Introduction Both varicose veins (VV) and iliac vein compression syndrome (IVCS) can cause skin damage and functional impairment in the lower extremities, and these issues often coexist. However, the question of whether IVCS exacerbates VV progression and leads to differences in the surgical outcomes of therapy for VV remains unanswered. Therefore, no high-level evidence-based medical data is available to support the concomitant use of iliac vein stenting in patients with VV and severe IVCS, and treatment protocols vary significantly among different centres. This study will investigate the effects of concomitant iliac vein stenting on post-procedure varices recurrence and quality of life (QoL) on the basis of a prospective, multicentre, randomised controlled trial with the goal of providing a foundation for the standardised treatment of patients with VV and IVCS.Methods and analysis This prospective, multicentre, randomised controlled trial will enrol 160 patients with VV and severe IVCS. All patients will be randomly divided into either the VV endovenous thermal ablation (ETA) alone group or the VV ETA combined with iliac vein stenting (ETAS) group. Baseline data will be collected and follow-up will be conducted at 1, 6, 12 and 36 months after the procedure. The primary outcome is post-procedure VV recurrence (as assessed by clinical and ultrasound examination). Secondary outcomes include QoL scores (according to the Aberdeen Varicose Vein Questionnaire, the Chronic Lower Limb Venous Insufficiency Questionnaire, the European Quality of Life Five-Dimensions, and the Venous Clinical Severity Score) and the incidence of post-procedure complications. Bleeding complications resulting from anticoagulation therapy and stent-related complications (such as restenosis and deep vein thrombosis) will also be recorded for patients in the ETAS group.Ethics and dissemination This study has been approved by the Ethics Committee of the First Affiliated Hospital of Xi'an Jiaotong University (approval number: XJTU1AF2024LSYY-075). Written informed consent has been obtained from all participants. The final results of this study will be published in a peer-reviewed journal and presented at national or international conferences.Trial registration number This protocol was registered on chictr.org.cn prior to enrolment, which began on 19 June 2024 (Registration ID: ChiCTR2400085815).

BACKGROUND:The clinical outcomes of comparing covered stents (CSs) and drug-coated balloons (DCBs) angioplasty in femoropopliteal artery occlusion remain unknown. This study aimed to evaluate the midterm efficacy of CS and DCB procedures in patients with FPO. METHODS:All 194 patients were divided into CS (94 patients) and DCB (100 patients) groups in this multicenter retrospective study. The primary end point was primary patency at 24 months, and the secondary end points included freedom from clinically driven target lesion revascularization, limb salvage, major adverse events, and overall survival rates. Propensity score matching analysis was performed to reconfirm the main end points. RESULTS:Compared with the patients in the DCB group, those in the CS group had a lower prevalence of smoking (54.3% versus 74.0%, P=0.004) and diabetes (38.3% versus 66.0%, P<0.001) before propensity score matching. Compared with the DCB procedure, the CS procedure resulted in a significantly greater primary patency at 24 months (74.4% versus 55.8%, P=0.019), with comparable primary patency at 12 months; similar results were obtained after matching. However, there was no difference in terms of clinically driven target lesion revascularization, limb salvage, major adverse events, or overall survival rates. Subgroup analyses confirmed the superior clinical patency of CS in patients with diabetes (P=0.010) and proximal reference vessel diameter ≥5.0 mm (P=0.038). A baseline ankle brachial index <0.40 was likely to be an independent risk factor for restenosis, and a postprocedural ankle brachial index ≥0.80 and the CS used (hazard ratio [HR], 0.54 [95% CI, 0.32-0.91], P=0.021) were potential protective factors for restenosis after multivariate analysis. CONCLUSIONS:Compared with the DCB procedure, the CS procedure resulted in greater primary patency at 24 months in complicated femoropopliteal artery occlusion lesions.

As the pediatric patient with right pulmonary artery agenesis (PAA) matured, she progressively presented symptoms of pulmonary hypertension and hemoptysis. There is limited clinical literature on this condition, and currently, there is no consensus regarding its diagnosis and treatment. This article presents a case study of a 16-year-old female patient with right pulmonary artery hypoplasia, providing a comprehensive summary and analysis of her developmental progression, pathology, diagnosis, and treatment.

Objective Non-tuberculous bacterial infection delayed the prognosis and discharge time of patients with hemoptysis. This paper mainly analyzed the bacterial infection of lung and its mechanism. Methods Sixty-two patients with pulmonary hemoptysis accompanied by bacterial infection in the past 5 years were screened and divided into the experimental group and the control group according to whether leukocytes were elevated after bacterial infection. Multiple COX regression analysis was performed on gender, age, leukocytes, C-reactive protein, prothrombinase time and platelets of the two groups, and the correlation between PLT and PT and bacterial infection was analyzed by subject work characteristic curves. Results The decrease of PLT and the prolongation of PT were positively correlated with the hemoptysis caused by leukocyte elevation. Conclusion Patients with elevated white blood cells after bacterial infection can significantly prolong PT and decrease PLT. For patients with hemoptysis accompanied by bacterial infection, increasing PLT can play a dual role in hemostasis and control inflammation.

The abnormal anatomical alterations of blood vessels during DSA angiography in patients with hematological disorders were retrospectively examined, and the influencing factors of short-term (≤ 6 months) recurrent hemoptysis were statistically analyzed, and the consistency between admission diagnosis and intraoperative diagnosis was evaluated. The intraoperative angiography data of patients who underwent selective bronchial artery embolization for hemoptysis in our hospital from January 2022 to December 2022 were reviewed. They were divided into the observation group and the control group based on whether there was recurrent hemoptysis. The Logistic regression model and forest map were employed to analyze the factors influencing the recurrence rate. A total of 104 patients were encompassed in this study (12 cases of tuberculosis, 35 cases of infection, 4 cases of lung cancer, 8 cases of bronchiectasis, 22 cases of arteriovenous fistula, 16 cases of aneurysm, and 7 cases of pulmonary hypertension). The coincidence rate of preoperative and intraoperative diagnoses was 73.1

BACKGROUND:Metabolic syndrome is affected by many factors, including lifestyle, mood, etc. Self-management of chronic diseases has attracted significant attention from researchers. Some studies have shown that patient self-management is a very important link, which can effectively alleviate the risk of further deterioration of the disease. However, so far, there has been no report on the basis of the summary of self-management intervention programs based on emotion management, which needs further in-depth discussion by researchers.METHODS:The Medline (PubMed), Embase (Elsevier), PsycINFO (Ovid), CBM, CNKI and Wanfang databases were searched from the establishment of the databases to June 2022, and a total of 25 studies were traced. The inclusion criteria on stress management in patients of metabolic syndrome complicated with psychological symptoms uses meta-analysis. Two investigators independently assessed the risk of bias for each study using the Cochrane risk of bias tool.16 studies and 2687participants and relevant characteristics of studies.RESULTS:In the effects of intervention measures based on stress management on depression, fasting plasma glucose, 2hFPG, high-density cholesterol, self-management behavior and quality of life in patients with psychological symptoms (depression, anxiety, and schizophrenia) complicated with metabolic diseases, there are statistically significant differences between the intervention group and the control group (P < .05).CONCLUSIONS:Stress management intervention can effectively improve the health outcomes of patients. In all included analysis indicators, the results of the experimental group are better than those of the control group.

下肢肌间静脉血栓是院内检查常见血栓形式,现较公认属于深静脉血栓范畴,但因范围和血栓负荷较小,其治疗方案与较大范围深静脉血栓有差异.本文通过对肌间静脉血栓的介绍,较详细总结了肌间静脉血栓目前国内外的抗血栓治疗等进展,认为针对血栓蔓延高危患者需抗凝治疗,低危患者可动态彩超监测,后续酌情调整治疗方案;同时提出了合并急性脑血管病、肝功能异常等情况时,抗血栓方案尚未明确、有待进一步研究的问题.

There is controversy regarding the use of older grafts for liver transplantation (LT) in HCV-infected patients, but the introduction of direct-acting antivirals (DAA) can radically change that debate.The aim of this retrospective cohort study was to evaluate outcomes of the use of liver grafts from donors older than 70 years in recipients with HCV infection who underwent pre- or post-LT treatment with DAA. We compared two groups of patients who underwent LT using livers >70 years; the groups were defined according to antiviral therapy: non-DAA therapy group (n = 62; LT between May 1996 and December 2013), and DAA therapy group (n = 31; LT between January 2014 and December 2019).Thirty (96.8%) patients of DAA therapy and nine (14.5%) of non-DAA therapy (21 patients underwent complete therapy with interferon-ribavirin) achieved sustained viral response (SVR). One, 3-, and 5-year patient survival were 83.9%, 67.7%, and 56.5% in the non-DAA group vs 93.5%, 88.4%, and 88.4% in the DAA group (P = 0.04); the 1-, 3-, and 5-year graft survival were 77.4%, 62.9%, and 51.6% in the non-DAA group vs. 88.6%, 83.7%, and 83.7% in the DAA group (P = 0.03). Multivariate analysis demonstrated donor female sex and DAA therapy as protective factors of graft survival.Pre- or post-LT therapy with DAA in HCV-infected patients has achieved an almost overall SVR. The use of liver grafts >70 years in these patients treated with DAA was associated with significantly higher 5-year patient and graft survival in DAA group compared to non-DAA group. Thus, the introduction of DAA therapy has allowed the safe use of livers >70 years in HCV-positive recipients.

目的 探讨子宫肌瘤合并下肢深静脉血栓形成(DVT)经介入手术的方法抗凝、置管溶栓、子宫动脉栓塞处理.方法 2010年5月-2018年5兰州大学第一医院介入医学科回顾性分析15例子宫肌瘤合并下肢DVT成患者的治疗方法,治疗效果及随访结果进行统计学的分析.结果 15例子宫肌瘤合并下肢DVT的患者全部行双侧子宫动脉超选择性栓塞(uterine artery embolization,UAE),同期根据患者一般状况、血栓的新鲜成度、部位,有无肺动脉栓塞等行腔静脉滤器植入,置管溶栓;并基于抗凝、活血等对症支持治疗.其中5例患者贫血较为严重,纠正贫血后再行抗凝、溶栓治疗.15例患者经治疗后全部治愈出院,并无子宫出血.结论 子宫肌瘤合并下肢DVT患者行子宫动脉栓塞,同期根据患者一般状况及血栓状况行介入溶栓治疗,可取得安全、有效得止血与溶栓治疗双重疗效,使患者取得最大的获益.

目的 研究主动脉夹层不同DeBakey分型患者的相关病史及临床特征,探讨其对疾病发生和预后的影响及其意义.方法 纳入兰州大学第一医院2010年1月1日～2017年12月31日主动脉夹层患者593例,以DeBakey分型为分型标准,回顾性分析患者的临床资料及观察患者临床特征.结果 高血压患者发生主动脉夹层DeBakeyⅢ型概率高于Ⅰ型和Ⅱ型,差异有统计学意义(P<0.05).主动脉夹层DeBakeyⅠ型和Ⅲ型患者胸痛和背痛发生率高于Ⅱ型患者,差异有统计学意义(P<0.05).主动脉夹层DeBakeyⅠ型和Ⅱ型患者胸闷发生率高于Ⅲ型患者,差异有统计学意义(P<0.05).结论 主动脉夹层动脉瘤DeBakeyⅠ型患者的临床症状较其他两型明显,主要表现为胸闷、胸痛及背痛;已确诊为高血压的患者并发主动脉夹层多为DeBakeyⅢ型.

MicroRNAs (miRNAs) are considered to be critical mediators of gene expression with respect to tumor progression, although their role in ischemia-induced angiogenesis is poorly characterized, including in peripheral arterial disease (PAD). Furthermore, the underlying mechanism of action of specific miRNAs in PAD remains unknown. Reverse transcription-quantitative polymerase chain reaction analysis revealed that microRNA-93 (miR-93) was significantly upregulated in patients with PAD and in the EA.hy926 endothelial cells in response to hypoxia. Additionally, miRNA (miR)-93 promoted angiogenesis by enhancing proliferation, migration and tube formation. Cyclin dependent kinase inhibitor 1A (CDKN1A), verified as a potential target gene of miR-93, was inhibited by overexpressed miR-93 at the protein and mRNA expression levels. Furthermore, a hind-limb ischemia model served to evaluate the role of miR-93 in angiogenesis in vivo, and the results demonstrated that miR-93 overexpression enhanced capillary density and perfusion recovery from hind-limb ischemia. Taken together, miR-93 was indicated to be a promising target for pharmacological regulation to promote angiogenesis, and the miR-93/CDKN1A pathway may function as a novel therapeutic approach in PAD.

The effects of different doses of folic acid and vitamin B12 on rabbits with deep vein thrombosis (DVT) and hyperhomocysteinemia were investigated. In total, 60 New Zealand rabbits were divided into untreated control, low-dose and high-dose groups. After inducing DVT, hemorheology and coagulation indexes were measured 3 and 10 days later. We found that both treatment groups performed better than the control group, and the high-dose performed better than the low-dose. Ten days after thrombosis, the levels of Hcy and D-dimer were lower in the high-dose group. Moreover, the changes of lower extremity deep venous thrombosis were significantly reduced in both high- and low-dose groups, but the high-dose group showed the most improvement. The effective rate of the high-dose group was 100%, higher than the rate in the low-dose and control groups. Overall, high-dose of folic acid and vitamin B12 can significantly improve plasma Hcy, coagulation indexes, and pathological changes in the venous thrombosis of the lower extremity.

血栓闭塞性脉管炎是一种较为特殊的周围血管病变,起病隐匿,发展缓慢,病程较长.目前中医治疗该病遣方用药动辄予以活血化瘀,疗效差强人意.瘀血是否为该病的主要原因尚需进一步探讨.文中从痰瘀论治血栓闭塞性脉管炎,深入探讨该病病机,以期为中医药治疗血栓闭塞性脉管炎提供新的思路.

METHODS:Ninety lower-limb stage II or worse TAO patients were randomly divided into three groups: group A (30 cases) treated by intervention and oral administration of Chinese medicine; group B (30 cases) treated by intervention alone; and group C (30 cases) treated only with oral administration of Chinese medicine. Therapeutic effects were observed, including the cure rate; the recurrence rate after one month, three months, six months, nine months, and one year; the ankle brachial indexes; the incidence of complications; and the level of C-reactive protein and erythrocyte sedimentation rate. RESULTS:Group A had significantly better clinically curative effects, related indexes, and outcomes during the long-term follow-up survey, than that of groups B and C. CONCLUSION:Integrated treatment is more effective for treating lower-limb stage II or worse TAO. OBJECTIVE:To observe if integrated treatment is better than other therapies for lower-limb stage II thromboangiitis obliterans (TAO).

Approximately half or more of patients diagnosed with late malignant tumors may suffer from metastatic bone pain, effective palliation of pain becomes an important part of comprehensive therapy for malignant tumors. In this study, we examined the efficacy and safety of the combined regimen of cryoablation and zoledronic acid in patients of bone metastatic pain. A total of 84 subjects were randomly divided into three groups, and underwent treatments of cryoablation plus zoledronic acid, cryoablation alone, zoledronic acid alone between June 2009 and March 2012. Patients responses had been assessed for a total of 6 months by using the Brief Pain Inventory (BPI)-Short Form. The results showed that the mean response of worst and average pain significantly dropped at week 2 (all P < 0.05) in group with cryoablation treatment but at week 4 (all P < 0.05) in group with zoledronic acid treatment. While between week 16 and week 24, zoledronic acid treatments showed more durable response to worst and average pain compared to cryoablation (all P < 0.05). Cryoablation plus zoledronic acid regimen showed significant drop in worst and average pain between week 1 and week 4 compared to zoledronic acid alone (all P < 0.05) and more durable effect on bone metastatic pain between week 12 and week 24 than cryoablation alone (all P < 0.05). Additionally, no serious adverse effects and complication were observed by this combination use. In conclusion, cryoablation combined with zoledronic acid was safe and effective regimen and showed its superiority of fast response and durable effect on painful bone metastases.

This study aimed to examine the efficacy and safety of cryoablation, combined with zoledronic acid or alone, in the treatment of bone metastatic pain. A total of 84 patients were randomly divided into three groups: group A (cryoablation plus zoledronic acid), group B (cryoablation) and group C (zoledronic acid). In group A, the overall response [OR = complete response (CR) + partial response (PR)] was 85.7% (24/28), the CR was 35.7% (10/28) and the PR was 50.0% (14/28). In group B, the OR was 50.0% (14/28), the CR was 14.3% (4/28) and the PR was 35.7% (10/28). In group C, the OR was 67.9% (19/28), the CR was 21.4% (6/28) and the PR was 46.4% (13/28). The differences in OR, CR and PR among the three groups were statistically significant (P<0.05). The mean onset time of pain relief for the cryoablation combined with zoledronic acid treatment group was 1.96±2.26 days, for cryoablation treatment alone was 1.43±1.79 days and for zoledronic acid alone was 11.67±3.14 days; there were statistically significant differences among the three groups (P<0.05). The response duration was 146.68±1.89 days in group A, 71.60±2.94 days in group B and 112.99±1.37 days in group C; the differences among the three groups were statistically significant (P<0.01). In conclusion, cryoablation combined with zoledronic acid is an effective and safe therapeutic strategy for the treatment of bone metastatic pain.

Objective To explore the effectiveness and the safety of super early enteral nutrition (SEEN) in the treatment of severe acute pancreatitis (SAP). Methods Clinical data of 120 patients diagnosed as SAP in this hospital during June 2008 to March 2011 were retrospectively reviewed .Among the 120 patients, nose intestinal feeding tube placement under the guidance of DSA within 24 hours after admission was carried out in 60 patients (super early enteral nutrition group, SEEN), while the other 60 patients did not accept the treatment of intestinal feeding tube placement ( total parenteral nutrition group , TPN) .The length of stay ,incidence of serious complications, mortality, curative effects, APACHEⅡ scores, Ranson grades,amylase levels 14 days after treatment, and serum albumin and prealbumin changes were compared between the two groups . Results The SEEN group showed shorter length of hospital stay[(41.5 ±21.1) d vs.(58.9 ±26.7) d, t=-3.369, P=0.001] and lower hospitalization expenses [(67 416.9 ± 22 659.5) yuan vs.(383 592.5 ±92 493.5) yuan, t=-25.718, P=0.000].The SEEN group had an abdominal infection rate of 6.7%(4/60) and a nosocomial infection rate of 26.7%(16/60), which were less than the TPN group [25.0% (15/60), χ2 =7.566, P=0.006;56.7%(34/60),χ2 =11.109, P=0.001].There were significant differences in serum amylase , urine amylase, C-reactive protein, serum prealbumin, APACHE Ⅱ scores, and Ranson scores before and after the treatment in both groups (P<0.05).After treatment, there were significant differences between the two groups in levels of blood amylase , urine amylase,prealbumin, serum albumin, and C-reactive protein (t =16.968,P=0.000;t =35.348,P =0.000;t =20.072,P =0.000;t=-22.359,P=0.000;t=-2.234,P=0.027).There were no obvious statistical significances in APACHE Ⅱ scores and Ranson scores between the two groups after treatment (P>0.05). Conclusion Super early enteral nutrition is a safe and effective method for SAP, bearing advantages of no serious complications , cost-effectiveness, and rich nutrition.

<正>血管平滑肌脂肪瘤(angiomyolipoma,AML)又称错构瘤。随着现代影像诊断学和介入放射学的飞速发展,对AML的诊断治疗也有了新的认识。自1993年1月至2011年6月,我科对58例AML行超选择性动脉栓塞术,均取得良好的疗效,现总结报告如下。1资料和方法1.1临床资料:本组资料来源于自1993年1月至2011年6月间兰州大学第一医院收治的单纯肾AML57例,

目的 比较氩氦刀或唑来膦酸单一治疗和联合治疗骨转移癌疼痛的疗效和安全性.方法 84例患者随机分为A组(联合)、B组(氩氦刀)、C组(唑来膦酸)各28例；A组氩氦刀冷冻消融治疗结束后给予唑来膦酸注射液4 mg加入0.9％氯化钠注射液100ml静脉滴注15 min以上；B组单一使用氩氦刀冷冻消融骨转移癌局部组织；C组给予唑来膦酸注射液4 mg加入0.9％氯化钠注射液100 ml静脉滴注15 min以上.结果 ①A组止痛总有效率为85.7％,其中显效为35.7％ (10/28),有效为50.0％(14/28)；B组止痛总有效率为50.0％,其中显效为14.3％ (4/28),有效为35.7％( 10/28),C组总有效率为67.9％ (19/28),其中显效为21.4％(6/28),有效为46.4％( 13/28),3组间比较差异有统计学意义(P＜0.05).②平均起效时间:A组为(1.96±2.26)d,B组为(1.43±1.79)d,C组为(11.67±3.14)d,A、B两组与C组之间差异有统计学意义(P＜ 0.05).③疗效维持时间:A组为(146.68±1.89)d,B组为(71.60±2.94)d,C组为(112.99±1.37)d,3组间比较差异有统计学意义(P＜0.01).结论 氩氦刀冷冻消融联合唑来膦酸治疗骨转移癌性疼痛是一种安全、有效的技术.