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Objective To investigate the incidence of venous thrombosis related to totally implantable access port (TIAP) in upper arm in cancer patients, and to discuss its risk factors. Methods The clinical data of a total of 1 724 patients, who received upper arm TIAP for deliverance of chemotherapy at authors' hospital during the period from February 2014 to April 2018, were collected. The general data of patients, catheterization, disease progression and incidence of venous thrombosis in upper limbs were analyzed. The univariate analysis and multivariate logistic regression analysis were used to determine the risk factors related to symptomatic thrombus. Results A total of 17 patients developed symptomatic venous thrombosis of the upper extremities, the incidence rate was 0.99％ (17/1 724) . The mean time interval from the implantation of upper arm TIAP to the diagnosis of thrombosis was 55.6 d (2-334 d) . Univariate analysis indicated that infection (P<0.01) and spontaneous catheter dislodgment (P<0.01) were significantly related to the risk of upper extremity venous thrombus (UEVT) . Multivariate binary logistic regression analysis revealed that infection (RR =16.85, P <0.01) and catheter spontaneous dislodgment (RR =101.09, P <0.01) were two important independent predictors for UVTE related to upper arm TIAP. Conclusion Infection and spontaneous catheter dislodgment are independent risk factors for upper arm TIAP-related thrombosis.
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Objective To explore the safety,technical feasibility,and catheter-related complications of ultrasound-guided implantation of totally implantable access port (TIAP) in the upper arm.Methods A total of 642 patients,who were admitted to authors' hospital during the period from February 2014 to December 2016 to receive ultrasound-guided implantation of TIAP in the upper arm,were enrolled in this study.The patients included 407 males (63.4％) and 235 females (36.6％),their age ranged from 11 to 89 years old,with a mean age of (58.29±4.33) years old.Under ultrasound guidance,by using Seldinger's technique TIAP was implanted in the upper arm.Results Implantation of TIAP in the upper arm was performed in all 642 patients.The initial success rate of implantation was 99.53％ (639/642),in 3 patients successful implantation was obtained in the second time of implantation as the initial puncturing failed.During the follow-up of 155,302 catheter days,complications occurred in a total of 58 patients (9.0％),including early complications in 9 patients and late complications in 49 patients.The complications included TIAP-related infection (n=28,4.4％),venous thrombosis (n=7,1.1％),sac bleeding (n=3,0.4％),port hub rotation (n=3,0.4％),cracked skin (n=l,0.2％),catheter obstruction (n=2,0.3％),catheter displacement (n=4,0.6％),movement restriction of catheter-side upper limb (n=7,1.1％),venous return obstruction of upper limb (n=2,0.3％) and median nerve injury (n=l,0.2％).No port-related death occurred.Conclusion The ultrasoundguided implantation of TIAP in the upper arm is technically-safe,clinically-effective and minimally-invasive,besides,it carries lower incidence of complications.Therefore,this method is worthy of clinical popularization and application.
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ObjectiveTo study the effect of lentivirus-mediated microRNA-21 RNAi on biological behaviors in human hepatic cancer cells.MethodsMicroRNA-21 specific siRNA gene was synthesized and cloned into the recombinant lentiviral vector,pGCSIL-GFP.HepG2 cells were infected by microRNA-21 siRNA recombinant lentivirus (miR-21-siRNA-Ⅳ).The HepG2 cells were devided into SI group,NC group and N group in vitro.The expression of the targets of miR-21 was detected by RT-PCR.Cell growth was analyzed by MTT assay.The invasion was dectected by tmnswell method.Apoptosis was detected by Hoechst33258.BALB/c nude mice were randomly divided into SI group and NC group.The growth of transplant tumors in BALB/c nude mice were observed.Results ( 1 ) The expression level of miR-21 was inhibited significantly by miR-21-siRNA-lⅣ.(2) The proliferation of HepG2 was also markedly suppressed in MTT at the 96 h point ( P =0.0031,P ＜ 0.05 ).(3) The number of cells that migrated through the chamber of SI group decreased ( P =0.0004,P ＜ 0.05 ).(4) The cell apopotosis in SI group increased markedly.In addition,the caspase 3 mRNA significantly increased ( P =0.0002,P ＜ 0.05 ).( 5 ) Tumor growth curve was not statistically different between groups ( P =0.0002,P ＜ 0.05 ).ConclusionsMicroRNA-21 specific siRNA suppresses the proliferation and migration of HepG2 cells and induces tumor cell apoptosis inhibiting the growth of transplanted tumor in Balb/c nude mice.