Objective To investigate the role of revascularization procedures with autologous greater saphenous vein in surgical management of iliac-femoral artery pseudoaneurysm in parenteral drug abusers. Methods Twenty-one pat...Objective To investigate the role of revascularization procedures with autologous greater saphenous vein in surgical management of iliac-femoral artery pseudoaneurysm in parenteral drug abusers. Methods Twenty-one patients with iliac-femoral artery pseudoaneurysm caused by parenteral drug abuse from 2004 to 2007 were enrolled. Among them,15 patients were male and 6 were female; their average age was 31.3 years. The size of pseudoaneurysms ranged from 3.0 cm to 7.5 cm. Common femoral artery and distal external iliac artery were often involved. We performed arterial reconstruction on these patients with autologous greater saphenous vein as a graft after excising iliac-femoral artery pseudoaneurysm through a single curved inguinal incision. All patients were followed up,and the complications were recorded. Results The surgical procedures were finished without intraoperative mortality or perioperative complications. All patients were free of claudication symptoms after the surgery except one case with preoperative popliteal artery stenosis. One case of infection and wound tissue fistula was found later. One case had inguinal incisional hematoma and another complained of numbness in thigh skin. Conclusions The use of autologous greater saphenous venous grafts for arterial reconstruction after pseudoaneurysm excision in drug abusers is safe and effective. This technique offers more advantages than arterial ligation alone without revascularization. An optimal greater saphenous venous graft is a prerequisite for revascularization.展开更多
Background To document the pharmacotherapy of chronic heart failure （CHF） and to evaluate the adherence to treatment guidelines in Australian population. Methods The pharmacological management of 677 patients （fema...Background To document the pharmacotherapy of chronic heart failure （CHF） and to evaluate the adherence to treatment guidelines in Australian population. Methods The pharmacological management of 677 patients （female 46.7%, 75.5 ±11.6 years） with CHF was retrospectively analyzed. Results The use of angiotensin converting enzyme （ACE） inhibitors/angiotensin receptor blockers （ARB） and β-blockers were 58.2 % and 34.7 %, respectively. Major reasons for non-use of ACE inhibitors/ARBs were hyperkalemia and elevated serum creatinine level. For patients who did not receive β-blockers, asthma and chronic obstructive pulmonary disease were the main contraindications. Treatment at or above target dosages for ACE inhibitors/ARBs and β-blockers was low for each medication （40.3% and 28.9%, respectively）. Conclusions Evidenced-based medical therapies for heart failure were under used in a rural patient population. Further studies are required to develop processes to improve the optimal use of heart failure medications.展开更多
Increasing reports on application and safety of liposomal amphotericin B (Amphotec) in the treatment of deep fungal infections have been described recently. This is the first report that a case of liver abscess due to...Increasing reports on application and safety of liposomal amphotericin B (Amphotec) in the treatment of deep fungal infections have been described recently. This is the first report that a case of liver abscess due to Candida albicans was completely cured with intra-abscess and intravenous administration of liposomal amphotericin B without recurrence in three-year follow-up period.展开更多
To investigate the effects of long-term low dose hormone replacement therapy （HRT） on postmenopaosal women in homone level, cognition score, hippocampus volume, and magnetic resonance spectroscopy （MRS） parameters...To investigate the effects of long-term low dose hormone replacement therapy （HRT） on postmenopaosal women in homone level, cognition score, hippocampus volume, and magnetic resonance spectroscopy （MRS） parameters. Methods A total of 182 postmenopausal women aged 50-87 years were chosen at Peking Union Medical College Hospital and assigned to HRT group and control group. The volunteers of HRT group had taken low dose hormone [ estradiol （E2 ） 0. 5-1.0 mg and progesterone 0.5-2.0 mg, once a day ] for 4-33 years. The concentrations of E2, progesterone, and testosterone were measured using enzyme-linked immunosorbent assay （ELISA）. The gene types of apolipoprotein E （ApoE） were measured by polymerase chain reaction, and the subjects with susceptible genes （ ApoE ε3/ε4） of Alzheimer＇s disease （AD） were screened. Their hippocampus volumes and MRS parameters were obtained through magnetic resonance imaging （MRI）, and results in two groups were analyzed by statistical method. Results Compared with control group, the concentrations of E2 at each age stage in HRT group were significantly higher （P 〈0. 05） except the 80-89 years old subgroup; yet, there were no statistical differences in the concentrations of progesterone and testosterone between the two groups. There was no obvious difference in ApoE subtypes distribution between the two groups The results of hippocampus MRI for the subjects with susceptible genes ApoE ε3/ε4 （HRT group 14 cases, control group 11 cases） showed that the ratio of bilateral hippocampus volume to whole brain volume in HRT group （0. 406 ± 0.028） was signiticantlyhigher than control gronp （0.369±0.031, P〈0.05）. Theresults of ^1H MRS for the subjects with susceptible genes ApoE ε3/ε4 （ HRT group 12 cases, control group 11 cases） showed that the N-acetylaspartate/total creatine at the area of hippocampus in HRT group （ 1.54±0. 08 ） were significantly higher than control group （ 1.45±0. 13, P 〈 0. 05）. Conclusions For postmenopausal women, long-term low dose HRT can maintain the physiological concentration of E2 in plasma. Furthermore, the hippocampus MRI performed on those with ApoE ε3/ε3 genes shows that long-term low dose HRT can prevent hippocampus atrophy, which is beneficial to maintain the brain function and prevent AD.展开更多
文摘Objective To investigate the role of revascularization procedures with autologous greater saphenous vein in surgical management of iliac-femoral artery pseudoaneurysm in parenteral drug abusers. Methods Twenty-one patients with iliac-femoral artery pseudoaneurysm caused by parenteral drug abuse from 2004 to 2007 were enrolled. Among them,15 patients were male and 6 were female; their average age was 31.3 years. The size of pseudoaneurysms ranged from 3.0 cm to 7.5 cm. Common femoral artery and distal external iliac artery were often involved. We performed arterial reconstruction on these patients with autologous greater saphenous vein as a graft after excising iliac-femoral artery pseudoaneurysm through a single curved inguinal incision. All patients were followed up,and the complications were recorded. Results The surgical procedures were finished without intraoperative mortality or perioperative complications. All patients were free of claudication symptoms after the surgery except one case with preoperative popliteal artery stenosis. One case of infection and wound tissue fistula was found later. One case had inguinal incisional hematoma and another complained of numbness in thigh skin. Conclusions The use of autologous greater saphenous venous grafts for arterial reconstruction after pseudoaneurysm excision in drug abusers is safe and effective. This technique offers more advantages than arterial ligation alone without revascularization. An optimal greater saphenous venous graft is a prerequisite for revascularization.
文摘Background To document the pharmacotherapy of chronic heart failure （CHF） and to evaluate the adherence to treatment guidelines in Australian population. Methods The pharmacological management of 677 patients （female 46.7%, 75.5 ±11.6 years） with CHF was retrospectively analyzed. Results The use of angiotensin converting enzyme （ACE） inhibitors/angiotensin receptor blockers （ARB） and β-blockers were 58.2 % and 34.7 %, respectively. Major reasons for non-use of ACE inhibitors/ARBs were hyperkalemia and elevated serum creatinine level. For patients who did not receive β-blockers, asthma and chronic obstructive pulmonary disease were the main contraindications. Treatment at or above target dosages for ACE inhibitors/ARBs and β-blockers was low for each medication （40.3% and 28.9%, respectively）. Conclusions Evidenced-based medical therapies for heart failure were under used in a rural patient population. Further studies are required to develop processes to improve the optimal use of heart failure medications.
文摘Increasing reports on application and safety of liposomal amphotericin B (Amphotec) in the treatment of deep fungal infections have been described recently. This is the first report that a case of liver abscess due to Candida albicans was completely cured with intra-abscess and intravenous administration of liposomal amphotericin B without recurrence in three-year follow-up period.
文摘To investigate the effects of long-term low dose hormone replacement therapy （HRT） on postmenopaosal women in homone level, cognition score, hippocampus volume, and magnetic resonance spectroscopy （MRS） parameters. Methods A total of 182 postmenopausal women aged 50-87 years were chosen at Peking Union Medical College Hospital and assigned to HRT group and control group. The volunteers of HRT group had taken low dose hormone [ estradiol （E2 ） 0. 5-1.0 mg and progesterone 0.5-2.0 mg, once a day ] for 4-33 years. The concentrations of E2, progesterone, and testosterone were measured using enzyme-linked immunosorbent assay （ELISA）. The gene types of apolipoprotein E （ApoE） were measured by polymerase chain reaction, and the subjects with susceptible genes （ ApoE ε3/ε4） of Alzheimer＇s disease （AD） were screened. Their hippocampus volumes and MRS parameters were obtained through magnetic resonance imaging （MRI）, and results in two groups were analyzed by statistical method. Results Compared with control group, the concentrations of E2 at each age stage in HRT group were significantly higher （P 〈0. 05） except the 80-89 years old subgroup; yet, there were no statistical differences in the concentrations of progesterone and testosterone between the two groups. There was no obvious difference in ApoE subtypes distribution between the two groups The results of hippocampus MRI for the subjects with susceptible genes ApoE ε3/ε4 （HRT group 14 cases, control group 11 cases） showed that the ratio of bilateral hippocampus volume to whole brain volume in HRT group （0. 406 ± 0.028） was signiticantlyhigher than control gronp （0.369±0.031, P〈0.05）. Theresults of ^1H MRS for the subjects with susceptible genes ApoE ε3/ε4 （ HRT group 12 cases, control group 11 cases） showed that the N-acetylaspartate/total creatine at the area of hippocampus in HRT group （ 1.54±0. 08 ） were significantly higher than control group （ 1.45±0. 13, P 〈 0. 05）. Conclusions For postmenopausal women, long-term low dose HRT can maintain the physiological concentration of E2 in plasma. Furthermore, the hippocampus MRI performed on those with ApoE ε3/ε3 genes shows that long-term low dose HRT can prevent hippocampus atrophy, which is beneficial to maintain the brain function and prevent AD.
