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Objective To analyze three-dimensional imaging characteristics and advantages for severe portal vein stenosis after liver transplantation, and to evaluate clinical efficacy of portal vein stent implantation. Methods Clinical data of 10 patients who received portal vein stent implantation for severe portal vein stenosis after liver transplantation were retrospectively analyzed. Imaging characteristics of severe portal vein stenosis, and advantages of three-dimensional reconstruction imaging and interventional treatment efficacy for severe portal vein stenosis were analyzed. Results Among 10 patients, 3 cases were diagnosed with centripetal stenosis, tortuosity angulation-induced stenosis in 2 cases, compression-induced stenosis in 2 cases, long-segment stenosis and/or vascular occlusion in 3 cases. Three-dimensional reconstruction images possessed advantages in accurate identification of stenosis, identification of stenosis types and measurement of stenosis length. All patients were successfully implanted with portal vein stents. After stent implantation, the diameter of the minimum diameter of portal vein was increased [(6.2±0.9) mm vs. (2.6±1.7) mm, P<0.05], the flow velocity at anastomotic site was decreased [(57±19) cm/s vs. (128±27) cm/s, P<0.05], and the flow velocity at the portal vein adjacent to the liver was increased [(41±6) cm/s vs. (18±6) cm/s, P<0.05]. One patient suffered from intrahepatic hematoma caused by interventional puncture, which was mitigated after conservative observation and treatment. The remaining patients did not experience relevant complications. Conclusions Three-dimensional visualization technique may visually display the location, characteristics and severity of stenosis, which is beneficial for clinicians to make treatment decisions and assist interventional procedures. Timely implantation of portal vein stent may effectively reverse pathological process and improve portal vein blood flow.
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Objective:To investigate the effect of early interventional therapy with fiberoptic bronchoscope in patients with inflammatory infiltrating type (Ⅰ type) tracheobronchial tuberculosis (TBTB).Methods:Using prospective research methods, 306 patients with Ⅰ type TBTB diagnosed by fiberoptic bronchoscopy in the Third People′s Hospital of Kunming City from January 2019 to April 2022 were selected. The patients were divided into observation group and control group according to the random number table method with 153 cases each. The patients in control group were given routine anti-tuberculosis chemotherapy, and the patients in observation group were given routine anti-tuberculosis chemotherapy combined with early interventional therapy with fiberoptic bronchoscope. Sputum smear examination and tuberculosis culture were performed at the end of 1, 3 and 6 months of treatment, and the negative conversion of sputum culture was recorded. Chest X-ray, pulmonary function and fiberoptic bronchoscope were performed at the end of 1, 3 and 6 months of treatment to evaluate the improvement rate of clinical symptoms, effective absorption rate of lesions and effective absorption rate of obstructive pneumonia. The CD 4+, CD 8+, CD 4+/CD 8+, interferon γ (IFN-γ), interleukin-6 (IL-6) and C reactive protein (CRP) before and after treatment were detected. The random walking model of immune inflammation was evaluated. Results:The sputum negative conversion rates at the end of 1, 3 and 6 months of treatment in observation group were significantly higher than those in control group: 64.71%(99/153) vs. 52.29%(80/153), 80.39%(123/153) vs. 62.09%(95/153) and 91.50%(140/153) vs. 73.86%(113/153), and there were statistical differences ( P<0.05 or <0.01). The improvement rate of clinical symptoms at the end of 1 month of treatment in observation group was significantly higher than that in control group: 94.77%(145/153) vs. 66.67%(102/153), and there was statistical difference ( P<0.01); the clinical symptoms disappeared in both groups at the end of 3 and 6 months of treatment. The effective absorption rates of lesions at the end of 1 and 3 months of treatment in observation group were significantly higher than those in control group: 73.20%(112/153) vs. 51.63%(79/153) and 96.73%(148/153) vs. 85.62%(131/153), and there were statistical differences ( P<0.01); all the lesions were absorbed at the end of 6 months of treatment in both groups. The effective absorption rates of obstructive pneumonia at the end of 1 and 3 months of treatment in observation group were significantly higher than those in control group: 78.43% (120/153) vs. 39.87%(61/153) and 89.54%(137/153) vs. 79.08%(121/153), and there were statistical differences ( P<0.01 or <0.05); all obstructive pneumonia were absorbed at the end of 6 months of treatment in both groups. There were no statistical differences in CD 4+, CD 8+, CD 4+/CD 8+, IL-6, IFN-γ and CRP before treatment between the two groups ( P>0.05); the CD 4+, CD 4+/CD 8+ and IFN-γ after treatment in observation group were significantly higher than those in control group: 0.343 ± 0.032 vs. 0.311 ± 0.023, 1.37 ± 0.18 vs. 1.12 ± 0.16 and (38.47 ± 3.50) ng/L vs. (20.52 ± 2.96) ng/L, the CD 8+, IL-6 and CRP were significantly lower than those in control group: 0.251 ± 0.020 vs. 0.268 ± 0.021, (19.40 ± 3.31) ng/L vs. (34.58 ± 5.82) ng/L and (10.41 ± 2.87) mg/L vs. (17.47 ± 3.14) mg/L, and there were statistical differences ( P<0.01). The evaluation results of random walking model showed that CD 4+, CD 8+, CD 4+/CD 8+, IFN-γ, IL-6 and CRP in the observation group were better than those in the control group in the maximum random fluctuation, number of walking steps, positive walking growth rate, random fluctuation power law value, comprehensive improvement rate, recording times of comprehensive evaluation index and expected improvement value. Conclusions:Early interventional therapy with fiberoptic bronchoscope can effectively assist systemic drug therapy in patients with Ⅰ type TBTB, which can accelerate focus absorption, promote sputum negative conversion, enhance cellular immunity and effectively inhibit inflammatory reaction.
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Objective:Based on the business reengineering theory, to construct the emergency nursing process of acute massive hemoptysis in hospital and explore the effect of it.Methods:According to the order of hospitalization, 200 patients with acute massive hemoptysis admitted to the emergency department in Shanghai Pulmonary Hospital Affilated to Tongji University from January to June in 2020 were selected as the control group, and the original treatment process was adopted. Two hundred patients admitted to the emergency department of this hospital from July to December in 2020 were selected as the experimental group, and the reconstructed in-hospital emergency nursing process for acute massive hemoptysis was applied. In both groups, the researchers recorded the time spent in each sub-process by using the in-hospital treatment time record of acute massive hemoptysis and collected the clinical outcomes of patients through electronic cases. The time-consuming, treatment efficiency and patient outcome of each link of the treatment process in the backyard of the two groups were compared.Results:Finally, 192 patients were enrolled in the control group and the experimental group. The median time from admission to intravenous use of hemostatic drugs and from admission to endovascular treatment in the experimental group were 21.50(20.00, 22.50) and 82.50(79.50, 84.50) min, which were lower than those in the control group which spent 40.87(37.06, 44.43) and 135.50(123.50, 147.00) min, and the differences between the two groups were statistically significant ( Z=-16.84, 16.63, both P<0.01). The incidence of asphyxia caused by acute massive hemoptysis in the experimental group was 4.2%(8/192), which was lower than that in the control group, which was 13.0%(25/192) . There was a statistically significant difference in the incidence of asphyxia between the two groups( χ2=9.58, P<0.01). Conclusions:The emergency nursing process of acute massive hemoptysis effectively shortens the time of in-hospital treatment of acute massive hemoptysis, further promotes the seamless connection of multiple links of in-hospital treatment of acute massive hemoptysis, and improves the overall efficiency of in-hospital treatment of patients with acute massive hemoptysis.
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Abstract Purpose: To explore differences in the changes of clinical and CT manifestations related to liver abscess before and after CT-guided interventional therapy between patients with and without Diabetes Mellitus (DM). Materials and methods: Fifty-eight consecutive patients with liver abscesses were retrospectively enrolled in this study. All patients underwent upper abdominal contrast-enhanced CT scans before and after CT-guided interventional therapy. They were divided into two groups including the DM group (n = 30) and the Non-DM group (n = 28) if the liver abscess occurred in patients with and without DM, respectively. The changes in the clinical and CT manifestations related to liver abscess after CT-guided interventional therapy in both groups were statistically analyzed. Results: After CT-guided interventional therapy, the length of hospital stay, white blood cell recovery time and drainage tube removal time in the DM group were longer than in the Non-DM group (all p-values < 0.05). The incidence of postoperative complications in the DM group was higher than in the Non-DM group (p < 0.05). As shown on CT, the postoperative reduced percentage of maximum diameter of abscess cavity and the reduction rate of edema band surrounding the liver abscess in the DM group were smaller than in the Non-DM group (both p-values < 0.05). The time intervals of the previous characteristic changes on CT before and after interventional therapy in the DM group were longer than in the Non-DM group (all p-values < 0.05). Conclusions: The liver abscesses patients with DM could not have a faster recovery and better therapeutic effect than those without DM after the CT-guided interventional therapy.
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Objective To investigate the awareness of and attitudes towards radiation safety and protective measures among clinical nurses in liver interventional department, so as to provide insights into the formulation of radiation-protective measures among clinical healthcare workers. Methods A cross-sectional study was performed. Clinical nurses in liver interventional departments of class A tertiary hospitals in Jiangsu Province were sampled, and the awareness of and attitudes towards radiation safety and protective measures were investigated using self-designed questionnaires. Results A total of 112 questionnaires were allocated, and 97 valid questionnaires were recovered, with an effective recovery rate of 86.61%. The awareness of questions including “interventional therapy may cause radiation exposure” and “wearing lead apron may reduce radiation exposure” was both 100.00% among respondents, and the awareness of questions including “radiation exposure may cause congenital malformations in babies”, “radiation exposure may cause cancers such as skin cancer and leukemia”, “radiation exposure may cause death”, “wearing lead goggles may reduce radiation exposure”, and “wearing thyroid shields may reduce radiation exposure” was all higher than 95.00%, while the awareness of questions “radiation exposure may cause cataract of the eye lens” and “radiation exposure may cause bone marrow depression” was relatively low. Respondents presented high-level attitudes towards lead aprons, and low-level attitudes towards goggles and thyroid shields. Conclusion The awareness of radiation safety knowledge is high among clinical nurses in liver interventional departments; however, an overall low-level attitude is seen towards radiation-protective measures. Health education pertaining to radiation safety and protective measures is required to be improved, so as to increase the compliance to radiation-protective measures.
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@#<b>Objective</b> To complete the Monte Carlo design and preliminary test of X-ray protective rubber. <b>Methods</b> According to the characteristics of X-ray energy spectrum for interventional therapy, the shielding effects of lead rubber, tungsten and bismuth composite rubber, and gadolinium and bismuth composite rubber samples were calculated by Monte Carlo simulation. The variation law of lead equivalent of lead-free rubber and lead rubber with X-ray peak tube voltage was obtained through actual measurement. <b>Results</b> Within the peak tube voltage range of 60-110 kV, lead-free rubber effectively replaced lead rubber. <b>Conclusion</b> The shielding and attenuation effect of the existing lead-free protective rubber on low-energy stray X-rays is better than that of lead rubber. Considering the inherent defects of lead rubber, flexible X-ray protective materials with thermoplastic elastomer as filler will have broad development prospects.
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@#<b>Objective</b> To apply a phantom for dose measurement in interventional therapy for pediatric vascular diseases, and calculate the effective dose (<i>E</i>) and conversion coefficient of dose area product (DAP) to <i>E</i>, and to provide a dose reference for studying radiation dose and radiation protection in children. <b>Methods</b> Thermoluminescent dosimeters were placed in the organs of the phantom. Low-, medium-, and high-dose groups were set for three types of vascular anomalies based on the duration of fluoroscopy. Digital subtraction angiography was used to simulate exposure conditions at different dose levels. The organ dose was measured, and the effective dose was calculated. <b>Results</b> For the three groups of vascular anomalies in the head and face, the red bone marrow doses were 8.15, 30.34, and 43.53 mGy, respectively, the effective doses were 12.88, 47.84, and 73.12 mSv, respectively; and the average conversion coefficient of DAP to <i>E</i> was 2.16. For the three groups of vascular anomalies in the trunk, the red bone marrow doses were 2.11, 15.62, and 31.21 mGy, respectively; the effective doses were 12.39, 70.56, and 134.60 mSv, respectively, and the average conversion coefficient of DAP to <i>E</i> was 3.03. For the three groups of vascular anomalies in the lower extremities, the red bone marrow doses were 3.58, 6.50, and 12.28 mGy, respectively, the effective doses were 3.64, 7.04, and 14.85 mSv, respectively, and the average conversion coefficient of DAP to <i>E</i> was 0.73. <b>Conclusion</b> Patient dose and DAP-to-<i>E</i> conversion coefficient are in the following order: vascular anomalies in the trunk > vascular anomalies in the head and face > vascular anomalies in the lower extremities. The dose data obtained can be used to estimate children’s radiation exposure.
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Objective To establish a model for estimating the eye lens dose of the first operator in interventional therapy based on the Monte Carlo simulation, and to provide a scientific basis for the rapid and accurate evaluation of the eye lens dose for radiation workers in interventional therapy. Methods Based on the MIRD phantom and eye model for adult Chinese males, the MCNPX program was used to establish the physical model to calculate the spatial distribution of radiation field and eye lens dose for the first operator. A GR200 Type A LiF (Mg, Cu, P) thermoluminescence dosimeter was used for experimental measurement to verify the simulation results. Results Monte Carlo simulation and experimental measurements showed that the spatial distribution of radiation field was symmetrical. Compared with the measured doses, the errors of the simulated eye lens dose of the first operator were between −8.3% and 7.3%. The dose of the left eye lens was higher than that of the right eye. Conclusion The Monte Carlo model constructed in this study initially realizes the simulation of eye lens dose of the first operator in interventional therapy. In the future, the model will be further optimized based on irradiation parameters such as exposure time, tube voltage, tube current, and projection direction used in clinic practice, so as to more accurately evaluate the eye lens dose of interventional therapy staff.
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Objective:To compare the results of operative versus interventional treatments in patients presenting with sentinel hemorrhage after hepatobiliary and pancreatic surgery.Methods:The clinical data of patients presenting with sentinel hemorrhage after hepatobiliary and pancreatic surgery at the Department of Hepatobiliary Surgery, the Second Affiliated Hospital of Guangzhou Medical University from August 2017 to July 2022 were retrospectively analyzed. Of 82 patients who were enrolled in this study, there were 50 males and 32 females, aged (59.0±7.7) years. The patients were divided into the interventional group ( n=42) and the surgical group ( n=40) based on the treatment they received for sentinel hemorrhage. The vascular injury rate, the first operation time for sentinel bleeding, the rate of successful hemostasis in a single operation, the number of deaths and other indicators were compared between groups. Results:In both the two groups of patients who underwent percutaneous transhepatic cholangial drainage, hepatectomy, endoscopic retrograde cholangiopancreatography, hilar cholangiocarcinoma resection and cholecystectomy were mainly performed hepatic artery injury, pancreaticoduodenectomy with gastroduodenal artery injury, and splenectomy with splenic artery injury. In the intervention group, 36 patients (85.7%) were successfully hemostasis after single treatment, and 32 patients (80.0%) in the operation group, and there was no significant difference between the two groups (χ 2=0.47, P=0.492). The first operation time for the intervention group was (40.5±8.5) min and the mortality rate was 2.4% (1/42), which were significantly better than that of the operation group (90.6±20.8) min and 15.0% (6/40) (all P<0.05). Conclusion:Interventional therapy can be used as the first-line diagnosis and treatment for sentinel bleeding after hepatobiliary and pancreatic surgery. It has the advantages of a lower mortality rate in treating these patients.
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Objective:To investigate the influencing factors of learned helplessness in patients with primary liver cancer treated by interventional therapy.Methods:This study was a cross-sectional study. The 221 patients with primary liver cancer treated by interventional therapy in the Second Affiliated Hospital of Air Force Military Medical University from August 2020 to October 2021 were selected as the subjects. General data statistics, Learned Helplessness Scale and Support in Intimate Relationships Rating Scale were used for questionnaire survey.Results:The total score of learned helplessness in the 221 patients with primary liver cancer treated by interventional therapy was 74.12 ± 6.55. Gender, education level, family per capita monthly income, number of interventions and perceived spouse support were the main influencing factors of learned helplessness in patients with primary liver cancer treated by interventional therapy (adjusted R2=0.891, F=65.65, P<0.05). Conclusions:The sense of learned helplessness of patients with primary liver cancer treated by interventional therapy is at a high level. According to patients with features of male, lower education level, lower family per capita monthly income, more number of interventional therapy or lower perceived spouse support, medical staff can use dialectical behavior therapy, symptom group intervention, spouse support intervention and other methods to reduce learned helplessness of patients.
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Objective:To study the clinical characteristics and etiological distribution characteristics of plastic bronchitis in children, analyze its early warning indicators, and evaluate the clinical diagnosis and treatment effect of flexible bronchoscopy.Methods:The clinical data of 232 children with severe pneumonia admitted to Guiyang Maternal and Child Health Hospital from January 2019 to February 2021 were retrospectively analyzed.The children were divided into the plastic bronchitis group and non-plastic bronchitis group according to bronchoscopic results.The gender, age, clinical manifestations, auxiliary examinations, imaging features, bronchoscopy findings and treatment of the children were collected, compared and analyzed, comparison between two groups by t test and χ2 test. Results:A total of 232 children were included in this study, including 98 cases in the plastic bronchitis group and 134 cases in the non-plastic bronchitis group.The main symptoms of both groups were fever, cough and shortness of breath.The age of onset in the plastic bronchitis group was (54.640±37.085) months, and the age of onset in the non-plastic bronchitis group was (14.870±19.813) months.The difference in the age of onset between the two groups was statistically significant ( t=9.656, P<0.001). The average hospitalization days of the plastic and non-plastic bronchitis groups were (16.133±6.227) d and (12.690±4.287) d, respectively.Significant difference was found in the average hospitalization days between the two groups ( t=4.721, P<0.001). The average fever days of the plastic bronchitis group were (10.090±3.473) d, and the average fever days of the non-plastic bronchitis group were (6.030±4.850) d. There was significant difference in the average fever days between the two groups ( t=5.654, P<0.001). The age of onset, hospitalization days, and fever days of the plastic bronchitis group were larger than those of the non-plastic bronchitis group (all P<0.001). The physical examination suggested that 40% (39/98) of patients in the plastic bronchitis group had reduced the breath sounds, and this percentage was significantly higher than that in the non-plastic bronchitis group[6%(8/134)]. The plastic bronchitis group had lower partial pressure of blood oxygen (PO 2) and oxygen saturation (SO 2) levels than the non-plastic bronchitis group (all P<0.01). The plastic bronchitis group had a higher percentage of neutrophils (N), C-reactive protein (CRP) level, procalcitonin (PCT) level, lactate dehydrogenase (LDH) level and D-dimer level than the non-plastic bronchitis group (all P<0.01). According to the imaging results, in the plastic bronchitis group, lung consolidation was found in 72 cases (73%, 72/98), atelectasis in 32 cases (33%, 32/98), and pleural effusion in 33 cases (34%, 33/98). In the non-plastic bronchitis group, 65%(87/134) cases had lung consolidation, 5%(7/134) cases had atelectasis, 3.7% (5/134) cases had pleural effusion.The first pathogen detected in 46.9% of the patients in the plastic bronchitis group was Mycoplasma pneumoniae (MP), and the percentage was significantly higher that in the non-plastic bronchitis group (11.1%). Flexible bronchoscopy was performed on both groups at their admission.The plastic bronchitis group received the flexible bronchoscopy check for (2.960±1.157) times on average, and the non-plastic bronchitis group was tested for (1.140±0.371) times on average.Of 98 children in the plastic bronchitis group, 95 cases were improved and discharged, 2 cases were transferred, and 1 case died.All 134 children in the non-plastic bronchitis group were improved and discharged. Conclusions:Preschool and school-age children, fever ≥10 d, PCT, CRP, LDH, D-dimer levels are early warning signs of plastic bronchitis clinically.MP is still the primary pathogen causing plastic bronchitis.Flexible bronchoscopy technique is a key measure for timely diagnosis and effective treatment of plastic bronchitis.
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Objective:To explore the efficacy of Matas test combined with endovascular intervention on patients with traumatic internal carotid-cavernous fistula.Methods:A retrospective case study was performed on 144 patients with traumatic internal carotid-cavernous fistula treated in our department from August 2012 to June 2018. The clinical symptoms, intraocular pressure and visual acuity data before and after surgery were counted, and the paired t test was used for statistical analysis. Logistic regression was performed to analyze factors affecting recurrence.Results:The main symptoms of traumatic internal carotid-cavernous fistula were proptosis, bulbar conjunctival hyperemia and cranial sound. Postoperative intraocular pressure was significantly lower than preoperative intraocular pressure [(11.13±2.97) mmHg vs. (22.37±6.64) mmHg] and postoperative visual acuity was significantly higher than preoperative visual acuity [(0.69±0.36) vs. (0.47±0.25)] and (both P<0.05). Postoperative intraocular pressure was an independent risk factor for recurrence within 3 months ( OR=0.357, 95% CI: 0.135-0.944, P=0.037), and the recurrence rate was 10.42%. Conclusions:Matas test combined with endovascular intervention in the treatment of traumatic internal carotid-cavernous fistula can effectively reduce intraocular pressure, improve visual acuity, and has a definite curative effect. It is one of the effective treatment methods for traumatic internal carotid-cavernous fistula.
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Objective To explore the application value of computed tomography (CT)-based three-dimensional digital navigation technology in microwave ablation of lung cancer. Methods A total of 92 patients with lung cancer in our hospital were retrospectively analyzed, and randomized to receive microwave ablation with the three-dimensional digital navigation technology or traditional CT-guided microwave ablation (three-dimensional navigation group and traditional group). The two groups were paired according to tumor location, size (the maximum diameter difference of less than or equal to 2 mm), and microwave ablation conditions, for a total of 46 pairs. The operation time, times of microwave ablation needle puncture, CT dose index, incidence rates of intraoperative complications, and postoperative lesion control were compared between the two groups. Results The operation time [(30.07 ± 6.36) min vs (47.20 ± 9.65) min], times of puncture [(1.72 ± 0.69) times vs (7.13 ± 3.00) times], CT dose index [(11.16 ± 2.20) mGy vs (26.67 ± 8.72) mGy], and incidence of intraoperative complications (10.87% vs 34.78%) in the three-dimensional navigation group were lower than those in the traditional group, and the response rate was higher in the three-dimensional navigation group than in the traditional group (93.48% vs 71.74%) (P < 0.05). Conclusion CT-guided three-dimensional digital navigation technology for microwave ablation of lung cancer makes the operation of interventional puncture more accurate and safe.
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Objective:To calculate the conversion coefficient from dose area product (DAP) to organ absorbed dose by Monte Carlo method in order to conveniently estimate doses to patient organ during coronary intervention procedure.Methods:The Geant4 Monte Carlo simulation kit was used to calculate the organ absorbed dose conversion coefficients by simulating exposure scene.Results:The conversion coefficients used in coronary angiography (CAG) for lung, bone marrow, liver and heart were (0.283±0.068), (0.169±0.049), (0.110±0.077) and (0.080±0.032) mGy/(Gy·cm 2) for male, and (0.376±0.121), (0.192±0.056), (0.153±0.105), and (0.102±0.033) mGy/(Gy·cm 2) for female, respectively. These were similar to those in the case of percutaneous coronary intervention (PCI). The DAPs for different interventional procedures were statistically significant ( t=-6.012, P<0.05). The DAPs for difference gender groups had no statistically significant ( P>0.05). Conclusions:Conversion coefficient for organ absorbed dose has little correlation with CAG and PCI in the same sex group. Dose conversion coefficients for female group are greater than those for male group in the same procedure. Conversion coefficients from DAP to organ absorbed dose calculated with Monte Carlo method can provide convenience for rapidly estimating the organ absorbed dose to clinical patients.
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Objective:To investigate the current status of interventional radiology discipline in the provincial-level and national cancer hospitals of China, and to provide supportive data for the future systematic construction of interventional radiology.Methods:A questionnaire was used to survey 32 provincial and national cancer hospitals of China. The survey included data such as discipline settings, medical treatment, medical education, and scientific research. Then descriptive statistical analysis was performed based on the data.Results:All 32 provincial and national cancer hospitals of China had interventional radiology services and were equipped with independent wards; the deployment rates of DSA, ultrasound, CT, and radiofrequency ablation equipments were: 100%(32/32), 81.3%(26/32), 40.6%(13/32), and 75.0%(24/32), respectively. Of all 32 hospitals, 27 (84.4%) had performed more than 1 000 interventional operations per year. The proportion of hospitals that had interventional subspecialties was 21.9% (7/32). As for the interventional radiology doctors in these hospitals, the ratio of doctors with a background of medical imaging specialty was 69.6%(256/368); the proportion of doctors with ages ≤ 45 years old was 72.0%(265/368); and the ratio of doctors with a master degree was 79.9%(294/368). Among the 32 hospitals, 22 (68.8%) had more than 500 000 yuan research funds in intervention radiology discipline, and 71.9%(23/32) had intervention radiology discipline postgraduate tutors.Conclusions:The overall development of interventional radiology discipline in provincial-level and national cancer hospitals is good. The discipline development pattern might set a good example for interventional radiology discipline construction in general hospitals.
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The pandemic of Corona Virus Disease 2019 (COVID-19) continues, which shows the concentrated or sporadic cases in multiple places. Current COVID situation is still complex. During the COVID-19, routine diagnosis and treatment of liver cancer patients has been affected in different degrees. Under the premise of following the treatment guidelines, how to reduce the risk of infection of patients and medical staff, utilize limited medical resources to maximally ensure anti-tumor treatment and related emergency treatment, and help patients get through the epidemic period is a problem for liver oncologists. Thus, experts of liver cancer treatment related disciplines of Zhongshan Hospital, Fudan University have written the Expert guidance on overall management of liver cancer during the COVID-19, which aims to provide references for liver oncolo-gists to conduct clinical work safely and effectively under the epidemic prevention and control, and to help patients fight against the epidemic smoothly.
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Primary liver cancer is the fourth most common malignancy and the second most common cause of cancer death in China, which poses a serious threat to the life and health of the Chinese people. Hepatocellular carcinoma (HCC) represents more than 90% of the pathology of primary liver cancer, among them around 60% of patients are at the intermediate-advanced stage when diagnosed. Therefore, increasing the rate of resection via conversion therapies is particularly important to improve the prognosis of these patients. Vascular interventional therapies represented by transarterial chemoembolization and hepatic arterial infusion chemotherapy are important treatment methods for HCC patients in intermediate-advanced stage, showing good rates of tumor response and surgical conversion. Combined with research data at home and abroad, the authors analyze research progress of vascular interventional therapy in the conversion therapy of HCC, review the history and the strategies of conversion therapies based on vascular interventional therapy in this article.
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As an efficacious treatment for end-stage liver diseases and primary malignant liver tumors, liver transplantation has been widely applied worldwide, and gradually receives widespread recognition from patients. With the development of organ transplant technique, vascular complications have rarely occurred after adult liver transplantation. However, vascular complications, such as postoperative thrombosis and anastomotic stenosis, are still common in the recipients undergoing living donor liver transplantation and split liver transplantation. Inappropriate treatment may lead to the loss of grafts and death of recipients. The authors have been engaged in liver transplantation for many years, witnessing persistent development of diagnostic and therapeutic technologies for vascular complications after liver transplantation. In this article, current status and development trend of diagnosis and treatment of different vascular complications were illustrated from the etiology, clinical manifestations, diagnosis and treatment of hepatic artery complications, portal vein complications, inferior vena cava and hepatic vein complications, aiming to further improve the survival rate of grafts and recipients and provide reference for promoting the development of clinical liver transplantation.
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Interventional embolization therapy is widely used for procedures such as targeted tumour therapy, anti-organ hyperactivity and haemostasis. During embolic agent injection, doctors need to work under X-ray irradiation environment. Moreover, embolic agent injection is largely dependent on doctors' experience and feelings, and over-injection of embolic agent can lead to reflux, causing ectopic embolism and serious complications. As an effective way to reduce radiation exposure and improve the success rate of interventional embolization therapy, embolic agent injection robot is highly anticipated, but how to decide the injection flow velocity of embolic agent is a problem that remains to be solved. On the basis of fluid dynamics simulation and experiment, we established an arterial pressure-injection flow velocity boundary curve model that can avoid reflux, which provides a design basis for the control of embolic agent injection system. An in vitro experimental platform for injection system was built and validation experiments were conducted. The results showed that the embolic agent injection flow speed curve designed under the guidance of the critical flow speed curve model of reflux could effectively avoid the embolic agent reflux and shorten the embolic agent injection time. Exceeding the flow speed limit of the model would lead to the risk of embolization of normal blood vessels. This paper confirms the validity of designing the embolic agent injection flow speed based on the critical flow speed curve model of reflux, which can achieve rapid injection of embolic agent while avoiding reflux, and provide a basis for the design of the embolic agent injection robot.
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Embolization, Therapeutic/methodsABSTRACT
Biliary tract cancer (BTC) is a digestive system malignancy with extremely poor prognosis, and the survival time of patients with BTC has been prolonged with the development of various treatment methods in recent years. This article reviews the current status and advances in surgery, systemic therapy, radiotherapy, and interventional therapy for BTC, so as to provide a reference for the treatment of BTC in clinical practice.