According to program of vascular examination of diabetic foot, the first choice is vascular ultrasonography as the general survey, followed by CTA and MRA for assessment of bilateral lower extremities arterial morphological changes. Lastly, arterial angiography including DSA still remain as the gold standard for estimation. The main pathologic changes of diabetic foot including arteriolar and microvascular disorders induce the extemely important interventional treatment especially the local thrombolytic infusion to be the real practical management besides local PTA and stenting are furthermore in consideration. As a general metabolic disease, the serial treatment should also include promoting blood flow, removing blood stasis and improving microcirculation . Evaluation of interventional treatment for diabetic foot should undertake not only the vascular stenosis and restenosis ,but also the relief of clinical symptom and improvement of amputation level.

Objective Nowadays imaging-guided nonvascular interventional procedures are becoming increasingly important in musculoskeletal field. Percutaneous interventional procedures include a broad spectrum of minimal invasive techniques, involving diagnostic and therapeutic procedures. In this article we present our views and suggestions in percutaneous musculoskeletal biopsies, percutaneous periradicular steroids infiltration, diskography, percutaneous cementoplasty, percutaneous treatment of disk herniation, and percutaneous treatment of osteoid osteoma.

Objective To lower immunogenesis of human adult islets,reduce the dose of immunosuppressors and promote wide development of transplantation of adult islets,isolated adult islets were in vitro pretreated.Methods Isolated adult islets were cultured at 24 ℃ for 2 days(24 ℃ group) or pretreated using MHC-II monoclonal antibody(monoclonal antibody and complements were added and cultivated for another day following one-day-24 ℃-culture,antibody group) as observation groups.Adult islets were cultured at 37 ℃ in CMRL 1066 medium plus 20 % fetal bovine serum for 2 days as control.The immunogenics of the islets was detected using lymphocyte-islet mixed culture(MILC) and immunohistochemical staining of HLA-DR and lymphocyte common antigen(LCA).The function and activity of the islets were identified using()~3H-leucine incorporation assay,insulin release test and in situ apoptosis assay.Results Compared with control,MILC stimulation index was remarkably lower in the antibody group(P(0.05)).The percentage of HLA-DR and LCA positive cells in the antibody groupand in the 24 ℃ group was much lower than that in control(All P

The incidence of vascular malformations is very low, and its clinical manifestations are infinite in variety, from an asymptomatic birthmark to life-threatening massive bleeding, even to congestive heart failure. The pathogenesis of vascular malformations is still unknown, therefore, its effective treatment is a real challenge. With the development of interventional technology and the accumulation of clinical experience in ethanol embolization, in local direct puncture injection and in endovascular embolization, the ethanol embolization will hopefully become the therapy of first choice for this kind of complicate and intractable disorders.

Percutaneous sacroplasty is a technique, derived from percutaneous vertebroplasty, with minimal invasion and better safety for refractory sacroiliac pain. The procedure is involved with bone cement injected into the diseased sacral body under fluoroscopic or computed tomography guidance and in turn for stabilizing and strengthening the vertebral body with outcome of decrease or even complete relief of pain. The author introduces and comprehends the definition, preoperative imaging examinations, indications, contraindications, techniques and complications of the procedure.

0.05) but remarkable change after therapy was shown at one week later (P

The hypersplenism is a common disease caused by cirrhosis of different reasons. With the development of interventional radiology, partial splenic embolization (PSE) has been widely applied in clinical practice, especially in the treatment of secondary hypersplenism. There is a variety of embolization materials used in PSE, each has its own merits. Because of the anatomical characteristics of the splenic artery, the embolized volume and extent of the spleen will directly affect the therapeutic results. Peripheral blood test, immunological function, hemodynamics and hepatic function can be used to evaluate the effects of PSE. Owing to a variety of reasons, there are still some shortages of PSE in clinical practice, which are badly in need of being improved.

Objective To examine the association between vitamin D and alendronate response,and to investigate the proper vitamin D levels for the efficacy of alendronate treatment of osteoporosis.Methods In this retrospective study,559 post-menopausal women with osteoporosis were devided into two groups:non-responders and responders,based on the European Study of Forsteo (EUROFORS).Demographic and clinical data including mean 25-hydroxy vitamin D (25-OHD) levels between dual-energy X-ray absorptiometry (DEXA) scans were obtained.Mean 25-OHD levels were compared between responders and non-responders and multiple logistic regression analysis was performed to identify factors associated with non-response.Results There were 437 (75.5％) responsers to alendronate therapy and 142 (24.5％) non-responders.Responders with a mean serum 25-OHD level of (59.96 ±12.56) nmol/L,obtained a more favorable result than non-responders,whose serum 25-OHD level was (47.50 ±9.92) nmol/L (P＜0.01).25-OHD level was significantly associated with response.Conclusion Patients with a mean 25-OHD ≥50 nmol/L had a substantially greater likelihood of maintaining bisphosphonate response.

Objective To examine the relationship of body mass index (BMI) with levels of vitamin D,parathyroid hormone (PTH),and bone turnover markers among women in Shanghai area.Methods Altogether 810 Chinese women aged 45 year and older were enrolled to study the associations by multiple linear regression analyses.Bone mineral density was measured by a dual energy X-ray absorptiometry (Lunar,Prodigy,GE),Serum 25-hydroxyvitamin D [25 (OH) D],PTH,C-telopeptide of type Ⅰ collagen (CTX),osteocalcin (BGP),and bonespecific alkaline phosphatase (BSALP) were measured.Results (1) 25 (OH) D,BGP,BSALP,and CTX levels were significantly lower in obesity group than in control group ; PTH level was significantly higher in obesity group than in control group.(2) In multiple linear regression analyses,BMI was significantly associated with lower 25 (OH) D (β =-0.017,P =0.006),BGP (β =-0.077,P =0.019),and higher PTH (β =0.025,P =0.000).Conclusions (1) There were siginificant associations between higher BMI and lower 25 (OH) D among women in Shanghai.(2) Serum osteocalcin was associated not only with bone metabolism but also with energy metabolism.

Objective To explore the diagnostic value of five infection markers in bloodstream infection.Methods Randomly selected 110 bloodstream infection patients with positive blood cultures and 30 bacterial infection patients with negative blood cultures.Blood was simultaneously drawn with blood cultures;the complete blood count and C-reactive protein (CRP) levels were measured.The white blood cell count (WBC),neutrophil count (NEU),lymphocyte count (LMY),CRP level and neutrophil-lymphocyte count ratio (NLCR) were compared between the two groups.Results The levels of WBC,NEU,NLCR and CRP in bloodstream infection group were significantly higher than those in control group (P＜0.05),while LYM was significantly lower than that in control group (P＜ 0.05).Among these five infection markers,the area under the receiver operating characteristic curve (ROC-AUC) was the highest for NLCR (0.808) and LMY (0.756);when the cutoff value for NLCR was ＞9.33,sensitivity was 63.6％,specificity was 93.3％;and the cutoff value for LYM was ≤0.97,sensitivity was 58.2％,specificity was 86.7％.Furthermore,the NLCR of patients with gram-negative bloodstream infection was higher than those in patients with gram-positive bloodstream infection.NLCR showed important clinical significance in distinguishing strains of different bloodstream infections.Conclusions NLCR is the better predictors than routine parameters in diagnosing bloodstream infection.