Along with increasing use of inferior vena cava (IVC) filter implantation, more and more attention has been paid to the filter - related complications by scholars both at home and abroad. For the present the generally accepted filter- related complications include filter deformation, filter tilt, filter fracture, filter migration, IVC perforation, IVC thrombosis, IVC occlusion, recurrence of pulmonary embolism, deep vein thrombosis (DVT), post - thrombosis syndrome (PTS), etc. Accurate recognition of filter - related complications and prompt use of appropriate measures that are directed against a given complication in order to reduce or avoid complications are of great clinical significance in applying the inferior vena cava filter to clinical practice in a more safe and effective way. This paper aims to make a comprehensive review about the filter- related complications and the research progress concerning their prevention in recent years.

Objective To compare the clinical efficiency between laparoscopic enterodialysis and open enterodialysis. Methods Clinical data of 25 cases of adhesive intestinal obstruction treated by laparoscopic enterodialysis (Laparoscopic Group) from December 1999 to December 2002 were retrospectively reviewed and compared with clinical records of 23 cases receiving open enterodialysis (Open Group) in the same period. The operating time, intra-operative blood loss, incidence of complications, postoperative recovery time of bowel movement and length of hospital stay of the two groups were compared, respectively. Results In the Laparoscopic Group operation was successfully accomplished in 23 cases while a conversion to open surgery was required in 2 cases. Of the Laparoscopic Group and the Open Group, the operation time was (58.3?8.1) min and (84.0?7.5) min (t=11.383, P=0.000), respectively; the intra-operative blood loss was (31.4?5.1) ml and (192.6?26.4) ml (t=29.995, P=0.000), respectively; the postoperative hospital stay was (4.1?1.4) days and (9.7?2.0) days (t=11.413, P=0.000), respectively; the postoperative recovery time of bowel function was (19.6?2.2) hours and (49.0?8.8) hours (t=16.207, P=0.000), respectively and the postoperative complications were seen in 1 case and 9 cases (?2=6.960, P=0.008), respectively. Conclusions Compared with open enterodialysis, laparoscopic enterodialysis has advantages of short operation time, less blood loss, rapid recovery and fewer complications.

Objective To evaluate changes of venous hemodynamics during laparoscopic cholecystectomy(LC).Methods A total of 25 cases of LC was included in the study.A Doppler ultrasonography of the lower limb veins was performed in all the patients to exclude those with abnormal veins or thrombosis.During the LC,the diameter and venous flow volume of the femoral vein were measured under Doppler ultrasonography.Measurements were obtained at three different times:after the induction of anesthesia but prior to the creation of the pneumoperitoneum,during the pneumoperitoneum,and after abdominal deflation but prior to the reversal of anesthesia.Results All the operations were successfully completed.The mean operation time was 45 min(range,30～70 min).No intraoperative hemorrhage or bile duct complications occurred.No conversion to open surgery was required.All the patients were dismissed from hospital on the first postoperative day.After the establishment of the pneumoperitoneum,the cross-sectional area of the femoral vein was increased from 0.94?0.18 cm2 to 1.12?0.23 cm2(q=3.919,P0.05).The venous flow was significantly increased from 7.62?0.72 cm3/s to 9.65?0.63 cm3/s(q=12.971,P

Objective To explore the imaging(Ultrasonography and CT)characteristics of endodermal sinus tumor of the ovary.Methods US and CT images of endodermal sinus tumor of the ovary in ten patients were analyzed proved by operation and pathology retrospectively and the imaging characteristics were discussed correlated with their pathology.Results All ten patients underwent sonography.In addition,five patients underwent CT scans.On sonography,five showed solid echo,two showed cystic-solid echo and the other two showed cystic echo.The blood flow of solid parts were abundant.In local part,honeycomebed appearance could be seen.On CT,one presented as solid mass with large irregular hyperdense necrotic area,two presented as cystic-solid mass with irregular and blurred cystic area,the other two presented as predominantly cystic mass with multiple internal septations.Conclusion Endodermal sinus tumor of the ovary has their characteristic sonography and CT features,particularly for CT.These imaging characteristics with the patients' age and serum a-fetoprotein levels can be helpful in presurgical accurate diagnosis.

OBJECTIVE:To study the relationship between Tort Liability and Special Relief for Adverse Drug Reactions (ADRs). METHODS: An analysis was conducted by literature review, logical reasoning and comparative study etc. RESULTS & CONCLUSIONS: In different country or area, the relationship between Tort Liability and Special Relief for ADRs manifested as German’s risk-sharing type, Japan’s supplement type, America’s mixed type. Tort Liability put an emphasis on the assignment and prevention of loss, while Special Relief on the sharing and shifting of risks. The functions of the two were different yet not incompatible, and they should work together to make up for the loss. Meanwhile, we should regard the trend of gradual socialization of the tort law seriously.

Objective To evaluate the feasibility and efficacy of Separate stent placement in the palliative treatment of inoperable malignant gastroduodenal obstruction.Methods Thirty four consecutive patients with inoperable malignant gastroduoenal obstruction were treated with peroral placement of Separate stent. Gastroduodenal obstruction was caused by gastric ( n =11), pancreatic ( n =12), matastatic ( n =3), biliary duct ( n =6) or duodenal ( n =2) cancers. Separate outer partial covered stent overlapping with inner bare stent were placed coaxially under fluoroscopic guidance.Results The technical successful rate reached 97% (33 of 34) with no major complication. Symptoms of gastroduodenal obstruction relieved in 33 patients. The average score of food intake capacity improved from 3.8 to 1.2 after Separate stent placment. Stent migration and tumor ingrowth were not detected during the follow up period. Tumor overgrowth was confirmed in one patient and a second stent was placed to solve the problem.Conclusions Peroral placement of Separate stent is a feasible and effective treatment for patients with inoperable malignant gastroduodenal obstruction.

Objective To evaluate multi-slice spiral CT venography (MSCTV) and digital subtraction venography (DSV) in diagnosing iliac vein compression syndrome (IVCS) and secondary thrombosis. Methods The imaging materials, including MSCTV and DSV performed before and after the thrombolysis therapy, of 38 patients with clinically-suspected IVCS were collected. The inner diameters of the compressed iliac veins were measured on MSCTV images and the compression ratio was calculated. Usingχ2 test, the detection rates of IVCS by MSCTV and DSV were compared. Results Of 38 patients, IVCS was detected by MSCTV in 29, by pretreatment DSV in 20 and by post-treatment DSV in 29. The difference in the detection rate of IVCS between MSCTV and pre-treatment DSV was statistically significant (χ2=4.65, 0.010.05). Conclusion For the diagnosis of IVCS, MSCTV is superior to pre-treatment DSV in the diagnostic accuracy of iliac vein compression syndrome. Therefore, MSCTV should be used as the preferred method of examination.(J Intervent Radiol, 2015, 24:301-305)

Objective To investigate the safety and clinical efficacy of catheter-directed thrombolysis(CDT) with prolonged infusion of low dose urokinasefor treatment of acute iliac-femoral vein thrombosis.Methods From January 2005 to March 2011,63 patients of unilateral acute iliac-femoral vein thrombosis were treated by CDT and followed up for more than 12 months.The complications during CDT,thrombus clearance ratio,time for CDT,dose of urokinase,degree of limb swelling and clinical follow-up data were retrospectively reviewed.The Fisher exact test was used for enumeration of data.The measurements of data were tested with the one-way analysis of variance and two-two comparison LSD test.Thrombus clearance ratio in different time frame was tested by repeated measurement of data and analysis of variance.Results During the CDT,no symptomatic pulmonary embolism (PE) and significant bleeding happened.Ten (15.9％) patients had complications of minor bleeding,including 3 patients with blood oozing along the edge of vascular sheath,3 patients with subcutaneous ecchymosis or hematoma around the puncture site,3 patients with hematuria and 1 patient with gums bleeding.In four (6.3％) patients,complications were caused by catheter placement,including 3 patients with soft tissue inflammation around puncture site and 1 patient with secondary thrombosis surrounding the vascular sheath.Fifty three patients (84.1％) achieved thrombolytic degree Ⅲ and Ⅱ at 4th to 8th day during CDT.Thrombus clearance ratio was higher in CDT with urokinase 500 000 U/d and 750 000 U/d than 250 000 U/d[(91.2 ± 10.1)％ vs (75.9±20.1)％,(91.3 ± 12.2)％ vs (75.9±20.1)％,all P ＜0.05].Thrombus clearance ratio showed no significant difference between CDT with urokinase 500 000 U/d and 750 000 U/d [(91.2 ±10.1) ％ vs (91.3 ± 12.2) ％,P ＞0.05].There was no significant difference between CDT with urokinase 500 000 U/d and 750 000 U/d in perfusion thrombolytic time to reach thrombolytic degree Ⅲ [(7.1 ± 1.0)vs (6.2±1.3)d,P＞0.05]and Ⅱ[(6.4±1.0) vs (6.0±0.8)d,P＞0.05].Thrombus clearance ratio increased along with an increase in thrombolytic time for CDT (P ＜ 0.05).After 24 hours of CDT,58 (92.1％) patients showed reduction of soft tissues tension.After 48 hours of CDT,affected limb circumference decreased significantly compared with the preoperative measurement [thigh (54.25 ±5.79) cm vs (56.46±5.91) cm; leg(44.05 ±5.18) cm vs (45.68 ±5.16) cm,all P＜0.05].At the time of discharge,there was no significant difference between affected limb circumference and normal side [thigh (49.00±4.67) cmvs (48.38 ±4.68) cm; leg(38.41 ±4.15) cm vs (37.73 ±3.92)cm,all P ＜ 0.05].The patency rate of iliac venous stent was 91.1％ (41/45) after 6 months.Doppler ultrasound showed regurgitation of femoral venous valve in 11 patients after 12 months.Conclusions CDT with prolonged infusion of low dose urokinase is a safe,highly effective method for the treatment of acute iliacfemoral venous thrombosis.

ObjectiveTo investigate prospectively the feasibility and clinical value of catheterization via the ipsilateral great saphenous vein in catheter-directed thrombolysis (CDT) for acute iliofemoral deep vein thrombosis (IFVT) by a comparative study.MethodsThe prospective study included 93 cases of IFVT proved by venography.All patients were divided into three groups randomly.In group A,31 patients received CDT via the ipsilateral great saphenous vein.In group B,27 patients received CDT via the ipsilateral popliteal vein.In group C,35 patients received anterograde thrombolysis via an ipsilateral dorsalis pedis vein.Urokinase was adopted as the thrombolytic agent in all cases.The assessment of the curative effect include therapeutic effective rate,rate of edema reduction and venous patency which were observed according to the clinical symptoms and the follow-up venograms obtained 5 days after thrombolysis.The time and comfort scores of procedures was recorded and compared between group A and B using two independent samples t test.The rate of edema reduction and venous patency were assessed using analysis of variance (LSD method).Therapeutic effective rate and complication rate were assessed using Chi-square test.Results The total effective rate of the three groups were 90.3％ (28/31),92.6％ (25/27) and 68.6％ (24/35) respectively.The limbs edema reduction rate were (83.5 ±21.1)％,(82.4 ±20.1)％,and(67.0±23.3)％ respectively(F=6.059,P = 0.003 ).The venous patency rate after thrombolysis were (61.2 ± 20.2) ％,(55.7 ± 20.5 ) ％,and (44.2 ±23.6)％ respectively.There was no significant difference between group A and B in therapeutic effective rate( x2 =0.09,P =0.759),rate of edema reduction( P =0.822 ) and venous patency ( P =0.343 ).There was a significant difference statistically in therapeutic effective rate(x2 =4.65,P =0.031 ),rate of edema reduction (P = 0.002) and venous patency (P = 0.002) between group A and C.Compared with group A and B,the procedure time [group A (8.3 ±3.1) min,group B (16.3 ±3.5) min,t =9.379,P ＜0.05],comfort scores during treatment [ group A (2.2 ± 1.2),group B (5.0 ± 1.4 ),t = 8.129,P ＜ 0.05 ] had statistical significant difference.The CDT-asscciated complications in group A were less than group B significantly(3 cases in group A,11 cases in group B,x2 =7.60 P ＜0.05).ConclusionsCatheterizationvia the great saphenous vein in CDT therapy for acute IFVT is feasible and effective.It is easily operable with less complications.

Objective To compare the efficacy and the side-effect of three different ways in treating the patients with malignant pleural effusion. Methods 98 patients histologically proved malignant pleural effusion were randomly divided into three groups, bleomycin group(BLM), bleomycin with mycobacterium group( BLM + UTL) and blemycin with intertleukino2 ( BLM +IL). 31 patients were treated with bleomycin intrapleural injection in BLM group,32 patients were treated with bleomycin and Utilin's(mycobacterium) intrapleural injection in BLM + ULL group and 35 patients were treated with bleomycin and intertleukin-2 intrapleural injection in BLM + IL group. The therapeutic efficacy, change of performance and side effects were compared among the three groups after one period of treatment. The changes of CEA and TNF in the pleural effusion were examined before and after treatment. Results The therapeutic efficacy and performance improvement were higher in BLM+UTL and BLM+IL group than that of BLM group(P＜0. 05) ,the pleural CEA of post-treatment in three groups were lower than that of pre-treatment(P＜0.01) ,the CEA after treatment in BLM+UTL group and BLM+IL group was lower than that of BLM group(P＜0. 01,respectively). The pleural TNF of post-treatment in BLM+UTL and BLM+IL groups was higher than that of pre-treatment(P＜0. 01 ) in BLM group. The pleural TNF of post-treatment in BLM+UTL and BLM+IL group was higher than that of BLM group ( P＜0. 01 ). Conclusion Intrapleural injection of mycobacterium with bleomycin or interlekin-2 with bleomycin has better efficacy than using bleomycin only in treating malignant pleural effusion.