ABSTRACT
Background: The standard approach for transarterial embolization of uterine fibroids or adenomas is via the femoral artery, but this approach limits the patient's quality of life and increases the risk of deep vein thrombosis in the lower extremities. We applied the distal radial approach technique for the treatment of uterine artery embolization, and aimed to explore the feasibility and safety of uterine artery chemoembolization through the distal radial approach. Methods: We conducted a retrospective study at The First Hospital of Jilin University from January 1, 2021 to November 30, 2023. The main inclusion criteria were: (I) uterine fibroids and adenomyosis were confirmed by preoperative imaging examination; (II) able to accurately palpate the distal radial artery pulse, and the Allen test is negative. Exclusion criteria: patients with distal radial pulses that cannot be palpated, or who are palpable but have radial arteriotomy dialysis, have a tortuous angle on preoperative radial artery ultrasound, which is not conducive to guidewire catheter passage. The primary endpoint of this study was the success rate of distal radial artery puncture. The secondary endpoints included complications and the duration of the puncture. Results: Sixteen patients were enrolled in this study, of which 8 (50%) had uterine fibroids, 5 (31.25%) had uterine adenomas, and 3 (18.75%) had both. The puncture success rate was 93.75% (15/16) and one patient who failed to puncture the distal radial artery was changed to the radial artery approach. The mean time of puncture was 21±8.54 minutes. There were no complications, including bleeding, hematoma, arterial dissection, pseudoaneurysm formation, or distal radial artery occlusion, observed. Conclusions: Uterine artery embolization by the distal radial artery approach is safe and feasible, and should be widely promoted in uterine artery embolization.
ABSTRACT
BACKGROUND: Adjuvant therapy after surgery is effective for the treatment of advanced gastric cancer (GC), but the regimens are not uniform, resulting in imbalanced benefits. OBJECTIVES: To compare the overall survival (OS), relapse-free survival (RFS) and disease-free survival (DFS) of patients with local-advanced GC (LAGC) after surgery plus adjuvant therapy and with surgery alone based on meta-analysis. MATERIAL AND METHODS: Literature search was performed among the articles published in the PubMed, Embase and Cochrane Library databases from January 2000 to December 2018. Study selection was conducted based on the following criteria: randomized clinical trials (RCTs) on surgery plus adjuvant therapy compared to surgery alone; studies compared OS and/or RFS/DFS; and cases medically confirmed with LAGC. Only articles in English were included. RESULTS: A total of 12 datasets from 11 randomized controlled trials (RCTs) involving 4606 patients were included in the meta-analysis. There was a significant improvement in OS of patients who underwent postoperative adjuvant therapy (HR 0.78; 95% CI: 0.72-0.84; p < 0.001). In the subgroup analysis, it showed a higher improvement in OS patients who received adjuvant chemotherapy plus immunotherapy or radiotherapy (HR 0.72; 95% CI: 0.61-0.85; p < 0.001). CONCLUSION: Adjuvant therapy led to survival benefits in patients with LAGC.
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To achieve the "Double Carbon" target, China is paying increasing attention to green building development. Thus, this study selected 26 regional green building development planning documents that have been put into practice since the implementation of the 14th Five-Year Plan and analyzed different development goals and common development barriers and paths presented in regional documents by conducting qualitative research. After the analysis of common goals and goals with regional characteristics, this study verified that spatial imbalances did exist in the development targets of green building in each region during the "14th Five-Year Plan", and the development priorities also varied from region to region. Due to the relation between development goals and the current situation, this study can also illustrate the spatial imbalances of the development situation between different regions. The results of this study can assist regional governments in gaining a clear self-positioning to judge whether they keep pace with the national development level of green buildings and encourage them to take measures to guarantee the stable development of green buildings.
Subject(s)
Sustainable Development , Sustainable Growth , ChinaABSTRACT
BACKGROUND: Feeding by nasoenteral tube (NET) is safe and effective for supporting the nutrition needs of patients with inadequate oral intake. However, during insertion of the NET with fluoroscopic guidance, both the professional staff and patients are exposed to radiation. To improve the success rate of NET placement and minimize radiation exposure, this retrospective study evaluated potential factors associated with successful fluoroscopy-guided NET placement and short total fluoroscopy time (TFT) among Chinese patients. METHODS: An assessment was conducted among patients (n = 348) who received NET placement by physicians under fluoroscopic guidance. Multivariate logistic regression models and linear models were used to validate factors that affected the success of placement and TFT. RESULTS: NET was placed successfully in 319 patients (91.7%), with a median TFT of 6.1 (interquartile range [IQR], 4.9-9.9) minutes. The median TFT of patients with unsuccessful placement was 15.4 (IQR, 12.7-20.9) minutes. Factors associated with successful placement included lack of upper gastrointestinal (GI) surgery history and normal peristalsis of the upper GI tract (P ≤ .015). The TFT was significantly influenced by upper GI surgery history and characteristics of the upper GI tract (P ≤ .025). The professional title or experience of the operators had no association with successful NET placement or TFT. CONCLUSIONS: NET placement under fluoroscopic guidance had a high success rate. Factors that are crucial for planning the approach include a history of upper GI surgery, the dynamic status of the upper GI tract, and features of the upper GI tract.
