1.Single-centre diagnosis, treatment and prognostic analysis of abdominal aortic endograft infection
Xuebin WANG ; Bin LIU ; Zhe ZHANG ; Hongzhi YU ; Zhiwen ZHANG ; Lishan LIAN ; Xiang GAO ; Hai FENG ; Xueming CHEN
International Journal of Surgery 2024;51(11):759-765
Objective:To summarise and analyse the experience in the diagnosis and management of abdominal aortic endograft infection in recent years.Methods:Retrospectively summarised and analysed the general data, clinical presentation, laboratory and imaging findings, causative organisms and treatment choices of 14 patients with abdominal aortic endograft infection treated in Beijing Friendship Hospital, Capital Medical University, from January 2018 to June 2024, and analysed the prognosis of the patients and the risk factors associated with prognosis.Results:Positive bacterial cultures were 10 out of 14 patients. One non-operatively treated patient died of infectious toxic shock. Thirteen surgically treated patients underwent axillary-bifemoral artery bypass, removal of the infected stent, and closure of the aortic stump. Four of the 13 cases had combined aortoenteric fistula, 3 cases underwent one-stage enterocutaneous fistula repair, 1 case only fistula drainage, 3 cases of gastrojejunal anastomosis, all of them underwent gastric or jejunal nutrient tube implantation. Two of the 13 patients had combined the infection foci spread to the renal artery openings. To save the kidney, intraoperative left kidney autologous renal transplantation was performed in 1 case, and autologous saphenous vein reconstruction from celiac trunk artery-left renal artery and superior mesenteric artery-right renal artery was performed in the other case. All 14 patients were retrospectively summarised and followed up in August 2024, with 5 deaths in the early postoperative period (< 3 months), 3 deaths in the mid- to long-term period (≥3 months), and 5 survivors, with a median follow-up time of 2 years (1-5 years) for surviving patients. Among the 13 operated patients, 4 cases were combined with aortoenteric fistula, and 3 cases died in the early postoperative period; 4 cases of abdominal aortic infection foci involving renal artery openings, 2 cases of early postoperative death; 4 cases with pleural effusion, 4 cases died in the early postoperative period; 2 cases of combined creatinine elevation, 2 cases of early postoperative death; 2 cases of postoperative infection of artificial blood vessels.Conclusions:Abdominal aortic endograft infection are aggressive. The risk of early death is increased in patients who are elderly, in poor general condition, with aortoenteric fistula or with pre-existing cardiac, pulmonary, hepatic and renal insufficiency, but surgery based on adequate anti-infective therapy remains an effective means of saving the patient′s life.
2.Mechanical thrombus aspiration combined with superior mesenteric artery transcatheter thrombolysis in the treatment of portal vein thrombosis
Bin LIU ; Hai FENG ; Xueming CHEN ; Wenrui LI ; Hongzhi YU
International Journal of Surgery 2023;50(3):155-159,F3
Objective:To compare the effectiveness and safety of mechanical thrombus aspiration combined with superior mesenteric artery transcatheter thrombolysis with those of simple superior mesenteric artery transcatheter thrombolysis in the treatment of portal vein-superior mesenteric vein thrombosis.Methods:A retrospective case-control study was used to analyze the clinical data of 27 patients with portal vein thrombosis treated by interventional therapy in Beijing Friendship Hospital Affiliated to Capital Medical University from February 2020 to October 2022. According to different interventional procedures, they were divided into two groups: 13 cases were treated with mechanical thrombus aspiration combined with superior mesenteric artery catheterization thrombolysis (combined treatment group), and 14 cases were treated with superior mesenteric artery catheterization thrombolysis alone (catheterization thrombolysis group). The postoperative and preoperative portal vein thrombus grade, catheterization thrombolysis time, parenteral nutrition time and operation-related complications were observed and compared between the two methods, and the incidence of long-term intestinal necrosis was compared after postoperative follow-up. Measurement data of normal distribution were expressed as mean±standard deviation( ± s), t-test was used for comparison between groups. Counting data were expressed as cases and percentage(%), and comparison between groups was used Chi-square test or Fisher exact probability method. Results:There was significant difference in the grade of portal vein thrombosis between the combined treatment group and the catheterization thrombolysis group( P<0.05). The thrombolytic time of catheterization in the two groups was (2.38±0.74) d and (4.79±1.15) d, respectively, and the time of parenteral nutrition was (4.08±2.87) d and (8.50±3.16) d, respectively. The difference was statistically significant ( P<0.05). There was no significant difference in operation-related complications between the two groups ( P>0.05). There were no severe injury of liver and kidney function in both groups. One patient in each group underwent long-term enterectomy. Conclusions:Mechanical thrombus aspiration combined with superior mesenteric artery thrombolysis is safe and effective in the treatment of portal vein thrombosis. Compared with simple superior mesenteric artery thrombolysis, mechanical thrombus aspiration combined with superior mesenteric artery thrombolysis can increase the rate of thrombus clearance and reduce the time of thrombolysis and parenteral nutrition support.
3.Clinical application of G-iliac? iliac branch device in the treatment of common iliac artery aneurysm
Wenrui LI ; Hai FENG ; Zhiwen ZHANG ; Bin LIU ; Hongzhi YU ; Xiang GAO ; Zhe ZHANG ; Xueming CHEN
International Journal of Surgery 2023;50(7):464-468,C2
Objective:To analyze the safety and efficacy of G-iliac? iliac branch device (IBD) in the treatment of common iliac artery aneurysm.Methods:The clinical data of 7 patients with common iliac artery aneurysm who were treated with G-iliac? IBD and internal iliac artery (IIA) preserved were retrospectively analyzed in the Department of Vascular Surgery, Beijing Friendship Hospital, Capital Medical University from June 2021 to June 2022, and the surgical effects and related complications were analyzed.Results:All 7 patients were male, aged from 57 to 80 years, with an average age of 70.9 years. There were 6 cases of abdominal aortic aneurysm combined with common iliac artery aneurysm and 1 case of simple common iliac artery aneurysm, all of them were successfully applied with G-iliac? IBD to preserve IIA. Cardiogenic shock occurred in 1 patient after the operation. 7 patients were followed up for 3-15 months, with an average of 8 months. During the follow-up period, the iliac artery and IIA stents were all patency, and there was no IBD-related endoleak, stent displacement, buttock claudication, sexual dysfunction, or aortic-related death. The diameter of abdominal aortic aneurysm and common iliac artery aneurysm were stable.Conclusion:For patients with common iliac artery aneurysm, preservation of IIA with G-iliac? IBD is a safe and effective technique with a high technical success rate and IIA patency rate, and has a low complication rate, but the long-term effect still requires more data and longer follow-up data to support.
4.Clinical analysis of Rotarex percutaneous mechanical thrombectomy for treatment of lower extremity artificial bypass occlusion
Zhao LIU ; Hai FENG ; Xueming CHEN ; Hongzhi YU ; Renming ZHU ; Xiang GAO ; Zhe ZHANG ; Bin LIU
International Journal of Surgery 2022;49(11):752-756,C1
Objective:To evaluate the clinical efficacy of Rotarex percutaneous mechanical thrombectomy(PMT) for treatment of lower extremity arterial graft occlusion.Methods:The clinical data of 19 patients with lower extremity arterial bypass occlusion admitted to our hospital from January 2016 to December 2020 were retrospectively analyzed. All patients were treated with Rotarex-based endovascular therapy. After 12 months follow-up, the clinical features, surgical outcomes and follow-up data were analyzed to identify effectiveness and safety of the therapy. Independent sample t test was used to analyze the measurement data of continuous normal distribution which were expressed as mean±standard deviation( ± s), enumeration data were expressed as number and percentage, and the comparison between groups were analyzed by chi-square test. Results:A technical success rate of 100% was demonstrated. Rotarex combined with catheter directed thrombolysis was performed in 2 cases, Rotarex combined with percutaneous transluminal angioplasty (PTA) was performed in 9 cases. Rotarex combined with stent implantation was performed in 8 patients. The Ankle brachial index significantly increased (0.82±0.14 vs 0.47±0.11, P<0.05). Critical limb ischemia (Rutherford class 4 or higher) improved significantly (0 case vs 9 cases, P<0.05). Distal embolism occurred in 1 patient and acute myocardial infarction occurred in 1 patient. There was no vascular rupture, haemorrhage, infection, pseudoaneurysm, death and amputation. Kaplan-Meier survival analysis revealed 12-month primary patency rate and freedom from clinically driven target lesion revascularization was 78.9% and 89.5% respectively. Conclusion:Rotarex-based endovascular therapy is a safe and effective treatment for graft occlusion after lower extremity arterial prosthesis bypass with high patency rate and few complications.
5.Analysis of influencing factors of therapeutic strategies for spontaneous isolated superior mesenteric artery dissection
Lishan LIAN ; Zhe ZHANG ; Zhiwen ZHANG ; Hongzhi YU ; Xueming CHEN ; Hai FENG
International Journal of Surgery 2022;49(6):427-432,F5
Objective:To investigate the influencing factors and clinical effect analysis of the choice of treatment method for spontaneous isolated superior mesenteric artery dissection (SISMAD).Methods:The clinical data of 35 patients with SISMAD admitted to Beijing Friendship Hospital, Capital Medical University from December 2015 to November 2021 were retrospectively analyzed. They were divided into conservative group ( n=24) and surgical group (endoluminal stent group + open surgery group, n=11). The conservative group was treated with conservative methods, the endoluminal stent group ( n=10) was treated with endoluminal stent placement, and the open surgery group ( n=1) was treated with superior mesenteric artery endarterectomy + angioplasty + ileal resection. The white blood cell (WBC) count on admission, the time of abdominal pain, YOO classification, aorta mesenteric angle(AMA), and the length of hospital stay between the two groups were analyzed. All patients were followed up for more than 24 months, at the end of which the vascular remodeling rate of superior mesenteric artery (SMA) between the two groups was studied. In addition, the primary patency rate and secondary patency rate of intracavitary stents were analyzed. Measurement data that conform to normal distribution were expressed as mean ± standard deviation ( ± s), and independent samples t-test was used for comparison between groups; measurement data that do not conform to normal distribution were expressed as median (interquartile range) [ M( Q1,Q3)], the nonparametric test was used for comparison between groups. Enumeration data were compared between groups using the Chi-square test. Results:Univariate analysis showed that compared with the conservative group, the IVS type in YOO classificationin of surgical group was significantly more than the conservative group. There was no significant difference in WBC, duration of abdominal pain, or AMA at admission ( P>0.05). In addition, the length of hospital stay in the conservative group was significantly shorter than that in the surgical group. No intestinal necrosis occurred in endoluminal stent group. After 24 months of follow-up, the remodeling rate of SMA in the surgical group was higher than that in the conservative group; the primary patency rate of the endoluminal stent group was 87.5%, and the secondary patency rate was 100%. One patient in the conservative group developed SMA dissection aneurysm during 12 months of follow-up and received endovascular treatment. Conclusions:For the treatment of SISMAD, most patients can be cured by conservative treatment. However, for patients with consistent abdominal pain and IVS type in YOO classification, if there is no severe manifestation of peritonitis, it is recommended to perform endovascular stent placement as soon as possible to open the blood supply. Meanwhile, the SMA stenting has an ideal long-term patency rate and vascular remodeling rate.
6.Analysis on sensory processing characteristics of mental health problems in preschoolers
JIANG Xueming, SUN Yanxiang, FENG Zhe, HUANG Yanke, CHEN Yuhuang, WAN Guobin
Chinese Journal of School Health 2020;41(8):1189-1192
Objective:
To analyze the sensory processing characteristics among preschoolers with mental health problems in Nanshan District, Shenzhen.
Methods:
Random cluster sampling was used to select kindergartens for psychological screening from March to June 2018. The Strengths and Difficulties Questionnaire (SDQ) and the Simplified Sensory Questionnaire (SSP) were used to evaluate 6 365 preschool children.
Results:
A total of 15.15% preschoolers were detected with abnormal results. The SSP scores of preschoolers with emotional symptoms/conduct problems/prosocial behaviors were lower than normal preschoolers’(P<0.01). Among the preschoolers with hyperactivity-inattention, taste/smell sensitivity (F=12.45)/underresponsive/seeks sensation(F=102.44), auditory filtering(F=93.51), low energy/weak(F=13.33), visual/auditory sensitivity (F=4.32) scores were lower than normal preschoolers’(P<0.05), the scores of tactile sensitivity movement sensitivity were no statistical difference with normal preschoolers’. Among the preschoolers with peer problem, taste/smell sensitivity(F=5.86), tactile sensitivity(F=6.05), movement sensitivity(F=4.70), auditory filtering(F=17.32), low energy/weak (F=9.56), visual/auditory sensitivity (F=4.16) scores were lower than normal preschoolers’ (P<0.05), and the scores of under-esponsive/seeks sensation were no statistical difference with normal pre-schoolers’. Prosocial behavior and tactile (r=0.30), under-responsive/seeks sensation(r=0.37), auditory filtering(r=0.37), low energy/weak (r=0.31) were positive associated(P<0.01). Emotional symptoms were negatively associated with lack of energy/weakness(r=-0.33, P<0.01).
Conclusion
Mental health problems are related to sensory processing ability in preschoolers. Preschoolers with mental health problems have weak sensory processing ability. Clinicians and occupational therapists should pay attention to evaluation and intervention of sensory processing ability in preschoolers with mental health problems.
7.Rotarex debulking combined with paclitaxel drug-coated balloon in treatment of ischemia of lower limb artery
Bin LIU ; Xueming CHEN ; Hai FENG ; Chenyu LI ; Hongzhi YU ; Renming ZHU
Chinese Journal of General Surgery 2020;35(9):703-708
Objective:To evaluate the effect of Rotarex debulking combined with paclitaxel drug-coated balloon in the treatment of ischemia of lower limb artery.Method:The clinical data of 34 patients who had lower extremity arterial ischemic disease treated by Rotarex debulking combined with paclitaxel drug-coated balloon from Nov 2016 to Sep 2018 was retrospectively analyzed.Results:There were male 25 cases, with an average age of (69±10) years, the lesion length was (216.7±110.0)mm, and the course of disease was(169.3±303.0) days. Fourteen (41.18%) had primary lesions, 8 (23.53%) had stent occlusion, 11 (32.35%) had primary+ stent occlusion, and 1 (2.94%) had primary+ artificial vascular thrombosis.The technical success rate was 97.06% (33/34), and 100% after catheter directed thrombolysis (CDT). Thirty patients (88.24%) received percutaneous transluminal angioplasty (PTA) and 6 patients (17.65%) received stent placement. The clinical success rate was 97.06% (33/34). There were 2 cases (5.88%) with distal vascular embolism during the operation, no bleeding or artery rupture. The ankle brachial index (ABI) (0.86±0.13) significantly increased (0.40±0.28) ( t=8.851, P<0.01). All patients were followed up for 12 months. The patency rate was 94.12% (32/34), 87.88% (29/33) and 75.76% (25/33) in 3, 6 and 12 months respectively. There was no death in perioperative period and no amputation above ankle in follow-up period. 93.94% of patients were free from clinical driven target lesions. Conclusion:Rotarex debulking combined with paclitaxel in the treatment of lower extremity arterial ischemic disease is safe and effective.
8. Percutaneous mechanical thrombectomy and angioplasty for femoropopliteal artery stent restenosis
Hai FENG ; Xueming CHEN ; Zhiwen ZHANG ; Bin LIU ; Zhao LIU ; Chenyu LI ; Hongzhi YU ; Xiaobo GUO
Chinese Journal of General Surgery 2019;34(9):750-752
Objective:
To evaluate percutaneous mechanical thrombectomy and angioplasty in patients with femoropopliteal artery stent restenosis.
Methods:
The clinical data of 41 cases with critical limb ischemia caused by femoropopliteal artery stent restenosis were analyzed retrospectively from Jun 2015 to May 2017, who were treated by percutaneous mechanical thrombectomy(PMT)+ percutaneous angioplasty (PTA) simultaneously. Clinical status assessment, ankle brachial index (ABI) test and color duplex ultrasonography (CDU) were administered at 3rd, 6th and 12th month during follow-up; and computed tomography angiography (CTA) or digital subtraction angiography (DSA) was performed at 6th and 12th month after discharged.
Results:
Procedures were successful in all patients. 27 cases were under PTA after PMT, other 14 cases were under PTA+ stenting after PMT. The average ABI increased from 0.34±0.28 to 0.84±0.32(
9.Discussion on the regional medical scientific research alliance
Ran YI ; Tianyu CAO ; Yingxia XU ; Yingmei FENG ; Xueming CHEN ; Zhili JI
Chinese Journal of Medical Science Research Management 2019;32(3):176-178
Objective Through analyzing and summarizing the experiences and reflections during the construction of regional medical scientific research alliance,to explore the ultimate goal and ideal model of such work.Methods Literature review,as well as working experience summary and analysis.Results The purpose of setting up regional medical scientific research alliance lies in shared regional medical scientific research data information,using the two-way transformation model of laboratory and clinical research to support the medical service of primary health care in local hospitals,at the same time,promoting the construction and development of regional medical alliance.The ideal model is to make good use of the regional clini cal scientific research data sharing platform and related information sharing platform to promote the collaborative development of regional medical scientific research.Conclusions The ultimate goal of collaborative development of scientific research is to establish "an information map of regional scientific research resources",the map can be used for scientific research project cooperation,resource allocation,integration of scientific research forces and training of talent echelon,thereby comprehensively improve the regional research capacity.
10.Analysis of future scientific research work planning of the tertiary from the perspective of subject declaration
Ran YI ; Tianyu CAO ; Yingxia XU ; Yingmei FENG ; Xueming CHEN ; Zhili JI
Chinese Journal of Medical Science Research Management 2019;32(1):34-38
Objective From the perspective of the application of Beijing Tongzhou district science and technology project,we can grasp the present situation,existing problems and opportunities of the hospital.Methods Taking the information of the application declared by Beijing Luhe Hospital in 2017 as the research object,using the Excel,statistical analysis of the applicants'age,professional title,degree and departments distribution;summing up the common problems of the expert feedback.Results The study found that the 144 subjects participated in the declaration had been laying particular stress on each of the five areas,including:research category,applicants‘ age,professional title,degree and department.Conclusions Based on the data of the application,we have made a preliminary discussion about the overall planning and management measures of the future hospital scientific research.


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