Application of manual carbon dioxide angiography in endovascular treatment for arteriosclerosis obliterans of lower extremity in patients with renal insufficiency or iodine allergy / 介入放射学杂志

Objective To assess the safety and diagnostic accuracy of manual carbon dioxide (C02) digital angiography in performing endovascular therapy (EVT) for arteriosclerosis obliterans (ASO) of lower extremity in patients who have renal insufficiency or iodine allergy. Methods The clinical data of 19 patients with lower extremity ASO complicated by renal insufficiency or iodine allergy, who were admitted to authors' hospital to receive EVT of lower extremity with intraoperative C02 angiography during the period from January 2013 to March 2015, were retrospectively analyzed. Using manual bolus injection of C02, or with additional use of minimum dose of iodinated contrast media, CO2 angiography was performed so as to guide EVT procedure. The safety and diagnostic accuracy of manual C02 angiography were evaluated. Results A total of 21 endovascular treatments were performed in 19 patients with lower extremity ASO, and a total of 28 arterial segment lesions were treated. The technical success rate was 100％. Ankle-brachial index (ABI) was improved from preoperative 0. 56±0. 08 to postoperative 0. 74±0. 07, the difference was statistically significant (t= -20. 605, P＜0. 00l). The mean serum creatinine (sCr) levels tested at 48 h and one week after the treatment were (159. 91±33. 21) μmol/L and (143. 44±43. 59) μmol/L respectively, which were not significantly different from preoperative (139. 5±37. 6) μmol/L (t=-1. 098, P=0. 285), and none of these results met the standard of contrast nephropathy. Among the 21 times of EVT procedure, additional use of iodinated contrast media was employed in 13 procedures, the average used amount of iodine contrast agent was (12±5. 5) mL. After the treatment, sCr level was elevated, the estimated glomerular filtration rates (eGFR) were lower than 50 mL· min-1 · 1. 73 m-2, which restored to preoperative level in one week. CO2 angiography showed that the image quality of all arteries above the knee joint met the requirements of treatment, except for one patient whose images could not accurately display the length and extent of the stenosis due to restenosis of the superficial femoral artery. The image quality of the arteries below the knee level was usual. Conclusion In performing EVT procedure to treat lower extremity ASO the use of C02 angiography is safe. The image quality of all arteries above the knee joint is satisfactory, it can significantly reduce, or even avoid, the use of iodine contrast agents. Therefore, this technique is especially suitable for patients who have renal insufficiency or iodine allergy. (J Intervent Radiol, 2018, 27:211-214)

Biological effects of 125I-UdR chitosan nanoparticles on hepatoma cells / 中华放射医学与防护杂志

Objective To evaluate the internal irradiation biological effects of 125I-UdR chitosan nanoparticles in hepatoma cells.Methods The accumulation and distribution of 125I-UdR-CS-DLN in hepatoma cells HepG2 and human liver tissue cells HL-7702 were observed with a confocal microscopy.The internal irradiation biological effects were evaluated by MTT assay,flow cytometry and single cell gel electrophoresis.The apoptosis of in situ rabbit liver tumor treated with 125I-UdR-CS-DLN was assayed by TUNEL staining technique.Results After 30 min of nano-particle treatment,its accumulation in the cytoplasm of HepG2 cells was significantly greater than that in HL-7702 cells.When the concentrations of 125I-UdR-CS-DLN was higher than 37 kBq/ml,the cell viability of HepG2 was significantly lower than that of lL-7702 at 24 and 48 h post-treatment(t =-4.46-6.31,P＜0.05),and the HepG2 cells were arrested at G1 phase and significantly impaired at G2/M phase.In addition,the degrees of DNA doublestrand break of both cell lines irradiated by 125I-UdR-CS-DLN were significantly higher than those treated with 125I-UdR,and the DNA repair capacity of HepG2 cells was significantly lower than that of HL-7702 cells(OTM:t =2.94,P ＜0.05;TDNA％:t =10.64,P ＜0.01).TUNEL staining showed that cell apoptosis could be induced in the rabbit liver carcinoma by 125I-UdR-CS-DLN but not by 125I-UdR.Conclusions The amount of 125I-UdR-CS-DLN absorbed by hepatoma cells is significantly higher than that of 125I-UdR,which suggests that 125 I-UdR-CS-DLN induces more stronger internal radiation biological effects of apoptosis and DNA damage on hepatoma cells.

An observation on efficacy of lung detoxification soup for treatment of patients with ventilator associated pneumonia / 中国中西医结合急救杂志

Objective To observe the clinical efficacy of lung detoxification soup for treatment of patients with ventilator associated pneumonia(VAP)and its effects on serum procalcitonin(PCT),high sensitivity C reactive protein (hs-CRP)and white blood cell count(WBC). Methods A prospective randomized controlled trial was conducted, sixty cases of VAP with traditional Chinese medicine(TCM)syndrome of accumulation of phlegm and heat in lung from Department of Intensive Care Unit(ICU)in the First Affiliated Hospital of Anhui TCM University were enrolled, and the CASIO fx-360P function calculator was applied to generate random numbers to proceed to simple randomized dividing into two groups(each,30 cases). In the control group,mechanical ventilation,anti-infection,prevention of stress ulcer,early enteral nutrition,early weaning of ventilator and conventional western medicine treatment were given to the patients,while in the treatment group,based on the above conventional treatments in the control group,additionally the lung detoxification soup was given(soup composition:radix astragali 20 g ,baical skullcap root 15 g,coptis 10 g,shellfish 8 g,pinelliae tuber 10 g,white mustard seed 10 g,heartleaf houttuynia herb 15 g, honeysuckle flower 15 g,forsythia 15 g,banlangen 15 g,rhubarb 10 g,salvia miltiorrhiza 30 g)by nasal feeding, once 100 mL,twice a day. The therapeutic course was 7 days in both groups. The changes of TCM syndrome integral, levels of serum PCT,hs-CRP and WBC before and after treatment and the clinical efficacy were compared between the two groups. Results After treatment,the TCM syndrome integral,the levels of WBC,serum PCT,hs-CRP were significantly lower than those before treatment in both groups,and the decrease in treatment group being more marked〔TCM syndrome integral:4.73±1.10 vs. 10.33±1.46,WBC(×109/L):8.71±0.55 vs. 10.77±0.65,PCT (μg/L):1.64±0.40 vs. 5.71±1.25,hs-CRP(mg/L):4.96±1.06 vs. 8.85±1.53,all P<0.05〕. The total effective rate of treatment group was significantly higher than that in the control group〔(93.33%(28/30)vs. 73.33(22/30),P<0.05〕. Conclusion The lung detoxification soup can significantly improve the clinical symptoms,reduce the levels of WBC,serum PCT and hs-CRP in patients of VAP with TCM syndrome of accumulation of phlegm and heat in lung, therefore the soup may play a beneficial role as an adjuvant therapy for such patients.

Early non-invasive positive pressure ventilation in treatment of serious hypoxemia following acute left heart failure / 中国综合临床

Objective To observe the effect of early non-invasive positive pressure ventilation(NIPPV)on the treatment of serious hypoxemia induced by acute left heart failure. Methods Forty patients with acute left heart failure( Grade Ⅳ heart function)were randomly divided into two groups. Patients in both groups accepted supportive treatment included cardiotonics, diuretics, vasodilators, in additional to these high concentrations of oxygen were given in conventional group, and non-invasive positive pressure ventilation were given in NIPPV group by biphasic positive airway pressure(BiPAP). Systolic blood pressure, heart rate, respiratory rate, blood-gas analysis( pH, PaO2, PaCO2, SaO2 )and clinical signs were observed at 2 hours after treatments. Results Compared to control,RR( [ 19.55 ± 1.88] vs [21.85 ±3.51 ] ) BPM] ,HR ( [96.40 ±2.80] vs[ 103.20 ±6.78 ] BPM), SBP ( [ 116.30 ± 8.95 ] mm Hg vs [ 122.50 ± 6.13 ] mm Hg), pH (7.404 ± 0.027 vs 7.358 ±0.05) ,SaO2 ( [93.57 ± 1.18]% vs [91.97 ± 1.85]% ) ,PaO2 ( [75.58 ±4.61 ]mm Hg vs [68.38 ±7.95]mm Hg), PaCO2 ( [ 38.69 ± 3.06 ] mm Hg vs [ 43.61 ± 2.65 ] mmHg) were significantly different in NIPPV group( t = 2.582,4.146,2.558,3.534,3.256,3.505,5.428, Ps ＜ 0.05 ). We found no significant differences in the comparisons before treatments. Hypoxia improved in NIPPV group,and the total effective rate was 95% in NIPPV group and 70% in control group,which showed significant difference( x2 =4.329 ,P ＜0.05 ) Conclusion BiPAP non-invasive positive pressure ventilation combined with routine treatment in treating heart failure, could promptly correct hypoxia, improve heart function and shortening disease course.

Complications of stenting in superior vena cava syndrome / 中华放射学杂志

Objective To investigate the incidence and causes of complication of stenting in the treatment of superior vena cava syndrome (SVCS) for its proper prevetions. Methods Thirty nine patients with SVCS due to various diseases were retrospectively analyzed. The location, extension and degree of the stenosis were identified on venography before stent placement. Lumen narrowing becoming less than 50% or 20% improvement after stenting was taken as effective. Complications after stenting were analyzed. Results Thirty-five(89.7%, 35/39) patients relieved after stenting. Six patients (15.4%) had complications, including stents displacement due to mass lessened after chemotherapy in 1 cases, stents displacement and thrombogenesis due to lack of anticoagulant therapy and mass lessened after chemotherapy in 1 cases, restenosis due to mass growing into the screening of Gianturco Z-type stent in 1 cases, acute pericardial effusion in 1 cases, 1 of acute pulmonary embolism(PE) in 1 cases and acute congestive right heart failure and relieved after treatment in 1 cases. Conclusions Some complications of stenting in SVCS is serious. Proper procedure, stents selection and skillful handling can reduce the frequency of the complications.

Vascular endothelial growth factor receptor-2 and its phosphorylated state in cancerous and peri-cancerous tissues of hepatocellular carcinoma after transcatheter arterial chemoembolization / 中华放射学杂志

Objective To investigate vascular endothelial growth factor receptor-2(VEGFR-2)and its phosphorylated state in cancerous and peri-cancerous tissues of hepatocellular carcinoma(HCC)after transcatheter arterial chemoembolization(TACE).Methods Forty-three cases of second-stage surgery of HCC after TACE(TACE & surgery group)and twenty cases of surgery without TACE(direct surgery group)were performed.Surgical specimens were made into paraffin-embedded slices.VEGFR-2,phosphorylated VEGFR-2,hypoxia induced factor-1α(HIF-1α)and microvessel density(MVD,labeled by CD31)were detected using immunohistochemical method.All data was statistically processed with SPSS for Windows.Results The absorption factor(A factor)of phosphorylated VEGFR-2 and HIF-1α in the cancerous tissue of HCC were(0.034±0.016)and(0.047±0.021)in TACE & surgery group,and(0.024±0.009)and(0.035±0.016)in direct-surgery group,which showed statistically significant difference(F=6.75,4.77,P＜0.05).The A factors of VEGFR-2,phosphorylated VEGFR-2 and HIF-1α in the peri-cancerous tissue were(0.040±0.017),(0.031±0.011)and(0.037±0.015)respectively in TACE & surgery group,and(0.030±0.015),(0.020±0.008)and(0.024±0.014)respectively in direct-surgery group,all of which showed statistically significant difference(F=4.60,13.72,11.65,P＜0.05).MVD of the peri-cancerous tissue was(58.3±15.2)/HP in TACE & surgery group and(44.4±10.5)/HP in direct-surgery group,which showed statistically significant difference(χ2=13.64,P＜0.05).Conclusion The cancerous and peri-cancerous tissues in HCC after TACE showed more hypoxic changes.Both expression and function of VEGFR-2 were enhanced following TACE.

Effects of Reduqing Oral Liquid on Body Temperature and Plasma Nitric Oxide Level in Rabbits with Endotoxic Induced Fever / 中国中医药信息杂志

Objective To investigate the effects of Reduqing Oral Liquid (RDQ) on endotoxic fever and plasma nitric oxide (NO) levels of rabbits. Methods Sixty rabbits were randomly divided into 6 group:Acetylsalicy Acid (APC) group, RDQ high dosage group, RDQ low dosage group, RDQ middle dosage group, Shuanghuanglian (SHL) group, model group, ten rabbits of each group. Body temperature and plasma NO of each group were observed. Results In RDQ high dosage group and middle dosage group, plasma NO and fever were reduced significantly (P

Retrospective analysis of the treatment of hypervascular hepatic metastasis with TACE / 介入放射学杂志

Objective To evaluate the treatment of hypervascular hepatic metastasis with TACE. Methods One hundred and twenty nine cases of hepatic metastasis treated by TACE were selected retrospectively and then analyzed the survival rate,clinical effectiveness and lipidol deposition quantity in tumor.Results Malformation of tumor vessels and rich blood supply were found in all cases of this study.The survival rates of 6 months,1 year and 3 years were 100%,73.6% and 26.4% respectively.The clinical effective rate was 68.2%(88/129)and no-progress rate was 23.3%(30/129).The satisfactory lipidol deposition quantity was obtained in 80.9%(97/129).Conclusions TACE is a favorable method for hepatic metastasis,and discerning the hypervascular subgroup could improve the treating effectiveness and be useful to make an appropriate planning.

Minimally invasive non-surgical lung volume reduction / 介入放射学杂志

Minimally invasive treatment with lung volume reduction is the promising future for severe pulmonary emphysema patients. With emerging and improving of new techniques and instruments, it would become an important choice for managing severe emphysema. A comprehensive review is here documented through the corvelative techniques, instruments, new achievements and latest research work.(J Intervent Radiol, 2006,15:53-56)