RESUMO
Objective To study the clinical efficacy of transjugular intrahepatic portosystemic shunt (TIPS) combined with agitation thrombolysis in treatment of acute portal vein thrombosis (PVT) in patients with liver cirrhosis.Methods The clinical data of 37 cirrhotic patients with acute PVT treated from January 2014 to December 2017 at the First Affiliated Hospital of Henan University of Science and Technology was analyzed.There were 20 males and 17 females with age ranging from 29 to 71 years.The patients were divided into the combined group (n =15) and the anticoagulation group (n =22).The combined group was treated with TIPS combined with agitation thrombolysis anticoagulation.The anticoagulation group was treated with anticoagulation.The changes in liver function and hemodynamics of portal vein of the two group were compared.Follow-up studies included postoperative portal vein patency,bleeding and survival rates of patients.Results The postoperative portal vein pressure and maximum burden of PVT in the combined group were significantly lower than those before operation,and the portal vein maximum blood volume and flow velocity of portal vein were significantly higher than those before operation (all P ＜ 0.05).At 2 weeks,6 months and 12 months after operation,the maximum burden of PVT of the combined group was (13.9 ±5.4)％,(16.1 ±5.5)％ and (13.8 ±6.2)％,respectively,which was significantly lower than that of the anticoagulant group (84.1±31.3)％,(85.9±27.6)％ and (88.2±39.5)％ (all P＜0.05).At 2 weeks,6 months and 12 months after operation,the flow velocity of portal vein of the combined group was (21.6 ± 5.7) cm/s,(16.1 ± 6.3) crn/s and (17.6 ± 4.9) cm/s,respectively,which was significantly higher than that of the anticoagulation group (9.7 ± 4.6) cm/s,(8.1 ± 4.3) cm/s and (8.2 ± 3.5) cm/s (all P ＜ 0.05).After operation,3 patients in the combined group developed recurrence of portal vein thrombosis,while the remaining patients had smooth blood flow in the portal vein and shunt.In the anticoagulation group,only 3 patients had unobstructed portal vein blood flow.The cumulative rate of no gastrointes tinal bleeding in the combined group was significantly better than the anticoagulant group.The cumulative survival rate of the combined group was also significantly better than the anticoagulation group (P ＜ 0.05).Conclusion TIPS combined with agitation thrombolysis was more effective than the traditional anticoagulant therapy in treatment of acute portal vein thrombosis in cirrhotic patients.
RESUMO
Objective To evaluate the curative effect of fallopian tube perfusion with ozone water in treating obstructed fallopian tube in pluripara.Methods A total of 116 patients with distal fallopian tube obstruction were included in this study.The diagnosis was confirmed by clinical and laboratory materials.The patients were randomly divided into the study group and the control group with 58 patients in each group.During hospitalization period all patients received interventional recanalization therapy for obstructed fallopian tube.For the patients of the study group,ozone water perfusion of fallopian tube was employed,while for the patients of the control group,fallopian tube perfusion with conventional anti-inflammatory drug and antiadhesion solution was adopted.All the patients were followed up for 6 months,the pregnancy rate and the fallopian tube re-occlusion rate of both groups were calculated,and 2 weeks after the treatment the patients'discomfort symptoms were evaluated.Results The success rate of fallopian tube recanalization,the pregnancy rate and the re-obstruction rate in the study group were 93.1％ (54/58),79.3％ (46/58) and 5.2％(3/58) respectively,which in the control group were 91.4％ (53/58),60.3％ (35/58) and 172％ (10/58) respectively.Statistical analysis indicated that no significant difference in the success rate of fallopian tube recanalization existed between the two groups (P＞0.05).The pregnancy rate of the study group was higher than that of the control group,while the re-obstruction rate in the study group was lower than that in the control group;the differences between the two groups were statistically significant (P＜0.05).No significant differences in discomfort symptom scores existed between the two groups (P＞0.05).Conclusion Fallopian tube perfusion with ozone water can be adopted for tubal recanalization,this technique can effectively improve the postoperative pregnancy rate and reduce the tubal re-obstruction rate.
RESUMO
Purpose To investigate the diagnostic value of parameters derived from intravoxel incoherent motion (IVIM) model for benign and malignant breast lesions,and to provide reference for the identification of breast lesions.Materials and Methods 27 cases with 28 benign breast lesions and 34 cases with 35 malignant breast lesions were collected and analyzed retrospectively.All of the patients were examined with IVIM-DWI scans.GE AW 4.4 workstation was used to calculate the value of ADC,D,D* and f.The diagnostic performance of different parameters was evaluated by receiver operating characteristic curve (ROC curve).The ADC,D,D* and f value of malignant group and the benign group were compared,respectively.Results The value of ADC and D were significantly lower in malignant group than in benign group (P＜0.05),and the value of D* and fwere significantly higher in malignant group than in benign group (P＜0.05).The cutoff value of D was 0.74× 10-3 mm2/s,and the AUC were 0.907,the specificity,sensitivity in the diagnosis of malignant breast lesions was 0.86,0.95,respectively.Conclusions Parameters of IVIM-DWI are helpful in the differential diagnosis of benign and malignant breast lesions.
