Objective By using CT-guided percutaneous inoculation with "external pre-loaded and traced one-step implantation technique" to establish VX2 liver and kidney tumor model in experimental rabbits, and to evaluate the effectiveness and convenience of this technique. Methods By using a disposal 16G thoracic puncture needle (length of 8. 5 cm) and a self-made 18 G puncture probe, inoculation of tumor cells was performed in experimental rabbits. Retrograde filling of gelatin sponge strip, which was infiltrated with 0. 3 mL contrast medium, into the thoracic puncture needle lumen was performed, which was followed by retrograde loading of 1X1X3 mm3 VX2 tissue block, and the pre-assembly in vitro was completed. Under CT guidance, percutaneous puncturing of the target organ of experimental rabbit with pre - assembly probe was conducted, then, the end of the needle was inserted into the probe to push out the tumor tissue and gelatin sponge when it was verified that the needle tip reached the desired target point. After 30 seconds, the needle and probe were pulled out slowly and integrally, and the puncture point was manually pressed for 60 seconds. CT scan was performed to check the location of high-density gelatin sponge. The tumor inoculation time was recorded. Contrast - enhanced CT scan was employed at 2, 3 and 4 weeks after inoculation to validate the modeling results. Results Immediate postoperative CT scan showed that the inoculation site was manifested as nodular high density shadow in the liver or kidney parenchyma. Liver tumor modeling was used in 10 rabbits, and tumor formation was obtained in all 10 rabbits (100％, 10/10), and the mean time used for inoculation was 4. 3 minutes. Kidney tumor modeling was adopted in 10 rabbits, and tumor formation was obtained in 9 rabbits (90％, 9/10), and the mean time used for inoculation was 4. 9 minutes. The inoculated tumor was characterized by a single lesion in all experimental rabbits, the location of the tumor was basically the same as that of the high density gelatin sponge. Check-up contrast-enhanced CT scan showed that the liver implanted tumor had peripheral enhancement, which presented as ring - shaped enhancement on DSA. The kidney implanted tumor was manifested as renal parenchyma staining defect on both contrast - enhanced CT scan and DSA. After 3-4 weeks of inoculation, the implanted tumors grew rapidly. Conclusion For the establishment of rabbit VX2 liver and kidney tumor models, CT - guided percutaneous inoculation with "external pre-loaded and traced one-step implantation technique" is very effective. This technique has several advantages, such as convenient and time-saving, postoperative immediate confirmation of the inoculation site, higher tumor formation rate, solitary tumor formation, etc. (J Intervent Radiol, 2018, 27:252-256)

Dalian Medical University, aiming at cultivating innovative talents, has formulated and implemented a "5+3" innovative talents training reform plan. In the whole process of medical undergraduate education, tutorial system is used as the carrier to develop a phased innovative ability training system, which covers basic scientific research ability training such as courses, lectures, experimental design, papers and so on, and strengthens the cultivation of undergraduate scientific research ability. Through statistical analysis of the results of the first "5+3" students' periodic training, it is found that the proportion of "5+3" students publishing Chinese periodicals and SCI, and hosting national innovation projects and provincial innovation projects is significantly higher than that of ordinary 5-year students ( P<0.05). Although there are some problems and deficiencies in the implementation process, the basic scientific research training with tutorial system as the core has a significant effect on improving students' scientific research thinking and innovation ability, and is feasible for training medical innovative talents.

Objective To investigate the application of Rotarex mechanical thrombectomy system in lower extremity arterial thrombosis and to evaluate its clinical efficacy.Methods The clinical data of 61 patients(71 limbs,35 cases in acute phase,21 cases in subacute phase and 5 cases in chronic phase)with lower extremity arterial thrombosis treated with Rotarex were analyzed retro-spectively.Distal protective device was used in patients with poor distal artery outflow.High pressure saline was used during the pro-cedure and stent was used in patients with flow-limiting dissection.Catheter aspiration was performed in patients with distal artery embo-lization.Anticoagulant therapy was used in patients with thromboembolism and dual antiplatelet therapy was used in patients with in-situ thrombosis.Postoperative follow-up was performed with color Doppler ultrasound or computed tomography angiography(CTA)at 1 month,3 months and 6 months.Results Fifty-nine cases were treated with 6F Rotarex catheters and 2 cases were treated with 8F Rotarex catheters.Distal protective device was used in 10 cases,balloon dilation was performed in 49 cases and stent was used in 5 cases.Catheter aspiration was performed in 10 cases.Vessel rupture occurred in 4 cases,among whom 3 cases were successfully treated with the method of balloon compression and 1 case was treated with covered stent.Severe adverse events occurred in 4 cases and perioperative toe amputation was performed in 7 cases.Follow-up time was 3 to 6 months(mean 4.9 months).Lower extremity ischemic event occurred in 1 case at 6th month follow-up and was treated with stent.No other lower extremity ischemic events occurred in the course of follow-up.Conclusion For the treatment of lower extremity arterial thrombosis,Rotarex mechanical thrombectomy sys-tem has the advantages of minimally invasion,rapid and high efficiency.Combined with the therapy of catheter aspiration and stent place-ment,vascular patency can be further maintained and the lower extremity ischemic symptoms can be quickly relieved.

Objective:To discuss the method of modified balloon-occluded retrograde transvenous obliteration (M-BRTO) combined with antegrade transvenous obliteration (ATO) using tissue adhesive and (or) coils in the treatment of portal hypertension with spontaneous portosystemic shunt (SPSS), and to evaluate its clinical efficacy.Methods:From February 2018 to October 2022,clinical data of patients with portal hypertension with SPSS treatment in Henan Anyang District Hospital were retrospectively analyzed. A total of 21 patients were enrolled. Under the blood flow limit of SPSS outflow tract, ATO was firstly performed, then followed by M-BRTO. The ATO route could be performed from percutaneous transhepatic portal vein, percutaneous transumbilical vein or transjugular intrahepatic portal vein shunt (TIPS) approach and the M-BRTO route could be performed from femoral vein (FV), jugular vein (JV) or anterior cubical vein (ACV). The operation of M-BRTO+ATO was performed under local anesthesia and was suitable for patients with isolated gastric varicose bleeding, hepatic encephalopathy or cardiac insufficiency. TIPS combination with M-BRTO+ATO was performed under general anesthesia and was suitable for patients with gastrointestinal hemorrhage complicated with severe gastrorenal or splenorenal shunt, or with portal thrombosis. Abdominal plain CT scan was performed 1 week later to show the deposition of embolic agent. Abdominal color ultrasound was done 1 month later, contrast-enhanced CT scan was performed 3 months and 6 months later, and then color ultrasound or contrast-enhanced CT was performed every 6 months to show the portal vein blood flow or the patency of TIPS stent. Hepatic artery chemoembolization was performed 1 month later for patients with liver cancer.Results:A total of 23 times of operation were performed in 21 patients, including 1 case with 3 times of operation. The approach of percutaneous transhepatic route was used in 11 cases (7 cases combined with FV, 3 cases combined with JV and 1 case combined with ACV), the approach of TIPS route combination with FV was used in 9 cases, paraumbilical vein combination with FV was used in 2 cases and paraumbilical vein combination with ACV was used in 1 case. Ectopic embolization occurred in 3 cases (1 case to the spleen vein, 2 cases to the liver). Perioperative fever occurred in 5 cases, bleeding of hepatic puncture tract occurred in 1 case, and death happened in 2 cases (1 case of acute liver failure induced by bile duct stone, 1 case of acute heart failure combined with acute gastrointestinal massive hemorrhage). During the follow-up, 4 cases died (3 cases of liver cancer and 1 case of infection). The remaining 15 patients were followed up for 2 to 47 (22±13) months and there was no recurrence of hepatic encephalopathy and gastrointestinal hemorrhage during follow-up.Conclusions:The operation of M-BRTO+ATO using tissue adhesive or combining with coils as embolic agent can quickly obliterate outflow tract of SPSS and completely block the whole tract of SPSS, so it is a fast, safety and effective method for the treatment of PH with SPSS.