Objective To discuss the clinical effect of artificial pneumothorax combined with intercostal nerve block in alleviating chest pain occurring during and after percutaneous microwave ablation (MWA) for subpleural lung malignancy.Methods A total of 30 patients with subpleural lung malignancy were randomly and equally divided into group A (n=10),group B (n=10) and group C (n=10).The patients in group A received both artificial pneumothorax and intercostal nerve block before MWA.The patients in group B only received artificial pneumothorax before MWA,and the patients in group C only received intercostal nerve block before MWA.The degree of pain was evaluated by visual analogue scale (VAS) score during MWA,immediately after MWA and at 6 h,12 h and 24 h after WMA.The side effects after MWA were recorded.Results During MWA,no statistically significant differences in VAS scores existed between each other among the three groups (P=0.885).The VAS scores determined at 6 h,12 h and 24 h after MWA in group C were significantly increased (P=0.014,P=0.006 and P=0.006 respectively).No patient in group A and group B developed symptoms of chest tightness after artificial pneumothorax was performed.After treatment,a small amount of asymptomatic residual pneumothorax was still observed in 6 patients of group A and group B,which disappeared spontaneously in about one week.Another patient still showed massive pneumothorax even after thoracic gas suction,and the patient recovered after thoracic closed drainage for three days.No other serious complications related to artificial pneumothorax occurred.Conclusion Artificial pneumothorax combined with intercostal nerve block can effectively relieve the chest pain occurring during and after MWA in patients with subpleural lung malignancy,and clinically this technique is quite safe.(J Intervent Radiol,2017,26:269-273)

Objective To deplore the immunoregulatory function changes of mesenchymal stem cells(MSCs)from multiple myeloma(MM)patients and its effects on the pathogenesis of myeloma bone disease.Methods MSCs from MM patients and normal controls were isolated and the immunophenotype was detected.Real-time PCR was performed to detect the expressions of TGF-β1,TGF-β2,TGF-β3,IL-6,IL3,TNF-α,FasL and RANKL of MSCs.Transwell coculture systems were performed between MSCs and T cells.Lymphocyte proliferative assay was employed to detect the effect of MSCs on T cell proliferation.The effect of MSCs on T cell cycle and T cell activation markers CD25 and CD69 expression were analyzed by flow cytometry.Cleaved caspase 3 protein by western blot and hoechst 33258 staining were employed to detect the apotosis of T cells.Influence of T cells on the osteogenesis potential of MSCs were detected by Von kossa stain,real-time PCR and Western blot.Results MSCs from both MM patients and normal controls possessed similar morphology and immunophenotypes.MM derived MSCs exhibited increased expressions of TGF-β1,IL-6,IL-3,TNF-α and RANKL and decreased expression of TGF-β2,TGF-β3 and FasL.The inhibitory effect of MM derived MSCs on T cell proliferative ability was attenuated compared to control MSCs.MSCs from normal controls silence more T cells in Go/G1 phase than those from MM patients.The daupening effect of MM derived MSCs on activation-induced T apoptosis seemed to be enhanced.Expression of T cell activation markers were significantly inhibited by MSCs from normal controls.Both T cells cocultured with MM deprived MSCs and T cells directly from MM patients inhibited osteogenesis potential of MSCs from normal controls.Conclusion MSCs from MM patients showed impaired immunoregulatory capability on T cells.The activated T cells,in turn,inhibited the osteogenesis potential of MSCs.This may participate in the pathogenesis of myeloma bone disease.

OBJECTIVETo evaluate the application of small intestine double stoma and succus entericus reinfusion in the patients with severe intra-abdominal infection.

METHODSTen patients with high intestinal perforation from February 2005 to November 2014 were enrolled in the study. All the cases received emergency operation. Small bowel with intestinal perforation was resected, and double stoma was applied in the proximal and distal small intestine. When abdominal infection under control, total enteral nutrition was successfully administered from nasogastric tube. The succus entericus from the proximal intestine was collected and transfused back to the distal intestine. Stool was collected and fecal nitrogen, fat and carbohydrate contents were determined. Related serum protein levels were measured.

RESULTSAs compared to pre-reinfusion, the absorption rate of carbohydrate [(90.9±7.8)% vs. (82.7±15.2)%], fat [(87.6±6.4)% vs. (59.1±10.8)%], and nitrogen [(82.4±9.8)% vs. (67.2±15.4)%] increased after succus entericus reinfusion (P<0.05). The serum protein levels increased significantly as well[fibronectin: (285.6±3.6) vs. (157.0±22.6) mg/L, P<0.01; transferrin: (4.86±0.21) vs. (3.60±0.25) g/L, P<0.05; pre-albumin: (291.3±112.5) vs. (199.1±53.3) mg/L, P<0.05].

CONCLUSIONSmall intestine double stoma and succus entericus reinfusion are effective in improving the absorption of carbohydrate, fat and nitrogen in the patients with severe intra-abdominal infection.

Enteral Nutrition ; Humans ; Intestinal Perforation ; Intestinal Secretions ; Intestine, Small ; Intraabdominal Infections ; Surgical Stomas

Objective To evaluate the application of small intestine double stoma and succus entericus reinfusion in the patients with severe intra-abdominal infection. Methods Ten patients with high intestinal perforation from February 2005 to November 2014 were enrolled in the study. All the cases received emergency operation. Small bowel with intestinal perforation was resected, and double stoma was applied in the proximal and distal small intestine. When abdominal infection under control, total enteral nutrition was successfully administered from nasogastric tube. The succus entericus from the proximal intestine was collected and transfused back to the distal intestine. Stool was collected and fecal nitrogen, fat and carbohydrate contents were determined. Related serum protein levels were measured. Results As compared to pre-reinfusion, the absorption rate of carbohydrate [(90.9±7.8)% vs. (82.7± 15.2)%], fat [(87.6±6.4)% vs. (59.1±10.8)%], and nitrogen [(82.4±9.8)% vs. (67.2±15.4)%] increased after succus entericus reinfusion (P<0.05). The serum protein levels increased significantly as well[fibronectin:(285.6±3.6) vs. (157.0±22.6) mg/L, P<0.01﹔transferrin:(4.86±0.21) vs. (3.60± 0.25) g/L,P<0.05﹔pre-albumin:(291.3±112.5) vs. (199.1±53.3) mg/L, P<0.05]. Conclusion Small intestine double stoma and succus entericus reinfusion are effective in improving the absorption of carbohydrate, fat and nitrogen in the patients with severe intra-abdominal infection.

Objective To evaluate the application of small intestine double stoma and succus entericus reinfusion in the patients with severe intra-abdominal infection. Methods Ten patients with high intestinal perforation from February 2005 to November 2014 were enrolled in the study. All the cases received emergency operation. Small bowel with intestinal perforation was resected, and double stoma was applied in the proximal and distal small intestine. When abdominal infection under control, total enteral nutrition was successfully administered from nasogastric tube. The succus entericus from the proximal intestine was collected and transfused back to the distal intestine. Stool was collected and fecal nitrogen, fat and carbohydrate contents were determined. Related serum protein levels were measured. Results As compared to pre-reinfusion, the absorption rate of carbohydrate [(90.9±7.8)% vs. (82.7± 15.2)%], fat [(87.6±6.4)% vs. (59.1±10.8)%], and nitrogen [(82.4±9.8)% vs. (67.2±15.4)%] increased after succus entericus reinfusion (P<0.05). The serum protein levels increased significantly as well[fibronectin:(285.6±3.6) vs. (157.0±22.6) mg/L, P<0.01﹔transferrin:(4.86±0.21) vs. (3.60± 0.25) g/L,P<0.05﹔pre-albumin:(291.3±112.5) vs. (199.1±53.3) mg/L, P<0.05]. Conclusion Small intestine double stoma and succus entericus reinfusion are effective in improving the absorption of carbohydrate, fat and nitrogen in the patients with severe intra-abdominal infection.