Objective To evaluate the efficacy and clinical value of percutaneous transluminal angioplasty(PTA)with stenting for the treatment of superior vana cava syndrome(SVCS)with malignant causes.Methods A total of 13 patients with SVCS with malignant causes were enrolled in this study.Among the patients,2 had mediastinal cancer,and 11 had metastatic mediastinal tumor.The malignancy of the primary tumors of the 11 patients,including pulmonary cancer in 8,esophageal cancer in 2,and breast cancer in 1,were all confirmed by pathological examination.Via the right femoral vein,a pigtail catheter was introduced percutaneously into the proximate or remote end of the stenotic segment for the visualization of the SVC.After the location,length,and gravity of the stenosis were determined,Wallstent(Boston Scientific,USA)was placed into the SCV,if the patients had no local thrombosis in the stenotic segment.In one patient,a Z-shape stent(COOK,USA)was inserted simultaneously.For the cases complicated with thrombosis,the Wallstent was inserted after local thrombolysis.Results The procedure was completed in all the 13 patients with a success rate of 100%.The average length of the stenotic segment was 4.3 cm(3-6 cm).In one patient,two stents were used,while in the others only one stent was inserted.Thrombolysis was carried out before stenting in 6 patients.The intravenous pressure at the proximate end of the stenotic segment was determined with the patients supine before and after stenting.The pressure decreased from(26.2?1.6)cm H2O to(4.3?0.8)cm H2O after the operation.Postoperative angiography showed no collateral vein in the patients.The SCVS disappeared 0 to 3 days after the surgery.The patients were followed up for 8-26 months with a median of 13.During this period,8 patients died of multiple organ failure caused by multiple metastasis of the primary tumor in 4 to 10 months;the other 5 patients survived(3 of them received further therapies)without recurrence of SCVS.Conclusion PTA with stenting combined with local thrombosis is an effective and invasive treatment for patients with SCVS with malignant causes.

Objective To evaluate the effectiveness and method of intraarterial embolization in treatment of hepatic cavernous hemangioma. Methods 17 patients,8males and 9 females, were treated by super selective hepatic artery embolization with iodized oil, gelfoam pieces, and embolization coils. Results All patients had been embolized successfully. The rate of success was 100%. 11 cases were followed up by CT/USG for 1～12 months. The size of tumor was decreased more than 50% in 8 cases, more than 30% in 2 cases, and the effect was uncertain in 1 case. Symptoms of 11 patients were disappeared and relief was obvious in 5 cases.Total effective rate was 94% with no significant complications. Conclusions HAE is a safe and effective method. It may be considered as the first method of choice in treatment of hepatic cavernous hemangioma.

Objective To evaluate the effect of simpler and chemotherapeutic renal artery embolizations in the treatment of renal carcinoma preoperatively Methods 19 patients including simpler renal artery embolizaiton group( n =8) and chemotherapeutic renal artery embolization group( n =11) were retrospectively studied. The surgical procedures were recorded and pathology sections were observed for all the patients. Results All the preoperative embolization were achieved successfully. We found vessels obliteration of the renal carcinoma in the operation. In pathology, the tumor had clear border with the necrosis. Conclusions Preoperative renal artery embolization could decrease the risk in operation, and had positive effects on the prognosis of these patients.

Objective To evaluate the effectiveness of pulmonary embolectomy by cathether for the treatment of acute pulmonary embolism. Methods 38 cases were diagnosed pulmonary embolism by pulmonary angiography, treated by thrombus fragmentation and suction by cathethers, and local fibrinolysis. The symptoms, PaO 2, PAPM and pulmonary arteries were observed after the procedure. Results 36 patients survived and showed clinical improvement with significant decrease in PaPm and increase in PaO 2( P

Objective: To investigate changes of plasma glucagon level in patients with heart failure (HF) caused by coronary heart disease (CHD) and its clinical significance. Methods: A total of 30 HF patients caused by CHD were selected as HF group, another 30 healthy subjects with corresponding age and gender were regard as normal control group. HF patients received comprehensive therapy of enhancing myocardial contractility, diuretic and vasodilator of 7~10d according to Chinese diagnostic and treatment guideline of chronic heart failure. Changes of glucagon level before and after treatment were observed. Results: Before treatment, plasma level of glucagon in HF group was significantly higher than that of normal control group [(205.67±120.22) ng/L vs. (90.53±20.5) ng/L, P<0.05]. After treatment, plasma level of glucagon [(120.42±30.33) ng/L] significantly decreased than before treatment (P<0.05) in HF group. Conclusion: Plasma glucagon significantly increases in patients with heart failure and gradually decreases to near normal level after treatment. Glucagon level may be regard as one of indexes judging patients’ condition.

Objective To evaluate the clinical effect of infrapopliteal arterial balloon angioplasty in the treatment of ischaemic diabetic lower limbs.Methods 53 cases of ischaemic diabetic lower limb containing 64 ischeamic limbs were treated with infrapopliteal angioplasty by Amphirion Deep Balloon.Observation of clinical remission including the ulcers was carried out before and after the procedure.Results 119 ateries of the 53 cases were chosen for PTA and 101 PTA in 50 cases were accomplished,with technical success rate of 84.9%.All the 50 patients got clinical remission including the shrinkage of ulcers and none amputation.Conclusin Infrapopliteal arterial angioplasty is effective,minimal invasive and safe for the ischaemic diabetic lower limbs.

Objective To demonstrate the pharmacokinetic characters of cisplatin in isolated prefusion of dog pelvic.Methods Pelvic isolated perfusion with the balloon occlusion was performed in 11 dogs.Blood samples of perfusion and non-perfusion regions were assayed for platinum using atomic absorption spectrophotometer.Pharmacokinetic characters of cisplatin were analized. Results C_(pel max) 30.3 ?g/ml,and C_(sys max) 4.8 ?g/ml,and AUC_(pel 0～25min) 330 ?g/ml?min were observed in perfusion area.AUC_(sys 0～25min) in non-perfusion area was 56 ?g/ml?min. Conclusions Balloon catheter-mediated pelvic I-P has favorable pharmacokinetic characters for chemotherapeutics and therefore should be an alternative method to treat pelvic neoplasma.

Objective To evaluate the accuracy of multi-slice CT(MSCT) angiography in detection of carotid artery stenosis. Methods A total of 29 consecutive patients with known or suspected carotid artery disease were studied by MSCT. The results were compared with quantitative carotid angiography.Results In the 203 carotid arteries of 29 patients, 22 of 24 carotid arteries with significant stenosis ( ≥ 30% reduction of vessel diameter) were correctly detected by MSCT,and 171 of 179 carotid arteries with normal or mild stenosis ( ＜ 30% reduction of vessel diameter) were correctly detected by MS CT. These values corresponded to sensitivity of 91.7% (22/24), specificity of 95.5% (171/179), positivè predictive value of 73.3% (22/30), and negative predictive value of 98.8% ( 171/173 ) for the detection of significant carotid artery stenosis by MSCT. In the 203 carotid arteries of 29 patients, 14 of 14 carotid arteries with high-grade stenosis were correctly detected by MSCT,and 186 of 189 carotid arteries with normal or mild stenosis were correctly detected by MSCT. These values corresponded to sensitivity of 100.0%(14/14), specificity of 98.4% (186/189), positive predictive value of 82.4% (14/17),and negative predictive value of 100.0%(186/186) for the detection of high-grade carotid arteries stenosis by MSCT. Conclusions MSCT angiography shows significant carotid artery stenosis with high accuracy. It may be used as an alternative for carotid angiography in detection of carotid artery stenosis.

Objective To develop a real-time PCR assay for the rapid identification of Clostridium(C.)difficile and its toxin. Methods TaqMan real-time PCR was developed for the rapid identification of species specific gene(tpi)of C. difficile strains and the toxins A(TcdA),B(TcdB) and truncated toxin A(TcdAT). Sensitivity,specificity and anti-interference ability of these methods were estimated,as well. Feces sampled from fifty diarrhea patients were tested by real-time PCR and compared to the results from VIDAS assay. Results The detection limits of tpi were 6×10-2 CFU/μl and 6 × 10-1 CFU/μl in the non-oxin producing and toxin producing strains,respectively. The coefficients of variability (CV) of intra-assay and inter-assay for the detection limits of tpi in the non-toxin producing strain were 2.1% and 2.3%. The CVs of intra-assay and inter-assay for the detection limit of tpi,tcdA,tcdB and tcdAT in the toxin producing strain were 3.0%and 3.4%,2.9%and 3.2%,5.3%and 5.7%,2.7%and 2.8%,respectively. No interferance was detected from other genus or species in clostridium. From 50 clinical samples,thirty-nine of them were negative and six of them were positive under the TaqMan-MGB probe technique in accordance with VIDAS. Five samples appeared positive using the TaqMan-MGB probe technique,in which 3 were dubious and 2 were negative under VIDAS. Conclusion The newly developed method was a sensitive and reliable assay for rapid identification of C. difficile and its toxin. This method could be used to screen C. difficile isolates harboring truncated toxin A to avoid misdiagnosis,clinically.