Objective To prospectively investigate superselective renal arterial embolization (SRAE) in the treatment of iatrogenic renal hemorrhage MethodsFrom November 2005 to November 2010,19 patients with iatrogenic renal hemorrhage in the Affiliated Hospital of Hangzhou Normal University underwent diagnostic renoarteriography to reveal the site and degree of renal artery rupture,then superselective embolization by coins,or coins combined with spongia gelatinosa were performed for these patients.Results Renal arteriography showed hemorrhage was located at the renal segmental arteries and/ or their branches ( 9 cases at segmental renal artery,6 cases at interlobar artery and 4 cases at arciform artery),two cases were found with simple hemorrhage of segmental renal artery ( SRA ),9 cases with pseudoaneurysm,5 cases with arterio- venous fistula (AVF),3 cases with pseudoaneurysm combined with AVF.Seventeen cases received embolization with coins,while 2 cases with pseudoaneurysmes received embolization with coins and spongia gelatinosa at the same time.Bleeding was successfully ceased immediately and did not recur in all cases.Conclusions Superselective renal arterial embolization could be considered as a safe and effective method to treat hemorrhage of iatrogenic renal vascular injuries..

Objectives To investigate the risk factors of cardiorenal syndrome type 1 (CRS1) in patients with acute myocardial infarction (AMI).Methods The medical date of hospitalized patients with AMI from January,2013 to February,2014 in Hunan Provincial People~ Hospital were reviewed.A total of 265 patients with AMI was divided into CRS1 and non-CRS1 groups.The univariate comparison and multivariate Logistic regression analysis were performed to obtain the CRS1 risk factors.Results In the 265 AMI patients,CRS1 was found in 59 patients (22.3％).Age,history of diabetes,Killip classification,left ventricular ejection fraction (LVFF),baseline serum creatinine,blood urea nitrogen,uric acid,baseline evaluated glomerular filtration rate (eGFR),serum sodium,the left anterior descending artery lesion,emergency percutaneous coronary intervention (PCI),β-blocker,and angiotensin converting enzyme inhibitor/angiotensin receptor antagonist (ACEI/ARB) were statistically different between CRS1 and non-CRS1 groups (all P ＜ 0.05).Multivariate logistic regression showed that age,history of diabetes,Killip classification,reduced LVEF,reduced eGFR,hyponatremia,the left anterior descending artery lesionn,emergency PCI non-undergo,and β-blocker non-use were independent risk factors for CRS1 after AMI.Conclusions CRS1 is a common complication in AMI patients,which is associated with many factors.Our data suggest that patients with AMI should be more comprehensively assessed and monitored,thereby preventing the occurrence of CRS1.

Amino Acids ; urine ; Animals ; Biogenic Monoamines ; metabolism ; urine ; Male ; Microwaves ; Rats ; Rats, Wistar

Humans ; Sinus of Valsalva ; Death, Sudden, Cardiac/etiology* ; Coronary Stenosis/complications*

Objective: To develop a new rat model for studies of enteral nutrition support.Methods: After acute pancreatitis models induced by laparotomy,32 SPF rats were put a catheter always used for epidural anesthesia, through pylorus to 5 cm of jejunum below Treitz ligament, and sutured and fixed apart at the entrance, stomach, peritoneum, neck, and the tail, which then connected to an one-time infusion tube. By regulating the infusion tube on the pulley, the enteral nutrition input was kept uniform.Results: The routes All rats were successfully built in all rats for TEN, with an average input time of 7days in which rats well tolerated without diarrhea. All rats got positive nitrogen balance after TEN for 3-4 days. No extrusion, bending, or leakage of the infusion tubes happened.Conclusion: This rat model of enteral feeding had advantages of simplicity, firmness, reliability and cheapness, which could be used in large-scale and fulfill the need of experimental EN study in small animals like rats.

OBJECTIVETo investigate the early clinical efficacy of induced membrane technique for reconstruction of large bone defects after debridement in adults with chronic osteomyelitis of limbs.

METHODSFrom March 2010 to March 2012,a total of 23 adult patients with chronic osteomyelitis of limbs were treated in our department. There were 15 males and 8 females, with a mean age 35.2 years old (ranged from 26 to 49 years old). Sixteen patients had open fracture history. According to the lesion site, there were 12 cases of tibia, 7 cases of femur, 3 cases of humerus, and 1 case of both radius and ulna. Among them, 19 patients had diseases in diaphysis and 4 patients in the metaphysis. The mean interval from infection to operation was 6.9 months (ranged from 4 to 13 months). All the patients were treated by using induced membrane technique. The follow-up evaluation included clinical complications, time of bone healing and limbs function. The Chinese version of SF-36 scores was used in the assessment of quality of life pre- and post-operation.

RESULTSThe average duration of follow-up was (27.6 ± 5.3) months (ranged from 18 to 43 months). Two patients had postoperative flap edge necrosis, 1 patient had superficial iliac incision infection, no obvious complications were recorded. Twenty patients obtained radiological union at a mean time of 4.6 months (ranged from 3 to 7 months). Among them, 16 patients treated with lower limbs surgery achieved full weight-bearing at about 5.2 months (ranged from 4 to 8 months) postoperatively. Four patients suffered from reinfection during follow-up, but 3 of them achieved complete bone healing after the second surgeries with induced membrane technique. At the final follow-up, there was a substantial improvement in each dimension scores and total scores of SF-36 as compared with those before surgery.

CONCLUSIONWhen treating with adult chronic osteomyelitis of limbs, the induced membrane technique can effectively reconstruct large bone defects after debridement, significantly shorten treatment cycle, provide satisfactory results with minimal complications, promote good recovery of limbs function and require relatively simple operation technique.

Adult ; Chronic Disease ; Extremities ; surgery ; Female ; Humans ; Male ; Middle Aged ; Osteomyelitis ; surgery ; Reconstructive Surgical Procedures ; methods

Objective To investigate the correlation between serum homocysteine (HCY) and chronic heart failure (CHF) hypercoagulable state in patients.Methods A total of 105 cases of patients with CHF was divided into three groups according to the New York Heart Association (NYHA) classification standard functions:heart functional grade Ⅱ group (42cases),cardiac function grade Ⅲ group (35 cases) and,NYHA class Ⅳ group (28cases).At the same time,40 healthy individuals were regard as the control group.HCY,fibrinogen (Fbg),D-dimer (DDI),HCY,N-terminal pro-brain natriuretic peptide (NT-proBNP) were detected by fasting venous blood samples which were collected within 24 hours after admission.Results Compared to the control group,the expression of Fbg,DDI,HCY and NT-proBNP increased,whereas,antithrombin Ⅲ (AT-Ⅲ) was reduced.Fbg,DDI,HCY,NT-proBNP,and AT-Ⅲ were found in all patient cases.Four groups were compared with each other,except for cardiac function Ⅱ group and the normal group had no significant difference between them (P ＞ 0.05),the difference between both other groups was significantly different (P ＜ 0.05),HCY had a positive correlation with Fbg,DDI,and NT-proBNP (r =0.268,0.295,and 0.404,P ＜ 0.05),and negative correlation with AT-Ⅲ (r =-0.240,P ＜ 0.05).Conclusions HCY might be a reliable indicator as a judge of CHF patients with hypercoagulable state,to detect HCY,FBG,DDI,and AT-Ⅲ in CHF patients.It benefits for judging thrombosis risk and determining the severity of the diseases.Anticoagulant therapy might be beneficial to reduce the long-term adverse events.

Objective To analyze the imaging findings of osteosarcomatosis, and to explore the value of imaging in the diagnosis of osteosarcomatosis.Methods Clinical data and imaging findings in 15 cases of osteosarcomatosis were reviewed.All of them had conventional X-ray films, 13 cases had CT scanning, 11 cases had ECT scanning, 5 cases had MR scanning, and 4 cases with DSA.Results Eight primary lesions were located in the distal femur, 5 in the proximal tibia, 1 in humerus, and 1 in clavicle.Secondary lesions were scattered in proximal tibia in 8, distal femur in 6, spine in 6, pelvis in 2, and other sites.The primary lesion showed typical X-ray finding of osteosarcoma, but lesions at other position showed mainly high density of osteogenesis in all 15 cases.In 13 cases, CT played an important role in defining the extent of the tumor and soft tissue masses.CT scanning was sensitive in detecting osteosclerotic lesions in the bone marrow.In 5 cases, MRI was useful in delineating the extent of tumor and soft tissues mass, as well as the extent of tumor in bone marrow.ECT had the capacity of showing the radionuclide concentration of tumor focus in the whole body in a single scan in 11 patients.Conclusion Osteosarcomatosis has multiple lesions all over the body.Imaging modalities including X-ray plain film, CT, MRI, and ECT are all important in finding the lesions and in diagnosing osteosarcomatosis.