Activation of Methane by Rhodium Clusters on a Model Support C20H10.

Supported metals represent an important family of catalysts for the transformation of the most stable alkane, methane, under mild conditions. Here, using state-of-the-art mass spectrometry coupled with a newly designed double ion trap reactor that can run at high temperatures, we successfully immobilize a series of Rhn- (n = 4-8) cluster anions on a model support C20H10. Reactivity measurements at room temperature identify a significantly enhanced performance of large-sized Rh7,8C20H10- toward methane activation compared to that of free Rh7,8-. The "support" acting as an "electron sponge" is emphasized as the key factor to improve the reactivity of large-sized clusters, for which the high electron-withdrawing capability of C20H10 dramatically shifts the active Rh atom from the apex position in free Rh7- to the edge position in "supported" Rh7- to enhance CH4 adsorption, while the flexibility of C20H10 to release electrons further promotes subsequent C-H activation. The Rh atoms in direct contact with the support serve as electron-relay stations for electron transfer between C20H10 and the active Rh atom. This work not only establishes a novel approach to prepare and measure the reactivity of "supported" metal clusters in isolated gas phase but provides useful atomic-scale insights for understanding the chemical behavior of carbon (e.g., graphene)-supported metals in heterogeneous catalysis.

Filtration of the preferred catalyst for reverse water-gas shift among Rhn- (n = 3-11) clusters by mass spectrometry under variable temperatures.

The key to optimizing energy-consuming catalytic conversions lies in acquiring a fundamental understanding of the nature of the active sites and the mechanisms of elementary steps at an atomically precise level, while it is challenging to capture the crucial step that determines the overall temperature of a real-life catalytic reaction. Herein, benefiting from a newly-developed high-temperature ion trap reactor, the reverse water-gas shift (CO2 + H2 → CO + H2O) reaction catalyzed by the Rhn- (n = 3-11) clusters was investigated under variable temperatures (298-783 K) and the critical temperature that each elementary step (Rhn- + CO2 and RhnO- + H2) requires to take place was identified. The Rh4- cluster strikingly surpasses other Rhn- clusters to drive the catalysis at a mild starting temperature (∼440 K). This finding represents the first example that a specifically sized cluster catalyst that works under an optimum condition can be accurately filtered by using state-of-the-art mass spectrometric experiments and rationalized by quantum-chemical calculations.

Exploring the Level of Physical Fitness on Physical Activity and Physical Literacy Among Chinese University Students: A Cross-Sectional Study.

Physical literacy (PL) has received considerable attention in the field of physical education and physical activity (PA) worldwide. According to recent studies, the level of physical fitness (PF) among Chinese university students is gradually decreasing. This study aims to examine the impact of the PF level (fit/unfit) on PA and PL, as well as the relationships among PF, PA, and PL, in Chinese university students. Participants comprised 798 university students (390 men; mean age, 19.2 ± 1.2 years) in Chongqing, China. Participants completed the tests of vital capacity, cardiorespiratory fitness, muscular strength, and flexibility, according to the National Physical Fitness Measurement Standards Manual (NPFMSM), as well as questionnaires on PA (time spent performing PA at various intensities) and PL. The independent t-tests were conducted to examine sex differences in the evaluated variables, and the Pearson's correlation between each PF test and PL attributes and PA was calculated according to sex. In addition, the independent t-tests were conducted to determine whether the PF level had an effect on PL attributes and PA at various intensities. Significant sex differences were found in the PF domains of vital capacity, muscular strength, and aerobic fitness, with higher scores in men than in women (all p-values < 0.05), but not in the PF domain of flexibility and total PL score. Furthermore, the PF domains of muscular strength and aerobic fitness were significantly and positively correlated with the PL attributes of confidence and physical competence in both men and women, while the PF domains of vital capacity and aerobic fitness were significantly and positively correlated with the PL attribute of motivation in men. In addition, PL was significantly and positively associated with cardiorespiratory fitness, vital capacity, muscular strength, and flexibility among participants in the fit group. These findings support advocating for increased participation in PA in university students and using PL as a tool to improve PF components.

A restored humoral environment ameliorates acute brain injury after Angiostrongylus cantonensis infection.

Circulating factors in the circulatory system support important functions of living tissues and the body. Parabiosis is a condition in which two living animals are connected using surgical methods and share a single circulatory system. Angiostrongylus cantonensis is the major cause of infectious eosinophilic meningitis, which causes severe damage to the central nervous system (CNS) and immune system. However, the mechanism of immunopathology remains largely unknown. We hypothesize that a restored humoral environment can help relieve damage to the CNS and immune system. In the present study, we found that administration of normal serum significantly reduced mortality, alleviated thymic atrophy and reduced inflammation in the brains of mice infected with A. cantonensis. We further generated parabiotic pairs between two healthy mice, one of which was then orally infected with A. cantonensis. The results showed that compared with singleton mice, mice connected with a healthy parabiotic partner were protected against CNS and immune system damage, as revealed by significantly reduced inflammation in the brain, alleviated thymic atrophy, and decreased expression of proinflammatory cytokines. These findings revealed that a healthy systemic environment can relieve damage to the CNS and immune system in infected mice, suggesting novel therapeutic approaches for diseases involving severe brain and immune system damage.

Iron-Based Metal-Organic Frameworks as Platform for H2S Selective Conversion: Structure-Dependent Desulfurization Activity.

Three classical Fe-MOFs, viz., MIL-100(Fe), MIL-101(Fe), and MIL-53(Fe), were synthesized to serve as platforms for the investigation of structure-activity relationship and catalytic mechanism in the selective conversion of H2S to sulfur. The physicochemical properties of the Fe-MOFs were characterized by various techniques. It was disclosed that the desulfurization performances of Fe-MOFs with well-defined microstructures are obviously different. Among these, MIL-100(Fe) exhibits the highest catalytic performance (ca. 100% H2S conversion and 100% S selectivity at 100-180 °C) that is superior to that of commercial Fe2O3. Furthermore, the results of systematic characterization and DFT calculation reveal that the difference in catalytic performance is mainly because of discrepancy in the amount of Lewis acid sites. A plausible catalytic mechanism has been proposed for H2S selective conversion over Fe-MOFs. This work provides critical insights that are helpful for rational design of desulfurization catalysts.

[The expression of Endophilin II and VEGF-C in human laryngeal cancer and connection with clinical treatment].

OBJECTIVE: To study the expression of Endophilin II and VEGF-C in human Laryngeal cancer and its relationship with the clinical treatment effect. METHOD: The expression and distribution of Endophilin II and VEGF-C protein were checked in 47 patients with laryngeal carcinoma in our hospital in 2006-09-2009-10 and 23 samples of normal tissues around the cancer by immunohistochemical staining SP method. After an appropriate surgical treatment, patients accepted a 5-year followup to evaluate their recurrence situation and 5-year survival rate. RESULT: Immunohistochemistry showed that Endophilin II protein was strongly positive expressed in normal tissues around the cancer (positive rate 82.61%). And the expression level was dependent on the lymph metastasis, T stage and lymph invasion (P < 0.05). Patients with positive Endophilin II expression had a higher survival rate and better recurrence situation. Expression of VEGF-C was significantly higher in laryngeal carcinoma than in normal tissue around the cancer (positive rate 51.06% and 13.04%). the expression level was dependent on the lymph metastasis and lymph invasion (P < 0.05), and negatively correlated with recurrence and 5-year survival rate. CONCLUSION: Endophilin II and VEGF-C may involve in laryngeal cancer, and the expression of Endophilin II and VEGF-C has a positive correlation with pathological features and lymph metastasis, and both are related with recurrence and 5-year survival rate. So these two proteins are likely to be a potential target for diagnosis and treatment of laryngeal cancer.

The expression of Endophilin II and VEGF-C in human laryngeal cancer and connection with clinical treatment / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study the expression of Endophilin II and VEGF-C in human Laryngeal cancer and its relationship with the clinical treatment effect.@*METHOD@#The expression and distribution of Endophilin II and VEGF-C protein were checked in 47 patients with laryngeal carcinoma in our hospital in 2006-09-2009-10 and 23 samples of normal tissues around the cancer by immunohistochemical staining SP method. After an appropriate surgical treatment, patients accepted a 5-year followup to evaluate their recurrence situation and 5-year survival rate.@*RESULT@#Immunohistochemistry showed that Endophilin II protein was strongly positive expressed in normal tissues around the cancer (positive rate 82.61%). And the expression level was dependent on the lymph metastasis, T stage and lymph invasion (P < 0.05). Patients with positive Endophilin II expression had a higher survival rate and better recurrence situation. Expression of VEGF-C was significantly higher in laryngeal carcinoma than in normal tissue around the cancer (positive rate 51.06% and 13.04%). the expression level was dependent on the lymph metastasis and lymph invasion (P < 0.05), and negatively correlated with recurrence and 5-year survival rate.@*CONCLUSION@#Endophilin II and VEGF-C may involve in laryngeal cancer, and the expression of Endophilin II and VEGF-C has a positive correlation with pathological features and lymph metastasis, and both are related with recurrence and 5-year survival rate. So these two proteins are likely to be a potential target for diagnosis and treatment of laryngeal cancer.

[Impact and related mechanisms of stromal cell-derived factor-1α on serum deprivation-induced cardiac stem cells apoptosis].

OBJECTIVE: To explore the impact and related mechanisms of stromal cell-derived factor-1α (SDF-1α) on serum deprivation-induced apoptosis of cardiac stem cells (CSCs). METHODS: CSCs were isolated from adult mouse heart tissue and cultured in vitro. Obtained cells were purified using magnetic-activated cell sorting (MACS) with c-kit magnetic beads. C-kit(+)CSCs were divided into five groups: normal control group, serum deprivation group, serum deprivation+SDF-1α group, serum deprivation+SDF-1α+AMD3100 group, serum deprivation+SDF-1α+LY294002 group. Cell apoptosis was assessed using the DeadEnd Colorimetric TUNEL System and flow cytometry analyses with an Annexin V-FITC Apoptosis Detection Kit. The viability of CSCs was assessed by CCK-8. The protein expression of Bcl-2 and phosphorylated Akt were detected by Western blot. The caspase-3 activity was determined using caspase-3 Colorimetric Assay Kit. RESULTS: After magnetic separation, more than 85% of cardiosphere derived cells were positive for c-kit expression. Compared with the normal control group, the apoptosis rate of serum deprivation group was significantly increased[(27.03 ± 0.80)% vs. (1.51 ± 0.54)%, P < 0.01], which could be significantly reduced by SDF-1α in a concentration dependent manner and peak effect was seen with 100 ng/ml SDF-1α[(10.67 ± 1.06)% vs. (27.03 ± 0.80)%, P < 0.01]. The expressions of p-Akt and Bcl-2 were significantly increased and the activity of caspase-3 was significantly decreased in serum deprivation+SDF-1α group compared to serum deprivation group (P < 0.01). Further more, the expression of p-Akt and Bcl-2 were significantly decreased and the activity of caspase-3 was increased in both serum deprivation+SDF-1α+AMD3100 group and serum deprivation+SDF-1α+LY294002 group compared to serum deprivation+SDF-1α group (P < 0.01). CONCLUSIONS: SDF-1α reduces serum deprivation induced CSCs apoptosis via modulating PI3K/Akt signaling pathway.

Impact and related mechanisms of stromal cell-derived factor-1α on serum deprivation-induced cardiac stem cells apoptosis / 中华心血管病杂志

<p><b>OBJECTIVE</b>To explore the impact and related mechanisms of stromal cell-derived factor-1α (SDF-1α) on serum deprivation-induced apoptosis of cardiac stem cells (CSCs).</p><p><b>METHODS</b>CSCs were isolated from adult mouse heart tissue and cultured in vitro. Obtained cells were purified using magnetic-activated cell sorting (MACS) with c-kit magnetic beads. C-kit(+)CSCs were divided into five groups: normal control group, serum deprivation group, serum deprivation+SDF-1α group, serum deprivation+SDF-1α+AMD3100 group, serum deprivation+SDF-1α+LY294002 group. Cell apoptosis was assessed using the DeadEnd Colorimetric TUNEL System and flow cytometry analyses with an Annexin V-FITC Apoptosis Detection Kit. The viability of CSCs was assessed by CCK-8. The protein expression of Bcl-2 and phosphorylated Akt were detected by Western blot. The caspase-3 activity was determined using caspase-3 Colorimetric Assay Kit.</p><p><b>RESULTS</b>After magnetic separation, more than 85% of cardiosphere derived cells were positive for c-kit expression. Compared with the normal control group, the apoptosis rate of serum deprivation group was significantly increased[(27.03 ± 0.80)% vs. (1.51 ± 0.54)%, P < 0.01], which could be significantly reduced by SDF-1α in a concentration dependent manner and peak effect was seen with 100 ng/ml SDF-1α[(10.67 ± 1.06)% vs. (27.03 ± 0.80)%, P < 0.01]. The expressions of p-Akt and Bcl-2 were significantly increased and the activity of caspase-3 was significantly decreased in serum deprivation+SDF-1α group compared to serum deprivation group (P < 0.01). Further more, the expression of p-Akt and Bcl-2 were significantly decreased and the activity of caspase-3 was increased in both serum deprivation+SDF-1α+AMD3100 group and serum deprivation+SDF-1α+LY294002 group compared to serum deprivation+SDF-1α group (P < 0.01).</p><p><b>CONCLUSIONS</b>SDF-1α reduces serum deprivation induced CSCs apoptosis via modulating PI3K/Akt signaling pathway.</p>

Emergent endovascular embolization of iatrogenic renal vascular injuries / 介入放射学杂志

Objective To evaluate the efficacy and safety of the interventional techniques for emergent treatment of iatrogenic renal injuries.Methods Nine patients with iatrogenic renal vascular injuries were treated with superselective renal arterial embolization.The causes of renal injury included post-renal biopsy in 5 patients,endovascular interventional procedure-related in 2,post-renal surgery in 1,and post-percutaneous nephrostomy in 1 patient.The patients presented clinically with hemodynamical unstability with blood loss shock in 7 patienrs,severe flank pain in 7,and hematuria in 8 patients.Perirenal hematoma was confirmed in 8 patients by CT and ultrasonography.The embolization materials used were microcoils in 7 and standard stainless steel coils in 2 patients,associated with polyvinyl alcohol particles(PVA)in 5,and gelfoam panicles in 2 cases.Results Renal angiogram revealed intra-renal arteriovenous fistula in 6 cases,intrarenal pseudoaneurysm in 2 cases,and the contrast media extravasation in 1 patient.The technical success of the arterial embolization was achieved in all 9 cases within a single session.All angiographies documented complete obliteration of the abnormal vessels together with all major intrarenal arterial branches maintaining patent.Seven patients with hemodynamically compromise experienced immediate relief of their blood loss related symptoms,and another 7 with severe flank pain got relief progressively.Hematuria ceased in 8 patients within 2-14 days after the embolization and impairment of renal function occurred after the procedure in 5 cases,including transient aggrevation(n=3)and developed new renal dysfunction(n=2).Two of these patients required hemodialysis.Perirenal hematoma were gradually absorbed on ultrasonography during 2-4 months after the procedures.Follow-up time ranged from 6-78 months(mean,38 months),4 patients died of other primary diseases of renal and multi-organ failures.Five patients are still alive without further intervention,and suffering no more of rebleeding and deterioration of renal function.Conclusions Transcatheter selective renal arterial embolization is safe and effective in the treatment of iatrogenic renal vascular injuries,resulting in permanent cessation of bleeding.(J Intervent Radiol,2007,16:807-810)

[Treatment of celiac and mesenteric arteries stenoses with interventional radiologic techniques].

OBJECTIVE: To evaluate the safety and efficacy of the interventional techniques for management of celiac and mesenteric arteries stenoses. METHODS: Eight patients with celiac artery (CA) or superior mesenteric artery (SMA) focal stenotic lesions were treated with percutaneous transluminal balloon angioplasty (PTA) and stent placement. CA stenosis was present in 2 patients, SMA stenosis was present in 4, and both CA and SMA were involved in 2 patients. Postprandial pain was present in 4 patients, an epigastric bruit was present in 5. All patients presented with weight loss averaging 8 kg. The causes of the stenoses were atheroscleroses in 7 patients, median arcuate ligament syndrome (MALS) involvement of the CA in 1 patient. RESULTS: PTA and stent placement was technically successful in the 8 patients. Three patients underwent stent placement in CA, 5 patients in SMA. Seven patients were treated with 1 stent, one was treated with 2 stents. The post-procedural arteriograms showed good dilation of the stenotic lesions in all patients. The puncture site hematoma occurred in 2 patients without severe consequences. Complete alleviation of abdominal pain occurred in 5 patients, significant improvement in 2, and no improvement in 1 patient. At three months after the procedures, weights were regained in 6 patients. Clinical follow-up was available in all 8 patients, with a mean follow-up of 42 months (median 28 months, range 6 to 72 months). Follow-up Doppler ultrasound examinations showed normal flow patterns, without evidences of re-stenosis in the stenting arteries. Five patients remained asymptomatic, one patient had intermittent abdominal pain even the stenting SMA to be patent. Two patients respectively died of unrelated CA/SMA stenosis in 14 and 24 months after the treatment. CONCLUSION: PTA and stent placement are safe and effective methods for treatment of chronic CA and SMA focal stenoses, especially useful for these patients with a high surgical risk.

[Investigation of bile duct injury after transcatheter arterial chemoembolization].

OBJECTIVE: To investigate the image findings of bile duct injury after transcatheter arterial chemoembolization (TACE) for hepatic malignancy. METHODS: During the past 3 years, 1240 patients with different hepatic malignancies had undergone a total of 2680 TACE procedures. Eighteen patients (1.4%) developed bile duct injuries from 3 weeks to 3 months after TACE. All of the 18 patients received follow-up CT and ultra-sonography, 14 MRI and 15 digital subtract angiography (DSA). The image data was retrospectively reviewed, with the potential predisposing factors correlated to TACE-induced bile duct injury. RESULTS: TACE-induced bile duct injuries developed in 13 of 148 patients with liver metastasis (8.8%), 5 of 1092 patients with hepatocellular carcinoma (HCC) (0.5%). On image examination, focal peripheral intrahepatic bile duct dilatation was detected in 4 cases, multiple bile duct dilatations with segmental or sub-segmental distribution in 8, and a large lobular cystic lesion or biloma in 6 cases, and progressive atrophy of the corresponding hepatic parenchyma in 6 patients in whom the TACE induced-bile injury developed at different intervals after TACE. The incidence of bile duct injury was higher in non-cirrhotic patients with metastatic liver lesions than in patients with hepatocellular carcinoma associated with cirrhosis (P < 0.01), and it was also higher in patients using an emulsion of lipiodol-cisplatin or carboplatin than in patients using other emboliging agents (P < 0.01). The incidence was higher either in patients with hypovascular lesions than in patients with hypervascular lesions (P < 0.05). CONCLUSION: Biliary abnormalities, including focal and multiple intrahepatic bile duct dilatation, and cystic lesion or biloma, may develop and can be detected during the follow-up examination imaging in patients with hepatic malignancy after TACE. Noncirrhotic liver and intact function, due to the lack of peri-biliany collateral circulation, are the significant predisposing factors to the development of TACE-induced bile duct injury.

Treatment of celiac and mesenteric arteries stenoses with interventional radiologic techniques / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the safety and efficacy of the interventional techniques for management of celiac and mesenteric arteries stenoses.</p><p><b>METHODS</b>Eight patients with celiac artery (CA) or superior mesenteric artery (SMA) focal stenotic lesions were treated with percutaneous transluminal balloon angioplasty (PTA) and stent placement. CA stenosis was present in 2 patients, SMA stenosis was present in 4, and both CA and SMA were involved in 2 patients. Postprandial pain was present in 4 patients, an epigastric bruit was present in 5. All patients presented with weight loss averaging 8 kg. The causes of the stenoses were atheroscleroses in 7 patients, median arcuate ligament syndrome (MALS) involvement of the CA in 1 patient.</p><p><b>RESULTS</b>PTA and stent placement was technically successful in the 8 patients. Three patients underwent stent placement in CA, 5 patients in SMA. Seven patients were treated with 1 stent, one was treated with 2 stents. The post-procedural arteriograms showed good dilation of the stenotic lesions in all patients. The puncture site hematoma occurred in 2 patients without severe consequences. Complete alleviation of abdominal pain occurred in 5 patients, significant improvement in 2, and no improvement in 1 patient. At three months after the procedures, weights were regained in 6 patients. Clinical follow-up was available in all 8 patients, with a mean follow-up of 42 months (median 28 months, range 6 to 72 months). Follow-up Doppler ultrasound examinations showed normal flow patterns, without evidences of re-stenosis in the stenting arteries. Five patients remained asymptomatic, one patient had intermittent abdominal pain even the stenting SMA to be patent. Two patients respectively died of unrelated CA/SMA stenosis in 14 and 24 months after the treatment.</p><p><b>CONCLUSION</b>PTA and stent placement are safe and effective methods for treatment of chronic CA and SMA focal stenoses, especially useful for these patients with a high surgical risk.</p>

Investigation of bile duct injury after transcatheter arterial chemoembolization / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the image findings of bile duct injury after transcatheter arterial chemoembolization (TACE) for hepatic malignancy.</p><p><b>METHODS</b>During the past 3 years, 1240 patients with different hepatic malignancies had undergone a total of 2680 TACE procedures. Eighteen patients (1.4%) developed bile duct injuries from 3 weeks to 3 months after TACE. All of the 18 patients received follow-up CT and ultra-sonography, 14 MRI and 15 digital subtract angiography (DSA). The image data was retrospectively reviewed, with the potential predisposing factors correlated to TACE-induced bile duct injury.</p><p><b>RESULTS</b>TACE-induced bile duct injuries developed in 13 of 148 patients with liver metastasis (8.8%), 5 of 1092 patients with hepatocellular carcinoma (HCC) (0.5%). On image examination, focal peripheral intrahepatic bile duct dilatation was detected in 4 cases, multiple bile duct dilatations with segmental or sub-segmental distribution in 8, and a large lobular cystic lesion or biloma in 6 cases, and progressive atrophy of the corresponding hepatic parenchyma in 6 patients in whom the TACE induced-bile injury developed at different intervals after TACE. The incidence of bile duct injury was higher in non-cirrhotic patients with metastatic liver lesions than in patients with hepatocellular carcinoma associated with cirrhosis (P < 0.01), and it was also higher in patients using an emulsion of lipiodol-cisplatin or carboplatin than in patients using other emboliging agents (P < 0.01). The incidence was higher either in patients with hypovascular lesions than in patients with hypervascular lesions (P < 0.05).</p><p><b>CONCLUSION</b>Biliary abnormalities, including focal and multiple intrahepatic bile duct dilatation, and cystic lesion or biloma, may develop and can be detected during the follow-up examination imaging in patients with hepatic malignancy after TACE. Noncirrhotic liver and intact function, due to the lack of peri-biliany collateral circulation, are the significant predisposing factors to the development of TACE-induced bile duct injury.</p>

[Treatment of acquired arteriovenous fistulas with interventional minimally invasive techniques].

OBJECTIVE: To evaluate the efficacy and safety of the interventional techniques for treatment of acquired arteriovenous fistulas (AVF). METHODS: Ten patients with acquired AVFs, including 4 with renal AVF, 3 with iliac AVF, and 3 with subclavian AVF, were treated with interventional procedures. The etiological factors of the AVFs were penetrating trauma in 5 cases, iatrogenic injury in 3, malignancy in 1, and intestine Crohn's disease in 1. The patients presented with peripheral venous hypertension (n = 6), local bruit (n = 10), cardiac overload (n = 10), the right cardiac failure (n = 2), and hematuria (n = 4). Three patients underwent transcatheter super-selective coils embolization and 7 underwent stent-graft placement in the involved arteries. RESULTS: The technical success was achieved in all cases. Completion angiography documented complete exclusion of the fistulas. Minor complications occurred in 3 patients, but without significant consequences. The patients experienced immediate relief of the limb swelling, peripheral venous hyperemia, and tachycardia. The local bruit was disappeared. The cardiac overload conditions were improved significantly, which was confirmed by ultrasound scan. Renal function tests in patients with renal AVF were stable. Radioactive isotopic scan revealed that the function was preserved in the treated kidney in two patients using stent-graft placement in the renal arteries. Follow-up time ranged from 6 months to 6 years. Three patients respectively died of unrelated AVF diseases in 6, 9, and 14 months after the treatment. Re-intervention with an another stent-graft placement was performed on 2 patients with recurrence of the AVF respectively at 3 weeks and two months after the procedures. The minor stenosis was found in stent-graft 2 of patients on the follow-up angiography respectively at 6 and 8 months after the treatment. Seven patients are still alive and in good condition without further intervention. CONCLUSIONS: Minimally invasive interventional procedures, including super-selective embolization and stent-graft exclusion, are safe and effective in the treatment of acquired arteriovenous fistulas.

Treatment of acquired arteriovenous fistulas with interventional minimally invasive techniques / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of the interventional techniques for treatment of acquired arteriovenous fistulas (AVF).</p><p><b>METHODS</b>Ten patients with acquired AVFs, including 4 with renal AVF, 3 with iliac AVF, and 3 with subclavian AVF, were treated with interventional procedures. The etiological factors of the AVFs were penetrating trauma in 5 cases, iatrogenic injury in 3, malignancy in 1, and intestine Crohn's disease in 1. The patients presented with peripheral venous hypertension (n = 6), local bruit (n = 10), cardiac overload (n = 10), the right cardiac failure (n = 2), and hematuria (n = 4). Three patients underwent transcatheter super-selective coils embolization and 7 underwent stent-graft placement in the involved arteries.</p><p><b>RESULTS</b>The technical success was achieved in all cases. Completion angiography documented complete exclusion of the fistulas. Minor complications occurred in 3 patients, but without significant consequences. The patients experienced immediate relief of the limb swelling, peripheral venous hyperemia, and tachycardia. The local bruit was disappeared. The cardiac overload conditions were improved significantly, which was confirmed by ultrasound scan. Renal function tests in patients with renal AVF were stable. Radioactive isotopic scan revealed that the function was preserved in the treated kidney in two patients using stent-graft placement in the renal arteries. Follow-up time ranged from 6 months to 6 years. Three patients respectively died of unrelated AVF diseases in 6, 9, and 14 months after the treatment. Re-intervention with an another stent-graft placement was performed on 2 patients with recurrence of the AVF respectively at 3 weeks and two months after the procedures. The minor stenosis was found in stent-graft 2 of patients on the follow-up angiography respectively at 6 and 8 months after the treatment. Seven patients are still alive and in good condition without further intervention.</p><p><b>CONCLUSIONS</b>Minimally invasive interventional procedures, including super-selective embolization and stent-graft exclusion, are safe and effective in the treatment of acquired arteriovenous fistulas.</p>

[Analysis of clinical application for various types of esophageal stents made in China].

BACKGROUND & OBJECTIVE: Dysphagia is the main clinical symptom of the patients with esophageal carcinoma. The stent placement in esophagus is an effective method to resolve dysphagia.There are many types of stents. Through comparing observation of the stents made in China, which is the stainless steel "Z" stent, the Ni-Ti wire mesh-like stent, and the covered or uncovered-stent, the authors analyzed the clinical application of various types of esophageal stents in the treatment of malignant esophageal stricture. METHODS: The various types of esophageal stents were implanted into 40 patients with esophageal carcinoma. 13 cases for stainless steel "Z" stents, 27 cases for Ni-Ti wire mesh-like stents(24 cases were the covered stents and 16 cases were uncovered). All the patients were not operated with the dilation of balloon before stent placement. RESULTS: The esophageal stents were successfully implanted into 40 patients without complication of operation. Stainless steel "Z" stent were all dilated immediately at the time of operation, and all the 13 patients had obvious intra-breastbone pain after operation, which lasted 10-20 days. Although Ni-Ti wire mesh-like stents could not dilate completely in operation, all these can be dilated completely after 1 to 3 days; nine cases of them had obvious intra-breastbone pain, which lasted 3-5 days. In all these, 7 cases were the covered-stents and 2 cases uncovered. In 9 cases, tracheoesophageal fistulas were blocked completely. There was barium sulphate retention between the covered-stent implanted to the patients without tracheoesophageal fistula and the dilated esophagus. CONCLUSION: The clinical adaptability of the Ni-Ti wire mesh-like stent is better than that of the stainless steel "Z" stent. For the patients with tracheoesophageal fistula, the first choice is covered-stent, while for the patients without tracheoesophageal fistula, uncovered-stent is better. The dilation of balloon is not necessary before the stent placement.

Inferior phrenic arteries supply to the pulmonary hemorrhagic lesions:angiographic identification and interventional management / 中华放射学杂志

Objective To describe the manifestations of the inferior phrenic arteries(IPA)supply to the pulmonary hemorrhagic lesions and to evaluate the safety and efficacy of transcatheter arterial embolization(TAE)of the IPA.Methods The clinical data and imaging findings of eighteen patients with the additional blood supply to the pulmonary hemorrhagic lesions from the IPA were evaluated retrospectively.The causes of the bleeding were lung malignancies in 9,bronchiectasis in 7,and chronic inflammation in 2 patients.TAE supplementally was performed in patients with IPA supply to the pulmonary lesions,using polyvinyl alcohol particles,gelatin sponge particles,and microcoils.Results Selective arteriogram demonstrates an enlarged IPA,with numerous branches and hypervascularity in all 18 cases, with tumor staining in 9,the contrast material extravasation in 6,and non-specific staining in 2 cases.In addition,IPA-to-pulmonary shunting was found in 9 cases.All the lesions supplying by IPA were adjacent to the pleurae,including adjacent to the diaphragmatic pleura in 11,the mediastinal pleura in 5,and the lateral pleura of the lower lobe in 2 cases.Technical success of IPA embolization was achieved in the 18 cases.Embolization of other nonbronchial systemic arteries(the internal thoracic artery in 7 and intercostal artery in 3)was performed at the same session.All bleeding ceased immediately after supplemental IPA embolization.Follow-up time ranged from 8 months to 4 years.Mild recurrent hemoptysis occurred in 3 patients at 1,2,6 months respectively,after the embolization.These patients were responsive to conservative management.Recurrent bleeding did not occur in 15 patients during the follow-up. Conclusion The pulmonary hemorrhagic lesions,especially adjacent to the diaphragmatic and mediastinal pleurae,can be supplied by IPA,and may result in clinical failure following BAE.Supplemental TAE of IPA is a safe and effective adjunct to BAE in the management of bronchial bleeding supplied by IPA.