Objective To investigate the value of transcatheter thrombolysis treatment of acute A V internal fistula thrombogenesis in hemodialysis patients. Methods The acute A V fistula thrombogenesis in 32 hemodialysis patients with chronic renal failure were treated with transcatheter pulse spray pharmacomechnical thrombolysis (PSPMT). Results Acute A V fistula thrombogenesis was verified in all 32 patients by angiography and treated with transcatheter PSPMT. The immediate clinical success rate of thrombolysis was achieved in 97% except for one case. The A V fistulas were proved to reopen by post treatment angiography. Recurrent thrombosis was found in 4 cases, reopenning with transcatheter PSPMT was achieved in 2 of them and the rest 2 cases were undergone PTA because of localized vascular stenosis. All the 32 A V fistulae, were reopened after treatment without serious complications such as hemorrhage, pulmonary embolism and others.Conclusions Transcatheter PSPMT is a safe, effective and microinvasive treatment for acute A V fistula thrombolysis with higher immediate reopenning rate. Transcatheter PSPMT combined with PTA and intravascular stent grafting can improve long term patency rate.

In the progress of viral hepatitis, lymphocytes migrate and infiltrate liver tissues, which is relevant to antiviral therapy.However, the related mechanism is still poorly understood.In recent years,CXC chemokine ligand (CXCL)10 and its receptor CXCR3 have been extensively studied.The interaction between CXCL10 and CXCR3 would be a breakthrough point for study of the mechanism of viral hepatitis pathogenesis.This article reviews the research advances of CXCL10 in the progression of viral hepatitis and in the evaluation of antiviral therapy.

Objective To explore the feasibility and value of treating esophageal thoracic fistula with covered esophageal stent through nasal esophagus drainage tube. Methods Seven patients with esophageal thoracic cavity fistula were enrolled and treated by 5F pigtail side-holes catheter inserting into thoracic cavity for drainage and then again through nasal esophagus and fistula, placing a covered stent in the esophagus to occlude the orifice of the fistula. The abscess cavities were washed and radiographied periodically through drainage tubes. Results The insertion of the drainage tube and the placement of covered stent were all successful. The drainage tubes were placed in abscess cavities for 12-22 days, average 15 days. The radiography through drainage tubes showed that the abscess cavities disappeared or shrank obviously with control of hydropneumothorax before the drainage tubes being pulled out. The esophagogram after withdrawal of the drainage tubes notified that the fistulae were occluded satisfactorily with stents expanded fully without displacement and stenosis. Conclusions Treating esophageal thoracic cavity fistula with covered esophageal stent through nasal esophagus drainage tube is feasible and safe with clinical efficiency.

Objective To evaluate the effects of low-dose 125I seeds to the esophagus fibroblast cell proliferation in vitro.Methods The titanium wire was implanted in the beagle dog's esophagus to induce fibroblast proliferation,and the esophageal tissue was removed after two weeks and cultured in vitro.The 125I seeds with different dose commonly used were chosen to irradiation fibroblast in group B (11.1 MBq × 9)、C (22.2 Mbq ×9) 、D (33.3 MBq ×9) for 72 hours,while in control group no 125I seeds were used.After irradiation,cells were collected.MTT and AnnexinV/PI double staining were performed respectively to evaluate the effects of 125I seeds in cell proliferation and apoptosis.Results The inhibition rate respectively:(26.81 ± 1.96) ％、(34.52 ± 3.21) ％ and (45.33 ± 2.59) ％ ; the apoptosis rate respectively:(6.73 ±0.57)％ 、(13.11 ± 1.39)％ and (15.23 ± 0.90)％.There were significant differences among the experimental groups and between every experimental group and the control group.Conclusion The three doses of 125I seeds could significantly inhibit the fibroblast proliferation and promote cells apoptosis,of which 33.3 MBq 12sI seed was the most significant.

Objective To investigate the feasibility and preventive effect of benign esophageal restenosis by binding 125I seeds to upper esophageal stent through animal experiments.Methods Eight 125I seeds were evenly bound to upper normal esophageal stents for the animal experiments.A total of 32 beagle dogs were randomly assigned to 2 groups:experimental group,implanted with esophageal stents with eight 125I seeds (33.3 MBq),and the control (stents without 125I seeds).Four dogs of each group were killed at the 1 st,2nd,4th,and 8th week after imaging studies.The tissue of 2 cm upper stent underwent pathology analysis.Results All the novel stents were successfully implanted.No radioactive leak was detected by ECT.The lumen diameter of the top stent showed the tract gradually narrowed and at the 4th and 8th weeks,the experiment group narrowed more seriously compared with the control group and the difference was statistically significant (P ＜ 0.05).PCNA,ot-SMA mean optical density were significantly different in the 4th week.Both hydroxyproline and total amino acid increased progressively,with significant difference at the 4th and 8th weeks.The macroscopic and optical findings of the trachea and major vessels were basically the same in both groups.Conclusion The novel stent is feasible and safe for preventing benign esophageal restenosis and preventing benign esophageal stent restenosis.

Objective To investigate the effects of intratumoral implantation of ~(32)P-CP-PLLA seeds on the normal canine liver tissue and to exolore the metabolism of ~(32)P-CP-PLLA seeds implanted in the liver of experimental dogs.Methods Twelve beagles were enrolled in this study.The dogs were randomly and equally divided into four groups:group A(185 MBq),group B(370 MBq),group C(740 MBq)and group D(0 MBq).By using laparotomy procedure ~(32)P-CP-PLLA seeds were implanted into dog's liver.CT scan was performed before operation as well as before the dog was sacrificed.All dogs were sacrificed three months after the implantation.Before the procedure and 1,2,4,8 and 12 weeks after the procedure the blood tests and serum biochemical tests were conducted.One dog from group B and group C was selected respectively and was fed in a metabolic cage.Within one month after the procedure the cpm in feces and in urine was determined every 24 hours.One dog was picked out from each of the three groups and was punctured to get its liver tissue for pathologic exam each time at 1,2,4,8 and 12 weeks after the implantation,and SPECT imaging was also performed at the same time.Pathologic study,both macroscopic and microscopic(including optical and electronic microscopy)was made to observe the liver damage after the dog was sacrificed.The statistical analysis was processed by using SPSS 13.0 software and the measuring data were expressed with mean±standard deviation((x)±s).Results Two months after the procedure,serological examination found that the serum alkaline phosphatase(BKP)in both group Band group C was significantly higher than that in other groups,the difference was statistically significant (P ＜0.05),and the BKP levels returned to normal in three months.The postoperative 30-day inspection of the urine showed that the radioactive particles slowly released into the body and eliminated from the body with the urine and feces,mainly through the renal excretion.The 30-day cumulative percentage of eliminated radioactive dose in the urine and in the feces was 6.34% and 11.64% respectively.No sign of particle displacement was found on SPECT imaging.On autopsy three months after the implantation,the size of the radioactive seeds became smaller and fragile.With the radioactive dose used increasing,the area of liver damage at the site of seed implantation became bigger,which was demonstrated on CT scan,macroscopic exam and pathologic study.The local damaged focus of the liver caused by ~(32)P-CP-PLLA seeds was manifested as a spherical lesion which was encysted by a layer of fibrous tissue with an edematous zone peripherally.Conclusion The implantation of ~(32)P-CP-PLLA seeds in dog's liver causes only localized hepatic damage with no general adverse effects.The implanted seeds can slowly release the radioactive dose and will not immigrate to other organs in the body.Besides,the seeds possess excellent stability,targeted orientation and safety.

BACKGROUND: Autologous vein transplantation is a common means for clinical treatment of coronary atherosclerotic heart disease. Identification of basic pathological changes of autologous vein transplantation will provide basis for further studies on how to protect transplanted vein and reduce the possibility of restenosis of transplanted vein.OBJECTIVE: This study was designed to investigate effects of hyperlipemia, an independent influential factor, on venous endothelial functions and histomorphology.DESIGN, TIME AND SETTING: This study, a randomized controlled animal experiment, was performed at the key laboratory of Department of Cardiothoracic Surgery, Changhai Hospital, Second Military Medical University of Chinese PLA.MATERIALS: A total of 50 healthy adult male rabbits were randomly and equally divided into a control group and a hyperlipemia group.METHODS: In the control group, rats were daily fed with normal diet 100-120 g. In the hyperlipemia group, rats were daily fed with normal diet 100-120 g plus cholesterol 1g. For all rats, water was freely available.MAIN OUTCOME MEASURES: Prior to and 2,4,8, and 12 weeks after feeding, blood sample and cervical vein specimens were taken for detection of blood lipid levels and observation of endothelial nitricoxide synthase (eNOS)expression, nitric oxide (NO) production, and histomorphologic change. Prior to harvesting vein sample, blood flow of jugular vein and carotid artery was examined using ultrasonic Doppler flowmeter. Simultaneously, histopathological changes including the thickness of intima and media, the diameter of the veins, and the presence of lipid or atherosclerotic plaque were observed.RESULTS: Eight weeks after feeding, blood lipid levels in the hyperlipemia group were significantly higher than those prior to feeding and in the control group (P<0.01), and maintained at this level. Obvious lipid plaques formed in the carotid artery of rabbits in the hyperlipemia group. Eight and twelve weeks after feeding, eNOS expression levels and NO production in the jugular veins were lower than those prior to feeding and in the control group (P<0.05). Simultaneously, endothelial denudation was noticed and the elastic fibers almost disappeared in the hyperlipemia group; there were no foam cells or lipid plaques.CONCLUSION: Hyperlipemia may result in endothelium dysfunction and histomorphological change of venous conduit.Nevertheless, autogenous vein transplanted into artery system, will greatly influence the remodeling of transplanted vein,even lead to restenosis of transplanted vein.

Objective To investigate the value of positron emisson tomography-computed tomography ( PET-CT) in monitoring the residual lesions in lipiodol sedimentary region and extrahepatic metastastic lesions of hepatocellular carcinoma ( HCC) with alpha fetoproteins ( AFP) positive after interventional therapy. Methods The data of 20 cases with primary HCC confirmed by histopathology were retrospectively analyzed. Their AFP levels decreased to normal range after interventional treatments, but rose to abnormal high level during following-up. After the abdominal routine imaging examinations, the definite diagnosis of the residual lesions in lipiodol sedimentary region or extrahepatic lesions can't be made confidently. All cases were scanned by PET-CT, and according to their PET-CT results, the further treatments were given and the therapeutic results were monitored with radiology and AFP tests. Results In all 20 cases, 10 of them were detected to have the extrahepatic metastastic lesions by PET-CT, including 4 with abdominal wall metastasis upon the liver, 3 with solitary pulmonary metastasis with diameter less than 1 cm, 2 with mesenteric mestastasis, 1 with mestastasis of operative incisions, but these lesions were neglected by abdominal routine imaging examinations. Eight cases showed the uneven lipiodol sedimentary region in the primary lesion by CT or MRI examination, but can't be diagnosed whether it was residual lesion with other examinations including DSA. A definite diagnosis was obtained by PET-CT. In 2 cases, lymph nodes less than 1. 5 cm were found in the hepatic portal area(PHA) and retroperitoneum on CT images,which was determined to be metastatic by PET-CT. All the detected lesions were given further treatments of surgery or interventional therapy. Most patients showed decreased AFP levels except the 2 patients with lymph node metastasis. The imaging examinations also indicated that the treatments had a good effect on lesions. Conclusion In the patients with HCC and abnormal high levels of AFP, in addition to abdominal routine imaging examinations, PET-CT is beneficial for those who is suspected of residual lesions in lipiodol sedimentary region or extrahepatic metastasis.

Objective To investigate the trans-arterial delivery of p53 gene transfection efficiency and therapy effect on hepatic carcinoma in combination with transferrin mediated by liposome. Methods Twenty-five VX2 experimental rabbits were randomly divided into five groups, and the different doses of transferrin combined with p53-LipofectAMINE complex were delivered into the hepatic arteries of the VX2 hepatic carcinoma models. The tissue protein of the carcinoma was extracted after 48 h and the transfection efficiency and expression rate of p53 gene were analyzed by western blot and immune histochemical techniques, to inspect the expression proportion of p53 with different doses transferring. Another ten VX2 were divided into two groups, recombinant plasmid p53-LipofectAMINE complex and transferrin-p53-LipofectAMINE complex were delivered into the hepatic arteries in two groups respectively. The liver function, size of the tumor and survival time of the animals was compared between the two groups, and results were analyzed statistically. Results Semiquantitative analysis by Western Blot showed that the transfection and expression efficiency of p53 gene combined with transferrin were higher than those without it. By immune histochemieal techniques, the p53 gene's positive rate of highly expression with various doses of transferrin were found to be different, and there was remarkable difference between the groups with and without transferring. They were 58. 33%, 69. 44%, 80. 00%, 83.33%, 81.67% respectively, there was remarkable difference between the groups with and without transferring ( Totality: x2 = 42. 37, P < 0. 01 ). The p53 gene's positive rate of expression increased gradually as the doses of transferrin increasing from 0 up to 200 μg, but the differences of positive rate had no statistical significance as the doses of transferrin increasing from 200 up to 400 μg ( x2 section : 3 groups as former x2 = 4. 82, P < 0. 05,3 groups as latter x2 =0. 67 ,P <0. 05). There was no statistical difference in the liver function at points of time between VX2 rabbits with and without transferring. But the tumors' sizes had significant difference at various points of time. Conclusion Liposome-mediated p53 gene on treating hepatic carcinoma by trans-arterial gene delivery combined with transferrin is safe, and it can markedly enhance transfection efficiency and improve the therapy effect of p53 gene.

OBJECTIVETo investigate the blood supply patterns of the anteriorlateral thigh adipofascial flap for clinical applications.

METHODSTo investigate the blood supply patterns of the anteriorlateral thigh (ALT) adipofascial flap, 16 fresh cadavers were anatomically examined by intraarterial injection of colored latex. Three-dimensional analysis of the vasculature of the subcutaneous adipofascial tissue was performed. Sixteen patients underwent microsurgical correction with the ALT adipofascial flap. Among them, there were fifteen with hemifacial atrophy, one with micromastia.

RESULTSThe three-dimensional arterial structures of the ALT adipofascial flap were the same in all the cadaver specimens. Each layer of the adipofascial tissue was supplied by several blood vessels of the axial pattern, especially in the deep layer. Sixteen patients were successfully treated with this flap. The postoperative follow-up ranged from six months to eleven years. There was not postoperative flap necrosis or absorption of the fatty tissue. Stable restoration of the facial contour or the breast was achieved. The donor-site morbidity was minimal.

CONCLUSIONThe blood supply of the ALT adipofascial flap is reliable. A considerable amount of the fatty layer of the flap can be removed primarily. It is a preferable procedure for reconstructing soft tissue defects.

Adipose Tissue ; Adolescent ; Adult ; Breast ; surgery ; Female ; Humans ; Male ; Mammaplasty ; methods ; Surgical Flaps ; blood supply ; Thigh