Objective To report experience of endovascular aneurysm repair (EVAR) with Endurant stent-graft for abdominal aortic aneyrysm. Methods Between May,2010 and May,2011,19 patients underwent EVAR with Endurant stent-graft at Department of Vascular Surgery,Peking Union Medical College Hospital. Clinical and morphological characteristics, operative result, peri-operative complications and follow-up data were reported. Results Procedures were successful in all these 19 cases,among those 9 were with complicated anatomical alterations.There were no type Ⅰ,Ⅲ and Ⅳ endoleak found immediately after procedure,while 4 cases were found with type Ⅱ endoleak. Major adverse event during the 30-days after operation included:consumption coagulopathy,myocardial infarction combined with heart failure,wound infection or hematoma.All cases were followed-up from 1 to 12 months. No death occurred.Eight cases had at least one CT angiography.Five cases showed aneurysm shrink,the remaining 3 cases showed aneurysm diameter did not change.One case suffered from occlusion of unilateral iliac limb artery obliteration,and was treated by fem-fem graft bypass.One case had secondary type Ⅰ B endoleak,without increase of aneurysm diameter. Conclusions EVAR with Endurant stent-graft is safe and effective.Some complicated anatomic cases could be treated successfully with Endurant stent-graft.

This study aimed at investigating the utilization of TCM services and exploring the influencing factors,such as education,economic condition,health condition,attitude to TCM treatment and TCM health literacy,of TCM treatment-seeking behavior in the elders in Zhejiang Province.In this study,a cross-sectional study with stratified sampling was adopted for the further investigation of the elders over 55 years by questionnaire.The questionnaire contained four aspects:1.demographic information:gender,age,education,pension mode,medicare and self-evaluation of economic level;2.health status:self-evaluation of health and current diseases;3.attitude to TCM treatment:Would you accept the TCM health services? 4.health literacy:self-made KAB questionnaire including health knowledge,attitude and behavior.Nine hundred and fifty questionnaires were issued and 945 valid questionnaires were returned.Among them,four hundred and eighty-four cases were male and 461 were female.The average age was 72.0 ± 8.9 years with a low level of education,mainly junior high school or lower (88.3％).Over the past year,only 50.11％ elders sought for TCM treatment.Generally speaking,age,gender,education,pension mode and health behavior showed no significant association with TCM treatment.The elders seeking for TCM treatment over the past year held favorable attitude to TCM treatment and high economic status,yet,with poor health status,high prevalence and health literacy (or health attitudes).It was concluded that the utilization rate of TCM services in the elders in Zhejiang Province was not optimist,probably resulting from the lack of publicity and market competitiveness of TCM.Therefore,TCM services should be promoted to meet the health needs of the elders and enhance the utilization rate of TCM services for the achievement of a significant role in the aging society in China.

Objective:To observe the effect of electroacupuncture (EA) and herbal cake-partitioned moxibustion on anxiety and depression in patients with Crohn’s disease (CD) in remission. Methods:Sixty CD cases were randomly allocated into an EA group (n=30) and an herbal cake-partitioned moxibustion group (n=30) using the random number table by the ratio of 1:1. In addition, 30 healthy subjects were included in a control group. Bilateral Tianshu (ST 25), Qihai (CV 6) and Zhongwan (CV 12) were used in the EA and herbal cake- partitioned moxibustion groups. The treatment was done 3 times a week, for a total of 12 weeks. The efficacy was evaluated using self-rating anxiety scale (SAS), self-rating depression scale (SDS) and traditional Chinese medicine (TCM) symptom scores. Results:Before treatment, the SAS and SDS scores in CD patients were remarkably higher than those in healthy subjects. After EA or herbal cake-partitioned moxibustion treatment, the SAS and SDS scores were significantly decreased in both groups, showing significant intra-group differences (P<0.05); the symptom scores of abdominal pain (severity, frequency and duration), bowel sounds/flatus and general fatigue were significantly decreased, showing significant intra-group differences (P<0.05); however, there were no between-group statistical differences (P>0.05). Conclusion:Both EA and herbal cake-partitioned moxibustion can significantly decrease abnormally high SAS and SDS scores in CD patients as well as TCM symptom scores. The two therapies share similar effects in alleviating common symptoms and improving anxiety and depression.

AIM: To establish a method for determination of volatile components(? pinene、? pinene、camphor、menthol、isoborneol、borneol、cinnamaldehyde、paeonol and laurocapram)in Liangmiao Honghua Ointment (Radix Zanthoxyli, Flos Carthami, Radix Notoginseng, paeonol, etc.). METHODS: Nine volatile components were isolated and determined on ZB WAX capillary column(30 m?0.25 mm?0.25 ?m) by GC. The column temperature was raised by program, 50 ℃(3 min)→30 ℃?min -1 →120 ℃(5 min)→10 ℃?min -1 →150 ℃ (1 min)→60 ℃?min -1 →230 ℃(12 min). Split stream sampling was applied,split ratio was 20∶1; injection port temperature was 210 ℃; detector: FID, temperature at 250 ℃. RESULTS: The nine volatile components were isolated well. The linearities were fine with the recoveries of 97%-100%, respectively. CONCLUSION: The method is convenient,rapid and accurate.It can be used to control the quality of Liangmian Honghua Ointment.

Local focal adhesion kinase (FAK) is a non-receptor intracellular tyrosine kinase that plays an important role in tumor initiation, development, metastasis and invasion, and is considered to be an important target for the development of antineoplastic drugs. It has both kinase-dependent and non-kinase-dependent scaffolding functions. However, traditional small molecular inhibitors can only inhibit its kinase-dependent activity, so it is difficult to target the kinase-independent scaffolding function. Therefore, there is an urgent need for novel strategies to enhance FAK targeting to lay the foundation for determining the druggability and discovery of FAK inhibitors. Proteolysis targeting chimera (PROTAC) is a new drug development strategy that can recruit E3 ligase to specifically ubiquitinylate target proteins for degradation through the proteasome system. The unique mechanism of action of the PROTAC system could be used to target and degrade the FAK protein, thus eliminating the scaffolding function of FAK. In this review, FAK protein, the signaling pathway, and small molecule inhibitors are briefly described, and the latest research progress in targeting the degradation of FAK using PROTAC technology is summarized.

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.

Objective To compare the therapeutic efficacies of fire-needle acupuncture and Halometasone cream in treating sub-acute and chronic eczema. Method Totally 114 patients were divided into a treatment group and a control group. The treatment group was intervened by using fire-needle acupuncture, and the control group was by Halometasone cream. Itchy score and Eczema Area and Severity Index (EASI) were used for comparison before and after intervention. Result There were significant differences in comparing the markedly-effective rate and total effective rate between the fire-needle acupuncture group and the Halometasone control group according to the itchy score (P＜0.01). There were no significant differences in comparing the markedly-effective rate and total effective rate between the two groups according to EASI (P>0.05). Conclusion Fire-needle acupuncture is superior to Halometasone cream for acute and chronic eczema in relieving itch, action time and effect-sustaining duration.

Objective To investigate the imaging manifestations of lung neoplasms in pre- and post- treatment with CT-guided Argon-Helium cryoablation.Methods All the lung neoplasms in 96 patients have been treated with CT-guided percutaneous Argon-Helium targeted cryoablation.All patients have pre- and post-treatment CT scanning in measurement of lesion size and CT value.The CT scanning has been rerpeated afterl,3,6,12 months of treatment.Results Among total 96 cases,there are 82 cases of lung cancer and 14 cases of metastasis with 110 lesions(89 cases with single lesion,7 cases with multiple lesions).The Ar-He cryoablation has been given 103 times in total.The size of each lesion ranged from 1.2 cm to 15.0 cm in diameter with mean value of(4.0?2.5)cm,including 12 lesions less than 2 cm,51 lesions between 2— 4 cm,24 lesions between 4—6 cm,23 lesions over 6 cm.There are 25 patients whose lesions covered by iceball with 1 cm of overloaping it's margin.There are 63 lesions with diameter less than 4 cm gained 100% ablation rate,24 lesions with 4—6 cm diameter gained 95.8% ablation rate,and 23 lesions with over 6 cm diameter gained 69.6% ablation rate.The post-treatment CT show a progressively enlarged round,low density refrigerant area which clearly demarked with non- refrigerant area.The center of each refrigerant area has negative CT value,the mean decreased CT value of lesion instantly after the treatment are about 30— 50 HU with P

A 39-year-old man presented with recurrent lower back and leg pain for 8 months due to repeated hemorrhage into an L5 ligamentum flavum cyst. Lumbar MR imaging showed an extradural cystic mass originating from the ligamentum flavum on the right side in the L5 segment. Microsurgical laminotomy and flavectomy were performed. The symptoms resolved completely and the patient had an uneventful postoperative recovery.
Adult ; Cysts ; diagnosis ; surgery ; Humans ; Ligamentum Flavum ; pathology ; surgery ; Male

Objective To evaluate the efficacy and safety of perioperative anticoagulation and antiplatelet therapy of carotid endoarterectomy (CEA). Methods A retrospective study on 110 cases (122 CEAs) of carotid stenosis between Jan 2004 and Dec 2008 was undertaken. 122 cases were divided into anticoagulation group and antiplatelet group according to the perioperative medical treatment. Postoperative results of stroke/death and wound hemotoma were compared between the two groups and statistically analyzed. Results 45 CEAs were given perioperative combination of anticoagulation and antiplatelet treatment. This comprised the anticoagulation group. The antiplatelet group consisted of the other 77 CEAs which were treated with antiplatelet solely. Perioperative stroke/death rates were equivalent (2.2% anticoagulation vs. 2.6% antiplatelet, P =0.897). Wound hemotoma rates were found with statistical significant difference between the two groups (13.3% anticoagulation group vs. 1.3% antiplatelet group, P = 0. 006 ). Conclusion Our results suggest that perioperative antiplatelet therapy in perioperative carotid endoarterectomy does not increase perioperative stroke/death risk, while perioperative anticoagulation increases the risk of wound hematoma.