Objective To explore the embolization technique,embolus choice and preventing complications of transcatheter internal iliac artery embolization in treating pelvis massive hemorrhage.Methods Bilateral selective internal iliac artery embolization utilizing gelfoam was done in 11 patients of pelvis massive hemorrhage (including 3 cases of bladder carcinoma,5 cases of cervix carcinoma,one case of choriocarcinoma and 2 cases of puerperal hemorrhage.Results Prompt hemostasis was obtained immediately after first embolization in all 11 patients,one of them showed recurrent bleeding after 24 hours and underwent treatment again.Patients were followed up for 10~90 days,no hemorrhage or any kind of complication noted in all patients.Conclusion Transcatheter internal iliac artery embolization is a simple,less invasive,safe and effective therapy for pelvis massive hemorrhage,should be taken as the first choice.

Objective To study the methods,therapeutic effect and complications of transcatheter uterine artery embolization(TUAE)for hysteromyoma.Methods There were 82 patients with hysteromyoma confirmed by clinical,color Doppler ultrasound and CT in this study.Among them,5 hysteromyoma located under mucous membrane,72 in the myometrium,5 under serous membrane.15 cases were single hysteromyoma,67 were multiple hysteromyoma.Bilateral uterine arteries were embolized with lipiodol-pingyangmycin emulsion(LPE)and Gelfoam particles using Seldinger technique.All patients were followed up for 3 to 6 months.Results The successful rate of catheterization almost reached 100%.B-mode ultrasound examination 3 months after the procedure showed averagely 51% of decrease in volume of the masses and decrease of blood flow of tumors in all cases,the volume of tumors decreased 43% and 19 hysteromyoma disappeared for 6 months later.Menses returned to regular cycle.In the patients with anemia,the hemoglobin concentration recovered to normal level.The rate of complication was 6%(5/82),and recovered to normal after special treatment.Conclusion TUAE is an effective and less invasive way to treat hysteromyoma,the complications of TUAE are preventable and curable.

Objective To investigate the cytotoxicity of vascular endothelial growth factor (VEGF) siRNA combined with fusion suicide gene yCDglyTK on human gastric cancer cell line in vitro.MethodsThe gastric cancer cell line SGC7901 was transfeeted with blank plasmid pcDNA3.1 (-) null [pcDNA3.1 (-) group], or VEGF-siRNA expression plasmid pGenesil-shVEGF (SGC7901/shVEGF group),or fusion suicide gene plasmid pcDNA3.1 (-)CV-yCDglyTK (SGC7901/CDTK group),or combined gene plasmid pcDNA3.1 (-)shVEGF-yCDglyTK (SGC7901//shVEGF-CDTK group) with calcium phosphate nanoparticles (CPNPs).Un-transfected gastric cells were set as control group.The stable transfected cells were selected by G418.The target gene expression was verified by RT-PCR and Western-blot.After given prodrug 5-fluorocytosine (5-FC), the biologic characters variation, apoptotic morphology and apoptotic rate of cells in each group were observed through cell growth curve by MTT assays, by-stander effect, Hoechst 33258 staining and flow cytometry.The data was analyzed with SPSS 13.0 software and multiple groups’ comparison was analyzed with LSD test.ResultsFour gastric cancer cells lines transfected with different plasmids were successfully established.The expression of gene yCDglyTK was detected both in SGC7901/CDTK cells and SGC7901/shVEGF-CDTK cells.By MTT assays, the cell growth curve indicated that the A570 value of SGC7901/shVEGF cells, SGC7901/CDTK cells and SGC7901/shVEGF-CDTK cells decreased significantly compared with that of SGC7901 and SGC7901/null cells after a 24-hour 5-FC treatment (P＜0.01).When the percentage of stable gene trasfected SGC7901 cells was 60％, 80％and 100％, the cell relative viability was 13.09％±2.40％, 9.74％±2.83％ and 5.68％±1.03％,respectively. A large number of cells in SGC7901/CDTK and SGC7901/shVEGF-CDTK group appeared typical apoptotic morphology under fluorescence microscope.The result of flow cytometry showed that the apoptosis rates in SGC7901/shVEG group、 SGC7901/CDTK group and SGC7901/shVEGF-CDTK group were 16.40％ ±4.68％, 57.63％ ± 4.96％ and 69.07％ ± 4.69％,respectively, and there were significant differences compared with control (P＜0.01).Conclusion VEGF siRNA combined with suicide gene can effectively kill gastric cancer cell line SGC7901.Apoptosis induction may be one of the important mechanisms of killing tumor cells.

Objective To evaluate the effects of different strategies on short-and long-term clinical outcomes of renal transplantation in Chinese subjects.Methods 2520 renal transplantations were retrospectively evaluated,including 2490 first renal transplantations and 30 second renal transplantations.Triple-immunosuppressant including cyclosporine A,azathioprine or myeophenolate mofetil(MMF)and prednisone(Pred)was adopted.Patients receiving kidney transplantation were given low dose immunosuppressants since 2000.Immunosuppressants including tacrolimus,MMF and Pred were adopted in some patients since 2000.Risk factors leading to graft loss and patients'death were analyzed.Results Until the cut date of June 30,2009,135 patients lost follow-up,and the follow-up rate was 94.6%.Incidence of acute(within 6 months post-transplantation) rejection was 18% among 2520 patients.Incidence of acute rejection (within 6 months post-transplantation) was 25.7% in panel reactive antibody (PRA) positive patients,significantly higher than 17.0% in PRA negative patients(P<0.05).Incidence of acute rejection within 6 months post-transplantation was 16.9% in HLA mismatches<4 patients,significantly lower than 23.7% in HLA≥4 patients (P<0.01).Total patient/death censored graft 1-,3-,5- and 1O-year survivals were 94.5%/96.0%,91.6%/93.1%,88.5%/90.1% and 81.7%/80.6%,respectively.Acute rejection and immunosuppressant regimen were independent risks for allograft loss.1mmunosuppressant regiment,pulmonary infection,cardio-brain-vessel accident, hepatic failure and tumor were independent risks for patients' death.Conclusion Renal allograft and patient survival appeared to be improved by optimal immunosuppressant regimen,strict HLA match and efficient post-transplant complication prophylaxis.