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Objective To evaluate the clinical efficacy of interventional techniques in the diagnosis and therapy of Dieulafoy disease. Methods A retrospective study was performed, including 17 patients with massive upper gastrointestinal hemorrhage (patients without peptic ulcer and portal hypertension or diagnosed with Dieulafoy disease by endoscopic examination). All patients had both DSA and interventional embolization treatment, and were followed for 12 months to appraise the clinical effectiveness. Results Sixteen patients were diagnosed as Dieulafoy disease by using DSA. Fifteen of the 16 patients were treated with embolization successfully withoutserious complications. One patient received subtotal gastrectomy because of upper gastrointestinal hemorrhage recurrence. Nine patients with irregular upper abdominal pain and burning sensation had complete remission after symptomatic management. Fifteen patients who had embolization showed no serious complications during the follow-up period of 12 months, there was no hematemesis and melena for the 15 cases with successful embolization. Conclusion The angiography and embolization are safe and efficacious in the diagnosis and therapy of Dieulafoy disease.
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Objective To explore the clinical efficacy of indwelling suture in preventing re-adhesion of fallopian tube after fallopian tube recanalization(FTR). Methods Screen 93 patients with fallopian tube obstruction and FTR indications of prospective, the patients without other interference factors of infertility, they were randomized with random sampling into two groups (treatment group 50 and control group 43)and treated by FTR,then the treatment group with indwelling sutures in fallopian tube for 3 days, the control group were infused lipiodol into the tube and with a intrauterine cavity perfusion in 3 days. The two groups received followed up examination at 2,6 months after operation ( a treatment was repeated with the case of re-obstruction) . Follow-up for 12 months to appraise the pregnancy rate and the influence of pregnancy competence of tube with indwelling suture(6 months after operation, to collect and compare the pregnancy rate and ectopic pregnancy rate of patent tube in two groups). Results The tubal patency rate were 89.8%(53/59),89.5%(51/57)of treatment group at 2,6 months after operation and the control group were75.9%(44/58),75.0%(39/52), there was a significant difference between the two groups(2 m:χ2=4.027, P months after operation, the pregnancy rate and ectopic pregnancy rate of patent tube in treatment group were 21.6%(11/51),2/11, the control group were15.4%(6/39),1/6, there was no significant difference between them(pregnancy rate:χ2=0.552,P>0.05). Conclusions The indwelling suture of fallopian tube can prevent re-adhesion better after FTR, then improve the long-term recanalization rate and the pregnancy rate. There is no change on the pregnancy competence of fallopian tube.
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Objective To compar the cerebrospinal fluid (CSF) flow between empty sella syndrome (ESS) and normal volunteer in the cerebral aqueduct with MRI in phase contrast cine mode. Methods Thirty-eight ESS patients (ESS group) and 38 normal volunteers (control group ) were involved in this study.The aqueduct CSF flow image was positioned perpendicularly to the midbrain aqueduct at the middle sagittal T1WI or T2WI image. The waveforms were analyzed for the flow direction, flow rate, flow volume rate and cardiac cycle. Results The CSF flow of the aqueduct in control group and ESS group had two directions which was downward flow during the systolic period and upward flow during the diastolic period of the cardiac cycle. The.systolic period downward peak flow rate, diastolic period upward peak flow rate, mean downward flow rate, mean upward flow rate and mean flow rate were (5.231 ± 0.262), (4.902 ± 0.281 ),(3.083 ± 0.191 ), (3.032 ± 0.151 ), (3.151 ± 0.162) cm/s in control group, and (6.244 ± 0.356), (6.091 ±0.430), (3.916 ± 0.196), (3.812 ± 0.273 ), (3.690 ± 0.291 ) cm/s in ESS group respectively,and there was no significant difference between the two groups ( P ＞ 0.05 ). The systolic period downward peak flow volume rate, diastolic period upward peak flow volume rate, mean downward flow volume rate,mean upward flow volume rate and mean flow volume rate were (0.050 ± 0.003 ), (0.050 ± 0.004), (0.030± 0.002), (0.031 ±0.002), (0.030 ± 0.003 ), ( 0.004 ± 0.001 )ml/s in control group, and (0.058 ± 0.003 ), (0.063 ± 0.005),(0.039 ±0.002), (0.038 ±0.003), (0.038 ±0.003), (0.004 ±0.001) ml/s in ESS group respectively,and there was no significant difference between the two groups(P ＞ 0.05 ). The correspond cardiac cycle of systolic period downward peak flow rate, correspond cardiac cycle of diastolic period upward peak flow rate, mean cardiac cycle were (40.890 ± 37.096), (501.026 ± 19.374), (719.511 ± 14.946) ms in control group,and (35.921 ±6.218), (531.553 ± 16.764), (770.700 ±21.579) ms in ESS group,and there was no significant difference between the two groups (P ＞ 0.05 ). Conclusion Part of CSF flows into the area of saddle in ESS patients, but it has no effect on CSF indexes in area of cerebral aqueduct.
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Objective: To study the correlation between MR perfusion imaging and pathology after transcatheter arterial chemoembolization (TACE) using VX2 liver cancer model and to provide a theoretical basis to evaluate the curative effect of TACE. Methods; Fifteen New Zealand white rabbits (weight: 2.5-3.0kg) were randomly divided into three groups, with 5 in each group (group 1, pre-TACE; group2, 3 days after TACE; group 3,1 week after TACE). The rabbit VX2 hepatic carcinoma models were presented in all rabbits. All of the three groups received TACE at three weeks after the tumor was implanted. The MR perfusion imaging was performed before chemoembolization, at 3 days and 1 week after chemoembolization respectively for group 1, 2 and 3. Each animal was then sacrificed for pathology observation after MR examination. Results: The lesions assessed before TACE were hyperintense compared with the surrounding liver parenchyma on DWI images. The volume of neoplastic cells became large. Nucleus was hypertrophic with different size and shape. Phase of nucleous mitosis showed in many cells and necrosis was hardly seen. No obvious difference was found between the peripheral area and the core area. At 3 days after TACE, the heterogeneous hypo-intense was observed on DWI images. Many nuclear fragmentation and caryolysis appeared on pathology. Neoplasm necrosis was seen. At 1 week after TACE, the heterogeneous hypo-intense areas became larger. Light microscopy showed incomplete necrosis. There were increased karyopycnosis and nuclear fragmentation. Conclusion: MR perfusion imaging of VX2 liver cancer corresponds well with pathology and can reflect the outcome of liver cancer after TACE.
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Objective To evaluation of the result of transplantation of BDNF gene transfected olfactory ensheathing cells (OECs) to repair spinal cord injury (SCI). Methods The rat with SCI were divided into non-OECs, OECs and transfected OECs groups. The evidences of anatomical regeneration across the transection site were demonstrated by both neuronal tracing and immunohistochemical methods. Results 12w after implantation the retrograde labeling study with flurogold showed abundant labeled neurons in the superior part of CNS. There were a lot of labeled neurons in the intermediate zone and dorsal column of lower thoracic spinal cord rostral to the transection site. Labeled neurons were also observed in the upper thoracic and cervical spinal cord, reticular nucleus and raphe nucleus of oblongata, as well as reticular nucleus and parabrachial nucleus of pons. The anterograde labeling of PHA-L showed that regenerated fibers of upper neurons overcame glial scar and regrew into the distal part of spinal cord through the grafts. Some labeled fibers extended long enough to the caudal gray matter of the transected site. Conclusion The implantation of OECs transfected by BDNF gene may benefit the survival and regeneration of the injured axons, and accelerate the repair of the injured spinal cord in a more efficient way than that with OECs alone.