Objective To evaluate the effectiveness, safety and clinical feasibility of long-term drainage following percutaneous transhepatic cholangiography and drainage (PTCD) for the treatment of ischemic-type biliary lesion (ITBL) after liver transplantation. Methods There were 11 patients with ITBL after liver transplantation. Of the 11 patients with a mean age of 42. 3, 10 were male and 1 female. All 11 cases were diagnosed by PTC or ERC (endocopic retiogiade cholangiogiaphy) before PTCD, and they responded poorly to medication or draining and stenting with ERCP. Long-term drainage following PTCD was performed, whereas adjuvant percutaneous aspiration through double guidewire technique was used for the patients with large quantities of chole mud. Results There were three types of ITBL: type Ⅰ (extrahepatic lesions, n=7), type Ⅱ (intrahepatic lesions, n= 1), and type Ⅲ (intra- and extra-hepatic alterations, n=3). PTCD was performed in all 11 patients successfully. The values of total bilirubin (TBIL) and direct reacting bilirubin (DBIL) were 206.70±54.18μmol/L, 170. 65±53. 97μmol/L and 90. 63± 13.00μmol/L, 63. 83± 13.61μmol/L before and 1 week after PTCD, respectively. The follow-up period was from 3 through 71 months (mean 20 months). During the follow-up, TBIL values ranged between 23.70 μmol/L and 241.0 μmol/L (mean 55.3±15.6 μmol/L), and DBIL values were between 8. 1 and 162.0 μmol/L (mean 32. 53±10. 21 μmol/L). Hepatic functions were good in 9 cases including 5 cases in which the drainage tube was withdrawn after long-time drainage (6～ 12 months, mean= 8.2 months) and 4 cases in which drainage continued. The other 2 cases received liver retransplantation for the grafts dyssynthesis of albumen after drainage for 3 and 8 months. Conclusion Long-term drainage following PTCD is an effective and safe approach for ITBL following liver transplantation.

Objective To analyze the factors that might affect the therapeutic results of pingyangmycin-lipiodol emulsion intra-arterial sclerosing embolization (PLE-IASE) in treating symptomatic cavernous hemangioma of liver (SCHL). Methods PLE-IASE was performed in 89 patients with SCHL (32 males and 57 females). Before treatment the mean diameter of the hemangioma was (8.3±3.8) cm. Of 89 patients, 53 experienced anxiety, 35 suffered from right upper abdominal pain and the remaining one developed Kasabach-Merrit syndrome. Before PLE-IASE, the arteriographic classification was conducted based on hepatic arteriographic findings. Then pingyangmycin-lipiodol emulsion (PLE) was injected through the feeding artery. The dosage of pingyangmycin (PYM) was (9.8±4.4) mg and the dosage of lipiodol (LP) was (5.9±2.9) ml. The lipiodol deposition status was judged by the follow-up spot film taken immediately after PLE-IASE. The observations of the occurrence of complications, the relief of symptoms and the minification of SCHL were followed for 6-72 months after PLE-IASE. The linear regression analysis statistics was conducted by taking the minification as dependent variable and taking the arteriographic classification, lipiodol deposition status, the dosage of PYM, the dosage of lipiodol and the preoperative SCHL diameter as independent variable. Results Of all 89 cases of SCHL, hypervascular type was seen in 51, hypovascular type in 26 and arteriovenous shunt (AVS) type in 12. Good lipiodol deposition status was found in 64 patients and poor deposition in 25 patients after PLE-IASE. After PLE-IASE, the symptom of anxiety in 53 patients was relieved and the right upper abdominal pain was reduced in 33 cases although intermittent pain still remained in 2 patients. The blood platelet count of the patient with Kasabach-Merrit syndrome returned to normal after the treatment. The symptomatic relieve rate was 98.7%. No serious complications occurred in the follow-up period. The linear regression analysis showed that arteriographic classification, lipiodol deposition status and PYM dosage used in treatment had statistically significant impact on tumor minification, while the preoperative diameter of SCHL and lipiodol dosage used in treatment had no statistically significant impact on it. Conclusion PLE-IASE is an effective and safe interventional treatment for SCHL. Arteriographic classification, lipiodol deposition status and PYM dosage used in treatment have a significant correlation with the minification of SCHL, while the preoperative diameter of SCHL and lipiodol dosage used in treatment bear no relationship to the minification of SCHL.

Objective To explore the early diagnosis, option of the surgical procedures, preven-tion and treatment of the complications in patients with pancreatic trauma.Methods All patients with pancreatic trauma during the past 20 years were studied retrospectively in respect of sex, age, cause of injury, grade by AAST, style of operation, therapeutic efficacy, complications and factors for death etc.Statistical analysis was made with Chi-square test.Results In all 148 cases of the present series, 132 underwent surgical interventions including simple suture or external drainage alone, distal pancre-atectomy, distal pancreaticojejunostomy or other internal drainage, diverticularization, Whipple's pro-cedure, and Damage Control Surgery (DCS) etc.Postoperative morbidity was 27.83% with a signifi-cant difference of the incidence of pancreatic fistula between pancreas grade Ⅲ-Ⅴ injuries and grade Ⅰ-Ⅱ(P＜0.01).The mortality rate was 11.49%.The cause of the deaths was mainly massive bleed-ing due to severe associated injuries(76.47%).Among various grades, the difference of the mortality was not significant (P＞0.05).Conclusion To improve the survival rate, it is important to control massive hemorrhage from associated injuries precedes dealing with pancreas trauma.Selection of surgi-cal procedures should be based on whether the main duct is injured.The removing of devitalized tis-sue, adequate external and internal drainage are essential for treatment of pancreatic injuries.Early recognition of pancreatic injury and correct choice of surgical procedures may obviously decrease the in-cidence of postoperative complications.

AIM: To investigate the expression of Th1-typed cytokine IFN-? and Th2-typed cytokine IL-4 on T lymphocytes that infiltrate in nasal polyps for searching the pathogenesis of nasal polyps. METHODS: Nasal polyps tissue samples and peripheral blood were obtained from 21 patients. Normal human inferior turbinate mucosa and peripheral blood were obtained as well. Flow cytometry was adopted to detect the expression of IFN-? and IL-4 of T lymphocytes. RESULTS: Th cytokines were rarely detected in inferior turbinate from normal human. Nasal polyps tissue consisted of abundant T lymphocytes. The expression of IL-4 and IFN-? increased in peripheral blood from patients [(6 686?0 204)%, (64 312?1 611)%, respectively] compared with normal human [(0 560?0 051)%, (0 246?0 020)%, respectively] ( P

Objective To compare the curative effect of thoracic endovascular repair (TEVAR) plus medication with that of pure medication in treating uncomplicated type B aortic dissection,and to discuss the treatment strategy for uncomplicated type B aortic dissection.Methods The clinical data of 118 patients with definitely confirmed uncomplicated type B aortic dissection,who were admitted to authors' hospital during the period from 2004 to 2015,were retrospectively analyzed.Among the 118 patients,57 patients received TEVAR plus medication (TEVAR group) and 61 patients were treated with pure medication (drug group).The complications and mortality within one month and during follow-up period in both groups were calculated respectively,and Kaplan-Meier survival curves were used to compare the survival rate between the two groups.Results The incidences of complications and morbidity during hospitalization and within one month after treatment in TEVAR group were 5.2％ and 0％ respectively,which in the drug group were 0％ and 0％ respectively.The patients were followed up for 1-110 months,with a mean of (43.3±36.7) months.The incidence of main complications and the mortality in TEVAR group were 7.0％ and 5.3％ respectively,which in the drug group were 6.6％ and 8.1％ respectively.The one-,2-,4-and 7-year cumulative survival rates in TEVAR group were 100％,97.1％,93.5％ and 78.0％ respectively,which in the drug group were 98.4％,96.4％,90.8％ and 72.7％ respectively,the differences between the two groups were not statistically significant (~=0.019,P=0.890).Conclusion For the treatment of uncomplicated type B aortic dissection,TEVAR plus medication is superior to pure drug therapy in reducing expansion rate of false cavity,but TEVAR carries some procedure-related complications,besides,TEVAR can not improve the survival rate.(J Intervent Radiol,2017,26:266-269)

Objective To study the value of 320 slice volume CT venography (CTV)and ultrasound in the diagnosis of lower limb deep vein thrombosis(DVT).Methods 51 patients with DVT confirmed by DSA were analyzed retrospectively,with comparing detection rate by direct method of CTV and ultrasound of the emboli in different parts of lower limb.Results In 5 1 patients,48 cases with DVTs were detected by CTV,including 124 thrombi,and 46 cases by ultrasound,finding 86 thrombi.CT diagnosed 34 pelvic deep vein thrombi,and ultrasound found 10.CT diagnosed 25 tibiofibular vein thrombi,and ultrasound found 5.CT diagnosed 2 femoral deep vein thrombi,and ultrasound found 1 1.Conclusion Direct method of CTV and ultrasound have high clinical value in the diagnosis of deep venous thrombosis,the former is better for the thrombosis in the pelvic deep veins and tibiofibular vein,while the latter is better for the thrombosis in the femoral deep vein.

Objective To analyze the learning curve of an experienced interventional radiologist engaged in thoracic endovascular aortic repair (TEVAR) for Stanford type B aortic dissection.Methods The clinical data of 70 patients with Stanford type B aortic dissection,who received TEVAR that was carried out by the same group of interventional physicians over the past 10 years,were retrospectively analyzed.According to the sequence of operation date,the patients were equally divided into group A,B,C,D and E with 14 patients in each group.The operation time,procedure-related complications,postoperative hospitalization days were compared among the 5 groups,and the curative effects at different stages were evaluated.Results No statistically significant differences in the age,sex,classification,concurrent hypertension,concurrent diabetes,active smoking,maximum diameter of false lumen,viscera artery supplied by the false lumen,etc.existed between each other among the 5 groups (P＞0.05).The operation time of group A and group B was (3.29±0.61) hours and (2.87±0.37) respectively (P＜0.05),while the operation time of group C,group D and group E was (1.80±0.62) hours (1.74±0.34) hours and (1.52±0.39) hours respectively (P＞0.05).The operation time of group A and group B was significantly longer than that of group C,D,and E (P＜0.001).The difference in the occurrence of complications was not statistically significant between each other among the 5 groups (P＞0.05).The hospitalization time was gradually shortened from group A to group E,although the difference was not statistically significant (P＞0.05).The surgeries of 28 patients in group A and group B were completed within 2 years and 6.2 years respectively,with an operation frequency being 3.3 patients per year and 7 patients per year respectively;while the surgeries of 42 patients in group C,group D and group E were completed within 2.2 years,1.2 years and 0.5 years respectively,with an operation frequency being 6.4 patients per year,11.7 patients per year and 17.5 patients per year respectively.Conclusion The learning curve of performing TEVAR for type B aortic dissection is approximately 28 cases;after completing 28 TEVAR procedures for type B aortic dissection at the yearly frequency of 4.6 cases by one interventional radiologist,the operation time becomes significantly shortened,and the surgical skills of theinterventional physician team can been significantly improved.

Purpose To investigate estrogen receptor ( ER ) , progesterone receptor ( PR ) expression in PTEN-deficient endometrial carcinoma and to analysis the relationship of PTEN, ER and PR protein expression with histological grade, pathological staging and muscle invasive. Methods Immunohistochemistry EnVision was used to detect the expression of PTEN, ER and PR protein in 100 ca-ses of endometrial carcinoma. Results The rate of PTEN-deficient endometrial carcinoma was 52. 0% (52/100). The expression rate of ER, PR protein on PTEN-deficient endometrial carcinoma was 15. 4% (8/52), 19. 2% (10/52), respectively. And the expression rate of ER, PR protein on PTEN over-expression endometrial carcinoma was 72. 7% (8/11), 63. 6% (7/11), respectively. The rate of PTEN, ER and PR expression types shown PTEN-ER-PR- was 42. 0% (42/100), which was higher than other types (P <0. 05). Different PTEN, ER and PR expression types were well correlated with histological grade and pathological staging (P<0. 05), but not with muscle invasive. Conclusion Combined detection of PTEN, ER and PR may have an important reference value for prog-nosis and treatment of endometrial carcinoma.

Humans ; MicroRNAs ; Muscle, Smooth, Vascular ; Myocytes, Smooth Muscle ; Phenotype

Objective To evaluate the efficacy of Fluency stent-graft (Bard Corp) in transjugular intrahcpatic portosystemic shunt (TIPS).Methods The clinical data of 21 consecutive patients treated by TIPS using Fluency stent-grafts were retrospectively reviewed.All of them were recurrent variceal bleeding secondary to portal vein hypertension,1 was bleeding secondary to primary hepatic carcinoma with port vein thrombns,and 1 was Budd-Chiari syndrome.They were followed-up after (10.1 ± 4.6) months (2.0 to 24.0 months).Stent-grafts patancy,portal vein pressure and liver function were recorded and compared.Results Twenty-five stent-grafts were successfully implanted in 21 patients,23 stent grafts were 8 mm 2 were 10 mm in diameter.The covered length of the stents varied from 6 to 8 cm.The bleeding was stopped and the portal vein pressure decreased significantly from (25.4 ± 3.5) mm Hg to (15.4 ± 2.8) mm Hg (t = 12.495,P < 0.01).During the follow-up period,The patient with primary HCC and portal vein thrombosis died 4 months after the procedure. One case had a new primary HCC during the follow-up and died 24 months after the procedure.One ease with variceal bleeding secondary to portal vein hypertension died of muhisystem organ failure.One case occluded in the hepatic vein and had another stcnt graft implanation.The other 17 cases had no stenosis after 7 to 17 months follow-up.Ultrasound showed that the stents were patent 1 week before the patients died.Three cases had transient symptoms of hepatic encephalopathy and recovered after treatment.The Child scores of the 19 patients survived more than 6 months were 6.3 ±1.4 before and 6.4 ± 1.9 after the procedure without significant difference (t = 0.645,P > 0.05).Conclusion The Fluency stent-grafts could increase the patency of the TIPS,but its efficacy on the long-term effect and hepatic encephalopathy need further investigation.