Objective To explore the methods of embolism in simple and complex arteriovenous malformation of body.Methods Ten cases with the body arteriovenous malformations treated with interventional embolization were retrospectively analysed. Coil or detached bollon were used in simple arteriovenous malformations which could be embolized directly, while IBCA were used in complex ones, which could embolize the abnormal vascular group, blocking blood supply of multiple arteries and preventing construction of collateral circulation which could lead to recur. Results The abnormal vasculars were embolized completely in all ten cases, and there were no recurrent followed-up for 1～6 years.Conclusion Interventional embolization is a simple and credible therapeutic method for arteriovenous malformations of body , and it should be the primary plan.

Objective To investigate the difference in occurrence of pneumothorax and bleeding under lung biopsy between the elderly and the non-elderly. Methods A total of 297 consecutive patients were involved in the study and divided into non- elderly group (＜ 60 yrs,122 cases),and elderly group (≥60 yrs,175 cases).Eighteen gauge (18G) cutting needles were used for biopsy with computed tomography (CT) guidance. Biopsy samples were detected by histology and cytology pathology. Results Pneumothorax occured in 108 of 297 biopsies (36.4％),pneumothorax rate was higher in elderly group (76 cases,43.4％) than in non-elderly group(32 cases,26.2％) (x2=9.19,P＜0.01).No statistical significance was found in different degrees of pneumothorax between the two groups.Perifocal hemorrhage occured in 156 of 297 biopsies (52.5％),higher frequency of hemorrhage occurred in elderly group (105 cases,60.0％) than in non-elderly group(51 cases,41.8％)(x2=9.55,P＜0.01),and the more flake bleeding vas found in elderly group than in nonelderly group(x2 =20.28,P＜0.01). Conclusions In CT guided coaxial cutting needle biopsy,the incidence of pneumothorax and considerably bleeding are higher in the elderly than in non-elderly.

Objective To investigate the application value of multi-slice spiral CT angiography (MSCTA) in liver cancer patients interventional treatment.Methods Fifty-four liver cancer patients were selected,all patients underwent MSCTA examination,after the image post-processing,and with 17 cases of patients with the same period digital subtraction angiography (DSA) examination results for comparison,in order to analyze the application value of MSCTA in liver cancer patients interventional treatment.Results The patients with liver cancer were seen MSCTA arterial phase varying degrees of tumor staining,2 cases had hepatic arteriovenous fistula.Some patients in the portal vein and hepatic vein were found vein tumor thrombus.MSCTA showed 10 cases of hepatic artery variation,variation rate of 18.5％ (10/54),in line with the DSA rate of 100.0％.MSCTA showed 11 rami liver cancer parasitic artery,1 case of DSA was not found for the right phrenic artery of liver cancer,there was no significant difference in showed liver cancer parasitic artery between the two methods (P ＞ 0.05).Conclusion MSCTA as a minimally invasive diagnostic method of tumor blood supply,can clearly show the origin of the hepatic artery and its branches and walk the line,liver cancer feeding artery,liver cancer parasitic artery with DSA showed highly consistent results,interventional treatment of liver cancer with important guiding significance.

Objective To retrospectively analyze the complications and management of complications during percutaneous implementation of biliary stents in 17 patients. Methods Percutaneous biliary drainage and implementation of biliary stents for malignant biliary obstruction under fluoroscopic guidance was performed in 64 patients. 17 cases developed complications. Bradycardia and hypotension was seen in 5 cases, slipping of the stent into the duodenum in 1, bile duct perforation in 2, the fine guidewire broken in the hepatic parenchyma in 2, malposition of the stent in 3, hepato renal failure leading to hemorrhage in 2, exchanging guidewire broken in the duodenum in 1, and balloon broken leading to stent dislocation in 1, respectively. Results Bradycardia and hypotension in the 5 cases was treated medically and the procedure was interrupted. Slipping of the stent into the duodenum was passed off spontaneously. Broken of the fine guidewire in the liver did not present any complaints until the death of the patients. Perforation of bile duct was treated conservatively with a clinical successful outcome. Malposition of the stent was treated by reimplementation of shorter stents. The broken exchanging guidewire in the duodenum during implementation was removed with the gastroscope. The hepato renal failure leading to hemorrhage had poor prognosis. The broken balloon caused stent dislocation was treated by reimplementation of stent. Conclusion Percutaneous implementation of stent is effective and safe for elderly patients with proximal stenosis of the biliary tract. However, one must be very careful to avoid the complications.

Objective To study the value of magnetic resonance vessel wall imaging in assessing the atherosclerotic plaque burden of rabbit model.Methods We built up abdominal atherosclerotic animal model in 30 New Zealand rabbits by high lipid diet combined with abdominal artery denudation.The animals were divided into 3 groups randomly,which were the 1-week group,1-month group and 2-months group.The MRI and histology examination were carried out at relative time points.The correlations of area or thickness of vessel wall by MRI with histology examination were analyzed.Results Among the 30 rabbits,3 died due to anesthesia or surgery,one rabbit model failed because of the thin vessel,and another 3 died of diarrhea or inflammation during the high lipid diet feeding.Eventually,totally 23 rabbits fulfilled the examinations (7 in 1-week group,7 in 1-month group and 9 in 2-months group).The vessel wall area of histology examination grew larger along with the post-surgery duration,from 1.7663 mm2of 1-week group to 2.4371 mm2 of the 1-month group till 3.5978 mm2 of 2-months group,with statistic significant difference among 3 groups (F=5.052,P=0.017).There were strong correlations of area or thickness vessel wall resulted from MRI with histology examination(r=0.688,0.642;P=0.001,0.002).Conclusions High resolution MR vessel wall imaging technique may evaluate and follow up the plaque burden in the early stage of atherosclerosis.

Objective To investigate CT and MRI features of dermatofibrosarcoma protuberans (DFSP).Methods Totally 16 patients with DFSP confirmed by pathology were enrolled.Tumor morphology,CT and MRI imaging appearance (11 cases underwent plain and enhanced CT,5 cases underwent plain and enhanced MRI) were analyzed retrospectively.Results DFSP usually occurred in the skin of truck,head and neck,protruding from the skin surface in different extent.Some lesions even suspended out of the skin.The lesions were divided into nodular type (n=12) and diffuse type (n=4) according to their morphological appearance.The tumors usually demonstrated as iso-density or slightly low density solid mass compared to muscle on CT.On MRI,it usually demonstrated as low signal on T1WI and high signal on T2WI.Tumor blood supply was rich,and it usually showed progressively moderate to strong enhancement.The signs within DFSP include hanging sign (n=2),skin tail sign (n＝6),fascia tail sign (n=l),fat tail sign (n=4).Conclusion DFSP can be characterized by nodular or diffuse lesions,the manifestations of different form are slightly different,but still have a certain characteristic.

Objective To review the serial CT findings of cryptogenic organizing pneumonia(COP)and semiquantitatively analyze the changes after corticosteroid therapy.Methods The clinical and radiological features of 13 patients with COP confirmed by pathology were retrospectively collected and analyzed.The lung lesions extent on CT scans was estimated using semi-quantitative method.Changes of overall disease extent were evaluated by comparing the initial CT images and the follow-up CT scans after corticosteroid therapy.Results CT images of all cases revealed diffuse and bilateral lesions,mainly located in lower zone,distributed as predominantly subpleural and(or)along the bronchovascular bundle.The two most common manifestations of lung abnormality on initial scans were ground-glass opacity(GGO)(13 cases)and consolidation(12 cases),the average areas of which were 13％ and 10％ respectively.The treatment with antibiotics was ineffective.After treatment with corticosteroid,the lesions resolved completely in 2 patients ; the disease was decreased in extent in 8 patients ; and the lesion showed no change in extent in one patient,while the disease progressed in extent in 2 patients on follow-up CT.The most common CT findings were GGO(10 cases)and reticulation(5 cases),followed by consolidation(4 cases),the average areas of which were 19％,2％ and 1％ respectively.Conclusion The CT features of the patients with COP are characteristic.The most lesions resolved or improved after corticosteroid therapy on follow-up CT scans.The estimation of disease extent with semi-quantitative method is helpful for the clinicians to evaluate the therapeutic effect.

Objective To investigate clinical relevance of the acute Stanford B aortic dissection vascular repair time for treatment and prognosis.Methods A retrospective clinical data of our hospital treated 1 10 cases of vascular repair of acute aortic dissection type Stanford B were analyzed according to the onset to treatment time.They were divided into three groups:group A (onset to treatment time of 7 days),group B (onset to treatment time 14) and group C (onset to treatment time than 14 days);the three groups were observed after aortic repair status and prognosis related indicators.Results The true lumen false lumen diameter and maximum diameter ratio in group A was the largest (1.8 ±0.5),which was significantly higher than that of group B and group C (1.3 ±0.3)and (1.3 ± 0.2),the difference was statistically significant (F=7.352,P<0.05).Ratio of preoperative minimum true lumen diameter and the maximum diameter of the false lumen,ratio of postoperative maximum true lumen diameter and the maximum diameter of the false lumen were associated with the onset of the endovascular repair time,showed a negative correlation (r=-0.452,-0.281,all P<0.05).postoperative complication rate of group A was 12.8%,complica-tion rate of group B was 29.5%,complication rate of group C was 33.3%,data of group A was significantly lower than those of group B and group C,the difference were statistically significant (χ2 =4.024,4.721,all P<0.05).group A died three cases,group B had 1 patient died and in group C there was no deaths.Hospital stay and hospital costs of group A were significantly lower than those of group B and group C,the difference werestatistically significant (F=4.125,7.375,all P<0.05).Conclusion As soon as possible to implement acute aortic dissection stanford B aortic vascular repair could better improve outcomes,and reduce the cost of hospitalization and treatment.At the same time, it can reduce the incidence of complications and improve clinical safety.

Objective To evaluate the feasibility of precise hepatic segmentectomy or subsegmentectomy using intraoperative image-guided interventional intravascular segmental vessel balloon catheter occlusion of the segmental hepatic artery and portal vein.Methods 6 patients with liver resection carried out from 2011.3-2011.8 were retrospectively analyzed.Results The mean operating time was (270.83±21.31) min,the median of blood loss was 800 ml,the median of intraoperative transfusion volume was 450 ml.The tumors were mainly located in segments Ⅴ,Ⅵ,Ⅶ,Ⅷ.The mean diameter of tumor was (5.67±1.03) cm.Postoperative liver function in the first postoperative day showed the mean alanine aminotranferase (ALT) was (570.00±157.76) U/L,the mean aspirate aminotrarsferase (AST) was (410.00 ±189.94) U/L,and the mean total bilirubin (TBIL) was (10.83± 1.60) mmol/L.Liver function recovered to normal within 7 days.There was intestinal leakage and wound dehiscence in one patient,pleural and effusion in two patients.Conclusion Imageguided interventional intravascular segmental vessel balloon catheter occlusion was a safe and efficacious maneuver.This technique allowed hepatic segmentectomy or subsegmentectomy to be carried out,decreased intraoperative bleeding,and protected the function of the liver remnant.

[ ABSTRACT] AIM:To investigate the effects of tanshinone IIA ( Tan IIA) on proliferation, apoptosis and its mo-lecular mechanism in human hepatoma HepG2 cells under hypoxic condition.METHODS:Hypoxia model was established by treatment with cobalt chloride ( CoCl2 ) .The cells were divided into normoxia control group, hypoxia control group and hypoxia combined at different concentrations of Tan IIA groups.After HepG2 cells were incubated with different concentra-tions of Tan IIA (0.5, 1.0, 2.0, 5.0 and 10.0 mg/L) for 24 h, 48 h and 72 h under hypoxic condition, the cell prolifer-ation was determined by MTT assay.After Tan IIA was added to the media at different concentrations for 24 h and 48 h, the apoptotic cells were observed by Hoechst 33258 staining.The protein levels of hypoxia-inducible factor 1 alpha (HIF-1α) , vascular endothelial growth factor ( VEGF) and wild-type P53 were detected by Western blotting after cultured with different concentrations of Tan IIA for 48 h.RESULTS:Tan IIA inhibited the proliferation of HepG2 cells in a dose-and time-dependent manner.Tan IIA induced the typical morphology of apoptotic cells and increased the apoptotic rate in a dose-and time-dependent manner after treatment with 1.0 mg/L~5.0 mg/L for 24 h and 48 h under hypoxic condition. The protein levels of HIF-1αand VEGF were weakly expressed in HepG2 cells under normoxia but up-regulated after incu-bated under hypoxia for 48 h.The protein expression of HIF-1αand VEGF were decreased with the increase in the concen-tration of Tan IIA under hypoxia.The protein expression of wild-type P53 was increased with the increase in the concentra-tions of Tan IIA under hypoxia.CONCLUSION:Tan IIA significantly inhibits the proliferation and induces the apoptosis of human hepatoma HepG2 cells under hypoxia, which may be related to the down-regulation of HIF-1αand VEGF and up-regulation of wild-type P53.