Objective To discuss the correlative factors affecting the short-term prognosis in treating malignant obstructive jaundice with percutaneous transhepatie biliary drainage (PTBD) and/or percutaneous transhepatic biliary stenting (PTBS). Methods During the period of December 2008-June 2009, PTBD and/or PTBS were performed in 67 patients. The clinical date were reviewed and analyzed. According to the reduction degree of serum bilirubin and survival condition in 30 days, the patients were divided into effective group (54 cases) and ineffective group (13 cases). Single factor affecting the short-term prognosis was analyzed by using X~2 test and multi-factors were analyzed by using non-conditional logistic regression mode. Results Single variable analysis showed that time of obstruction, way of drainage, preoperative biliary infection, Child-Pugh grade, TBIL, HGB and Cr level were of statistical significance. The logistic regression analysis showed that there were obvious correlation among preoperative biliary infection, Child-grade ≥ 11 and Cr > 115 μmol/L. Conclusion The infection of the bile duct before operation, Child-grade ≥ 11 and Cr >115μmol/L carry a close relationship with the short-term prognosis of PTBD and PTBS. Therefore, an overall preoperative evaluation for malignant obstructive jaundice is of great importance.

The incidence of hilar cholangiocarcinoma is very rare worldwide. Radical resection is the only prognostic factor for long survival in patients with hilar cholangiocarcinoma. Postoperative radiation therapy can improve local control and survival rates for patients with palliative resection,but it remains controversial in patients with radical resection. Biliary drainage can effectively release bile duct obstruction for the majority of patients with locally advanced disease,and may even prolong survival when combined with radiation therapy. Radiation therapy includes extrernal beam therapy alone,external beam therapy with intraluminal brachytheapy and new radiation technique,such as three dimentional conformal therapy and intensity modulated radiation therapy. The propective randomized clinical study is needed for further investigation in the role of combined modality therapy especially for hilar cholangiocarcinoma.(J Intervent Radiol,2007,16: 705-709)

Intervetional therapy as an important therapeutic method for malignant biliary obstruction has been used extensively,but there still remain some problems worthy for our emphasis and research. We retrospectively reviewed more than 800 patients with malignant obstructive jaundice during 12 years. Indications,contraindications,complications and corresponding treatment methods were studied. Furthermore,discussion including methods of biliary drainage,proper time of stent implantation,methods of anesthesia,usage of antibiotics and haemostat were also carried out. Use of analgesics (pain-suppressal)pre-and post procedure,development of acute pancreatitis and its management,and peri-operative mortality were further investigated in detail. We hope our experiences and lessons would give interventional doctors some help in their career.(J Intervent Radiol,2007,16: 649-651)

Objective To optimize the injection protocol of spiral CT portography(SCTP) and to evaluate its diagnostic value.Methods 48 normal individuals were randomly divided into three groups with different injection rates of contrast material:4 ml/s,3 ml/s and 2 ml/s.Single-level dynamic CT was performed through the trunk of portal vein.In each scan,time-attenuation curves of the portal vein,liver and P-L(the difference between portal vein and liver)were obtained.And SCTP was prospectively performed in 30 cases.The SCTP findings in a variety of disease were analyzed and the quality of SCTP images was assessed.Results ①The groups of 4 ml/s and 3 ml/s had greater peak enhancement of the portal vein and P-L than the group of 2 ml/s(?

Objective To report our experience of interventional procedure for arterial complications in post renal transplantation and to evaluate its clinical value.Methods In a retrospective analysis of renal transplantations in our center,52 cases of renal allograft artery abnormalities had taken angiography.Interventional procedure included transluminal angioplasty of arterial stenoses,treatment of arterial occlusion,and embolization of pseudoaneurysm.Results Renal allograft artery abnormalities included artery stenosis (n=21),artery thrombosis (n=13) and embolision (n=1),renal artery pseudoaneurysms (n=2),and decrease of renal artery flow (n=3).Of the 21 artery stenosis,2 grafts with artery stenosis were lost because the stenosis could not be corrected,and 3 with mild stenosis received no treatment.Another 16 accepted renal artery angioplasty (balloon dilation,n=12,and stent implantation,n=4).14 achieved long-term allograft function.1 graft was lost because renal function failed to recover.Restenosis occurred in one stent implantation,and lost the allograft function after secondary dilation.13 cases received thrombolytic therapy through artery catheter for thrombosis and 9 achieved long-term allograft function.Thrombolyses failed in 3 cases,and renal function failed to recover in 1 case.One pseudoaneurysm received stent implantation after embolization,and got a short-term allograft function.The other one received allograft excision.Conclusion Intravascular interventional therapy will be the first-line therapy for any indications of complication in post renal transplantation,and it can surely save the kidney in a majority of instances.

Objective To determine the added clinical applications of MR virtual endoscopy (MRVE) plus MRCP in cholangiopancreatography. Methods In 14 month, 44 patients with obstructive jaundice and symptomatic bile trace were assessed by MRVE in biliary tract.The 2D data of heavily T 2 weighted images with FSE(non breath hold, respiratory trigger) and SSFSE(breath hold, multi slice single shot fast spin echo) sequence were transferred to the computer workstation. Navigator software (GEMS) was used to display intraluminal views of the pancreaticobiliary tract with a surface rendering technique. Results Patients suffered from neoplasm ( n =18), bile stone (17), postoperative complications of cholecystectomy( n =3), and other disease of biliary tract( n =6). MRVE could clearly demonstrate the anatomical structures in biliary tract, extended pancreas tract,biliary meatus narrowing and obstruction, bile duct stones, duct branches, and the inner wall of pathological obstruction.The main limitation of virtual endoscopy was inability to evaluate mucosa and lack of histological diagnosis. Sensitivity for detection of bile duct dilatation and site of obstruction was: 2D FSE 91 7%, and SSFSE 97 9%. Conclusion MRVE provided noninvasively endoscope like display of biliary tract.Its display ability was a supplement to image biliary trace. MRVE effect of multi slice SSFSE sequence was better than that of fast spin echo.

Objective To evaluate the application value of 64-row spiral CT coronary angiography(CAG)in myocardial bridge (MB)and mural coronary artery(MCA) .Methods Imaging data of 436 consecutive subjects underwent coronary CT angiography in Hospital of Beijing Puren were enrolled in this study .The prevalence ,clinical effects of patients ,precise location and incidence of each branch were evaluated .In addition ,the length and depth of MB ,as well as their relationship with MCA in stenosis were evalua-ted .Moreover ,the group of subjects with MB was compared with the control group(subjects without MB)in the probability of ath-erosclerosis .Results Among the total of 436 subjects ,76 subjects(17 .4% ,76/436)were found to have MB .The left anterior de-scending artery(LAD)was the most common coronary artery involved(68 .4% ,52/76) .The pressure level of MCA associated with the length and depth of MB .A significant difference was found between the LAD-MB-MCA group and the control group in the presence of coronary artery plaques(P<0 .05) .Conclusion The anatomic relation between MB and MCA can be precisely displayed on 64-row spiral CT coronary angiography ,which is considered to be an excellent diagnostic method to screen MB-MCA initially . There is a relationship between stenosis of MCA and the length and depth of MB .The present and stenosis of MB-MCA are meant to form coronary artery plaques in LAD segment more easily .

Objective This research is one of the sub-researches of"The comparative study of the standards of interventional therapies and the evaluation of the long-term and middle-term effects for common malignant tumors",which is one of the National Key Technologies R&D Program in the eleventh five-year plan. Based on the project,the authors need to establish an international standard in order to set up the national tumor interventional therapy database and registration system.Methods By using the computing programs of downloading software,self-management and automatic integration,the program was written by the JAVA words.Results The database and registration system for the national tumor interventional therapy Wag successfully set up,and it could complete both the simple and complex inquiries.The software worked well through the initial debugging.Conclusion The national tumor interventional therapy database and registration system can not only precisely teU the popularizing rate of the interventional therapy nationwide,compare the results of different methods,provide the latest news concerning the interventional therapy,subsequently promote the academic exchanges between hospitals,but also help as get the information about the distribution of the interventional physicians,the consuming quantity and variety of the interventional materials,so the medical costs can be reduced.

Objective To study the anatomic characteristics of the infraorbital ethmoid cells on muhislice CT(MSCT)and explore the relationship between the infraobital ethmoid cells and mueosal swelling of sinuses.Methods Two hundred sixty patients(520 sides) of consecutive axial scans by GE HisDeed VCT and the multiplunar reformation(MPR),virtual endoscopy(VE)reconstruction images by GE AW 4.2 workstation were reviewed retrospectively.The following CT features were assessed:(1)the anatomic characteristics of the infraobital ethmoid ceils,including the frequency of identification,origin,classification.(2)presence of mucosal swelling of sinuses,(3)the maximal transversal diameter of the inflraobital ethmoid cells in ostium of maxillary sinus(perpendicular to the uncinate process),and the diameter of the ostium of maxillary sinus,(4)presence of infraobital ethmoid ceils inflammatory findings and a contact between the mucosal surface of the ostium of maxillary sinus.The results were analyzed by using Chi-square test and logistic regression analysis with the statistical software SPSS 11.5.Results (1) UniLateral infraobital ethmoid cells were f10und in 68 patients(26.1%),and bilateral infraobital ethmoid cells were found in 81 patients(31.2%).Infraobital ethmoid ceHs were found in 230 sides on left Bide (120 sides)and right side(110 sides).(2)Infraobital ethmoid cells originated from the anterior ethmoid cells in 124 sides(53.9%)and from posterior ethmoidal cells in 62 sides(27%),originated from both the anterior ethmoidal cells and the posterior ethmoidal cells in 44 sides(19.1%).(3)The classification of the infraobital ethmoid cells included three types.Infraobital ethmoid cells with different origination differed significantly in theirtypes(x2=193.433,P<0.01).Most ofthe infraobital ethmoid cells originated from tlle anterior ethmoidal cells were type Ⅰ(160 sides),while the type Ⅱ(48 sides)and Ⅲ(45 sides) frequently originated from the posterior ethmoidal ceHs(4)The mueosal swelling of sinuses,were found in 165 sides in presence of infraobtial ethmoid cells and 192 sides in absence of infraobtial ethmoid cells.The presence of infraobtial ethmoid cells had no effect on mucosal swelling(X2=1.824,P>0.05).The maximal transversal diameter of the infraobital ethmoid cells in ostium of maxillary sinus did not differ significantly between the cases with or without mucosal swelling of sinuses(t=0.273,P>0.05).and the diameter of the ostium of maxillary sinus were not significantly related with mucosal swelling of sinuse8 (Wald=2.534,P>0.05).Presence of infraobital ethmoid cells inflammatory findings (Wald=10.817. P<0.01,OR=4.125)and a contact between the mucosal surface of the ostium of maxillary sinus (Wald= 6.640,P<0.01,OR=3.728)were significantly related to mucosal swelling of 8inuses. Conclusions (1)MSCT scan could clearly demonstrate the detailed information of infraobital ethmoid ceIIs.(2)The presence of infraobtial ethmoid cells Was not a risk factor for chronics sinusitis. When we assess inflraobtial ethmoid cells as a possible etiologic factor in chronics sinusitis we should observe presence of infraobital ethmoid cells inflammatory findings and a contact between the mucosal surface of the ostium of maxillary sinud.

Objective To evaluate the radiosensitization effect of gemcitabine in human cholangiocarcinoma cells(QBC939)in vitro. Methods The IC10,IC50 and IC90 of gemcitabine in QBC939 cells were determined by clonogenic assay,which were adopted in the following experiments.The cells were divided into five groups:control group,chemotherapy group,radiation group,radiation after chemotherapy(C+R)group and radiation before chemotherapy(R+C)group.The radiation dose ranged from 1 Gy to 10 Gy.The cell survival Curves were fit using two-component equation and the sensitive enhancement ratio(SER)was calculated.Results The IC10,IC50 and IC90 of gemcitabine in QBC939 cells were 0.1 nmol/L(low concentration),11.0 nmol/L(moderate concentration)and 21.5 nmol/L(high concertration),resDectively.Gemcitabine in low concentration radiosensitized the cells at low irradiation dose(≤2 Gy)in R +C group(SERDq=1.52).Gemcitabine in moderate concentration had radiosensitization effect at all irradiation doses in C+R group(SERD0=1.27,SERDq=116.93),and at low irradiation dose(≤2 Gy)in R+C group.Gemcitabine in high concentration had radiosensitization effect at all irradiation doses in both R+C and C+R groups,which was most markedly at low irradiation dose(≤2 Gy)in R+C group(SERDq =323.30). Conclusions Gemeitabine has radiosensitization effect in QBC939 cells,which is based on the optimal scheduling and concentration.