Stent intervention has become one of the most effective ways in treating cardiac and cerebral vascular stenosis. However, postoperative in-stent restenosis remains a major unsettled issue. The occurrence of in-stent restenosis is related not only to the mismatch between stent and artery, as well as the stress induced by mechanical support of the stent struts on arterial wall, but also to the intimal hyperplasia induced by the hemodynamic change. Recent literatures on biomechanics of the stented artery were reviewed in this paper. In particular, from the view of solid mechanics and hemodynamics, the research progress of stented artery in biomechanical simulation was given detailed discussion; moreover, the biomechanical factors associated with in-stent restenosis were analyzed and summarized. Numerical simulation is a good method for investigating the relationship between stent intervention and in-stent restenosis, and it also provides a scientific guideline for the design of stent structure and clinical procedure of stent intervention.

OBJECTIVETo compare the short-term clinical outcome of non-fusion techniques using interspinous implantation Coflex(TM) and Wallis treatment in patients with lumbar spine degenerative diseases.

METHODSForty-one cases of lumbar stenosis, 18 of lumbar disc herniation, and 34 of lumbar stenosis with lumbar disc herniation were evaluated. Among the 43 cases receiving Coflex(TM) implantation, 41 had operations in one segment and 2 in 2 segments. In the other 50 cases with Wallis implantation, 47 had fixation of 1 segment and 3 had 2 segments fixed. JOA Score, Oswestry Disable Index (ODI) and VAS were used to evaluate the short-term clinical results.

RESULTSThe average operating time was 64.55 min in Coflex(TM) implantation with an average blood loss of 81.82 ml. The average operating time was 82.71 min in Wallis implantation, which caused an average blood loss of 89.66 ml. Significant improvements in the JOA Score, ODI and VAS were noted after the operations.

CONCLUSIONThe two interspinous non-fusion techniques, Coflex and Wallis, produce good short-term clinical outcome in the treatment of lumbar spine degenerative diseases.

Adult ; Aged ; Aged, 80 and over ; Female ; Fracture Fixation ; methods ; Humans ; Intervertebral Disc Displacement ; surgery ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Spinal Stenosis ; surgery ; Young Adult

OBJECTIVETo explore clinical effect of minimally corrective osteotomy for the treatment of hallux valgus with deformity of little toe varus through small incision.

METHODSFrom January 2013 to June 2016, 168 hallux valgus patients with deformity of little toe varus were treated by minimally corrective osteotomy through small incision. Among them, 7 males and 161 females were aged from 22 to 75 years old with an average of(59.3±3.5) years old. Preoperative clinical manifestation mainly focus on red and swollen of bunion, pain around with metatarsal bones, and diagnosed as hallux valgus with deformity of little toe varus through small incision. Operative time, postoperative complications, pre and post-operative IMA(angle between the first and the second metatarsal bones), HVA (hallux valgus angle), LDA(valgus angle of the fifth metatarsal bones), MPA(valgus angle of little toe), IM4-5 (angle between the forth and the fifth metatarsal bones) and PASA(fixed angle of proximal joint), postoperative AOFAS score were used to evaluate foot function.

RESULTSOne hundred and sixty-eight patients were followed up for 6 to 48 months with an average of (28.6±3.2) months. All wounds were healed well without infection, sinus tract and other complications. Operative time ranged from 16 to 28 min with an average of (18.3±2.1) min. IMA, HVA, LDA, MPA and IM A 4-5 were (10.1±2.1)°, (32.6±4.2)°, (6.9±2.3)°, (18.5±5.2)°, (15.1±2.9)°preoperatively, improved to (8.3±2.2)°, (10.9±2.9)°, (2.7±0.4)°, (6.5±1.6)°, (8.9±1.8)° postoperatively, and had significant differences before and after operation. While there was no difference in PASA before (9.1±2.1)°and after operation(8.7±1.9)°. AOFAS score were improved from (31.6±3.9) before operation to(83.7±5.2) after operation, but no significant difference(>0.05). According to AOFAS score, 147 patients obtained excellent results, 13 good, 6 moderate and 2 poor.

CONCLUSIONSMinimally corrective osteotomy for the treatment of hallux valgus with deformity of little toe varus through small incision could obtain satisfied clinical effect, and has advantages of small incision, no stitches, beautiful appearance, shorter operation time, and rapid recovery. It is worth popularization in clinical practise.

Adult ; Aged ; Female ; Hallux Valgus ; surgery ; Humans ; Male ; Metatarsal Bones ; pathology ; Middle Aged ; Minimally Invasive Surgical Procedures ; Osteotomy ; methods ; Postoperative Period ; Radiography ; Toes ; pathology ; Treatment Outcome ; Young Adult

Objective To investigate the hemodynamic effect of stents with different types of links on treating vertebral artery stenosis, and provide scientific guidelines for the design of stent structure and the clinical procedure of stent intervention. Methods Models of vertebral artery with stenosis and three kinds of stents with different types of links (named as L-stent, V-stent and S-stentaccording to the shapes) were constructed by using Pro/Engineering. The expansions of these stents in the stenotic vertebral artery were simulated using ABAQUS, and three finite element models of the stented vertebral artery were then established for fluid flow analysis, and hemodynamic simulation was performed using ANSYS-CFX. Results Compared with V-link and S-link stent, L-link stent had smaller area of low wall shear stress distributions and smaller blood stagnation area. Conclusions With better hemodynamic effect, L-stent can potentially reduce the possibility of in-stent restenosis and provide scientific references for the choice of stent, the design of stent structure and surgical planning of stent intervention.

Objective To investigate the mechanical effect of stents with different links on the treatment of vertebral artery stenosis, and provide scientific guidelines for the design of stent structure and clinical procedure of stenting intervention. Methods Models of three kinds of stents with different types of links (namely, L-stent, V-stent and S-stent according to the shape of links) and vertebral artery with stenosis were established by using Pro/Engineering, then the same boundary conditions were exerted on the three models to simulate the stent deployed in the vertebral artery by finite element analysis using ABAQUS. Results Compared with L-stent and V-stent, S-stent had a better compliance, generating smaller stress in the arterial wall, causing relatively weak vascular straightening. Due to smaller stress and axial shortening generated in the stent strut, S-stent made less lesion on the arterial wall. Conclusions The therapeutic effect of S-stent is the best among the three kinds of stents, which could reduce in-stent-restenosis, and has good prospect in clinical application.

OBJECTIVETo evaluate the safety of domestically produced idarubicin in the treatment of acute leukemia by a multicenter randomized control trial.

METHODSThis trial was carried out in the hemotologica department of five hospitals throughout China, with hospitalized patients who suffered from acute myelogenous leukemia ( AML except M3 type) , acute lymphocytic leukemia ( ALL) , chronic myelogenous leukemia-blast (CML-blast) , totally 155 patients. Those with severely cardial, hepatic or renal disfunction or those who had ever treated with > or = 200 mg/m(2) idarubicin were excluded from the trial. All patients signed the letter of consent as required by the Ethics Committee of our government. In this study, 155 leukemia patients were randomly grouped into: 1. test group treated using domestic idarubicin, 2. control group using imported idarubicin. The acute myelogenous leukemia regimen included idarubicin 8 mg/m(2), dl -3 plus cytosine arabinoside 100 mg/m(2), dl - 7 for 1-2 cycles. The regimen for acute lymphocytic leukemia was idarubicin 8 mg/m2, dl - 3; vincristine 2 mg/mr, dl; cyclophosphamide 750 mg/m2, dl ; plus prednisone 60 mg/m(2),dl - 14 for 1-2 cycles.

RESULTSClinical response rate of the tested group treated with domestic idarubicin and control group treated with imported idarubicin was 78. 1% (50/64) vs. 76.9% (50/65) without any statistically significant difference between the two groups(P >0. 05). Grade Ill - IV hematological toxicity rate of the domestic idarubicin group and imported idarubicin group was 74. 0% vs. 73. 1% , respectively (P = 0. 73). Drug-related death was observed in 3 of 77 patients in the domestic idarubicin group (3.9%) due to cerebral hemorrage or septic infection. The incidence of non-hematological toxicities in domestic idarubicin group and imported idarubicin group was 84. 4% vs. 79. 5% for nausea or vomiting, 70. 1% vs. 71. 8% for infection, 42. 9% vs. 41. 0% for mucositis, 33. 8% vs. 33. 3% for alopecia, 28.6% vs. 28. 2% for serum glutamicoxalacetic transaminase abnormalitis, 16. 9% vs. 10. 3% for cardiac toxicity, all without statistically significant differences between these two groups (P > 0. 05). Discontinuation of treatment due to non-hematological toxicity was not neccessary.

CONCLUSIONDomestic idarubicin is comparable to imported counterpart in efficiency and safety for the treatment of acute leukemia. The most severe side effects of domestic idarubicin is hematological toxicity, which should be closely observed and treated in time, while its non-hematological toxicity is tolerable.

Adolescent ; Adult ; Aged ; Agranulocytosis ; chemically induced ; Antibiotics, Antineoplastic ; administration & dosage ; adverse effects ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Blast Crisis ; drug therapy ; Cyclophosphamide ; administration & dosage ; adverse effects ; Cytarabine ; administration & dosage ; adverse effects ; Female ; Humans ; Idarubicin ; administration & dosage ; adverse effects ; Leukemia, Myeloid, Acute ; drug therapy ; Male ; Middle Aged ; Mucositis ; chemically induced ; Nausea ; chemically induced ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; drug therapy ; Prednisone ; administration & dosage ; adverse effects ; Remission Induction ; Treatment Outcome ; Vincristine ; administration & dosage ; adverse effects

OBJECTIVETo evaluate the efficacy and safety of IDA (Haizheng Parmacy, China) in the treatment of acute leukemia.

METHODSA multi-institutional single-blind randomized controlled clinical trial was carried out. A total of 155 newly diagnosed patients with AML and ALL were enrolled. The patients were randomly divided into two groups, one was given IDA (n = 77) and the other given zevodas (Pharnacia & Upjohn, n = 78) for comparison.

RESULTSAll the patients enrolled in this trial were eligible for assessment of side effects, and 129 patients for evaluation of overall response rate. In patients treated with IDA vs zevodas, the overall response rate (OR) was 78.1% vs 76.9%, CR was 68.8% vs 67.7%; in AML patients, OR was 82.4% vs 71.8%, and CR was 76.5% vs 64.1%; in ALL patients, OR was 80.0% vs 81.8%, and CR was 68.0% vs 68.2%. There was no sitatistically significant difference in hematologic and non-hematologic toxicities between the two groups.

CONCLUSIONThe efficacy of IDA in the treatment of acute leukemia is comparable to that of zevodas. Both have similar toxic side effects.

Adolescent ; Adult ; Aged ; Antibiotics, Antineoplastic ; adverse effects ; therapeutic use ; China ; Female ; Humans ; Idarubicin ; adverse effects ; therapeutic use ; Leukemia, Myeloid, Acute ; drug therapy ; Male ; Middle Aged ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; drug therapy ; Single-Blind Method

Aim To explore the mechanism of Danshen decoction in the treatment of colon cancer using network pharmacology and molecular docking.Methods The active components and corresponding target proteins of Salvia miltiorrhiza, Santalum album and Amo-mum villosum in Danshen decoction were screened based on Traditional Chinese Medicine Systems Pharmacology database and analysis platform.The targets of colon cancer were searched by using Genecards database, and the common targets were selected.The network diagram of traditional Chinese medicine-active components-target-disease was constructed by using Cytoscape 3.7.0.The protein protein interaction network of common targets was constructed by using STRING database.The gene ontology(GO)and Kyoto Encyclopedia of Genes and Gnomes(KEGG)enrichment analysis were carried out based on R4.0.2.The important targets in the key pathways and the important active components in the network diagram of traditional Chinese medicine-active ingredients-target-disease network were selected for Surflex Dock.Results A total of 78 active components, 142 targets, 3 239 colon cancer targets, 105 overlapping targets and 69 corresponding active components were screened out.KEGG analysis showed that the key signaling pathway was PI3K/AKT.Luteolin and Tanshinone IIA with high correlation were selected to dock with protein kinase B(AKT1).Both active components had hydrogen bonding with AKT1.Conclusions Danshen decoction plays a positive role in colon cancer treatment.The mechanism may be related to the regulation of PI3K/AKT signaling pathway.

OBJECTIVETo compare the clinical and angiographic outcome in patients with total occlusion lesion treated with drug-eluting stent (DES) or bare-metal stent (BMS).

METHODSA total of 155 (138 males) consecutive patients with total occlusion lesion underwent successful revascularization with DES (n = 74) or BMS (n = 81) in our hospital were included in this study. All patients received aspirin 300 mg and clopidogrel 75 mg once daily for at least 3 months after the procedure. Clinical and angiographic follow-up were completed in all patients at 6 months post stenting.

RESULTSDemographic data between the two groups were similar except there was more diabetic patients in DES group (33.8% vs. 18.5%, P < 0.05). A total of 232 stents for 159 target lesions (77 treated with DES, 82 treated with BMS) were implanted. There were 85.4% C ACC/AHA type lesions and 17.0% lesions were treated with overlapping stents. Six months post stenting, the incidence of restenosis (15.6% vs. 41.5%, P < 0.001), the cumulative rate of major adverse cardiac events (MACE) (1.4% vs. 11.1%, P = 0.032) and TLR (5.8% vs. 19.9%, P = 0.001) were significantly lower in DES group than that of BMS group. The incidence of local restenosis in DES group is higher in DES group than that in BMS group (58.3%, 17.6%, P < 0.001). Two DES treated patients developed late in-stent thrombosis.

CONCLUSIONFor patients with total occlusion lesion, the clinical and angiographic outcome 6 months post DES stenting is clearly superior to that of BMS stenting.

Aged ; Coronary Angiography ; Coronary Disease ; complications ; diagnostic imaging ; therapy ; Diabetes Mellitus, Type 2 ; complications ; diagnostic imaging ; Female ; Follow-Up Studies ; Humans ; Hypertension ; complications ; Male ; Middle Aged ; Prognosis ; Stents

BACKGROUNDCoronary artery disease (CAD) is generally considered as a disease of middle-aged men. It is widely accepted that the risk for CAD of premenopausal women is low because of hormone protection. Based on our clinical experience, more and more premenopausal women suffer from angina and myocardial infarction without adequate concern. Even now, there are still limited detailed data to describe the characteristics, mechanism and prognosis of premenopausal CAD patients. This article aimed to analyze the clinical and angiographic characteristics of premenopausal women with CAD.

METHODSA total of 565 premenopausal women and 721 postmenopausal women (56 - 60 years old) who underwent coronary angiography for the first time from April 2004 to December 2007 were enrolled. The clinical data and coronary angiographic characteristics (presence, localization, length and severity) were compared between the premenopausal and postmenopausal CAD groups.

RESULTSPremenopausal CAD patients presented less frequently with hypertension, diabetes mellitus and dyslipidemia compared with postmenopausal CAD patients (55.0% vs 66.0%, 15.0% vs 31.5%, 23.9% vs 37.4%, respectively; all P < 0.05). Although we found more frequent involvement of single vessel in premenopausal CAD (43.2% vs 26.9%, P = 0), and triple vessels in postmenopausal (56 - 60 years old) CAD patients (33.8% vs 20.4%, P = 0), much more severe lesions (> or = 90%) at left main (2.9% vs 1.1%, P = 0.048) and proximal left anterior descending artery (LAD) (28.2% vs 16.6%, P = 0) in the premenopausal CAD group were found.

CONCLUSIONPremenopausal women with chest discomfort are always found to have obvious atherosclerosis, more inclined to be located at the left main and proximal LAD, which is a strong predictor of an adverse clinical outcome.

Coronary Angiography ; Coronary Artery Disease ; diagnostic imaging ; pathology ; Diabetes Mellitus ; pathology ; Dyslipidemias ; pathology ; Female ; Humans ; Hypertension ; pathology ; Middle Aged ; Postmenopause ; Premenopause