Comparison of open and endovascular repair for abdominal aortic aneurysm mid-term outcomes: a single center randomized controlled trial / 中华外科杂志

<p><b>OBJECTIVE</b>To compare the effects of open and endovascular repair for abdominal aortic aneurysm.</p><p><b>METHODS</b>Between January 2009 and January 2011, 84 patients were randomized to endovascular aneurysm repair (EVAR) or open repair. There were 48 patients in EVAR group, 42 cases were male (87.5%), 6 cases were female (12.5%), aged from 50 to 83 years with a mean of 70.8 years. There were 36 patients in open repair group, 31 cases were male (86.1%), 5 cases were female (13.9%), aged from 50 to 80 years with a meal of 67.4 years. The results of perioperative period and follow-up were analyzed.</p><p><b>RESULTS</b>Between the two groups, there was significant difference on operative time (t = 9.863, P = 0.000), blood loss (t = 4.647, P = 0.000), blood transfusion (t = 3.334, P = 0.002), hospital stay (t = 2.327, P = 0.022), and medical expense (t = 2.314, P = 0.023). There was no significant difference for perioperative complications (χ(2) = 0.480, P = 0.488). There was no significant difference for complications (χ(2) = 0.664, P = 0.415) and mortality (P = 0.429) during 3 months follow-up. There was no significant difference for complications during 6 months follow-up (χ(2) = 0.128, P = 0.720).</p><p><b>CONCLUSIONS</b>Operative time, blood loss and transfusion, hospital stay in EVAR group are less than which in open repair group, the medical expense of EVAR was higher than open repair. There is no significant difference for complications during 6 months follow-up between 2 groups. Long-term follow-up and more patents are needed to analyze survival rate and long-term complications.</p>

Comparison of open and endovascular repair for abdominal aortic aneurysm / 中华外科杂志

<p><b>OBJECTIVE</b>To compare the effects of open and endovascular repair for abdominal aortic aneurysm.</p><p><b>METHODS</b>From January 2002 to July 2007, clinical data of 223 patients with infrarenal abdominal aortic aneurysm undergoing open (141 patients) or endovascular repair (82 patients) were retrospectively reviewed. The intra- and post-operative complications, mortality, complications, survival, life quality, and cost during follow-up were analyzed.</p><p><b>RESULTS</b>Operative time in endovascular group was significantly shorter than open repair group. Blood loss and transfusion in endovascular group were significantly less than open repair group (P < 0.01). There was no significant difference of intra- and post-operation complications (P > 0.05). Six-month total SF-36 scores were significantly higher in open repair group compared with endovascular group. There was no significant difference of survival rate at 2 years (P > 0.05), but endovascular group had fewer complications (P < 0.01).</p><p><b>CONCLUSIONS</b>Endovascular repair is mini-invasive, but has more complications of long-term follow-up. The life quality in open repair group is better than endovascular group, and a prospective random trial is required.</p>

Problems and strategies for reoperation of vascular diseases / 中国医学科学院学报

Appropriate reoperation of the lower extremity artery may be required because of graft stenosis, occlusion, and infection. For high-risk patients who have no autogeneic vein available or who are not suitable for open reoperation, endoluminal plasty may be an alternative. The options of treatment for abdominal aortic aneurysm include traditional procedures and endovascular aneurysm repair (EVAR). The reintervention rate is higher in EVAR than in traditional procedures. The options of treatment for recurrent carotid artery stenosis remain controversial. The advantages and disadvantages of carotid endarterectomy (CEA) and carotid artery stent (CAS) should be compared under comparable clinical situations.

Change of the chromosome conformation of human alpha-globin gene locus in transgenic mice / 中国医学科学院学报

<p><b>OBJECTIVE</b>To establish chromosome conformation capture (3C) strategy and to use this method for exploring the effect of chromosome conformation on human alpha-globin gene expression in the human alpha-globin transgenic mouse.</p><p><b>METHODS</b>Homozygous human alpha-globin transgenic male mouse was crossed with KM female mouse. The 14.5-day post-coitum (dpc) embryos were used for the isolation of fetal liver and fetal brain cells. Homogeneous single-cell suspension was treated with formaldehyde to crosslink the chromatin conformation in the nuclear. The cross-linked chromatin compound was digested with Nco I and then ligated with T4 DNA ligase. The ligated compound was reversely cross-linked and then the ligated genomic DNA was purified for PCR analysis. The primers were designed along the two sides of cut and ligated sites. Semi-quantitative PCR was used to analyze the chromosome conformation of the whole human alpha-globin gene locus in fetal liver and fetal brain cells.</p><p><b>RESULTS</b>When HS40 fragment was used as the fixed fragment, in fetal brain cells, the ligation frequencies of HS40 fragment with other fragments were decreased as the linear distances to HS40 fragment were increasing; while in fetal liver cells, two active genes (alpha1 and alpha2) fragments showed higher ligation frequencies with HS40 fragment than other fragments. However, the fragment containing an inactive gene (xi) displayed the comparable low ligation frequency as that in fetal brain. When alpha2 fragment was used as the fixed fragment, similarly, in fetal brain cells the ligation frequencies of alpha2 fragment with other ones were decreased as the linear distances increasing; when in fetal liver cells, it showed higher ligation frequencies with two upstream regulatory elements (HS 40 and 33). However, it showed a little bit lower ligation frequency with another two upstream regulatory elements (HS10 and 8) than those in fetal brain.</p><p><b>CONCLUSION</b>In fetal liver cells, the distant regulatory elements are in close proximity to the downstream of the expressed globin genes through looping out, the interval region; however, in fetal brain, they were not in vicinity to the expressed globin genes.</p>