Objective:To compare the clinical results of different endovascular thrombus reduction techniques in the treatment of acute lower extremity arterial thrombosis.Methods:The clinical data of 96 consecutive patients with acute femoral popliteal arterial thrombosis who were treated with catheter directed thrombolysis (CDT) and mechanical thrombus aspiration system (PMT) between Jan 2016 and Dec 2018 at Cangzhou People's Hospital and Peking University People's Hospital were retrospectively analyzed.Results:Ninty-six patients underwent thrombolytic surgery,including 36 with CDT thrombolysis, 28 with AngioJet aspiration alone and 32 with Rotarex aspiration alone. Angiojet thrombus aspiration reduced thrombus rate by 89.3% (25/28) and clinical success rate by 92.8% (26/28).The thrombus reduction rate of Rotarex group was 87.5% (28/32), and the clinical success rate was 96.8% (31/32). In the CDT thrombolytic group, the thrombolytic reduction rate was 61.1% (22/36), including 8 patients who underwent thrombectomy and 6 patients with PMT, with a clinical success rate of 86.1% (31/36). The rate of distal arterial embolization, puncture point and local subcutaneous hematoma and vascular rupture was 21.4%, 10.7% and 2.1%, respectively. There were no amputation cases reported during a mean 13 months follow-up.The survival rate was 97.9%. The first-stage patency rate of 67.8%, while the second-stage artery patency rate of 85.7% during the follow-up.Conclusion:Compared with CDT, PMT has higher efficiency and lower complication rate in the treatment of acute lower extremity arterial thrombosis.

December 2019 witnessed the outbreak of COVID-19 in Wuhan and spread of the epidemic across the country. As a provincial designated hospital for critical patients, the First Affiliated Hospital of Zhejiang University responded rapidly since then by advocating the four-concentration principles, namely " concentrating patients, experts, resources and treatment" . In its rescue of critical patients, the hospital formulated comprehensive emergency plans, optimized hospital-wide resources, effectively arranged rescue spacing, established medical echelons, and implemented multi-disciplinary strategy. These efforts ensured efficient rescue and treatment, achieving a cure rate up to 98.7% of such patients, with no deaths.

Objective To study the significance of leptin and its receptor(OB-R) in the occurrence and development of pulmonary arterial hypertension(PAH) induced by monocrotaline(MCT).Methods Fifteen SD rats were divided into the control group(n=5) and two experimental groups(n=10).The experimental groups were intraperitoneally injected by MCT for constructing the PAH model and the control group was injected by the same dose of solvent groups.The venous blood was extracted at 2,4 weeks after MCT injection in the two experimental groups.The mean pulmonary artery pressure(mPAP) and right ventricular hypertrophy index(RVHI) were measured and then the lung tissue was removed.The pathological change of lung blood vessels was observed.The expression of serum leptin was detected by ELISA.The expression of OB-R in lung tissue was tested by Western blot.Results Compared with the control group,mPAP and RVHI in the experimental groups were significantly increased(P＜0.05);the expression levels of serum leptin and lung tissue OB-R were increased significantly(P＜0.05),moreover,which were positively correlated with mPAP(r=0.912,P＜0.05;r=0.861,P＜0.05).Conclusion Leptin and OB-R may play an important role in the occurrence and development of PAH induced by MCT.

Objective To investigate the microsurgical managements of intracranial ruptured aneurysms combined with intracranial hematomas and to observe their therapeutic efficacy.Methods A total of 32 patients with intracranial ruptured aneurysms combined with intracranial hematomas,treated in our hospital from January 2009 to January 2013,were chosen in our study;18 male and 14 female patients ranged from 32 to 78 years old (mean age of 55 years) were enrolled,with sudden headache,vomiting,disturbance of consciousness as the first symptoms.The preoperative status on admission was Hunt-Hess grade Ⅲ in 7,grade Ⅳ in 20 and grade Ⅴ in 5.Radiographic imaging demonstrated 7 anterior communicating artery aneurysms,3 posterior communicating artery aneurysms,7 internal carotid artery aneurysms,13 middle cerebral artery aneurysms and 2 multiple aneurysms.The associated hematoma was greater than 20 mL.All patients were brought emergently to the operating room and treated with aneurysm clipping within 72 h.Decompressive craniectomy was performed in 19 patients,and external ventricular drainage was performed in 19 patients.Results Postoperative follow up (ranged from 3-24 months) showed good recovery,moderate recovery,severe disability,persistent vegetative state and death in 6,12,11,0 and 2,respectively,graded by Glasgow Outcome Scale;the remaining one patient was lost to follow-up.The percentage of good prognosis in patients with preoperative Hunt-Hess grade of Ⅲ grade (84.6％) was higher than that of patients with Ⅳ-Ⅴ grade (36.8％,P＜0.05).Conclusions Early evacuation of space-occupying hematoma,aneurysm clipping and emergent decompessive cranioctomy could lead to survival with good recovery in some patients.

Schistosomiasis hematobia is one major human schistosomiasis. The disease is endemic in Africa and Mediterra-nean region,and is the main cause of urogenital diseases. Although only Schistosoma japonicum is spreading across the Main-land China,now more schistosomiasis hematobia cases are reported among aid projects and migrant workers to Africa,with the economy development and the increasing degree of foreign exchanges. Meanwhile,the relevant clinical data of schistosomiasis hematobia are rare in China. This article reviews the clinical manifestations and progress in diagnosis and treatment of the dis-ease.

Objective To summary the microsurgery clinical experience of 21 patients with cerebellopontine angle tumor by the help of three dimensional individual digital anatomy. And to evaluate the value of three dimensional individual anatomy in the treatment of tumors in cerebellopontine angle. Methods Between January 2011 and November 2011,21 patients with various cerebellopontine angle tumor,managed at the Third Affiliated Hospital of Sun Yat-Sen University, underwent CTA scan, and reconstruct the local anatomy by 3D view software. According to the individual anatomical model, the microsurgery program by restrosig moid approach was developed. Results All patients had reposition of the bone flap at original site after craniectomy during the same operative setting mentioned above with retrosigmoid approach. No complication was noted.Patients did not have any delayed postcraniectomy pain at operation site.Postoperative computed tomography of the skull showed good healing and shaping of the suboccipital bone at the surgical region. Conclusion With the help of three dimensional individual anatomy, the microsurgery of cerebellopontine angle tumor underwent less postoperative complications.This study provides a safe and effective individualized microsurgical methods by restrosig moid approach.

Objective To compare the therapeutic effect of anatomic plate (AP)and locking compression plate(LCP) in treatment of fermoral intertrochanteric fracture in elderly patients. Methods Nineteen and three patients with fermoral intertrochanteric fracture were treated with anatomic plate (AP) and locking compression plate (LCP). The therapeutic effects were compared in the study. Results All operations were done successfully. Of all cases,72 patients were followed up for 5-24 months. Excellence rate: AP was 66. 7% and LCP was 88. 2%.Conclusions AP had significantly low excellence rate with more complications when compared with LCP. LCP could be the first choice in treatment of fermoral intertrochanteric fractures with high excellence rates and few complications.

Objective To assess the preventive effect of artesunate against reinfection of Schistosoma japonicum.Methods Volunteers were divided into 3 groups,Medication Group Ⅰ took artesunate 6 mg/kg ,once a week for 4 weeks,Medication Group Ⅱ took artesunate 6 mg/kg in the 1st and 3rd week,twice a week,and a control group was given a placebo.The 3 teams took praziquantel 40 mg/kg on the 4th weekend.The effects of artesunate in early treatment were observed at the 8th weekend,and the preventive effects of artesunate against reinfection were assessed at the 12th weekend.The positive rate of fecal examination was used as the indicator.Results In the stage of early treatment,the positive rates of fecal examination in Medication Group Ⅰ ,Ⅱdecreased significantly compared with the data before the study with all P values less than 0.05 ;in the stage of preventing reinfection,compared with the data before the study,the positive rates of the fecal examination declined significantly in Medication Group Ⅰ,Ⅱ ,with all P values less than 0.05.While in the control group,the positive rates of the fecal examination had no significant changes in the two stages.Conclusions Artesunate has a valid effect against schistosome infections in the early treatment and can prevent residents from reinfection,and the suitable dosage is 6 mg/kg,once a week for 4 weeks.

Objective To report effects of microsurgical treatment for tumors in cervical spinal canal. Methods A total of 32 cases of tumors in cervical spinal canal had received microneurosurgery through a posternmedial approach. 22 cases had received reconstruction of cervical spinal canal stability. Results A total tumor resection was performed in 26 cases (81.25%),a subtotal tumor resection was conducted in 6 cases(18.75%). A cemplete recovery was achieved in 23 cases(71.88%), an improvement of symptoms was achieved in 6 cases(18.75%), and no improvement in 3 cases(9.38%), no death was encountered. Follow up observations were carded out in 30 cases for 3 months to 3 years. MRI examinatious 3 months after operation in 26 cases found no residual or recurrent tumor,recurrence was seen in 3cases of astrocytoma, 1 case was invariable. X-ray radiography in 26 cases showed good vertebral stability ,spinal deformation was found in 4 eases. Conclusion Microsurgery in early period play a key role in treatment of cervical spinal tumors. Reconstruction of spinal canal stability is important to patients.

Objective To investigate the protective effect of prostaglandin E1 (PGE1) on platelet during cardiopulmonary bypass (CPB).Methods A total of 24 patients undergoing cardiac valve replacement were randomly divided into the experimental group (n=12) and the control group (n=12).The levels of thromboxane B2 (TXB2) and 6-keto-prostaglandin F1?(6-K-PGF1?) in serum were measured at different intervals during and after CPB. The ultrastructure of platelets was also observed by transmission electron microscope.Results The levels of TXB2 and 6-K-PGF1? during CPB were significantly higher than those before CPB in the both groups(P