ObjectiveTo summarize the differences between Budd-Chiari syndrome (BCS) and hepatic veno-occlusive disease (HVOD). MethodsBased on the current reports about BCS and HVOD, combined with the authors' clinical experience, a review was performed for the 2 kinds of diseases. ResultsBCS and HVOD were both post-hepatic portal hypertension symptoms, and both would result in liver cirrhosis in the late phase. According to the different causes of 2 kinds of diseases clinically, and the corresponding clinical characteristics, most cases can be confirmed by the preliminary judgment. As for the cases without clear diagnosis, corresponding imaging examinations may be helpful, but the final diagnosis depended on the pathologic examination after liver biopsy. ConclusionThere are some differences on the cause, clinical characteristic, and characteristic of images between the BCS and HVOD, that all of them contribute to differential diagnosis.
ObjectiveTo review the current status of da Vinci surgical system in vascular surgery. MethodsRecent literatures published in Chinese or English about the application of da Vinci surgical system in vascular surgery were reviewed and analyzed. Resultsda Vinci surgical system was mainly applied in diseases such as aortoiliac occlusive disease, aneurysm, typeⅡ endoleak after endovascular aortic repair, celiac artery compression syndrome, and so on. It was used to expose arteries, or assist to ligate and dissect arteries. da Vinci surgical system showed apparent advantages in shorting the time of aortic clamping, however, the high cost, the loss of tactile feedback, and the long learning curve may be its shortcomings. Conclusionda Vinci surgical system is safe and effective in vascular surgery, while much more experience is required to evaluate its long-term effect and complication.
ObjectiveTo investigate the risk factors of carotid endarterectomy.MethodThe literatures about carotid artery stenosis in the past 30 years were screened through literature retrieval, and the study of surgical risk factors related to carotid artery stenosis were reviewed.ResultsThere were many risk factors associated with the carotid endarterectomy, including demographic, underlying disease, surgical factors, perioperative management, and so on. However, the risk factors analysis were not comprehensive enough in the current study, so there was still lack of effective methods to predict the surgical risk of carotid artery stenosis.ConclusionTo fully understand the risk factors of carotid endarterectomy and to establish a multi-factor prediction model is the direction of further research.
Objective To summarize the research progress of gene-based therapeutic angiogenesis in lower limb ischemia, so as to provide a new method for non-invasive treatment of lower limb ischemia. Method The literatures on studies of gene-based therapeutic angiogenesis in lower limb ischemia in recent years were read and reviewed. Results The incidence of peripheral arterial disease had been increasing annually. How to effectively reduce the amputation rate and mortality rate of patients with critical limb ischemia was still a clinical problem that needs to be solved urgently. A large number of basic and clinical studies had shown that gene-based therapeutic angiogenesis could effectively induce angiogenesis and collateral circulation in ischemic tissue of lower limb, leading to the significant improvements of blood perfusion in ischemic areas. Additionally, the construction of many kinds of new non-viral gene delivery vectors could also improve the safety and effectiveness of gene therapy to a certain extent. Conclusion Although promising therapeutic effect of gene-based therapeutic angiogenesis brings new ideas and strategies for the treatment of lower limb ischemia, issues still exist that have not been solved.
Objective To summary the effects and prospects of percutaneous radiofrequency catheter-based renal sympathetic denervation for resistant hypertension. Methods Literatures which about the relationship between renal sympathetic nerves and hypertension， and the technical prospect and inadequacy of percutaneous radiofrequency catheter-based renal sympathetic denervation for resistant hypertension， were analyzed and reviewed. Results Hypertension， which as a seriously public health problem， was the focus of clinical treatment currently. Renal sympathetic nerve was certified playing an important role in regulation of blood pressure， and percutaneous radiofrequency catheter-based renal sympathetic denervation had potential superiority in the treatment of resistant hypertension. Conclusion Percutaneous radiofrequency catheter-based renal sympathetic denervation is an effective method for resistant hypertension.
ObjectiveTo review the progress of percutaneous radiofrequency catheter-based renal sympathetic denervation for resistant hypertension as well as the inadequacy, and to reevaluate the clinical significance of the technology. MethodsDomestic and foreign literatures were collected to summary the progress of percutaneous radiofrequency catheter-based renal sympathetic denervation in treatment of resistant hypertension. ResultsThe percutaneous radiofrequency catheter-based renal sympathetic denervation in the treatment of resistant hypertension had obtained some positive results recently, but the long-term outcomes and safety of the technology were still subjected to further evaluation. ConclusionThe effect of percutaneous radiofrequency catheter-based renal sympathetic denervation for resistant hypertension remains to be controversial, and both the equipment and technology of radiofrequency catheter-based ablation need to be improved.
ObjectiveTo summarize the research status and progress of interleukin-6 (IL-6) in Takayasu arteritis (TAK). MethodRecent literature published at home and abroad about the study of IL-6 in the TAK was reviewed and analyzed. ResultsIL-6 was a pro-inflammatory cytokine secreted by a variety of cells, which participated in a variety of inflammatory and immune reactions, and played an important role in the progress of TAK. The expression levels of IL-6 in the peripheral blood and vascular wall tissues of patients with TAK were increased. The gene polymorphism of IL-6 might be related to the occurrence of TAK. Tocilizumab, an IL-6 receptor antagonist, was effective and safe in the treatment of TAK. ConclusionsIL-6 can be used as one of the monitoring indicators for the active phase and recurrence of TAK. IL-6 receptor antagonist can be used as the treatment choice of TAK, but the application results in different stages of TAK are still worth expecting.
The International Society on Thrombosis and Hemostasis (ISTH) recently released the first ISTH guideline for antithrombotic treatment of COVID-19, which provides recommendations on anticoagulant and antiplatelet agents for patients with COVID-19 in different clinical settings. The target audience includes clinicians in internal medicine, intensive care, infectious diseases, hematology, vascular medicine, residents, family physicians, and other health care providers providing inpatient or outpatient care to COVID-19 patients. This article interprets the important parts of ISTH guideline.