Volume 24,Issue 6,2015 Table of Contents

1 Application of hybrid procedure in complex aortic diseases

WAN Heng , LIN Zhiqi , LIU Hao , LU Jingbo , ZHOU Zhongxin , FU Fangyong , YE ling , HUANG Xianying , LIU Zhengjun

2015, 24(6):783-786. DOI: 10.3978/j.issn.1005-6947.2015.06.003

[Abstract](275) [HTML](0) [PDF 1.28 M](1009)

Abstract:
Objective: To investigate the application of hybrid procedure in treatment of complex aortic diseases. Methods: The clinical data of the 12 patients with complex aortic disease undergoing hybrid treatment from August 2007 to August 2012 were retrospectively analyzed. Of the patients, 9 cases had aortic dissection, and 3 cases had thoracoabdominal aortic aneurysm. The procedures included various prosthetic bypass graftings combined with endovascular covered stent placement. Results: Technical success was achieved in all patients. Proximal type I endoleak occurred in one patient with aortic dissection after operation, for which no treatment was given; one patients with aortic dissection died during perioperative period due to severe mediastinal infection; the rest of the patients recovered well after operation. Follow-up was obtained in 8 patients for 3 months to 2 years, and all of them were alive without endoleak or other complications. Conclusion: Hybrid procedure is a viable alternative to patients with complex aortic diseases.

2 Treatment strategy of iliac artery aneurysm in endovascular repair for abdominal aortic aneurysm

GE Hongwei , ZHU Yunfeng , ZHU Yongbin , WU Yuanbing , JIANG Yunfei , HUANG Yiming , CHEN Cheng

2015, 24(6):787-791. DOI: 10.3978/j.issn.1005-6947.2015.06.004

[Abstract](309) [HTML](0) [PDF 1.48 M](935)

Abstract:
Objective: To investigate the method of endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA) combined with iliac artery aneurysm. Methods: The clinical data of 35 patients with AAA and concomitant iliac artery aneurysm undergoing EVAR from August 2007 to March 2014 were retrospectively analyzed. The patients consisted of 9 cases complicated with unilateral internal iliac artery aneurysm, one case with bilateral internal iliac artery aneurysm, 14 cases with unilateral common iliac artery aneurysm (diameter larger than 18 mm) and 11 cases with bilateral common iliac artery aneurysm. The endovascular procedures performed included internal iliac artery embolization followed with stent coverage, simple stent coverage of the internal iliac artery aneurysm, use of a braided stent, and Sandwich technique for internal iliac artery endorevascularization. Results: All endovascular procedures were successfully performed, with an average operative time of (125± 40) min and blood loss of (173±65) mL. Intraoperative endoleak was observed in 8 patients (22.9%), including type I endoleak in 4 cases (2 from the proximal and 2 from the distal attachment site) which were all resolved after balloon dilatation, type III endoleak in one case which was resolved by dilatation plus adjunctive coil embolization, type II endoleak in 2 cases and type IV endoleak in one case, none of which received further intervention. Postoperative follow-up was conducted for 6 to 26 months in the 35 patients, during which time no aneurysmal rupture occurred; AAA enlargement was found in 2 cases 6 months after procedure, which was identified as distal type I endoleak by radiography and resolved by coil embolization, and no aneurysmal enlargement occurred in any of the remaining 33 cases. Conclusion: Ideal short-term results may be obtained in patients with AAA and concomitant iliac artery aneurysm by appropriate treatment of the internal iliac artery and then suitable endovascular techniques according to the diameter of the common iliac artery.

3 Surgical versus conservative treatment for small-diameter abdominal aortic aneurysm: a meta-analysis

ZHANG Xianlan , GUO Jiangang

2015, 24(6):792-799. DOI: 10.3978/j.issn.1005-6947.2015.06.005

[Abstract](218) [HTML](0) [PDF 1.22 M](921)

Abstract:
Objective: To systematically evaluate the efficacy of surgical and conservative treatment for small-diameter abdominal aortic aneurysm (AAA). Methods: The randomized controlled trails (RCTs) comparing surgical (endovascular aortic repair and open surgery) and conservative treatment for small-diameter AAA were collected by searching the national and international databases. After assessment of methodological quality of the included studies according to the Cochrane Reviewers’ Handbook criteria, Meta-analysis was performed by using RevMan 5.1 software. Results: Four RCTs were finally included, with a total of 3 314 patients, of whom 1 680 cases underwent surgical treatment and 1 634 cases underwent conservative treatment. Results of Meta-analyses showed no significance difference between the two groups of patients in all-cause mortality (SMD=0.97, 95% CI=0.68–1.38), aneurysm-related mortality (SMD=0.81, 95% CI=0.56–1.17), incidence of aneurysm rupture (SMD=0.49, 95% CI=0.09–2.54) and mortality within postoperative 30 d or during hospitalization (SMD=0.88, 95% CI=0.60–1.29) (all P>0.05). Conclusion: In treatment of small-diameter AAA, the outcomes between surgery and conservative treatment are similar. However, the clinical significance of this conclusion is uncertain, and the authors based on comprehensive analysis deem that small-diameter AAA still needs aggressive surgical treatment.

4 Interventional therapy for juxtarenal aortic occlusion: a report of 14 cases

ZHAO Junlai , ZHANG Xiaoming , ZHANG Xuemin , JIANG Jingjun , LI Qingle , HE Zhibin , LI Wei

2015, 24(6):800-803. DOI: 10.3978/j.issn.1005-6947.2015.06.006

[Abstract](216) [HTML](0) [PDF 1.44 M](794)

Abstract:
Objective: To describe the experience in endovacular treatment of juxtarenal aortic occlusions. Methods: The clinical data of 14 patients with juxtarenal aortic occlusion admitted from March 2012 to November 2014 were retrospectively analyzed. Of the patients, 9 cases were male and 5 cases were female; ages ranged from 42 to 71 years; 8 cases presented with intermittent claudication, 5 cases manifested as rest pain, and one case had toe gangrene, and the course of disease ranged from one month to 72 months. All patients received covered stent implantation after thrombolysis via a multi–side-hole catheter. Results: Interventional procedures were successfully completed in all patients. The thrombi in the abdominal aorta disappeared after catheter-directed thrombolysis in all patients except two cases, in whom little mural thrombi remained. All patients received covered kissing stent placement, after which, their symptoms of limb ischemia were significantly relieved. Follow-up period ranged from one month to 26 months, with average of 14.8 months, and the patency rate was 78.6%. Conclusion: Thrombolytic therapy combined with covered stent placement is a safe and effective endovascular treatment method for juxtarenal aortic occlusion.

5 Endovascular therapy of subclavian artery occlusion via combined brachial and femoral approach

TONG Zhu , GU Yongquan , GUO Lianrui , GUO Jianming , GAO Xixiang , MA Tianyu , LIU Mengxia , LI Jianxin , WANG Zhonggao , ZHANG Jian

2015, 24(6):804-808. DOI: 10.3978/j.issn.1005-6947.2015.06.007

[Abstract](282) [HTML](0) [PDF 1.16 M](811)

Abstract:
Objective: To investigate the indications, advantages and complications of using combined brachial and femoral approach for endovascular treatment of subclavian artery occlusion. Methods: Fifty-seven patients with subclavian arterial occlusive disease undergoing endovascular therapy via the combined approach in Department of Vascular Surgery, Xuanwu Hospital of Capital Medical University from January 2011 to June 2014 were reviewed. The pathological characteristics of the patients, success rate of operation, advantages of the combined approach, complications, and follow-up results were analyzed. Results: There was three lesion types among the patients, which included subclavian artery occlusion that failed to be recanalized by anterograde approach (31 cases), the stenosis or occlusion located in the opening of right subclavian artery (16 cases), and the distal subclavian artery stenosis or occlusion adjacent to the opening of the vertebral artery (10 cases). The success rate of endovascular treatment was 91.2% for the entire group, and puncture complications occurred in 3 cases. The stent patency rate at postoperative 6, 12, 24, and 36 months was 100%, 100%, 90% and 77.7%, respectively. Conclusion: For subclavian artery occlusion difficult to be recanalized by conventional approach, the combined approach can effectively improve the recanalization rate, with the advantages of helping to ensure the accuracy of stent positioning and reduce the occurrence of complications.

6 Efficacy analysis of surgical treatment for vertebral artery occlusion

FANG Jie , CHEN Xueming , LI Chenyu , FENG Hai , YU Hongzhi , ZHU Renming

2015, 24(6):809-812. DOI: 10.3978/j.issn.1005-6947.2015.06.008

[Abstract](417) [HTML](0) [PDF 1.28 M](913)

Abstract:
Objective: To investigate the efficacy of open surgery for vertebral artery occlusive disease. Methods: The clinical data of 7 patients with vertebral artery occlusion admitted between 2013 and 2014 were retrospectively analyzed. All patients underwent open surgical procedures such as artery bypass operation or arterial endarterectomy, and the efficacy was evaluated according to the results of postoperative examinations and follow-up interview. Results: The symptoms were improved in all cases after surgery and then they were discharged. The surgical success rate was 100%. No perioperative complications occurred and postoperative examinations showed good blood flow in the vertebral artery. The short-term patency rate was 100%, and no recurrence of symptoms such as apparent vertigo occurred within 2-year follow up. Conclusion: Open surgery has significant efficacy in treatment of vertebral artery occlusive disease, with a higher postoperative patency rate.

7 Efficacy analysis of Viabahn covered stent for arteriosclerosis obliterans of the lower limbs

WANG Luobo , WANG Bing , WANG Ying , ZHANG Di , YANG Wenyu , GUAN Haibo

2015, 24(6):813-817. DOI: 10.3978/j.issn.1005-6947.2015.06.009

[Abstract](212) [HTML](0) [PDF 1.21 M](875)

Abstract:
Objective: To investigate the short and medium term efficacy of Viabahn covered stent in treatment of arteriosclerosis obliterans of the lower limbs. Methods: The clinical data of 73 patients (73 affected limbs) with arteriosclerosis obliterans of the lower limb undergoing endovascular treatment from January 2013 to January 2014 were retrospectively analyzed. Of the patients, 32 cases underwent endovascular Viabahn covered stent placement (Viabahn stent group), and 41 cases received bare-metal stent placement (bare-metal group). The clinical outcomes between the two groups of patients were compared. Results: In Viabahn stent group compared with bare-metal stent group, the primary patency rate at postoperative 3 and 6 months showed no significant difference (96.8% vs. 90.2%; 87.5% vs. 75.6%, both P>0.05), but it was significantly increased at postoperative 9 and 12 months (84.4% vs. 63.4%; 75.0% vs. 51.2%, both P<0.05). Log-rank test result showed that the 12-month patency rate in Viabahn stent group was significantly higher than that in bare stent group (P<0.05). The ankle brachial index (ABI) at postoperative 12 months between the two groups had no significant difference (P>0.05). Conclusion: Viabahn covered stent placement following endovascular angioplasty has significant short and medium term efficacy in treatment of arteriosclerosis obliterans of the lower limbs, and it may be a therapeutic option for arteriosclerosis obliterans of the lower limbs with lesions close to, and especially those crossing over the knee joint.

8 Subintimal angioplasty through retrograde popliteal approach for long superficial femoral artery sclerotic occlusion

ZHANG Senmiao

2015, 24(6):818-822. DOI: 10.3978/j.issn.1005-6947.2015.06.010

[Abstract](324) [HTML](0) [PDF 1.10 M](1164)

Abstract:
Objective: To investigate the effectiveness and feasibility of subintimal angioplasty/stent placement through retrograde popliteal approach for long superficial femoral artery sclerotic occlusion with failed recanalization by conventional endovascular antegrade approach. Methods: The data of fifty patients with long superficial femoral artery sclerotic occlusions, in whom the guide wire and catheter failed to advance into the distal true lumen through the occlusive lesions by antegrade ipsilateral or contralateral femoral approach, and then underwent subintimal angioplasty by retrograde popliteal approach were analysed. Results: The immediate success rate of stent placement was 100%, with primary and secondary patency rate of 48.0% and 92.0% at 12 months. In all the patients, the ankle brachial index (ABI) was increased and Rutherford classification was improved significantly compared with those before operation (all P<0.05). Postoperative limb swelling occurred in 5 patients and popliteal pseudoaneurysm developed in 3 patients at 3 months after operation, which were all improved after treatment. Restenosis occurred after one year in 16 patients (32.0%). Conclusion: Subintimal angioplasty/stent placement through retrograde popliteal approach is effective and feasible in treatment of long superficial femoral artery sclerotic occlusion with failed recanalization after conventional endovascular antegrade approach.

9 Combined anticoagulation and antiplatelet therapy for prophylaxis of restenosis after stent placement for leg atherosclerosis obliterans in diabetic patients

SU Shaofei , TIAN Yufeng , CHEN Linbao , YAN Bo

2015, 24(6):823-827. DOI: 10.3978/j.issn.1005-6947.2015.06.011

[Abstract](210) [HTML](0) [PDF 1.28 M](848)

Abstract:
Objective: To investigate the clinical efficacy of combined anticoagulation and antiplatelet aggregation therapy in prevention of restenosis after stent placement for leg atherosclerosis obliterans in diabetic patients. Methods: Sixty-one diabetic patients with lower limb atherosclerosis obliterans were designated to observational group (30 cases) and control group (31 cases). Patients in observational group received warfarin plus cilostazol regimen, and aspirin plus cilostazol regimen was used in those in control group. Follow-up was performed for one year, and the incidence of restenosis and other relevant variables were compared between the two groups. Results: The preoperative data were comparable between the two groups. During follow-up, the postoperative incidence of restenosis, late lumen loss and plasma D-dimer level in observation group were significantly lower than those in control group (all P<0.05), while preoperative platelet aggregation rate, and blood glucose/lipid-related parameters as well as incidence of bleeding events showed no significant difference between the two groups (all P>0.05). Conclusion: Combined anticoagulation and antiplatelet therapy for prophylaxis of restenosis after stent placement for leg atherosclerosis obliterans in diabetic patients is safe and effective, so it is recommended to be used in clinical practice.

10 Quercetin inhibiting growth of hepatocellular carcinoma cells: in vivo experimental study

HUANG Chunlong , PENG Wei , ZHANG Jihong , DENG Liang , WANG Xiaofeng

2015, 24(6):828-833. DOI: 10.3978/j.issn.1005-6947.2015.06.012

[Abstract](325) [HTML](0) [PDF 1.52 M](803)

Abstract:
目的：探讨quercetin对肝癌细胞体内生长的抑制作用及机制。方法：用人肝癌HepG2细胞皮下接种法建立裸鼠移植瘤模型，成瘤后随机分为对照组、quercetin治疗组、5-FU治疗组、5-FU+quercetin联合治疗组，溶剂或药物均1次/d腹腔注射，3周后观察各组移植瘤大小并计算各治疗组的抑瘤率，分别用RT-PCR、Western blot、免疫组化法检测各组移植瘤组织中cyclin D1、cyclin E、增殖细胞核抗原（PCNA）的表达。结果：与对照组比较，各治疗组移植瘤体积明显减小、移植瘤组织中cyclin D1、cyclin E mRNA和蛋白表达以及PCNA阳性指数均明显降低（均P<0.05），其中联合治疗组的抑瘤率明显大于两个单药组，cyclin D1、cyclin E、PCNA表达的降低程度也明显大于两个单药组（均P<0.05），而两个单药组间各项指标差异均无统计学意义（均P>0.05）。结论：quercetin能通过下调cyclin D1与cyclin E的表达而抑制肝癌细胞的增殖，且与5-FU联合应用具有协同作用。

11 Influence of renal capsule block on gastric myoelectrical activity and motility in rats

TANG Yongzhong , LIAO Qin , LU Xi

2015, 24(6):834-837. DOI: 10.3978/j.issn.1005-6947.2015.06.013

[Abstract](261) [HTML](0) [PDF 1.11 M](889)

Abstract:
Objective: To investigate the influence of renal capsule block on gastric myoelectrical activity and motility in rats, and provide a theoretical basis for using this method in treatment of gastrointestinal motor disorders. Methods: Thirty-six SD rats were equally randomized into 3 groups, and then underwent intraperitoneal injection of atropine, neostigmine or normal saline to create the models of gastrointestinal motor suppression (suppression group), gastrointestinal hyperactivity (hyperactivity group), or normal control (control group), respectively. Rats in each group underwent renal capsule block procedure by renal capsule injection of lidocaine. The gastric electrical activity and gastric residual rate in rats of each group were detected and compared. Results: Compared with control group after model creation, the average peak amplitude and cycle length of the electrogastrography were reduced, and gastric residual rate was increased significantly in suppression group, while the changes in these parameters in hyperactivity group were opposite to those in hyperactivity group (all P<0.05). After renal capsule block, all the parameters in control group showed no significant change compared with those before renal capsule block (all P>0.05), while the average peak amplitude and cycle length of the electrogastrography in suppression group were elevated and gastric residual rate was decreased significantly compared with the values before renal capsule block, and the average peak amplitude and cycle length of the electrogastrography in hyperactivity group were decreased and gastric residual rate was increased significantly compared with those before renal capsule block (all P<0.05). Conclusion: Renal capsule block exerts no obvious impact on normal gastric myoelectrical activity and motility, but has a bidirectional correction effect on abnormal gastric myoelectrical activity and motility.

12 Clinical analysis of fistula between pseudoaneurysm of celiac trunk branches and digestive tract after abdominal surgery: a report of 5 cases

FANG Shunyong , CAI Lisheng , LIN Xiaolei , HONG Jianming

2015, 24(6):838-842. DOI: 10.3978/j.issn.1005-6947.2015.06.014

[Abstract](240) [HTML](0) [PDF 2.52 M](823)

Abstract:
Objective: To present and analyze the diagnosis and treatment of the delayed massive gastrointestinal hemorrhage caused by fistula formation between pseudoaneurysm of the celiac trunk branches and digestive tract following abdominal surgery. Methods: The clinical data of 5 patients from January 2013 to September 2014 who developed massive gastrointestinal hemorrhage after abdominal tumor surgery and were identified as fistula formation between pseudoaneurysm of the branches and digestive tract by angiography were analyzed. Results: Of the 5 patients, the average time to postoperative gastrointeatinal hemorrhage was 53.6 d; the pseudoaneurysm was located in the splenic artery in 2 cases, in the common hepatic artery in 2 cases and in the left hepatic artery in one case; 4 cases underwent embolization therapy after angiography, and one case underwent covered stent implantation. No severe postoperative complications or perioperative death occurred. Postoperative follow-up was conducted for 6 to 16 months, during which time, no rupture and hemorrhage of the pseudoaneurysm occurred, but there was sudden death of unknown cause in one case who had undergone common hepatic artery covered stent implantation. Conclusion: The fistula between pseudoaneurysm of celiac axis branches and digestive tract is a rare but fatal complication after abdominal surgery and its awareness should be enhanced. Angiography and endovascular repair are preferred for its diagnosis and treatment, and avoidance of iatrogenic injury may be critical for reducing the incidence of this condition.

13 Surgical treatment of carotid body tumor: a report of 24 cases

GAO Jinhui , CAI Mingzhi , LIN Xiaolei , CAI Lisheng , HONG Jianming , ZENG Yanhua

2015, 24(6):843-846. DOI: 10.3978/j.issn.1005-6947.2015.06.015

[Abstract](254) [HTML](0) [PDF 1.63 M](1008)

Abstract:
Objective: To report the experience in diagnosis and treatment as well as the surgical complications of carotid body tumors (CBTs). Methods: The data of 24 CBT patients with a total of 30 CBTs treated from January 1999 to September 2012 were retrospectively reviewed. Of the patients, 6 cases had bilateral lesions, and 18 cases had a unilateral lesion. Results: All the 24 patients (30 CBTs) underwent surgical treatment that included simple tumor excision of 17 Shamblin I tumors, tumor removal plus external carotid artery resection of 7 Shamblin II tumors, and tumor removal plus partial internal carotid artery resection and reconstruction of 6 Shamblin III tumors. Tumors were completely removed in all the 24 patients, and no operative death occurred, Transient postoperative cranial nerve injury occurred in 5 cases (16.7%) and permanent postoperative cranial nerve damage occurred in one case (3.33%). Follow-up lasted for 1 year to 15 years, and no delayed complications or tumor recurrence occurred. Conclusion: Surgery is the most effective treatment for CBTs, and favorable outcomes may be obtained by appropriate surgical procedures decided according to the size of the tumor and the relationship between the tumor and its adjacent arteries.

14 Application of interventional catheterization procedure in arteriovenous fistula dysfunction

HE Zhibin , ZHANG Xuemin , ZHANG Xiaoming , JIANG Jingjun , JIAO Yang , LI Qingle , HE Changshun

2015, 24(6):847-851. DOI: 10.3978/j.issn.1005-6947.2015.06.016

[Abstract](349) [HTML](0) [PDF 1.96 M](943)

Abstract:
Objective: To investigate the interventional surgery for arteriovenous fistula (AVF) dysfunction and evaluate its therapeutic effect and application value. Methods: The clinical data of 20 patients with autogenous AVF dysfunction undergoing interventional treatment from April 2006 to January 2015 were retrospectively reviewed. Results: Among the 20 patients, 16 cases underwent angiography through venous approach, and 4 cases had angiography through femoral/aortic/axillary artery approach; 4 cases had simple anastomotic stenosis that was significantly improved by balloon dilatation, 5 cases had anastomotic stenosis with thrombosis, which was treated by balloon expansion after venous embolectomy; 3 cases had thrombosis at the venous anastomotic site, and good backflow was obtained after embolectomy; 7 cases with venous anastomotic stenosis and thrombosis underwent balloon angioplasty after venous embolectomy, and one case with long segment stenosis of the cephalic vein was treated by inserting a prosthetic arteriovenous graft. All patients restarted dialysis treatment using the original vascular access, with dialysis flow greater than 200 mL/min. Follow-up was obtained in 17 patients, with an average follow-up period of 13.2 months, and the 12-month patency rate was 47.1%. Conclusion: Interventional catheterization procedure is safe and effective in treatment of AVF dysfunction.

15 Influence of surgery for superficial varicose veins on function of deep venous valves in lower extremities

QIU Tian , GUO Shuguang , FANG Wei , ZHOU Xingli , PENG Mingsheng , YIN Cunping , ZHANG Peng , SU Hongbin , ZHANG Kai

2015, 24(6):852-856. DOI: 10.3978/j.issn.1005-6947.2015.06.017

[Abstract](420) [HTML](0) [PDF 1.08 M](792)

Abstract:
Objective: To investigate the impact of operation for lower extremity superficial varicose veins on function of deep venous valves in patients with primary deep vein valvular incompetence (PDVI). Methods: The clinical data of 94 PDVI patients (95 limbs) undergoing surgery for superficial varicose veins of the lower extremity were retrospectively analyzed. The changes in deep venous valve function before and after operation were compared. Results: All the 95 limbs were definitely diagnosed to have PDVI by color Doppler ultrasonography before operation, in which according to CEAP classification, 31 limbs were classified as C2, 22 were C3, 25 were C4, 7 were C5, and 10 were C6, respectively. Results of color Doppler ultrasonography half a year after operation showed that valvular function returned to normal in 40 limbs (42.1%), improved in 21 limbs (22.1%), was unable to be determined in 23 limbs (24.2%), and the valvular incompetence was aggravated in 11 limbs (11.6%), 10 of which were classified as C5–6 by preoperative CEAP classification; the average valve closure time (VCT) and maximum velocity (Vmax) of the 95 limbs were all significantly decreased compared with preoperative values (both P<0.05). Conclusion: The valvular function of deep veins in PDVI patients may be improved to some extent after operation for lower extremity superficial varicose veins. However, for patients with C5–6 classification, the synchronous repair of deep vein valves is recommended because of the serious damage of their valvular function.

16 Numerical simulation of hemodynamics in Budd-Chiari syndrome caused by membrane obstruction of the inferior vena cava

ZHUANG Yinping , WANG Quan , HOU Lin , ZHANG Bin , ZHOU Siyuan , WANG Aming , ZU Maoheng

2015, 24(6):857-860. DOI: 10.3978/j.issn.1005-6947.2015.06.018

[Abstract](214) [HTML](0) [PDF 1.38 M](820)

Abstract:
Objective: To investigate the vascular hemodynamic changes during the formation of obstructive membrane of the inferior vena cava (IVC) in Budd-Chiari syndrome (BCS) using computer simulation methods. Methods: The vascular model of BCS caused by membranous obstruction of the IVC was established based on MRA slice images, and then numerical simulation of hemodynamic parameter changes was demonstrated by using Ansys Fluent software. Results: The vascular model of BCS with membranous obstruction of the IVC was established successfully. The results of numerical simulation experiments demonstrated that during the formation of the obstructive membrane, there was a low flow speed region between the membrane and the region of confluence of the IVC and the three main hepatic veins, which increasingly enlarged with the extension of the membrane; with the development of the membrane, the low shear stress field located close to the IVC and the right hepatic vein was continuously amplified, and moreover, the shear stress gradually increased. Conclusion: The formation and development of the obstructive membrane of the IVC is a process of slow change, which may be closely related to alterations in shear stress of the wall of IVC.

17 Correlation between thyroid disorders and blood lipid level

HUANG Min , XIAO Chuangqing

2015, 24(6):861-864. DOI: 10.3978/j.issn.1005-6947.2015.06.019

[Abstract](302) [HTML](0) [PDF 1.04 M](990)

Abstract:
Objective: To investigate the relationship between thyroid dysfunction and blood lipid level. Methods: Two hundred patients with thyroid function problems admitted during April 2013 to March 2015 were enrolled for the study, including 100 cases each with hyperthyroidism or hypothyroidism, and 80 participants undergoing health maintenance examination during the same period served as control. The levels of thyroid hormones and blood lipids in all subjects were measured, and the correlation between their levels was analyzed. Results: By univariate analysis, significant difference was found in all the studied thyroid hormones and blood lipids among the three populations (all P<0.05). Correlation analysis in patients with abnormal thyroid function showed that the level of thyroid stimulating hormone (TSH) had a positive correlation with the levels of total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), and apolipoprotein B100 (ApoB10) (r=0.695, 0.714, and 0.632); the level of free triiodothyronine (FT3) had a negative correlation with the levels of TC, LDL-C and ApoB100 (r=–0.769, –0.705 and –0.689); the level of free thyroxine (FT4) had a negative correlation with the levels of TC, LDL-C and ApoB100 (r=–0.728, –0.676 and –0.625) (all P<0.05). Conclusion: Thyroid dysfunction may cause blood lipid metabolic abnormity, which deserves attention in clinical practice.

18 Relations of inflammatory reactions with diagnosis and prognosis of aortic dissection: recent progress

TAN Mengjie , ZHANG Lei , ZHOU Jian , JING Zaiping

2015, 24(6):865-869. DOI: 10.3978/j.issn.1005-6947.2015.06.020

[Abstract](198) [HTML](0) [PDF 1.08 M](876)

Abstract:
As one of the life-threatening diseases in cardiovascular system, aortic dissection (AD) is an extremely dangerous condition with a complex pathogenesis. In recent years, the role of inflammatory reactions in the development of aortic dissection has increasingly attracted great attention, and many findings have shown that inflammatory reactions contribute greatly to the pathophysiology and outcomes of AD. In this article, the authors address the possible mechanisms for inflammatory reactions participating in the occurrence and development of AD, the relationship between markers of inflammation and diagnosis of AD, and the influence of inflammatory reactions on prognosis of different types of AD, as well as the current problems and future prospects.

19 Surgical treatment of abdominal aortic aneurysm associated with horseshoe kidney: essentials and difficulties

YANG Chunqing , HU Haidi , ZHANG Jian , XIN Shijie

2015, 24(6):870-841. DOI: 10.3978/j.issn.1005-6947.2015.06.021

[Abstract](256) [HTML](0) [PDF 1.14 M](935)

Abstract:
Abdominal aortic aneurysm (AAA) with concomitant horseshoe kidney (HSK) is a rare clinical entity. Special consideration to the abnormal anatomy of the kidney, such as the isthmus of the HSK straddling the aneurysm and the accessory renal arteries originating from the abdominal aorta, should be taken during its surgical treatment. Current treatment methods include open surgery (transabdominal or retroperitoneal), endovascular repair and hybrid surgery. But the indications and specific technical approach for those procedures remain inconclusive. In this paper, the authors present and analyze the essentials and difficulties in surgical treatment of this condition, so as to provide a reference for clinical practice.

20 Application and development of peritoneovenous shunt

LI Chunmin , WANG Zhonggao , ZHANG Wangde

2015, 24(6):875-879. DOI: 10.3978/j.issn.1005-6947.2015.06.022

[Abstract](387) [HTML](0) [PDF 1.07 M](1033)

Abstract:

Refractory ascites is a common clinical symptom, for which the conventional treatment methods have minimal effect. Peritoneovenous shunt (PVS) is an effective approach to eliminating ascites, and can improve the patient’s quality of life, so it has increasingly been used in clinical practice. In this article, the authors mainly address the application of PVS in treatment of refractory ascites and related progresses.

21 Iliac vein compression syndrome: recent progress

ZHANG Jie , SHAO Chuxiao

2015, 24(6):880-884. DOI: 10.3978/j.issn.1005-6947.2015.06.023

[Abstract](370) [HTML](0) [PDF 1.10 M](1067)

Abstract:
The iliac vein compression syndrome is important cause for lower venous hypertension, and frequently manifests as lower extremity varicose veins and deep venous thrombosis. With the development of diagnostic technology and rising awareness, an increasing number of patients with iliac vein compression are being identified. There are presently some controversies concerning the treatment of iliac vein compression syndrome complicated with lower extremity varicose veins or deep venous thrombosis. In this paper, the authors present the recent viewpoints as well as diagnostic and treatment advances on iliac vein compression syndrome.

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Volume 24,Issue 6,2015 Table of Contents

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