Selective intra-arterial cold saline infusion combined with intravascular reperfusion for acute ischemic stroke with large artery occlusion: a preliminary safety and feasibility study / 国际脑血管病杂志

Objective To preliminarily investigate the safety and feasibility of intra-arterial cold saline infusion combined with intravascular reperfusion for acute ischemic stroke with large artery occlusion. Methods From March 2016 to March 2018, consecutive acute ischemic stroke patients with large artery occlusion within 8 h after onset admitted to the Department of Neurology, the People's Hospital of Longhua District, Shenzhen and recanalized successfully after endovascular treatment were enrolled. After recanalization, cold saline was infused through the guiding catheter via the ipsilateral guilty vessel (10 ℃, 33 ml/min for 30 min). Results A total of 20 patients were enrolled, including 15 males. Their median age was 67 years (interquartile range, 53-80 years). Fifteen patients were treated with thrombolysis. A median onset-to-needle time was 300 min (interquartile range, 260-360 min). During the infusion of cold saline, the lowest rectal temperature was only decreased 0. 1 ℃, but within 5 min after completion of perfusion, it returned to the temperature before perfusion. Complications associated with intra-arterial hypothermia were not observed. The median National Institutes of Health Stroke Scale score was significantly decreased from 21 (interquartile range 15-55) before needle to 15 (interquartile range 10-16; Z = -4. 549, P < 0. 001) at discharge. Conclusion Selective intra-arterial cold saline infusion combined with intravascular reperfusion for acute ischemic stroke with large artery occlusion is safe and feasible.

[Pay attention to the application of the international intraocular retinoblastoma classification and sequential multiple modality treatment].

Retinoblastoma (RB) is the most common intraocular malignancy in childhood. It may seriously affect vision, and even threaten the life. The early diagnosis rate of RB in China remains low, and the majority of patients are at late phase with high rates of enucleation and mortality. The International Intraocular Retinoblastoma Classification and TNM staging system are guidances for therapeutic choices and bases for prognosis evaluation. Based on the sequential multi-method treatment modality, chemotherapy combined with local therapy is the mainstream in dealing with RB, which may maximize the results of eye saving and even vision retaining. New therapeutic techniques including supra-selective ophthalmic artery interventional chemotherapy and intravitreal chemotherapy can further improve the efficacy of treatment, especially the eye salvage rate. The overall level of RB treatment should be improved by promoting the international staging, new therapeutic techniques, and the sequential multiple modality treatment. (Chin J Ophthalmol, 2017, 53: 561-565).

[The key points in intravenous chemotherapy and intra-arterial chemotherapy on retinoblastoma treatment].

Intravenous chemotherapy and intra-arterial chemotherapy (IAC) both are the first-line treatment for retinoblastoma (RB) in clinical. There is a controversy on if intra-arterial chemotherapy can substitute the intravenous chemotherapy due to its high eye salvage rate in retinoblastoma therapy. The advantages and disadvantages of these two therapies were retrospectively reviewed here to suggest an individualized and comprehensive regimen for getting the proximal results for retinoblastoma afflicted children. (Chin J Ophthalmol, 2017, 53: 566-569).

2015 American Heart Association/American Stroke Association Focused Update of the 2013 Guidelines for the Early Management of Patients With Acute Ischemic Stroke Regarding Endovascular Treatment: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association.

PURPOSE: The aim of this guideline is to provide a focused update of the current recommendations for the endovascular treatment of acute ischemic stroke. When there is overlap, the recommendations made here supersede those of previous guidelines. METHODS: This focused update analyzes results from 8 randomized, clinical trials of endovascular treatment and other relevant data published since 2013. It is not intended to be a complete literature review from the date of the previous guideline publication but rather to include pivotal new evidence that justifies changes in current recommendations. Members of the writing committee were appointed by the American Heart Association/American Stroke Association Stroke Council's Scientific Statement Oversight Committee and the American Heart Association/American Stroke Association Manuscript Oversight Committee. Strict adherence to the American Heart Association conflict of interest policy was maintained throughout the consensus process. Recommendations follow the American Heart Association/American Stroke Association methods of classifying the level of certainty of the treatment effect and the class of evidence. Prerelease review of the draft guideline was performed by 6 expert peer reviewers and by the members of the Stroke Council Scientific Statement Oversight Committee and Stroke Council Leadership Committee. RESULTS: Evidence-based guidelines are presented for the selection of patients with acute ischemic stroke for endovascular treatment, for the endovascular procedure, and for systems of care to facilitate endovascular treatment. CONCLUSIONS: Certain endovascular procedures have been demonstrated to provide clinical benefit in selected patients with acute ischemic stroke. Systems of care should be organized to facilitate the delivery of this care.

Intraarterial CT Angiography Using Ultra Low Volume of Iodine Contrast - Own Experiences.

BACKGROUND: High volume of intravenous contrast in CT-angiography may result in contrast-induced nephropathy. Intraarterial ultra-low volume of contrast medium results in its satisfactory blood concentration with potentially good image quality. The first main purpose was to assess the influence of the method on function of transplanted kidney in patients with impaired graft function. The second main purpose of the study was to evaluate the usefulness of this method for detection of gastrointestinal and head-and-neck haemorrhages. MATERIAL/METHODS: Between 2010 and 2013 intraarterial CT-angiography was performed in 56 patients, including 28 with chronic kidney disease (CKD). There were three main subgroups: 18 patients after kidney transplantation, 10 patients with gastrointestinal hemorrhage, 8 patients with head-and-neck hemorrhage. Contralateral or ipsilateral inguinal arterial approach was performed. The 4-French vascular sheaths and 4F-catheters were introduced under fluoroscopy. Intraarterial CT was performed using 64-slice scanner. The scanning protocol was as follows: slice thickness 0.625 mm, pitch 1.3, gantry rotation 0.6 sec., scanning delay 1-2 sec. The extent of the study was established on the basis of scout image. In patients with CKD 6-8 mL of Iodixanol (320 mg/mL) diluted with saline to 18-24 mL was administered at a speed of 4-5 mL/s. RESULTS: Vasculature was properly visualized in all patients. In patients with impaired renal function creatinine/eGFR levels remained stable in all but one case. Traditional arteriography failed and CT-angiography demonstrated the site of bleeding in 3 of 10 patients with symptoms of gastrointestinal bleeding (30%). In 8 patients with head-and-neck bleeding CT-angiography did not prove beneficial when compared to traditional arteriography. CONCLUSIONS: 1. Ultra-low contrast intraarterial CT-angiography does not deteriorate the function of transplanted kidneys in patients with impaired graft function. 2. 3D reconstructions allow for excellent visualization of vascular anatomy of renal transplants. 3. Intraarterial CT-angiography is useful for detection of the bleeding site.

Clinical observation on the bronchial artery infusion in the treatment of central NSCLC with obstructive pneumonia / 重庆医学

Objective To observe the effect of bronchial artery infusion chemotherapy in the treatment of central non-small cell lung cancer (central NSCLC)with obstructive pneumonia and its efficacy clinical factors.Methods Retrospective analysis method was applied to the 64 cases of central NSCLC with obstructive pneumonia.All patients were confirmed by pathology.We main contrasted the efficacy between intravenous infusion of antimicrobial agents and bronchial artery infusion chemotherapy (BAI).we focused on the efficacy between treatment group using standard systemic vein chemotherapy/radiotherapy and primary group with no chemotherapy/radiotherapy.Results In control group,the improvement rate was 43.33%.The improvement rate in treatment group was 70.59%.In treatment group,the curing rate was 50.00% for the patients who had ever taken standard sys-temic chemotherapy/radiotherapy.But the curing rate was 88.89% for the primary group.Conclusion For the patients who have the central NSCLC with obstructive pneumonia,intravenous infusion of antimicrobial agents and bronchial artery infusion chemo-therapy (BAI)can obviously increase the curing rate of obstructive pneumonia.

Application of selective intra-arterial brain hypothermia in acute ischemic stroke / 国际脑血管病杂志

Therapeutic hypothermia has been shown to improve neurological outcomes after global ischaemia/hypoxia in patients who have had cardiac arrest. Therapeutic hypothermia is one of the most extensively studied and influential therapeutic strategies of acute ischemic stroke. Previous studies of therapeutic hypothermia mainly focused on whole-body cooling. However, delayed induction and systemic complications have limited the clinical application of whole-body cooling. As a selective cerebral hypothermia, the selective intra-arterial brain hypothermia treatment has the characteristics of rapid and even induction of hypothermia, and less affecting the core body temperature. Therefore, it has become a promising treatment modality. This article reviews the application of selective intra-arterial brain hypothermia in acute ischemic stroke and its advantages and limitations in order to provide reference for further experimental studies and future clinical trials.

Clinical study on the treatment of ectopic pregnancy by methotrexate and the particle of gelatin sponge with uterine artery embolization / 中国医师杂志

Objective To investigate the clinical application value of methotrexate and the particle of gelatin sponge treat ec -topic Pregnancy .Methods A total of 48 cases of ectopic pregnancy was analyzed retrospectively .Methotrexate and gelatin sponge particles were injected into the uterine artery embolization for the method of intervention , and its clinical application value was evalua-ted.Results All 48 patients were embolized uterine artery successfully .It treated successfully ectopic pregnancy 44 cases (92%), including 38 cases of tubal pregnancy and other parts of the 6 cases.All patients were detected in β-human chorionic gonadotropin (β-HCG) until normal about 3 weeks.No serious postoperative complications were found , only 30 patients with abdominal pain, 16 cases of patients with nausea and vomiting , 9 patients with low-grade fever were found .After four months , 29 patients were recanalizated successfully .Conclusions Treatment of ectopic pregnancy can kill embryos efficiently , stanch the bleeding rapidly , and have small operation wound .It is safe and reliable method and is worth populating .

Efficacy and safety of hepatic arterial infusion of fluorouracil with leucovorin as salvage treatment for refractory liver metastases from colorectal cancer.

BACKGROUND/AIMS: Limited options remain for patients with metastatic colorectal cancer (CRC) after failure of standard systemic chemotherapy. Readministration of chemotherapeutic agents by hepatic arterial infusion (HAI) has the rationale of providing higher concentrations of chemotherapeutic agents to hepatic metastases. The present study was conducted to evaluate the efficacy and safety of HAI of fluorouracil with leucovorin (HAI 5-FU/LV) for patients with liver metastases from CRC. METHODS: Fourteen patients with liver metastases from CRC who received HAI 5-FU/LV after failure of systemic chemotherapy containing fluorouracil and leucovorin were identified and their medical records were reviewed. RESULTS: Of 10 patients evaluable for response, one partial response, six stable disease, and three progressive disease were reported. Additionally, the overall response and disease control rates were 7% and 50%, respectively. The median time to progression was 4.3 months (range, 2.9 to 5.6), to hepatic progression was 5.8 months (range, 4.7 to 6.9), and to extrahepatic progression was 5.8 months (range, 2.3 to 9.2). No grade 3/4 hematologic toxicities occurred and one case of abdominal pain and two cases of oral mucositis were the only grade 3 nonhematologic toxicities. Catheter-related complications occurred in three patients: one thrombosis, one infection, and one displacement. CONCLUSIONS: HAI 5-FU/LV was well tolerated and showed modest efficacy for patients with liver metastases from refractory CRC. Readministration of previously used chemotherapeutic agents via the hepatic artery could be an effective salvage option and warrants further investigation in a prospective trial.

Comparison the therapeutic effect of intra-arterial thrombolysis and intravenous thrombolysis for acute ischemic cerebral infarction within 6 hours of onset: A meta-analysis / 中国脑血管病杂志

Objective: To evaluate the efficacy and safety of intra-arterial thrombolysis and intravenous thrombolysis in the treatment of acute ischemic cerebral infarction through a meta-analysis. Methods: The literatures of the randomized controlled trials of using urokinase or recombinant tissue plasminogen activator for intra-arterial thrombolysis and intravenous thrombolysis in the treatment of acute ischemic cerebral infarction from January 1 ,2000 to August 5,2010 were reviewed. The primary outcome measures were the proportions of neurological improvement (basic cure + excellent results) in the intra-arterial thrombolysis and intravenous thrombolysis groups. The secondary outcome measures were the European Stroke Scale (ESS) scores after the treatment and the proportion of symptomatic intracranial hemorrhage. The meta-analysis software, RevMan 4. 2 was applied for pooling the data of all the findings. Two reviewers extracted the data independently. Results: A total of 11 articles either from foreign or domestic sources and 723 patients with acute cerebral infarction were included, in which 305 patients underwent intra-arterial thrombolysis and 418 underwent intravenous thrombolysis. Circled digit oneThe total improvement rate of the intra-arterial thrombolysis was 70. 92% and that of intravenous thrombolysis was 61. 29%. There was significant difference between them (χ2 =4. 895,P 0. 7 ). There was no significant difference in thrombolytic modes in the risk of complicating intracranial hemorrhage between the two groups (OR = 1. 12, 95% CI:0. 63 - 2.01,P = 0.69). Conclusion: The efficacy of intra-arterial thrombolysis for acute cerebral infarction is superior to that of intravenous thrombolysis, and both the incidences of symptomatic intracranial hemorrhage is comparable. A large, high-quality randomized controlled trial is need for further verification.

Cerebral protective effect of intracarotid propofol in patients undergoing resection of cerebral gliomas / 中华麻醉学杂志

Objective To investigate the cerebral protective effect of intracarotid infusion of propofol in patients undergoing resection of cerebral gliomas. Methods Sixty ASA Ⅰ- Ⅲ patients with cerebral glioma aged 40-64 yr weighing 48-73 kg were enrolled in this study. Forty patients undergoing resection of glioma under general anesthesia were randomly divided into 2 groups ( n = 20 each): intracarotid propofol group (group IA ) and intravenous propofol group (group Ⅳ). Twenty patients undergoing biopsy of glioma under local infiltration anesthesia with 2% lidocaine 15-20 md served as control group (group C). In IA and Ⅳ groups anesthesia was induced with TCI of propofol and remifentanil. Tracheal intubation was facilitated with rocuronium 0.6 mg/kg. The patients were mechanically ventilated. PErCO2 was maintained at 35-45 mm Hg. Anesthesia was maintained with TCI of propofol and remifentanil and intermittent iv boluses of rocuronium. In group IA internal carotid artery was cannulated after induction of anesthesia and propofol was administered by TCI via carotid artery while remifentanil was administered by TCI via peripheral vein. BIS was maintained at 40-60 during operation. ECG, MAP, HR, SpO2, PETCO2 and BIS were continuously monitored. MAP and HR were recorded before induction of anesthesia (T1) ,during skin incision (T2 ), at the end of operation (T3), during extubation ( T4 ). The glioma specimens were obtained for microscopic examination and determination of aquaporin 1 and aquaporin 4 ( AQP1, AQP4) expression by immunohistochemistry. Results MAP and HR were significantly decreased at T2 and T3 as compared with the baseline at T1 in group Ⅳ ( P ＜ 0.05), while there was no significant change in MAP and HR after induction of anesthesia in group IA ( P ＞ 0.05). The expression of AQP1 and AQP4 was down-regulated in IA and Ⅳ groups compared with group C (P ＜0.05). The propofol consumption during anesthesia was significantly less in group IA than in group Ⅳ (P ＜0.05). There was no significant diffe-rence in AQP1 and AQP4 expression, the amount of remifentanil and recuronium consumed and duration of operation betweenIA and Ⅳ groups ( P ＞ 0.05). Concltsion Intracarotid propofol can decrease the amount of propofol needed for maintenance of anesthesia as compared with intravenous administration and attenuate brain edema,indicating cerebral protective effect.

Efficacy and Safety of Hepatic Arterial Infusion of Fluorouracil with Leucovorin as Salvage Treatment for Refractory Liver Metastases from Colorectal Cancer

BACKGROUND/AIMS: Limited options remain for patients with metastatic colorectal cancer (CRC) after failure of standard systemic chemotherapy. Readministration of chemotherapeutic agents by hepatic arterial infusion (HAI) has the rationale of providing higher concentrations of chemotherapeutic agents to hepatic metastases. The present study was conducted to evaluate the efficacy and safety of HAI of fluorouracil with leucovorin (HAI 5-FU/LV) for patients with liver metastases from CRC. METHODS: Fourteen patients with liver metastases from CRC who received HAI 5-FU/LV after failure of systemic chemotherapy containing fluorouracil and leucovorin were identified and their medical records were reviewed. RESULTS: Of 10 patients evaluable for response, one partial response, six stable disease, and three progressive disease were reported. Additionally, the overall response and disease control rates were 7% and 50%, respectively. The median time to progression was 4.3 months (range, 2.9 to 5.6), to hepatic progression was 5.8 months (range, 4.7 to 6.9), and to extrahepatic progression was 5.8 months (range, 2.3 to 9.2). No grade 3/4 hematologic toxicities occurred and one case of abdominal pain and two cases of oral mucositis were the only grade 3 nonhematologic toxicities. Catheter-related complications occurred in three patients: one thrombosis, one infection, and one displacement. CONCLUSIONS: HAI 5-FU/LV was well tolerated and showed modest efficacy for patients with liver metastases from refractory CRC. Readministration of previously used chemotherapeutic agents via the hepatic artery could be an effective salvage option and warrants further investigation in a prospective trial.

LateTIME: a phase-II, randomized, double-blinded, placebo-controlled, pilot trial evaluating the safety and effect of administration of bone marrow mononuclear cells 2 to 3 weeks after acute myocardial infarction.

A realistic goal for cardiac cell therapy may be to attenuate left ventricular remodeling following acute myocardial infarction to prevent the development of congestive heart failure. Initial clinical trials of cell therapy have delivered cells 1 to 7 days after acute myocardial infarction. However, many patients at risk of developing congestive heart failure may not be ready for cell delivery at that time-point because of clinical instability or hospitalization at facilities without access to cell therapy. Experience with cell delivery 2 to 3 weeks after acute myocardial infarction has not to date been explored in a clinical trial. The objective of the LateTIME study is to evaluate by cardiac magnetic resonance the effect on global and regional left ventricular function, between baseline and 6 months, of a single intracoronary infusion of 150 × 106 autologous bone marrow mononuclear cells (compared with placebo) when that infusion is administered 2 to 3 weeks after moderate-to-large acute myocardial infarction. The 5 clinical sites of the Cardiovascular Cell Therapy Research Network (CCTRN) will enroll a total of 87 eligible patients in a 2:1 bone marrow mononuclear cells-to-placebo patient ratio; these 87 will have undergone successful percutaneous coronary intervention of a major coronary artery and have left ventricular ejection fractions ≤0.45 by echocardiography. When the results become available, this study should provide insight into the clinical feasibility and appropriate timing of autologous cell therapy in high-risk patients after acute myocardial infarction and percutaneous coronary intervention.

Pulmonary artery perfusion with cold modified Low- Potassium Dextran solution reduces lung injury in combined aortic and mitral valve replacement / 中国医师杂志

Objective This study was to evaluate the protective effect of pulmonary perfusion with cold modified low- potassium dextran (LPD) solution on lung function after cardiopulmonary bypass in combined aortic and mitral valve replacement. Method Twenty-four consecutive adult patients with combined aortic and mitral valve disease were divided into a control group ( n =14) and a perfused group ( n = 10). Cold modified LPD solution was infused to the main pulmonary artery in the protective group. PaO_2/FiO_2 were monitored at six different time points; preoperation, 0 hour, 1 hours, 2 hours, 6 hours and 12 hours after the termination of CPB. Concentrations of interleukin-6 and interleukin-10 in plasma were measured at four different time points; preoperation, 0 hour, 6 hours, and 12 hours after the termination of CPB. Result PaO_2/FiO_2 in the perfused group were increased more than that in the control group. The IL-6 and IL-10 increased in both groups after operations( P <0. 05). Patients of the perfused group showed significantly reduced IL-6 expression, compared with the control group ( P <0. 001), but the rising extents of IL-10 in the perfused group were higher than that in the control group ( P <0.001). Conclusion Pulmonary artery perfusion with cold modified LPD solution during cardiopulmonary bypass relieved lung injury in combined aortic and mitral valve replacement.

Experimental study of intra-arterial and intravenous recombinant staphylokinase in canine model with acute ischemic stroke / 中华放射学杂志

Objective To discuss the safety,efficacy and time window of thombolysis using recombinant staphylokinase(r-Sak).Methods The model of acute cerebral infarction was established with interventional embolization technique in 24 adult beagle dogs,which were randomly divided into 3 groups including control group,6 h intra-arterial group and 3 h intravenous group.Angiography was performed before thrombolysis.We administered r-Sak for thrombolysis(10 ml of saline in control group,0.2 mg/kg of r-Sak in the intra-arterial group through left internal carotid artery 6 h after embolization,and 0.2 mg/kg of r-Sak in the intravenous group through femoral vein 3 h after embolization).Follow-up angiography was repeated half,1 and 2 hours after thrombolysis.The plasma levels of PT,APTT and D-dimer were assayed at the time points of 30 min before thrombolysis,30 min,60 min and 120 min after thrombolysis.These canines were sacrificed,and their brains were taken out for pathological study at 24 hours after embolization.Results The recanaled vessels at 2 hours after thrombolysis was 11(11/13) in the intra-arterial group,8(8/11) in r-Sak intravenous group and 1(1/10) in control group,and the vessels of complete recanalization was 6(6/13),2(2/11) and 0(0/10),respectively.There were statistically significant differences among the three groups (P=0.001 and P=0.035 respectively),but there were no statistically significant differences between the intra-arterial and the intravenous groups (P=0.630 and P=0.211).The PT and APTT are significantly prolonged in the thrombolytic groups.The levels of D-dimer was not changed after thrombolysis (P＞0.05). All dogs were alive 24 h ours after embolization.The clinical presentations in the thrombolytic groups were better.Pathologically,there were no cerebral hemorrhage in all groups.Conclusion r-Sak has strong effect of thrombolysis,and its complication of intracerebral hemorrhage is rare.The intra-arterial thrombolysis 6 h after embolization using r-Sak is safe and effective.

Comparison of effectiveness between intra-arterial and intra-venous neoadjuvant chemotherapy in stage Ⅰb2-Ⅱ b cervical carcinoma / 中华妇产科杂志

Objective To compare the effect between intra-arterial and intra-venous neoadjuvant chemotherapy(NACT)in stage Ⅰb2-Ⅱ b cervical carcinoma.Methods A retrospective analysis Was done on 52 cases of intra-venous NACT and 95 eases of intm-arterial NACT for stage Ⅰ b2-Ⅱ b cervical carcinoma treatad in Peking Union Medical College Hospital from 1999.ResulIs The response rate of intraveHous NACT and intra-arterial NACT was 88%(46/52)and 79%(75/95).and the operative rate after NACT Was 81%(42/52)and 72%(68/95)respectively(P>0.05).There were no significant differences in surgery time,blood loss and pest-operative morbidity between these two groups.Pathological parametrial positive rate after NACT in arterial group(6%)Was significantly lower than that of venous group (50%,P>0.05).The venous group had very similar recurrence rates(13%vs 17%)and death rates (9%VS 12%)when compared with the arterial group(P>0.05).Conclusions The intra-arterial and intra-venous NACT for stage Ⅰ b2-Ⅱb cervical carcinoma show similar response rate.operative rate and surgical difficulties.Arterial NACT shows a better effect on parametrial infiltration.

Effect of preoperative chemotherapy on bulky cervical cancer by internal iliac arterial infusion / 中华妇产科杂志

Objective To evaluate the effect of preoperative chemotherapy on bulky cervical cancer by internal iliac arterial infusion. Methods One hundred and eighty-six patients with bulky cervical cancer were randomly divided into two groups: chemotherapy + radiotherapy group (C+R group, n=105) and radiotherapy group (R group, n=81). Patients in C + R group underwent internal iliac arterial infusion chemotherapy by using Seldinger technique internal iliac arterial or epigastric arterial catheterization. Combined regimens were prescribed including cisplatin as the major drug. Meanwhile ~192 Ir high-dose-rate intracavitary radiotherapy was performed,with A point dose at ~12-24 Gy/2-4 times (C + R group). Patients in R group were only given radiotherapy. Both groups of patients received radical hysterectomy two weeks after radiotherapy. Results The tumor regression rate of C+R group was 97.1%, significantly higher than 79.0% in R group(P0.05). Postoperative pathologic examinations showed the percentage of cervical tumor residue, parauterine invasion,pelvic lymph node metastasis in C+R group was lower than those of R group(P

Super-selective intraarterial placement of pump and regional chemotherapy in the treatment of advanced gastrointestinal cancer / 中国普通外科杂志

Objective To evaluate the effect of intraoperative placement of super-selective intraarterial pump and postoperative regional infusion chemotherapeutics for the treatment of laparotomy proved inoperable advanced gastrointestinal cancer. Methods Intraoperatively the major artery supplying the tumor was identified and cannulated with the placement of a pump. Postoperative regional chemotherapy was carried out in 79 cases of gastrointestinal cancer. Among them there were 42 cases of gastric cancer, 37 of colorectal cancer. Results Complete tumor remission was achieved in 1 case, partial remission in 69 cases. This therapy also enabled second stage tumor resection in 11 cases. The total effective rate reached 88.6%. The 1-, 2-, and 3- years' survival rates were 84%,28% and 9%, respectively, averaging the survival period at 20.6 months. Conclusion Super-selective intraarterial pump-insertion and postoperative regional chemotherapy is effective in the treatment of advanced inoperable gastrointestinal cancer.

Effects of preoperative selective gastric arterial chemoembolization on the tumor vasculature in patients with gastric carcinoma / 中国普通外科杂志

Objective To investigate the effects of preoperative selective gastric arterial chemoembolization on the tumor vasculature in patients with gastric carcinoma.Methods 40 patients with gastric cancer were divided into two groups :(1)gastric arterial influsion(GAI)group;and (2)gastric arterial chemoembolization(GAE)group.The peripheral vein plasma tumor necrosis factor(TNF ?) and thrombomodulin(TM)were determined before radiologic intervention(RI),and1d,3d after R1;and the gastric vein plasma TNF ? and TM were also determined during operation.The curative surgical resection of gastric cancer was performed between 7 and 10 days after treatment.Stomach histological alterations were observed postoperatively.Results Compared with GAI group ,the plasma TNF ? levels increased markedly at all the time points,and gastric vein plasma TM levels decreased siginificantly in GAE group (P

Pathological and clinical observation of preoperative selective arterial infusion chemotherapy of colorectal cancer / 中国普通外科杂志

Objective To study the effect of preoperative selective arterial infusion chemotherapy (PSAIC) on large intestine cancer. Methods 63 patients with colorectal cancer underwent PSAIC with 5 fluorouracil,mitomycin and E adriamycin; the changes of clinical manifestation and pathology were observed and analyzed. Results (1)clinical manifestation:abdominalgia relieved in 18 patients and abdominal distention relieved in 16 patients.Improvement of hematochezia was found in 7 patients.In addition, of 13 patients with partial ileus, the clinical symptoms relieved in 9 patients. (2) pathology: there were karyopyknosis,karyorrhexis,coagulation and necrosis of cytoplasm in cancer cells. infiltration of inflammatory cells, edema and fibroelastosis in mesenchyne of cancer tissue. Proliferous intima and thrombus were also observed in the vessels. Most of these changes were moderate,and marked changes could also be seen in necrosis of cytoplasm and vessel intima proliferation. Conclusion PSAIC can control the focus of primary disease and the micrometastatic foci as well as improve the clinical symptoms, such as intestinal obstruction, and hematochezia, so PASIC is helpful to subsequent operation,and can improve the survival rate of patients with colorectal cancer.