Objective: To examine the effect of excimer laser ablation (ELA) combining with drug-coated balloon (DCB) for atherosclerotic lesions in no-stenting zones (NSZ) of the lower extremity. Methods: From June 2019 to December 2021, 46 patients who underwent ELA combining with DCB in lesions of NSZ at Zhongshan Hospital, Fudan University and Jinshan Hospital, Fudan University were retrospectively enrolled, including 29 males and 17 females. The age was (72.5±11.7) years (range: 42 to 93 years). Among them, 44 lesions (95.7%, 44/46) were in popliteal artery and 2 lesions (4.3%, 2/46) were in common femoral artery. Chronic total occlusion (CTO) was observed in 31 patients (76.4%, 31/46), and stenotic lesions were observed in 15 patients (32.6%, 15/46). The length of lesions was (7.3±2.7) cm (range: 3.0 to 13.2 cm). Patients were followed at 6, 12 months after surgery and every year thereafter, and they underwent Doppler and CT angiography examination at each follow-up point. The primary endpoint was primary patency. The secondary endpoints included major amputation-free survival (MAFS) rate, technical success, bailout stent, ankle-brachial index (ABI), target lesion reintervention (TLR). Student t test was applied to compare the difference between ABI of 6 or 12 months after surgery and the baseline. Primary patency, freedom from TLR, and MAFS rate were calculated by Kaplan-Meier method. Results: The technical success rate was 91.3% (42/46). The rate of procedure-related complication was 6.5% (3/46), and all the complications were distal embolization. The rate of flow-limiting dissection was 8.7% (4/46). ABI was significantly increased at 6 and 12 months compared to preoperatively (0.90±0.10 vs. 0.42±0.10, t=-4.48, P<0.01; 0.87±0.12 vs. 0.42±0.10, t=-5.21, P<0.01). The follow-up time[M(IQR)] was 22.5 (8.8) months (range: 6 to 32 months). TLR was performed in 4 patients (4/46, 8.7%). The 2-year primary patency was 86.2% (95%CI: 71.8% to 93.5%). The 2-year freedom from TLR and MAFS rate were 90.7% (95%CI: 77.0% to 96.4%) and 97.8% (95%CI: 85.6% to 99.7%), respectively. Conclusion: ELA combining with DCB can be applied to treat atherosclerotic lesions in NSZ.
Humans ; Adult ; Middle Aged ; Aged ; Aged, 80 and over ; Retrospective Studies ; Arteries ; Laser Therapy

Objective To analyze the trend of death level and the probability of premature death caused by chronic obstructive pulmonary disease (COPD) in Jinshan District of Shanghai from 1980 to 2020, and to provide reference for the formulation of prevention and control measures of COPD. Methods The death cases of COPD in Jinshan District from 1980 to 2020 were collected through the death cause registration information system. The crude mortality, standardized mortality, age group mortality, early death probability and annual change percentage in different periods were calculated. Results From 1980 to 2020, the crude mortality of COPD in Jinshan District was 154.38/100 000, and the standardized mortality was 82.66/100,000. In the past 41 years, the standardized mortality of COPD showed a downward trend in males and females (APC=-1.79%, -2.52%, P<0.001). In the same period, the mortality of COPD in subjects aged 30-69 years old and subjects aged 70 years old and above also decreased (APC=-8.79%, -4.79%, P<0.001), and the probability of premature death caused by COPD showed a downward trend in males and females (APC=-9.61%, -10.71%, P<0.001). Conclusion The mortality rate and the probability of premature death of COPD in Jinshan District have decreased in the past 41 years. However, COPD is still one of the major chronic diseases that pose a serious threat to the health of residents in Jinshan District. Comprehensive prevention and treatment measures should be taken to reduce the mortality and the probability of premature death of COPD.

Objective To analyze the epidemiological characteristics and seasonal distribution of hand, foot and mouth disease (HFMD) in a suburban town in Shanghai from 2012 to 2018, and to provide a scientific basis for formulating effective prevention and control strategies. Methods The incidence data of a suburban town in Shanghai from 2012 to 2018 was collected through the Chinese disease prevention and control information system and analyzed by descriptive epidemiological methods. Results From 2012 to 2018, a total of 538 cases of hand, foot and mouth disease were reported in the suburban town in Shanghai, with an average annual incidence of 186.27/100,000. The difference in incidence between each year was statistically significant (χ²=107.95, P<0.05). The age of onset was mainly children under 5 years old. Peak incidence was from May to September. The main occupation was scattered children. HFMD outbreaks mainly occurred in nurseries and schools, accounting for 60.53% of the total number of outbreaks. Conclusion From 2012 to 2018, the incidence of HFMD in a suburban town in Shanghai had a certain seasonality. It is recommended to implement preventive measures against HFMD for key populations and key places before the high incidence period to reduce the occurrence of severe cases and epidemic situations.

BACKGROUND: Although endovascular therapy has been widely used for focal aortoiliac occlusive disease (AIOD), its performance for extensive AIOD (EAIOD) is not fully evaluated. We aimed to demonstrate the long-term results of EAIOD treated by endovascular therapy and to identify the potential risk factors for the loss of primary patency. METHODS: Between January 2008 and June 2018, patients with a clinical diagnosis of the 2007 TransAtlantic Inter-Society Consensus II (TASC II) C and D AIOD lesions who underwent endovascular treatment in our institution were enrolled. Demographic, diagnosis, procedure characteristics, and follow-up information were reviewed. Univariate analysis was used to identify the correlation between the variables and the primary patency. A multivariate logistic regression model was used to identify the independent risk factors associated with primary patency. Five- and 10-year primary and secondary patency, as well as survival rates, were calculated by Kaplan-Meier analysis. RESULTS: A total of 148 patients underwent endovascular treatment in our center. Of these, 39.2% were classified as having TASC II C lesions and 60.8% as having TASC II D lesions. The technical success rate was 88.5%. The mean follow-up time was 79.2 ± 29.2 months. Primary and secondary patency was 82.1% and 89.4% at 5 years, and 74.8% and 83.1% at 10 years, respectively. The 5-year survival rate was 84.2%. Compared with patients without loss of primary patency, patients with this condition showed significant differences in age, TASC II classification, infrainguinal lesions, critical limb ischemia (CLI), and smoking. Multivariate logistic regression analysis showed age <61 years (adjusted odds ratio [aOR]: 6.47; 95% CI: 1.47-28.36; P = 0.01), CLI (aOR: 7.81; 95% CI: 1.92-31.89; P = 0.04), and smoking (aOR: 10.15; 95% CI: 2.79-36.90; P < 0.01) were independent risk factors for the loss of primary patency. CONCLUSION Endovascular therapy was an effective treatment for EAIOD with encouraging patency and survival rate. Age <61 years, CLI, and smoking were independent risk factors for the loss of primary patency.
Arterial Occlusive Diseases/surgery* ; Endovascular Procedures/methods* ; Female ; Humans ; Iliac Artery/surgery* ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors ; Stents ; Survival Rate ; Treatment Outcome ; Vascular Patency

Objective To investigate the pathogenesis characteristics and epidemic tendency of notifiable infectious diseases (NID) in Zhujing County of Shanghai from 2013 to 2017, and to provide scientific basis for effective prevention and control measures. Methods Descriptive epidemiological method was used to statistically analyze the epidemic data of NID in Zhujing County of Shanghai during 2013-2017 reported by the China Information System for Disease Control and Prevention. Results A total of 3 259 cases of 17 different NID were reported in Zhujing County of shanghai during 2013-2017.The average annual incidence rate was 509.89/10⁵, A total of 7 cases of death were reported and average annual rate of mortality was 1.10/10⁵.No type A NID was reported and a total of 1 089 cases of 13 type B NID were reported, with the average annual incidence rate of type A and B NID being 170.38/10⁵; a total of 2 170 cases of 4 type C NID were reported, with the average annual incidence rate of type C NID being 339.51/10⁵. The top 5 diseases were HFMD, influenza, syphilis, gonorrhea and tuberculosis, accounting for 32.46%, 25.65%, 17.40%, 7.24% and 5.43% of the total.The onset was mainly to occur from May to August and from December to January, mostly in 0-6 years and 18-40 years groups.Most of the cases were students, scattered children, nursery children, farmers, workers.The incidence rate was higher in men than in women, and the incidence rate of household-registered residents in this city was higher than that of floating population.Intestinal infectious diseases were the main components. Conclusion As HFMD, influenza, syphilis, gonorrhea, tuberculosis prove to be the key NID in Zhujing County of Shanghai, we should act according to the epidemic features of the infectious diseases to formulate perfect control strategy to prevent the outbreak and prevalence of infectious diseases.

Chest wall tuberculosis is a common extra-pulmonary tuberculosis, which often occurs in lung or pleura tuberculosis, or coexists with tuberculosis in other parts. The final manifestation of the disease is cold abscess on the chest wall, chronic sinuses with repeated exudation after the abscess is broken. At present, There were a series of problems in the diagnosis, treatment, and extremely prognosis of tuberculosis of the chest wall. Therefore, we reviewed the diagnosis of chest wall tuberculosis, including B-ultrasound, chest CT and positron emission tomography/computed tomography (PET/CT), tuberculous infectin of T cells spot test (T-SPOT TB), pathological examination. The related treatments including medical treatment, surgical treatment and other local treatment in order to better understand the chest wall tuberculosis.

BACKGROUND:In perioperative period of total knee replacement in elderly patients, it is crucial to maintain the normal function of blood coagulation. However, many factors may influence coagulation function of patients in perioperative period. Of them, anesthesia is an important factor. Different anesthesia methods wil produce different effects on blood coagulation. Appropriate anesthesia methods should be selected in the clinic to maintain the stability of coagulation function. OBJECTIVE:To explore the effect of application of general anesthesia and epidural anesthesia in elderly knee replacement and the effects on the function of blood coagulation. METHODS:A retrospective analysis was performed on clinical data of 135 elderly patients after total knee replacement in Dongying Hospital of Shandong Provincial Hospital Group from September 2012 to September 2013. Al patients were divided into control group (67 cases;general anesthesia) and observation group (68 cases;epidural anesthesia) according to the mode of anesthesia. Coagulation indexes and D-dimer levels were observed before anesthesia, 6 hours after anesthesia, and 1 day after replacement in both groups. The incidence of deep venous thrombosis was measured and compared between the two groups in 12-month fol ow-up.
RESULTS AND CONCLUSION:Through the statistics and comparison, no significant difference was detected in blood coagulation indexes at different time points in the two groups (al P>0.05). However, significant differences in D-dimer levels were detectable between the two groups at 6 hours after anesthesia and in the morning at 1 day after replacement. D-dimer levels were significantly lower in the observation group than in the control group (al P<0.05). The incidences of deep venous thrombosis were 3%and 21%in the observation and control groups, respectively, showing significant differences (P<0.05). These results suggest that epidural anesthesia during elderly totak knee replacement obtained good effects, and could maintain stable coagulation function.

OBJECTIVETo demonstrate the feasibility of extralevator abdominoperineal excision (ELAPE) for locally advanced low cancer in China.

METHODSA prospective multicenter clinical trial was carried out by 7 general hospitals across China from August 2008 to October 2011. A total of 102 patients underwent ELAPE for primary locally advanced low rectal cancer. There were 60 male and 42 female patients. The patients' characteristics, complications and prognosis were recorded.

RESULTSAll patients underwent the ELAPE procedure successfully. The median operating time was 180 minutes (range 110-495 minutes) and median intraoperative blood loss was 200 ml (range 50-1000 ml). The rates of sexual dysfunction, perineal complications, urinary retention, and chronic perineal pain were 40.5%, 23.5%, 18.6% and 13.7%, respectively. Chronic perineal pain was associated with coccygectomy (12 months postoperatively, t = 8.06, P < 0.01), and the pain might gradually ease over time. Reconstruction of pelvic floor with biologic mesh was associated with lower rate of perineal dehiscence (χ(2) = 13.502, P = 0.006) and overall perineal wound complications (χ(2) = 5.836, P = 0.016) compared with primary closure. A positive circumferential margin (CRM) was demonstrated in 6 (5.9%) patients, and intraoperative perforations occurred in 4 (3.9%) patients. All CRM involvement and intraoperative perforation located at anteriorly and anterolaterally. The local recurrence was 4.9% at a median follow-up of 35 months (range, 18-58 months).

CONCLUSIONSELAPE performed in the prone position for low rectal cancer leads to a reduction in CRM involvement, intraoperative perforations, and local recurrence, but it might result in a little high rate of perineal wound related complications. Reconstruction of pelvic floor with biologic mesh might lower the rate of perineal wound complications.

Adult ; Aged ; Digestive System Surgical Procedures ; methods ; Female ; Humans ; Male ; Middle Aged ; Perineum ; surgery ; Postoperative Complications ; Prognosis ; Prospective Studies ; Rectal Neoplasms ; surgery ; Treatment Outcome

Objective:To investigate the relationship between helicobacter pylori ( Hp) infection and proliferation as well as invasion of Uygur esophagus squamous cell carcinoma.Methods: Immunohistochemistry were used to detect Hp , Ki67 and MMP2 protein in 164 cases of Xinjiang Uygur esophageal squamous cell carcinoma tissue specimens.Results: The positive rates of Hp,Ki67 and MMP2 were 81.7%(134/164),67.1%(110/54) and 86.6%(142/164) respectively in 164 cases of esophageal squamous cell carcinoma.The expression of Ki67 in the Hp positive group of patients with esophageal squamous cell carcinoma were significantly higher than that in the Hp negative group and had positive correlation between them (rs=0.340,P<0.01),the expression of MMP2 in the Hp positive group were significantly higher than that in the Hp negative group and had positive correlation between them ( rs=0.739,P<0.01).Conclusion:The relationship between Xinjiang Uygur esophageal squamous cell carcinoma patients with Hp infection and cancer cell malignant degree of proliferation and invasion is close.