Clinical follow?up study of paclitaxel?coated balloon in the treatment of symptomatic lower extremity arteriosclerosis obliterans / 中国综合临床

Objective To investigate the clinical effect of paclitaxel coated balloon in the treatment of symptomatic lower extremity arteriosclerosis obliterans.Methods From January 2016 to April 2017,64 patients with symptomatic lower limb arteriosclerosis obliterans ( ASO ) of femoral and popliteal artery stenosis admitted to Chongming Branch Xinhua Hospital affiliated to Shanghai Jiaotong University School of Medicine were selected as the research subjects.According to the principle of randomization, they were divided into two groups, 32 cases in each group.In the drug?coated group, ordinary balloon was pre?expanded,and then paclitaxel drug?coated balloon was used to expand.If there were still retraction and stenosis of diseased vessels, which affected the blood flow of lower limbs, remedial stents were implanted.Bare stent group used a slightly smaller balloon to pre?expand superficial femoral artery and then release the stent.After one year follow?up, the changes of ankle?brachial index ( ABI), restenosis rate of target lesion vessels, Rutherford grading changes, clinical drive target vessel revascularization rate, perioperative period,death rate of patients during follow?up period, amputation rate and complication rate were observed.Results There were no amputations or deaths in the whole group during the perioperative period and follow?up.The incidence of complications in the drug?coated group was 3.1%( 1／32 ), significantly lower than that in the bare stent group 18.8%( 6／32) ( χ2 ＝4.010, P＝ 0.045).Before treatment,the ABI of patients in drug?coated group and bare stent group at 6 months and 12 months after treatment were significantly different ( Finter?group ＝ 7.028, Pinter?group ＝ 0.024, Fintra?group ＝ 219.028, Pintra?group＝0.000,Finteraction＝350.028,Pinteraction＝0.000),and ABI of the two groups at 12 months after treatment were (0.73± 0.11) and ( 0.68 ± 0.09),respectively, the difference was statistically significant ( t＝1.990, P＝0.025).Six months after operation, the restenosis rates of target lesions in the two groups were 9.4%(3／32) and 15.6%(5／32), respectively, with no significant difference ( χ2 ＝0.571, P＝0.450); The restenosis rate of bare stent group was 37.5%(12／32) 12 months after operation,which was significantly higher than that of drug?coated group by 15.6%(5／32) (χ2＝3.925,P＝0.048).Clinical observation results showed that 12 months after operation,the target?lesion revascularization (TLR) of the drug?coated group was 3.1%(1／32) and that of the bare stent group was 9.4%(3／32),with no significant difference.Rutherford grading was improved in both groups(χ2＝1.067,P＞0.05). Conclusion Paclitaxel drug?coated balloon is safe and effective in the treatment of symptomatic lower limb arteriosclerosis obliterans,which is worthy of clinical application.

Research on the Law of Prevention of Deep Vein Thrombosis (DVT) Based on Text Mining and Doctor-Patient Interaction Forum / 医学信息学杂志

Based on the doctor-patient interaction forum of Haodaifu Online,Xunyiwenyao and Youwenbida,taking advantage of the text mining technologies and methods such as Chinese word segmentation,data cleaning and filtering,word frequency statistics,semantic network map and visualization,extract and summarize the symptoms,causes,common drugs,complications,non-drug therapy and nursing method of Deep Vein Thrombosis (DVT),the paper verifies the availability of text mining method in exploring the prevention law and method of diseases and the feasibility of application of doctor-patient interaction Q&A network data source in medical research.

Clinical effects and safety of catheter-directed thrombolysis for acute lower extremity deep vein thrombosis in patients aged 70 years and over / 中华老年医学杂志

Objective To analyze the efficacy and safety of catheter-directed thrombolysis (CDT) for acute lower extremity deep venous thrombosis (DVT) in patients aged 70 years and over.Methods Clinical data of 109 cases who had acute lower extremity DVT and had been treated with CDT from March 2011 to September 2014 were retrospectively analyzed.Results Inferior vena cava filters (IVCF) were implanted in 109 patients.A thrombolytic catheter was inserted from the contralateral femoral vein (21 cases),ipsilateral popliteal vein (44 cases),posterior tibial vein (28 cases) or small saphenous vein (16 cases).The duration of thrombolysis was (5.47±2.13) d.The dosage of urokinase was (3.80 ± 0.56) million units.Forty-two cases underwent balloon dilatation alone,and 67 cases combined balloon dilatation with stent implantation.Gingival bleeding occurred in 7 patients and gross hematuria occurred in 4 patients during thrombolysis,which disappeared after medication adjustment.No symptomatic pulmonary embolism (PE) or other serious complications were found in any patients.There were significant differences in the venous patency score and lower limb circumferences at 10 cm above and below the knee one week after treatment (t=3.874,P=0.031).Ninety-seven cases were followed up for a mean period of (20.76.5) months,and the vein patencyrate was (77.9± 10.5) ％ and (73.1±9.4) ％ at 6 and 18 months after treatment,respectively.Recurrence of deep vein thrombosis was found in 6 cases,of which 2 cases had recurrent stent thrombosis,and treatment with CDT again was successful.No severe deep venous thrombosis syndrome (PTS) was found during the follow-up.Conclusions CDT is a minimally invasive procedure and can rapidly resolve limb venous drainage disorders.CDT is safe,has few complications and usually generates satisfactory outcomes.For very-old elderly patients who have no anticoagulation and thrombolytic contraindications,CDT is a useful option for the treatment of acute lower limb DVT.

Study of dexamethasone, baicalin and octreotide on brain injury of rats with severe acute pancreatitis.

OBJECTIVE: To investigate the protecting effects of dexamethasone (DXM), baicalin and octreotide on brain injury of rats with severe acute pancreatitis (SAP) and explore their underlying mechanism. METHODS: This experiment was divided into two different parts: (1) In the first part, 90 SAP rats were randomly divided into a model control group and a DXM treated group (n = 45, respectively). (2) In the second part, 135 SAP rats were randomly divided into a model control group, a baicalin treated group and an octreotide treated group (n = 45, respectively). In two different experiments, the same number of normal rats were considered as the sham-operated group (n = 45, respectively). At 3, 6 and 12 h after operation, the pathological changes in the brain were observed. The expression levels of nuclear factor-κB (NF-κB), Bax and Bcl-2 proteins were detected and apoptosis indexes were calculated, using brain tissue microarray section. RESULTS: (1) First part: The expression levels of Bax and Bcl-2 were significantly higher in the DXM treated group than those in the model control group at different time points, while the content of NF-κB protein and pathological changes were significantly lower in the treated group than those in the model control group (P < 0.05, P < 0.01 or P < 0.001). But the apoptotic indexes of brain tissue were not significantly different at different time points (P > 0.05). (2) Second part: At all time points after operation, the expression levels of NF-κB in the brain of treated groups were, to varying degrees, significantly lower than those in the model control group while the expression levels of Bcl-2 protein in baicalin and octreotide group were significantly higher than those in model control group (P < 0.01, P < 0.01 and P < 0.05, respectively). At 12 h after operation, the expression level of Bax protein in baicalin treated group was significantly higher than those in model control group and octreotide treated group (P < 0.05 and P < 0.01, respectively). CONCLUSIONS: Dexamethasone, baicalin and octreotide can exert protective effects against brain injury in SAP rats mainly through inhibiting the expression of NF-κB protein.

Research on scutellarin parenteral solution's protective effects in rats with severe acute pancreatitis and multiple organ injuries.

The aim of this study was to observe scutellarin parenteral solution's therapeutic effects and mechanisms in rats with severe acute pancreatitis (SAP). We divided SD rats into four groups randomly: (1) sham-operated group, (2) model control group, (3) scutellarin-treated group, and (4) Salvia miltiorrhiza-treated group. All of those rats in the abovementioned groups are randomly subdivided into 6 and 12 h subgroups, respectively, according to the postoperative time. Rats have been mercifully killed at different time after operation, and then detected their serum amylase, contents of ALT, AST, BUN, and Cr and observed the pathologic changes of multiple organs (pancreas, liver, kidneys, and lungs). We found that the survival rates have no marked differences (P < 0.05) between model control group and two treated groups at any time points. AST and BUN serum contents have no marked difference (P > 0.05). ALT serum contents in S. miltiorrhiza-treated group (6 and 12 h) and scutellarin-treated group (12 h) are obviously less than those in model control group (P < 0.05). The serum contents of Cr and amylase in scutellarin-treated group (6 h) are obviously less than those in model control group (P < 0.05). There is a different degree of relief on the pathologic changes of multiple organs in the two treated groups compared with those in model control group, of which pancreas and liver's pathologic severity scores in scutellarin-treated group (6 and 12 h) have reduced (P < 0.01) significantly compared with those in the model control group. However, there are no significant differences between scutellarin-treated group and S. miltiorrhiza-treated group (P > 0.05). We think the scutellarin parenteral solution has a certain protective effect on SAP rats' multiple organ injuries.

Experimental studies on methionine dependence of human primary gastric cancer cells / 肠外与肠内营养

Objectives:To study the methionine dependence (Met-dependence) of human primary gastric cancer cells in vitro when Met in the culture medicine was replaced by its precussor homocysteine(Hcy). Methods:Fresh and sterile gaotric cancer samples and normal gastric mucosa were managed into single-cell suspension and were cultured in the Met -Hcy + and Met\++ Hcy\+- medium separately.proliferation of these cells in the two different culture media was examined by cell counter and flow cytometry (FCM). Results:In the Met\++Hcy\+- medium,the growth of primary gastric cancer cells was inhibited,manifesting that the percentage of G 0G 1 tumor cells decreased and that of the S phase increased signiflcantly.However,normal gastric mucosal cells grew well and their cell cycles had no change. Conclusions:Human primary gastric cancer cells are Met dependent in vitro whereas normal gastric mucosal cells have no similar results.

The experimental studies on the effect of methionine deprivation with chemotherapy to human primary gastric cancer cells / 肠外与肠内营养

Objectives:To study the methionine dependence(Met dependence) of human primary gastric cancer cells in vitro when Met in the culture medium was replaced by its precursor homocysteine(Hcy),and the effect of methionine starvation in combination with chemotherapeutical agents on gastric cancer cells. Methods:Fresh and sterile gastric cancer samples were managed to single cell suspensions and then were cultured in Met -Hcy + and Met +Hcy - medium separately,the proliferation of tumor cells in different culture media was examined by microcytotoxicity(MTT) assay.Meanwhile,the inhibition rate of tumor cells by ADM、DDP、5 FU、MMC and MTX in Met -Hcy +medium was separately tested. Results:①In Met -Hcy + medium,the human primary gastric cancer cell decreased;②Methionine deprivation in combination with chemotherapy enhanced obviously the killing capacity of each chemotherapeutical agent. Conclusions:①Human primary gastric cancer cells in vitro appears Met dependent.②The combined application of Met -Hcy + medium and different chemotherapeutical agents could enhance the antitumor effect of chemotherapy on primary gastric cancer cells.③MTT assay was an efficient way to examine the sensititivity of methionine starvation therapy combined with individualized chemotherapeutical agents.