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Objective To evaluate the curative effect of percutaneous puncturing drainage in treating liver abscess,to analyze the factors affecting curative effect,and to discuss the methods ior reducing mortality and complication rate as well as for shortening hospitalization time.Methods Clinical data of 121 patients with liver abscess,who were admitted to authors' hospital during the period from January 2011 to January 2016,were retrospectively analyzed.For the patients with confirmed liver abscess,adequate antiinfective therapy was adopted,at the same time CT scan was performed to evaluate the liquefaction of lesion,and under CT guidance percutaneous puncturing drainage was carried out.The mortality,complication rate,hospitalization time and the factors affecting curative effect were analyzed.Results A total of 121 patients with liver abscess were enrolled in this study.Two patients died after percutaneous puncturing drainage,the mortality was 1.6％.The factors affecting mortality included old age,underlying disease,the diameter and solid components of abscess.Two patients developed peripheral hepatic abscess and abdominal wall abscess,the complication rate was 1.6％,and clinical cure was achieved after active treatment in these two patients.The main factor affecting complication rate was inappropriate surgical manipulation.Clinical cure was achieved in all 119 patients,with a cure rate of 98.3％,and the average hospitalization time was (15.1±6.0)days.The risk factors that affected hospitalization time included the number of abscess X6 (r=0.232,P=0.021),abscess size X7 (r=0.26,P=0.005) and white blood cell count X8 (r=0.238,P=0.009).Multiple linear regression equation analysis indicated that statistically significant correlation existed between the above influence factors and hospitalization time (P＜0.05).The multiple regression equation was as follows:Y=-3.438+3.055X6+0.527X7+0.297X8,F=5.819,R2=0.416.No statistically significant correlation existed between the hospitalization time and other factors,including gender,age,diabetes mellitus,pathogenic bacteria and location of abscess (P＞0.05).Conclusion Percutaneous puncturing drainage is an effective treatment for liver abscess,it carries lower mortality and lower complication rate,and its hospitalization time is short.(J Intervent Radiol,2017,
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Objective To investigate the application of lower limb electromyography in guiding preoperative localization for multiple segment intervertebral disc herniation treated with ozone injection and in predicting the curative efficacy.Methods A total of 51 patients with MRI-proved multiple segment lumbar intervertebral disc herniation,who were admitted to authors' hospital during the period from January 2012 to December 2013 and who had complete clinical materials,were included in this study.Guided by DSA,intradiscal injection of ozone together with the injection of ozone plus compound betamethasone and bupivacaine into the space around the spinal nerve was carried out in all patients.The degree of lower lumbago was evaluated with M-JOA score,and Oswestry disability index (ODI) was adopted to assess the curative effect.Results Preoperative electromyography showed that 43 patients had nerve root injury,the positive rate was 84.3％.The positive HIZ sign was detected in 30 patients,with the positive rate being 58.8％.The positive Modic sign was observed in 24 patients,the positive rate was 47.1％.Postoperative MJOA scores indicated that one-,3-and 6-month effective rates were 90.1％,86.2％ and 78.5％ respectively;and postoperative ODI values showed that one-,3-and 6-month effective rates were 87.3％,79.5％ and 74.6％ respectively.Conclusion In treating multiple segment intervertebral disc hemiation with ozone injection,lower limb electromyography is very valuable in accurately making preoperative localization as well as in precisely predicting the curative efficacy,thus this technique is worth popularizing in clinical practice.
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Objective To investigate the short term effect of licartin transarterial infusion in combination with chemoembolization (LTACE) and compare its effect with conventional transcatheter arterial chemoembolization (TACE) for advanced hepatocellular carcinoma (HCC).Methods Seventy-two cases of advanced HCC were included in this analysis.There were 50 males and 22 females with the average age of (58±12) yrs (range 34-86 yrs).Twenty-nine patients received LTACE treatment while the other forty three patients received conventional TACE treatment.Before intervention,there was no variation (P>0.05) in gender (X2 =0.202),Child-Pugh grading for hepatic function (X2=2.428),as well as in white blood cell count (t=1.101)and platelet count (t =0.080) between the two groups except for age and portal vein thrombosis.For LTACE group,30 minutes after the infusion of licartin (27.75 MBq/kg) into proper hepatic artery,an emulsion of 40 rag pharmorubicin and 30 ml uhrafluid lipidol was infused until hemostasis within target artery.For TACE group,only an emulsion of 40 nag pharmorubicin and 30ml uhrafluid lipidol was infused until hemostasis within target artery.Following these interventions,the two groups were given the same treatment to stabilize hepatic function and relief embolization-relating symptoms; Patients' follow-up included clinical symptoms and signs,hepatic and renal function,peripheral blood test,CT and radionuclide study(ECT).All data were analyzed with SPSS 11.5.Measurement data were expressed with mean and processed by t test; numeration data were processed by Chi square test and Fisher precise test; Kaplan-Meier analysis and log-rank test were applied for comparing the survival rate of the two groups.P <0.05 means the exist of a statistic variation.Results After treatment,there was no variation of Albumin,GPT,serum bilirubin,white blood cell,platelet and serum creatinine level between the two groups [t=0.250,0.907,0.629,0.005,0.250,0.453 (7 days) and 0.978,1.250,1.942,0.733,0.315,1.243 (14 days); P >0.05].ECT imaging demonstrated a 55.17% (16/29) uptake ratio of licartin within tumor areas by the time of 7-days follow-up study.The lesions in both LTACE and TACE groups exhibited a decrease in their size and statistically significant difference was demonstrated before and after treatment in either group( t=7.207,8.006,P <0.01).But between the two groups,the tumor size reduction showed no statistical difference,the tumor size in LTACE and TACE groups were( 1.68±0.32),(1.74±0.31)respectively (t =0.786,P>0.05)before treatment and(1.52±0.38),(1.61±0.36) respectively(t=0.891,P>0.05) after treatment.There was no variation between the two groups comparing the 6 months cumulative survival rate(LTACE 52%,TACE 76%,log-rank test,X2=3.080,P >0.05).Conclusion There was no statistically significant differences between LTACE and TACE groups concerning the short term effect and adverse reaction for treatment of advanced HCC.The long term outcomes should be established on the basis of a large-sample,multiconter,randomized trail.
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According to program of vascular examination of diabetic foot, the first choice is vascular ultrasonography as the general survey, followed by CTA and MRA for assessment of bilateral lower extremities arterial morphological changes. Lastly, arterial angiography including DSA still remain as the gold standard for estimation. The main pathologic changes of diabetic foot including arteriolar and microvascular disorders induce the extemely important interventional treatment especially the local thrombolytic infusion to be the real practical management besides local PTA and stenting are furthermore in consideration. As a general metabolic disease, the serial treatment should also include promoting blood flow, removing blood stasis and improving microcirculation . Evaluation of interventional treatment for diabetic foot should undertake not only the vascular stenosis and restenosis ,but also the relief of clinical symptom and improvement of amputation level.
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Diabetes is common in men and women aged 50 years and older often complicated with peripheral arterial disease(PAD) arousing more serious attention by vascular surgeon and interventional radiologist. The present review of this article put the main focus on curative effect and limitation of intravascular treatment for patients with diabetic PAD, including proper medical imagings for suitable follow-up and formation of regular managing program for accessing limb function and whole body condition. Furthermore the dosage and proceduce of medical thrombolysis in dealing diabetic PVD, together with the possibility of mechanical thrombolysis approach should expecially emphasized. For further objective acknowledgement of interventional therapy for diabetic PVD; the selection of interventional procedune, the management of single or mutliple lesions and post procedural treatment ought to be considered thoroughly before hard.
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Objective To evaluate clinical effectiveness and influence factors in the treatment of benign and malignant esophageal stenosis by placing esophageal stent. Methods A series of this research comprised of 29 cases with esophageal cancer, 10 cardiac carcinoma, 5 cardiac achalasia, 6 benign esophageal stricture after operation. The lengths of lesion ranged from 2 to 14 cm in length with mean of 7.3 cm. Fistuli were found among malignant esophageal stenosis in 6 cases. According to the dysphagia scores, 12 cases were designated as Ⅰ grade, 31 with Ⅱ, and 14 with Ⅲ. 46 cases of malignancy were undertaken radiation therapy combined with transcatheter arterial chemotherapy from 15 to 30 days after stent placement. Results 62 stents were placed in 57 cases (52 domestic stents, 10 Boston ultraflex), including 4 cases with 2 stents being once placed, 1 case with second time stent placement because of restenosis 4 month later. All stents were placed successfully without serious complications, such as esophageal perforation, massive hemorrhage. 5 cases of cardiac achalasia and 6 cases of benign esophageal stricture are still alive now. The survival rates of 6, 12, 24 and 36 months in 46 malignant cases, were 67.4%(31/46), 43.5%(20/46), 26.1%(12/46), and 19.6%(9/46) respectively. Dysphagia were relieved significantly form 7 to 15 days after stent placement. Conclusions Esophageal stent placement combined with radiation therapy and transcatheter arterial chemotherapy could improve patient life qualities and survival rates significantly in malignant stricture. The effects on benign esophageal stricture by stent placement are comparable with that of surgical treatment.
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Objective To investigte the possibility of interventional mechanical thrombectomy dealing with chronic vascular thrombus, and assessing its curative effects. Methods Twenty three cases included 17 males 6 females, and aged from 46 to 80 year with a mean of 64.8. All patients were coinsided with MRA, vascular ultrasound and angiography, in which 12 patients with chronic heart and vascular disease, and 11 patients with serious diabetes. Thrombi were located in iliac artery ( n=9,L=4,R=3 , bilaterals=2), femoral artery( n =2), populiteus artery ( n =2), popliteus artery( n =3), iliac vein ( n =7, L=5,R=2), portal vein ( n =1). The length of thrombi varied from 3 to 8 cm, and the diameter from 5 to 10mm.Filter should be placed in inferior cava vein before venous thrombus treatment ( n =7). Mechanical thrombectomy was undertaken as following: ATD ( n=9, Vein=7), PTD( n =2), and Oasis( n =1). After guide wire passing through thrombus segment, Oasis was inserted for remove thrombus. Urokinase (500 000U) was usually administered for catheter directed thombolysis before/during mechanical thrombectomy. Stent should be placed in the segment if stenosis was confirmed after thrombectomy angiography. Drugs were used after thrombectomy including thromboyltic drug, heparinzed anticoagulation and changing microcirculation. Vascular ultrasound, reconstruction CTA and clinical follow up had all been carried out. Results 12 cases (85.7) were undergone successfully thrombectomy. One case failured with portal vein thrombus formation, the other with multiple segments involvement in femoral artery was treated by combined ATD and Oasis. Sy mptoms of 15 cases were either released or disappared, including ischemia, swelling and motion limitations. The patency shown by vascular ultrasound follow up were 100% in three months, 85.4% in six months, 73.2% in twelve months, with simultaneously blood flow improvement to normal and obviously corrected 76.5%,65.4% 60.1% in 3,6,12 month respectively.Conclusions Interventional mechanical thrombectomy is a new choice of treating chronic vascular thrombus with its direct curative effects, but still needs long term follow up.
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Objective On the purpose of assessing inhibition efficacy and mechanism of Xiaoaiping (XAP, a kind of Chinese medicine) for SGC 7901 gastric carcinoma cellular strains.Methods 1. Extracorporal inhibition experiments were undertaken for SGC 7901 gastric carcinoma cellular strains using XAP 50,40,30,20,10mg/ml concentrations respectively. 2. SGC 7901 gastric carcinoma cellular strains on the logarithmic growth periods(4?10 7 cells) were concentrated to 1ml in volume. It was coagulated after mixing with thrombin and fibrin and then the coagulated clot was implanted in renal capsules of Kunming water mouse(certifications: No.005, CSAC) for intracorporal experiments. After continual injecting Xiaoaiping intra abdominal cavity was seven days, with 0.4,0.6,0.8ml/kg concentrations respectively. On the 8th day all the water mice were sacrificed using eyepicec ruler for calculating tumor size under microscope including inhibition hate. 3. In order to pursue mechanism of Xiaoaiping on gastric carcinoma, analyses were carried out on FACSTar with cellular analysis of cellfit DNA analysis software, after Xiaoaiping(30mg/ml) mixed with SGC 7901 cellular strains(1?10 6 cells) seven days. Simultaneously Giemsa decoration method as used for observing tumor cell morphologic changes. Results 1. Extracorporal inhibition rates were 100%,59%,29%,19% and 15% to SGC 7901 gastric carcinoma cells using XAP 50,40,30,20,10mg/ml concentrations respectively. Obvious differences were found in comparison with control groups, inhibition rate of XAP in high concentration is similar with HCPT(98%), IC 50 concentration was 21mg/ml after used XAP for seven days. 2. Tumor inhibition rates were 50%,53% and 71% respectively with continual injecting Xiaoaiping into abdominal cavity seven days by 0.4,0.6,0.8ml/kg concentrations. ED 50 was 0.44/kg for Kunming Water Mouse by logit method. Obvious differences were found in comparison with control groups. Inhibition rate(71%) of XAP in high concentration reached favorabler standard with 5 Fu (76%). 3. DNA analyses showed that cellular period were 65.70% in G 0 G 1 period, 16.22% in G 2 M period, 18.09% S period respectively. G 2/G 1 ratio was 1.86 after XAP(30mg/ml) mixed with SGC 7901 cellular strains seven days, the ratio of cellular nucleus to syrup was reduced as tumor cell morphology. Conclusion Xiaoaiping appears to have good inhibition effect on gastric carcinoma cellular strains and should be as an alternative choice for treatmenting gastric carcinoma and metastases.
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Prevention and management of liver injury via hepatic arterial chemoemboliza- tion;and improvement of its curative effects,223 among 704 patients with more than three years survival after the treatment were assessed on liver tissue and vascularity and lives function.Hepatic clrrhosis(189/223,85.56%)were found rapidly and seriously on CT scan follow-up,Vascular occlusion(3.4%),localised stenosis(fringed duct wall,asymmetric and circumcrsent)were caused latrogenically and generalised stenosis(linear or serrated)could be found unavoidably via chemotherapeutic drugs,lipoidal and gelatine sponge.Collateral bran- ches were found originating from superior mesenteric artery etc.Liver dysfunction and portal hypertension(98/119,82.35%)were the common fatal causes.Acorrding to this assessment, authors expressed the opinoin on the resime of long-term effects by hepatic arterial chemoem- bolization.