Objective To explore the efficiency, complications and probability of preserving part renal function by local renal microwave ablation. Methods The fresh pig renal pelvis full filled with 30% diatrizoate meglumine and the dogs kidney taken arterial pyelography were both ablated with microwave. Dogs were divided into three groups: measuring temperature after ablation group, single point ablation both on the two kidneys group and double points ablation on unilateral kidney group. In measuring temperature after ablation group, DSA and pathology were performed immediately after ablation. In the other groups, DSA with blood and urine samplings were taken for routine tests including renal function right after the ablation and 10 days later. Results Experiment in vitro showed conspicuous renal pelvic contraction and convolution. The group under power rate of 70, 3 min produced urine leak easily. Preliminary test in vivo with DSA showed the disappearance of local kidney blood supply. The residual renal function was related to areas of necrosis. Acute stage pathology revealed acute renal cortex medulla and pelvic cells injury. DSA of chronic stage showed no change in size of the area of ablation. The blood supply of necrotic areas was not restored. The residual kidney possessed the excretion contrast medium with no urine leaks. Upper pole of right kidney adhered with adjacent tissue, together with thickened covering. Pathology revealed fibrous proliferation around the coagulative necrosis. Conclusion Microwave ablation can inactivate the local renal tissue, and, effectively preserve the big blood vessels and function of residual kidney. No urine leaks occurred in chronic stage but easily to produce adhesions with adjacent tissue.

Objective To discuss the DSA characteristics of primary hepatocellular carcinoma (HCC) and to investigate the relationship between the DSA findings and the expression of tumor’s vascular endothelial growth factor (VEGF). Methods Fifty-four patients with pathologically-proved primary HCC were enrolled in this study. The DSA findings, including tumor’s size, lesion’s number, lesion’s margin, the degree of blood supply, the presence or absence of artreiovnous shunting (AVS), etc. were observed and analyzed. The qualitative test of VEGF of HCC tissue was made by using Elivision TMplus method, and based on the stain degree and the percentage of the positive cells a comprehensive analyse was carried out. With HE stain the pathologic classification was conducted by using Edmmond method. In this study, grade I and II were regarded as well-differentiated group and grade III and IV were regarded as poorly-differentiated group. The data were processed by software SPSSS13.0 and the results were statistically analyzed. Results The expression degree of VEGF in HCC tissue was related to the blood supply pattern, the lesion’s number, the integrity of the tumor’s border and the degree of differentiation (P 0.05). Conclusion Some DSA manifestations of primary HCC bear a certain relationship to the VEGF content in the tumor tissue. Through observing the DSA characteristics, the assessment of the invasion and metastasis of HCC can be well made, which will afford the clinical physicians a useful reference in making individualized therapeutic schedule and in estimating the prognosis.

OBJECTIVE: To investigate the causes and features of medical disputes in percutaneous coronary intervention (PCI) in the cardiology and to provide references for forensic expert testimony and medical disputes prevention. METHODS: Fifty one disputed fatal cases in PCI were analyzed in terms of the cause of death, informed consent and medical operations retrospectively. RESULTS: Thirty five cases were due to medical negligence, 28 due to defect technical operation, 2 due to mistake medical management and 5 due to both defect technical operation and mistake medical management. CONCLUSION The causes of PCI medical negligence are defect medical operation, violate medical disciplines and insufficiency of informed consent.
Adult ; Aged ; Angioplasty, Balloon, Coronary ; Cause of Death ; Coronary Artery Disease/therapy* ; Expert Testimony ; Female ; Humans ; Male ; Malpractice ; Medical Errors/statistics & numerical data* ; Middle Aged ; Myocardial Infarction/etiology* ; Postoperative Complications/etiology* ; Retrospective Studies