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Objective To evaluate the efficacy of DSA-guided percutaneous transhepatic gallbladder catheter drainage (PTGCD) in treating aged patients with acute cholecystitis complicated by severe diseases. Methods The clinical data of 15 aged patients with acute cholecystitis or complicated by severe diseases, who were encountered at authors’ hospital in the past three years and were treated with PTGCD, were retrospectively analyzed. The clinical results were discussed. Results PTGCD was successfully accomplished with single procedure in all 15 patients. Abdominal pain was relieved within one to three days, and the abdominal symptoms and signs subsided or disappeared. Reexamination of routine blood test showed that the white blood cell count decreased to normal range in 1 - 2 weeks, and complete cure was achieved in some patients. Secondary surgery was carried out in some patients after the clinical condition was improved. During the follow-up period no complications occurred in all patients except one who developed biliary leakage after the catheter was retrieved two weeks after the treatment. Conclusion For the treatment of complicated acute cholecystitis in aged patients who are not suitable to receive surgery, DSA-guided percutaneous transhepatic gallbladder catheter drainage is an ideal therapeutic means as it can significantly relieve clinical symptoms.
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Objective To evalute the feasibility of treatment for rabbit model with hepatic cirrhosis by transplantation of autologous bone marrow-derived stem cells via the hepatic artery and evaluate the effect of hepatocyte growth-promoting factors (pHGF) in the treatment of stem cells transplantation to liver cirrhosis.To provide empirical study foundation for future clinical application.Methods Chronic hepatic cirrhosis models of rabbits were developed by subcutaneous injection with 50% CCl4 0.2 ml/kg.Twenty-five model rabbits were randomly divided into three experimental groups,stem cells transplant group (10),stem ceils transplant + pHGF group (10) and control group (5).Autologous bone marrow was harvested from tibia of each rabbit,and stem cells were disassociated using density gradient centrifugation and transplanted into liver via the hepatic artery under fluoroscopic guidance.In the stem cells transplant + pHGF group,the hepatocyte growth-promoting factor was given via intravenous injection with 2 mg/kg every other day for 20 days.Liver function tests were monitored at 4,8,12 weeks intervals and histopathologic examinations were performed at 12 weeks following transplantation.The data were analyzed using analysis of variance Results Following transplantation of stem cells,the liver function of rabbits improved gradually.Twelve weeks after transplantation,the activity of ALT and AST decreased from (73.0±10,6)U/L and(152.4± 22.8) U/L to (48.0±1.0)U/L and(86.7±2.1)U/L respectively; and the level of ALB and PTA increased from (27.5 ±1.8)g/L and 28.3% to (33.2 +0.5)g/L and 44.1% respectively.The changes did not have statistically significant difference when compared to the control group(P >0.05).However,in the stern cellstransplant + pHGF group,the activity of ALT and AST decreased to (43.3±0.6)U/L and (78.7±4.0)U/L respectively and the level of ALB and PTA increased to (35.7 ±0.4)g/L and 50.5% respectively.The difference was statistically significant when compared to the control group(F=47.38,23.52,52.27,174.45,P < 0.05).In pathohistology,the degeneration and necrosis of hepatic cells and the degree of fibrous hyperplasia in stem cells transplant group were less obvious than that of the control group.Hepatic pseudo-lobules persisted.The improvement of liver architecture in the stem cells transplant + pHGF group was more evident than that in stem cells transplant only group.In addition,there were more hepatic CD34 <'+> cells within liver tissue in the stem cells trasplant group when compared to the control group,and the most hepatic CD34<'+> cells were seen in the stem cells transplant + pHGF group.Conclusion Autologous bone marrow stem cells transplanted via the hepatic artery for the rabbit hepatic cirrhosis model is an effective method to treat hepatic cirrhosis.The hepatoeyte growth-promoting factor can help to enhance the results of treatment.
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Purpose:To study the angiographic characteristics and mechanism of shunt stenosis-occlusiion after TIPSS.Materials and methods:Eighty-nine portal venograms were obtained in 58 patients.Venograms analysis had been performed according to shape,position and degree of shunt stenosis.Results:Thirty-six shunt abnormaloties were found in the portal venograms of 58 patients,Shunt stenosis(diameter
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Purpose:To evaluate the effect of metallic stent in the treatment of malignant stricture in esophagus and cardia.Materials and Methods:Treated by metallic stent:14patients with malignant stricture in esophagus and cardia,13 males and 1 female aged ranged from 57 to 81,were discussed in this article.Among 12 patients,8 were proved as esophageal squamous carcinoma,4 as esophagus adenocarcinoma,and 1 was complicated with esophagotrachial fistula,l0 of the pa- tients could take fluid food and 4 only water.After catheterizing from mouth,the strictured portions dilated with hallon catheter,15 selfmade Z stents coveted with dacron and 1 strecker stent were in 13 and 1 patients respectively.Results:All stems were successfully placed.Patients could eat more easily after the operations.The esophogotrachial fistula was completely sealed.The average lifetime after the operation was 5.5 months.Conclusions:Metallic stent prosthesis is an effective method to treat malignant stricture in esophagus and cardia,and could elevate the life quality of patients sig- nifieantly.
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Purpose: To evaluate the feasibility of interventional biopsy, the component of stenotic tissues of shunt tract and mechanism of shunt stenosis. Materials and Methods: The pathologic specimens of stenotis shunt tract were obtained in 10 patients with catherization endovascular biopsy clamp and atherectomy methods, then they were undergone routinely with HE stain and immunocytochemical stain, and observed procedures under microscope. Rusults: all of interventional biopsy were succeeded without complication. The microscopies, findcarge of stenotic tissue were primarily composed of fibrotic granulations and thrombi with inflammatory cells and exuberant foam cells derived from endothelial cells, smooth muscle cells and rhagiocrine cells. Conclusion: 1)The interventional biopsy is a safe and effective method. 2)The stenosis in parenchymal tract is related to thrombosis and tissue orangnization.