:1.09～5.32,P = 0.030).Due to the low local recurrence rate and distant metastasis rate,Meta-analysis couldn't be compared.Safety outcome index showed that,there were no significant differences in the incidence of total complications,bleeding and perforation among groups.Conclusion In the treatment of RNEN,EMR-CI can achieve the endosopic complete resection,histological complete resection and positive rate of horizontal resection margin similar to ESD without increasing surgical complications and significantly saving surgical time.However,attention should be paid to the differences between EMR-CI and ESD in positive rate of vertical resection margin.