Correlation between serum HIF-1α and VEGF level pre-and post-TACE in patients with primary liver cancer / 中国介入影像与治疗学

Objective To investigate the expression and correlation of serum hypoxia inducible factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF) level pre-and post-transcatheter arterial chemoembolization (TACE) in patients with primary liver cancer (PLC) .Methods Expression of serum HIF-1α and VEGF were studied in 40 patients of PLC pre-and 1 day,1 week,1 month post-TACE and 20 healthy volunteers (as control group) .Results The expression of HIF-1α and VEGF was (154.94±83.29) pg/ml and (264.00±148.10) pg/ml before TACE,higher than those in control group (P＜0.01) .The expression of HIF-1α and VEGF was (570.64±230.87) pg/ml and (362.07±102.25) pg/ml in PLC patients 1 day post-TACE,higher than those before TACE (P＜0.01) ; (198.62±92.11) pg/ml,and (283.52±145.46) pg/ml 1 week post-TACE; (133.96±57.02) pg/ml and (150.96±84.89) pg/ml in the complete response (CR) group 1 month after TACE, (255.74±123.44) pg/ml and (368.95±161.90) pg/ml in partial response (PR) and stable disease (SD) group (P＜0.05) .The expression of serum HIF-1α was positively correlated with VEGF before TACE,and the serum HIF-1α also correlated with portal vein tumor thrombosis and metastasis.Serum VEGF was also correlated with clinical stage,portal vein tumor thrombosis and capsule.Conclusion The expression of serum HIF-1α and VEGF plays an important role in relapse of tumor,and contributes to the evaluation of the efficacy of TACE and metastasis of PLC.

The clinical value of treatment for hepatocellular carcinoma complicated with arterio-portal fistula wing N-butyl 2-cyanoacrylate / 中华放射学杂志

Objective To evaluate the clinical application of embolization therapy using N-butyl 2-cyanoacrylate(NBCA)for hepatocellular carcinoma(HCC)complicated with arterio-portal fistula(APF).Methods Eighty patients with HCC and APF underwent embolothempy with NBCA(NBCA group,26 patients)or absolute alcohol(alcohol group,54 patients).The APF wag first treated with liquid embolic agent during the TACE procedure.We used NBCA-Lipiodol mixtures in concentration of 20%-50% according to tlle different circulation times of these APF in NBCA group,Absolute alcohol plus gelfoam or other materisis were used for embolization of APF in alcohol group.The pain reaction during the procedure,influence for liver function(X2 test).occlusive suceessfxil rate after single embolization(Fisher's exact test)and the survival rate of 1 year(log-rank analysis)between two groups were compared after the embolotherapy.Results Four patients in NBCA group and 52 patients in alcohol group felt painful during the pmcedures.There wag statistically significant difference between two groups(x2=58.86,P＜0.001).The APF disappeared after only sin~e embolization in 24(92.3%,24/26)cages of NBCA group and in 37(68.5%,37/54)patients of alcohol group.There wag also significant difference between two groups (P=0.024).There were no statistical ditierence in the post.embolization liver function change and 1 year survival rate between two groups.Conclusions The embolization therapy using NBCA for HCC complicated with APF is safe.effective and more accurate.It can be used as a new technique for these patients.

Dextran uterine artery embolization to treat fibroids / 中华医学杂志(英文版)

<p><b>OBJECTIVES</b>To analyze the technical aspects of uterine artery embolization with dextran microspheres and to evaluate the effectiveness of this technique as the primary treatment of uterine fibroids in a series of 38 patients.</p><p><b>METHODS</b>Thirty-eight volunteers (age range, 24-48 years; mean, 37.2 years) with symptoms caused by uterine fibroids (menorrhagia, mass-related symptoms, and pelvic pain) were randomly included in this study. The fibroids were single in 32 patients and multiple in 6 patients. According to the tumor location, subserous fibroids were found in 4 patients and interstitial or submucosal fibroids in 34. Tumor size was from 2 to 10.9 cm in diameter. We performed embolization with a single Headhunter catheter using the right-femoral artery approach, injection of dextran microspheres (225-450 micro m), and an absorbable gelatin sponge. Follow-up included clinical and sonographic examinations at one-month intervals for 6 months.</p><p><b>RESULTS</b>Embolization was successfully performed in all patients. Post-procedural pain control was good in 35 (92%) patients. In most patients, symptoms were improved at 3 months (36/38, 95%). Clinical failure of the treatment occurred in only 2 patients (2/38, 5%). Progressive reduction in leiomyoma size was revealed during sonographic follow-up, and the reduction rate at the sixth month after embolization was 68%. The tumor had vanished in five submucosal fibroid patients. Histopathological tests showed that the tumor was degenerative as fibrosis and hyalinosis.</p><p><b>CONCLUSIONS</b>Uterine artery embolization with dextran microspheres is a micro-invasive method for the treatment of uterine fibroids. It is clinically effective in most patients and induces a progressive reduction in the size of fibroids. Based on this study, we believe that this new technique is much more suitable for submucosal fibroids with massive menorrhagia.</p>

Angiographic diagnosis and interventional treatment for alimentary tract bleeding of unknown causes / 介入放射学杂志

Objective To study the diagnoses and treatment of alimentary tract bleeding of unknown causes. Methods All cases were undergone angiographic exarmination. Results 23 cases of angiographic display of alimentary tract bleeding showed the localization and causes of bleeding were clear in 21 casses. 2 cases were negative in radiography. 8 had been given the treatment of interventional embolization. Conclusions This article showed the angiographic display for the diagnosis, and the interventional treatment of alimentary tract bleeding with points for attention.