<International Circulation>:  In addition to atherosclerosis in association with hypertension， hypercholesterolemia， cigarette smoking and diabetes， it is also necessary to attach importance to less frequent causes of CLI， such as Buerger’s disease (thromboangiitis obliterans) and some forms of arteritis. Is there any progress in the treatment of these CLI- related conditions??
   《国际循环》：在重症肢体缺血的危险因素中，除了动脉粥样硬化、高脂血症、吸烟等常见疾病，我们还应该关注一些比较少见的原因，比如Buerger’s病、闭塞性脉管炎以及其他类型的动脉炎，请问您在治疗这些CLI相关疾病方面有哪些进展？

   Prof. Emmerich: There has been no medical progress in recent years. Gene and cell therapies were tested in Buerger’s disease and we are a little more reluctant to use these options in this condition for two reasons. We are always wary that stimulation of angiogenesis could have a side effect of creating a large cancer from a small one in terms of an angiogenic switch， which is well-known in the development of cancer. There is also a risk of inducing retinopathy， but that is not really a problem in peripheral arterial disease. There is an intriguing trial which was published in Circulation which demonstrated that in Buerger’s disease， a cell therapy was associated with a side effect on the coronary side. We cannot completely exclude that stimulating angiogenesis could destabilize a stable plaque in the coronary bed for example. In Buerger’s disease and heavy smokers， you can have small stable plaques and usually in Buerger’s disease there is no major risk of coronary artery disease but I was intrigued by this report. It is probably a good indication but too early to be included in large trials.
    Emmerich教授：近些年这方面好没有医学的进展，基因和细胞治疗被用来实验性治疗Buerger’s 病，同时我们有点并不情愿在这种情况中使用这些选择有两点原因。我们总是谨慎