Objective To study the safety of transcatheter arterial chemoembolization(TACE)via the intercostal artery(ICA)for hepatic carcinoma.Methods A total of 24 patients with hepatic carcinoma(HCC)fed by the ICA underwent TACE via the artery in our hospital.Among the cases,15 were mass type and 9 were nodular type.Plain and enhanced CT or MRI scan were performed before the operation.During the procedure,we carried out intercostal arteriography.Selected catheterization of the feeding branch and then TACE were done.The ICA angiographic features,tumor location,clinical observation,laboratory tests,and imageology were evaluated after the surgery.Results In our cases,the HCCs supplied by the ICA collaterals were located at segments six and/or seven.Angiography showed that all the ICA collaterals originated from the right side at the levels of T8(7.5%,3/40),T9(15.0%,6/40),T10(47.5%,19/40),or T11(30.0%,12/40).The procedure was completed in 22 of the patients.CT scan performed after the procedure showed that the tumor was completely filled with lipiodol in 87.5%(21/24)of the cases.The serum level of AFP decreased significantly in 82.6%(19/23)of the patients.Three patients complained of severe pain at the shoulder after the operation,1 patient had skin itching during TACE,and 5 developed skin erythema after the procedure.Conclusions HCC supplied with ICA collaterals are often detected in the patients who have the tumor at the right posterior segment(S6 and S7)and had received TACE for several times.TACE via the ICA is safe but may leads to skin injuries.

[Objective] To investigate X-ray and CT manifestations of tobereulosis of ankle joint and to discuss the differentiation with other diseases.[Method]The X-ray and CT findings in 5 cases with pathalogically proved tuberculosis of ankle joint were retrospectively analyzed.The differentiation with other diseases was discussed.[Result]The lesions involved entire right ankle joint in all 5 cases,The typical signs were as follows:(1)indistlnct and erosive joint surface,insect bitten-like of bony destruction ofjotht surface,digging-like shape of cancellous bone's destruction;(2)narrowed or irregular widened joint space;(3)ostooporosis of diseased region and surrounding;(4)extensive periostoal reaction of distal fibia and fibula;(5)to form cold abscess and sinus tract.[Conclusion]The tuberculosis of ankle joint earyies certain characteristic X-ray and CT signs,CT is better than X-ray in diagnosis.Highly alert of ankle joint tuberculosis is the key of early correct diagnosis.

Objective To investigate the safety of thyroid gland resection and primary resection in the treatment of thyroid nodule and its influence to thyroid function.Methods 86 patients with thyroid nodules were selected as the research subjects.The patients were randomly divided into two groups.43 cases in the observation group implemented the thyroid gland resection treatment.43 cases in the control group received thyroid gland subtotal resection.The curative effect,safety,thyroid function and other indicators were compared between the two groups.Results The operation time and hospitalization time in the observation group after operation[(105.65 ± 12.54)min;(6.35 ± 2.01)d]were shorter than those in the control group[(149.41 ± 13.68)min;(9.62 ± 2.45)d].The amount of bleeding during operation in the control group [(134.51 ± 9.64) mL] was significantly higher than the observation group [(84.62 ± 6.35) mL],there was significant difference between the two groups (P ＜ 0.05).The total effective rate of the observation group was 95.55％,which was significantly higher than 72.09％ in the control group,the difference was statistically significant (P ＜ 0.05).Before operation,the between the two groups had no significant difference (P ＞ 0.05).After surgical treatment,serum FT3 and serum FT4 levels in two groups were decreased,but those in the observation group[(11.62 ± 3.02),(51.24 ± 7.25)pmol/L] were significantly lower than the control group [(14.14 ± 5.11) pmoL/L;(60.52 ± 6.35) pmol/L],there were obvious differences (P ＜ 0.05).The incidence rate of complications such as throat edema,hemorrhage,postoperative hoarseness in the observation group was 9.30％,which in the control group was 23.26％,the difference was statistically significant (P ＜ 0.05).Conclusion The thyroid gland resection therapy for thyroid nodules has high safety and significant curative effect,it can quickly improve the thyroid function,reduce relapse rate,has higher application value in benign and malignant tumors indistinguishable after surgery.It can reduce the length of stay in hospital,is conducive to the recovery of patients,it is worthy of clinical promotion.

Objective To assess the feasibility of interventional techniques in the establishment of animal model of superior mesenteric vein-portal vein (SMV-PV) thrombosis. Methods Nine miniature pigs were involved in the study including one for preliminary experiment. After general anesthesia, a balloon catheter was placed in the main trunk of PV to block the portal flow and then thrombin or autologous blood clot was injected to the SMV. Venography was performed to confirm the thrombosis 30 minutes later. Changes in the imaging before and after the thrombosis were observed. Pigs died during the experiment were anatomized to analyze the causes, and pathological examination was performed when necessary. Results The model of SMV-PV thrombosis was successfully established in all the pigs. One pig died of diffuse intravascular coagulation 10 minutes after model establishment in the preliminary experiment. Two pigs died of hepatorrhexis and over dose of anesthetics respec-tively 3 hours after model establishment, and the rest 6 pigs were fed for 14 days. Conclusion Interventional techniques are effective in the establishment of SMV-PV thrombosis model.

Objective To approach the mechanism and efficacy of regional intra-arterial infusion chemotherapy with the mixture of lipid emulsion-CDDP (LE-CDDP) for treatment of locally advanced pancreatic cancer. Methods Twenty-four health dogs were divided into four groups (group A, B, C, and D). The dosage of CDDP was used in 4 mg/kg/body weight for each animal The 20% LE, as a solvent, was used in the experimental animals with 2 ml/kg/ body weight (group A) and 1 ml/kg/bedy weight (group B), respectively. Normal sodium (NS) as a solvent was used as control with 2 ml/kg/bedy weight (group C) and 1 ml/kg/body weight (group D), respectively. The LE-CDDP mixture and the NS-CDDP mixture were infused into the proximal segment of splenic artery under the DSA, with transfemoral arterial approach. Blood samples were collected after infusion at 0,3,5,10,20,30,40,50,60 min and the tissues were obtained after the 60 min's blood sample was collected. Blood samples, absorbent gland in peripancreas, liver, spleen, kidney, heart, portal vein, the superior segment of jejunal and pancreas and parapancreatic tissues were obtained for CDDP concentration analysis and histopatholngic examination. Results The values of the area under curve (AUC), the incipient serum concentration ( C0 ) and the elimination half-life (t1/2 ) of the serum CDDP concentration-time curve in four groups were A (54. 5 ± 10.1)%,(2.6±0.5) mg/L, (16.7±3.6) min;B (18.3±6.0)%,(1.5±0.2) mg/L, (47.9 ± 11.1) min; C (116.7±20.6)%, (6.5±0.4) mg/L, (10.5±2.8) min and D (126.6±30.7)%, (5.5±0.4) mg/L, ( 10. 1±3. 1 ) min, respectively. There were significant difference among these four groups ( F(AUC) = 42. 42, F(C0) = 249. 61, F( t1/2 ) = 12. 48, P < 0. 01 ). The values of AUC and C0 in the group A were significantly lower than those in the group C (t(AUC) = 6. 64,t(C0) = 16. 34, P <0. 01 ), and the corresponding values in the group B being also significantly lower than those in the group D (t(AUC) = 8.49, t(C0) =22. 30, P<0. 01 ). The value t1/2 in the group A was significantly longer than that of in the group C ( t = 3.36, P < 0. 01 ), and that of group B was also significantly longer than that of group D ( t = 3.71, P <0. 01 ). The values of AUC and C0 in the group B were significantly lower than those in the group A (t(AUC) = 7. 57, t(C0) = 5.48, P < 0. 01 ), and the value t1/2 in the group B was significantly longer than that in the group A (t = 3.22, P < 0. 05 ). The concentrations of the left lobe and horn of pancreas were higher in the group B (0. 18, 0. 18 mg/L) than those in the group A (0. 05, 0. 05 mg/L) (t =2. 52, 2. 73, P < 0. 05). The tissue CDDP concentration of the right lobe of pancreas and spleen were no significant difference between group A ( 0. 11, 0. 29 mg/L ) and group B ( 0. 07, 0. 24 mg/L) ( P > 0. 05 ). Perivascular lymphocytic and neutrophilic infiltration, congestion and hemorrhage were found in the pancreas, parapancreatic absorbent gland, liver and spleen in the group A and group B. The micro-particles of intralipid were present in the capillary vessel of these tissues. No specific pathological changes were found in other groups and organs. Conclusions The regional intra-arterial infusion with LE-CDDP mixture could increase the pancreatic CDDP concentration, meanwhile, it also could decrease the serum CDDP concentration. The more of the CDDP concentration in the LE-CDDP mixture, the more CDDP concentration at the pancreatic tissue accordingly.

Objective To assess the value of transcatheter arterial chemoembolization(TACE)via omental artery for hepatocellular carcinoma(HCC).Methods Twenty-seven patients with HCC which was nourished by omental artery underwent TACE.Postoperative clinical manifestations,laboratory tests and imaging findings were observed and compared with the angiographic findings.Results The tumor Was located at the peripheral region of right lobe in 26 patients and at the lower part of segment IV in 1.Thirty-eight omental arteries supplying HCC were observed angiographically.The omental artery in 18 patients was successfully embolized.Hepatic hemostasis was achieved in all patients with ruptured HCC.No severe complication occurred,and tumor recurrence Wag observed in 15 patients postoperatively.Conclusions Omental artery supplying HCC is mostly seen in patients who have undergone multiple TACEs and patients with the focus which is located at the peripheral region of right lobe.TACE via omentai artery is safe and feasible,although the residual rate of the HCC is high.

Objective To explore the clinical characteristics and the cause of misdiagnosis of child suffering from cerebral parago-nimiasis with intracranial hemorrhage as initial symptom,and to improve the diagnosis and treatment level of cerebral paragonimiasis.Methods The clinical data of the children who suffered from cerebral paragonimiasis with intracranial hemorrhage as initial symptom were collected from January 2011 to December 2015 in Affiliated Hospital of Zunyi Medical College.The clinical manifestation,imageology and laboratory tests,outcome of therapy were analyzed and then the effect of treatment and the prognosis were followed up.Results There were 7 patients meeting the inclusion criteria for cerebral paragonimiasis,including 4 male and 3 female.They were from 6 to 13 years old with the average age of 9.3 years old.All patients presented with headache and vomiting,and showed intracranial hemorrhage through CT or MRI of brain.All of the 7 patients were misdiagnosed as cerebrovascular malformation by the neurosurgeons.Three of them showed typical imaging pattern including tunnel sign and the ring-like shape of cerebral paragonimiasis.Five of these cases were attacked by pulmonary distomiasis at the same time.Six of them had an increasing eosinophil,and the paragonimus antibody was positive.They were treated with Praziquantel.Six patients recovered completely,and 1 patient had the dysfunction of left extremities.Conclusions The childhood cerebral paragonimiasis has strong clinical heterogeneity and diversity in manifestation.Intracranial hemorrhage may be the initial symptom,which should be paid more attention to.Cerebral paragonimiasis can be diagnosed and treated early according to the clinical characteristics,the increase of eosinophil,the typical changes in imageology and the specific antibody test.

Objective To investigate the effects on IL-6 and PGE2 expression in wear-particles-induced osteoblast cells by blocking calcium phosphatase (Cn)/ activated T nuclear factor (NFAT) pathway. Methods Fetal Sprague-Dawley rats were used in this study. Osteoblast were prepared from the calvariae of rats . Osteoblast cells were incubated in four group according to different supplementation:(1) neither Ti particles nor 11R-VIVIT (Control group), (2) only Ti particles (Ti group), (3) both Ti particles and 11R-VIVIT (Ti/VIVIT group), and (4) only 11R-VIVIT (VIVIT group). Cells were incubated for 96 hours and the expression of NFATc1 protein was detected by western blot. The expression of IL-6 and PGE2 in liquid supernatant of osteoblast were detected at 6, 24 and 96 hours by ELISA. Results The expression of NFATc1 in the Ti group was higher than that in the Control group (P < 0.01), but in Ti/VIVIT group that was significantly lower than in the titanium particle group (P < 0.01). The IL-6 and PGE2 expression in the supernatant of the Ti group were significantly increased than those in the control group (P < 0.05). The IL-6 and PGE2 in the Ti/VIVIT group were significantly lower than that in the Ti group (P < 0.05). Conclusions 11R-VIVIT peptide specific blockade of Cn/NFAT signaling pathway significantly inhibited IL-6 and PGE2 of osteoblast cells induced by titanium particles.

OBJECTIVETo summarize the experience of treating the obliteration of the cerebral venous sinus in 17 patients by using direct thrombolysis and stent angioplasty.

METHODSAll 17 patients with thrombosis and stenosis of the venous sinus were confirmed by digital subtraction angiography. Of these 3 patients had thrombosis in a single sinus and 14 had thrombosis in multiple sinuses. The circulating time was prolonged for over 13 seconds. The micro-catheter was preserved in the sinus for 5 days, followed by infusion of urokinase 1.5 million units and oral warfarin 3-5 mg each day. Stent angioplasty was done for 4 patients with obvious stenosis of the venous sinus detected by DSA after thrombosis.

RESULTSAfter contact thrombosis and stent angioplasty in sinuses of the 17 patients, remarkable recanalization of obliterated sinuses was achieved. After treatment, intracranial hypertension pressure (ICP) returned to normal in 7 patients, and 8 thrombosis relapsed in different degree after 7 days. Anticoagulation was prescribed. Only 2 patients showed the ICP above 280 mm H(2)O. No obvious relapse was found in 15 patients during the follow-up for 3-60 months.

CONCLUSIONOur results demonstrated that successive thrombolysis and stent angioplasty for occlusion and thrombosis of the venous sinus are effective in promoting drainage of cerebral venous blood and rapidly decreasing ICP.

Administration, Oral ; Adolescent ; Adult ; Angioplasty, Balloon ; methods ; Anticoagulants ; administration & dosage ; Child ; Combined Modality Therapy ; Drug Therapy, Combination ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Plasminogen Activators ; administration & dosage ; Sinus Thrombosis, Intracranial ; therapy ; Stents ; Thrombolytic Therapy ; methods ; Urokinase-Type Plasminogen Activator ; administration & dosage ; Warfarin ; administration & dosage