Balloon dilation of epidermolysis bullosa-related esophageal strictures: A report of two cases

Epidermolysis bullosa (EB) is a very rare inherited disease featured with skin blistering resulting from minor trauma. Sometimes the esophageal mucosa could also be involved, which leads to esophageal strictures. Here we report two cases of EB-related esophageal strictures who were successfully treated with esophageal balloon dilations. The two cases with EB had severe dysphagia. Clinical examination showed signs of malnutrition, skin blisters and loss of toenails due to EB. They underwent careful fluoroscopic balloon dilation with 10- and 16-mm-sized balloon catheters, respectively. They could ingest soft and some solid foods after the procedure and maintained during the 20 months and 16 months follow-up periods.

A cross-sectional survey on the prevalence of Brucellosis among workers in Jiangsu province, 2012 / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the status of infection and risk factors on Brucellosis among workers in Jiangsu province so as to provide related preventive and control measures.</p><p><b>METHODS</b>A cross-sectional survey was conducted on 238 workers at three butcheries, one trading market and one stockyard. Related risk factors on the different exposures to the disease were also analyzed.</p><p><b>RESULTS</b>50 workers were identified to have had the infection, with a infection rate as 21% (50/238). No significant differences in gender, age, working length and occupations were found. Jobs as slaughtering (RR = 1.80, 95%CI:1.1-3.1), particular on bleeding (RR = 1.90, 95%CI:1.1-3.3) were risk factors. Habit as hand-washing before eating was a protective factor (RR = 0.25, 95% CI: 0.14-0.44).</p><p><b>CONCLUSION</b>Workers from butcheries, trading markets and stockyards were seriously infected with Brucellosis in Jiangsu province and related. Control measures and education should be implemented to the workers in that trade.</p>

Follow-Up of 58 Traumatic Carotid-Cavernous Fistulas after Endovascular Detachable-Balloon Embolization at a Single Center

BACKGROUND AND PURPOSE: This study evaluated the clinical value of detachable-balloon embolization for traumatic carotid-cavernous fistula (TCCF), focusing on the frequency, risk factors, and retreatment of recurrence. METHODS: Fifty-eight patients with TCCF underwent transarterial detachable-balloon embolization between October 2004 and March 2011. The clinical follow-up was performed every 3 months until up to 3 years postprocedure. Each patient was placed in either the recurrence group or the nonrecurrence group according to whether a recurrence developed after the first procedure. The relevant factors including gender, fistula location, interval between trauma and the interventional procedure, blood flow in the carotid-cavernous fistula, number of balloons, and whether the internal carotid artery (ICA) was sacrificed were evaluated. RESULTS: All 58 TCCFs were successfully treated with transarterial balloon embolization, including 7 patients with ICA sacrifice. Recurrent fistulas occurred in seven patients during the follow-up period. Univariate analysis indicated that the interval between trauma and the interventional procedure (p=0.006) might be the main factor related to the recurrence of TCCF. The second treatments involved ICA sacrifice in two patients, fistula embolization with balloons in four patients, and placement of a covered stent in one patient. CONCLUSIONS: Detachable balloons can still serve as the first-line treatment for TCCFs and recurrent TCCFs despite having a nonnegligible recurrence rate. Shortening the interval between trauma and the interventional procedure may reduce the risk of recurrence.

Value of percutanous catheter fragmentation in the management of massive pulmonary embolism / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Acute massive pulmonary embolism (PE) is a clinical emergency requiring rapid and supportive measures. Percutanous mechanical thrombectomy is considered as a treatment option. The purpose of this study was to evaluate the clinical efficacy and safety of peructaneous mechanical catheter fragmentation in the management of acute massive PE.</p><p><b>METHODS</b>From January 2003 to June 2007, 28 patients (20 men, 8 women; mean age 64 years) with acute massive PE initially diagnosed by computed tomography and confirmed by pulmonary angiography were treated with inferior vena caval filter placement and percutaneous catheter fragmentation. Twenty-six patients received thrombolytic agents after embolus fragmentation.</p><p><b>RESULTS</b>Technical success was achieved in all patients. The improvement of clinical status and restoration of blood flow in the main branches of the pulmonary artery were seen in 27 patients. Only one case did not benefit from the percutaneous therapy and died from the failure of the surgery. Oxygen saturation increased from (86.2 +/- 4.5)% to (96.1 +/- 3.2)% (P < 0.001) after the interventional procedure. The post-procedure mean pulmonary artery pressure decreased from (34.2 +/- 4.8) mmHg to (25.2 +/- 5.1) mmHg (P < 0.001). During clinical follow-up (range, 1 - 5 years), no patients had recurrence of PE.</p><p><b>CONCLUSION</b>Percutaneous catheter fragmentation combined with thrombolysis is an effective and safe therapy in the clinical management of acute massive PE.</p>

Embolization of high flow arteriovenous malformations with HepaSphere microspheres / 中华整形外科杂志

<p><b>OBJECTIVE</b>To determine the effect, safety, and feasibility of embolization of high flow arteriovenous malformations (AVMs) with HepaSphere microspheres.</p><p><b>METHODS</b>HepaSphere particles swell by absorbing fluids and become soft and deformable with a precisely calibrated diameter. 13 patients with AVMs were treated by transarterial embolization with HepaSphere particles. 3 cases underwent a following AVMs resection surgery. The follow-up period was 3 months to 3 years. Symptoms improvement and image examination were studied.</p><p><b>RESULTS</b>28 transarterial embolizations were performed in 13 cases. The resection operation was performed in 3 cases after transarterial embolizations. The symptoms in diffused AVMs improved after several transarterial embolizations. Histologically, HepaSphere particles penetrated into the intralesional vessels and conformed to the vessel lumen, resulting in vessel occlusion. Minimal perivascular reaction was observed.</p><p><b>CONCLUSIONS</b>Embolization of high flow AVMs with HepaSphere microspheres is safe and effective. Combined treatment is necessary for diffuse AVMs.</p>

Efficacy analysis of interventional therapy on patients with primary liver carcinoma accompanied with hypoglycemia / 中国基层医药

Objective To study the therepeutic effect of interventional treatment on patients with primary liver carcinoma accompanied with hypoglycemia.Methods 10 cases liver carcinoma patients with hypoglycemia un- derwent TACE.Results Blood sugar of 10 patients was kept in normal range after TACE.Hypoglycemia recurred in 1 case half a month after interventional therapy.CT showed carcinoma was not completely controlled,and the blood supar was turned to normal after a second interventional therapy.2-month follow-up showed no recurrence of hypoglycemia in 10 patients.Conclusion Application of TACE had good therapeutic effect on liver carcinoma pa- tients accompanied with hypoglycemia.