Observation on the clinical effiect of Aidi injection and Huaier particles combined with interventional therapy for primary liver cancer / 中国基层医药

Objective To observe the clinical effiect and toxicity of Aidi injection and Huaier particles combined with interventional therapy for primary liver cancer patients.Methods 43 paients with primary liver cancer were randomly divided into two groups:the treatment group 22 cases(Aidi injection and Huaier particles combined with interventional therapy to the primary liver cancer)and the control group 21 cases(treated only with intervention therapy of liver cancer).The recent efficiency and toxicity of the two groups were compared.Results The effective rate of the treatment group was 59.1%,and in control group was 33.3%,and the differences was significant(P＜0.01).In the treatment group,clinical benefit rate was 86.4%higher than than of the control group(71.4%),and the difference was significant(P＜0.05);The treatment group significantly improved the quality of life of patients,T cell and NK cell activity were improved,and better than the control group(P＜0.05).The incidence of gastrointestinal reactions and neutropenia rate in treatment group was lower than the control group(all P＜0.05).Conclusion Aidi injection and Huaier Granule interventional therapy could improve the curative effect of primary liver cancer、the immune activity、quality of patients life,and the adverse effects.

Clinical value of CT Airbronchogram in diagnosis of Peripheral Bronchogenic Carcinoma / 中国基层医药

Objective To explore the clinial value of airbronchogram in diagnosis of peripheral lung cancer (diameter≤3). Methods Comparing study between thin section CT and pathology was done on 174 nodules (129malignant and 45 benigin) in 150 patients. Results Thin section CT showed 30 cases (23%) of airbronehogram in nodules,only seen in bronchioalveolocarcinoma, adenocarcinoma and squamous cell carcinoma (significance difference). Conclusion Airbronchogram in peripheral small nodules was a certain sign of malignant nodule. The sign suggested diagnosis of histologic types in lung center.

Quantitative evaluation of salivary gland dysfunction after radioiodine therapy using salivary gland scintigraphy / 中国基层医药

Objective To assess the variation of salivary gland function in differentiated thyroid carcinoma (DTC) patients receiving different doses of 131 I therapy in the first.Methods 40 DTC patients were divided into two groups according to the application 131I doses,salivary scintigraphy was performed with 99TcmO4-on DTC patients before and 3months after 131 I therapy.Quantitative analysis of salivary gland function were performed.Results In low dose group,only the uptake ratio of 30min (UR30) of bilateral parotid decreased ( P ＜ 0.05 ) ; but in high - dose group,the uptake ratio of 30min (UR30),excretion fraction ( EF ),excretion rate (ER) of bilateral parotid and submandibular glands were significantly decreased,excretion time(EP) significantly prolonged after 131 I therapy( all P ＜0.05) ;the parotid gland was more severely than the submandibular gland.Conclusion Salivary gland function was damaged of DTC patients receiving different doses of 131I therapy in the first,salivary gland dysfunction correlated well with the administered dose.

Interventional therapy of pseudoaneurysms occurred after surgery / 介入放射学杂志

Objective To summarize the therapeutic results and experience of the interventional managements for pseudoaneurysms occurred after surgery. Methods Five pseudoaneurysms with different location that occurred after surgery in five patients were treated with different interventional managements. One patient suffered from a ruptured pseudoaneurysm of left common iliac artery, which was treated by obstructing the diseased artery with balloon via the abdominal aorta followed by the replacement of vascular prostheses. One patient had a pseudoaneurysm of right subclavian artery and endovascular covered stent was employed to isolate it. The remaining three patients were affected by pseudoaneurysm of terminal arteries and intraarterial embolization with gelfoam and/or steel coils was camed out. Results Complete closing of the pseudoaneurysm was obtained in all five patients and no therapy-related complications occurred. Conclusion Pseudoaneurysms occurred after surgery can be effectively treated with different interventional managements, it is worth popularizing this technique in clinical practice.

Early diagnosis value of MRI combined with DSA in cancer nodules from cirrhotic nodules / 中国基层医药

Objective To evaluate the early diagnosis value of MRI combined with DSA in cirrhotic nodules (regenerative nodules, dysplastic nodules) becoming small hepatocellular carcinoma. Methods 40 patients diagnosed as cirrhosis and whose liver nodules detected by ultrasound were followed up as MR dynamic study. All patients were followed up by three dynamic contrast-enhanced MR scanning once every 3 months,and the changes of cirrhotic nodules were observed and analyzed in the signal. If MRI suggested cancerous nodules cirrhosis, hepatic artery DSA would be carried out. Results 40 patients were followed up for 1.5 to 3 years,all patients MR nodules were found in liver regeneration. Follow-up process, the dysplastic nodules were founded in 28 cases and the small hepatocellular carcinoma were founded in 18 patients. 16 cases of 18 patients with small hepatocellular carcinoma carried out routine DSA all had typical of hepatic arterial blood supply and angiogenesis, and were given to Integrated Traditional and Western intervention simultaneously. Conclusion Combined use of MRI-DSA in the evaluation of cirrhotic nodules had a definite value, and could find smaller hepatocellular carcinoma,provide the basis for smaller hepatocellular carcinoma therapy.

Application of percutaneous transhepatic portal vein port-catheter system implantation in preventing small hepatocellular carcinoma recurrence after curative treatments / 中国基层医药

Objective To investigate the technical outline and clinical value of percutaneons transhepatic portal vein port-catheter system implantation in preventing small hepatocellular carcinoma recurrence after curative treatments. Methods Fifteen patients with small hepatocellular carcinoma after curative treatment were included in this study. Guided by ultrasound and fluoroscopy, left branch of the portal vein were punctured and port-catheter system were implanted. Then drugs infusion into portal vein system was done for preventing recurrence of hepatic carcinoma. Results Interventional operations were succeed in all 15 cases. Drugs could drop into portal vein smoothly. No operating complications occurred. Conclusion Percutaneous transhepatic portal vein port-catheter system implantation was an easy operating and micro traumatic method. This technique could play an important role in preventing recurrence.

Extra-fine choledochoscope in treating polypoid lesions of gallbladder by percutaneous trans-hepatic and trans-gallbladder puncture / 中华消化内镜杂志

Objective To evaluate the therapeutic effect of extra-fine choledochoscope in treating polypoid lesions of gallbladder by percutaneous trans-hepatic and trans-gallbladder puncture(PTGB). Methods Extra-fine choledochoscope(2. 7 mm diameter)was inserted into tract soon after it was made per-cutaneously trans-hepatic and dilated in one session,gallbladder polyps was removed with biopsy forceps or snare or basket,and PTCD drainage tube(10. 2 F diameter)was imbedded for external drainage until 10 days after. If the gallbladder puncture point fell on the bed and gallbladder polyps were not clearly visual-ized,or puncture points were on non-gallbladder bed of the body,drainage tube(10. 2 F diameter)was placed for external drainage. Results Forty-two patients were successfully punctured,and 40 patients were punctured accurately on the bed in,and the fresh endoscope tract of these patients was established in 45 mi-nutes on average. Of the 29 cases of simple bottom and body ventral polyps,complete clearance of gallbladder polyps was achieved in 27. Gallbladder polyps clearance rate was 93. 10%. Complications of minor hemobi-lia occurred in 9 cases,and infection of biliary tract occurred in 3 cases after operation. There was no recur-rence after a follow-up of 15 months on average. Conclusion Extra-fine choledochoscope by PTGB is a less invasive,more reliable and effective method to cure benign polypoid lesions of the gallbladder. The gallblad-der is preserved and for malignant polyps,it can help to achieve early diagnosis and provide reliable evidence for further treatment.

Percutaneous vertebroplasty using instruments and drugs made in China for vertebral metastases / 中华医学杂志(英文版)

<p><b>OBJECTIVES</b>To evaluate the effect of percutaneous vertebroplasty on vertebral tumor metastasis using instruments and drugs made in China and to explore the technique of percutaneous vertebroplasty.</p><p><b>METHODS</b>Thirty-two patients with vertebral metastasis were treated with percutaneous vertebroplasty with instruments and drugs made in China. Anterolateral approach for cervical vertebrae and transpedicular approach for thoracic and lumbar vertebrae were used. The volume of disease focus and the amount of polymethy methacrylate (PMMA) injected were calculated with formula V = 4/3pi (D/2)(3) preoperatively. PMMA with contrast was mixed according to the ratio of powder/liquid/contrast of 3:2:1. The procedures were monitored under fluoroscopy. PMMA was injected in the polymerization time. CT scanning was performed before and after the operation.</p><p><b>RESULTS</b>The percentage of lesion PMMA fill was more than 50% as demonstrated by CT. Clinical data were obtained from the cases followed up for 7 - 12 months, and the rate of pain relief was 90.6% (29/32) at one week, 71.8% (23/32) at six months, and 58.6% (17/29) at 12 months after operation. There were no cases of PMMA leakage that affected clinical performance.</p><p><b>CONCLUSIONS</b>Percutaneous vertebroplasty for vertebral tumor metastasis using instruments and drugs made in China was effective. It is important to prevent paravertebral leaks of PMMA and to ensure that PMMA is injected within the polymerization time.</p>

The effect of interventional treatment on the expression of drug-resistance gene in primary lung carcinomas / 中华放射学杂志

Objective To study the effect of interventional treatment on the expression of PgP and GST ? in different histopathological types of primary lung carcinoma. Methods One hundred and eighteen cases of histopathologically verified primary lung carcinoma were studied. SCLC was found in 26 cases and NSCLC in 92 cases. The non chemotherapy group had 50 cases, and the interventional treatment group had 68 cases. PgP and GST ? were examined in all specimens with 2 step immunohistochemistry. Results The positive expression rates of PgP and GST ? were 32.0% and 34.0% in non chemotherapy group, respectively, 75.0% and 78.6% in interventional treatment with non embolization group, respectively, and 50.0% and 52.5% in interventional treatment with embolization group, respectively. The positive expression rates of PgP and GST ? had significant difference between non chemotherapy group and interventional treatment with non embolization group( P 0.05). There was a tendency of positive correlation between differentiated degree of carcinoma and the expression of PgP and GST ? in NSCLC. Condusion To detect PgP and GST ? in carcinoma tissue is important and has the instructive significance for chemotherapy of lung carcinoma. The positive rate of multidrug resistant gene is obviously increased in the primary lung carcinoma with bronchial arterial chemotherapy. The inducement to multidrug resistance gene in bronchial arterial embolization with the emulsifying agent of oil anticarcinogen was lower.

Interventional therapy of renal artery stenosis in kidney transplants / 中华放射学杂志

Objective To evaluate efficacy of percutaneous transluminal angioplasty (PTA) and stenting for treatment of transplanted renal artery stenosis (TRAS). Method Seven patients with TRAS were included in this study. By femoral or axillary approach, balloon angioplasty and /or metallic stents placement at stenostic renal artery were performed. Results Of the seven patients, balloon angioplasty was carried out in 3 (2 cases via femoral artery, 1 via axillary artery), both balloon angioplasty and metallic stents placement were performed in 4 (2 via femoral artery, 2 via axillary artery). After the procedure, blood pressure recovered to normal in 5 cases, controlled with administration of antihypertensive in the other 2 cases. By 9 to 36 month′s follow up, restenosis of renal artery occurred in only 1 case at 9 months after stent implantation. The second balloon angioplasty were taken and better renal artery blood flow was obtained in this case. Other 6 cases showed no restenosis. Conclusion PTA and stents placement were effective and safe approach in treatment of TRAS. Further investigation was needed to prevent and manage restenosis after these procedures.

Infusion of drug via portal vein for liver cirrhosis / 介入放射学杂志

Medication is still the main means for treating liver cirrhosis. However, micro-circulation obstacle in the liver and dynamic abnormality of portal vein flow suggest that liver protecting drugs via peripheral veins can hardly give full requirement for their effect. The authors reviewed a new method of percutaneous transhepatic portal vein implantation of port-catheter system for infusion of drugs in the treatment of liver cirrhosis, with theoretical basis and the outlook of application.

The effect of embolization of gastric coronary and short gastric veins on the control of hemorrhage from (gastric) varices / 中华消化杂志

Objective To study the effect of embolization of gastric coronary and short veins on the control of hemorrhage from gastric fundal varices. Methods Thirty-two patients with liver cirrhosis and hemorrhage from esophagus and fundal varices, who still had variceal bleeding after endoscopic banding or sclerosing of esophageal varices were included in the study. Gastric coronary and short veins were (embolized) by percutaneous, transhepatic embolization with absolute alcohol, steel ring, or gelfoam. The follow-up of 3 to 11 months was carried out after embolization. Results The follow-up endoscopy showed that the varices of gastric fundus disappeared completely in 21 of 29 patients (72.4%), and (eleminated) partially in 8 patients (27.6%). Only one patient (3.1%) had re-bleeding due to portal (hypertensive) gastropathy in the follow-up period. No obvious complication was found in these patients. Conclusions The varices of gastric fundus could be obliterated by percutaneous, transhepatic embolization of gastric coronary and short veins.

Two stents insertion via single tract for treatment of hepatic hilar cholangiocarcinoma / 介入放射学杂志

Objective To evaluate the feasibility and clinical application of two stents insertion via single tract for treatment of hepatic hilar cholangiocarcinoma. Methods Eighteen patients with hepatic hilar cholangiocarcinoma who had left and right bile duct obstruction were treated with stents insertion via right bile duct puncturing routeway. These two stents were implanted between right and left bile duct, and between right bile duct and common bile duct. Results Eighteen patients obtained successful two stents placement by right bile duct puncturing tract and succeeded with internal drainage for all bilialy tree jaundice subsided distinctly. Conclusions The technique of two stents insertion via single tract could predigest interventional drainage procedure of high bile duct obstruction ,reduce operation trauma, shorten handling time and possese promising application value.

An experimental study of percutaneous vertebroplasty using instruments and drugs made in China / 中华放射学杂志

Objective To evaluate the efficacy of percutaneous vertebroplasty(PVP) using instruments and drugs made in China, and to provide the data for the clinical application Methods Polymethylmethacrylate(PMMA) without adding contrast was classified into 3 groups according to the ratio of powder/liquid as 2∶1,3∶2,1∶1,PMMA with contrast was also classified into 3 groups according to the ratio of powder/liquid/contrast as 2∶1∶1,3∶2∶1,1∶1∶1 There were 6 groups totally The periods and temperature of polymerizing process were measured The PMMA specimens of different group were made,with the diameter of 1 0 cm, height of 3 0 cm The density was determined in X ray pictures and mechanical testing with universal testing machine was performed PVPwas performed in the spines of 3 human cadavers with transpedicular route under fluoroscopic control The PMMA was injected into vertebra at an interval of one vertebra from T4-L4, 7 vertebra were injected on each cadaver The injected volume was recorded The spines were dissected into 42 single vertebrae, with all soft tissues removed Overall,21 pairs of adjacent vertebrae were subjected to axial compression in an universal testing machine The cranial vertebra of each pair was injected with PMMA, the caudal one served as a control Results Lower temperature was observed in the PMMA groups with adding contrast than those without adding contrast during the polymerizing process, the average temperature in the PMMA group with the ratio of powder/liquid/contrast as 3∶2∶1 was 67 4℃ There was significant X ray density difference between the groups with contrast and corresponding groups without contrast ( t = 20 00, t = 20 00, t = 22 86, P 0 05) The group with ratio of power/liquid/contrast 3∶2∶1 was (127? 4 70) s in the period of the paste, and the ultimate compressive strength (mPa) was 47 23 The punctures were successfully reached in all vertebra The injected PMMA average volume was 5 ml in the thoracic vertebra and 7 5 ml in the lumbar vertebra PMMA leaking into adjacent paravertebral tissue was demonstrated in 3 of 21 vertebrae The ultimate compressive strength of the vertebrae without PMMA injection in the 3 groups was 3 28,3 63,and 3 69, respectively The ultimate compressive strength of the injected PMMA vertebrae in the 3 groups was 4 52,4 73,and 4 81, respectively The ultimate compressive strength was significantly higher in the injected PMMA vertebrae than that in the vertebrae without PMMA injection( t =3 17,3 55,3 99, P

Attention to the application of vein anaesthesia in interventional radiology / 介入放射学杂志

Interventional radiology is mostly carried out under local anesthesia with micro invasive characteristics.However,the questions of patient's pain,nerve intense,change of blood pressure and heart rate always influence the performance of operation.General anaesthesia in interventional radiology is a comparatively simple venous anaesthesia modality with a controlled dose of anesthetics injecting via periphery vein through persistent minimally injecting pump to keep the patient in dormancy under electrocardiagraphic monitoring.It doesn't require a tube insertion of trachea.The anaesthesia depth and time are under control.The half-life of the anaesthesia drugs is short with less side-effect.It is necessary to introduce the advanced anaesthesia into commom interventional radiological therapy with attentions of promoting the development through new modalities.