Objective To compare the clinical efficacy of targeting arterial embolization before sacral chordoma excision and temporary balloon oc-clusion of abdominal aorta during sacral tumors surgery. Methods A total of 34 patients with sacral chordoma were recruited for this study and fol-lowed up. Totally 18 patients received bi-iliac artery,sacrococcygeal artery and other target arteryl embolization before excision(target arterial emboli-zation group),and the other 16 received temporary balloon occlusion of abdominal aorta during surgery(balloon occlusion group). The blood loss during operation,drained blood after operation,operation time and wound healing were recorded. Results The blood loss during operation,drained blood after operation and operation time in targeting arterial embolization group were less than balloon occlusion group. There was no statistical differ-ence in wound healing between the two groups. Conclusion Targeting arterial embolization can be more effective than temporary balloon occlusion of abdominal aorta in the control of blood loss.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Headache ; therapy ; Humans ; Male ; Pain, Intractable ; therapy ; Scalp ; Treatment Outcome

Objectve To investigate the correlation between vertebral artery hypoplasia (VAH) and posterior circulation ischemic stroke (PCIS).Methods The patients who were diagnose as ischemic cerebral stroke and underwent brain magnetic resonance imaging and cervical three-dimensional contrast-enhanced magnetic resonance angiography from March 2012 to March 2014 were enrolled.VAH was defined as vertebral artery diameter ＜ 2 mm and thin or did not develop.They were divided into either an anterior circulation ischemic stroke (ACIS) group or a PCIS group according to the sites of disease.The clinical and imaging data were compared.Results A total of 137 patients were enrolled,including 96 patients (70.07％) with ACIS and 41 (29.93％) with PCIS.Thirty-seven patients were (27.01％) diagnosed as VAH,including 13 on the left and 24 on the right; 14 females and 23 males.The detection rate of females (29.17％) was higher than that of males (25.84％),but the difference was not statistically significant (x2 =0.175; P =0.676).There were significant differences in TOAST classificanon (x2 =6.710; P =0.035),combined with ischemic heart disease (14.6％ vs.61.5％ ; x2 =25.262,P ＜ 0.001) and VAH (58.5％ vs.13.5％ ; x2 =9.505,P ＜0.001) between the PCIS group and the ACIS group.Multivariable logistic regression analysis showed that VAH was independently correlated with PCIS (odds ratio 10.788,95％ confidence interval 3.863-30.131; P ＜ 0.001),and combined with ischemic heart disease was independently correlated with ACIS (odds ratio 0.082,95％ confidence interval 0.024-0.278; P ＜ 0.001).Conclusions VAH is not rare in patients with ischemic stroke.It may promote the occurrence of PCIS.

Objective To compare the therapeutic efficacy of 125Iodine seed implantation and gamma knife in treating portal vein tumor thrombosis (PVTT) in hepatocellular carcinoma (HCC), and to discuss their clinical applications. Methods Between January 2009 and May 2013, a total of 60 HCC patients associated with PVTT were encountered at authors’ hospital. The patients were divided into gamma knife group (n=30) and 125Iodine seed group (n = 30). Gamma knife treatment was carried out for the patients of gamma knife group. A total of 3 - 10 target points were designed. Single dose of 3 - 6 Gy per fraction was used and 2 - 5 times radiotherapy every week were conducted. The total treatment dose was 30 - 50 Gy. In designing the therapeutic scheme, 50%-70%of iso-dose curve contained PTV. 125Iodine seed implantation was performed for the patients of 125Iodine seed group. After the treatment, the change of PVTT size was assessed. The clinical efficacy was evaluated. Results Three months after the treatment, in gamma knife group complete remission (CR) was seen in 0 patient (0%), partial remission (PR) in 8 patient (26.6%), stable disease (SD) in 17 patients (56.7%) and progressive disease (PD) in 5 patients (16.7%). In 125Iodine seed group, CR was obtained in 3 patients (10.0%), PR in 19 patients (63.4%), SD in 7 patients (23.3%) and PD in one patient (3.3%). Statistically significant differences in responding the therapy existed between the two groups (P < 0.05), although no significant difference in the improvement of ascites and hepatic function existed between the two groups (P<0.05). Conclusion For the treatment of portal vein tumor thrombosis of hepatocellular carcinoma, the short-term efficacy of 125Iodine seed implantation is much better than that of gamma knife, although its long-term effect needs to be further studied.

Objective To investigate the change regulation of the serum ferritin level and its correlation with the clinical outcomes.Methods The patients with spontaneous intracerebral hemorrhage were enrolled.Their clinical data were collected.The serum ferritin levels were detected within 24 h after admission and on day 3,7,and 14,respectively.The modified Rankin Scale (mRS) were used to evaluate the clinical outcomes at day 90 after onset.mRS 0 to 2 was defined as good outcome and ＞ 2 was defined as poor outcome.Results A total of 32 patients with spontaneous intracerebral hemorrhage were enrolled,including 18 in the good outcome group and 14 in the poor outcome group.There were significant differences in age (66.33 ±12.57 years vs.76.50 ±6.55 years;t =-2.908,P =0.007),baseline National Institutes of Health Stroke Scale (NIHSS) scores (median [interquartile range];9.50 [4.75-11.25] vs.15.00 [11-20];Z=-3.499;P=0.001),diastolic blood pressure (82.16± 13.79 mmHg vs.94.76± 12.17mmHg,1 mmHg=0.133 kPa);t=-1.145,P=0.045),amount of bleeding (4.50 [2.75-9.00] mlvs.11.00 [7.50-15.00] ml;Z=-2.613,P=0.008],blood glucose (5.82±0.87 mmoFL vs.7.09±1.72 mmoFL;t =-2.548,P =0.020),and white blood cell count ([7.26 ± 2.36] × 109/L vs.[10.94 ±5.83] × 109/L;t =-2.440,P =0.021) between the good outcome group and the poor outcome group.The serum ferritin levels of the good outcome group were 139.81 ± 98.50 μg/L,181.77 ± 97.29 μg/L,198.17 ±96.63 μg/L,and 159.59 ±72.43 μg/L,respectively,within 24 h on admission and at day 3,7,and 14.There were no significant differences at each time point (F=1.397,P =0.251),and those of the poor outcome group were 226.07 ± 119.22 μg/L,297.36 ± 81.48 μg/L,305.45 ± 97.05 μg/L,and 307.74 ± 82.54 μg/L,respectively,and they increased progressively over time (F =4.245,P =0.044);at each time point,the good outcome group was significantly lower than the poor outcome group (within 24 hon admission:t =-2.242,P=0.033;at 3 days after onset:t =-3.234,P =0.003;at 7 days after onset:t =-3.149,P =0.004;at 14 days after onset:t =-3.628,P =0.001).Multivariate logistic regression analysis showed that the serum ferritin level within 24 h on admission (odds ratio 1.048,95％ confilence interval 1.004-1.095;P=0.034)and baseline NIHSS score (odds ratio 1.021,95％ confidence interval 1.004-1.039;P =0.016) were the independent risk factors for affecting the outcomes in patients with acute intracerebral hemorrhage.Conclusions The serum ferritin level increases in the poor-outcome patients with acute intracerebral hemorrhage.The increased serum ferritin level is an independent risk factor for poor outcome in patients with acute intracerebral hemorrhage.

[Summary] This article reviewed the clinical features in two diabetes cases complicated with nasal‐brain mucormycosis by pathology and pulmonary mucormycosis. In one patient with diabetes combined with pulmonary mucormycosis ,manifestations of chest pain and hemoptysis ,the right upper lung biopsy tip morphology was consistent with Mucor ,successfully cured with amphotericin and operation treatment. The other patient with diabetes‐complicated nasal mucormycosis with headache and nasal cavity clump , showed black caseous matter ,finally hemiplegia. A nasal cavity tumor was proved by pathological examination. After treatment with fluconazole and operation ,the patientdied. Mucormycosisis rare and may be secondary to diabetes and hypoimmunity disease. It needs rapid diagnosis and treatment.

Objective To retrospectively analyze the effectiveness and safety of drug-eluting stents (DES) on prevention of restenosis in old female patients (≥65 years) with multi-vessel coronary artery disease. Methods 387 old female patients with multi-vessel coronary artery disease underwent percutaneous coronary intervention (PCI) were divided into the DES group (n=139) and the metallic stent (BMS) group (n=248). Acute and long-term outcomes were compared between the two groups. Results The ratio of patients with diabetic disease was higher in DES group than that in BMS group (P0.05). The rates of restenosis shown by angiography and major adverse cardiac events (MACE) were significantly lower in the DES group compared with BMS group (4.2% vs 15.8%, 7.5% vs 17.3%, P

Objective To evaluate the 6-month result of implantation of drug eluted stent (DES) in diabetic mellitus (DM) patients with multivessel coronary artery disease (MVD) to compare with that of bare metal stent (BMS). Methods From November 2002 to June 2005, 443 consecutive T2DM patients with MVD without previous myocardial revascularization underwent successful percutaneous coronary intervention (PCI). There were 226 patients in BMS group, 91patients in Cypher stent group, and 126 patients in TAXUS stent group. The results during hospitalization and 6-month clinical follow-up were analyzed among the 3 groups. Results There were no difference in clinical characteristics, PCI success rate, and incidence of in-hospital major adverse cardiac events (MACE) among 3 groups. However, concerning the characteristics of coronary lesions, the rate of bifurcation lesions and lesion length in Cypher stent group and the rates of bifurcation lesions and triple coronary lesions in TAXUS stent group were significantly higher than that in BMS group, respectively (P

Objective To evaluate long-term clinical effectiveness in old female patients with multi-vessel coronary artery disease (≥65 years) treated with percutaneous coronary intervention (PCI). Methods 601 female patients with multi-vessel coronary artery disease underwent PCI were divided into the elder group (≥65 years, n=354) and the younger group (0.05). Conclusion PCI can be performed in old female patients with multi-vessel coronary artery disease with high success rate and few complications. Long-term clinical outcomes of PCI in old females with multi-vessel disease are similar to younger females.

ObjectiveTo review our experience in the use of a pedicled umbilical vein graft in the repair of the defect in the bile duct in Mirizzi's syndrome. MethodsThis is a retrospective study on the use of a pedicled umbilical vein graft to repair the defect in the bile duct in 35 patients with Mi rizzi's syndrome. These patients suffered for Mirizzi's syndrome type Ⅱ in 19 patients, type Ⅲ in 15 patients, and type Ⅳ in 1 patient. ResultsThere was no peri-operative death. Five patients developed postoperative biliary leak which healed spontaneously after drainage of the bile collection. All patients had been followed up for at least 6 months, and 27 patients had been followed up for 3 years.There was no biliary complication. ConclusionsBile duct reconstruction with a pedicled umbilical vein graft is simple. It is a good procedure to repair the defect in the bile duct in Mirizzi's syndrome.