Background: Neurogenic erectile dysfunction (ED) is a prevalent complication following radical prostatectomy in elderly patients, primarily resulting from the apoptosis of corpus cavernosum smooth muscle cells (CCSMCs) and the subsequent excessive fibrosis of the corpus cavernosum. Aim: This study aimed to compare the therapeutic effects of exosomes derived from lentivirus-transfected miR-145 bone marrow mesenchymal stem cells (Exo-145) and unmodified BMSCs-derived exosomes (Exo) in aged rats with bilateral cavernous nerve injury (BCNI) and investigate the underlying mechanisms. Methods: Twenty-four-month-old male rats were assigned to four groups, namely Sham, BCNI, Exo, and Exo-145. Three weeks after treatment, erectile function was assessed by measuring the maximal intracavernosal pressure to mean arterial pressure (ICP/MAP) ratio. Apoptosis and fibrosis were semi-quantitatively analyzed using TUNEL and Masson's trichrome staining, respectively. In vitro, CCSMCs were subjected to H2O2-induced oxidative stress, and the protective effects of Exo-145 were evaluated through flow cytometry and Western blot. Lastly, the targets and mechanisms of miR-145 were further validated using dual-luciferase reporter assays and rescue experiments. Results: Exo-145 significantly outperformed Exo in restoring erectile function in aged BCNI rats, as evidenced by the significantly higher maximal ICP/MAP ratio, a marked reduction in TUNEL-positive cell count, and marked suppression of fibrosis in cavernous tissue. Moreover, Masson's trichrome staining displayed a substantial decrease in collagen deposition. In vitro, Exo-145 alleviated H2O2-induced apoptosis in CCSMCs by downregulating Cleaved Caspase-3 expression and Bax while concurrently upregulating Bcl-2 expression. TGFBR2 was identified as a direct target of miR-145 through dual-luciferase reporter assays, with its overexpression partially reversing the protective effects of Exo-145. Conclusion: Exo-145 demonstrates superior efficacy compared to Exo in treating aged neurogenic ED by targeting TGFBR2 to alleviate apoptosis and fibrosis. It may represent a promising cell-free therapeutic option for neurogenic erectile dysfunction in elderly patients and could offer new perspectives for improving their prognosis.

Long non-coding RNAs (lncRNAs) primarily engage with mRNA, DNA, proteins, and microRNAs (miRNAs), thereby regulating gene expression; however, its specific role in diabetic erectile dysfunction (DED) has not been studied. This study aims to investigate the effects and mechanisms of LncRNA CRYM-AS1 in DED. The differential target gene LncRNA CRYM-AS1 was identified in the penile tissues of rats with DED through bioinformatics analyses. A KEGG signaling pathway enrichment analysis suggested a potential association between LncRNA CRYM-AS1 and the Hippo-YAP1 pathway. Real-time fluorescent quantitative PCR (RT-qPCR) results indicated a significantly lower expression of LncRNA CRYM-AS1 in the penile tissue of DED rats compared to the control group. Western Blot and immunohistochemistry (IHC) staining results demonstrated significantly elevated protein expression levels of YAP1, Caspase3, BAX, and Bcl-2, with a decreased Bcl-2/BAX ratio. CCK8 cell viability results showed a significant decrease in cell viability in the high glucose group at 4 days of modeling, and compared with the normal glucose group, RT-qPCR results showed that the expression of LncRNA CRYM-AS1 in the high glucose group in human umbilical vein endothelial cells (HUVECs) was significantly reduced; Western Blot results showed that the protein expression of YAP1, Cleaved-caspase3 and BAX was significantly up-regulated, and the protein expression of Bcl-2 was significantly down-regulated in the high glucose group. Compared with the empty vector group, RT-qPCR results after transfection of siLncRNA CRYM-AS1 showed that the expression of LncRNA CRYM-AS1 was down-regulated, the mRNA and protein expression of YAP1, Caspase3, Cleaved-caspase3, BAX, and Bcl-2 were significantly up-regulated, and the Bcl-2/BAX ratio decreased. Flow cytometry results showed that the apoptosis rate of HUVECs increased after interference. Low expression of LncRNA CRYM-AS1 may activate the Hippo-YAP1 signaling pathway to regulate apoptosis in HUVECs, leading to ED development, and the discovery of new target genes may provide new therapeutic targets to regulate diabetic erectile disfunction.

Purpose: Drug-coated balloon (DCB) angioplasty and laser atherectomy (LA) have been frequently utilized to treat femoropopliteal in-stent restenosis (ISR); however, no studies have concurrently compared available regimens, including DCB, LA+DCB, and LA + plain balloon angioplasty (PB). Therefore, we conducted this network meta-analysis to determine whether there were significant differences in outcomes among these regimens. Materials and Methods: A comprehensive search was conducted in PubMed, EMBASE, and the Cochrane library to identify all randomized controlled trials comparing DCB or LA-based regimes with POBA or each other for treating femoropopliteal in-stent restenosis (ISR) from their inception until March 2021. The primary outcome measure was binary restenosis, and secondary outcome measures were target lesion revascularization (TLR) and mortality, evaluated at 6 and 12 months, respectively. Statistical analysis was performed using Aggregate Data Drug Information System (ADDIS) 1.4 software, and all data were graphically summarized using Microsoft Excel software. Results: The final analysis included 11 studies, of which 6 studies compared DCB with PB, 2 studies compared PB vs LA+PB, 2 studies compared DCB vs LA+DCB, and 1 study compared LA+DCB with LA+PB. DCB was better than PB in decreasing binary restenosis at 6 (odds ratio [OR]: 0.22, 95% credible interval [CrI]: 0.04–0.91) and 12 (OR: 0.26, 95% CrI: 0.12–0.50) months. DCB was associated with lower TLR than PB at 6 months (OR: 0.31, 95% CrI: 0.13–0.69). LA+DCB was also superior to PB in treating binary restenosis at 12 months (OR: 6.10, 95% CrI: 1.94–24.41) and TLR at 6 months (OR: 5.32, 95% CrI: 1.43–28.06). There was no statistical difference in mortality between PB, DCB, and LA+PB. DCB and LA+DCB were the first 2 options for reducing binary restenosis and TLR. Conclusion: The current network meta-analysis demonstrates that both DCB and LA+DCB are superior to PB alone, and that DCB and LA+DCB may be the preferred treatment options for reducing binary restenosis and TLR. Clinical Impact The treatment for femoropopliteal in-stent restenosis (ISR) remains challenging clinical practice. One important reason is that no optimal treatment strategy was available. Drug-coated balloon angioplasty (DCB) and laser atherectomy (LA) have been extensively utilized to treat ISR; however, different combinations of these treatments further confused the clinicians’ choices. This network meta-analysis systematically investigated the difference between the currently available treatments regarding therapeutic effects and safety, indicating that DCB and LA+DCB may be the optimal treatment for decreasing the risk of binary restenosis and target lesion revascularization. The results of the current network meta-analysis help to resolve the confusion of clinicians in making the decision.

BackgroundTo investigate the mechanism of exosomes (Exo) secretion by hypoxic pretreated adipose-derived mesenchymal stem cells (ADSCs) promoting skin wound healing in diabetic (DM) mice.MethodsHigh-throughput sequencing was used to investigate abnormal expression of circRNA in hypoxic pretreatment ADSCs exosome (HExo) and ADSCs exosome (Exo). Bioinformatics analysis and luciferase reporting analysis were used to clarify the interacted relationship among circRNA, miRNA and mRNA. EPCs cells were employ to analysis the ROS, inflammatory cytokines expression, angiogenic differentiation function under hypoxic condition by using immunofluorescence, ELISA detection and tube forming experiment. DM ulceration mice model were constructed and the therapeutic effect of Exo were detected using immunohistochemistry, immunofluorescence.ResultsThe result show that HExo have more treatment effect than Exo in promotes cutaneous wound healing of DM mice. High-throughput sequencing found that circ-Erbb2ip play a role in HExo mediated tissues repair. Downregulation circ-Erbb2ip decreased the therapeutic effect of HExo to wound healing in diabetic mice. Bioinformatics analysis and luciferase reporting analysis confirmed that both miR-670-5p and Nrf1 were downstream targets of circ-Erbb2ip. Downregulation of Nrf1 or overexpression of miR-670-5p reversed the protective effect of circ-Erbb2ip to EPCs after exposure to high glucose microenvironment. Upregulation circ-Erbb2ip increased the therapeutic effect of Exo to wound healing in diabetic mice by increased angiogenesis and decreased ROS, inflammatory cytokines expression.ConclusionIn conclusion, ADSC-Exos containing circ-Erbb2ip promotes wound healing by targeting miR-670-5p/Nrf1 pathway, and their effects in promoting soft tissue wound healing warrant further study.

To investigate the effect of paired box protein 5 (PAX5)/integrin subunit alpha X (ITGAX) in atherosclerosis (AS). AS model was established using ApoE-/- mice (C57BL/6). Human vascular smooth muscle cells (HVSMCs) were stimulated with ox-LDL. Quantitative reverse transcription polymerase chain reaction and Western blotting were used to detect the expression levels of genes and proteins. Reporter constructs and luciferase assays were used to investigate the role of ITGAX and PAX5. Cells proliferation and inflammation factors were detected. The results presented that aortic plaque area, lipid content, serum triglyceride, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol levels were significantly increased in the high-fat diet group (p < 0.05). ITGAX was upregulated in atherosclerotic tissues. In addition, ox-LDL treatment induced HVSMCs proliferation, migration, and invasion. Reporter constructs and luciferase assays indicated ITGAX interaction with PAX5. Furthermore, siITGAX and siPAX5 cotransfection restored the rate of HVSMCs in G1 and S and G2/M phases, decreased the content of tumor necrosis factor-alpha (TNF-ɑ), interleukin (IL)-6, and IL-8 (p < 0.05). Interestingly, siITGAX and siPAX5 cotransfection also decreased the expression levels of TNF-α, TNF-R1, TNF-R2, CD19, and CD86 (p < 0.05). Our results suggest that ITGAX may be a potential therapeutic target for AS.

目的:探讨PBL教学方法在血管外科临床实习中的应用价值.方法:选取2017年3 月至2019年3 月我院血管外科临床专业本科及硕士研究生共60 名,按随机数字表法分为试验组和对照组,每组各30 人.对照组采取传统的LBL教学方法,试验组采取采取PBL教学方法.比较两组学生教学之后的基础理论知识、病例分析成绩及两组学生的教学效果.结果:考核后,试验组学生基础理论知识成绩高于对照组,但差异不具有统计学意义(P>0.05);试验组学生病例分析成绩高于对照组,差异具有统计学意义(P<0.05).考核后,试验组学生在文献检索能力、学习兴趣、对疾病的认识、手术操作、总体满意度、团队协作能力和探索创新能力方面的评分显著高于对照组,差异具有统计学意义(P<0.05).两组学生在语言表达能力和综合分析能力方面的评分比较,差异不具有统计学意义(P>0.05).结论:PBL教学方法在血管外科临床实习中的应用效果显著,值得推广.

Purpose: To study the potential therapeutic effects of salvianolic acid A (Sal A) on thromboangiitis obliterans (TAO). Methods: An in vitro model of TAO-mimicking endothelial cell damage was established by incubating ECV304 cells with H2O2. An in vivo model of TAO rats was developed via injection of sodium laurate. After treatment with varying doses of Sal A, TAO symptoms were monitored over time and compared. The effects of Sal A on oxidative stress, pyroptosis, inflammation, and thrombosis were assessed using biochemical assays, enzyme-linked immunosorbent assay (ELISA), western blot, and histopathology. Results: Sal A significantly alleviated the inhibition of cell viability induced by H2O2 (p < 0.05). The H2O2-induced increases in levels of ROS, IL-1β, and IL-18 in ECV304 cells were significantly decreased by Sal A (p < 0.05). Moreover, Sal A alleviated TAO symptoms in rats. The enhanced levels of IL-1β, IL-18, NLRP3, and active Caspase-1 observed in TAO rats were reduced by Sal A in vivo (p < 0.05). Moreover, Sal A significantly reduced the size of thrombus in TAO rats. In addition, upregulated levels of ROS were significantly inhibited by Sal A (p < 0.05). Conclusion: Sal A exerts significant therapeutic effects on TAO. This provides mechanistic insights into the clinical effects of RSMA on TAO patients, which might be beneficial in the development of effective drugs against TAO in the future.

Atherosclerosis (AS) is the main cause of cardiovascular diseases. However, the role of AQP9 in AS is not well understood. In the present study, we predicted that miR-330-3p might regulate AQP9 in AS through bioinformatics analysis, and we established AS model using ApoE−/− mouse (C57BL/6) with high-fat diet (HFD). Hematoxylin and eosin (H E) and Oil red O staining were used to determine atherosclerotic lesions. CCK8 and Ethyny1-2-deoxyuridine (EdU) assays were used to investigate human umbilical vein endothelial cells (HUVECs) proliferation after treatment with 100 μg/mL ox-LDL. Wound scratch healing and transwell assays were used to measure the cell invasion and migration ability. Flow cytometry assay was used to determine apoptosis and cell cycle. A dual-luciferase reporter assay was performed to investigate the binding of miR-330-3p and AQP9. We identified that the expression of miR-330-3p in AS mice model decreased while the expression level of AQP9 increased. miR-330-3p overexpression or down-regulation of AQP9 could reduce cell apoptosis, promote cell proliferation, and migration after ox-LDL treatment. Dual-luciferase reporter assay result presented that AQP9 was directly inhibited by miR-330-3p. These results suggest that miR-330-3p inhibits AS by regulating AQP9. miR-330-3p/AQP9 axis may be a new therapeutic target for AS.

This paper discusses the imaging diagnostic features of arteriosclerotic encephalopathy and combines the spatial context information of local features to study the clinical imaging image copy detection algorithm. Moreover, this paper proposes a clinical imaging copy detection algorithm that combines the BOW model and spatial context embedding and a clinical imaging copy detection algorithm that combines the BOW model and global context verification. In addition, this paper applies the algorithm to the imaging diagnostic features of arteriosclerotic encephalopathy and sets up a controlled experiment to start research. The experimental research shows that the application of imaging diagnosis to the detection of subcortical arteriosclerotic encephalopathy has good clinical effects and rapid remission of patients’ symptoms. The effectiveness of this method can be verified by a large number of clinical practices in follow-up studies.

目的:探讨跨理论模型健康教育在下肢深静脉血栓形成患者中的应用效果.方法:采取便利抽样法选取下肢深静脉血栓形成患者100例为研究对象,按住院单双号分为观察组( n=50)和对照组( n=50) .对照组给予常规健康教育,观察组在常规护理的基础上进行基于跨理论模型的健康教育,采用Morisky服药依从性问卷和SF-36量表评价效果.结果:2组患者服药依从性得分比较,观察组出院后1个月[ (7. 85±0. 25) vs(6. 06±1. 23)分] 、2个月[ (7. 96±1. 36) vs(5. 53±1. 31)分] 、3个月[ (7. 89±0. 42) vs (4. 89±1. 02)分]均高于对照组( P<0. 05);出院后3个月、6个月生理角色限制、生理功能、心理健康、躯体疼痛、总体健康、情感角色职能、活力和社会功能评分明显高于对照组,差异有统计学意义(P<0. 05).结论:应用跨理论模型健康教育有助于提高下肢深静脉血栓患者的用药依从性和生存质量.

MicroRNAs (miRNAs) play critical roles in the development of vascular diseases. However, the effects of miR-130a-5p and its functional targets on atherosclerosis (AS) are still largely unknown. In this regard, our aim is to explore the potentially important role of miR-130a-5p and its target gene during the progression of endothelial cell injury. We first found oxidized low-density lipoprotein (ox-LDL) induced FAS and cell apoptosis in HUVECs. Subsequently, miR-130a-5p expression was verified to be downregulated after ox-LDL treatment and negatively correlated with FAS, and FAS was identified as substantially upregulated in the ox-LDL-treated HUVEC cells. After that, the knockdown of FAS and overexpression of miR-130a-5p together were observed to aggregate ox-LDL-induced reduction of cell viability and apoptosis, cell cycle progression, cell proliferation, cell migration and invasion. In conclusion, we detected that miR-130a-5p contributed to the progression of endothelial cell injury by regulating of FAS, which may provide a new and promising therapeutic target for AS.

目的 探讨在超声医学科实习、规培学员教学中开展以问题为基础的学习(problem based learning,PBL)教学法联合以病例为基础的学习(case based learning,CBL)教学法的效果.方法 选取2020年1-12月于蚌埠医学院第一附属医院超声医学科实习、规培的学员50名为研究对象,按随机数字表法分为观察组与对照组,每组25人.对照组以传统教学方式进行教学,观察组采取PBL结合CBL教学模式进行教学.通过理论考核,对超声基础知识和专业知识的掌握情况、操作技巧能力的掌握情况进行考察.同时在教学结束后,以问卷调查表的形式,对2组学员在超声理论知识的掌握、学习兴趣情况、解决实际问题能力、自主学习能力、团队合作能力、临床技能的提高、总体满意度等方面进行了解及分析,综合判断学员对教学模式的满意度.结果 观察组学员的考核成绩分别为(83.45 ±8.45)分、(84.86±8.28)分和(85.25 ±5.26)分,均高于对照组的考核成绩[(76.45±5.78)分、(74.35±6.68)分和(76.45 ±4.38)分],差异有统计学意义(均P＜0.05).观察组所有学员对采取PBL结合CBL教学模式的评价均为良好.结论 与传统教学方式相比,在超声医学科教学中采用PBL结合CBL教学模式进行教学更能够促进学生综合能力的培养,取得良好的教学效果,值得推广应用.

Objective:To compare drug-coated balloon (DCB) and standard angioplasty balloon (SAB) in the treatment of postoperative in-stent restenosis (ISR) in patients with arteriosclerosis obliterans (ASO) of the lower extremity.Methods:From Jan 2017 to Dec 2018, 43 ISR patients after percutaneous transluminal angioplasty for ASO of the lower extremity at our hospital were enrolled.Patients were divided into 2 groups with 18 patients treated by DCB and 25 by SAB. The patients were followed up for 6~12 months.Results:There was no significant difference in the incidence of complications between DCB group and SAB group ( P>0.05).Compared with that in SAB group, the plasma level of ET-1 in DCB group was lower while NO was higher at 6, 24 h and 2 weeks after surgery ( P<0.05), there was no significant difference in P-selectin ( P>0.05). The ABI values in both groups increased, and that in DCB group were higher than SAB group at 6 and 12 months after surgery ( P<0.05). The lumen loss in DCB group at 6 and 12 months after surgery was significantly lower ( P<0.05). At 6 and 12 months, the primary patency of target lesions in the DCB group was 100.00% and 88.89%, which was higher than the 72.00% and 52.00% in the SAB group ( P<0.05); the CD-TLR rate in the DCB group was 11.11%, which was lower than 48.00% in the SAB group ( P<0.05). Conclusion:DCB comes with lower postoperative ISR in ASO patients of the lower extremity.

Thromboangiitis obliterans (TAO), Buerger's disease, is a thromboocclusive inflammatory peripheral vascular disease with unknown etiology. There has been no highly effective treatment for it so far. Therefore, it is urgent to further explore the pathogenesis and effective treatment drugs. In this study, sodium laurate (0.2 mL; 10 mg/mL) was adopted to construct rat models of TAO to study the role of angiotensin I (Ang I) in cases with TAO. The TAO rats were randomly assigned to control group, TAO model group, group of TAO rats injected with adenovirus empty vector (TAO+vector group), and group of TAO rats injected with adenovirus overexpressing Ang I (TAO+oeAng I group). The local pathological signs of hind limbs of rats in each group were evaluated at 7, 14, and 21 days after modeling. At 21 days after modeling, the pathological changes of muscle tissues, oxidative stress level and expression of serum inflammation cytokines in the rats in each group were evaluated. The results showed that overexpression of Ang I strongly lowered the pathological signs, oxidative stress, levels of serum tumor necrosis factor-alpha (TNF-alpha), interleukin-1 beta (IL-1 beta), interleukin-6 (IL-6), and interleukin-18 (IL-18). The expression of pyrin domain-containing 3 (NLRP3), pro-caspase-1, and active caspase-1 in muscular tissues in TAO rats were also decreased. Therefore, overexpression of Ang I has a good therapeutic effect on TAO rats, and its mechanism is related to its antioxidation and inflammation reduce of vascular endothelial cells.

BACKGROUND Mesenchymal stem cells (MSCs) have shown great potential in the treatment of cardiovascular diseases, with fat being a more accessible source of MSCs. This study investigated the effect of human adipose-derived mesenchymal stem cells (hMSCs-Ad) exosomes on T lymphocytes and its role in atherosclerosis (AS). METHODS The exosomes were preliminarily isolated hMSCs-Ad and co-cultured with human H9 T lymphocytes. The effects of hMSCs-Ad exosomes on the proliferation and apoptosis of H9 were examined by performing functional experiments. The serum lipid level and inflammatory factor level in tail vein of mice were measured by biochemical analyzer and enzyme linked immunosorbent assay (ELISA) respectively. RESULTS The hMSCs-Ad-derived exosomes up-regulate the expression of micro (mi)R-125b-1-3p in H9 and AS arterial tissues. miR-125b-1-3p shared a targeted binding site with B-cell chronic lymphocytic leukemia (CLL)/lymphoma 11B gene (BCL11B). miR-125b-1-3p negatively regulated the expression of BCL11B in H9, and that knocking down BCL11B in H9 promoted its apoptosis. Injection of hMSCs-Ad-derived exosomes via the tail vein effectively reduced blood lipid and inflammatory factors, and that relieved the symptoms of AS in AS model mice. CONCLUSIONS miR-125b-1-3p was expressed in hMSCs-Ad exosomes and can promote T lymphocyte apoptosis and alleviate AS by down-regulating BCL11B expression. It provides potential molecular targets for the clinical treatment of AS.

目的:探讨超声弹性对比指数(elasticity contrast index,ECI)在诊断甲状腺结节中的应用价值,同时比较不同测量方法的效能.方法:选取甲状腺结节病人31例共36个结节,分别以勾勒横切面结节边界、横切面结节内不均质区、纵切面结节边界3种方法测量ECI,绘制受试者工作特征(ROC)曲线,比较不同测量方法对甲状腺结节的诊断效能.结果:3种方法中,横切面结节内不均质区测量法ROC曲线下面积最大,为0.82,对应ECI界值2.93,其评价甲状腺结节恶性风险的敏感性、特异性、准确性分别为82.0％、76.4％、75.3％,以横切面结节内不均质区法测定,恶性结节的ECI值高于良性结节(P<0.05).结论:横切面结节内不均质区测量ECI法对甲状腺结节有较高的诊断效能.

目的 探讨以问题为基础的教学模式(problem based learning,PBL)联合血管腔内模拟器在血管外科临床医学实习生教学中开展的作用.方法 选取在蚌埠医学院第一附属医院实习的2016级临床本科生100人为研究对象,按随机数字表法分为试验组与对照组,每组各50人;对照组采用传统教学模式及PPT手术演示,试验组采用PBL教学法联合血管腔内模拟器教学.带教结束后分别对2组学生进行理论知识、技能操作考核,最后以不记名形式对2种教学模式的学习兴趣、学习能力、课堂氛围、掌握理论情况、掌握技能情况进行评价.最终通过理论考核及调查问卷比较2种教学模式的教学效果.结果 试验组的考核成绩分别为(83.15±9.45)分和(84.36±7.28)分,均高于对照组的考核成绩[(75.45±7.78)分和(73.38±6.96)分],差异均有统计学意义(均P＜0.05);问卷调查对学生学习兴趣、学习能力、课堂氛围、掌握理论及技能情况进行打分及结果分析显示:试验组学生对调查内容的评价明显高于对照组,差异有统计学意义(P＜0.05),总之,试验组学生对PBL教学法联合血管腔内模拟器教学模式的调查评价均为良好.结论 在血管外科临床实习教学中,采用PBL教学法联合血管腔内模拟器教学模式比传统教学更可促进学生综合能力的培养,取得了良好的教学效果,值得推广应用.

目的:探讨彩色超声引导下行下腔静脉滤器(VCF)置入术的可行性、安全性和临床实用价值.方法:收集行VCF置入术的203例病人资料,其中21例在彩色超声引导下放置VCF(超声引导组),182例在DSA下放置VCF(DSA引导组),比较2组住院时间、住院费用、手术时间、滤器倾斜率、手术成功率及随访期间VCF相关并发症.结果:2组手术成功率、滤器倾斜率差异均无统计学意义(P>0.05).超声引导组住院时间、住院费用、手术时间均低于DSA引导组(P<0.05～P<0.01).术后随访3～6个月均未出现VCF相关并发症.结论:超声引导和DSA引导VCF置入均有很好的安全性及可行性,彩色多普勒超声引导对于造影剂过敏、肾功能不全及搬动困难者更适宜,值得临床推广.

Objective:This study aimed to explore the application value of personalized hybridization in the treatment of complex lower extremity arteriosclerosis obliterans (LEASO).Methods:Retrospective analysis was performed on the clinical data of 26 patients with complex multi-segmental LEASO at the Vascular Surgery Department of the First Affiliated Hospital of Bengbu Medical College from July 2016 to September 2018. A total of 17 males and 9 females, aged between 45 and 88 (66.4±10.8) years, were included in this study. Ankle brachial index (ABI), intermittent claudication distance, and primary patency rate were observed.Results:The success rate of hybrid surgery was 100% in 26 patients, no serious complications occurred during and after the operation, symptoms of lower limb ischemia were improved, and the examination of postoperative ABI was significantly improved compared with that before the operation. The average ABI of the affected limbs increased to 0.89±0.14, which was significantly higher than 0.41±0.46 before the operation, with statistically significant difference( t=5.151, P<0.05). The distance of intermittent claudication was (523±56) m, which was significantly longer than (132±46) m before the operation, and the difference was statistically significant( t=4.982, P<0.05). All 26 patients were followed up for 12 months. The primary patency rate was 92.30% (24/26), the limb salvage rate was 100% (26/26), and the survival rate was 100% (26/26). The primary patency rate was 76.92% (20/26), the limb salvage rate was 92.30% (24/26), and the survival rate was 100%(26/26). Conclusions:For complex LEASO involving multiple segments, individualized hybrid surgical approach is safe and effective with increased patient benefit.

Objective:To identify and quantitatively analyze serum protein expression in patients with Budd-Chiari syndrome (BCS) and control group by isobaric tags for relative and absolute quantitation (iTRAQ).Methods:Serum was collected from 30 patients with BCS and 30 patients with varicose veins of lower limbs, using iTRAQ technology to detect the significant differentially expressed proteins, to explore the differences in protein biological information and related signaling pathway.Results:A total of 143 kinds of differentially expressed proteins were detected. 76 proteins in the BCS group were significantly increased and 67 proteins were significantly decreased (all P<0.05). The main biological processes involved are defense response, vesicle-mediated transport, immune effect process, complement activation and blood agglutination (all P<0.05). Conclusion:ITRAQ technology is used to identify the differential proteins between BCS group and control group, Some proteins may be specific serum biomarkers for the diagnosis of BCS, and these proteins provide new directions for the study of the pathogenesis of BCS.