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Arsenic trioxide (ATO) is involved in a variety of biological processes of hepatocellular carcinoma (HCC) cells, including apoptosis induction, proliferation inhibition, invasion and metastasis inhibition, and tumor stem cell inhibition. ATO has a variety of therapeutic approaches in the treatment of HCC, mainly including single drug therapy, combined local therapy, combined systemic therapy, and so on. Further research on the anti-cancer mechanism and clinical application of ATO is expected to provide new ideas for the treatment of liver cancer.
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Many studies have proven that arsenic trioxide (As2 O3 )as a single agent is not effective against hepatocellular carcinoma (HCC).Many scholars believe that chemotherapy drug resistance of HCC to As2 O3 is the most important reason.The underlying drug resistance mechanism of HCC cells to As2 O3 remains unclear.Studies show that potential mechanism may be tightly associated with As2 O3 pharmacokinetics and properties of HCC tissues and complex molecular biology.
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Objective To investigate the safety and clinical efficacy of uterime artery chemoembolization in postpartum hemorrhage (PPH) caused by abnormal placental implantation.Methods Between December 2006 and September 2009, there were 23 cases of abnormal placental implantation with PPH in our hospital, among which 9 presented with continuous small amount of vaginal bleeding and 14 with acute excessive bleeding.The average bleeding time was (8±6) d and the mean blood loss was (980±660) ml.Abnormal placental implantation was confirmed by color Doppler ultrasound (CD-US) in all cases, the internal lilac artery angiography was performed to identify the uterine artery and bilateral uterine artery chemoembolization (UACE) with methotrexate (MTX) and gelfoam particles to the distal end of uterine artery was conducted after.CD-US rechecked all patients within 48 h after UACE and those patients with blurred margins between placenta and uterus and abnormal blood flow (> 1 cm×1 cm) received ultrasonic-guided per vagina MTX multipoint injections.All cases were followed up for 3-26 months (average 12 months) to observe vaginal bleeding, placenta tissue discharge, serum human chorionic gonadotropin (hCG), uterine involution, menses, and side-effects or complications.Results (1) Curative effect: These 23 cases underwent 24 procedures of UACE successfully and vaginal bleeding ceased at an average of (3.5±1.3) min after UACE.Reduced blood flow in the placental implantation area was detected under CD-US after UACE.Among the 23 patients, wterine curettage was required in 16 cases due to retained placenta tissues with the mean blood loss of (40 ± 28) ml during the operation, 2 underwent subtotal hysterectomy and confirmed to be placenta percreta by pathology examination, and placenta tissues were spontaneously discharged completely in 5 cases.Totally, 91% of the patients (21/23) reserved their uterus.(2) Follow-up: the serum hCG reduced to normal within 1-13 d after the placenta tissue were evacuated.Regular menstruation returned within 2-3 months in those patients who reserved uterus and normal size uterus was found under sonography at 3 months.No severe complication was reported except for some post embolization syndrome, such as pelvic pain or fever.Conclusions UACE, combined with ultrasonic-guided transvaginal MTX injection, is a safe, minimal invasive and quick hemostatic procedure in treatment of abnormal placental implantation with PPH, and allows the preservation of uterus possible.CD-US is helpful in evaluation of the blood flow changes before and after UACE in abnormal placental implantation patients.
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Objective To assess the value of selective renal arteriography and embolization in the therapy of nephrorrhagia diseases.Methods Fifteen patients of renal hemorrhages including 10 iatrogenic renal trauma,3 renal harmatoma and 2 renal closed injury with ineffective medical treatment underwent selective renal artery embolization.Results Renal artery an-giographies confirmed renal segmental arteries and/or their branches injuries.Gelatin sponge,PVA or steel coil were used for embolization.During 1-3 months fllowing-up,renal abscess was found in 2 patients without superselective embolization,while haematuria occurred in one case after embolization with gelatin sponge but stopped after medical treatment.The renal function of all patients were normal after embolization.Conclusion Superselective renal artery embolization has reliable effect and slight complication in the treatment of nephrorrhagia,especially suitable for patients after surgery and renal inadequacy.
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Objective To analyze the causes,treatment and prevention of operation-related complications in liver malignancy patients after CT-guided percutaneous microwave coagulation therapy (PMCT).Methods A total of 68 patients with liver malignancy underwent CT-guided PMCT and their complications were analyzed retrospectively.Results The tumor diameter was 2.0-13.8 cm,mean 6.2 cm.Transcatheter arterial chemoembolization (TACE) was performed before PMCT in 64 patients,and 68 patients received 120 times of PMCT (1-8 times per patient).The main untoward reaction of PMCT was vagus nerve accentuation.Seven patients (7/120,5.83%) had complications including needle-tract implantation (n=2),liver abscess (n=2),pneumatothorax (n=1),cardiovascular accident (n=l) and enormous biloma with infection (n=l),6 were treated finally,and implanted tumor advanced in 1 patient.Conclusion CT-guided PMCT in liver malignancies is a safe therapeutic option with low rate of operation-related complications,which can be prevented and treated.Complications of PMCT are associated with the needle tract,frequency,coagulation range and perioperative management.
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OBJECTIVE@#To evaluate the value of super-elective transcatheter external carotid arterial embolization (TAE) in the treatment of intractable epistaxis.@*METHOD@#Forty-six cases of intractable epistaxis were selected, TAE was performed in 36 cases and externa carotid artery ligation was elected in 10 cases.@*RESULT@#The curing rate was 88.9% (32/36) in cases treated by TAE and was 40.0% (4/10) in cased treated by external carotid artery ligation, and the average hospital days of the former was 4.8 days, while the latter was 10 days. Recurrency were effectively stopped bleeding by all kinds of methods, and complications were rare.@*CONCLUSION@#Transcatheter external carotid arterial embolization is a simple, safe and effective treatment for the intractable epistaxis, which has more advantages than external carotid artery ligation, and comprehensive methods can effectively and thoroughly cure intractable epistaxis.