Endovascular and hybrid treatments for subclavian artery aneurysms.

OBJECTIVE: This paper retrospectively reviews our experience with endovascular and hybrid treatments for subclavian artery aneurysms (SAA). METHODS: Seventeen patients with SAAs were treated at our center between July 2011 and October 2018. Clinical and follow-up data were extracted from the hospital records and retrospectively reviewed. We routinely use endovascular treatments and stenting or axillary-axillary bypass to treat SAA if vertebral artery blood flow requires restoration. Patients were followed up at 3, 6, and 12 months after their operations and yearly thereafter. RESULTS: Median follow-up was 30.5 months. In 6 patients, the SAAs involved the ipsilateral vertebral artery. Simple coil embolization was performed for 1 patient; endovascular covered stenting and coil embolization for 4 patients; and hybrid treatment for 1 patient. In 11 patients, the SAAs did not involve the ipsilateral vertebral artery. Hybrid treatment was performed for 1 patient; thoracic aortic stent implantation with coil embolization for 1 patient; and covered stent placement in the subclavian artery for 9 patients. Among the 9 patients who were symptomatic at presentation, 8 had relief of symptoms. Leakage was observed in 1 patient, but it stopped spontaneously. Stent occlusion occurred in 18.8% (3/16), but all were asymptomatic, and no interventions were necessary. CONCLUSION: Endovascular and hybrid treatments appear to be effective for SAAs with few complications and good clinical outcomes. KEY WORDS: Covered stent, Coil embolization, Endovascular treatment, Hybrid, Subclavian artery aneurysm.

[Effect of vinegar processing on esculentosides in n-BuOH fraction and main toxic components in Phytolaccae Radix].

This study was to investigate the effect of vinegar processing on esculentosides in n-BuOH fraction and the contents of the main toxic components esculentoside B (EsB) and esculentoside C (EsC) in Phytolaccae Radix pieces. n-BuOH fraction of Phytolaccae Radix pieces was processed with vinegar according to the processing method in Chinese Pharmacopoeia. HPLC-MS-MS was adopted to analyze the esculentosides composition changes in n-BuOH fraction before and after vinegar processing. HPLC-ELSD was used to detect EsC and EsB contents in raw and vinegar processed Phytolaccae Radix pieces, and investigate the content changes before and after vinegar processing. Results showed that the esculentosides contents in n-BuOH fraction were significantly decreased except esculentoside A (EsA); there were significant changes in saponins compositions, but no new compounds were generated in n-BuOH fraction after vinegar processing. The contents of EsC and EsB were 0.12% and 0.20% respectively in raw Phytolaccae Radix, and decreased to 0.048% and 0.094% accordingly after vinegar processing. It showed that vinegar processing could significantly change the composition of esculentosides in n-BuOH fraction from Phytolaccae Radix and reduce the contents of toxic components EsC and EsB, indicating the scientificity of vinegar processing for Phytolaccae Radix.

[Intestinal toxicity of n-BuOH fraction from Phytolacca Radix before and after being processed with vinegar].

To research the intestinal toxicity of n-BuOH fraction in Phytolacca Radix before and after being processed with vinegar. Toxic n-BuOH fractions were separated from Phytolacca Radix. In the animal model, the level of intestinal edema, water content of intestine and stool, IC50 values of HT-29 and IEC-6 were detected with MTT method to compare the changes in toxicity of n-BuOH fractions from Phytolacca Radix before and after being processed with vinegar. n-BuOH fractions of Phytolacca Radix could cause intestinal edema in mice, increase the edema of duodenum, jejunum and the water content in stool, inhibit the proliferation of HT-29 cells and IEC-6 cells, indicating its intestinal toxicity, with HT-29 IC50 at 14.59 mg•L⁻¹ and IEC-6 IC50 at 43.77 mg•L⁻¹. After being processed with vinegar, the level of intestinal edema, edema of duodenum and jejunum and the water content in stool and inhibition ratio of cells line were reduced, with HT-29 IC50 at 58.51 mg•L⁻¹ and IEC-6 IC50 at 84.37 mg•L⁻¹. After being processed with vinegar, the toxicity of n-BuOH fractions from Phytolacca Radix decreased obviously.

[Antagonism mechanism of gingerols against inflammatory effect of toxic raphides from Pinella pedatisecta].

This study was to investigate the mechanism of gingerols antagonizing the inflammatory effect of toxic raphides from Pinella pedatisecta. Mice peritonitis models induced by toxic raphides from P. pedatisecta were applied to observe the effect of gingerols on inflammatory mediators PGE2 in the exudates of abdominal inflammation in mice; rats peritoneal macrophage in vitro culture models were adopted to study the anti-inflammatory effects of gingerol against toxic raphides, with TNF-α and IL-1ß in supernatant as indexes. Scanning electron microscopy was used to observe the changes in surface morphology of macrophages treated by raphides and gingerols. Macrophages-neutrophils co-cultured models were used to study the antagonism of gingerols against the effect of toxic raphides' stimulation on neutrophils migration. Results showed that gingerols could significantly inhibit the production of PGE2 in the exudates of abdominal inflammation induced by toxic raphides from P. pedatisecta in mice. Gingerols could significantly inhibit the toxic raphides from P. pedatisecta to induce the release of inflammatory factors, with certain dose dependence. Scanning electron microscopy showed that gingerols could significantly inhibit phagocytosis of macrophages, cytomembrane injury, and neutrophils migration induced by toxic raphides from P. pedatisecta. The results showed that the antagonism mechanism of gingerols against the toxic raphides from P. pedatisecta may be associated with inhibiting the pro-inflammatory toxicity including macrophage activation, inflammatory factors release, and neutrophils migration.

[Totoxicity fraction from Euphorbia pekinensis and composition change after vinegar processing].

To look for the toxicity fraction of Euphorbia pekinensis and discuss the vinegar processing mechanism. The level of intestinal edema, water content of intestine and stool, IC50 values of IEC-6 were applied to evaluate the toxicity of different fractions. RT-PCR was employed for detecting AQP1, AQP3 mRNA expression. The petroleum ether (PE) fraction and ethyl acetate (EtOAc) fraction could significant cause intestinal edema in mice, increase the water content of duodenum, colon and stool, inhibited the mRNA expression of AQP1 and increased the mRNA level of AQP3 in colon, and the petroleum ether (PE) fraction was more poisonous. After the petroleum ether (PE) fraction was processed with vinegar, the level of intestinal edema, water content of duodenum, colon, stool and inhibition ratio of cells line were reduced. And we compared the composition change after vinegar processing, finding that the conpekinensis.

The laparoscopic nissen fundoplication eliminates obstructive sleep apnea syndrome due to gastroesophageal reflux disease.

Gastroesophageal reflux disease may produce esophageal syndromes, such as heartburn and regurgitation. It is a common clinical presentation with extraesophageal manifestations, such as asthma, arrhythmia, snoring, and sleep disturbance, which could make identifying it more difficult than the usual esophageal symptoms. The aim of this study is to characterize the extraesophageal manifestations in patients with gastroesophageal reflux disease and investigate the effect of laparoscopic Nissen fundoplication. We describe the case of a 38-year-old male patient with a history of sleep disturbance attributable to gastroesophageal reflux disease, which resolved on successful laparoscopic Nissen fundoplication treatment. The long-standing sleep apnea obviously improved after laparoscopic Nissen fundoplication treatment. To our knowledge, this is a rare case of successful laparoscopic Nissen fundoplication treatment of a patient with extraesophageal manifestations induced by gastroesophageal reflux disease. The results indicate an underlying mechanism for extraesophageal manifestations and the success of laparoscopic Nissen fundoplication treatment.

Mesocavoatrial shunt for Budd-Chiari syndrome: a case report with long-term follow-up.

BACKGROUND: A case of mesocavoatrial shunting for the treatment of Budd-Chiari syndrome (BCS) with long-term follow-up is reported. METHODS: A 25-year-old man with stage II BCS was treated with a mesocavoatrial shunt to decompress the portal and IVC hypertension. During the 6-year follow-up, the patient was able to resume work as a salesperson and has since led a normal life. His graft remains patent. CONCLUSION: A mesocavoatrial shunt can simultaneously decompress portal and IVC hypertension and has satisfactory long-term patency. A mesocavoatrial shunt can be used to treat patients with severe BCS who could not be successfully treated with medical therapy and intervention.

Radiofrequency treatment on respiratory symptoms due to gastroesophageal reflux disease.

BACKGROUND: Diagnosis and treatment for respiratory symptoms (RSs) of gastroesophageal reflux disease (GERD) is more difficult than that for common esophageal symptoms. The goal of this study was to evaluate the efficacy and safety of radiofrequency (RF) treatment on RSs of GERD in a preliminary 12-month follow-up observation. METHODS: From April 2006 to October 2008, 505 GERD patients with mainly respiratory presentations such as wheezing, chronic cough or hoarseness, were treated by endoscopic RF. A questionnaire was completed before and after treatment, using a six-point scale ranging from 0 to 5 to assess symptom severity and frequency. The symptom score was the sum of frequency and severity. RESULTS: Symptom scores were significantly improved at the end of the follow-up period. The mean heartburn score decreased from 5.31 to 1.79. The mean regurgitation score decreased from 5.02 to 1.64; mean cough score decreased from 6.77 to 2.85; mean wheezing score decreased from 7.83 to 3.07; and mean hoarseness score decreased from 5.13 to 1.81 (P < 0.01). No major complications or deaths occurred. Minor complications included temporary post-procedural retrosternal unease or pain (n = 106; 21.0%), mild fever (n = 86; 17.0%), transient nausea/vomiting (n = 97; 19.2%), and transient dysphagia (n = 42; 9.3%). Thirty-five (6.9%) patients had recurrence of symptoms. Endoscopic RF treatment was repeated in six patients, and laparoscopic fundoplication was performed in seven. CONCLUSION: Endoscopic RF is an effective and safe means to treat RSs in patients with GERD.