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Influenza virus causes serious threat to human life and health. Due to the inherent high variability of influenza virus, clinically resistant mutant strains of currently approved anti-influenza virus drugs have emerged. Therefore, it is urgent to develop antiviral drugs with new targets or mechanisms of action. RNA-dependent RNA polymerase is directly responsible for viral RNA transcription and replication, and plays key roles in the viral life cycle, which is considered an important target of anti-influenza drug design. From the point of view of medicinal chemistry, this review summarizes current advances in diverse small-molecule inhibitors targeting influenza virus RNA-dependent RNA polymerase, hoping to provide valuable reference for development of novel antiviral drugs.
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Hemagglutinin and neuraminidase, two important glycoproteins on the surface of influenza virus, play a considerable role in the entry and release stage of the viral life cycle, respectively. With in-depth investigation of influenza virus glycoproteins and the continuous innovation of drug discovery strategies, a new generation of glycoproteins inhibitors have been continuously discovered. From the point of view of medicinal chemistry, this review summarizes the current advances in seeking small-molecule inhibitors targeting influenza virus glycoproteins, hoping to provide valuable guidance for future development of novel antiviral drugs.
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OBJECTIVE@#To evaluate the clinical effectiveness and safety of the Chinese medicine (CM) Qixiong Zhongzi Decoction (, QZD) in the treatment of patients with idiopathic asthenozoospermia.@*METHODS@#A total number of 66 patients with idiopathic asthenozoospermia were included and randomly divided into treatment and control groups by SAS-generated code from January 2015 to August 2016, 33 patients in each group. Patients in the treatment group were administered with 150 mL of QZD twice a day, whereas those in the control group were given 1 g of levocarnitine oral liquid twice a day. The two groups received the indicated medication for 12 weeks and were then followed up for 4 weeks. The primary outcome was sperm motility, and the secondary therapeutic indices were sperm volume, density, pregnancy probability, and CM syndrome score. The comparison between groups was carried out at 4, 8 and 12 weeks, respectively. The safety was determined before and after treatment.@*RESULTS@#(1) Drop-off: 5 cases (7.58%) were lost after treatment (2 from the treatment group and 3 from the control group). (2) Primary outcomes: after 8- and 12-week treatment, the progressive sperms in the two groups were significantly higher than the baseline (all P0.05), however, the CM syndrome score of the treatment group significantly declined compared with baseline level at each time points (all P<0.05). (4) Safety: no obvious side reactions were found during the treatment in both groups.@*CONCLUSION@#QZD could improve the progressive and non-progressive grade sperm in the treatment of idiopathic asthenozoospermia. It is safe with no obvious side effects.
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Objective To observe the clinical efficacy of tendons layer overall release treatment by needle knife for the third lumbar transverse process syndrome (TLTPS). Methods Totally 66 cases of TLTPS patients were divided into control group and experimental groups by using random number table method, with 33 cases in each group. L3 spinous process opened 3 cm looking for tenderness. Control group received lumbar transverse pressure tender point knife release treatment. On the basis of control group, experimental group received tendons layer overall release treatment by needle knife. Both control group and experimental group received treatment once. VAS and ODI before treatment and after treatment of 1, 2 and 3 months were observed. Clinical efficacy was evaluated. Adverse reactions and complications were observed. Results The experimental group and control group lost 1 and 2 cases, respectively. Compared with before treatment, the VAS and ODI in both groups after treatment decreased (P<0.05). After treatment, the VAS and ODI in the experimental group were lower than those of the control group, with statistical significance (P<0.05). The total effective rate of clinical efficacy was 96.88% (31/32) in the experimental group and 93.55% (29/31) in the control group, with experimental group better than the control group (Z=-2.756, P=0.006). There were no adverse reactions or complications in both groups. Conclusion Tendons layer overall release treatment combined with lumbar transverse pressure tender point knife release treatment for TLTPS can significantly improve the clinical efficacy of TLTPS, with long effects.
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OBJECTIVE: To establish a weighted least square method for the accelerated degradation analysis of protein-type biological standard substances.METHODS: A mathematical model was proposed to estimate the parameters of degradation rate constants k at the elevated temperatures based on the Arrhenius or Eyring equation and chemical reaction principles under the suitable assumptions. Hence, it is probably to predict the stability of biological standard at the normal condition by solving the model.RESULTS: According to the experimental data of recombinant human granulocyte colony-stimulating factor and interferon α-2a, the preliminary numerical experiments were also performed and the results confirm the reliability of the method in the paper.CONCLUSION: The same methodology may be applied in the pharmaceutical industry where it is necessary to predict the viable shelf-life of biological products.
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<p><b>OBJECTIVE</b>To observe the effificacy and safety of Qiaoshao Formula (, QSF) on patients with lifelong premature ejaculation (LPE) of Gan (Liver) depression and Shen (Kidney) defificiency syndrome.</p><p><b>METHODS</b>A total of 60 LPE patients were randomly divided into treatment (QSF) and control (dapoxetine) groups. The treatment group received QSF twice a day and the control group received dapoxetine 1 to 2 h prior to planned sexual intercourse for 4 weeks. The outcomes included intra-vaginal ejaculation latency time (IELT), premature ejaculation diagnostic tool (PEDT), clinical global impression of change (CGIC), scores of Chinese medicine symptoms (CMSS), sex life satisfaction (SLS) and adverse events (AEs).</p><p><b>RESULTS</b>In the treated group, the median IELT was 3 min vs. 1.5 min before and after treatment (P<0.05). PEDT in the treated group was reduced to 11.76±1.68 from 15.83±2.30 after treatment (P<0.05). Besides, patient's SLS was improved from 1.30±0.05 to 6.30±0.04 (P<0.05), and spouse's SLS was increased from 1.30±0.to 6.10±0.06 (P<0.05); CMSS was decrease from 14.86±3.02 to 9.62±2.87 (P<0.05). In addition, no significant AE was observed in both groups.</p><p><b>CONCLUSION</b>QSF may be effective and safe on LPE patients with Gan depression and Shen defificiency syndrome.</p>
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Adult , Humans , Male , Middle Aged , Young Adult , Drugs, Chinese Herbal , Therapeutic Uses , Kidney , Pathology , Liver , Pathology , Personal Satisfaction , Premature Ejaculation , Diagnosis , Drug Therapy , Syndrome , Time Factors , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To evaluate the clinical efficacy of acupuncture for treatment of diarrhea-predominant irritable bowel syndrome and discuss its action mechanism.</p><p><b>METHODS</b>Fifty-seven cases were randomly divided into two groups. The acupuncture group (29 cases) was treated with acupuncture at Taichong (LR 3), Zusanli (ST 36) and Sanyinjiao (SP 6) etc., once a day and 5 times per week. The medication group (28 cases) was treated with oral administration of pinaverium (50 mg each time, 3 times a day) and live combined bifidobacterium and lactobacillus tablet (4 tablets each time, 3 times a day). Four weeks were taken as a treatment course in both groups. Before and after treatment ELISA method was applied to measure the level of serum 5-HT of the patients in two groups. The scores of clinical symptoms were observed before treatment, after one and four weeks of treatment and 3 months after treatment, respectively.</p><p><b>RESULTS</b>The level of serum 5-HT was significantly reduced in the acupuncture group and medication group (P < 0.01, P < 0.05), which had no statistical difference between two groups (P > 0.05). Compared with the medication group, the scores of clinical symptoms were obviously improved in the acupuncture group after one and four weeks of treatment and 3 months after treatment (P < 0.01, P < 0.05). The total effective rate was 89.66% (26/29) in the acupuncture group, which was superior to 67.85% (19/28) in the medication group (P < 0.05).</p><p><b>CONCLUSION</b>The efficacy of acupuncture is superior to that of medicine in the treatment of diarrhea-predominant irritable bowel syndrome. The acupuncture treatment could reduce the visceral sensitivity, improve the intestinal motility and regulate the imbalance of brain-intestine interactive function.</p>
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Female , Humans , Male , Acupuncture Points , Acupuncture Therapy , Diarrhea , Blood , Therapeutics , Irritable Bowel Syndrome , Blood , Therapeutics , Serotonin , Blood , Treatment OutcomeABSTRACT
<p><b>BACKGROUND</b>Central venous stenosis and obstruction (CVD) is a serious and prevalent challenge to both resolve the venous hypertension symptoms and maintain the pantency of the ipsilateral hemodialysis access in hemodialysis patients. This study aimed to summarize our experience of the endovascular management of the central venous stenosis or obstruction in hemodialysis patients.</p><p><b>METHODS</b>Twenty-four haemodialysis cases of central vein stenosis or obstruction with ipsilateral functional vascular access in our hospital between July 2006 and February 2012 were treated by interventional therapy and the data were analyzed retrospectively.</p><p><b>RESULTS</b>Eighteen males and six females with mean age of (66.4 ± 13.8) years and manifesting with arm swelling and venous hypertension were enrolled; 62.5% of them had a history of catheterization. Venography showed stenotic lesion in 10 cases including eight cases of brachiocephalic vein stenosis and two cases of subclavian vein stenosis and 14 cases of obstruction lesions including seven cases of short brachiocephalic obstruction and seven cases of long segment obstruction. Interventional therapy was performed and the technique success rate was 83.3%. Percutaneous transluminal angioplasty (PTA) was performed in nine cases and stent was performed in 11 cases firstly. The symptoms of venous hypertension were resolved after intervention in all the cases. There was no major complication and death perioperatively. During follow-up, reintervention was done, the primary patency rates were (88.9 ± 10.5)%, (64.8 ± 10.5)% and (48.6 ± 18.7)% at 3 months, 6 months and 1 year after treatment in the PTA group; (90.0 ± 9.5)% and (77.1 ± 14.4)% at 6 months and 1 year after treatment in the stent group, respectively. The secondary patency rates were (48.6 ± 18.7)% in the PTA group and (83.3 ± 15.2)% in the stent group 1 year after treatment, respectively. There was no significant difference between the two groups (primary patency, P = 0.20; secondary patency, P = 0.10).</p><p><b>CONCLUSIONS</b>The endovascular intervention is a safe and effective method for CVD in short term; enhanced follow-up and repeated interventions are required to maintain patency for long term. The prevention is most important. Avoiding and minimizing the placement of the central venous catheter may be the key point for the prevention.</p>
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Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Angioplasty, Balloon , Methods , Catheterization, Central Venous , Constriction, Pathologic , Renal Dialysis , Retrospective Studies , Stents , Treatment Outcome , Venous Thrombosis , TherapeuticsABSTRACT
<p><b>BACKGROUND</b>Endovenous laser ablation (EVLA) is an improved method to treat varicose great saphenous veins (GSV) with a high satisfactory rate. This study aimed to evaluate the efficiency and safety of treatment by EVLA procedures with ultrasound-guided perivenous tumescence.</p><p><b>METHODS</b>Thirty-one patients (31 limbs) with symptomatic varicose vein primary to chronic venous insufficiency (CVI) treated with EVLA were prospectively studied. The entire procedure was performed under ultrasound-guided tumescent local anesthesia. The patients were evaluated with a 18 month follow-up postoperation using clinical examination and venous duplex ultrasonography. Pain scores and quality of life (QOL) were recorded using visual analog scale (VAS) and the chronic venous insufficiency questionnaire (CIVIQ) at 1 week, 1 month, and 12 months after operation.</p><p><b>RESULTS</b>All patients tolerated EVLA procedure well. The overall success occlusion rates of GSV were 92%, 94%, and 94% at 1, 12, and 18 months follow-up, respectively. The score of CIVIQ one week preoperation was 69.14 ± 11.44 while that of CIVIQ one month postoperation was 85.32 ± 4.89. The life quality has significantly improved after the operation of EVLA (t = 12.71, P < 0.05). The VAS one month after treatment was lower than 1 week before therapy (t = 8.048, P < 0.05). Major complications such as deep vein thrombosis and skin burns were not found. Most of the complications were minor and improved quickly.</p><p><b>CONCLUSIONS</b>This refinement type of EVLA procedure is a safe and effective treatment with a high satisfaction rate; it displayed noteworthy features including shortening hospitalization, early ambulant activity, and preferable occlusion rates.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Laser Therapy , Methods , Prospective Studies , Saphenous Vein , Diagnostic Imaging , General Surgery , Treatment Outcome , Ultrasonography , Varicose Veins , Diagnostic Imaging , General SurgeryABSTRACT
<p><b>OBJECTIVE</b>To observe clinical therapeutic effects of acupuncture for pattern of liver-stagnation and spleen-deficiency in diarrhea-predominant irritable bowel syndrome (D-IBS) and its impact on cell factors.</p><p><b>METHODS</b>Forty cases were selected and divided into an acupuncture group (21 cases) in which acupuncture was applied and a medicine group (19 cases) in which oral administration of dicetel and bifidobacterium lactobacillus triple viable capsules were applied. The symptom scores, level of Th1-type cytokine (IFN-gamma, IL-2) and Th2-type cytokine (IL-4, IL-10) and ratio of IFN-gamma to IL-4 were compared in two groups before and after treatment to analyze acupuncture effect.</p><p><b>RESULTS</b>The clinical symptoms were improved after one-week treatment in the acupuncture group (P<0.05), which had faster onset than the medicine group (P<0.05). The total effective rate was 90.48% (19/21) in the acupuncture group, which was superior to 78.95% (15/19) in the medicine group (P<0.05). Compared with medicine treatment, imbalanced condition of Th1/Th2 was turning towards the direction of Th2 after acupuncture, indicating a tendency to recover the balance.</p><p><b>CONCLUSION</b>The clinical efficacy of acupuncture for D-IBS has close relationship with effectively improving balance of Th1/Th2 in patients with liver-stagnation and spleen-deficiency.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Acupuncture Therapy , Cytokines , Allergy and Immunology , Irritable Bowel Syndrome , Allergy and Immunology , Therapeutics , Liver , Spleen , Th1 Cells , Allergy and Immunology , Th2 Cells , Allergy and ImmunologyABSTRACT
<p><b>OBJECTIVES</b>To describe a procedure of the retrograde approach for endovascular treatment of complex popliteal and/or infrapopliteal occlusions and to determine its safety and efficacy in minimizing failure rates.</p><p><b>METHODS</b>Between January 2010 and March 2012, 28 patients (16 male and 12 female patients) received retrograde tibial approach after failure of antegrade intervention. There were 3 patients with severe claudication (Rutherford category 3) and 25 patients with critical limb ischemia (Rutherford category 4 to 6). From this group, two techniques were employed. Twenty-four patients were treated via a retrograde transpedal access site and 4 patients via a transcollateral loop technique. The clinical and follow-up data of these patients were analyzed retrospectively.</p><p><b>RESULTS</b>The technique success rates were 92.8% (26/28). No major complications and 3 (10.7%) minor sequelaes were documented in this study. Twenty-three patients were followed up for 3 to 29 months, with a mean of (14 ± 9) months. Overall patency was 73.9% (17/23) and 47.8% (11/23) at 6 and 12 months. Overall survival and limb salvage was 95.7% (22/23), ulcer were healed in 9/10 patients.</p><p><b>CONCLUSION</b>The use of retrograde tibial or pedal approach seems feasible and safety in case of failure in antegrade revascularization of popliteal and/or infrapopliteal occlusions.</p>
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Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Arterial Occlusive Diseases , Therapeutics , Popliteal Artery , Punctures , Methods , Retrospective Studies , Treatment OutcomeABSTRACT
<p><b>BACKGROUND</b>Endovascular recanalization (EVR) is becoming the primary therapy for patients with central venous (brachiocephalic, subclavian, and superior vena cava) occlusion (CVO) caused by benign etiology. In this study, we retrospectively analyzed our experience in using EVR to treat benign CVO in 10 patients between April 2005 and September 2010.</p><p><b>METHODS</b>The mean age of the patients was 65.3 years, 2/10 cases were female, and the origin of cause of CVO in 7/10 cases was the hemodialysis access in the upper extremity. The patients were treated with primary stent placement and evaluated with immediate technical success rate and post-interventional patency rate after the procedure.</p><p><b>RESULTS</b>Eight patients were treated successfully with stent placement and experienced symptomatic relief immediately. No technical complications were observed during EVR treatment. Patients were followed up by ultrasonography and venography. Median follow-up was 13 months. Three patients required secondary procedures to maintain patency.</p><p><b>CONCLUSIONS</b>EVR is an effective and safe treatment in patients with benign CVO. It provides immediate symptom relief and maintains a continuous access for hemodialysis.</p>
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Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Brachiocephalic Veins , Pathology , Endovascular Procedures , Methods , Subclavian Vein , Pathology , Vascular Diseases , Therapeutics , Vena Cava, Superior , PathologyABSTRACT
<p><b>OBJECTIVE</b>To discuss the technique details of subintimal arterial flossing with antegrade-retrograde intervention (SAFARI) to improve technical success in the treatment of chronic total occlusions (CTO) diseases in lower extremity when there is failure to reenter the distal true lumen.</p><p><b>METHODS</b>Between May 2009 and Aug 2010, 15 patients underwent endovascular recanalization with SAFARI technique. There were 8 male and 7 female patients with a mean age of 74.9 years. There were 3 patients with severe claudication (Rutherford category 3) and 12 patients with critical limb ischemia (Rutherford category 4 to 6). The clinical and follow-up data of these patients were analyzed retrospectively.</p><p><b>RESULTS</b>Fourteen patients were treated with SAFARI technique successfully. The technique success rates were 93.3%. The mean ankle brachial index increased from 0.39 to 0.83.Symptoms were relieved in 86.6% patients, Ulcer were healed in 93.3%patients.</p><p><b>CONCLUSIONS</b>SAFARI technique is a safe and effective method in treating CTO diseases, when it is failure to renter the distal true lumen with subintimal angioplasty technique.</p>
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Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Angioplasty, Balloon , Methods , Arterial Occlusive Diseases , General Surgery , Follow-Up Studies , Lower Extremity , Retrospective StudiesABSTRACT
<p><b>OBJECTIVE</b>To investigate the effect of preoperative use of viable Bifidobacterium supplement on the intestinal flora, immune status, inflammatory response and prognosis of patients undergoing colorectal cancer resection.</p><p><b>METHODS</b>Sixty patients with colorectal cancer were randomized into treatment group (n=30) and control group (n=30). Patients in the treatment group received oral viable Bifidobacterium with routine enteral nutrition and patients in the control group received routine enteral nutrition alone. The intestinal flora of stool was analyzed and stool SIgA, serum IgG, IgM, IgA, IL-6, and C-reactive protein (CRP) were detected.</p><p><b>RESULTS</b>Postoperative Bifidobacterium/E.coli (B/E) ratio in the treatment group decreased significantly as compared to the preoperative ratio (2.01+/-0.36 vs 26.53+/-4.22, P<0.05). However, the ratios remained above one. Both preoperative and postoperative B/E ratios in the control group (0.72+/-0.14, 0.02+/-0.06) were significantly lower than those in the treatment group (P<0.05). Indexes of immunity and inflammation were not significantly different between the two groups (P>0.05). At day 9 after operation, stool SIgA was higher in the treatment group, while serum IgG, IgM, IgA, IL-6, CRP in the treatment group were lower (P<0.05). Postoperative septic complications in the treatment group was less than that in the control group (P<0.05), but other complications and hospital stay were comparable.</p><p><b>CONCLUSIONS</b>In patients with colorectal cancer, supplementation of viable Bifidobacterium before surgery can improve bacterial dysbiosis and immunity, and can reconstruct the balance of intestinal flora, and reduce infection complication of surgery.</p>
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Antibodies , Blood , Bifidobacterium , C-Reactive Protein , Colorectal Neoplasms , Allergy and Immunology , Microbiology , Therapeutics , Inflammation , Interleukin-6 , Blood , Postoperative Period , Probiotics , Therapeutic UsesABSTRACT
<p><b>OBJECTIVE</b>To review the follow-up results of the crural artery bypass.</p><p><b>METHODS</b>Sixty-five limbs in 64 patients with long stenosis or occlusion in femoral artery and popliteal artery were performed 65 times femoral-crural artery bypass surgery or femoral-popliteal-crural bypass surgery during April 2001 to July 2007. The ankle-brachial index before bypass surgery was 0.35 +/- 0.20 in anterior tibial artery and 0.38 +/- 0.21 in posterior tibial artery. Critical limb ischemia was 93.8%.</p><p><b>RESULTS</b>The ankle-brachial index after bypass surgery was 0.84 +/- 0.26 in anterior tibial artery and 0.83 +/- 0.22 in posterior tibial artery. The perioperative mortality rate was 1.6%, the perioperative amputation rate was 1.5%. Fifty-four patients 54 limbs were followed up. The average follow-up time was (24.1 +/- 16.6) months. The follow-up limb salvage rate was 85.2%. The follow-up mortality rate was 25.9%. Critical limb ischemia decreased as 13.0%. The follow-up ankle-brachial index was difference with before and after bypass surgery as 0.66 +/- 0.26 in anterior tibial artery and 0.64 +/- 0.25 in posterior tibial artery. It was no difference in cumulative limb salvage rate, cumulative primary and secondary patency rate by comparing autogenous vein with composite vascular as graft and comparing femoral-crural artery bypass surgery with femoral-popliteal-crural bypass surgery as surgical method.</p><p><b>CONCLUSIONS</b>When the patients are failed in endovascular intervention or have long stenosis or occlusion in femoral artery and popliteal artery to face to amputation, the crural artery bypass is a feasible method. It's helpful to improve the secondary patency rate and limb salvage rate by enhancing the follow-up after operation and early intervention.</p>
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Arterial Occlusive Diseases , General Surgery , Femoral Artery , General Surgery , Follow-Up Studies , Leg , Popliteal Artery , General Surgery , Retrospective Studies , Treatment Outcome , Vascular Surgical ProceduresABSTRACT
<p><b>OBJECTIVE</b>To investigate the patency efficacy of small diameter artificial vascular graft with eNOS gene transfected endothelial cells in canine.</p><p><b>METHODS</b>By using the two steps high pressure injection, eNOS gene transfected endothelial cells were planted on artificial vascular graft with a diameter of 3 mm. The artificial vascular grafts were transplanted into canine femoral artery, and the patency of the artery was observed through digital subtracted angiography (DSA) and electron telescope 1, 4, 12 and 24 weeks after the operation.</p><p><b>RESULTS</b>The adherence rate of eNOS gene transfected endothelial cells to artificial vascular grafts was up to 90%. For 10 days, the cells extended and formed a continuous intima. One week after the operation, 3/9 grafts were obstructed in the group of simple artificial vascular grafts; 4 weeks after, all of grafts (9/9) were obstructed in the group of simple artificial vascular grafts and almost half grafts (5/10, 4/9) in un-transfected groups were obstructed; 12 weeks after, all of the grafts were obstructed in the group of simple artificial vascular grafts and in un-transfected groups (9/9, 9/10); 24 weeks after, all of the grafts were obstructed in the groups of un-transfected artificial vascular grafts, while nearly all of grafts (8/10) were open in eNOS groups. Electron microscope scanning showed that endothelial cells of artificial vascular grafts in eNOS transfected groups arranged closely and formed a continuous intima; only few red blood cells, leucocytes, platelets deposited at the surface of endothelial cells in the artificial vascular grafts.</p><p><b>CONCLUSIONS</b>The patency efficacy of eNOS gene transfected endothelial cells planting on artificial vascular graft is satisfactory. It could provide an experimental basis for further clinical application of the artificial vascular grafts.</p>
Subject(s)
Animals , Dogs , Female , Male , Blood Vessel Prosthesis , Blood Vessel Prosthesis Implantation , Cells, Cultured , Endothelial Cells , Cell Biology , Metabolism , Genetic Vectors , Nitric Oxide Synthase , Genetics , Random Allocation , TransfectionABSTRACT
<p><b>BACKGROUND</b>The influence of inflammatory processes has been one of the hot topics in discussions of the etiology of chronic venous insufficiency (CVI). Erythrocytes are very important in controlling inflammatory immunity and innate immune reactions. The purpose of this study was to analyze the correlation between the development of CVI and the change of CD35, Fy6 on erythrocytes, and interleukin-8 (IL-8) levels.</p><p><b>METHODS</b>A group of 43 patients with CVI were studied in parallel with 8 healthy individuals serving as control subjects. Control subjects were those with normal findings on lower extremity duplex examinations. We used an erythrocyte flow cytometer to examine the expression of both CD35 and Fy6 on red blood cells, and an enzyme-linked immunosorbent assay analysis method to measure plasma IL-8 levels. We also analyzed the change of IL-8 levels under the influence of erythrocytes using a modified method of the hemaimmune reaction.</p><p><b>RESULTS</b>Compared with normal control subjects, CD35 expression increased significantly among patients with CVI classified as C4 without lipodermatosclerosis, but tended to decrease and reach the lowest level among patients classified as C5-C6. Fy6 expression increased significantly among patients in the early stages of CVI, but tended to decrease remarkably among patients classified as C5-C6. The inflammatory response intensified at the C5-C6 classification, where high levels of IL-8 coexisted with a low expression of Fy6. The increase in IL-8 in the CVI group was higher than in the control group in association with the complete blood cells, regardless of the presence of erythrocytes, when inactive tumour cells were added, whereas the level of IL-8 in the CVI group was significantly lower than in the control group.</p><p><b>CONCLUSIONS</b>Abnormalities of erythrocyte innate immunity represents a fundamental derangement in CVI. These inadequate inflammatory responses may lead to local tissue and microvascular damage of the lower extremity.</p>
Subject(s)
Humans , Chronic Disease , Duffy Blood-Group System , Blood , Erythrocytes , Allergy and Immunology , Physiology , Interleukin-8 , Blood , Physiology , Leg , Receptors, Cell Surface , Blood , Receptors, Complement 3b , Blood , Venous Insufficiency , Allergy and ImmunologyABSTRACT
The evaluation systems for chronic venous insufficiency of lower extremities play a very important role in standardizing the diagnosis and evaluating the curative effect in patients with the disease. This paper gives an introduction to the CEAP classification system, VSS evaluation system and chronic venous insufficiency questionnaire.
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<p><b>BACKGROUND</b>We reviewed the outcomes of reoperations for 29 patients (30 limbs) who had undergone occluded arterial bypass in the lower limbs from May 1996 to September 2005.</p><p><b>METHODS</b>The 30 lower limbs of the 29 patients with arteriosclerotic obstruction received 44 reoperations, including thrombectomy alone (group T, 27) and inflow or outflow reconstruction plus thrombectomy (group C, 17). Among the 17 operations in group C, 17.6% (3/17) were inflow reconstructions involving the axillary-femoral (1), aorta-iliac (1) and aorta-femoral (1) arteries, and 76.4% (13/17) outflow reconstructions involving the femoral-popliteal bypass-tibial (8), femoral-tibial (1), femoral-popliteal bypass-popliteal arteries below the knee (2), and the femoral-popliteal bypass-tibial-peroneal trunk (2). One patient (1 limb) underwent both inflow and outflow reconstructions with an iliac arterial stent and a graft-popliteal anastomosis patch. Polytetrafluoroethylene (PTFE) grafts were used in the inflow or outflow reconstructions above the knee. Autovenous grafts or autovenously combined PTFE grafts were used in the outflow reconstructions below the knee.</p><p><b>RESULTS</b>The percentages of Fontaine stage III and IV before primary operation and reoperation were 60% (18/30) and 86.7% (26/30), respectively (P < 0.05). Four patients died of heart attack (2), stroke (1) and multiple organ failure (1) after reoperations. Among them, only 1 patient underwent occluded bypass, and others, patent bypass. Five patients after patent bypass are still alive. The accumulative patent rate was 28.6% (8/28). The average duration of patency in groups T and C was (4.16 +/- 5.68) (0.13 - 24) months and (7.14 +/- 6.37) (0.26 - 21) months, respectively (P > 0.05). Among 42 reoperations, 19 failed within 1 month in groups T (16) and C (3) (P < 0.01). Nine patients had limb amputated (10/28 limbs, 35.71%) because of graft infection (2 limbs), pseudo aneurysm at anastomosis (1 limb), and gangrene caused by failed grafts (7 limbs). The amputation was performed on 6 limbs within 1 month and on 4 limbs 1 month after reoperation (P > 0.05). The rate of limb salvage was 64.29% (18/28).</p><p><b>CONCLUSIONS</b>The percentages of Fontaine stage III and IV before reoperation may be much higher than those before primary operation. Thrombectomy plus inflow/outflow reconstruction creates patency better than thrombectomy alone for re-occluded bypass.</p>
Subject(s)
Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Arteriosclerosis , General Surgery , Lower Extremity , Plastic Surgery Procedures , Reoperation , ThrombectomyABSTRACT
Objective To study endothelial nitric oxide synthase (eNOS) gene transfecting endothelial cells (ECs). Methods eNOS gene was transfected into the steady ECs system by cationic liposomal transduction and check the transfection effect by RT-PCR and immunohistochemistry assay. To test the concentrations of NOS, nitric oxide (NO) and von willebrand factor (vWF) in culture media by colorimetry and ELISA, respectively,and transfected EC function was observed. Results The effect of transfection was satisfactory with RT-PCR products electrophoresis, sequence and immunohistochemistry. The concentrations of NOS and NO in transfected EC culture media increased with time (P