Observation of the effect of angiojet to treat acute lower extremity arterial embolization

BACKGROUND

Through significant advances in the treatment of peripheral arterial occlusive disease, acute ischemia of the lower extremity is still associated with significant morbidity, limb threat and mortality. The two main causes of acute ischemia in lower extremities are arterial embolism and atherosclerotic arteries. Timely recognition and treatment of acute limb ischemia in emergency situations is essential in order to minimize the duration of ischemia.

AIM

To investigate the application effect of angiojet thrombolysis in the treatment of acute lower extremity arterial embolization.

METHODS

Sixty-two patients with acute lower extremity arterial embolization admitted to our hospital from May 2018 to May 2020 were selected. Among them, the observation group (twenty-eight cases) had received angiojet thrombolysis, and the control group (thirty-four cases) had received femoral artery incision and thrombectomy. After thrombus clearance, significant residual stenosis of the lumen was combined with balloon dilation and/or stent implantation. When the thrombus removal was not satisfactory, catheter-directed thrombolysis was performed. The incidence of postoperative complications, recurrence rate and recovery of the two groups were compared.

RESULTS

There were no significant differences in postoperative recurrence (target vessel reconstruction rate), anklebrachial index and the incidence of postoperative complications between the two groups (P > 0.05); there were statistically significant differences in postoperative pain score and postoperative rehabilitation between the two groups (P < 0.05).

CONCLUSION

The application of angiojet in the treatment of acute lower limb artery thromboembolism disease is safe and effective, minimally invasive, quicker recovery after operation, less postoperative complications, which is more suitable for the treatment of femoral popliteal arterial thromboembolism lesions. If the thrombus removal is not satisfactory, the combination of coronary artery aspiration catheter and catheterized directed thrombolysis can be used. Balloon dilation and stent implantation can be considered for obvious lumen stenosis.

Cardiac myxoma shedding leads to lower extremity arterial embolism: A case report

BACKGROUND

Left cardiac myxoma (CM) is the most common benign tumor of primary cardiac tumors, but because of its special position caused by pathological physiology change, caused by the complications of the heavier, the surface is often accompanied by blood clots, once fall out, it causes peripheral vascular embolization, such as acute lower limb artery embolization, harmfulness is large, high morbidity, and easy to occur repeatedly.

CASE SUMMARY

A 67-year-old male patient suddenly appeared numbness and weakness of the left lower limb and could not walk without obvious incentive. The patient was finally diagnosed as left CM complicated with acute lower limb arterial embolism after completing cardiac ultrasound, computer tomography angiography, and histopathological analysis, such as hematoxylin-eosin stain staining, immunohistochemistry and special staining including alcian blue staining and periodic acid schiff staining. Arterial thrombosis was removed successfully by femoral artery thrombectomy, postoperative numbness and weakness of the patient's left lower limb disappeared, skin temperature became warm, and dorsal foot artery pulsation was accessible. The patient was readmitted to the hospital 8 mo after discharge for left atrial mass resection, and was diagnosed as CM by postoperative histopathological examination.

CONCLUSION

Although CM is rare, it may be considered as the source of embolism in patients with acute limb ischemia. Repeated loss of thrombus on the tumor and its surface may lead to repeated embolism of peripheral vessels. Cardiac ultrasound is helpful for early diagnosis. Here, we use this case report to highlight left CM as an important cause of acute limb ischemia and to report our experience in the diagnosis and treatment of lower limb arterial embolism caused by CM detachment.

Intravascular fasciitis involving the external jugular vein and subclavian vein: A case report

BACKGROUND

Intravascular fasciitis (IVF) is a rare nodular fasciitis that often involves the layers and lumens of blood vessels; therefore, it is easily misdiagnosed as a malignant tumor with invasion into blood vessels.

CASE SUMMARY

A 13-year-old boy was admitted due to a mass on the left side of his neck. Duplex ultrasonography revealed a circular solid hypoechoic mass in the external jugular vein, and magnetic resonance imaging revealed an enhanced longitudinal mass-like lesion in the left supraclavicular fossa. Surgical treatment was arranged and completed, histopathological analysis showed a large amount of spindle cell proliferation, and immunohistochemistry showed that the spindle cells were positive for the expression of vimentin, caldesmon, and smooth muscle actin and negative for the expression of S-100 protein, desmin, CD34, and c-kit; Ki-67 staining revealed a low proliferative index (5%-10%), which confirmed the differentiation characteristics of myofibroblasts. Fluorescence in situ hybridization detected the rearrangement of USP6. IVF was subsequently diagnosed.

CONCLUSION

IVF is characterized by intraluminal, intramural and extramural involvement of small to large arteries or veins. Unless the doctor has a deep understanding of the disease or suspects that there is an initial indicator, IVF may be confused with other intravascular malignancies, leading to unnecessary radical surgery. Imaging examination combined with histopathological examination can improve the diagnostic accuracy of this disease.

CiteSpace-based Document Information Visualization of Literature Published by Journal of Forensic Medicine from 1985 to 2018

Abstract

Objective To analyze a knowledge web of the literature published by Journal of Forensic Medicine from its founding in 1985 to 2018, describe the evolving process of forensic science research and explore the research hotspots and frontiers at present. Methods The literature that was published by Journal of Forensic Medicine from 1985 to 2018 was collected and analyzed in terms of elements, such as emerging research hotspots, high frequency keywords, authors, dispatching units, location of institution and funding, by CiteSpace5.3 information visualization analysis software. Results All disciplines of forensic medicine were continually developing and maturing, and the publication volume of the literature on forensic pathology had the highest weight; in research hotspots, the two categories, research and identification each had their own emphasis; as the main source of contributions to the journal, research institutes accounted for 38.99% of the total number of publications; Shanghai ranked first among all regions with 1 046 articles published. The number of funded articles was generally on the rise, with the number of funded articles published largest in 2015. Conclusion As an authoritative academic journal in the field of forensic science in China, Journal of Forensic Medicine carries the development of forensic science and witnesses the institutional reform of universities and colleges, and offers a wide range of communication and cooperation in terms of technicality and application. Many scholars and scientific research institutions have gained progress continually in various research directions in the form of teamwork; and emerging research hotspots will continue to play a huge role in future practical applications.

[The efficacy and safety of testa triticum tricum purif in treatment of functional constipation in the late middle-aged and elderly patients: a multicenter randomized controlled clinical trial]

Objective: To evaluate the efficacy and safety of testa triticum tricum purif for the treatment of functional constipation(FC) in the late middle-aged and elderly patients. Methods: This study was designed as a multicenter randomized controlled trial. Patients who met Rome Ⅲ diagnostic criteria of FC were enrolled, with age between 55-85 years old. Those with organic diseases were excluded. The patients were randomly allocated to receive testa triticum tricum purif (3.5 g bid) or polyethylene glycol 4000 powder (PEG4000, 10g bid) for 8 weeks, followed by single dose of maintenance therapy for 4 weeks. Follow-up visits were at 4 and 12 weeks after treatment discontinuation. The independent investigators in each center evaluated the constipation symptoms scores. The primary endpoints included rates of significant improvement, improvement and overall improvement at the end of 2, 4 and 8 weeks of therapy, which were calculated by the reduction of symptom scores ≥75%, 50%-74%, ≥25% respectively. Results: A total of 127 FC subjects were enrolled from 3 centers, and 122 cases valid for final analysis. The mean age was (69.4±6.9) years old, including 62 cases in testa triticum tricum purif group and 60 cases in PEG4000 group. The demographic data, constipated symptoms scores and proportion of FC subtypes at baseline were comparable. The rates of significant improvement, improvement and overall improvement in testa triticum tricum purif and PEG4000 groups at the end of 2, 4 and 8 weeks were 37.70% (23/61) vs 59.32% (35/59) (P=0.018), 57.38% (35/61) vs 74.14% (43/58) (P=0.054), and 64.41% (38/59) vs 79.31% (46/58) (P=0.073) respectively. Testa triticum tricum purif therapy significantly improved the proportion of spontaneous bowel movement(SBM) ≥3 times/week from 43.55% (27/62) to 80.33% (49/61), 83.61% (51/61) and 93.22% (55/59) at 2, 4, and 8 weeks respectively (all P<0.01), which were comparable with PEG4000 group (all P>0.05). The proportion of normalized stool forms in study group was significant higher than that of control group at the end of 8 weeks [86.44% (51/59) vs 67.24% (39/58), P=0.014]. Only one patient complained mild abdominal distension during testa triticum tricum purif therapy. Conclusions: The efficacy of testa triticum tricum purif for the treatment of FC in late middle-aged and older patients is comparable with osmotic laxatives PEG4000, which has significant effect on normalization of fecal forms and reliable safety.

[One case of multiple primary carcinoma: laryngeal neuroendocrine carcinoma complicated with splenic mantle cell lymphoma]

To report a rare case of multiple primary carcinoma：laryngeal neuroendocrine carcinoma complicated with splenic mantle cell lymphoma to improve the understanding of multiple primary carcinoma. The incidence rate of multiple primary carcinoma was low. Laryngeal neuroendocrine carcinoma with mantle cell lymphoma has not been reported yet. Early diagnosis and antidiastole is very important for MPC. Pathological examination and immunohistochemistry plays an important role in the diagnosis of multiple primary carcinoma, laryngeal neuroendocrine carcinoma and mantle cell lymphoma.

Disaster nursing experiences of Chinese nurses responding to the Sichuan Ya'an earthquake

AIM

The aim of this study was to investigate the disaster experiences of nurses called to assist survivors one month after the 2013 Ya'an earthquake.

BACKGROUND

China has experienced an increasing number of earthquake disasters in the past four decades. Although a health and disaster management system was initiated after the 2008 Wenchuan earthquake, nurses' roles and experiences in a disaster have been overlooked.

METHODS

The researchers used qualitative descriptive design that included 16 participants. Data were collected using semi-structured interviews and observation notes, after which a qualitative content analysis was conducted.

FINDINGS

Three major themes emerged: the process of being dispatched from hospitals to the disaster zone, the effort involved in getting to and working in the affected site and reflecting on the challenges they encountered.

DISCUSSION

About half of the participants had received disaster nursing training before deploying to the disaster site, but they consistently expressed a lack of physical and psychological preparedness regarding the process of being dispatched from their hospitals to the disaster zone.

LIMITATIONS

This was a single-incident experience. Caution should be taken when trying to extend the findings to other parts of China.

CONCLUSION

These findings highlighted the need for disaster in-service training as well as for having disaster plans in place.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Hospital and nursing leaders should provide disaster training opportunities that included topics such as compiling resource inventories, formulating disaster drills and simulations, managing emergencies, and using emergency communication methods. Health policy-makers should be required to prioritize capacity-building training for front-line nurses as well as to develop and implement disaster management plans to better prepare nurses for future disasters.

[Effect of hyperbaric oxygen therapy on antioxidant capacity in brains of rats after acute carbon monoxide poisoning]

OBJECTIVE

This study was designed to observe the antioxidant effects of hyperbaric oxygen (HBO) on brains of rats after acute carbon monoxide (CO) poisoning.

METHODS

Sixty-six Sprague-Dawley (SD) male rats were divided into three groups including control group, CO group and HBO group.Morris water maze experiments were used for monitoring cognitive function.Antioxidant capacities were evaluated by detecting T-AOC, GSH-PX, GR and CAT activities in the brain.

RESULTS

Compared with the control group (45±17, 43±14, 35±12, 34±11, 29±13) s and the HBO group (40±10, 39±6, 35±9, 31±11, 21±10) s, the CO group (57±5, 54±8, 52±8, 52±10, 46±8) s had the longer escape latency (P<0.05). Compared with the control group (51±6) s and the HBO group(40±10) s, the CO group (8±5) s had the shorter swimming time in I quadrant (P<0.05). Compared with the control group (1.25±0.40) U/mg and the HBO group(0.97±0.31, 0.97±0.39, 1.45±0.15, 1.40±0.25, 1.20±0.20) U/mg, the CO group (0.68±0.09, 0.45±0.17, 0.71±0.18, 0.69±0.29, 0.48±0.29) U/mg had the lower T-AOC activity of brain tissue.The GSH-PX activity (42±13, 106±46, 197±49, 173±42, 429±58) U/mg in the CO group decreased compared with the control group (182±53) U/mg and the HBO group (203±63, 325±86, 389±29, 385±100, 453±32) U/mg.GR activity (4.3±0.7, 2.6±0.5, 3.0±1.2, 1.8±0.8, 3.2±1.9) U/mg in the CO group decreased compared with the control group(14.5±3.0) U/mg and the HBO group (13.9±3.3, 4.3±1.0, 3.9±0.7, 4.8±0.9, 4.6±0.9) U/mg.CAT activity (1.6±0.8, 4.3±1.6, 3.9±1.0, 8.5±2.6, 5.4±1.7) U/mg in the CO group decreased compared with the control group(5.2±1.3) U/mg and the HBO group (5.2±2.2, 8.8±2.8, 5.3±1.0, 9.2±2.1, 14.1±3.8) U/mg.

CONCLUSIONS

HBO can improve the behavior of rats after acute CO poisoning.The antioxidant capacity in rat brain tissue after acute CO poisoning decreases, while after the HBO therapy, the antioxidant capacity in rat brain tissue can increase.

[A comparison of clinical characteristics between non-erosive reflux disease and reflux esophagitis]

OBJECTIVE

To summarize the clinical symptoms of patients with non-erosive reflux disease(NERD) and reflux esophagitis(RE), which is helpful to the differential diagnosis.

METHODS

Out-patients who met the criteria of NERD or RE according to the Montreal definition in Gastroenterology Department Wuhan Union Hospital from 2010-2014 were enrolled in our study. Clinical data were comprehensively collected. Incidence of disease, severity, frequency of esophageal and extraesophageal symptoms, and the rates of overlapping with functional dyspepsia (FD) or irritable bowel syndrome (IBS) were all studied.

RESULTS

Totally 446 subjects were recruited, including 225 patients with NERD and 221 patients with RE. The occurrence rates of esophageal symptoms including heartburn [76.0%(171/225) vs 52.0%(115/221), P<0.01] and acid regurgitation [74.7%(168/225) vs 54.3%(120/221), P<0.05] in NERD group were significantly higher than those in RE patients, with more severe and frequent (P<0.05). Despite the rates of food regurgitation were similar, NERD patients behaved more severely and frequently (P<0.05). Extraesophageal symptoms including throat burning and foreign body sensation in NERD group [40.9%(92/225) vs 27.6%(61/221), 42.2%(95/225) vs 31.7%(70/221), all P<0.05] were also higher than those in RE group, the degree of which was more severe too (P<0.05). RE patients claimed a higher proportion of chronic cough. The incidences of overlapping with IBS in two groups were similar. But there were more patients with FD in NERD group [72.0%(162/225) vs 62.9%(139/221), P<0.05] than in RE group.

CONCLUSIONS

The menifestations and degree of esophageal and extraesophageal symptoms in patients with NERD or RE are different, as well as comorbidities such as FD and IBS. These results suggest that NERD and RE are independent diseases.

Highly stable wideband microwave extraction by synchronizing widely tunable optoelectronic oscillator with optical frequency comb

Optical frequency combs (OFCs), based on mode-locked lasers (MLLs), have attracted considerable attention in many fields over recent years. Among the applications of OFCs, one of the most challenging works is the extraction of a highly stable microwave with low phase noise. Many synchronisation schemes have been exploited to synchronise an electronic oscillator with the pulse train from a MLL, helping to extract an ultra-stable microwave. Here, we demonstrate novel wideband microwave extraction from a stable OFC by synchronising a single widely tunable optoelectronic oscillator (OEO) with an OFC at different harmonic frequencies, using an optical phase detection technique. The tunable range of the proposed microwave extraction extends from 2 GHz to 4 GHz, and in a long-term synchronisation experiment over 12 hours, the proposed synchronisation scheme provided a rms timing drift of 18 fs and frequency instabilities at 1.2 × 10⁻¹⁵/1 s and 2.2 × 10⁻¹⁸/10000 s.

Monolithic 160 Gbit/s optical time-division multiplexer

We present the design and experimental characterization of a monolithic optical time-division multiplexer (MUX) for 160 Gbit/s operation based on periodically poled lithium niobate (PPLN) waveguides. Its key figures of merit agree well with theoretical predictions and meet or exceed those of a previously demonstrated PPLN-planar-light-wave-circuit hybrid MUX. The monolithic design has a simpler layout and higher efficiency while keeping the cross talk low.

Amplitude modulation and apodization of quasiphase-matched interactions

We propose several techniques to modulate the local amplitude of quasi-phase-matched (QPM) interactions in periodically poled lithium niobate waveguides and demonstrate apodization by using each of these techniques. When the hard edges are removed in the spatial profile of the nonlinear coupling, the sidelobes of the frequency tuning curves are suppressed by 13 dB or more, compared with a uniform grating, consistent with theoretical predictions. The sidelobe-suppressed gratings are useful for frequency conversion devices in optical communication systems to minimize interchannel cross talk, while the amplitude modulation techniques in general have potential uses in applications that require altering the tuning curve shapes.

Odd waveguide mode quasi-phase matching with angled and staggered gratings

Angled and staggered gratings are used for quasi-phase matching of antisymmetric TM(10) modes in periodically poled lithium niobate waveguides with high efficiency. Control of the symmetry of the nonlinear coefficient d adds a new degree of freedom in the choice of which waveguide modes will interact in a quasi-phase-matched device.

[Comparative study of the late results between two types of operations in the treatment of old derangement of distal radio-ulnar joint]

OBJECTIVE

To evaluate the clinical results of Darrach's procedure and Sauve-Kapandji's procedure in the treatment of old derangement of distal radioulnar joint.

METHODS

Twenty-three patients with old derangement of distal radioular joint were divided into two groups, in which 11 patients received resection of distal end of ulna by Darrach's procedure and 12 patients received pseudoarthrosis operation of the distal ulna by Sauve-Kapandji's procedure.

RESULTS

Fifty-six months after Darrach's procedure, complete relief of pain was obtained in 6 cases (P < 0.01), the flexion-extension movement improved from 104 degrees to 125 degrees (P < 0.01), rotation movement of the forearm improved from 106 degrees to 128 degrees (P < 0.01) and grippig strength improved from 17 kg to 28 kg (P < 0.01). Fifty-five months after Sauve-Kapandji's procedure, complete relief of pain was obtained in 9 cases (P < 0.01), the movement flexion-extension improved from 108 degrees to 126 degrees (P < 0.01), rotation movement of the forearm improved from 101 degrees to 135 degrees (P < 0.01) and grippig strength improved from 17 kg to 35 kg (P < 0.01).

CONCLUSION

1. The two operation showed no difference in relief of the wrist pain, improvement of the movement of the wrist and that of the forearm; 2. Sauve-Kapandji's procedure was superior to Darrach's procedure in increasing gripping strength; and 3. So the Sauve-Kapandji's procedure was superior to Darrach's procedure, especially in the long-term result, in the treatment of old derangement of the distal radioulnar joint.

[An electrophysiological analysis of pathways from lateral septum to hippocampal CA1 area in rat]

Upon stimulating the lateral septal region, a population spike could be recorded in the stratum pyramidale of hippocampal CA1 together with a recordable EPSP in the apical dendrites (stratum radiatum). After destruction of hippocampal CA3, CA4 pyramidal cells by intraventricular microinjection of kainic acid, electrical stimulation of the lateral septum could no longer evoke EPSP in the apical dendrites. This experiment suggests that the neural connection of the lateral septo-CA1 apical dendrites is mediated by the collaterals of the ipsilateral CA3 pyramidal cells. But after the destruction of CA3, CA4, electric stimulation of lateral septum could still evoke EPSP in the basal dendrites (stratum oriends). The neural connection mediating the response of the lateral septo-CA1 basal dendrites was not reported before, but the neural pathway remains to be investigated.

[A microcomputer processing system of evoked potentials of brain slices and applied examples]

Processing the evoked potentials of neurons with a computer can greatly increase the efficiency of data processing and obtain much more information from the data. Besides, it renders possibility of large quantities and prolonged observation. In this system, DMA mode is used for data transfer from A/D card to the computer, so total processing program including sampling subroutine was made in BASIC language. This article introduces the functions of this program in processing data and the technique in making this program.

Inhibition of long-term potentiation of the hippocampal CA1 EPSP by a negative cooperativity

Tetanization of commissural-CA1 input to the apical dendrites of the dorsal hippocampal CA1 area was found to produce a marked long-term potentiation of the field EPSP. Whereas by concurrent tetanization of the commissural pathway and medial septo-CA1 input, this potentiation was significantly reduced. Thus a negative cooperativity in LTP induction was revealed.