This paper aims to summarize the clinical application of interventional technique via portal venous system, laying stress on the necessity of reinforcing, improving and comprehensively applying this interventional technique, and to provide new conception concerning the diagnosis and therapy of the diseases involving portal venous system.

With the progress of imaging techniques, the diagnosis rate for portal vein thrombosis (PVT), that is used to be considered as a rare disease, has been rapidly increasing. PVT can be caused by systemic reasons such as various thrombophilic risk factors as well as a lot of local reasons such as cirrhosis, abdominal trauma and infection, malignant tumor, etc. At present, PVT is classified into acute and chronic entities based on the duration of clinical symptoms as well as on the presence or absence of portal cavernous transformation. The clinical manifestations and the treatment principles of the acute and chronic PVT are quite different. For acute PVT, the principle of treatment is to reopen the obstructed portal vein and to prevent the thrombus from entering into the superior mesenteric vein, while for chronic PVT the principle of treatment is focused on the management of the complications due to portal hypertension. The interventional management of portal thrombus plays an important role in reopening portal vein, reducing complications caused by portal hypertension, and restoring portal blood flow, etc. This paper aims to make a comprehensive review about the etiology and management of portal vein thrombosis.

Bnip3,a kind of mitochondrion apoptosis gene,belongs to the Bcl-2 gene family and BH3-only subfamily.It is one of the downstream response factors of hypoxia inducible factor (HIF).Bnip3 can induce cell apoptosis and autophagy under the oxygen deficit condition.Many studies show that Bnip3 is closely related to the occurrence,development and treatment of tumors.Molecular targeting treatment aimed at Bnip3 combined with chemoradiotherapy has preferable application foreground in tumor therapy.

Background: CT scan of hepatic carcinoma after transarterial embolization with Lipiodol (LP-TAE) will be influenced. A comparative study was made between CT scan and hepatoarteriography in hepatic carcinomas fully filled with Lipiodol after TAE for the purpose of demonstrating the difference. Materials and Methods: 20 cases of hepatic carcinoma fully filled with Lipiodol after TAE 1 to 8 months, confirmed by CT scans. Hepatoarteriography were then done 1 to 14 days afterwards. The demonstration of the original and new foci were thus be compared respec- tively by these methods. Results: The original tumor lesions were all stable on CT scans and new tumor lesions were found in 5 cases. Three features were found in arteriographies of the original tumor lesions: (1) stable, no obvious tumor vessels and stain; (2) tumor vessels and stains confined within the LP accumulated areas; (3) largely increased lesions exceeding the LP accumulated areas; (3)largely increased lesions exceeding the LP accumulated areas. Also other three features were found in new tumor lesion: (1) multiple intrahepatic daughter nodules; (2)small arterioportal shunts; (3) new masses. Conclusion: (1) Although good results had been archieved, but the lesions were not stabe in many of them. Long interval follow-up and TAE were not suitable. (2) Stage-Ⅱ surgical resection should be taken cautiously. (3) New techniques of CT scan and superselective he- patic arteriography with high flow rate should be adopted to improve the accuracy rate of de- monstrating tumor lesion.

Objective To evaluate the value of dynamic contrast-enhanced MRI (DCE-MRI)in the assessment of cervical cancer with different features.Methods A cohort study of 1 56 cervical cancer patients underwent routine MRI and DCE-MRI scanning on 3.0T MR unit.The semi-quantitative parameters from time-signal curve of DCE-MRI were divided into the following groups:1 ) squamous carcinoma and adenocarcinoma.2)different pathologic grades of cervical cancer (G1,G2,G3).3)early stage (FIGOⅠb/Ⅱa)tumor and advanced tumor (FIGOⅡb,Ⅲ and Ⅳ).4)cervical cancer with different lymph node status (no/yes).5)cervical cancer with dif-ferent tumor size (greatest diameter <2 cm,2-4 cm,>4 cm).6)cervical cancer with different age range.Statistical analysis was performed with the data analysis program SPSS and R3.1.1.Results There was a statistically significant difference between the squamous carcinoma and adenocarcinoma in the SI30s% and Slope,as well as between the tumor FIGO early and advanced stage in TTP and Slope.There was no significant difference among other groups.Conclusion The semi-quantitative parameters from time-signal curve of DCE-MRI can be used to differentiate histologic type and FIGO early/advanced stage of cervical cancer.The diagnostic accuracy may be high for Slope for histologic type differentiation,and the diagnostic accuracy is equal for TTP and Slope in differenti-ation of FIGO early and advanced stage of cervical cancer.

[Objective]To evaluate the possibility and clinical value of total en bloc spondylectomy for the treatment of spinal tumors. [Method]Four cases of primary tumor of the thoracolumbar spine were treated with total en bloc spondylectomy TES through a single posterior approach performed in three cases(T10 solitary plasmacytoma,T8 hemangioma,and T12 hemangioma),and one case through a single stage anterior and posterior combined approach(L4 neuroblastoma with paraspinal mass).Improvements in osteotomy apparatus and surgical technique of TES were investigated.[Result]All patients attained significant clinical improvement after surgery without any severe complications.Patients were observed for 13 to 22 months.There was no local recurrence and distal metastasis by the last follow-up.[Conclusion]Total en bloc spondylectomy includes resection of the involved vertebra in two major blocs,rather than a piecemeal pattern.It is one of the most effective therapies for spinal tumors.Howerer,some components of TES remain to be further improved.

Objective To investigate the curative effect and influential factors of small hepatocellular carcinoma (SHCC) treated by interventional therapy. Methods 42 patients with SHCC were treated by interventional therapy. Some possible prognostic factors were analysed with COX proportional hazard regression model. Results (1)Hepatic arteriographic manifestations: 26 of 42 cases SHCC revealed rich tumor vessels, 37 had tumor stain including 34 with nodular stain. (2)The overall 1 , 3 , 5 year survival rates of SHCC using Kaplan Meier method were 88%(37/42),74%(31/42),51%(21/42), respectively. (3)Clinical staging and typing of the patients,and accumulation of Lipiodol within the tumor obviously influenced interventional effects of SHCC. Conclusion (1) The most important diagnostic angiographic sign of SHCC is tumor staining, besides tumor vessels. (2) Interventional therapy of SHCC has an ideal effect and should be an important nonoperable curative method.

Objective To investigate the effects of emulsified isoflurane preconditioning on lung ischemia-reperfusion (Ⅰ/R) injury in rats.Methods Thirty-two male Sprague-Dawley rats,weighing 250-320 g,were randomly divided into 4 groups (n =8 each) using a random number table:sham operation group (group S),group Ⅰ/R,intralipid group (group IL),and emulsified isoflurane preconditioning group (group EI).Lung Ⅰ/R was produced by clamping the left hilum of lungs for 1 h followed by 2 h of reperfusion in anesthetized rats.In group S,intraperitoneal normal saline 10.5 ml/kg was injected,but the hilum was only exposed 24 h later.In groups Ⅰ/R,IL and EI,intraperitoneal normal saline 10.5 ml/kg,30％ intralipid 10.5 ml/kg and 8％ emulsified isoflurane 10.5 ml/kg were injected intraperitoneally,respectively,and then the model was established 24 h later.At the end of reperfusion,blood samples were collected from the left ventricle for measurement of PaO2,PaCO2,plasma malondialdehyde (MDA) concentration (by ELISA).The rats were then sacrificed,and left lungs were removed immediately for microscopic examination and for determination of myleoperoxidase (MPO) activity (using colorimetric method) in pulmonary specimens.Wet/dry lung weight ratio (W/D ratio) was calculated.Results Compared with group S,W/D ratio,MPO activity,plasma MDA concentration and PaCO2 were significantly increased,and PaO2 was decreased in the other three groups.Compared with group Ⅰ/R,W/D ratio,MPO activity,plasma MDA concentration and PaCO2 were significantly decreased,and PaO2 was increased in IL and EI groups.W/D ratio,MPO activity,plasma MDA concentration and PaCO2 were significantly lower,and PaO2 was higher in group EI than in group IL.The pathological changes of the lung were significantly attenuated in group EI compared with group Ⅰ/R.Conclusion Emulsified isoflurane preconditioning can reduce lung Ⅰ/R injury in rats,and inhibition of pulmonary inflammatory responses and of production of oxygen free radicals are involved in the mechanism.

Objective To observe the clinical efficacy of acupuncture in treating primary hypertension and the effect of twirling reinforcing-reducing manipulations on the treatment of primary hypertension. Methods Totally 126 patients with primary hypertension were randomized into treatment group 1 of 40 cases, treatment group 2 of 44 cases, and a control group of 42 cases. The treatment groups were both intervened by acupuncture at Quchi (LI 11), while twirling reinforcing-reducing manipulations (twirling towards left) were applied in treatment group 1, while the manipulations (twirling towards right) were applied in treatment group 2;the control group was intervened by medication. The change of blood pressure after 10 min treatment was observed, and the clinical efficacies were compared. Results The total effective rate was 85.0%in treatment group 1, versus 88.6%in treatment group 2 and 61.9% in the control group, and the total effective rates in the two treatment groups were significantly different from that in the control group (P<0.05). In the two treatment groups, the systolic pressure and diastolic pressure respectively after 10 min treatment and 30 min treatment were markedly different from those 10 min before treatment in the same group (P<0.05). In the two treatment groups, the systolic pressure and diastolic pressure after 30 min treatment were markedly different from those after 10 min treatment in the same group (P<0.05). In the control group, the systolic pressure and diastolic pressure were significantly different from those 10 min before treatment in the same group (P<0.05). There were no significant inter-group differences in comparing the systolic pressure and diastolic pressure after 30 min treatment (P>0.05). Conclusions Acupuncture at Quchi (LI 11) is an effective approach in treating primary hypertension, and the reinforcing manipulation and reducing manipulation are both effective.