Mechanism of Honghua Oral Liquid in Alleviating Neuropathic Pain / 中国实验方剂学杂志

ObjectiveTo investigate the pharmacodynamic characteristics and explore the molecular mechanism of Honghua oral liquid （HOL） in relieving neuropathic pain （NP）. MethodHealthy male SD rats were randomly assigned into sham group， model group， low-， medium-， high-dose （0.5， 1.0， 2.0 mL·kg-1·d-1， respectively） HOL groups， and a positive drug （pregabalin， 25 mg·kg-1·d-1） group， with 6 rats in each group. Spinal nerve ligation （SNL） of L5 was conducted in other groups except the sham group. Drug administration was performed 3 days after the SNL surgery for 2 consecutive weeks， and samples were collected after the end of the administration. During the treatment period， the mechanical pain threshold and cold pain threshold were determined to measure the pain-relieving effect of HOL. Transcriptome sequencing was performed on hippocampal tissue samples from the sham， model， and high-dose HOL groups， and differentially expressed genes between the sham group and the model group as well as the model group and HOL high-dose group were obtained. After pathway enrichment analysis， we selected the targets which were closely related to neuroinflammation for validation， and predicted the specific binding sites of the major active components in HOL with the targets through molecular docking. In addition， the serum levels of tumor necrosis factor-α （TNF-α） and interleukin-10 （IL-10） were determined by enzyme-linked immunosorbent assay （ELISA） to evaluate the effect of HOL on neuroinflammation in NP rats. ResultCompared with the sham group， SNL decreased the mechanical pain threshold and cold pain threshold （P<0.05）. Compared with the model group， HOL recovered the mechanical pain threshold and cold pain threshold （P<0.05）. The transcriptome data showed that 376 differentially expressed genes （DEGs） were identified between the model group and the sham group， including 124 upregulated genes and 252 downregulated genes， and 194 DEGs between the model group and the high-dose HOL group， including 33 upregulated genes and 161 downregulated genes. Among them， insulin-like growth factor 1（IGF1）， matrix metallopeptidase-2 （MMP-2）， matrix metallopeptidase-14 （MMP-14）， erb-B2 receptor tyrosine kinase 2 （ERBB2）， and integrin subunit alpha 5 （ITGA5） associated with NP were selected for further validation. The Real-time fluorescence quantitative polymerase chain reaction（Real-time PCR） results showed that compared with the sham group， the modeling up-gurelated the mRNA levels of the above five molecules in the hippocampus （P<0.01）. Compared with model group， HOL down-regulated the mRNA levels of these molecules （P<0.01）. The molecular docking results showed that the main active components of safflower， hydroxysafflor yellow A， kaempferol， and quercetin， formed stable hydrogen bonds with the amino acid residues of IGF1， MMP-2， MMP-14， ERBB2， and ITGA5. The enzyme-linked immunosorbent assay（ELISA） results showed that compared with those in the sham group， the serum levels of TNF-α and IL-10 were out of balance in the model rats （P<0.01）. Compared with the model group， HOL lowered the level of the pro-inflammatory cytokine TNF-α （P<0.01） and elevated that of the anti-inflammatory cytokine IL-10 （P<0.05）. ConclusionHOL exerts analgesic effect on SNL rats by inhibiting neuroinflammation.

Application of outflow angle-assisted approach in diagnosing cerebral sidewall aneurysms with MRA / 介入放射学杂志

Objective To assess the value of outflow angle-assisted (OA-assisted) approach in diagnosing and differentiating sidewall cerebral aneurysms (SCAs) with magnetic resonance angiography (MRA). Methods A total of 438 patients with suspected SCAs and other cerebrovascular diseases were separately evaluated by OA-assisted approach MRA and digital subtraction angiography (DSA). An OA of ≥90o was considered to represent SCA. The diagnostic accuracy, sensitivity, and specificity of SCAs with OA assisted approach were evaluated with the number of aneurysms and the size of aneurysms. Results DSA revealed 301 SCAs in 267 patients, and no SCAs was detected in the remaining 171 patients, among them a total of 55 infundibulae were observed in 52 patients. OA-assisted approach MRA revealed 300 SCAs in 267 patients, among which 271 aneurysms in 238 patients had an OA of ≥90o(true positive of 90.3％) and 29 aneurysms in 29 patients had an OA of <90° (false negative of 9.7％). Based on the patient, the number of aneurysms and the size of aneurysms, OA-assisted approach MRA had higher accuracy, sensitivity and specificity in diagnosing SCAs. The OA of all 54 infundibulae observed in 51 patients was <90°(98.2％), and only one infundibula in one patient was ≥90° (false positive). Conclusion MRA with OA-assisted approach has higher accuracy in diagnosing SCAs and in differentiating SCAs with infundibula, therefore, it can substitute DSA for the diagnosis and differentiation of SCAs.

Clinical study of blood pressure variability in aged patients with H type hypertension / 心血管康复医学杂志

Objective: To explore characteristics and influencing factors for blood pressure variability (BPV) in aged patients with H type hypertension.Methods: A total of 100 patients with essential hypertension, who were treated in our hospital from Dec 2012 to Dec 2013, were selected.According to serum level of homocysteine (Hcy), patients were divided into pure hypertension group (n=42, Hcy<15.4 μmol/L) and H type hypertension group (n=58, Hcy≥15.4 μmol/L).All patients received 24h ambulatory blood pressure monitoring (24hABPM), and BPV indexes were recorded and compared between two groups.Correlation among BPV indexes and general data were analyzed, and multi-factor linear regression analysis was used to analyze influencing factors for BPV indexes.Results: Compared with pure hypertension group, there were significant rise in 24h systolic blood pressure standard deviation [24hSSD, (12.80±2.23) vs.(16.01±3.11)], daytime SSD [dSSD, (11.58±2.30) vs.(13.86±2.26)] and nighttime SSD [nSSD, (9.41±1.64) vs.(11.71±2.34)] in H type hypertension group, P<0.05 or <0.01.Pearson correlation analysis indicated that Hcy, total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) were significantly positively correlated with 24SSD, dSSD and nSSD (r=0.201~0.508, P<0.05 or <0.01).Multivariate linear regression analysis indicated that Hcy and TC were significantly positively correlated with 24SSD, dSSD and nSSD (B=0.194~0.546, P<0.05 or <0.01).Conclusion: Systolic blood pressure variability in aged patients with H type hypertension is significantly higher than that of patients with pure hypertension,their serum Hcy level, TC elevating level are significantly positively correlated with systolic blood pressure variability and are major influencing factors for BPV in these patients.

Hemostasis effect comparison between artificial pressing and Perclose vascular closure device on femoral artery / 心血管康复医学杂志

Objective:To observe hemostoisis efficacy and safety of Perclose vascular closure device on femoral artery in transfemoral pathway radiofrequency ablation (RFA) of supraventricular tachycardia (SVT) .Methods :A total of 199 patients undergoing transfemoral RFA of SVT were divided into Perclose vascular closure group (Perclose group ,n=98) and artificial pressing group (n=101) .Immediate success rate ,hemostasis time ,braking time and in-cidence rates of postoperative complications were observed between two groups .Results:There was no significant difference in immediate success rate of hemostasis (98% vs .100% ) between Perclose group and artificial pressing group , P> 0.05. Compared with artificial pressing group , there were significant reductions in hemostasis time [ (18.9 ± 9.1) min vs .(2.7 ± 0.7) min] ,braking time [ (21.6 ± 3.4) min vs .(6.3 ± 2.4) min] and total inci-dence rate of complications (16.8% vs .4.1% ) in Perclose group , P 0.05 all) . Conclusion:Perclose vascular closure device could shorten the duration of hemostasis and braking ,and reduce the complications .It could be the preferred choice for femoral artery hemostasis .

Comparison of three dimensional time-of-flight MR angiography at 3.0 T MR and DSA in the detection of intracranial aneurysms / 中华放射学杂志

Objective To investigate the diagnostic accuracy of contrast-free three dimensional time-of-flight (3D-TOF-MRA) with VR at 3.0 T in the detection of intracranial aneurysms in a large cohort of patients prospectively.Methods Four hundred and eleven patients with suspected aneurysms and other cerebral vascular diseases received contrast-free 3D-TOF-MRA examinations at 3.0 T MRA 2 weeks prior to DSA examination.2D-DSA and VR-DSA were regarded as the gold standard.Six patients were excluded because of motion artifacts,and 36 patients were excluded due to lack of VR-DSA data.Accuracy,sensitivity an specificity in detecting intracranial aneurysms were determined by patient-,aneurysm-,and aneurysm sizebased (＜ 3 mm,3-5 mm,＞ 5-10 mm,＞ 10 mm) evaluations.Results In 369 enrolled patients,VR-DSA revealed 306 aneurysms in 246 patients (66.7％) and no aneurysm in 123 patients; VR 3D-TOF-MRA revealed 311 aneurysms in 249 patients and no aneurysm in 120 patients.The patient-based evaluation of VR 3 D-TOF-MRA at 3.0T yielded accuracy of 97.6％ (360/369),sensitivity of 99.2％ (242/244),and specificity of 94.4％ (118/125) in the detection of intracranial aneurysms.The aneurysm-based evaluation yielded accuracy of 98.3％ (524/533),sensitivity of 99.3％ (304/306),and specificity of 96.1％(220/229).The evaluation based on aneurysm sizes (＜ 3 mm) yielded accuracy of 96.4％ (214/222),sensitivity of 98.2％ (112/114),and specificity of 94.4％ (102/108).Conclusion VR 3D-TOF-MRA at 3.0 T MR can detect intracranial aneurysms accurately and may replace DSA as a contrast-free,noninvasive and non-radiation-based modality for the diagnosis and screening of intracranial aneurysms.

A comparison of four dimensional time-resolved with keyhole and three dimensional time-of-flight MR angiography for the evaluation of cerebral aneurysms / 中华放射学杂志

Objective To evaluate the accuracy and reliability of 4D time-resolved MRA with keyhole (4D-TRAK) for the detection and characterization of cerebral aneurysms ( CAs),with a comparison of 3D time-of-flight MRA (3D-TOF-MRA).Methods3D-TOF-MRA,4D-TRAK and 3D-DSA were performed sequentially in 52 patients with suspected CAs.4D-TRAK was acquired using a combination of sensitivity encoding (SENSE) and contrast-enhanced (CE) timing robust angiography ( CENTRA ) k-space sampling techniques at a contrast dose of 10 ml at 3 T scanner. Accuracy,sensitivity,specificity of 4D-TRAK and 3D-TOF-MRA were calculated and compared for the detection of CAs on patient-based and aneurysm-based evaluation using 3D-DSA as a reference. Wilcoxon signed rank test were used. Results The overall image quality of 4D-TRAK was appropriate for the diagnostic purpose,but yet not comparable with that of 3D-TOF-MRA.In 52 patients with suspected GAs,58 CAs were confirmed on 3D-DSA finally.Fifty-one (with 2 false-positives and 9 false-negatives) and 58 (with 1 false-positive and 1 false-negative)CAs were visualized on 4D-TRAK and 3D-TOF-MRA,respectively.Accuracy,sensitivity and specificity on patient-based evaluation of 4D-TRAK and 3D-TOF-MRA were 92.31％ ( 48/52 ),93.33％ ( 42/45 ),85.71 ％ (6/7) and 98.08％ ( 51/52 ),100.00％ ( 45/45 ),85.71％ ( 6/7 ),respectively,and 74.07％(20/27),75.00％ ( 18/24),66.67％ (2/3) and 96.30％ (26/27),95.83％ (26/27),100.00％ (3/3)on aneurysm-based evaluation in patients with multiple CAs,respectively.Subgroup analysis revealed that for 19 very small CAs ( maximal diameter ＜3 mm,measured on 3D-DSA),9 were missed on 4D-TRAK and 1 on 3D-TOF-MRA( Z =- 2.464,P ＜ O.01 ). However,for 39 CAs with maximal diameter more than 3 mm,there was no significantly difference in the diagnostic accuracy (39 on 4D-TRAK vs.39 on 3D-TOFMRA) (Z =0.000,P ＞0.05).In 4 large CAs with maximal diameter more than 10 mm,4D-TRAK provided a better characterization of morphology than 3D-TOF-MRA.Conclusions 4D-TRAK with a combination of SENSE and CENTRA at 3 T shows potential value in the diagnosis of cerebral aneurysms.However,due to the compromise in spatial resolution and vascular edge artifacts,it does not yet have a diagnostic accuracy of CAs comparable with 3D-TOF-MRA.TRAK imaging can be of great help in patients with large-giant CAs to characterize the morphology of CAs and to diminish the risk of NSF in patients with renal impairment by using a lower-dose contrast.

Genetic Characteristics of 2009 Pandemic H1N1 Influenza A Viruses Isolated from Mainland China / 中国病毒学·英文版

A total of 100 HIN1 flu real-time-PCR positive throat swabs collected from fever patients in Zhejiang,Hubei and Guangdong between June and November 2009,were provided by local CDC laboratories.After MDCK cell culture,57 Influenza A Pandemic (H1N1) viruses were isolated and submitted for whole genome sequencing.A total of 39 HA sequences,52 NA sequences,36 PB2 sequences,31 PB1 sequences,40 PA sequences,48 NP sequences,51 MP sequences and 36 NS sequences were obtained,including 20 whole genome sequences.Sequence comparison revealed they shared a high degree of homology (96％～99％) with known epidemic strains (A/Califomia/04/2009(H1N1).Phylogenetic analysis showed that although the sequences were highly conserved,they clustered into a small number of groups with only a few distinct strains.Site analysis revealed three substitutions at loop 220 (221-228) of the HA receptor binding site in the 39 HA sequences:A/Hubei/86/2009 PKVRDQEG→PKVRDQEA,A/Zhejiang/08/2009 PKVRDQEG→PKVRDQER,A/Hubei/75/2009PKVRDQEG→PKVRDQGG,the A/Hubei/75/2009 was isolated from an acute case,while the other two were from patients with mild symptoms.Other key sites such as 119,274,292 and 294 amino acids of NA protein,627 of PB2 protein were conserved.Meanwhile,all the M2 protein sequences possessed the Ser32Asn mutation,suggesting that these viruses were resistant to adamantanes.Comparison of these sequences with other H1N1 viruses collected from the NCBI database provides insight into H1N1 transmission and circulation patterns.

Comparison between Willis covered stent placement and coil embolization in the treatment of cranial internal carotid artery aneurysm: a nonrandomized prospective trial / 中华放射学杂志

Objective To evaluate the clinical results of Willis covered stent implantation and coil embolization in the treatment of cranial internal carotid artery (CICA) aneurysm. Methods Eighty-nine patients with CICA aneurysms were selected for treatment with Willis covered stents (n = 43, group A) or coil embolization (n =46, group B) according to the patients'will. Data on the technical success, initial procedure time and in-hospital interval, initial and final angiographic results, mortality, morbidity, and final clinical outcomes were collected and analyzed for the two groups at 6 months post-procedure. Results Endovascular covered stent placement and coil embolization were technically successful in all patients,except for one patient in group A. The initial angiographic results showed complete occlusion in 34 patients of group A (81%, 95% CI: 69%, 93% ) and 24 patients of group B (52%, 95% CI: 37%, 67% ) ( P ＜0. 05). The final angiographic results indicated complete occlusion in 39 patients of group A (39/41,95%,95% CI: 88%, 102% ) and 22 patients of group B (22/45,49%, 95% CI: 34%, 64% ,P ＜0. 01 ). The average procedure time was(103 ± 13)min in group A and (143 + 39) min in group B (P＜0. 01). No significant differences were seen between the two groups in technique success, mortality, morbidity, or final clinical outcomes. Conclusion In this nonrandomized, prospective trial, CICA aneurysm treatment with covered stents yielded midterm angiographic results that were superior to those of coil embolization.

Treatment of distal internal carotid artery aneurysm with the willis covered stent: a prospective pilot study / 介入放射学杂志

Objective To evaluate the flexibility and efficacy of the Willis covered stent in the treatment of distal internal carotid artery(DICA)aneurysms.Methods The study was approved by the anthors' institutional review board,and the research was conducted by the authors' institution and the MicroPort Medical Company(Shanghai,China).Thirty-one patients with 33 DICA aneurysms were considered for treatment with a Willis covered stent.The angiographic assessments were categorized as complete or incomplete occlusion.The data on technical Success,initial and final angiographic results,mortality,morbidity,and final clinical outcome were collected,and follow-up was performed at 1,3,6,and 12 months and yearly after the procedures.Results Navigation and deployment of the covered stents were succssfnl in 97.6%(41 of 42;95%confidence interval[CI]:93%,102%)of the attempted stent placement procedures.The initial angiographic results showed a complete occlusion in 23 patients with 25 aneurysms(of 32 aneurysms,78.1%[95%CI:63%,93%])and an incomplete occlusion in seven patients with seven aneurysms(21.9%).The angiographic follow-up(mean,14 months[95% CI:12,15 months])findings exhibited a complete occlusion in 27 patients with 29 aneurysms(of 31 aneurysms,93.5%[95%CI:84%,103%])and an incomplete occlusion in two aneurysms(6.5%),with a mild in-stent stenosis in two patients.The clinical follow-up(mean,27 months[95% CI:23,30 months])demonstrated that 15 patients experienced a full recovery and 14 patients improved.Conclusion The preliminary results demonstrate good flexibility and efficacy of the Willis covered stent in the treatment of DICA aneurysms in selected patients:longer follow-up and expanded clinical trials are needed.

Treatment of traumatic internal carotid artery pseudoaneurysms with Willis covered steuts: a midterm follow-up result / 介入放射学杂志

Objective To evaluate the efficacy and mid-term follow-up results of endovascular treatment with Willis covered stent for traumatic pseudoaneurysms located in the internal carotid artery (ICA).Methods ICA angiogmphy was performed in 38 patients with traumatic brain and neck injury.Of the 38 patients.13 delayed traumatic pseudoaneurysms were found.All the pseudoaneurysms were treated with Willis covered stents.Follow-up angiography was performed at 1,3,6 and 12 months after the procedure,and the results were categorized as complete or incomplete occlusion.Clinical manifestations were graded as full recovery,improvement,unchanged and aggravation.Results Willis covered stent placement was technically successful in all traumatic pseudoaneurysms.No procedure-related complications occurred.The initial angiographic results showed a complete occlusion in 9 patients,and an incomplete occlusion in 4.The angiographic follow-up within 3-12 months exhibited a complete occlusion in 12 patients and the parent arteries remained patency in all patients.The clinical follow-up observation demonstrated that full recovery wag obtained in 11 patients,clinical improvement in one,and unchanged condition in one.No morbidity or mortality occurred.Conclusion Willis covered stent implantation iS a feasible and practical treatment for traumatic pseudoaneurysms located in the ICA.This technique can well preserve the parent artery with excellent therapeutic results.

Endovascular treatment of recurrent intracranial aneurysms with re-coiling or covered stents / 介入放射学杂志

Objective To report our experiences in the treatment of recurrent intracranial aneurysms with re-coiling or covered stents.Methods A total of 291 patients with 305 intracranial aneurysms were treated with detachable coils.and 41(28.9%)of 142 patients with aneurysms in the intemal carotid artery had a recurrent aneurysm during the follow-up period.For this study,31 recurrent aneurysms in 31 patients who had angiograms within 6 months following retreatment with detachable coils(group A,n=20)or covered stents(group B.n=11)were analysed.Aneurysms were categorised as complete or incomplete occlusion via angiographic assessment and graded as full recovery,improvement,no change or deterioration via clinical assessment.Data regarding technical success,initial and final angiographic results,final clinical outcome were collected and analysed postoperatively.Results Coil embolisation and covered stent placement.were technically successful in all recurrent aneurysms.The initial angiographic results showed complete occlusion in 11 patients(55%)in group A and in eight(72.7%)in group B(P=0.452),and the final angiographic results exhibited complete occlusion in 10 patients(50%)in group A and in 11(100%)in group B(P=0.005).There were no significant differences in technique success or final clinical outcome between the two groups.Conclusions Recurrent aneurysms after coiling can be successfully treated and occluded with re-coiling or covered stent placement.However,covered stents seem to be more effective than re-coiling with regard to complete occlusion of recurrent aneurysms.

Transarterial endovascular treatment of traumatic direct carotid-cavernous fistulas: a report of 51 cases / 介入放射学杂志

Objective To present our single-center experience in treating traumatic direct carotidcavemous fistulas (TDCCFs)by using detachable balloon,coil and Willis covered stent via arterial route.Methods During the last five years,transarterial endovascular treatment by using detachable balloon,coil and Willis covered stent was performed in fifty-one consecutive patients of traumatic direct carotid-cavernous fistulas.with a total of 54 TDCCFs.The detachable balloon was the material of first choice,while Willis covered stents and coils were regarded as the back-up materials.A clinical and angiographic follow-up for 348 months (mean 20.8 months) was conducted to evaluate the arterial patency and the stability of embolization.The clinical data were retrospectively analyzed.Results By using the detachable balloon alone via transarterial route.85%TDCCFs were successfully treated with good preservation of ICA.A total of 98% TDCCFs in this study were successfully treated by using detachable balloon,coil and/or Willis coveted stent,the fistulas became occluded,and ICAs were preserved except one patient.Forty TDCCFs were treated with detachable balloons alone,two TDCCFs with the Willis covered stent alone,and one DCCF with coils alone.Eight TDCCFs were treated with detachable balloons together with Willis covered stent.Of these eight TDCCFs,two were treated with a single session,three were treated with detachable halloons in combination with coils,and one had to receive Willis covered stent.Second and third times of endovascular treatment were needed in 12 TDCCFs.The TDCCF-rel(at)ed symptoms were gradually relived or improved within 1 day to 6 months after treatment,except for five patients who suffered from ipsilateral moderate visual loss or cranial nerve deficit.No perioperative complications.such as vessel rupture,distal embolization or new neurologic deficits,occurred.During the follow-up period lasting for six months,neither delayed neurologic or vascular complications nor recurrence of the lesions developed.Conclusion Via the transarterial route,using detachable balloon to occlude the fistula and at the same time to preserve ICA remains the optimal treatment for TDCCFs.When the standard treatment fails.various coils and the Willis covered stents can be used as an effective alternative or remedial tool in the treatment of TDCCFs,which can preserve ICA.Willis covered stent deployment seems to be an effective,safe,feasible and economical endovasculal treatment for TDCCF,but more clinical studies are needed before we can further clarify its specifications and indications.

Endovascular management of carotid-cavernous fistulas / 介入放射学杂志

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas (CCF) and their complications such as pseudoaneurysms. Methods: Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coil embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stent management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% (4/22). A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% (8/22). Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.

Bronchial stump fistula :treatment with covered retrievable hinged metallic stents-preliminary clinical experience / 介入放射学杂志

Objective To evaluate the preliminaily clinical efficacy and retrievability of a retrievable hinged covered metallic stent in the treatment of the bronchial stump fistula (BSF). Methods Between April 2003 and March 2005, 8 patients with bronchial stump fistula after pneumonectomy or lobectomy were treated with two types (A and B) of retrievable hinged covered metallic stents. Type A stent was placed in 6 patients and type B in 2 under fluoroscopic guidance. The stent was removed with a retrieval set when BSF was healed or complications occurred. Results Stent placement in the bronchial tree was technically successful in all patients, without procedure-related complications. Immediate closure of the BSF was achieved in all patients after the procedure. Stents were removed from all patients but one. Removal of the stents was difficult in two patients due to tissue hyperplasia. Patients were followed up for 6 - 21 months. Placement of the stents remained stable in all patients except one due to severe cough. Permanent closure of BSF was achieved in 7(87.5%) of 8 patients. Conclusion Use of a retrievable hinged covered expandable metallic stent is a simple,safe, and effective procedure for closure of the BSF. Retrieval of the stent seems to be feasible. (J Intervent Radiol, 2007, 16: 253-257)[ Key words ] Fistula, pulmonary; Bronchialpleural fistula; Stents and prostheses; Computed tomography

Spontaneous regression of a giant basilar artery aneurysm in a young adult after surgical injury:case report and literature review / 介入放射学杂志

A giant basilar artery aneurysm of young woman with endocrine disturbance was misdiagnosed as a large pituitary adenoma and treated surgically via a trans-sphenoidal approach was planned.But the neurosurgery was finally aborted because of massive bleeding during the procedure. One year later, a cerebral angiography confirmed this basilar artery aneurysm was obviously regressed and then endovascular coiling was successfully performed. No neurological complication occurred post-procedure and the endocrine dysfunction symptom was obviously improved.

Obstructive jaundice: a comparative study of forceps and brush biopsy under percutaneous transhepatic cholangiography / 介入放射学杂志

Objective To compare the sensitivity between forceps biopsy and brushing, and to explore a feasible approach to pathological diagnosis of the obstructive jaundice.Methods 92 consecutive patients with obstructive jaundice underwent transluminal foreceps biopsy and brushing during percutaneous transhepatic cholangiography and percutaneous transhepatic cholangiodrainage. The technique was performed through an preexisting percutaneous transhepatic tract with multiple specimens obtained after passing the forceps biopsy or brush into a 8-French sheath. Finally the specimens were fixed with formalin for pathologic or cytologic diagnosis. Results The histopathologic diagnosis was acquired in 81 out of 92 patients with forceps biopsy reaching the successful rate of 97.83%. Sensitivity of forceps biopsy in 92 patients was higher than that of brush in 84 patients(88.04% vs 76.19%,? 2=4.251,P=

New way in pathologic diagnosis of biliary obstructive jaundice: a clinical study in percutaneous transhepatic cholangiobiopsy / 介入放射学杂志

Objective To explore the technical feasibility and sensitivity of percutaneous transhepatic cholangiobiopsy in malignant obstructive jaundice, together with the guidance for clinical managements.. Methods 31 patients with obstructive jaundice after percutaneous transhepatic cholangiography and drainage were undesgone percutaneous transhepatic cholangiobiopsy. The technique was performed through an preexisted percutaneous transhepatic tract with a 8 Frerch sheath, multiple specimens were obtained after passing the forceps for the biopsy. The specimens were fixed with formalin, and then taken for histopathologic diagnosis. Results The histopathologic diagnosis was acquired in 30 of 31 patients(sensitivity, 96.8%). Conclusions Percutaneous transhepatic cholangiobiopsy is an accurate, safety and reliable way, easy to perform with a histopathologic diagnosis sensitivity rate of 96.8%.

The interventional treatment for biliary recurrent obstruction after palliative T tube drainage in patients with obstruction due to cholangiocarcinoma / 介入放射学杂志

Objective To explore the interventional method to treat biliary recurrent jaundice after T tube drainage in patients with malignant obstructive jaundice due to cholangiocarcinoma. Methods 7 bili ary metallic stents were placed in 7 patients with recurrent jaundice after T tube drainage in cholangiocarcinoma cases. Results Stent placement was once successful in all 7 cases with successful rate of 100%. For all cases, TBIL,ALT,GTP and AKP values 7 days postoperatively were significantly lower than that of preoperation together with subsidence of jaundice satisfactorily for 100% after the treatment.Conclusions Percutaneous placement of biliary metallic stents was effective economic, minimal invasive and safe for palliation of biliary recurrent jaundice after T tube drainage in cholangiocarcinoma induced obstructive jaundice.

The interventional treatment for recurrent jaundice after palliative bilio-intestinal anastomosis in patients with malignant obstructive jaundice due to cholangiocarcinoma / 介入放射学杂志

Objective To explore the interventional methods to treat recurrent jaundice after palliative bilio intestinal anastomosis in patients with malignant obstructive jaundice due to cholangiocarcinoma. Methods Ten patients with recurrent jaundice after bilio intestinal anastomoasis were retrospectively evaluated. Nine of ten underwent PTCD with metallic stent placement, one underwent the inner outer draining catheter procedure. The patients were evalualed with comparison in regard to preoperative conditions, TBIL,ALT,GTP and AKP values.Results Stent placement was successful only once in all 10 cases with successful rate of 100%. TBIL,ALT,GTP and AKP values were significantly lower 7 days postoperative by than that preoperation. Subsidence of jaundice was satisfactory for 100% in all patients after the treatment. Conclusions Percutaneous placement of biliary metallic stents is a safety, simple, low complication method for managing recurrent jaundice after palliative bilio intestinal anastomosis for the terminal stage of malignant obstructive jaundice.

Clinical study of percutaneous transhepatic bile duct biopsy in obstructive jaundice / 中华消化杂志

Objective To evaluate the technical feasibility and sensitivity of percutaneous bile duct biopsy in obstructive jaundice. Methods Eighty two consecutive patients with obstructive jaundice underwent transluminal bile duct biopsy and brushing since April 2001. The technique was performed through an existing percutaneous transhepatic tract. Multiple specimens were obtained after passing the forceps biopsy or brush into a long 8 French sheath and the specimens were fixed with formalin for pathologic or cytologic diagnosis. Results The successful rate of obtaining specimen with biopsy was 97.6%. There was no major complications occurred. The histopathologic diagnosis was established acquired in 72 of 82 patients with forceps biopsy(sensitivity 87.8%). Sensitivity of biopsy in the 56 patients with cholangiocarcinoma was higher than that in the 22 patients with malignant tumors other than cholangiocarcinoma (92.9% vs. 72.7% P =0.044). The cytologic diagnosis was established in 56 of 74 patients with brush cytology(sensitivity 75.7%). The sensitivity of biopsy in the 82 patients was higher than that of brushing in the 74 patients (87.8% vs. 75.7%, P = 0.049 ). Conclusion Percutaneous transhepatic bile duct biopsy is a simple, minimal invasion, high sensitivity and low complication procedure with high technical successive rate. It is a new approach to establish pathologic diagnosis