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One of the most important factors to maintain and improve competitiveness is to encourage voice behavior of an organization’s members. Leaders have an responsibility to create an atmosphere for members to express their own views freely, and to encourage members to improving the organization’s function. To fully understand the influence process of authentic leadership on members voice behavior, we argue that the affective commitment should be considered. We posit that authentic leadership positively influence affective identification, supportive voice behavior, challenging voice behavior, and affective commitment moderate the effect of relationship identification on voice behavior. Data from 367 respondents supported most of our hypotheses. Targeting the general workers in Beijing, China, we examine a mediated model of authentic leadership, voice behavior, and relational identification, with affective commitment as a moderator. We conducted an empirical analysis using the collected data and concluded based on the results of the study. First, our results confirmed that authentic leadership have a positive influence on both supportive voice behavior and challenging voice behavior. Second, relational identification partially mediated the interaction between authentic leadership and voice behavior. No significant indirect effect was found between authentic leadership and supportive voice behavior. Our results also showed that affective commitment has as a moderating role in the relationship of affective identification and member voice behavior. Members with high affective commitment showed more supportive voice behaviors than those with low affective commitment. This study advances prior research on the relationship of authentic leadership and voice behavior by demonstrating how the affective commitment level of individuals has different effects on their voice behavior. Finally, we presented the implications of this research and recommendations for future research.

Intrapreneurship has recently attracted considerable attention. This study aims to explore how intrapreneurship and trust in a supervisor (also referred throughout as “supervisor trust”) promote management performance so as to expand research on intrapreneurship. The study’s sample set is taken from 288 employees of 38 different companies to statistically verify the hypotheses. Through the SPSS 24 statistical method, the study’s main results were uncovered as follows. First, entrepreneurial education has a positive effect on intrapreneurship. Second, intrapreneurship has a positive effect on management performance. Third, trust in a supervisor has a positive impact on management performance, and the moderating effects of trust in a supervisor are found between intrapreneurship and management performance. The following implications are recognized. Firstly, although research on intrapreneurship has been carried out for more than 30 years, it is still in the stage of systematic theory, and there is room for further research, especially when the cultural background is different, the results may come out differently. Secondly, if the degree of intrapreneurship increases, the management performance will be high. Trust in the supervisor is consistent with this viewpoint, because if subordinates trust in their supervisors, there will be positive business performance and management performance. Therefore, intrapreneurship and trust are very important in the process of achieving performance and play an important role in the actual business. Thirdly, trust in the supervisor plays a moderating role between intrapreneurship and performance, which means that a structural mechanism exists between them. The study’s results indicate that it is necessary to emphasize entrepreneurship at the appropriate level in SMEs, and that it is important to ensure that intrapreneurs receive education and develop trust in their supervisors. In addition, it is obvious that entrepreneurial education leads employees to focus on management performance through intrapreneurship and that a high degree of supervisor trust will have a positive effect on performance. These findings can help companies strengthen their competitiveness and achieve their business targets.

Supplemental Material, Supplementary_Table for Long-Term Outcome of Chimney Technique Using a Balloon-Expandable Bare-Metal Stent to Preserve Supra-Arch Branches in Type B Aortic Dissection by Guoyi Sun, Yang-yang Ge, Wei Guo, Xin Jia, Dan Rong, Xiao-ping Liu, Jiang Xiong, Hong-peng Zhang and Xiao-hui Ma in Vascular and Endovascular Surgery

Due to the rapid development of new energy such as nuclear power at the transmission end of Northeast power grid, the improvement of transmission capacity of Lugu UHVDC and the large-scale development of power base, the problem of dynamic stability of Northeast Power Grid has surfaced. Based on the reality of Northeast power grid, this paper deeply and carefully carries out the dynamic stability level analysis of Northeast power grid from three aspects of source, network and load, studies the effective methods and measures to improve the damping ratio and robustness of main vibration modes between power grid regions, takes into account the scientificity, systematicness and scientificity of the measures, and provides reference for domestic and foreign related grid operation.

Gelatin, a natural proteinous polymer, was used to co-electrospin with poly(butylene succinate) (PBS) in order to improve the mechanical properties of PBS membrane and facilitate its applications in biomedical field. The PBS/gelatin blend membranes have narrower distribution of fiber diameter and smoother surface than neat PBS membrane. The contact angles, water absorption rates and water uptakes of the PBS/gelatin blend membranes were measured, showing increased hydrophilicity. The interaction between PBS and gelatin was investigated by attenuated total reflectance Fourier transform infrared spectroscopy (ATR-FTIR) and differential scanning calorimetry (DSC). The mechanical properties of PBS/gelatin blend membranes in both dry and wet states were evaluated by uniaxial tensile tests. In the dry state, the PBS/gelatin blend membrane containing 10% gelatin has a 3-times increase in tensile strength without any adverse effect on ductility because of the existence of interaction between the two blend components, little change in crystallinity of PBS, and possible interaction between any adjacent fibers; the tensile strength and elongation at break are even better in the wet state attributed to some gelatin on fiber surfaces, which act as a binder in the presence of water. The potential applications of PBS/gelatin blend membranes were demonstrated by successful immobilization of thrombin, a clinically-used hemostatic drug. The thrombin-loaded membrane could be used for rapid hemostasis.

Table S1. Sensitivity analysis of association between KIF1B polymorphism and HCC susceptibility under the allelic model G-allele vs A-allele: The corresponding pooled OR were not changed when any single study was removed. (DOCX 88 kb)

Table S2. Sensitivity analysis of association between KIF1B polymorphism and HCC susceptibility under the co-dominant genotype model GG vs AA: The corresponding pooled OR were not changed when any single study was removed. (DOCX 81 kb)

Figure S1. Sensitivity analysis of association between KIF1B polymorphism and HCC susceptibility under the allelic model G-allele vs A-allele: The corresponding pooled OR were not changed when any single study was removed. (DOCX 242 kb)

Figure S3. Sensitivity analysis of association between KIF1B polymorphism and HCC susceptibility under the co-dominant genotype model AG vs AA: The corresponding pooled OR were not changed when any single study was removed. (DOCX 220 kb)

A detection chip is designed and manufactured to study the relationship between iron wear particle content in hydraulic oil and the detected variation of average inductance, which detects content of iron wear particle by means of micro channel - inductive. Through experiments, we obtained inductive values in the cases. The case is that the sizes of iron wear particle are the same, while the content of iron wear particle are different. Thus the curve between content of iron wear particle content and variation of average inductance was drawn. Experimental results show that the inductance value increases with the increase of the iron wear particle content in hydraulic oil. Experiments prove that the way is feasible for the detection of iron wear particle content in hydraulic oil. This study has an important significance for the realization of iron wear particle content detection in hydraulic oil.

Hydraulic system is widely used in the ship, when the diameter of tiny particles in hydraulic oil exceeds 20μm it indicates that the abnormal wear occurred and the malfunction may cause. This paper uses the light blockage method, the microfluidic detection chip for hydraulic oil detection has been designed and fabricated, a simple and effective optical detection system is developed with the signal amplification and data collection to achieve the detection of tiny particles, and finally through the JAVA programming to count the number of particles in which the diameter is more than 20μm. The results of rapid detections on iron particles with diameter between 25μm and 38μm show the good performance of the detection system and prove that the method is feasible.

A microwave-induced catalytic removal device was designed and set up for studying removal of hazardous or toxic gas from contaminated air. Catalytic oxidative Removal ratios of several hazardous gases of VOCs, CO and H2under microwave field were tested. Results suggested that structure of hazardous gas and catalyst type were main factors affecting the removal efficiency of hazardous gas. Oxidative catalyst contributed to removal of reductive gas. In addition, the flow rate also affected the removal efficiency.

In recent years, with the aggravating of environmental pollution, the purification of carbon monoxide is currently a subject of interest. The catalytic oxidation method is an effective way. Manganese oxide nanoparticles were prepared by emulsion self-assembly method and then, synthetic and commercial manganese oxide-supported gold nanoparticle catalysts were successfully synthesized by the deposition-precipitation (DP) method. The catalysts were characterized by XRD, Raman, BET, ICP and HRTEM. The activity of the oxide and oxide-supported gold nanoparticle catalysts were evaluated on the fixed bed microreactor and Au/MnOx had the highest activity. The intrinsic activity of Au/MnOx at 35 °C is 0.81 molCO·mol-1Au·min-1. Compared with O2, CO concentration has bigger effect on the reaction activity.

Identifying the risk factors predisposing to aortic enlargement after thoracic endovascular aortic repair (TEVAR) is needed for DeBakey IIIb aortic dissection. The aim of the study is to assess the novel morphological features for DeBakey IIIb aortic dissection in predicting distal thoracic aortic enlargement after TEVAR.Sixty-seven patients who underwent TEVAR for DeBakey IIIb aortic dissection between January 2011 and December 2013 at our center were divided based on preoperative computer tomography angiography (CTA) features into 3 groups: I (n = 27) and III (n = 9), with true and false lumen, respectively, coursing closely along thoracic vertebral bodies and II, spiral configuration (n = 31). Distal thoracic aortic enlargement was determined using preoperative and postoperative CTA images.At median 12.2 (interquartile range, 4.3-26.6) months, 12 patients developed distal thoracic aortic enlargement, with estimated cumulative incidence tending to increase from categories I to III (P for trend 0.01). Categories II and III versus I had more frequently concave location of primary entry tear (P 0.01), larger dissection length and height index (L/Hi) (P = 0.05), and greater number of abdominal small branches involved preoperatively (P = 0.03), with otherwise similar baseline characteristics; and significantly greater total aortic diameter increase and lower false lumen regression up to 24 months, and lower true lumen expansion up to 12 months. In multivariable regression analysis, categories II and III were independently associated with distal thoracic aortic enlargement (hazard ratio, 19.95 [95% confidence interval, 2.14-186.09]; 41.23 [3.61-470.22], respectively) after adjustment for Society of Vascular Surgery score, preoperative maximum total aortic diameter, L/Hi, and number of abdominal small branches involved preoperatively.The CTA-based morphological features described in this study might improve preoperative risk stratification of DeBakey IIIb aortic dissection, with categories II and III having higher risk of distal thoracic aortic enlargement after TEVAR.

Viscosity of Watered fuel oil, which was prepared by a self-made mechanical micro-mixing device, was measured with rotation viscosimeter. The effects of oil temperature, agitation speed and water content on viscosity were investigated in this research. The experimental results showed that: viscosity of watered fuel oil decreases with the increasing of oil temperature between 60-80 °C and water contents in 2.0-8.0 %, but increases with the accelerating agitation speed at 1000-1300 r/min.

Three oxidant decontaminants, including NaClO, H2O2 and an organic peroxyl acid, were introduced to destroy the cyanide ion. The residual cyanide ion concentrations in different decontamination water were detected by a cyanide ion selective meter. Before the detection process, the oxidants left in the cyanide decontamination water were pretreated by adding a certain amount of Na2SO3. Results showed that starch-iodide solution indicator method presented a perfect function on determining the dosage of Na2SO3. Values of the relative mean deviations on residual cyanide detection were below 5%. After the decontamination water was deoxidized by Na2SO3, whether the sample distillated or not could not affect the value of CN- quite much. Non-distillation was confirmed alternative in the detection of cyanide ion decontamination water. Too much standing time would lead to a relatively lower CN- concentration, especially in that of non-distillation.

A series of novel zinc(II) phthalocyanines tetra-substituted or mono-substituted with piperazinyl moieties linked by different ethoxy chains has been prepared and characterized. The effects of the N-protecting group of piperazinyl moiety, length of ethoxy chains and number of substitutes on the photophysical, photochemical properties, cellular uptakes and in vitro photodynamic antifungal activities have also been examined. All of these compounds are essentially non-aggregated and good singlet oxygen generators with quantum yields (ΦΔ) of 0.54–0.77 in N,N-dimethylformamide. The photodynamic activity of these compounds against Candida albicans follows the order: 7 > 5a > 5b > 4a ≈ 4b. The mono-substituted phthalocyanine 7 exhibits the highest photodynamic inactivation of C. albicans with an IC90 value of 9 μM, which can be attributed to its better amphiphilicity and even higher cellular uptake. The results suggest that phthalocyanine 7 is a potential photosensitizer for antifungal photodynamic therapy.

Metal wear debris is an important component of contamination in lubrication oil, and is also an essential information carrier in hydraulic oil. Based on inductive Coulter counting principle, a microfluidic device to detect metal wear debris in oil is presented in this paper. The proposed device can make the distance between the particles in oil and the embedded induction coil very small, and hence greatly improve the sensitivity of the detection. The results indicate that eddy current within particles increase ability to detect copper particles, and decrease the sensitivity to iron particle.

In this paper we use the same idea as the complex analytic dynamics to study general Mandelbrot sets and Julia sets generated from the complex non-analytic iteration . The definition of the general critical point is given, which is of vital importance to the complex non-analytic dynamics. The general Mandelbrot set is proved to be bounded, axial symmetry by real axis, and have (m+1)-fold rotational symmetry. The stability condition of periodic orbits and the boundary curve of stability region of one-cycle are given. And the general Mandelbrot sets are constructed by the escape-time method and the periodic scanning algorithm, which present a better understanding of the structure of the Mandelbrot sets. The filled-in Julia sets Km,c have m-fold structures. Similar to the complex analytic dynamics, the general Mandelbrot sets are kinds of mathematical dictionary or atlas that map out the behavior of the filled-in Julia sets for different values of c.

The aim of this study was to investigate the safety and efficacy of endovascular abdominal aortic aneurysm repair (EVAR) in nonagenarians. From May 2003 to March 2011, 12 nonagenarian abdominal aortic aneurysm patients were treated with endovascular repair including two emergencies. The mean age of patients was 92.5 ± 1.6 years (range: 90-95 years), and 11 of the patients (91.7%) were men. Technical success, perioperative complications, and mortality were evaluated. The follow-up protocol consisted of computed tomography angiograms or ultrasounds performed at 3, 6, 9, and 12 months, and annually thereafter. Seven patients were operated under general anesthesia and five under local anesthesia. There was 100% technical success with no need for open conversion. The endografts used included two Endurant endografts, four Talent endografts, and six Zenith endografts. The mean operative time was 3.4 ± 1.3 h, mean procedural blood loss was 150.5 ± 60.5 mL, and mean postoperative length of stay was 8.4 ± 2.3 days. Mortality rates were 8.3% at 30 days, 16.7% at 1 year, 41.7% at 3 years, and 75% at 5 years. The mean survival of the 11 patients who expired beyond the first 30 days was 28.5 months (range: 9-73 months). Overall, EVAR in nonagenarians was associated with acceptable procedural success and perioperative morbidity and mortality. The medium and long-term results suggested that EVAR may be of limited benefit in some patients who are aged >90 years. Therefore, individual patient selection is very important.

This study evaluated the association between thoracic false lumen branches (TFLBs; dissected thoracic branches fed by a false lumen) and distal thoracic aortic enlargement (DTAE) after thoracic endovascular aortic repair (TEVAR) for DeBakey IIIb aortic dissection.We retrospectively analyzed the records of 67 patients with DeBakey IIIb dissection initially treated with TEVAR between January 2011 and December 2013. Preoperative and postoperative computed tomography angiography images were reviewed to evaluate the number of preoperative TFLBs and aortic diameter change after TEVAR. Patients were stratified into two groups by the estimated optimal cutoff value of preoperative TFLBs for the prediction of DTAE: group A (n = 28), preoperative TFLBs ≥8; group B (n = 39), preoperative TFLBs 8. The diameter changes over time were modeled by mixed models of repeated data. Multivariable Cox regression analysis was used to assess the independent association between preoperative TFLBs and DTAE after TEVAR.Baseline demographics, clinical features, and devices implanted were largely similar between the two groups. Group A had more preoperative abdominal false lumen branches (7 [4-8] vs 4 [1-6]; P = .02) and a greater proportion of preoperative patent thoracic false lumen (83.9% vs 66.7%; P = .04). Twelve patients experienced DTAE during a median imaging follow-up period of 12.2 months (interquartile range, 4.3-26.6 months). Log-rank testing revealed a significant increase in cumulative estimated proportion with DTAE in group A (P .01). The maximum thoracic aortic diameter decreased significantly in group B (P .01) but not in group A. The overall change in the maximum thoracic aortic diameter was statistically different between the two groups (P .01). Each group exhibited a significant increase in true lumen diameter and a significant decrease in false lumen diameter postoperatively. However, a lower degree of false lumen regression in group A was detected compared with group B (P = .03). Multivariable analysis identified that preoperative TFLBs were independently associated with DTAE after TEVAR (hazard ratio [for one increase], 1.46; 95% confidence interval, 1.20-1.77) after adjustment for gender, hyperlipidemia, length of dissected aorta and height index, preoperative abdominal false lumen branches, and preoperative false lumen status of thoracic aorta.Preoperative TFLBs are independently associated with DTAE after TEVAR in DeBakey IIIb aortic dissection. Long-term follow-up is necessary to further verify the preliminary finding.

With a piston ring reciprocating liner test rig, the tribological behavior at top dead center of diesel engine was evaluated between hydrorefined mineral oil (HMO) and two kinds of cylinder liner/piston ring, chromium-plated+honing/physical vapor deposition (CP/PVD) and boron-phosphrous alloy cast iron+honing/physical vapor deposition (CI/PVD). Friction coefficient vs. temperature at different loads was used to discriminate the principal function of tribofilm. The analysis shows that the interface between CP/PVD and HMO was subject to thin film lubrication with stearic acid at 70-150°C. When the temperature exceeds 150°C, zinc dialkyl dithiophosphate (ZDDP) began to change the friction status of interface. However, the steady boundary lubrication of CI/PVD exists from 50—250°C at different loads and can not distinguish the scope of additives effects. The reason can be attributed to the chemical reactivity of chromium and iron with the HMO. The soluble Fe2+ or Fe3+ of CI/PVD maybe played an important role in the tribofilm activation level. The understanding provides friction pairs selection at definite lubrication oil and a design guideline for boundary films.

Wear debris in hydraulic oil causes most of the faults of hydraulic system and is also an important information carrier, so it is essential to check the condition of wear debris in hydraulic oil. On the basis of inductive principle and microfluidic chip technology, the design of a microfluidic chip of oil detection is presented in this paper. the relation between coil geometry parameters and inductive change of planar inductor are analyzed through the related experimental statistics, the result being that when the ferrous metallic particle flows through planar inductor, the measured inductance variation increases with the number of turns and decreases with the coil line width.

Purpose: To analyze aortic elastic properties (AEP) characteristics, dissection and elastic data of ascending aorta (AA) in the population with a high risk of aortic diseases. Methods: Forty five patients with artery diseases undergoing aortic digital subtraction angiography (DSA) were enrolled in this study. The maximal, minimal diameter and changes in diameter of ascending and descending aorta were measured, and the aortic stiffness index (ASI) and aortic distensibility (AD) were calculated. Results: The mean changes in diameter were (2.34 ± 0.95), (1.6 ± 0.71), (1.65 ± 0.68) and (0.99 ± 0.28) mm. The ASI of D1-D4 aorta was (9.67 ± 5.02), (15.54 ± 7.85), (13.78 ± 6.45) and (15.53 ± 4.74). AD (mmHg-1) × 10-3 of D1-D4 aorta was (2.76 ± 1.65), (1.76 ± 1.15), (1.94 ± 1.23) and (1.33 ± 0.40). The ratio of diameter difference/minimal diameter was (7.18 ± 3.21), (4.6 ± 2.3), (4.96 ± 2.22) and (3.86 ± 1.16). The tapered angle of D2-D3 aorta was (2.47 ± 1.80)°. The maximal and minimal diameters of D1 aorta significantly differed between male and female subjects. Conclusion: DSA and artery pressure accurately measure the changes in diameter and artery pressure of aorta along with single beat. Aortic ASI and AD could be accurately calculated to precisely analyze AEP. Over aging and arteriosclerosis development, D2 aorta is the most vulnerable to elasticity attenuation, whereas D1 aorta is the least vulnerable part with certain elasticity.

Endovascular stent-graft with fenestration can improve proximal sealing in patients with juxtarenal abdominal aortic aneurysm (JAAA). The purpose of this study was to describe our primary experience and evaluate the safety and efficacy of fenestrated device for JAAA in high-risk patients.Between March 2011 and May 2012, nine male patients (mean age, (79.6 ± 8.6) years) with asymptomatic JAAAs underwent elective deployment of the Zenith fenestrated stent-grafts at a single institution. All patients were treated in the hybrid operating room under general anesthesia. Follow-up computed tomography angiography (CTA) was routinely performed before discharge, at 3, 6, and 12 months and annually thereafter.Procedural success was achieved in all cases. Total sixteen small fenestrations, two large fenestrations and eight scallops were used. Intra-operative complications occurred in four patients, which included one proximal type I endoleak, two type II endoleaks, and one renal artery dissection. The mean hospital stay was (8.9 ± 1.4) days, mean blood loss was (360.5 ± 46.8) ml, and mean iodinated contrast volume was (230.6 ± 58.3) ml. The mean follow-up time was (7.6 ± 4.2) months. The visceral graft patency was 100% until now. One patient had an increase of serum creatinine of more than 30%, but did not require dialysis. No patients died, no stent fractured, and migration were diagnosed during the follow-up.The early results of fenestrated device for high-risk patients with complex JAAAs are satisfactory. However, long-term fenestrated graft durability and branch vessel patency remain to be determined.

Hybrid procedures including debranching of visceral and renal arteries followed by endovascular exclusion of the thoracoabdominal aortic aneurysm (TAAA) have recently been proposed as a less invasive alternative to conventional TAAA surgery. This study aimed to evaluate the immediate and long-term outcomes of hybrid procedures for TAAA in high-risk patients.Between September 1998 and May 2012, 32 high-risk TAAA patients (five females, median age 61.5 years) underwent hybrid procedures at a single institution. Simultaneous approach and staged approach were performed on the basis of patients' conditions. Follow-up computed tomography angiography (CTA) was routinely performed before discharge and at 6, 12 months and annually thereafter.Procedural success was achieved in all cases. The median hospital stay was (21.5 ± 2.3) days, and the median procedure time was (420 ± 31) minutes. Blood loss averaged (2100 ± 261) ml. A total of 124 visceral artery bypasses was performed. Two patients (6.3%) died within 30 days. One patient exhibited complete paraplegia (3.1%). The visceral graft patency was 96.1% at 3 years. All-cause survival rates were 93.8%, 87.5%, 81.3% and 53.1% at 1, 2, 3 and 5 years, respectively. No patient died due to aortic events. The freedom rates from aortic events were 96.9%, 93.6%, 87.5%, 68.8% at 1, 2, 3 and 5 years, respectively.The results of visceral hybrid repair for high-risk patients with complex TAAAs are encouraging. However, the procedure is still a significant physiological insult to patients. Until branched and fenestrated endovascular repair become more common, hybrid procedure will continue to have a role in high-risk patients.

To evaluate the early and midterm results of covered Cheatham-Platinum (CP) stent for treatment of aortic coarctation (CoA) in adolescents and adults.From January 2007 to June 2011, 9 consecutive cases of CoA underwent covered CP stent implantation. There were 4 male and 5 female patients, aging from 13 to 44 years with a mean of (24 ± 11) years. The covered CP stent and balloon-in-balloon catheter were selected according to digital subtraction angiography measurements. The covered CP stents were expanded to appropriate diameter by inflation of the inner balloon and outer balloon successively. The systolic pressure gradient across the stenosis and narrowest degree of the stenotic vessels were compared before and after the procedure.After the procedure, the systolic pressure gradient across the stenosis decreased from (66 ± 21) mmHg to (9 ± 4) mmHg (1 mmHg = 0.133 kPa, t = 9.13, P = 0.000) and the narrowest degree of CoA decreased from 79% ± 12% to 17 ± 4% (t = 16.65, P = 0.000). During a mean follow-up of (33 ± 22) months (ranging 4 to 54 months), no intrastent restenosis were found and systolic pressure gradient from upper to low extremity was not more than 15 mmHg in each case.Covered CP stent implantation is safe and effective for treatment of CoA in adolescents and adults. The early and midterm results are encouraging, but long term results require further follow-up and observation.

To evaluate immediate- and median-term outcomes from subintimal recanalization of superficial femoral arteries (SFA) chronic total occlusions (CTO) with the Outback LTD catheter.From January 2010 to May 2011, 35 legs in 30 patients with CTO of the SFA and proximal popliteal artery were treated by Outback LTD catheter. There were 20 male and 10 female patients. The mean age of the patients was 68 years. Clinical presentation was severe intermittent claudication (Rutherford category 3, 10/35, 28.6%), rest pain (Rutherford category 4, 13/35, 37.1%), and minor ulceration (Rutherford category 5, 12/35, 34.3%). In all cases, the true lumen could not be entered by using standard antegrade catheter and guide wire techniques. Technical success, complications, procedure times, clinical outcomes and cumulative patency rates in follow-up were evaluated.Median lesion length was (210 ± 15) mm. Recanalization of the arterial occlusion was successful in 34 of 35 treated lesions (97.1%). None of the 30 patients showed any procedure-related complications during or after treatment. The mean follow-up was (7.2 ± 0.3) months. Cumulative primary patency rates after 3, 6, and 12 months were 90.9%, 84.8% and 50.6%. Three minor toe amputations and one major below-the-knee amputation were observed in patients with critical limb ischemia.The Outback LTD catheter is a safe and effective device to recanalize challenging superficial femoral arteries CTO. The technique could reduce radiation exposure time and raise the technique success rate.

To evaluate the early outcome of endovascular management of iatrogenic vascular injury (IVI).From July 2002 to July 2010, 21 cases of IVI undergoing endovascular therapy were studied retrospectively. There were aorta injury (n = 2), peripheral artery injury (n = 11), visceral artery injury (n = 5), arteriovenous injury (n = 1) and venous injury (n = 2). And the procedures included endograft implantation (n = 15), intravascular embolization with coil (n = 4), combination of endovascular balloon intervention and percutaneous thrombin injection (n = 1) and balloon compression for hemostasis (n = 1).Technical success was achieved in all patients. And clinical success, defined as arrested hemorrhage and hemodynamic stabilization, was obtained in 20 (95.2%) patients. There was one case of intra-operative mortality. After the procedure, there were cerebral infarction (n = 2) and partial renal infarction (n = 1). Among them, 19 patients received a median follow-up period of 23.9 months (range: 4 - 84 months). Only 1 patient with iliofemoral vein stent implantation developed stent collapse and thrombosis at Week 3. There were no other complications.Endovascular therapy is an effective procedure in the management of different types of IVI. Despite its encouraging early results, the long-term outcomes require further follow-ups and observations.

To explore the treatment of type II endoleak (TEE) after the endovascular aneurysm repair (EVAR) of abdominal aortic aneurysm (AAA).From January 2009 to July 2011, 10 patients with type II endoleak after AAA EVAR were recruited. Different treatment methods were employed for the criminal arteries, including transcatheter embolization with coils, percutaneous sac puncture, intrasac injection of fibrin glue and outcome follow-up.Among them, 9 patients underwent treatment and 8 received a mean follow-up of (2.4 ± 1.6) months. The mean secondary time was (62 ± 39) months. The criminal arteries were inferior mesenteric artery (n = 3), internal iliac artery (IA) (n = 1), IA with lumbar artery (n = 3) and lumbar artery (n = 3). Two patients died from cardiovascular and cerebrovascular events during the follow-up. The primary technical success was 44%, retreat rate 33% and clinical success rate 89%.Type II endoleak has a relatively benign course. In the absence of sac expansion, it can be followed for a long period of time without the needs for intervention. Treatment is necessary when it persists beyond 12 months or when there is a significant increase in aneurysm sac diameter.

To evaluate the initial and long-term results of endovascular aneurysm repair (EVAR) in high-surgical-risk abdominal aortic aneurysm (AAA) patients.From July 1997 to July 2011, 120 consecutive high-surgical-risk patients with AAA who were treated electively using a bifurcated aortic endograft were entered in a registry. There were 96 male and 24 female patients, aged from 52 to 95 years with a mean of 74 years. Follow-up protocol consisted of computed tomography angiograms or ultrasound performed at 3, 6, 9, 12 months, and annually thereafter. The main goal was evaluation of the operative mortality and the long-term survival of these patients. Secondary goals were determination of the frequency of secondary operations, the outcome of the aneurysm sac, and primary and secondary patency rates after aortic endograft placement.Mean aneurysm diameter was (57 ± 8) mm. Thirty-seven patients were operated under local anesthesia and eighty-three under general anesthesia. Five type I endoleaks, twenty-five type II endoleaks and one type III endoleak occurred during the perioperative period. The technical success rate was 95%. Operative mortality was 2.5%. The survival rates at 1-, 3- and 5-year were 92%, 75% and 43% respectively. The mean follow up was (36 ± 3) months. Primary and secondary patency rates at 3 year were respectively 97% and 100%. Secondary intervention rate was 10% (12/120) at 5 year. The reasons included endoleaks for 7 patients, stent-grafts fracture for 2 patients, stent-grafts migration for 2 patients and stent-graft thrombosis for 1 patients.Initial and long-term results with endograft repair of AAA in high-surgical-risk patients were satisfactory. These results appear to justify endovascular repair for this patient population.

Foam sclerotherapy of ovarian varicocele is a relatively new and promising treatment option for patients with axial reflux. But its usefulness may be limited by low primary occlusion rates. Here a standard technique for catheter-directed foam sclerotherapy was presented to facilitate a precise delivery of foam to its intended site of action so as to potentially improve the occlusion rates.A selective series of 13 females with ovarian varicocele were treated with foam sclerotherapy through a standard technique for foam delivery from 2008 to 2009. With a mean age 39.4 years, the patients were treated with 1% polidocanol foam through a catheter inserted percutaneously over a guidewire into the trunk of vena ovarian. All successfully treated patients were examined by colour duplex at 1 to 12 months post-procedure.Thirteen patients with an insufficiency reflux of vena ovarian were treated with catheter-directed foam sclerotherapy. Primary technical success was achieved in all patients. A dose of polidocanol 1.0% at 4 - 9 ml was administered. The mean follow-up period was 5.3 months. Pelvic cavity flatulency was totally released in 12 patients and 1 partially released. Two of 5 patients with algopareunia recovered and 3 with perineal region varicosis became relieved. On the follow-up ultrasonic examination, all trunks of vena ovarian became occluded.This type of foam sclerotherapy is feasible with a high rate of primary occlusion.

to compare the clinical outcome of foam sclerotherapy of the great saphenous vein (GSV) combined with sapheno-femoral junction (SFJ) ligation to standard stripping surgery.as a prospective randomized controlled trial, 60 consecutive patients with incompetence of the GSV resulting in varicose veins were prospectively randomized into 2 groups, treated by SFJ ligation and either foam sclerotherapy or standard stripping of the GSV. There were 26 male and 34 female with a median age of 49 years (ranging 37 to 66 years). Primary end points were patient recovery period, postoperative pain, quality of life and recurrence rate. Secondary end points were frequency of complications on the two arms of the trial.all treatments were completed as intended. The time taken to complete treatment was shorter in the foam sclerotherapy plus SFJ ligation group than the standard stripping (43 min vs. 65 min, P0.01). Less analgesic use postoperatively was recorded in the foam sclerotherapy group. Median time to return to normal activities was significantly reduced in the foam sclerotherapy group compared to the surgical group (3 d vs. 6 d, P0.01). After 3 months, median CEAP class dropped from four pre-operatively to one following treatment in both groups (P0.01). After 6 months, in the foam sclerotherapy group, 5 patients needed further sessions of foam sclerotherapy, resulting in a short-term closure rate of 80.0%. And the short-term obliteration rate was 89.5% in the conventional surgery group.foam sclerotherapy combined with sapheno-femoral ligation involves a shorter treatment time, less postoperative discomfort and results in more rapid recovery compared to conventional GSV stripping.

To determine the safety and efficacy of total percutaneous endovascular abdominal aortic aneurysm repair using the Perclose ProGlide suture-mediated closure system.From May 2008 to April 2010, 36 abdominal aortic aneurysm patients were undergone total percutaneous endovascular repair. There were 30 male and 6 female patients with a mean age of 68 years. Endografts used included 3 Endurant endografts, 13 Talent endografts, and 20 Zenith endografts. Prior to insertion of the introducer sheath, two ProGlides were pre-set to 18 to 24 F access sites and one to 14 to 16 F access sites. At last, suture the arteriotomy by tying down knots of the ProGlide following removal of the sheath. Technical success, complications, and procedure and access closure times were evaluated. Follow-up protocol consisted of computed tomography angiograms performed at 3, 6, 9, 12 months, and annually thereafter.Twenty patients were operated under local anesthesia and 16 patients under general anesthesia. A total of 68 femoral arteries were closed with 128 devices. Thirty-eight vessels were with 2 devices, while 8 arteries required 3 devices and 2 arteries required 4 devices for hemostasis and an additional 20 vessels only required a single device. Sixty-three (63/68, 92.6%) vessels were closed successfully. Two vessels converted to open closure. Three vessels complicated with hematomas without surgical procedure. The mean follow-up was (12±3) months. There was one asymptomatic femoral artery dissection 3 months after operation.Total percutaneous endovascular abdominal aortic aneurysm repair is safe and effective. But it should be performed at hybrid operating room where can convert to open procedure if necessary.

To investigate the treatment strategies of peripheral arterial aneurysms.Thirty-five cases were reviewed from July 1998 to December 2007, and 28 cases were male, 7 cases were female. Eleven cases were popliteal artery aneurysms, 15 cases were femoral artery aneurysms, 4 cases were extracranial carotid aneurysms and 5 cases were subclavian artery aneurysms. All cases had either open procedures or endovascular procedures.Surgical open procedures were performed on 24 cases, and endovascular procedures were performed on 11 cases. The perioperative complication rate were 16.7% (4/24) and 0% for open and endovascular groups respectively. The average follow-up time was 41 months (7 months to 8 years). The accumulative five year patency were 61% and 48% for surgical grafts and stent grafts respectively. Two cases died of diseases and one had stroke during follow-up.Surgical open repair is still standard procedure for most peripheral arterial aneurysms and endovascular repair may have its own advantage for high risk patients.

To describe observation of availability of catheter-directed foam sclerotherapy for the great saphenous vein varicosis.A selective series of 30 patients of vein varicosis were treated with foam sclerotherapy using a standard technique for foam delivery from April 2008 to August 2008. Patients were treated with 1% polidocanol foam through a catheter, which was inserted percutaneously over a guidewire in the great saphenous vein (GSV). All successfully treated patients were examined by colour duplex two weeks after the procedure.Thirty patients with an insufficiency reflux of the GSV were treated with the catheter-directed foam sclerotherapy. Primary technical success was achieved in all the patients. The concentrations (1.0%) and doses (6 to 8 ml) of polidocanol was mainly we used. Five patients experienced transient scotomas and developed segmental phlebitis of a collateral vein. The intervention was well tolerated in all patients without the occurrence of serious side effects. In 27 of the 30 treated patients (90%), a closure of the GSV was found at control visits 2 weeks, 3 months after treatment.The use of an endovascular catheter inserted percutaneously over a guidewire is feasible in most patients and has resulted in high primary occlusion rates.

As an alternative to open aneurysm repair, endovascular aortic repair (EVAR) has been applied to ruptured abdominal aortic aneurysm (rAAA). The aim of this study was to evaluate the immediate and long-term outcomes of EVAR for rAAA.From July 1997 to September 2007, 20 men and six women with rAAA (median age, 68 years) were treated with EVAR. Most patients with suspected rAAA underwent emergency computed tomographic angiography (CTA). The procedure was performed under general or local anesthesia. Endovascular clamping was attempted in hemodynamically unstable patients. Bifurcated endografts and aorto-uni-iliac (AUI) endografts with crossover bypass were used. Patients had CT scan prior to discharge, 3, 6, 12 months after discharge, and annually thereafter.Time between diagnosis and EVAR ranged from 1 hour to 5 days. EVAR was performed under general anesthesia in 21 patients, and under local anesthesia in five patients. Endovascular aortic clamping was performed in four patients. There was no conversion to open surgery during EVAR. Stent-graft insertion was successful in all patients. One patient died during EVAR from acute myocardial infarction. Ten patients had systolic blood pressure80 mm Hg. Eleven patients received a blood transfusion. Mean aneurysm size was (47 +/- 12) mm. Mean ICU stay was (8 +/- 3) days, mean hospital stay (18+/- 6) days, and mean procedure time (120 +/- 32) minutes. The 30-day mortality was 23% (6/26 patients), and major morbidity 35% (9/26 patients). Early endoleak occurred in 8/26 patients (31%). The mean follow-up was (18 +/- 7) months. No patient demonstrated migration of the stent-graft.EVAR is a safe and effective option for treatment of acute rAAA, independent of the patient's general condition. Immediate and mid-term outcomes are favorable, but long-term outcome is unknown. Multi-center studies are necessary to establish the role of EVAR for rAAA.

To review the experience of hybrid conventional open and endovascular treatment of thoracoabdominal aortic aneurysm (TAAA), and evaluate the immediate and long term outcomes.From September 1998 to October 2008, 15 TAAA patients were treated by hybrid-procedures. The mean patient age was 58.7 years (ranged from 44 to 72 years). The aneurysms were Crawford type I in 2, type II in 8, type III in 2, type IV in 3. The median aneurysms diameter was (67.5 +/- 7.5) mm (ranged from 55 to 82 mm). Patients were followed up before dismissal, 3, 6, 12 months later, and annually thereafter.Two patients were antegrade revascularization, the others were retrograde revascularization. Mean operation time was (8.1 +/- 1.4) h (ranged from 6.8 to 12.7 h), mean blood loss was (956.7 +/- 80.1) ml (ranged from 750 to 3,000 ml). Two patients died during perioperative time, no paraplegia. During follow up revealed shrinkage of aneurysm, no graft migration and paraplegia, but 1 died for acute myocardial infarct.Hybrid treatment is a safe and effective option for treatment of TAAA. Immediate and mid-term outcomes are favorable, but long-term surveillance is indefinite.

To investigate the methods and effects of secondary intervention for mid-long term complications of endovascular repair (EVR) in aortic diseases.From May 1999 to Jun 2007, 21 patients with mid-long term complications after EVR were treated in our center. Of these cases, 15 cases received first EVR for abdominal aortic aneurysm (AAA), 3 cases for thoracic aortic aneurysm (TAA) and 3 cases for aortic dissection (TAD). The mid-long term complications included 11 cases of type I endoleak, 4 cases of type II endoleak, 2 cases of type III endoleak and 4 cases of migration of stent grafts. Proximal or distal extensions were used for type I and III endoleak in 9 cases. Fenestrated, scallop and bifurcated stent grafts were used to reconstruct the aortic arch in 3 cases. Emboli technique was used in treating type II endoleak. Thrombectomy and bypass technique were used in 4 cases with stent graft limb occlusion. One ruptured AAA accepted open surgery.Secondary endovascular technique were undergone in 20 (95.2%) cases. One case died in 30 days after the secondary intervention and endoleak remained after the secondary operation in 5 cases. Three cases died of the secondary intervention.Endoleak and limb occlusion were the chief mid-long complications after EVR. Secondary endovascular technique can be used in most cases and carries great challenges in aortic arch lesions.

To design and manufacture a modular branched stent-graft system of endovascular reconstruction of the aortic arch in canine, and to investigate the feasibility of endovascular repair.After the length and the diameter of ascending aorta, aortic arch and super-arch branched vessel measurement, a modular branched stent-graft system, including two pieces bifurcated stent-graft and one piece straight stent-graft, was designed and manufactured. Under X-ray fluorescope, these three modulars were accessed from right subclavian, left subclavian and femoral artery respectively and connected one by one to reconstruct the aortic arch. The shape and structure of stent-grafts, haemodynamics in aortic arch and endoleak were observed.Eight of ten operations were completed successfully. Two dogs died of obstruction of coronary artery and artery rupture of left subclavian respectively during operation. In the eight successful cases, two proximal type I endoleaks were observed, and no other type endoleak occurred. The shape and the localization of stent-grafts were fine, and the coronary artery and carotid artery were unobstructed.It is feasible to reconstruct aortic arch of canine by modular branched stent-graft, and it is significant to direct the research of reconstruction of human aortic arch.

To investigate the treatments of left subclavian artery (LSA) in endovascular repair (EVR) of thoracic aortic aneurysm (TAA) and thoracic aortic dissection (TAD).In 54 TAD or TAA cases, all of the proximal landing zone (PLZ) were less than 15 mm and only the LSA was needed to be treated in EVR, the following methods and techniques were used in the treatments of LSA: complete cover, partial cover, endovascular reconstruction following complete cover, surgical reconstruction before complete cover.DSA was used to evaluate the condition of cerebral circulation in all cases. Forty left subclavian arteries were covered completely. Ten were covered completely after right subclavian artery (RSA)-LSA or left common carotid artery (LCCA)-LSA bypass. PTA and stent in LSA was done in 3 cases. In 1 case, LSA was covered completely first, and then the graft was punctured and bare stent was fixed after inflation by cutting balloon. All of the ancillary techniques were enforced successfully. No severe complications were found in brain and upper extremity. The proximal endoleak rate was 17% (9/54). In the 40 cases whose LSA were not reconstructed, the primary left subclavian steal syndrome (LSSS) happened in 8 cases (20%) and the primary average systolic pressure of left brachial artery was 63 +/- 24 mm Hg.EVR can be enforced safely and efficiently in TAA and TAD with short PLZ by some ancillary endovascular or surgical techniques. The methods to treat the LSA depend on the condition of the cerebral circulation.