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Objective To investigate the expression and significance of inducible nitric oxide synthase (iNOS), platelet-derived growth factor (PDGF)-B and lipopolysaccharide (LPS) in rat models with Budd-Chiari syndrome (BCS) . Methods BCS model was established by partial ligation of inferior vena cava in the posterior segment of the liver. The experimental rats were divided into control group (n=20), model group (n=20) and sham group (n=20) . Liver tissues were collected for immunohistochemistry, HE and Masson staining, and the expression levels of iNOS, PDGF-B and LPS were determined. Results The LPS value in model group was higher than that in both control group and sham group (P=0.001) . The mRNA and protein expressions of iNOS and PDGF-B in model group were higher than those in both control group and sham group (P=0.001) . Statistically significant differences in mRNA and protein expressions of iNOS and PDGF-B existed between each other among the subgroups (P=0.001) . In model group iNOS was positively correlated with PDGF-B and LPS; liver fibrosis was positively correlated with LPS and negatively correlated with PDGFB. Conclusion The damage and repair of BCS is a complicated process. The iNOS, PDGF-B and LPS may play different roles in different stages of BCS. How to regulate their balance in liver fibrosis may be a direction that deserves further study.
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Objective To evaluate the success rate,vascular patency time and their influencing factors of percutaneous transluminal angioplasty (PTA) in treating swollen hand syndrome in hemodialysis patients.Methods The clinical data of 16 hemodialysis patients with swollen hand syndrome,who were admitted to authors' hospital during the period from May 2015 to March 2017 to receive PTA,were retrospectively analyzed.The technical success rate,the follow-up primary vascular patency time and primary patency rate were calculated,and the factors influencing technical success rate and vascular patency time were analyzed.Results Venography with DSA revealed that a total of 16 segments of venous stenosis or occlusion were found in 16 patients,including 6 stenotic lesions and 10 occlusive lesions.Successful PTA was obtained in 14 patients,including one patient whose angiography performed immediately after PTA with balloon dilatation showed that the stenosis was still over 50％,and stent implantation had to be carried out.The technical success rate was 87.5％,in 2 patients PTA failed as the guide wire could not pass through the long segment of vascular occlusion.The 14 patients were followed up for 3-24 months,and the median patency time was 10.5 months.The 3-,6-and 12-month primary patency rates were 71.4％ (10/14),57.1％ (8/14) and 42.9％ (6/14) respectively.Univariate analysis indicated that the length of occlusive segment and the balloon pressure required for angioplasty were the potential factors that affected the postoperative vascular patency time.Conclusion For the treatment of swollen hand syndrome in hemodialysis patients,PTA is safe and effective,although long-term vascular patency rate needs to be further improved.
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Objective To discuss the perioperative nursing measures for patients with osteoporotic vertebral compression fractures who are receiving percutaneous vertebroplasty (PVP) treatment by using high viscosity bone cement.Methods A total of 30 patients with osteoporotic vertebral compression fractures were included in this study.All patients were treated with PVP by using high viscosity bone cement.Preoperative routine nursing,psychological intervention,dietary intervention,postoperative guidance of rehabilitation exercise of limbs,close observation of bone cement leakage were strictly implemented,and the corresponding nursing measures were promptly taken when needed.Results Through strict implement of the nursing intervention all 30 patients could actively cooperate with PVP treatment,and after PVP the pain was significantly relieved in all patients.Conclusion Adequate preoperative preparation,proper postoperative guidance,careful observation and effective nursing can help the patients resume their daily life activities as soon as possible,relieve the pain,and improve the quality of life as well.(J Intervent Radiol,2017,26:274-276)
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Objective To discuss the advantages of postoperative early ambulation for patients after high-viscosity bone cement injection treatment for osteoporotic vertebral compression fracture.Methods A total of 42 patients with osteoporotic vertebral compression fracture were divided into the study group (n=21)and the control group (n=21).High-viscosity bone cement injection was used to perform percutaneous vertebroplasty for the patients in the study group,while low-viscosity bone cement injection was adopted to complete percutaneous vertebroplasty for the patients in the control group.The patients of the study group were asked to get out of bed in 4 hours after vertebroplasty and to do off-bed activity in 8 hours after vertebroplasty,while the patients of the control group were asked to get out of bed in 12 hours after vertebroplasty and to do off-bed activity in 24 hours after vertebroplasty.CT reexamination was performed within 3 days after vertebroplasty to observe the paravertebral leakage and the cement distribution in vertebrae.The visual analogue scale (VAS),the ability score of daily life activy (Barthel),the risk score of pressure skin ulcer (Braden) and the risk rating of deep venous thrombosis were used to evaluate the clinical effectiveness for both groups.Results The procedure of vertebroplasty was successfully accomplished in all patients of both groups.No statistically significant differences in VAS score and in Barthel score at 24 hours and 7 days after vertebroplasty existed between the two groups (P＞0.05).Eight days after vertebroplasty,the differences in Barthel score,Braden score and the risk rating of deep venous thrombosis between the two groups were statistically significant (P＜0.05),although the difference in VAS score between the two groups was not statistically significant.Conclusion In treating osteoporotic vertebral compression fracture by using high-viscosity bone cement injection,postoperative early ambulation can effectively improve the patient's daily activities,reduce the risk of the formation of pressure skin ulcer and deep vein thrombosis,thus,reduce the nursing workload for both nurses and patient's family members.(J Intervent Radiol,2017,26:749-752).
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Objective To retrospectively analyze the correlation between uterine fibroid and ovarian blood supply, and to discuss the visualization of ovarian artery and uterine ovarian branch in uterine arterial embolization. Methods A total of 363 patients with clinically-confirmed uterine fibroid were enrolled in this study. Uterine arterial embolization was carried out in all patients. The visualization of ovarian artery and uterine ovarian branch during angiography was recorded. After the procedure the changes of uterine fibroid and ovarian functions were followed up. The results were statistically analyzed. Results The blood supply of uterine fibroid could be divided into three types: unilateral artery as the main source of blood supply (34.16%), bilateral balanced blood supply (43.80%) and unilateral uterine artery (22.04%). The visualization rate of uterine ovarian branch in bilateral balanced blood supply type was significantly higher than that of other two types (P<0.05). The visualization rate of ovarian artery at the side which was lack of blood vessels was higher than that at the opposite side (P< 0.05). Transient ovary functional impairment was observed in patients with visualization of uterine ovarian branch, which restored to normal in three months. No significant difference in the reduction of the tumor mass existed between each other among the different blood supply types. Conclusion The blood supply types of uterine fibroids have a parallel relationship with the ovarian blood supply from ovarian artery and/or uterine ovarian branch. Special attention should be paid to the uterine arterial embolization of the side that is lack of blood vessels, and it is needed to carefully observe the embolization extent, the flow velocity, etc. during the performance of embolization so as to avoid ovarian function impairment.
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Objective To evaluate the clinical effect of DSA-guided foam sclerotherapy for lower extremity varicose veins.Methods A total of 41 legs in 26 patients with lower extremity varicose veins were treated with foam sclerosing agent of lauromacrogol un-der DSA guidance.4 cases with venous return disorder (3 in iliac vein and 1 in inferior vena cava)were treated with balloon dilatation first,and then lauromacrogol foam sclerotherapy after 24 hours.For injection method,2 patients were injected sclerosing agent through a catheter inserted in the trunk of great saphenous vein of sick limb with retrograde catheterization,and the others were in-j ected sclerosing agent directly in the varicose veins.Results The sclerotherapy was successfully accomplished in all affected limbs of 26 patients.The average dose of lauromacrogol for each patient was 5.88 mL.No serious complications occurred during and after operation.In 1 to 12-month follow-up,varicose veins disappeared in 24 patients (92.3%),the soreness,fatigue and pigmentations disappeared in all patients,the ulcer healed in all limbs.Conclusion DSA-guided foam sclerotherapy is a micro-invasive,safe and ef-fective treatment for lower extremity varicose veins.
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Objective To evaluate the safety and efficacy of percutaneous endobiliary radiofrequency ablation combined with biliary stenting in treating malignant obstructive jaundice. Methods Percutaneous endobiliary radiofrequency ablation combined with biliary stenting was carried out in 2 patients with malignant obstructive jaundice after they received percutaneous transhepatic biliary drainage. The curative effect, complications and stent patency at 50 days after the treatment were recorded. The results were analyzed. Results Successful endobiliary radiofrequency ablation and intraluminal stent implantation was accomplished in both patients, with a technical success rate of 100%. Segmental radiofrequency ablation procedure was employed. After the treatment the serum total bilirubin level was significantly decreased. No bile duct bleeding, perforation of bile duct, bile leakage or other serious complications occurred. The stent remained unobstructed during the follow - up period of 50 days. Conclusion As a new treatment for malignant obstructive jaundice, percutaneous endobiliary radiofrequency ablation combined with biliary stenting is clinically safe and effective, although its long - term efficacy needs to be further proved with randomized controlled trials.
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Objective To analyze CT portal venography (CTPV) manifestations of portal collateral circulation in patients with cirrhosis by using a 16-detector row spiral CT scanner. Methods CTPV was performed in 36 patients with portal hypertension due to cirrhosis, the diagnosis was proved by clinical data, hepatic function findings and imaging signs. By using post-processing reconstruction technique, 3D images of portal venous system and portal collateral circulation were obtained. Results CTPV images displayed the portal venous system and its collateral circulation stereoscopically. Of 36 patients, left gastric varices were seen in 29 (80.6%), lower esophageal varices in 18 (50.0%), short gastric or posterior gastric varices in 15 (41.7%),paraesophageal varices in 9 (25.0%), gastro-renal or splenorenal shunts in 8 (22.2%), sponge-like transformation of portal vein in 7 (19.4%), paraumbilical and abdominal wall varices in 6 (16.7%), congenital cavernous in 6 (16. 7%) and paravertebral venous shunts in 4 (11.1%). Conclusion CTPV can well display the site, extent and severity of the portal collateral circulation in patients with portal hypertension due to cirrhosis, which is of great clinical importance for judging the patient's condition, for selecting therapeutic protocols and for estimating prognosis.
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Objective To assess the therapeutic effect of cerebral aneurysmal embolization with electro-detachable platinum coils(EDPC), and to discuss the timing of the embolization and points for attention during the procedure. Methods From February 1999 to July 2004, 60 intracranial aneurysms were treated with EDPC in 58 patients, of which 56 cases were subject to subarachnoid hemorrhage (SAH). 36 patients were Hunt & Hess Grade I, 12 Grade II and 8 Grade IV～V. Two of all 58 patients had no SAH. Two sorts of EDPC were used in this group: one is Guglielmi detachable coil from Boston Scientific Corporation and the other is Sapphire detachable coil from Micro Therapeutics Inc. All the sessions of embolization and each detachment of the EDPC were closely monitored both fluoroscopically and angiographically for the accurate and safe embolization of aneurysmal lumen. Results Of all 60 aneurysms, 58 were successfully treated with EDPC and 2 were failed to be embolized due to arterial spasm. The packing degree of aneurismal lumen was complete in 44 cases (75.9%) and incomplete in 12 cases (20.7%). The incidence of non-thrombotic complication was 6.9%. One patient had hemiplegia because of the hernia into the parent artery by EDPC. No death occurred in our group. 41 patients were followed-up during a period of 1～4 years and no SAH onset recurred after embolization. Conclusions Endovascular treatment of intracranial aneurysms with GDC is a better alternative. But the long-term effects should be verified by follow-up in the future.