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Objective To compare the efficacy of partial splenic embolization (PSE)with 150－350 μm and 350－560 μm polyvinyl alcohol (PVA).Methods A total of 24 patients were analyzed retrospectively in this study.Among them,9 patients underwent PSE with PVA of 1 50－350 μm (group A)and 1 5 patients with PVA of 350－560 μm (group B).Hematological parameters including white blood cell and platelet counts before and 1 week after surgery were compared between the two groups,as well as postoperative complications. Results The white blood cell and platelet counts were both significantly increased after 1 week of surgery compared with that before surgery (both P＜0.05).Furthermore,group A had obvious advantage over group B in increasing platelets (P＝0.05).The incidences of postoperative complications were 100% (9/9)in group A and 87% (13/15)in group B,respectively,but the incidence and severity of complications between two groups were comparable.Conclusion PSE with PVA of 1 50－3 50 μm has advantage in postoperative platelet improvement over PVA of 350－560 μm.
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Objective To study pharmacokinetics and tissue distribution of CalliSpheres Beads (CB) loaded Arsenic trioxide (ATO) on rabbit VX2 liver tumor by transcatheter arterial chemoembolization (TACE). Method Sixty four rabbits with VX2 liver tumors were randomly divided into 4 groups: control group, CB group, CBATO group and cTACE group. Blood samples were taken at specific time points after TACE.The blood concentration of ATO,liver and kidney functions were examined respectively. In each group, every 4 rabbits were sacrificed on 1 days,3 days,7 days and 14 days after operation. The tumor,liver,kidney, lung,heart and muscle were taken to detect the drug concentration. Bilateral t?test was used to compare the drug concentration in blood and tissue between CBATO group and cTACE group. Results Statistically,The levels of ALT and AST in group CBATO and cTACE on 1st,3rd and 7th days after TACE were significantly higher than those in CB group(ALT: F=25.872, 17.69, 7.016, AST: F=46.365, 32.385, 12.548, P<0.05) respectively. The ALT and AST levels in CBATO group were statistically lower than those in cTACE group (ALT: t=0.369, 0.432, 0.169, 0.353, AST: t=0.488, 0.593, P>0.05). There were no statistically significant differences in the levels of BUN and Scr between the four experimental groups at each observation time point. Statistically, 10 minutes and 20 minutes after TACE, the blood drug concentration inCBATO was significantly lower than that in cTACE (t=7.675, 6.461, P<0.001). while 12 hours after operation,blood drug concentration in CBATO group was higher than that in cTACE group. In tumor tissue,the concentration of ATO in CBATO was higher than that in cTACE,and there was no statistical differences on the 1st day after TACE(t=2.155, P=0.068), but there was a statistical differences between 3rd, 7th and 14th days (t=11.462, 7.624, 2.649, P<0.05). Conclusion CBATO could prolong the time of drug metabolism,increase the drug concentration in tumor tissue,and didn′t aggravate the damage of liver and kidney function.
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Objective To design a new integrated portable biliary internal-external drainage catheter carrying125 I seeds used for the treatment of malignant biliary obstruction lesions so as to achieve the dual curative effects of biliary drainage and brachytherapy. Methods A total of 15 patients with malignant obstructive jaundice, who were admitted to the First Affiliated Hospital of Zhengzhou University, China, during the period from September 2016 to January 2018, were enrolled in this study. Biliary stent implantation was performed in all patients, which was followed by insertion of a new integrated portable biliary internal-external drainage catheter carrying125 I seeds. The technical success rate, clinical success rate, complications, stent patency time and patient survival rate were evaluated. Results The placement of the drainage tube was simple and smooth, and the technical procedure was successful in all patients. One month after treatment, the bilirubin level was decreased significantly when compared with preoperative one (P<0.01), while the blood indexes and immunological indicators showed no obvious changes (P>0.05) . After treatment, 2 patients (13.3％) developed cholangitis and 2 patients (13.3％) had small amount of biliary bleeding, which returned to normal after symptomatic treatment. No severe complications such as perforation of bile duct, massive bleeding, radiation enteritis and radioactive source leakage, etc., occurred. The patients were followed up for 55-402 days, 6 patients (40.0％) developed biliary re-obstruction. The median patency time of stent was 255 days, and 6-month stent patency rate was 64.5％. Five patients died and 10 patients survived, the 9-month survival rate was 64.3％, the median survival time was 368 days. Conclusion By using the new integrated portable biliary internal-external drainage catheter carrying125 I seeds, the effects of bile drainage and brachytherapy can be simultaneously achieved. Preliminary clinical practice indicates that this new drainage catheter is feasible, safe and effective, although its long-term efficacy needs to be clarified with further follow-up observations and controlled studies.
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Objective To evaluate the necessity of prophylactic uterine artery embolization (UAE) before curettage in treatment of cesarean scar pregnancy (CSP).Methods A total of 142 patients with CSP were enrolled and divided into 3 groups according to Adler grading standard,including little vascularity (grade 0-Ⅰ,n=40),moderate vascularity (grade Ⅱ,n=41) and rich vascularity groups (grade Ⅲ,n=61).All patients were treated with curettage or prophylactic UAE before curettage.The differences of age,times of cesarean section,time to last cesarean section,intraoperative blood loss and success rate of therapy were compared between different treatment methods in each group.Results There was no statistical difference of age,times of cesarean section,time to last cesarean section,intraoperative blood loss and success rate of therapy between curettage and prophylactic UAE before curettage in little vascularity group and moderate vascularity group (all P＞0.05).Compared with curettage,the success rate of prophylactic UAE before curettage was higher and the intraoperative blood loss was lower in rich vascularity group (both P＜0.05).There was no statistical difference of age,times of cesarean section nor time to last cesarean section in rich vascularity group (all P＞0.05).Conclusion It is necessary to perform prophylactic UAE before curettage for cesarean scar pregnancy patient with rich vascularity,which is helpful to reduction of intraoperative blood loss.
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Objective To investigate the safety and feasibility of the interventional therapy on hemobilia induced by hepatic artery pseudoaneurysm(PsAn).Methods The clinical data of 28 patients with hemobilia in our department was analyzed retrospectively.All the patients were firstly treated with internal medicine,and then treated by interventional therapy.The angiography clearly displayed the shape,size and location of the PsAn,and superselective embolism was performed during the operation.The symptomatic treatment and the bile duct drainage were performed after operation.Postoperative follow-up time was 1-3 6 months,and the follow-up endpoint was the death of patient.Results 28 patients were diagnosed as hepatic artery PsAn.The interventional embolization therapy on hemobilia was completely effective.A total of 110 spring coils were applicated in the study,there was no complication related to interventional therapy.One patient with hilar cholangiocarcinoma was dead due to infection and liver failure after four weeks of operation.Two patients with choledochal carcinoma died of tumor progression after 11.5 and 14.2 months of interventional therapy,respectively.In addition,2 patients with gastric carcinoma died of tumor progression after 4 and 6.5 months of operation,respectively,and 1 patient with common bile duct stones who underwent laparoscopic surgery died of complications of coronary heart disease after 5 months of interventional therapy. The other patients all had satisfactory therapeutic effect and recovered well.Conclusion The interventional therapy has definite therapeutic effect on hemobilia induced by hepatic artery PsAn.The technique is worthy of popularized clinically due to its features of simplicity,safety and reliablity.
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The effect of 131I therapy for primary and metastatic lesions of thyroid carcinoma depends on the ability of iodine uptake.The loss or down-regulation of iodine-metabolizing genes represents dedifferentiation of DTC,which results in the disability to take up and accumulate 131I and eventually leads to radioiodine-refractory DTC (RR-DTC).The management of RR-DTC is extremely difficult and the prognosis is poor.It is important for the treatment and prognosis of RR-DTC to investigate the mechanism of redifferentiation.The up-regulation of thyroid iodine-metabolizing genes expression,inhibition of the changes in epigenetic modifications and intervention of the abnormal activation of signaling pathways are reviewed in this article.