Prevalence and Risk Factors of Renal Artery Stenosis in Patients with Refractory Hypertension / 中国医学影像学杂志

PurposeTo investigate the independent risk factors of refractory hypertension for effective screening and treatment.Materials and Methods 142 patients with refractory hypertension underwent renal angiography, morbidity of renal artery stenosis (RAS) and angiography results were analyzed using univariate and multivariate Logistic regression.Results Thirty-eight cases of RAS were identiifed with incidence of 26.8%. Univariate analysis indicated that diabetes, peripheral artery disease and coronary heart disease were the predictor for RAS (P<0.05 orP<0.01). Multivariate regression analysis demonstrated that peripheral artery disease (OR 5.011, 95%CI 2.17-8.93,P<0.001) was independent risk factors for RAS. Diabetes and coronary heart disease were not independent risk factors.Conclusion Peripheral artery disease is independent risk factor for RAS among patients with refractory hypertension, which can serve as a screening index of renal angiography or renal angioplasty and stenting for RAS.

The clinical efficacy of transcatheter super-selective hepatic artery embolization for the treatment of symptomatic polycystic liver disease / 介入放射学杂志

Objective To evaluate the clinical efficacy of transcatheter super-selective hepatic artery embolization (TAE) in treating symptomatic polycystic liver disease (PLD). Methods A total of 8 patients with PLD, who were admitted to authors’ hospital during the period from 2009 to 2013 to receive TAE, were enrolled in this study. The patients included 6 females and 2 males with a mean age of 59.5 years (54-65 years). The used embolic agents were polyvinyl alcohol (PVA) microspheres and micro spring coils. Both plain and contrast-enhanced CT scans of the upper abdomen were performed before TAE as well as at 12 months after TAE; the total volume of the hepatic cysts was measured and the changes of the cystic volume were determined. Statistical analysis was conducted using paired t test. Results The technical success rate was 100%. After TAE, the patients developed fever and different degrees of discomfort at liver area, which were disappeared after active symptomatic medication, and no serious complications occurred. The patients were followed up for 12 months , the mean total volume of the intrahepatic cysts decreased from preoperative (5 794±2 066) cm3 (range 3 120-8 935 cm3) to postoperative (3 832±1 525) cm3 (range 2 019-5 925 cm3), the difference was statistically significant (t=6.971, P<0.001). The reduction ratio of total volume of intrahepatic cysts was 34.6%±11.3%(24.3%-60.4%). Conclusion For symptomatic polycystic liver disease, transcatheter super-selective hepatic arterial embolization is a newly-developed treatment. This technique is safe and effective with reliable response and fewer complications. Therefore, it should be recommended in clinical practice.

Comparative study on digital substraction angiography and CT diagnosis for the residual and new lesions of primary hepatocelluar carcinoma after transcatheter arterial chemoembolization / 肿瘤研究与临床

Objective To comparative analyze the CT enhanced scan and digital substraction angiography (DSA) in showing the residual and new lesions after treatment of transcatheter arterial chemoembolization (TACE).Methods 60 cases of patients with complete clinical information and imaging data from June 2010 to February 2013 were collected,these patients were diagnosed of primary hepatocelluar carcinoma and underwent TACE treatment.The sensitivity and specificity of CT and DSA to detect the residual and new lesions after TACE treatment were analyzed.By analysis of the main factors affecting the low detection rate to seek a method that can improve PHC residual new lesions detection rate after TACE.Results There were 86 lesions in 60 cases,CT enhanced scan clearly determined the diagnosis of 49 lesions (42 residues,7 new lesions).37 lesions did not prompted to tumor recurrence (residual and new lesions).DSA as the gold standard,the sensitivity of CT enhanced scan to check out the lesions was 84.5 ％ (49/58),specificity was 100.0 ％ (28/28),the false negative rate was 15.5 ％ (9/58),the accuracy was 89.5 ％ (77/86).Enhanced CT detection rate of tumor recurrence was 57.0 ％ (49/86),the DSA detection rate of tumor recurrence was 67.4 ％ (58/86).The difference of determining tumor recurrence between the CT enhanced scan and DSA was significant (x2 =7.11,P ＜ 0.05).Conclusions Three dynamic contrast-enhanced CT scan is the first choice for follow-up examination methods after TACE for hepatocellular carcinoma,but many factors will affect the detection rate of the residual and new lesions.Compared with CT examination,DSA examination has more advantages.DSA examination should be performed when the clinical suspicion of tumor recurrence is negative after enhanced CT scan.

Application of problem-based learning in clinical nursing teaching in obstetrical and gynecological department / 现代临床护理

Objective To investigate the feasibility of using problem-based learning in nursing clinical teaching in the obstetrics and gynecology department.Methods Sixty-six nursing students were randomly divided into PBL group and lecture-based learning(LBL)group .At the end of their internship,the two groups were compared in terms of examination performance,learning attitude and aptitude,and their feedback on the two learning modes.Results The students in the PBL group were significantly better than those in the control group in terms of examination performance,learning attitude and aptitude,and their feedback on the learning mode(P<0.001).Conclusions PBL may be effective in the improvement of their attitude to learning and aptitude,the comprehensive ability.It can provide an environment to promote internal learning motivation for students.

Adopting wedge hepatic venography with CO2 during transjugular intrahepatic portosystemic shunt procedures / 中华放射学杂志

Objective To renovate angiography in identifying portal vein anatomy during transjugular intrahepatic portosystemic shunt (TIPS) procedures,saving the time of TIPS procedures,decreasing the risk of the complications of the post-procedure.MethodsThe difference between the Wedge hepatic venography with Carbon Dioxide in 6 cases and Inferior Mesenteric artery angiography in 7 cases during TIPS procedures were compared in the identification of portal vein anatomy.The quality of images,their effects on the procedures,the complications and the recovery post-procedure were evaluated.Results Using CO2,the portal veins were opacified in all 6 cases.TIPS procedures succeeded in all cases except 1 case because of poor coagulation function.Using Inferior Mesenteric artery angiography,the portal veins were opacified in al1 7 cases.TIPS procedure succeeded in all cases except 1 case because of chronic portal occlusion.Puncture-site hematoma occurred in 1 case after TIPS procedure.ConclusionWedge hepatic venography with Carbon Dioxide is superior,safer and more convenient than Inferior Mesenteric Artery angiography in identifying portal vein anatomy during TIPS.