Study on the correlation between IL-1β ,Hcy ,Cys-C and HbA1c levels and senile type 2 diabetic peripheral neuropathy / 国际检验医学杂志

Objective To investigate the correlation of interleukin-1β (IL-1β) ,homocysteine (HCY) ,cysta-tin (Cys-C) and glycosylated hemoglobin (HbA1c) levels and senile type 2 diabetic peripheral neuropathy. Methods 104 patients with type 2 diabetes mellitus received in the hospital from June 2014 to December 2016 were selected as study group ,52 patients with peripheral neuropathy were served as study group A (n=52) and 52 patients with type 2 diabetes were served as study group B (n=52) ,and 52 healthy persons who under-went health assessement were taken as the control group.The Cys-C level was measured by immunoturbidime-try ,the levels of HCY and IL-1β were measured by enzyme-linked immunosorbent assay.The HbA1c level was measured by high performance liquid chromatography ,the IL-1β ,HCY ,Cys-C and HbA1c levels were com-pared in the three groups ,and the relationship between IL-1β ,HCY ,Cys-C and HbA1c levels and senile type 2 diabetic peripheral neuropathy were analyzed.Results Single factor variance analysis showed that the levels of IL-1β ,HCY ,Cys-C and HbA1c in the three groups were statistically significant (P＜0.05) ;LSD-t test showed that the IL-1β ,HCY ,Cys-C and HbA1c levels in the study group B were higher than those in control group , and IL-1β ,HCY ,Cys-C and HbA1c levels in the study group A were higher than those in the study group B , and the difference was statistically significant (P＜ 0.05) ;logisticis regression analysis showed that IL-1β , HCY ,Cys-C ,HbA1c levels were associated with type 2 diabetic peripheral neuropathy (P＜0.05) ;Spearman test showed that IL-1β ,HCY ,Cys-C ,HbA1c levels were positively correlated with type 2 diabetic peripheral neuropathy (P＜0.05).Conclusion IL-1β ,HCY ,Cys-C and HbA1c levels are positively correlated with senile type 2 diabetic peripheral neuropathy in the elderly ,and the IL-1β ,HCY ,Cys-C and HbA1c levels can be used to determine type 2 diabetic peripheral neuropathy in clinical work.

Azathioprine-induced myelosuppression in a pemphigus patient with a heterozygous mutation in the NUDT15 gene / 中华皮肤科杂志

A 49-year-old male patient presented with repeated oral erosions for 1 year,as well as cutaneous erythema and blisters for 1 month.According to histopathological examination and detection of specific antibodies of pemphigus,the patient was diagnosed with pemphigus vulgaris.After the treatment with oral prednisone and azathioprine for 1 month,the white blood cell count and segmented neutrophilic granulocyte count both decreased.After withdrawal of azathioprine,the patient was subcutaneously injected with 150 μg recombinant human granulocyte colony-stimulating factor for 1 session.Then,the white blood cell count became normal.Genotyping test revealed that the patient carried a heterozygous mutation in the NUDT15 gene (JZ274),and was homozygous for wild-type TPMT*2,TPMT*3C and ITPA genes.The patient was diagnosed with azathioprine-induced myelosuppression.

Periulcerous suturing for chronic deep venous thrombosis / 中华普通外科杂志

Objective To investigate the effect of periulcerous suturing on the healing of skin ulceration in patients with chronic deep venous thrombosis. Methods Thirty-two patients were divided into two groups: control group treated with drugs and compression therapy; suturing group treated with drugs, compression therapy and skin suturing around the ulceration. The clinical data of these cases were retrospectively studied. Result In the suturing group, perforator veins (1.0±0.8) decreased, oxygen saturation of venous blood (39±7) mm Hg and transeutaneous oxygen monitoring (tcPO_2) (71±12)mm Hg were elevated, the number of mitochondrion increased and white cell infiltration decreased, the figure of rough surfaced endoplasmic reticulum recovered, ulcer healing (12±6) d quickened and recrudescence (12.5%) lessened after treatment. All differences were statistically significant when compared with those in the control group (P<0.05). Conclusion Suturing around the ulceration can lighten blood stagnation and inflammatory cell infiltration, improve dystrophy and oxygen supply of the tissue, shorten the period of ulcer healing. It is a simple, good therapeutic and economical method to cure ulcer and can decrease the recurrent rate with physiotherapy.

Perioperative complications in DVT patients treated by ultrasonic ablation and transluminal therapy / 中国普通外科杂志

Objective To analyse postoperative co mp lications of ultrasonic ablation and transluminal therapy in patients of deep v enous thrombosis(DVT) in the lower extremities. Meth ods In this study, 205 DVT patients with a history fro m 6h to 90d were treated by a combination of ultersonic ablation、Fogarty ca theter thrombectomy、balloon dilatation and stent placement. Results Major complications developed in 37 cases (18.05%) including vein perforation, thrombosis, bleeding and anaphylaxis to contrast medium, except for minor complications such as lymph exudation. The re was no mortality in this series. Conclusions This procedure is safe, miniinvasive and effective therap y for DVT patients.

OptEase recyclable vena cava filter in the treatment of lower limb deep venous thrombosis / 中国现代普通外科进展

Objective:To summarize experience of 8 lower limb deep venous thrombosis(DVT) patients who used OptEase recyclable vesa cava filter(VCF) during in operations.Methods:Through collecting the clinical data of 8 patients who used OptEase recyclable vena cava filter(VCF) ,analyzing the method of recycling and releted complications.Results:No pulmonary embolism happened during and after operations,when recycle VCF implanted,vena cava graphy shows:inperfection thrombous near the filter in 1 case and vena iliaca thromb of uninjure side in 1 case too,reclaiming successfully in 5 cases,3 cases turn to permanent placement.FolIowing-up observation for 3-8 months,recurrence of limbs vena thrombosis never happened.Conclusion:The recyclable vena cava lilter could prevent plamonary embolism effectively in lower limb deep venous thrombosis patients.

Clinical application of inferior vena cava filter in the treatment of deep venous thrombosis of lower extremity / 中国普通外科杂志

Objective To investigate the protection effect of inferior vena cava filter on pulmonary embolism in patients with deep venous thrombosis(DVT) of lower extremities. Methods Inferior vena cava filters were placed in 55 patients with DVT. Simon Nitiol filter(SNF) was used in 25 cases,Trap Ease filter(TEF) in 13 cases and Antheor Temporal filter(ATF) in 17 cases.10 patients with DVT were treated by non operation therapy,45 patients by operation and transluminal angioplasties.Whether patients occurred pulmonary embolism was observed clinically,and the form and site of SNF and TEF were monitored by periodic fluoroscopy . Results Inferior vena cava filter was placed successfully in all patients.Symptoms and signs of DVT disappeared in all the patients after treatment . None of the putients occurred pulmonary embolism in this series. One case occurred inferior vena cava thrombolism in 16 months after SNF placement. Thrombus attached to ATF after the ATF taking off from inferior vena cava was found in 17 cases.Conclusions Inferior vena cava filter placement is a simple, safe and efficient method to prevent pulmonary embolism in a short period.But its long term complications should be considered and investigated.

Surgical treatment of acute lower extremity ischemia:a report of 96 cases / 中国普通外科杂志

Objective To study methods of salvage therapy for acute lower extremity(ALEI) ischemia.(Methods) A restrospectively analyzsis was made on the clinical data of 96 patients with consecutive 106 ALEI limbs.In which Fogarty catheter embolectomy was used as the initial treatment for ALEI in a regular(operating) room or in an intervention therapy room under DSA monitoring,and graft bypass after embolectomy was performed on 8 cases(12 limbs).Results In 70 cases(75 limbs) successful embolectomy of the(iliac),femoral,popliteal and tibial artery was achieved.In 11 cases(12 limbs) embolectomy at distal to the popliteal artery was unsuccessful.Eight cases(12 limbs) with obstruction proximal to the femoral artery were treated by axillofemoral bypass in 4 cases,and femorofemoral bypass in 4 cases.One case of thoracoabdominal aortic dissection aneurysm and lower extremity ischemia had fenestration of the abdominal aoric dissection.Proximal embolectomy and distal amputation was performed in 6 cases.Fimally,76(79.2%) cases had(salvaged) limbs,11(11.4%) patients had amputated limbs,and 9(9.4%) patients died.Seventy-six(patients)(85 limbs) were followed up for 1 to 38 months,7 cases(7 limbs) were reoperated on because of recurrent embolism.Conclusions Embolectomy is the effective treatment method for ALEI.Embolectomy(under) DSA monitoring can improve therapeutic results.The prognosis lies on the duration and extent of(ischemia),and management of complications.

Causes of groin lymphatic fistula after transluminal ultrasonic angioplasty in the treatment of deep vein thrombosis of lower extremity / 中国普通外科杂志

ObjectiveTo investigate the causes of groin lymphatic fistula after transluminal ultrason ic angioplasty (TUA) in the treatment of deep vein thrombosis(DVT) of lower extremity through groin incision. Methods A retrospective anal ysis of the causes of groin lymphatic fistula(GLF) in 72 patients with DVT after treatment of ultrasonic ablation was made. ResultsTUA and thr ombectomy using Forgaty balloon catheter for DVT of lower extremity achieved successful recanalization in all the 72 cases (100%). Of the 72 cases,51 had i liac vein stenosis,the venous stenosis disappeared after balloon dilation;amo ng the 51 cases ,6 cases received stent placement. GLF occurred postoperati vely in 60 cases. No death occurred in this series. ConclusionsTUA is an effective method in the treatment of DVT of lower extremity,but t he incidence of postoperative GLF is high.The causes of GLF may be related to the injury of lymphatic vessels, increase of quantity of lymph flow induced by increased venous pressure, infection, surgical technique factors and postop erative medicine therapy etc.

Temporary vena cava filter for trapping thrombus in prevention of pulmonary embolism / 中国普通外科杂志

Objective To assess temporary filter in the inferior vena cava (IVC) for trapping thrombus and preventing pulmonary embolism in patients with deep vein thrombosis. Methods In 58 cases of deep vein thrombus in single lower extremity, Antheor temporary filter (ATF) was introduced into IVC prior to anticoagulation and/or vascular intraluminal procedures. Results All IVC filters were successfully introduced. No symptomatic pulmonary embolism was documented. ATF was removed after a mean of 12.0?2.0 days. Thrombus was trapped in 46 cases (79.3%). Thrombus more than 1 cm in size was trapped in 2 cases. Conclusion Temporary filter was safe and effective in prevention of pulmonary embolism.