Application of lower extremity arterial thrombosis with Rotarex mechanical thrombectomy system / 实用放射学杂志

Objective To investigate the application of Rotarex mechanical thrombectomy system in lower extremity arterial thrombosis and to evaluate its clinical efficacy.Methods The clinical data of 61 patients(71 limbs,35 cases in acute phase,21 cases in subacute phase and 5 cases in chronic phase)with lower extremity arterial thrombosis treated with Rotarex were analyzed retro-spectively.Distal protective device was used in patients with poor distal artery outflow.High pressure saline was used during the pro-cedure and stent was used in patients with flow-limiting dissection.Catheter aspiration was performed in patients with distal artery embo-lization.Anticoagulant therapy was used in patients with thromboembolism and dual antiplatelet therapy was used in patients with in-situ thrombosis.Postoperative follow-up was performed with color Doppler ultrasound or computed tomography angiography(CTA)at 1 month,3 months and 6 months.Results Fifty-nine cases were treated with 6F Rotarex catheters and 2 cases were treated with 8F Rotarex catheters.Distal protective device was used in 10 cases,balloon dilation was performed in 49 cases and stent was used in 5 cases.Catheter aspiration was performed in 10 cases.Vessel rupture occurred in 4 cases,among whom 3 cases were successfully treated with the method of balloon compression and 1 case was treated with covered stent.Severe adverse events occurred in 4 cases and perioperative toe amputation was performed in 7 cases.Follow-up time was 3 to 6 months(mean 4.9 months).Lower extremity ischemic event occurred in 1 case at 6th month follow-up and was treated with stent.No other lower extremity ischemic events occurred in the course of follow-up.Conclusion For the treatment of lower extremity arterial thrombosis,Rotarex mechanical thrombectomy sys-tem has the advantages of minimally invasion,rapid and high efficiency.Combined with the therapy of catheter aspiration and stent place-ment,vascular patency can be further maintained and the lower extremity ischemic symptoms can be quickly relieved.

Clinical application of individualized coil embolization in interventional therapy of renal artery aneurysm / 实用放射学杂志

Objective To explore the clinical application of individualized coil embolization in the interventional treatment of renal artery aneurysm(RAA).Methods Data of 23 patients with RAA treated by individualized coil embolization were analyzed.There were 27 RAAs,in which narrow-necked RAAs were treated with coil embolization and wide-necked RAAs were treated with stent-assisted coil embolization.The efficacy of the two embolization methods were analyzed and the changes of renal function and symptoms were observed.Results A total of 27 RAAs in 23 patients were successfully embolized at one time,including 23 narrow-necked RAAs in 19 cases treated with coil embolization and 4 wide-necked RAAs in 4 patients treated with stent-assisted coil embolization.The embolization effect of 20 cases(86.96%)reached Raymond grade Ⅰ,and 3 cases(13.04%)reached gradeⅡ.Postoperative computed tomography angiography(CTA)showed that all parent arteries were patent,the RAA was not visualized,and there was no renal infarction.There was no statistical difference in creatinine values before operation,1 month,6 months and 1 year after operation(P>0.05).In the 12 patients with hypertension,there were statistically significant differences in blood pressure at 1 year after operation compared with preoperative,1 month,and 6 months after operation(P<0.05).The symptoms of low back pain and hematuria disappeared after operation.Conclusion Individualized coil embolization for RAA is safe,effective and worthy of clinical promotion.

Classification of interventional therapy and ICD coding of hepatic malignant tumors:a case study / 现代医院

Interventional therapy for hepatic malignant tumours primarily includes cardiovascular system surgery,diges-tive system surgery,and various diagnostic and therapeutic procedures.Referring to the"International Classification of Diseases,Ninth Edition,Clinical Modification,ICD-9-CM-3"(2011 revision),the relevant surgical procedure codes on the front page of the case are contained mainly in the 9th chapter for cardiovascular system surgery,the 11th chapter for digestive system surgery,and the 18th chapter for various diagnostic and therapeutic procedures and other related chapters on diagnostic and therapeutic procedures.It has become a challenge for the history coders to complete the first page of interventional surgery cases by reviewing the surgery records,extracting the surgical steps,and then identifying the appropriate surgery codes and their sequencing.Accord-ing to the current classification of interventional therapy for hepatic malignant tumors,it is suggested to conduct the search and re-trieval using the keywords like"arteriography""embolization""perfusion""implantation""destruction"and"ablation".

Research progress of vascular interventional therapy combined with systemic therapy for unresectabl hepatocellular carcinoma / 中华肝胆外科杂志

Primary liver cancer is a malignant tumor with high morbidity and mortality. It also ranks in the forefront in the incidence and mortality of malignant tumors in China, which seriously threatens the lives and health of Chinese people. Most patients have already been in the intermediate and late stage when they are diagnosed, thus the chance of surgery is lost, and the prognosis is poor. In recent years, with the advancement of vascular interventional therapy technologies such as hepatic arterial chemoembolization and hepatic arterial infusion chemotherapy, the emergence of new tyrosine kinase inhibitors, immune checkpoint inhibitors, and especially the development of multimodal combination therapy, the treatment effect of unresectable hepatocellular carcinoma has been continuously improved, and it also provides a potential possibility for sequential surgical treatment. This article reviews the research progress of vascular interventional therapy combined with systemic therapy in unresectable hepatocellular carcinoma, in order to provide a reference for the clinical treatment of unresectable hepatocellular carcinoma.

Relationship between intracranial high-density foci and progressive stroke in patients with acute ischemic stroke after intravascular intervention / 中华神经科杂志

Objective:To investigate the relationship between intracerebral high-density foci and progressive stroke (PS) morbidity by using dual-energy CT, which can quantify the intracerebral high-density foci of patients with acute ischemic stroke after endovascular treatment.Methods:Ninety-two patients with acute ischemic stroke who received interventional treatment in Gaozhou People′s Hospital from May 2019 to August 2020, and underwent dual-energy CT scan immediately after intervention, were analyzed. The patients were divided into PS group ( n=35) and non-PS group ( n=57) according to the National Institutes of Health Stroke Scale (NIHSS) score, and the patients whose NIHSS score increased≥4 points within 72 hours of stroke were included in the PS group, while the patients whose NIHSS score increased<4 points were included in the non-PS group. The clinical data, volume of high-density foci and CT values were compared between the 2 groups. Logistic regression analysis was used to adjust for confounding factors and screen for risk factors. The correlations of the admission NIHSS score, presence and volume of high-density lesions, maximum CT (CTmax) value and average CT (CTave) value with the onset of PS were analyzed, and the receiver operating characteristic curve was used to screen predictive indicators of PS. Results:In the PS group, the NIHSS score (18.80±8.50 vs 14.40±9.58, t=2.229, P=0.028), proportion of high-density foci [29/35(82.9%) vs 32/57 (56.1%), χ 2=6.928, P=0.008], high-density focal volume [13.23 (39.33) cm 3vs 0.76 (9.82) cm 3, U=1 440.000, P<0.001], CTmax value [80.00 (92.00) HU vs 65.00 (87.50) HU, U=1 337.000, P=0.005] and CTave value [53.48 (23.79) HU vs 45.94 (55.11) HU, U=1 345.000, P=0.004] were higher than those in the non-PS group. The NIHSS score ( OR=1.054, 95% CI 1.004-1.106, P=0.033; rs=0.255, 95% CI 0.051-0.447, P=0.014), presence of high-density foci ( OR=3.776, 95% CI 1.358-10.503, P=0.011; rs=0.274, 95% CI 0.093-0.460, P=0.008), high-density focal volume ( OR=1.026, 95% CI 1.003-1.049, P=0.027; rs=0.381, 95% CI 0.183-0.560, P<0.001), CTmax value ( OR=1.006, 95% CI 1.001-1.011, P=0.014; rs=0.292, 95% CI 0.088-0.475, P=0.005) and CTave value ( OR=1.021, 95% CI 1.007-1.035, P=0.004; rs=0.299, 95% CI 0.092-0.484, P=0.004) were all risk factors affecting PS morbidity and were positively correlated with PS morbidity. The area under the receiver operating characteristic curve of NIHSS score, high-density lesion volume, CTmax value, and CTave value to predict the onset of PS was 0.652, 0.722, 0.670 and 0.674, respectively. The volume of high-density lesions had moderate predictive value for the onset of PS. Conclusions:For AIS patients, CT examination should be performed immediately after interventional operation. The volume, CTmax value and CTave value of high-density lesions newly appeared in the ischemic area are positively correlated with the onset of PS. Quantifying the volume of high-density lesions can help to predict the onset of PS.

Analysis of three-dimensional visualization imaging of severe portal vein stenosis after liver transplantation and clinical efficacy of portal vein stent implantation / 器官移植

Objective To analyze three-dimensional imaging characteristics and advantages for severe portal vein stenosis after liver transplantation, and to evaluate clinical efficacy of portal vein stent implantation. Methods Clinical data of 10 patients who received portal vein stent implantation for severe portal vein stenosis after liver transplantation were retrospectively analyzed. Imaging characteristics of severe portal vein stenosis, and advantages of three-dimensional reconstruction imaging and interventional treatment efficacy for severe portal vein stenosis were analyzed. Results Among 10 patients, 3 cases were diagnosed with centripetal stenosis, tortuosity angulation-induced stenosis in 2 cases, compression-induced stenosis in 2 cases, long-segment stenosis and/or vascular occlusion in 3 cases. Three-dimensional reconstruction images possessed advantages in accurate identification of stenosis, identification of stenosis types and measurement of stenosis length. All patients were successfully implanted with portal vein stents. After stent implantation, the diameter of the minimum diameter of portal vein was increased [(6.2±0.9) mm vs. (2.6±1.7) mm, P<0.05], the flow velocity at anastomotic site was decreased [(57±19) cm/s vs. (128±27) cm/s, P<0.05], and the flow velocity at the portal vein adjacent to the liver was increased [(41±6) cm/s vs. (18±6) cm/s, P<0.05]. One patient suffered from intrahepatic hematoma caused by interventional puncture, which was mitigated after conservative observation and treatment. The remaining patients did not experience relevant complications. Conclusions Three-dimensional visualization technique may visually display the location, characteristics and severity of stenosis, which is beneficial for clinicians to make treatment decisions and assist interventional procedures. Timely implantation of portal vein stent may effectively reverse pathological process and improve portal vein blood flow.

Efficacy and safety of interventional therapy combined with drug injection under bronchoscope in the treatment of central non-small cell lung cancer / 中国临床药理学与治疗学

AIM: To evaluate the efficacy and safety of interventional therapy combined with tumor drug injection under bronchoscope for central non-small cell lung cancer (NSCLC). METHODS: Sixty-four patients who met the test admission criteria were randomly assigned to the experimental group and the control group according to the ratio of 1:1, and were given bronchoscopic interventional therapy combined with local drug injection of recombinant human endostatin combined with platinum-containing dual-drug chemotherapy and platinum-containing dual-drug alone, respectively. The curative efficiency and safety of the two groups were compared. RESULTS: Compared with the control group, the KPS score, dyspnea grading were significantly improved (P<0.05). The effective rate of the test group was 78.12%, which was higher than 37.5% in the control group, the difference between the two groups was significant (P<0.05). Moreover, there was also a significant difference in the 1-year survival rate between the experimental group and the control group (P<0.05). CONCLUSION: The treatment of central NSCLC by interventional therapy combined with tumor drug injection through fiberoptic bronchoscope has obvious clinical efficacy, which can effectively alleviate the clinical symptoms and improve the quality of life of patients. There is no significant difference in adverse reactions between the two groups, and is worthy of popularization and application.

Clinical efficacy of closure operation guided by transthoracic echocardiography with simply delivery sheath for patent foramen ovale / 局解手术学杂志

Objective To investigate the clinical efficacy of percutaneous closure of foramen ovale guided by transthoracic echocardio-graphy with simply delivery sheath.Methods The clinical data of patients with patent foramen ovale underwent interventional closure and percutaneous closure guided by transthoracic echocardiography with simply delivery sheath in our hospital from January 2020 to December 2022 were analyzed retrospectively,the patients were divided into interventional closure group(40 cases)and simply delivery sheath group(39 cases).The operation time,incidence of surgical complications,and surgical success rates of patients in the two groups were compared.The closure effect were evaluated by ultrasound immediately after surgery.All the patients were followed up for 6 months after surgery to evaluate remission of the symptoms.Results The surgical success rate of simply delivery sheath group(100%)was higher than that of interventional closure group(90.0%),with statistically significant difference(P<0.05).The operation time of simply delivery sheath group was longer than that of interventional closure group,with statistically significant difference(P<0.05).One patient in the interventional closure group had small amount of pericardial effusion during the operation.Two patients had decreased blood pressure and slowed heart rate in simply delivery sheath group,and symptoms disappeared after treatment.There was no significant difference in the incidence of complications between the two groups(P>0.05).After 6-month follow-up,all occluders were in good position and no residual leakage was found.The symptoms of headache or dizziness disappeared in 28 patients in interventional closure group,significantly relieved in 8 patients;the symptoms of headache or dizziness disappeared in 30 patients in simply delivery sheath group,and significantly relieved in 9 patients.Conclusion Percutaneous closure for patent foramen ovale under the guidence of transthoracic echocardiography with simply delivery sheath is safe and feasible with satisfactory efficacy and higher successful rate without radiation hazard.It is worthy of clinical promotion.

Current applications of transcatheter edge-to-edge tricuspid valve repair / 中国介入心脏病学杂志

Tricuspid regurgitation(TR)is a common heart valve disease.According to the pathogenesis,TR can be divided into primary(organic)and secondary(functional)regurgitation,of which functional TR accounts for more than 90%.Patients with severe TR have poor prognosis and poor drug treatment,and surgery(valvuloplasty)is the main treatment.At present,transcatheter edge-to-edge tricuspid valve repair(T-TEER)has become an essential program of transcatheter treatment for TR,providing minimally invasive treatment for TR patients who cannot undergo surgery or are at high risk of surgery.T-TEER reduces the degree of regurgitation by clamping leaflets,and is currently in the early stage of research and development exploration and clinical validation,mainly for functional TR.T-TEER devices have also made significant progress(TriClip,PASCAL),and Chinese-made novel-designed T-TEER devices are also undergoing clinical trials(DragonFly-TTM,SQ-Kyrin-TTM,NeoBlazarTM).This paper reviews the current applications and research progress of T-TEER.

Study on the relationship between restenosis and endothelial function after interventional surgery for diabetic lower extremity arteriopathy / 中国现代医生

@#Objective To explore the relationship between postoperative restenosis and vascular endothelial function in patients with lower extremity arterial disease(LEAD).Methods A retrospective analysis was performed on 133 patients with diabetic lower extremity arteriopathy who had successfully undergone interventional therapy in our hospital,and the patients were followed up for one year,and the patients were grouped according to whether restenosis occurred,with 25 cases in the restenosis group and 108 cases in the non-stenosis group.The patient's vascular endothelial function index,inflammatory factor level,blood lipid four items and hemoglobin A1c(HbAlc)were detected,and peripheral blood cells of patients in the stenosis group and non-stenosis group were isolated for transcriptome sequencing.Multivariate unconditional logistic regression analysis was used to screen for independent risk factors for vascular endothelial function in postoperative restenosis.Results Serum endothelin-1(ET-1),von Willebrand factor(vWF),thromboxane B2(TXB2),vascular cell adhesion protein 1(VCAM-1),and nitric oxide(NO)were significantly higher in the stenosis group than in the non-stenosis group,while endothelial nitric oxide synthase(eNOS)and vascular endothelial growth factor(VEGF)were significantly lower than those in the non-stenosis group(P<0.01).There was no significant difference in blood lipids between the two groups(P>0.05).The HbAlc of the stenosis group was significantly higher than that of the non-stenosis group(P<0.01).The inflammatory factors in the stenosis group were significantly higher than those in the non-stenosis group(P<0.05).Transcriptome sequencing analysis results are consistent with test results.Multivariate Logistic regression analysis showed that TNF-α,IL-6,ET-1,and vWF were independent risk factors for LEAD vascular restenosis(P<0.05).Conclusion Vascular endothelial function indexes(ET-1,vWF)and inflammatory factors(TNF-α,IL-6)are independent risk factors for restenosis after interventional surgery.

Investigation on awareness of and attitudes towards radiation safety and protective measures among clinical nurses in liver interventional department / 中国辐射卫生

Objective To investigate the awareness of and attitudes towards radiation safety and protective measures among clinical nurses in liver interventional department, so as to provide insights into the formulation of radiation-protective measures among clinical healthcare workers. Methods A cross-sectional study was performed. Clinical nurses in liver interventional departments of class A tertiary hospitals in Jiangsu Province were sampled, and the awareness of and attitudes towards radiation safety and protective measures were investigated using self-designed questionnaires. Results A total of 112 questionnaires were allocated, and 97 valid questionnaires were recovered, with an effective recovery rate of 86.61%. The awareness of questions including “interventional therapy may cause radiation exposure” and “wearing lead apron may reduce radiation exposure” was both 100.00% among respondents, and the awareness of questions including “radiation exposure may cause congenital malformations in babies”, “radiation exposure may cause cancers such as skin cancer and leukemia”, “radiation exposure may cause death”, “wearing lead goggles may reduce radiation exposure”, and “wearing thyroid shields may reduce radiation exposure” was all higher than 95.00%, while the awareness of questions “radiation exposure may cause cataract of the eye lens” and “radiation exposure may cause bone marrow depression” was relatively low. Respondents presented high-level attitudes towards lead aprons, and low-level attitudes towards goggles and thyroid shields. Conclusion The awareness of radiation safety knowledge is high among clinical nurses in liver interventional departments; however, an overall low-level attitude is seen towards radiation-protective measures. Health education pertaining to radiation safety and protective measures is required to be improved, so as to increase the compliance to radiation-protective measures.

Monte Carlo simulation and analysis of eye lens dose of the first operator in interventional therapy / 中国辐射卫生

Objective To establish a model for estimating the eye lens dose of the first operator in interventional therapy based on the Monte Carlo simulation, and to provide a scientific basis for the rapid and accurate evaluation of the eye lens dose for radiation workers in interventional therapy. Methods Based on the MIRD phantom and eye model for adult Chinese males, the MCNPX program was used to establish the physical model to calculate the spatial distribution of radiation field and eye lens dose for the first operator. A GR200 Type A LiF (Mg, Cu, P) thermoluminescence dosimeter was used for experimental measurement to verify the simulation results. Results Monte Carlo simulation and experimental measurements showed that the spatial distribution of radiation field was symmetrical. Compared with the measured doses, the errors of the simulated eye lens dose of the first operator were between −8.3% and 7.3%. The dose of the left eye lens was higher than that of the right eye. Conclusion The Monte Carlo model constructed in this study initially realizes the simulation of eye lens dose of the first operator in interventional therapy. In the future, the model will be further optimized based on irradiation parameters such as exposure time, tube voltage, tube current, and projection direction used in clinic practice, so as to more accurately evaluate the eye lens dose of interventional therapy staff.

Diagnostic value and interventional treatment of elbow cyst by high frequency ultrasound / 中国骨伤

OBJECTIVE@#To study and analyze the diagnostic value and interventional treatment value of high-frequency ultrasound for elbow cyst.@*METHODS@#From February 2018 to February 2021, the data of 60 patients with elbow cyst treated by high-frequency ultrasound interventional therapy were retrospectively analyzed, including 30 males and 30 females with an average age of (30.93±5.32) years old ranging from 20 to 54 years old. The course of disease ranged from 1 to 10 years with an average of (3.45±0.25) years. High-frequency ultrasound features of all patients were analyzed. The clinical efficacy, the occurrence of adverse events and the changes of psychological status before and after treatment were analyzed.@*RESULTS@#In 60 cases of elbow cyst, the cyst size was from 6 mm×7 mm to 111 mm×60 mm. The characteristics of ultrasonic images included such as most of the morphology was regular, which was round or oval, and a few were irregular;the boundary was clear, there was a capsule wall, most of the inside of the capsule was good, no echo;when accompanied by bleeding or infection, small dense points can be seen floating;the cystic wall of the patients with long course of disease was coarser, and the internal light bands were separated, showing multilocular shape;no significant blood flow signal was observed. Final results involved olecranon bursa cysts in 19 cases, annular ligament cysts in 10 cases, radial bursa cysts in 9 cases, accessory ligament cysts in 7 cases, epidermoid cysts in 4 cases, ganglion cysts in 6 cases, nerve sheath cysts in 5 cases. After treatment, 33 cases were cured, 16 cases had obvious effect, 11 cases were improved, 0 cases were invalid. After treatment, mild adverse events occurred in 1 case, moderate adverse events in 1 case, and severe adverse events in 0 cases, with a total incidence of 3.33% (2/60). After treatment, positive affect score (38.04±1.74) was higher than that before treatment (35.92±2.34), and negative affect score (24.61±1.51) was lower than that before treatment (30.15±3.46), with statistical significance(P<0.05).@*CONCLUSION@#High-frequency ultrasound has high diagnostic value for elbow cyst, and it has ideal effect in interventional therapy.

Effect of emergency nursing process in hospital for acute massive hemoptysis based on business reengineering theory / 中国实用护理杂志

Objective:Based on the business reengineering theory, to construct the emergency nursing process of acute massive hemoptysis in hospital and explore the effect of it.Methods:According to the order of hospitalization, 200 patients with acute massive hemoptysis admitted to the emergency department in Shanghai Pulmonary Hospital Affilated to Tongji University from January to June in 2020 were selected as the control group, and the original treatment process was adopted. Two hundred patients admitted to the emergency department of this hospital from July to December in 2020 were selected as the experimental group, and the reconstructed in-hospital emergency nursing process for acute massive hemoptysis was applied. In both groups, the researchers recorded the time spent in each sub-process by using the in-hospital treatment time record of acute massive hemoptysis and collected the clinical outcomes of patients through electronic cases. The time-consuming, treatment efficiency and patient outcome of each link of the treatment process in the backyard of the two groups were compared.Results:Finally, 192 patients were enrolled in the control group and the experimental group. The median time from admission to intravenous use of hemostatic drugs and from admission to endovascular treatment in the experimental group were 21.50(20.00, 22.50) and 82.50(79.50, 84.50) min, which were lower than those in the control group which spent 40.87(37.06, 44.43) and 135.50(123.50, 147.00) min, and the differences between the two groups were statistically significant ( Z=-16.84, 16.63, both P<0.01). The incidence of asphyxia caused by acute massive hemoptysis in the experimental group was 4.2%(8/192), which was lower than that in the control group, which was 13.0%(25/192) . There was a statistically significant difference in the incidence of asphyxia between the two groups( χ2=9.58, P<0.01). Conclusions:The emergency nursing process of acute massive hemoptysis effectively shortens the time of in-hospital treatment of acute massive hemoptysis, further promotes the seamless connection of multiple links of in-hospital treatment of acute massive hemoptysis, and improves the overall efficiency of in-hospital treatment of patients with acute massive hemoptysis.

Effect of early interventional therapy with fiberoptic bronchoscope on inflammatory infiltrating tracheobronchial tuberculosis / 中国医师进修杂志

Objective:To investigate the effect of early interventional therapy with fiberoptic bronchoscope in patients with inflammatory infiltrating type (Ⅰ type) tracheobronchial tuberculosis (TBTB).Methods:Using prospective research methods, 306 patients with Ⅰ type TBTB diagnosed by fiberoptic bronchoscopy in the Third People′s Hospital of Kunming City from January 2019 to April 2022 were selected. The patients were divided into observation group and control group according to the random number table method with 153 cases each. The patients in control group were given routine anti-tuberculosis chemotherapy, and the patients in observation group were given routine anti-tuberculosis chemotherapy combined with early interventional therapy with fiberoptic bronchoscope. Sputum smear examination and tuberculosis culture were performed at the end of 1, 3 and 6 months of treatment, and the negative conversion of sputum culture was recorded. Chest X-ray, pulmonary function and fiberoptic bronchoscope were performed at the end of 1, 3 and 6 months of treatment to evaluate the improvement rate of clinical symptoms, effective absorption rate of lesions and effective absorption rate of obstructive pneumonia. The CD 4+, CD 8+, CD 4+/CD 8+, interferon γ (IFN-γ), interleukin-6 (IL-6) and C reactive protein (CRP) before and after treatment were detected. The random walking model of immune inflammation was evaluated. Results:The sputum negative conversion rates at the end of 1, 3 and 6 months of treatment in observation group were significantly higher than those in control group: 64.71%(99/153) vs. 52.29%(80/153), 80.39%(123/153) vs. 62.09%(95/153) and 91.50%(140/153) vs. 73.86%(113/153), and there were statistical differences ( P<0.05 or <0.01). The improvement rate of clinical symptoms at the end of 1 month of treatment in observation group was significantly higher than that in control group: 94.77%(145/153) vs. 66.67%(102/153), and there was statistical difference ( P<0.01); the clinical symptoms disappeared in both groups at the end of 3 and 6 months of treatment. The effective absorption rates of lesions at the end of 1 and 3 months of treatment in observation group were significantly higher than those in control group: 73.20%(112/153) vs. 51.63%(79/153) and 96.73%(148/153) vs. 85.62%(131/153), and there were statistical differences ( P<0.01); all the lesions were absorbed at the end of 6 months of treatment in both groups. The effective absorption rates of obstructive pneumonia at the end of 1 and 3 months of treatment in observation group were significantly higher than those in control group: 78.43% (120/153) vs. 39.87%(61/153) and 89.54%(137/153) vs. 79.08%(121/153), and there were statistical differences ( P<0.01 or <0.05); all obstructive pneumonia were absorbed at the end of 6 months of treatment in both groups. There were no statistical differences in CD 4+, CD 8+, CD 4+/CD 8+, IL-6, IFN-γ and CRP before treatment between the two groups ( P>0.05); the CD 4+, CD 4+/CD 8+ and IFN-γ after treatment in observation group were significantly higher than those in control group: 0.343 ± 0.032 vs. 0.311 ± 0.023, 1.37 ± 0.18 vs. 1.12 ± 0.16 and (38.47 ± 3.50) ng/L vs. (20.52 ± 2.96) ng/L, the CD 8+, IL-6 and CRP were significantly lower than those in control group: 0.251 ± 0.020 vs. 0.268 ± 0.021, (19.40 ± 3.31) ng/L vs. (34.58 ± 5.82) ng/L and (10.41 ± 2.87) mg/L vs. (17.47 ± 3.14) mg/L, and there were statistical differences ( P<0.01). The evaluation results of random walking model showed that CD 4+, CD 8+, CD 4+/CD 8+, IFN-γ, IL-6 and CRP in the observation group were better than those in the control group in the maximum random fluctuation, number of walking steps, positive walking growth rate, random fluctuation power law value, comprehensive improvement rate, recording times of comprehensive evaluation index and expected improvement value. Conclusions:Early interventional therapy with fiberoptic bronchoscope can effectively assist systemic drug therapy in patients with Ⅰ type TBTB, which can accelerate focus absorption, promote sputum negative conversion, enhance cellular immunity and effectively inhibit inflammatory reaction.

Treatment of patients with sentinel bleeding after hepatobiliary and pancreatic surgery / 中华肝胆外科杂志

Objective:To compare the results of operative versus interventional treatments in patients presenting with sentinel hemorrhage after hepatobiliary and pancreatic surgery.Methods:The clinical data of patients presenting with sentinel hemorrhage after hepatobiliary and pancreatic surgery at the Department of Hepatobiliary Surgery, the Second Affiliated Hospital of Guangzhou Medical University from August 2017 to July 2022 were retrospectively analyzed. Of 82 patients who were enrolled in this study, there were 50 males and 32 females, aged (59.0±7.7) years. The patients were divided into the interventional group ( n=42) and the surgical group ( n=40) based on the treatment they received for sentinel hemorrhage. The vascular injury rate, the first operation time for sentinel bleeding, the rate of successful hemostasis in a single operation, the number of deaths and other indicators were compared between groups. Results:In both the two groups of patients who underwent percutaneous transhepatic cholangial drainage, hepatectomy, endoscopic retrograde cholangiopancreatography, hilar cholangiocarcinoma resection and cholecystectomy were mainly performed hepatic artery injury, pancreaticoduodenectomy with gastroduodenal artery injury, and splenectomy with splenic artery injury. In the intervention group, 36 patients (85.7%) were successfully hemostasis after single treatment, and 32 patients (80.0%) in the operation group, and there was no significant difference between the two groups (χ 2=0.47, P=0.492). The first operation time for the intervention group was (40.5±8.5) min and the mortality rate was 2.4% (1/42), which were significantly better than that of the operation group (90.6±20.8) min and 15.0% (6/40) (all P<0.05). Conclusion:Interventional therapy can be used as the first-line diagnosis and treatment for sentinel bleeding after hepatobiliary and pancreatic surgery. It has the advantages of a lower mortality rate in treating these patients.

The systematic view of ventricular functional mitral regurgitation and the treatment through transcatheter mitral valve edge-to-edge repair / 中国介入心脏病学杂志

Mitral regurgitation is one of the most common valvular heart diseases,with a incidence rate of about 10％in the population,most of which are functional regurgitation.V-FMR patients are caused by weakened left ventricular systolic function combined with left ventricular enlargement,resulting in valve ring enlargement and relative tendon tethering.Due to poor cardiac function and basic condition,the surgical risk and prognosis of these patients are not as good as those with conventional mitral regurgitation.In recent years,transcatheter mitral valve edge-to-edge repair has gradually developed into a mature mitral regurgitation intervention technique,achieving good clinical results in V-FMR patients and providing new options for the treatment of V-FMR.

Neuroform Atlas stent-assisted coil embolization for treating wide-necked basilar artery tip aneurysm / 中国介入影像与治疗学

Objective To observe the value of Neuroform Atlas stent-assisted coil embolization for treating wide-necked basilar artery tip aneurysm(BTA).Methods A total of 21 patients with single wide-necked BTA who underwent Neuroform Atlas stent-assisted coil embolization were enrolled,including 14 cases of ruptured BTA complicated with subarachnoid hemorrhage(SAH).Clinical and imaging data after treatment were observed,and serious adverse event(SAE)was recorded.Prognosis was evaluated with modified Rankin scale(mRS),while the status of arterial occlusion was assessed with Raymond grade.The value of Neuroform Atlas stent-assisted coil embolization for treating wide-necked BTA was analyzed.Results Totally 29 Neuroform Atlas stents were successfully implanted in 21 cases.Four patients with ruptured BTA complicated with SAH developed SAE during hospitalization,among them,1 patient died of ruptured BTA and bleeding again,1 died of cerebral hernia,while shunt dependent hydrocephalus and ischemic event occurred each in 1 case.The rest 19 cases were followed up for 6(6,12)months,and the last follow-up mRS score of 12 cases were 0,of 3 cases were 1,of 2 cases were 2 and of the other 2 cases were 3.Fifteen patients underwent reexamination of digital subtraction angiography during follow-up,and 11 BTA were classified as grade Ⅰ,3 as grade Ⅱ and 1 as grade Ⅲ.No stent stenosis nor occlusion was observed.Conclusion Neuroform Atlas stent-assisted coil embolization was safe and effective for treating wide-necked BTA.

Interventional treatment of advanced portal vein occlusion after liver transplantation / 中华肝胆外科杂志

Objective:To evaluate the efficacy and safety of interventional treatment of advanced portal vein occlusion indifferent stages after liver transplantation.Methods:The clinical data of 13 patients with advanced portal vein occlusion after liver transplantation in Tianjin First Central Hospital from March 2016 to June 2022 were retrospectively analyzed, including 8 males and 5 females, with a median age of 47 (2 to 68) years. Based on the Yerdel’s Classification of portal vein thrombosis and Department of Radiology, Tianjin First Central Hospital practice experience, the classification of portal vein occlusion was further modified for a classification-base interventional treatment. The changes of portal vein pressure gradient, complications and protal vein after interventional treatment were analyzed.Results:All 13 cases underwent successful interventional treatment. A total of 15 stents were implanted in the 13 patients. The treatment time was (63.1±18.4) min. The pressure gradient at both ends of portal vein occlusion before treatment was [ M ( Q1, Q3)] 14.0 (9.5, 18.0) mmHg (1 mmHg=0.133 kPa), which declined after interventional treatment 1.0 (1.0, 2.5) mmHg ( Z=-3.19, P<0.001). Portal vein and right portal branch thrombosis recurred in one patient six days after interventional treatment, which was managed with re-interventional treatment. One patient underwent intrahepatic portal shunt through jugular vein 111 days after interventional treatment due to recurrent portal vein thrombosis. The other patients recovered uneventfully without recurrent portal vein thrombosis or occlusion during follow-ups. No intervention-related complications such as puncture point and intraperitoneal hemorrhage occurred in the patients. Conclusion:A modified classification-based interventional treatment could be safe and feasible for patients with advanced portal vein occlusion after liver transplantation.

Application of phantom for dose measurement in interventional therapy for pediatric vascular anomalies / 中国辐射卫生

@#<b>Objective</b> To apply a phantom for dose measurement in interventional therapy for pediatric vascular diseases, and calculate the effective dose (<i>E</i>) and conversion coefficient of dose area product (DAP) to <i>E</i>, and to provide a dose reference for studying radiation dose and radiation protection in children. <b>Methods</b> Thermoluminescent dosimeters were placed in the organs of the phantom. Low-, medium-, and high-dose groups were set for three types of vascular anomalies based on the duration of fluoroscopy. Digital subtraction angiography was used to simulate exposure conditions at different dose levels. The organ dose was measured, and the effective dose was calculated. <b>Results</b> For the three groups of vascular anomalies in the head and face, the red bone marrow doses were 8.15, 30.34, and 43.53 mGy, respectively, the effective doses were 12.88, 47.84, and 73.12 mSv, respectively; and the average conversion coefficient of DAP to <i>E</i> was 2.16. For the three groups of vascular anomalies in the trunk, the red bone marrow doses were 2.11, 15.62, and 31.21 mGy, respectively; the effective doses were 12.39, 70.56, and 134.60 mSv, respectively, and the average conversion coefficient of DAP to <i>E</i> was 3.03. For the three groups of vascular anomalies in the lower extremities, the red bone marrow doses were 3.58, 6.50, and 12.28 mGy, respectively, the effective doses were 3.64, 7.04, and 14.85 mSv, respectively, and the average conversion coefficient of DAP to <i>E</i> was 0.73. <b>Conclusion</b> Patient dose and DAP-to-<i>E</i> conversion coefficient are in the following order: vascular anomalies in the trunk > vascular anomalies in the head and face > vascular anomalies in the lower extremities. The dose data obtained can be used to estimate children’s radiation exposure.