Objective To compare the 12-month efficacy and safety of N-butyl cyanoacrylate (NBCA) versus radiofrequency ablation (RFA) in treating great saphenous vein (GSV) insufficiency. Methods A total of 155 patients with GSV insufficiency from five centers were randomly allocated to the NBCA group or RFA group. Postoperative efficacy and safety outcomes were evaluated. Results Immediate postoperative closure rates of the GSV trunk were 100% in both groups. The closure rates of NBCA and RFA group were 98.6% and 98.5% at 3 months, 97.1% and 98.5% at 6 months, 98.1% and 95.9% at 12 months, with no statistically significant differences (P>0.05). After treatment, CEAP classification improved significantly from baseline in both groups. In terms of safety, 1 case of phlebitis, 1 case of ablation-related thrombus extension (ARTE) and 2 cases of calf muscle venous thrombosis(CMVT) occurred in the NBCA group, while 2 cases of limb numbness, 1 case of persistent thigh pain and 2 cases of CMVT in the RFA group. All reported serious adverse events in both groups were assessed as unrelated to the medical device or the trial procedure. Conclusions NBCA demonstrates non-inferior efficacy and safety compared to RFA for treating GSV insufficiency over 12 months.

Objective To investigate the effect of ulinastatin on postoperative clinical outcomes in pa-tients undergoing elective laparoscopic colectomy. Methods 454 patients underwent elective laparoscopic colecto-my from January 2015 to September 2017 were included in this retrospective study. Patients were divided into 2 groups:ulinastatin group and control group. Propensity score matching was applied to balance the preoperative baseline differences between 2 groups. 155 patients in each group were successfully matched. Mixed linear model was used to exam the effect of ulinastatin on various clinical indicators within 3 days after the surgery,including in-flammation indicators(white blood cell counts,C reactive protein),liver function indicators(alanine transami-nase,aspartate transaminase,total bilirubin),renal function indicators(serum creatinine,blood urea nitrogen). Postoperative hospital length of stay was compared between 2 groups using student's t-test. Results Ulinastatin group showed significantly reduced postoperative white blood cell count and ? reactive protein level (P = 0.036 and 0.025)compared with the control group. The average mean inhibitory effects were 1.04×109/L and 23.93 mg/L respectively,which was 11.1% and 29.9% lower than that of the control group. Procalcitonin,transaminases,total bilirubin,serum creatinine,blood urea nitrogen levels and postoperative hospital length of stay showed no signifi-cant difference between the two groups(P > 0.05). Conclusion Ulinastatin can significantly reduce the level of inflammation response after laparoscopic colectomy,which is beneficial to the fast recovery.

Objective: To investigate the effect of 1q21 amplification (1q) on the therapeutic response and prognosis of bortezomib(Btz) in the treatment of newly diagnosed multiple myeloma (MM) patients. Methods: A total of 180 newly diagnosed MM were included for analyses of clinical characteristics, cytogenetics, objective response rate (ORR), progression-free survival (PFS) and overall survival (OS), retrospectively. Gene expression profiling (GEP) was analyzed using publicly available R2 platform. Results: ① In 180 patients, 1q was found in 51.1% cases. Of them, 174 patients had complete follow-up data, including 88 cases with 1q and 86 without 1q (non-1q). ②Incidence of 1q was positively associated with percentage of IGH rearrangement (72.2%, P=0.017) and 1p deletion (1p) (27.8%, P=0.040). ③ The median PFS was 15.0 and 20.3 months for the 1q group and non-1q group, and the median OS was 29.4 and 44.0 months, respectively. Both PFS and OS of 1q group was significantly shorter than those of the non-1q group (P=0.029 and 0.038, respectively). Multivariate analysis further revealed that 1q was an independent prognostic factor for both PFS (HR=1.910, 95% CI 1.105-3.303, P=0.020) and OS (HR=2.353, 95% CI 1.090-5.078, P=0.029). ④ In 91 evaluable cases with 1q, very good partial remission (VGPR) rate was higher after treatment with Btz than those without Btz (62.1% vs 40.0%, P=0.032). Of note, the patients with 1q who received auto-HSCT after induction with Btz had significantly longer PFS than those without auto-HSCT (19 months vs 13 months, P=0.048). ⑤GEP analysis revealed that 1q21 amplification predominantly up-regulated expression of >50% genes within 1q21 region, and also altered expression of 28% genes in chromosome 1 and 10% genes in whole genome, particularly related to DNA repair and cell cycle. Conclusions 1q is an independent adverse prognostic factor in patients with newly diagnosed MM. It is often associated with 1p deletion and IGH rearrangement. Patients with 1q respond well to Btz-based regimen, but they fail to gain long-term benefit from this treatment itself. However, auto-HSCT following Btz induction might improve survival of patients with 1q, suggesting a potential strategy to treat this high-risk subset of MM. GEP analysis warrants further attention in understanding the mechanisms underlying the high-risk of 1q.

Objective To observe the role of chronic inflammation in the development of atherosclerosis (AS) by analyzing the expression of TLR4 and NF-κB in artery endothelium. Methods To construct the atherosclerotic animal model, the balloon catheter was used to injure common carotid artery and rabbits were fed the high cholesterol diet. All the rabbits were divided into three groups: control group with the normal diet, high cholesterol diet-fed group and model group (balloon-injured common carotid artery and the high cholesterol diet fed rabbits). The rabbits were sacrificed after 8 weeks and their tissues were collected. Then morphological changes of rabbit common carotid artery were observed by light microscope. The expression of TLR4 and NF-κB in endarterium was displayed using immunochemistry method. Results Both hyperlipidemia and exterior inflammatory stimulation promoted the expression of TLR4 and NF-κB in vascular endothelium (P ＜ 0.01 ). And when both of them were present, the level of TLR4 and NF-κB expression would get higher even than that affected by one of them( P ＜ 0.01 ). Conclusion Both hyperlipidemia and chronic inflammatory process can improve the expression of TLR4 and NF- κB in vascular endothelium in different degree; the inflammatory stimulation would promote the atherosclerosis to some extent; TLR4/ NF-κB would play a role as a bridge between the internal environment changes and the arterial morphological changes.

Objective The treatment of limb bone fracture in combination with main vessel injury wasanalyzed retrospectively.Methods Twenty ccsese were respectively conducted by interlocking intramedullary pin fixation,plate and screw fixation,plate and screw fixation orextemal brace fixation according to the injury conditions of the fractures.Then,vascahr injaries were flexibly dwelt with direct repair,end-to-end anastomosis or blood vessel grafting.Results The-limb save rate in this study is 70%.and the reaoons which csllsed the amputation included:Long ischemia time and serious tissue damage.Conclusion Fractures of the extremities with major vascular injuries should be diagnosed promptly to be conducted properly.In this way,better outcome would be obtained.

Objective To study the early functional change of sinusoid endothelial cell after liver transplantation in rat, and to investigate the endothelia protective effect of prostaglandin E_1(PGE_1). Methods Rat orthotopic liver transplantation model was performed in "two-cuff method", grouped as follows: group A served as normal rat blank control, group B as operative control with normal donor, group C as experimental control with shock donor, and group D as experimental group with shock donor and PGE_1 administration ( n =8 in each group). Transplanted groups (referring to recipients without specific definition) were sacrificed 6 h after operation for blood taken to detect serum liver enzymes (ALT, LDH), malondialdehyde (MDA), nitric oxide (NO) and plasm endothelin (ET). Liver tissue was resected at the same time for standard pathologic examination. Comparison of the difference the results was made between groups. Results Cold preservation time and anhepatic phase were similar in each group, (2?0.5) h and (15?3) min respectively. All survived 6 h after transplantation (8/8) in group B and D with a survival rate of 100%, only 5 survived 6 h after transplantation in group C (5/8) with a survival rate of 62.5%. Comparing with group C, blood ALT, LDH, MDA, ET decreased and NO increased significantly in group D ( P

To study the significance of the levels of plasma inflammatory cytokines (IL-6,IL-8,IL-10 and TNF-?) in patients with acute deep venous thrombosis (DVT) of lower extremity. Methods Forty untreated DVT cases were selected as the subjects in the DVT group, while thirty healthy subjects, whose ages and genders showed no significant difference with the DVT patients, were collected as the control group. The plasma levels of IL-6, IL-8 and TNF-? were detected by radioimmunoassay (RIA), and the plasma level of IL-10 was measured by enzyme-linked immunosorbent assay (ELISA). Correlation analysis was used to investigate the relationships between the levels of different inflammatory cytokines within DVT group. Results The levels of plasma cytokines in the DVT group were all significantly higher than those in control group (P

Objective To explore the application of extracorporeal veno venous bypass in orthotopic liver transplantation in pigs and to compare hemodynamic changes during operation of two different bypass ways. Methods Twenty five porcine orthotopic liver transplantations were performed and extracorporeal veno venous bypass was established during anhepatic phase through a catheter in portal vein (group A, n =16) or in splenic vein (group B, n =9).Hemodynamic changes were monitored continuously.Results Fourteen recipients survived two days after operation (14/16) in group A while all survived in group B (9/9).Transient hemodynamic disturbance (MAP and CVP decreased,and HR increased) was monitored at both the beginning and the end of anhepatic stage in group A,while these parameters kept stable in group B ( P

Objective To explore the methods and the effect of the surgical treatment of patients with chronic ischemia of extremities.Methods In recent 6 years,the clinical data of 75 patients,including 7 upper(extremities) and 71 lower extremities with chronic ischemia,treated surgically were reviewed retrospectively.The surgical treatment included: traditional operation in 65 cases,interventional surgery in 4 cases and stem cell transplantation in 6 cases.Results Sixty-three patients(66 extremities) were followed up from 2 to 56 months after the surgical treatment,and the result showed that 9 extremities of 8 patients were amputated(within) 1 year(13.6%).In the other cases(83.3%),the ischemic symptoms were relieved or(disappeared),the ulcer healed or the amputating level had lowered(3.0%).The effective rate of the surgical treatment was 86.3%.Conclusions The appropriate surgical treatment of chronic ischemia limbs should be choiced based on the ischemic state of the limb,and a satisfactory result can be obtained in most patients.

Objective To understand the experimentnl resluts and the advance in gene therapy for restenosis of the vessel. Method Literature review was made on gene therapy for restenosis directly at cytotoxic, cell cycle regulators, intracellular signal transducers, transcription factors, cytokines growth factors, nitric oxide and Fas ligand. Results cytotoxic gene therapy by thymidine kinase and cytosine deaminase, mutant retinoblastoma protein (Rb), cyclin-dependent kinases(cdk) inhibitors (such as p21 p27 and p53), antisense basic fibroblast growth factor (bFGF) blocking intracellular signal transduce by A-Raf and C-Raf, antisense Ag ??, promoting NO, ?-nterferon, vascular endothelial growth factor (VEGF) and platelet-derived growth factor (PDGF), ? chain synthesize suppressing nuclear factor-kB (NF-kB) overexpression of gax and Fas ligand can inhibit restenosis of the vessel. Conclusions The effect of gene therapy for restenosis of the vessed is obvious in experimental studies. Conbination of more gene and several links gene therapy is the research direction in the future.