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Objective To solve the difficulty of intubation of nasojejunal feeding tube under digital subtraction angiography (DSA) system when conventional methods were failed.Methods Seventy-one patients who failed to place the nasojejunal feeding tube by single guide wire under DSA conventional methods.With the methods of decreasing the stomach volume,changing the body posi-tion,and using a catheter or gastrointestinal motility,the nasojejunal feeding tube was placed into the proper position (more than 30cm far away from Treitz or gastrointestinal anastomosis).Results All the procedures were successfully accomplished.No compli-cations,such as throat damage,abdominal pain,perforation and hemorrhage of digestive tract were found.The mean duration under DSA was four minutes (2-7min).Conclusion With the help of various methods above,we can improve the success rate of intuba-tion and reduce the duration of the nasojejunal feeding tube placement,when conventional methods were failed.
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Objective To discuss the feasibility of using three-dimensional simulation positioning of puncture route that is sketched according to the transversal and sagittal CT images to design percutaneous vertebroplasty (PVP) plan. Methods A total of 58 patients with 63 diseased vertebral bodies were enrolled in this study. Before PVP, the simulation puncture route was delineated according to the transversal and sagittal CT images, and the simulation puncture parameters were determined by using the software of PACS, in this way the three-dimensional simulation puncturing route was established , and the skin needle entry point as well as the puncture angle were calculated. Unilateral transpedicular approach was used when the simulation puncture route could meet the requirements of unilateral approach. Otherwise , bilateral transpedicular approach would be employed. Three months after PVP visual analogue score (VAS) was used to evaluate the degree of pain relief, and the result was compared with that determined before PVP. SPSS 13.0 software was used for statistical analysis. The estimating data were statistically analyzed with paired t-test and the results were expressed in the form of (x ± s). Results The measurement results showed that significant differences in the puncture angles and skin needle entry points existed between different vertebral bodies. Guided by the preoperatively determined simulation puncture route , PVP was successfully accomplished in all patients. The success rate of single puncturing was 100% (63 vertebral bodies in total). Among 63 vertebral bodies, unilateral transpedicular approach was adopted in 55 and the operation time was (28.5 ± 5.5) minutes, while bilateral transpedicular approach was carried out in 8 and the operation time was (37.5 ± 5.5) minutes. After PVP, complete pain relief was achieved in all patients. No serious complications occurred during the follow-up period. Conclusion Three-dimensional simulation positioning of puncture route that is sketched according to preoperative transversal and sagittal CT images is very useful in precisely determining the puncturing route before PVP, which is very helpful to increase the success rate of single puncture and to improve the procedural safety.
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Objective To investigate the effects of intratumoral implantation of ~(32)P-CP-PLLA seeds on the normal canine liver tissue and to exolore the metabolism of ~(32)P-CP-PLLA seeds implanted in the liver of experimental dogs.Methods Twelve beagles were enrolled in this study.The dogs were randomly and equally divided into four groups:group A(185 MBq),group B(370 MBq),group C(740 MBq)and group D(0 MBq).By using laparotomy procedure ~(32)P-CP-PLLA seeds were implanted into dog's liver.CT scan was performed before operation as well as before the dog was sacrificed.All dogs were sacrificed three months after the implantation.Before the procedure and 1,2,4,8 and 12 weeks after the procedure the blood tests and serum biochemical tests were conducted.One dog from group B and group C was selected respectively and was fed in a metabolic cage.Within one month after the procedure the cpm in feces and in urine was determined every 24 hours.One dog was picked out from each of the three groups and was punctured to get its liver tissue for pathologic exam each time at 1,2,4,8 and 12 weeks after the implantation,and SPECT imaging was also performed at the same time.Pathologic study,both macroscopic and microscopic(including optical and electronic microscopy)was made to observe the liver damage after the dog was sacrificed.The statistical analysis was processed by using SPSS 13.0 software and the measuring data were expressed with mean±standard deviation((x)±s).Results Two months after the procedure,serological examination found that the serum alkaline phosphatase(BKP)in both group Band group C was significantly higher than that in other groups,the difference was statistically significant (P ＜0.05),and the BKP levels returned to normal in three months.The postoperative 30-day inspection of the urine showed that the radioactive particles slowly released into the body and eliminated from the body with the urine and feces,mainly through the renal excretion.The 30-day cumulative percentage of eliminated radioactive dose in the urine and in the feces was 6.34% and 11.64% respectively.No sign of particle displacement was found on SPECT imaging.On autopsy three months after the implantation,the size of the radioactive seeds became smaller and fragile.With the radioactive dose used increasing,the area of liver damage at the site of seed implantation became bigger,which was demonstrated on CT scan,macroscopic exam and pathologic study.The local damaged focus of the liver caused by ~(32)P-CP-PLLA seeds was manifested as a spherical lesion which was encysted by a layer of fibrous tissue with an edematous zone peripherally.Conclusion The implantation of ~(32)P-CP-PLLA seeds in dog's liver causes only localized hepatic damage with no general adverse effects.The implanted seeds can slowly release the radioactive dose and will not immigrate to other organs in the body.Besides,the seeds possess excellent stability,targeted orientation and safety.
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Objective To explore the toxicity and safety of 32P-CP-PLLA seeds interstitial implantation. Methods 30 beagle dogs were randomly divided into 10 groups according to different drugs (32P-CP-PLLA and 32P-CP),different doses (185, 370 and 740 MBq) and different sites (gluteus and liver). At different time-points after surgery, the weights of dogs were measured. The blood routine and blood biochemical indexes,PC Ⅲ ,HA,CG,PCⅣ and LN were examined. ECT imaging was performed and histology was observed dynamically. Blood, urine and faeces were measured continuously for 12 weeks and 30 days, respectively. Results ECT imaging demonstrated in seed groups and 32P-CP muscle groups radioactivity concentrated continuously in the area of implantation, without liver imaging. 471.67 MBq/m2 of 32 P-CP was injected in liver,while the absorbed dose was 31 Gy,without significant liver damage. When the dose was 794. 28 MBq/m2 , the absorbed dose was 56 Gy,with strong liver and systemic toxicity. But implanting seeds at the same or higher dose, the absorbed dose was 89.83-178.68 Gy in the area of implantation, and the rest liver was 1.09-2. 18 Gy,without liver damage. Dogs in liver group died at 23, 29 and 45 d, respectively, and the inspections of liver fibrosis were higher than the means of the other groups.Blood routine and blood biochemistry indexes between the other groups showed no significant differences.Effective half-life of 32P-CP-PLLA was 11.78 d, while that of 32P-CP was 6. 82 d in liver, and 8. 73 d in gluteus. Mild to moderate injury were found in liver group at 4 weeks. Moderate to serious injury were found. Liver cell necrosis and proliferation were found at 4-6 weeks in other liver groups. In muscle groups,only cellular edema was found in muscle groups at 2 week. The radioactivity count rate in blood for seed groups showed slowly jagged decreasing over time, and decreased exponentially for 32PCP groups. The radioactivity count rate in urine and faeces were multi-peak descending in seed groups. Conclusions 32P-CP-PLLA seeds have the advantages of suitable target location, degradable, non-migration and easy to protection, and it could be used in treatment for different blood supply types of solid tumors. Liver of beagle dog could endure the dose from 32 P-CP-PLLA seed twice as 32P-CP lethal dose.
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Objective To investigate the effect of manganese-enhanced MRI (MEMRI) at 7.0T for tracing nerve tracts in rat brain in vivo. Methods With brain stereotactic apparatus, 0.4 μl Mncl_2 with aqueous solution of 1 mol/L was injected into the right somatosensory cortex of 9 SD rats. MR scan was performed for tracing corticospinal tracts and other coherent nerve tracts pre-, and 24, 48, 72 h, 7 days post-injection with 7.0T micro-MRI system, respectively. Results Corticospinal tracts were showed in intact after Mn~(2+) administration from somatosensory cortex, thalamus, cerebral peduncle to pons at the time point of 24, 48, 72 h and 7 days, while the best tdisplaying was achieved at 24-48 h after Mn~(2+) administration. Simultaneously a small quantity of Mn~(2+) reached the opposite somatosensory cortex through the corpus callosum. Conclusion MEMRI for tracing rat nerve tracts can be showed clearly with 7.0T MRI. The location of manganese-enhanced corticospinal tracts in agreement with the rat brain atlas in stereotaxic is in agreement with that Paxinos' published. MEMRI can display the relationship between the two sides of hemisphere, and may play an important role in investigating the brain function and nerve plasticity after nerve injury in vivo.