Focused ultrasound therapy for reducing recurrence of vulvar lichen simplex chronicus in rats: efficacy and mechanism / 南方医科大学学报

OBJECTIVE@#To explore the changes of collagen fibrosis in the vulva skin of SD rats with lichen simplex chronicus (LSC) after focused ultrasound therapy and explore the mechanism by which focused ultrasound reduces the recurrence of vulvar LSC.@*METHODS@#Fifty female SD rat models of vulvar LSC were established and randomly divided into the treatment group and the control group (=25) for treatment with focused ultrasound and sham treatment, respectively. Before and after the treatment, vulvar skin tissues were sampled to observe the pathological changes with HE staining and assess the density of collagen fibers using Masson staining. The ultrastructure of the collagen fibers in the superficial dermis was observed using transmission electron microscopy. The expressions of notch1 and c-fos in the vulvar tissue were detected by immunohistochemistry and Western blotting.@*RESULTS@#After 4 weeks of focused ultrasound therapy, 16% (4/25) of the rats in the treatment group showed lesion progression to LSIL, 4% (1/25) still had LSC, and 80% (20/25) showed normal vulvar skin. In the control group, progression to LSIL occurred in 19 (76%) rats, 3 (12%) rats still showed LSC, and only 3 (12%) had normal vulvar skin. The difference in the cure rate differed significantly between the two groups ( < 0.05). The density of collagen fibers in the superficial dermis and the expressions of notch1 and c-fos in the vulvar skin were significantly lower in the treatment group than in the control group ( < 0.05).@*CONCLUSIONS@#Focused ultrasound therapy can inhibit superficial collagen fibrosis of the dermis by lowering the expressions of notch1 and c-fos in the vulvar skin to reduce the recurrence of vulvar LSC in rats.

Management of complications during volume reduction therapy for peripheral arterial disease of lower extremities / 中国介入影像与治疗学

Objective To: investigate the management of complications during volume reduction therapy for peripheral arterial disease of lower extremities. Methods: Data of 167 patients (188 limbs) with lower extremity peripheral arterial disease who underwent volume reduction therapy were retrospectively analyzed. According to methods of volume reduction treatment, the patients were divided into thrombolysis (43 cases, 46 limbs), thrombectomy (42 cases, 49 limbs) and directional atherectomy (82 cases, 93 limbs) groups. The kinds, incidence and symptomatic treatment of complications in each group, and the efficacy of the treatments were analyzed. Results: A total of 46 limbs were treated with catheter direct thrombolysis in thrombolysis group. In thrombectomy group, 16 limbs underwent thrombectomy with Angiojet catheter and 33 limbs underwent thrombectomy with Rotarex catheter. In directional atherectomy group, 21 limbs underwent atherectomy with Silverhawk system and 72 limbs underwent atherectomy with Turbohawk system. The total technical success rate of volume reduction therapy was 98.93% (186/188). The incidence of operative complications was 28.26%(13/46), 6.12%(3/49) and 6.45%(6/93) in group of thrombolysis, thrombectomy and directional atherectomy, respectively. Surgical complications included 14 cases (14 limbs) of vascular rupture and bleeding, 5 cases (5 limbs) of embolism caused by embolus, 2 cases (2 limbs) of acute thrombosis and 1 case (1 limb) of guide wire rupture, all were resolved after symptomatic treatments including compression, balloon attachment, covered stent implantation or thrombolysis. There was no operative related death. Statistical difference only existed in the incidences of bleeding among three groups (P=0.002). After the volume reduction treatments, Rutherford classification of the patients were significantly improved (Z=2.730, P=0.002). Conclusion: The effectiveness of volume reduction treatments are definite. Bleeding is the commonest complication, which is highest in patients underwent catheter direct thrombolysis. Timely treatments are helpful to avoid adverse events caused by operation-related complications of volume reduction therapy.

Establishment of a rat model of dimethylbenzanthracene-induced vulvar squamous intraepithelial lesions / 南方医科大学学报

OBJECTIVE@#To establish a SD rat model of vulvar squamous intraepithelial lesions.@*METHODS@#Seventy female SD rats were randomized into 4 groups, namely the blank control group (=10), mechanical irritation group (=10), acetone solution group (=10), and mechanical irritation with DMBA acetone solution group (=40, model group), and the corresponding treatments were administered 3 times a week for 14 weeks. The changes of the vulvar skin of the rats were observed regularly until the 18th week. The expression of mutant p53 (mtp53) and vascular endothelial growth factor (VEGF) proteins were detected using immunohistochemistry and Western blotting, and the expressions of mtp53 and VEGF mRNA were detected with qRT- PCR in the blank control group and model group.@*RESULTS@#No significant differences were found in the morphological or histopathological changes of the skin among the blank control group, mechanical irritation group and acetone solution group. In the model group, low-grade squamous intraepithelial lesions (LSIL) occurred in 28 rats (70%) and high-grade squamous intraepithelial lesions (HSIL) in 11 rats (27.5%) at 14 weeks, with a success rate of 97.5% in inducing vulvar squamous intraepithelial lesions. Compared with the blank control group, the rats in the model group showed significantly increased expressions of mtp53 and VEGF at both the protein level ( < 0.05) and the mRNA level ( < 0.05).@*CONCLUSIONS@#DMBA in acetone solution combined with mechanical irritation can induce vulvar squamous intraepithelial lesions in female SD rats.

Clinical study of mechanical thrombectomy in treating in-stent restenosis of lower extremity arteriosclerosis obliterans / 中华放射学杂志

Objective To evaluate the safety and efficacy of mechanical thrombectomy in treating in-stent restenosis of lower extremity arteriosclerosis obliterans. Methods From May 2015 to Sep 2016, the clinical data of 9 cases of lower extremity arteriosclerosis obliterans who were with in-stent restenosis(3 were stent graft)were retrospectively collected, and of which 7 were males and 2 were females with a mean age of (75.4 ± 6.3)years old. All the cases were treated by mechanical thrombectomy of Rotarex catheter. All the patients were diagnosed via low-extremity artery CTA, and treated by means of the Rotarex catheter, combined with angioplasty and stent if necessary. All patients received antiplatelet therapy. Doppler ultrasonography was taken during the followed-up. Results All the 9 cases were successed in technology, without complications in hospital. All patients received Rotarex mechanical thrombectomy. Six of which used balloon and 1 stent implanted. The ABI increased from 0.29 ± 0.07 to 0.88 ± 0.07 after treatment, the difference was statistically significant(t=28.875,P<0.05). All the patients were followed up for 3—18 (median time, 11.5)months. No death and symptoms recurrence appeared during the follow-up. Conclusions Mechanical thrombectomy using Rotarex catheter is a safe and effective treatment for in-stent restenosis in lower extremity arterial diseases.

Application of ExoSeal vascular closure device in interventional management via antegrade femoral access / 中国介入影像与治疗学

Objective To investigate the safety and clinical value of using ExoSeal vascular closure device (VCD) in interventional management via antegrade femoral access.Methods Clinical and imaging data of 303 patients (316 affected limbs) who were received interventional procedure via antegrade femoral access closure were retrospectively analyzed.ExoSeal VCD (VCD group,n=127) and manual compression (MC group,n =176) were performed to make femoral artery puncture point hemostasis.The time of hemostasis,actual immobilization time,technical success rate and vascular related complications were recorded and compared between the two groups.Results In VCD group and MC group,the time of hemostasis were (3.68 ± 2.40) min and (18.32 ± 4.54) min,the actual immobilization time were (3.45±5.30) h and (10.44±14.68) h,the technical success rates were 98.52％ (133/135) and 93.92％ (170/181),and the complication rates were 2.22％ (3/135) and 8.84％ (16/181),respectively.There were statistically significant differences between two groups (all P＜0.05).In VCD group,there were 2 cases of subcutaneous hematomas,and 1 case of retroperitoneal hematoma.In MC group,there were 15 cases of subcutaneous hematomas and 1 case of acute thrombosis in the puncture side limb.Conclusion Regarding hemostasis of puncture site in interventional management via antegrade femoral access,the use of ExoSeal VCD is safe and effective.

Clinical research on the application of VIABAHN stent in the treatment of branching area lesions in lower extremity arterial diseases / 中华放射学杂志

Objective To explore the security and the short term efficacy of VIABAHN stents in the treatment of branching area lesions in lower extremity arterial diseases. Methods The data of 16 patients (11 male and 5 female, aged 59.0 to 81.0 with median of 71.6) with lower extremity arterial occlusive disease from November 2014 to June 2015 were analyzed retrospectively. All lesions were located around the branching area of the lower extremity artery (3 cases in the internal iliac artery orifice, 6 cases in the deep femoral artery orifice and 7 cases in the vascular net around the knee). The short?term effects on these patients in the follow-up period, such as the success rate of surgical technique, the improvement of symptoms and the incidence of complications were summarized. Results Revascularization was technically successful in all 16 patients, and ischemic symptoms relieved significantly after the operation. The ABI were 0.36±0.12 before and 0.89±0.10 after the operation. The patients were followed up for 3 to 9 months (median 5.5 months). All the patients were achieved limb salvage and no complication occurred. Conclusions VIABAHN stent is safe and effective for the treatment of lower extremity arterial occlusive disease. The branches around the lesion can be covered with VIABAHN stents.

Effect of low-intensity ultrasound on endothelin-1 and nitrogen monoxide in uterine tissues of SD rats following abortion / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effect of low-intensity ultrasound on the contents of endothelin (ET-1) and nitrogen monoxide (NO) in uterine tissues of SD rats after abortion.</p><p><b>METHODS</b>Thirty female pregnant rats were randomly divided into treatment group and control group and received mifepristone and misoprostol to induce abortion. The rats in the treatment group were treated by low-intensity ultrasound for 30 min/day for 5 consecutive days, and those in the control group received sham treatment. The uterine tissue was then taken and homogenized for measurement of ET-1 and NO contents using enzyme-linked immunosorbent assay and chemical testing.</p><p><b>RESULTS</b>ET-1 content in the uterine tissues was significantly higher in the treatment group than in the control group (P<0.05), but NO content showed no significant difference between the two groups (P>0.05).</p><p><b>CONCLUSIONS</b>Low-intensity ultrasound can promote the contraction of uterine smooth muscles by increasing the level of ET-1 to modulate the homeostasis of ET-1 and NO.</p>

Balloon embolization therapy for traumatic carotid cavernous fistula / 中华创伤杂志

Objective To analyze effect of balloon embolization therapy for traumatic carotid cavernous fistula (TCCF),so as to provide references for treatment of this disease.Methods A total of 21 patients with TCCF managed with balloon embolization from April 2006 to March 2012 were collected in the study.There were 17 males aged (32.3 ±5.4) years and 4 females aged (40.6 ±5.8)years.Perioperative clinical presentations and imageologic changes were observed as well as operative outcome was evaluated.Results After 3 months of follow-up,20 patients experienced successful detachable balloon embolization,but the other one patient had to have stent angioplasty due to the failure of the procedure.All patients had some improvements on clinical presentations after operation (P ＜ 0.05).Imageologic examination revealed that all patients had complete occlusion of TCCF following operation.In follow-up,one patient had a relapse,with total curative ratio of 95％.Conclusions Detachable balloon embolization is effective in treatment of TCCF.Presently,the technique is an optimal method for such kind of disease and is worthy of wide clinical use.

The effects of repeated irradiation with focused trasound on recurrent and metastasized murine cervical carcinoma / 中华物理医学与康复杂志

Objective To investigate the efficacy of twice irradiating with focused ultrasound on recurrent and metastasized U14 cervical cancer implanted in the legs of mice. Methods Seventy-two mice with U14 cervical cancer cells implanted in their legs were divided into three groups randomly,with 24 rats in each group.One group received a single dose of focused ultrasound,while mice in the second group were irradiated twice and surgery resection was administered to the third group 7 or 8 days after the tumor was implanted.After 23 days post implantation of the tumor,local tumor recurrence and metastasis to the lungs and lymph nodes were evaluated. Results The inhibition rate after double irradiation was 61.70％ for local recurrence and 68.18％ for metastasis,significantly higher than in the other two groups. Conclusions Both single and double irradiation with focused ultrasound are effective for inhibiting local recurrence and metastasis,but double irradiation is more effective.

Problem-based learning in clinical teaching ultrasonic therapeutic application / 中华医学教育探索杂志

ObjectiveTo explore the PBL mode in training students' ability,improve the quality of teaching effect,in the teaching of Clinical therapeutic ultrasound and the teaching method based on problems with discussion method.MethodsTo 31 subjects of study who were randomly divided into five groups,each 6 people,a PBL teaching mode was used for 12 periods by proposing and study,group discussion,the whole class exchange and commenting on summary.ResultsThe survey shows that 93.6％ students think the teachers' design has gained their ends,71％ students are impressed by the knowlege and 96.8％ of the students show the good learning attitude,64.5％ of the students raised their interest in learning,which shows teaching results are effective.ConclusionPBL mode is superior to LBL teaching mode in training students' ability,improving the quality of teaching effect.