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Objective To investigate the digital subtraction angiography (DSA) manifestations and clinical value of interventional embolization of renal artery with severe hemorrhage following percutaneous nephrolithotomy (PCNL).Methods 34 patients with severe hemorrhage following PCNL from Feb 2012 to Jun 2015 were subjected to perform renal arterial DSA, which was followed by super-selective renal arterial embolization (SRAE) with steel micro-coils and guglielmi detachable coils together with or without biological glue (GLUBRAN2). The patients were followed up for 6 ~ 12 months.Results Of the 34 patients, DSA examination showed that renal artery pseudoaneurysm (RAP) was found in 22 (64.7%), renal arteriovenous ifstula (RAVF) in 8 (23.5%) and RAP associated with RAVF in 4 (11.8%). Successful embolization with single session was achieved in all 34 patients. Both the technical success rate and the hemostasis rate were 100.0%. Meanwhile, the renal tissue and function were mainly reserved and no serious complication of embolization was observed. No hematuria recurrence or renal function failure appeared in all patients during the follow-up period. In 26 patients, different degree of embolism syndrome was observed after the treatment.Conclusions Renal artery pseudoaneurysm and renal arteriovenous ifstula are the main types of renal artery injury resulting in severe hemorrhage after percutaneous nephrolithotomy. Super-selective renal arterial embolization (SRAE) with steel micro-coils and guglielmi detachable coils together with or without biological glue (GLUBRAN2) is a minimally invasive method that can promptly stop the renal bleeding, and preserve the renal tissue and function to the greatest possible advantage. Therefore, this technique should be regarded as the ifrst choice in the treatment of the patients who suffered from severe hemorrhage occurred after PCNL.
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Objective: To study effects of tertiary rehabilitation training on upper limb motor function recovery in patients with cerebral hemorrhage.Methods: A total of 120 patients with cerebral hemorrhage, who were treated in our hospital from May 2013 to May 2015, were selected.According to random number table, they were randomly and equally divided into routine rehabilitation group and tertiary rehabilitation group, and both groups received the same routine medical treatment and nursing.Simple test for evaluating hand function scale (STEF), Fugal-Meyer motor assessment (FMA) and Brunnstrom limb motor function assessment were used to assess and compare limb recovery after rehabilitation training between two groups.Results: At the end of first month of rehabilitation training, there were no significant difference in STEF and FMA scores between two groups, P>0.05 both.On the end of second month of rehabilitation training and later, compared with routine rehabilitation group, there were significant rise in STEF score[end of second month: (3.3±0.5) scores vs.(4.2±1.1) scores, end of sixth month: (6.3±1.2) scores vs.(8.5±1.1) scores], total STEF score[(20.2±4.2) scores vs.(38.2±3.5) scores]and FMA score[end of second month: (28.4±3.6) scores vs.(33.4±2.7) scores, end of sixth month: (38.2±6.6) scores vs.(46.3±5.8) scores]in tertiary rehabilitation group, P<0.05 all.Compared with routine rehabilitation group after six-month rehabilitation training, there were significant rise in percentages of Brunnstrom stage V (23.33% vs.43.33%) and stage VI (6.67% vs.20.00%) in tertiary rehabilitation group(P<0.05 both).Conclusion: Tertiary rehabilitation training can significantly improve upper limb motor function in patients with cerebral hemorrhage, so it's worth extending.
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Objective To investigate the expression and significance of CCR9/CCL25 pathway in acute rejection of mouse skin transplantation.Method BALB/c mice and C57BL/6 mice were selected as allogeneic and syngeneic skin graft donors and C57BL/6 as recipients,then established a murine skin transplantation model of acute rejection.Allogeneic transplant recipient mice were injected with an AntiCCL25(2 g,as experimental group) mAb or IgG(2 g,as control group) every other day via tail vein,a total of 10 injections.The transplanted graft was scored visually daily,and then we collected skin graft and spleen from recipient mice of each group at 3,5,7 days after transplantation.HE staining was done to analyze necrosis of skin tissue Confocal and immunohistochemistry were also used to measure CCR9 and CCL25 expression in recipient skin grafts.Result HE staining indicated that there was a widespread inflammatory cell infiltration in the skin from allo-transplantation mice,and CCR9 expression measured by immunohistochemistry and confocal was significantly elevated in the surface of the infiltrated CD3 + T cells from skin grafts tissue and spleen.Neutralization of CCL25 with Anti-CCL25 mAb significantly prolonged allogra,ft survival and markedly reduced inflammation.Conclusion CCR9 was highly expressed in the spleen and skin grafts tissue of allogeneic transplanted mice Neutralization of CCL25 by intravenous injection of Anti-CCL25 monoclonal antibody significantly prolonged skin allograft survival.Our study indicates that CCR9/CCL25 pathway is involved in acute rejection process of skin transplantation model in mice were used as syngeneic and skin grit skin graft donor mice.
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Objective To discuss the X-ray characteristics of triple negative breast cancer(TNBC)for improving the diagnostic level.Methods 105 cases of TNBC which confirmed by pathology and immunohistochemistry were analyzed their X-ray performance and clinical pathology.Results (1)The main pathologic types of TNBC was infiltrating ductal carcinoma(64 cases,61.0%),secondly was medullary carcinoma(24 cases,22.9%).(2)The X-ray manifestations of this group were mainly the mass shape(78.1 %).Nearly half of them had clear edge(46.3%).And 24.4% were tumor with calcification.(3)The calcification in TNBC was rare and the distribu-tion mainly for regional or cluster,while the morphology was mainly for malignant and suspicious for malignancy.(4)The X-ray per-formance characteristics of infiltrating ductal carcinoma and medullary carcinoma in TNBC had differences in tumor morphology and edge(P <0.05).Conclusion (1)The X-ray manifestations were always the circular similarity of tumor with clear edge in TNBC.(2) The proportion of medullary carcinoma is larger in TNBC,and the X-ray manifestations is more likely show as benign lesions.(3) The calcification probability is lower in TNBC,and the calcification form is mainly as suspicious for malignancy and malignant.
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Objective To analyze the reasons of catheter fracture of implantable vascular access devices and to explore the prevention and handling measures. Methods A retrospective analysis was carried in 3 887 adult patients with implantable vascular access devices and 13 had catheter fracture. The clinical features and causes were analyzed and the successful handling measures were summarized. Results Of 3 887 cases, a total of 13 (0.33%) catheter fracture occurred. The incidence rate of catheter fracture via subclavian jugular venipuncture was 3.70%,(6/162) , via internal jugular venipuncture was 0.18% (7/3 725), via internal jugular venipuncture was significantly lower than that via the subclavian venipuncture (χ2=47.505,P=0.000). There had no statistical differences between the left and right of the two puncture ways(P=0.707,0.682). Conclusions Catheter fracture is one of the serious complications in the process of use and maintenance of implantable vascular access device. Choosing appropriate surgical method, strengthen maintenance education, specificating the operation procedure, closing observation and other measures can not only reduce the occurrence of the catheter fracture, but also can dealt with catheter fracture in time, which could ensure the safety of patients' life.
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Objective To investigate the sensitivity and specificity of different methods for the detection of mycoplasma pneu‐moniae .Methods The serum and throat swab specimens were collected from 199 pneumonia patients .ELISA and real‐time fluores‐cence quantitative polymerase chain reaction (FQ‐PCR) assays were used to detect the serum mycoplasma pneumoniae IgM antibod‐y and DNA .Results Among 199 pneumonia patients ,61 cases were diagnosed as mycoplasma pneumoniae pneumonia according to the diagnosis standard .The sensitivity and specificity of ELISA and FQ‐PCR for detecting mycoplasma pneumoniae were 86 .9%and 96 .7% ,and 78 .3% and 97 .1% ,respectively .Conclusion The sensitivity and specificity of FQ‐PCR for detecting mycoplasma pneumoniae are higher than those of ELISA .
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Objective To study the association between the cerebral infarction and the angiotensin converting enzyme (ACE) gene rs4646994 and rs35397082 polymorphisms in Binhai area ,Tianjin .Methods Gene sequencing and DNA electrophoresis were used for the detection of the ACE gene single nucleotide polymorphisms (SNPs)(rs4646994 and rs35397082) .53 samples from pa‐tients with acute cerebral infarction and 53 samples from healthy volunteers were used in our study .Serum sample were collected from each group and tested by ACE ELISA .Results There were only deletion type of rs35397082 SNP in both of the control and cerebral infarction group .In the control group ,the number of insertion type of rs4646994 was 45(84 .91% ) ,deletion type was 8(15 . 09% ) and in the patients group ,the number of insertion was 47(88 .68% ) and the deletion was 6(11 .32% ) .There was no signifi‐cant difference between the patients group and the healthy donors (P>0 .05) .The concentration of ACE in control group was high‐er than the patients with acute cerebral infraction (P<0 .05) .Conclusion There is no significant association between the ACE gene polymorphisms(rs35397082 and rs4646994) and cerebral infarction in Binhai area ,Tianjin .The different concentration of ACE is not caused by these two SNPs .In this study ,these two SNPs are not the are not the risk factors of the cerebral infarction in Tianjin based on our study .
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Objective:To investigate the mRNA and protein expressions of steroid sulfatase (STS) in breast cancer tissues and normal breast tissues, and analyze its relationship with clinicopathologic characteristics. Methods:The mRNA and protein expressions of STS, in 40 cases of breast cancer tissues and corresponding paracancerous normal breast tissues, were examined by reverse transcription-polymerase chain reaction(RT-PCR)and immunohistochemistry. The correlation of STS expression level with clinicopathologic characteristics was analyzed. Results:STS protein was mainly expressed in the cytoplasm of breast carcinoma cells and epithelial cells in normal breast glands, but not in the stroma. It could be detected in the nucleus of carcinoma cells in 3 cases of breast cancer tissues, which was pathologically classified as invasive ductal carcinoma, invasive lobular carcinoma, and invasive micropapillary carcinoma. STS was not observed in interstitial tissues of breast glands. STS protein expression had positive correlation with its mRNA expressing level. The positivity of STS was 70.0% in breast cancer tissues, significantly higher than that of normal breast tissues (42.5%). The difference was significant (P =0.013). Stratified analysis showed that the positive rates of STS protein were significantly higher in premenopausal patients, the patients with lymph node metastasis, and those with advanced breast carcinoma than those in the matched normal breast tissues (P<0.05). Conclusion:Breast cancer tissues highly expressed STS protein to stimulate local estrogen production, thereby enhancing the progression and migration of breast cancer cells. In addition, as the tumor growth, locally biosynthesized estrogens may play more and more important roles.
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Objective: To investigate the correlation of thrombospondin-1(TSP-1) expression and angiogenesis and clinical pathologic factors in breast cancer. Methods:Reverse transcription-polymerase chain reaction (RT-PCR) was used to detect the expression of TSP-1 mRNA in the primary breast cancer tissues and the tissues set apart 5 cm from the tumor. Im-munohistochemistry was used to detect the expressions of vascular endothelial growth factor (VEGF), c-erbB2, estrogen receptor (ER), progesterone receptor (PR) and microvessel density (MVD). All data were statistically analyzed. Results: The positive rate of TSP-1 was significantly higher in breast cancer than that in tissues set apart 5 cm from tumor (P < 0.05). The expression of TSP-1 was positively correlated with tumor size only (P < 0.05). MVD was lower in TSP-1 positive group than that of negative group (P< 0.05). Conclusion: The MVD was decreased with up-regulation of TSP-1 expression. Thrombospondin-1 may repress the angiogenesis in breast cancer.
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Objective To compare the effect of pedicles screw fixation through entry point of the “人" shape crest and traditional entry point (Weinstein method). Methods Ninety-two patients of lumbar spine disorders were treated by pedicles screw fixation combined with bone grafting through posterior approach. The screws were placed through the traditional entry point among 45 patients (group A, transverse process method, 186 screws), the others were through entry point of the “人" shape crest (group B, “人" shape crest method, 196 screws). The condition of accuracy of screw placement, operation time, bleeding amount and injury were compared. Results All patients accepted the examination of X-ray and CT scan after operation. The rate of screw bad placement was 6.5% in group A and 2.0% in group B, the incidence of injury of nerve and blood vessel was 8.9% in group A and 2.1% in group B. The accuracy of screw placement, operational time and bleeding amount in group B were significantly better than those in group A (P
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Objective:To further study concentration-response relationship between daily mortality and particulate air pollution,to provide scientific basis for making policy.Methods:We applied spline model to daily time-series data for Taiyuan city,China from 2004-2005,using concentration of particulate matter less than 10 ?m in aerodynamic diameter(PM10)as the exposure measure,and controlling confounding factors,such as season,meteorological factors,day-of-the-week,other air pollutions,etc.Results:The spline model showed a non-linear relationship for the relative risks of death for all causes(total deaths)and for specific causes in relation to PM10 concentration,and obtained threshold levels.For total mortality,malignant tumor mortality and cardiovascular-cerebrovascular-respiratory mortality,the threshold levels were 85.00 ?g/m3,89.59 ?g/m3,122.54 ?g/m3,respectively,using the value of differential deduction.Conclusion:Our nonlinear models are appropriate for assessing the effect of particulate air pollution on daily mortality at current ambient levels in Taiyuan,China,in contrast to those of Europe and America.
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Objective To evaluate the clinical applied value of spiral CT during arterial portography(SCTAP)in evaluating the surgical resectabitity of the hepatocellular carcinoma(HCC).Methods 23 patients with focal hepatic lesions (including HCC 21 cases) were examed with SCTAP,convenient CT and DSA.The difference and the sensitivity in detecting the number of lesions by these three examied methods were comparatively analysed.Results SCTAP had significant difference in comparision with convenient CT and DSA (?0.05) when the lesions were more than 30.0 mm in diameter.21 cases of HCC hepatic metastatic lesions were not found by SCTAP in 9 cases,they chosen the surgical treatment,and 12 cases underwent the interventional trans-catheter artenial chamical embolism(TACE),because of hepatic metastasis showed by SCTAP.Conclusion SCTAP is of high sensitivity in showing small hepatocellular carcinoma and small liver metastatic lesion in comparision with convenient CT and DSA,and it is of great clinical applied value in judging the patients with HCC whether can be or not be treated by surgery.
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Objective To observe the clinical value and the effect of interventional treatment on obstructive jaundice. Methods 24 patients with obstructive jaundice, including 21 cases of malignant biliary obstruction and 3 cases of chololithiasis post operative biliary stricture of bile duct, were treated after percutaneous transhepatic biliary moulding, 6 cases with percutaneous transhepatic cholangic drainage(PTCD), 18 cases with insertion of biliary stents, 13 net-type stents and 5 Z-type stents were used, according to the patient's state and financial condition. Results The total technical success rate was 100%. After 7～15 days of interventional treatment, the total serum bilirubin level declined from (454 93?64 52)?mol/L to (66 94?8 45)?mol/L, transaminase declined from (265 67?30 09)u/L to (56 21?8 73)u/L. There was very significantly difference (P
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Objective To assess clinic value of esophageal stent placement in the benign and malignant esophageal strictures,and the influence of stents selection on curative effect. Method 36 cases of esophageal strictures, 5 cases of benign strictures,31cases of malignant strictures,including 4 cases with esophagotracheal fistula and 3 cases with esophagomediastrinal fistula. 26 domestic Nickel-Titanium alloy memorial netlike stents and 14 membrane-covered stents were used for the treatment. All patients were treated by placing esophageal stent perorally under fluoroscopic guidance. Results 40 stents were planced successfully in 36 cases, only one case showed membrane covered stent migrating. Symptoms of dysphagia were considerably relieved after stent insertion. The total effective rate was 97.2%. Conclusion The esophageal stent is an effective and safe treatment for benign and malignant esophageal stenosis: The nutritive condition and the quality of life of patients are improved, which is favourable for tumor further treatment. Appropriate stent selection can keep esophageal patent rate and decrease sliding rate.