Objective To explore the effect of interventional ward to the development of interventional radiology.Methods Investigation of the first class of the third grade hospitals in northeast region of China for the development status of interventional radiology in 2005 through questionnaires was undertaken.The hospitals were divided into two groups according to setting up interventional ward or not,together with comparative studies of number of doctors,sorts of interventional techniques and number of cases.Results Altogether 52 3rd grade,1st class hospitals have established interventional therapy,including with ward of 29(55.8%)and no ward of 23(44.2%);furthermore the average numbers of doctors in the forementioned two kinds of hospitals were 4.8 ? 1.7 vs 2.8 ? 1.5(P

Objective To evaluate the therapeutic effect of percutaneous transhepatic biliary drainage (PTBD) with different approaches in patients with hilar cholangiocarcinoma type Ⅱ-Ⅳ.Methods The short-term clinical effect and longterm survival rate were analyzed retrospectively for a group of 97 patients with hilar cholangiocarcinoma type Ⅱ-Ⅳ receiving PTBD with different approaches,i.e.unilateral and bilateral biliary drainage,each including stent placement and drainage tube implantation.Results No significant difference was found in the decreasing of TBIL and DBIL,the survival rate and survival Curve between unilateral and bilateral biliary drainage.The median survival time was 7.5 months in unilateral and 6.7 months in bilateral biliary drainage,6.0 months in single stent and 6.5 months in single drainage tube,and 4.3 months in bilateral stents,respectively.The post operation complications mainly occurred in single drainage tube.Conclusion Single biliary drainage is able to decrease bilirubin for hilar cholangiocarcinoma type Ⅱ-Ⅳ,while stent implantation should be taken as the first choice.

Objective To evaluate the effi ciency of thrombectomy of iliac-femoral venous thrombosis (I-FVT) via transjugular approach. Methods Seven patients wit h I-FVT were treated with implantation of inferior vena caval filter, balloon- di rected drag, and catheter-directed suction. Some patients were treated with PTA and stent. Meanwhile, strict anti-coagulation was necessary. Results Thrombectom y via transjugular was successful in all 7 patients. The iliac- femoral veins w e re patent after the operation and swollen symptom of lower limb disappeared. The re was swollen of the lower limb in 1 patient after treatment. Symptom disappear ed after PTA or stent treatment again. There were no serious complications. Foll ow-up study showed no pulmonary embolization or recrudescence in all 7 patients . Conclusion Thrombectomy via transjugular approach is a safe an d effective method for the treatment of I-FVT.

Objective To investigate the clinicopathological significance of the expression of annexin A2 (ANXA2) in liver fibrosis and hepatocellular carcinoma (HCC).Methods The expression level of ANXA2 in normal liver,liver cirrhosis and HCC were examined by Western blot.The correlation between ANXA2 expression and clinicopathological parameters in liver fibrosis and HCC were analyzed by immunohistochemistry.Results Compared with the normal liver tissue,ANXA2 protein expression level increased significantly in HCC and liver cirrhosis,with the highest expression in HCC (P =0.000).There was significantly positive relationship between ANXA2 protein expression and stages for liver fibrosis (P ＜ 0.01).The expression of ANXA2 protein in HCC was closely associated with HBV infection,differentiation degree and the recurrence (P ＜ 0.05).In some cases,ANXA2-positive cancer cells were often dispersed in the periphery of cancer nodules and were adjacent to stromal cells.Conclusion Overexpression of ANXA2 may be involved in liver fibrosis and play a role in the development of HCC,indicating ANXA2 may serve as a diagnostic biomarker for liver fibrosis and tumor differentiation in HCC.

Objective To present the authors' initial experience of treating auricular arteriovenous malformations (AVMs) with ethanol embolization and to assess the clinical effectiveness of this therapeutic method. Methods Twenty-two patients with AVMs were enrolled in this study. Through local puncturing or super-selective catheterization the absolute ethanol, or diluted alcohol (based on the pattern of the AVMs), was manually injected into the abnormal vascular plexus of the auricular lesion. The clinical results were estimated with physical examination or angiography at intervals of 3 ～ 4 month, and telephone questionnaire was made at monthly intervals for all patients. Results Thirty-eight ethanol embolization procedures were performed, the amount of ethanol used during the procedure ranged from 4 ml to 65 ml. After the treatment the clinical symptoms were improved, which were manifested as healing of the ulceration, stop of bleeding, disappearing or alleviation of tinnitus. Angiographic examination showed that the abnormal vascular lesion was completely vanished in 9 cases, decreased by 50% -75% in 8 cases and decreased less than 50% in remaining 5 cases. The common complications included irreversible local necrosis and vesiculation. Conclusion For the treatment of auricular AVMs ethanol embolization is an effective and safe method, which might become the therapy of first choice.

ObjectiveTo study the relationship between C-erbB-2 and estrogen (ER) and progesterone (PR) receptors, and the relationship between C-erbB-2, ER, PR with histologic grade. MethodsTo detect ER, PR and C-erbB-2 states by using immunohistochemical analysis and fluorescence in situ hybridization for C-erbB-2 in 163 unselected invasive breast carcinomas. ResultsC-erbB-2, ER ,PR were expressed in 21.5％ ,64.4％ ,44.2％ of 163 cases respectivly . 5 pure mucinous carcinomas , 3 tubular carcinomas and 1 micropapillary carcinoma were ER + ( 100.0％ ) 、C-erbB-2 - ( 100.0％ ) and PR + (40.0％ ,66.7％, 100.0％ ). C-erbB-2 was positive in 22.3％ of grade Ⅱ and 27.0％ of grade Ⅲ invasive ductal carcinomas and negative in all grade Ⅰ invasive ductal carcinomas.ER and PR expression were decreased significantly in C-erbB-2 + tumors compared with C-erbB-2 - tumors( ER,25. 7％ vs 75.0％ ; PR,25.7％ vs 49.2％ ). Although ER or PR expression is decreased in C-erbB-2 + tumors, a substantial proportion of them still express ER or PR. ConclusionC-erbB-2 overexpression or amplifcation was limited to a minority of invasive breast carcinomas. Tumour grade was an independent predictor for ER expression. ER was expressed in small number of high-grade and in large number of grade Ⅰ invasive ductal carcinomas. C-erbB-2 overexpression or amplification essentially was limited to grades Ⅱ and Ⅲ ductal carcinomas and correlated inversely with ER or PR expression.

BACKGROUND:With the development and improvement of liver transplantation technology, patients waiting for or undergoing liver transplantation have continued to increase in number. Due to their fears and concerns about post-transplantation rehabilitation, patients are under physical and mental stress, most of whom are shown to have a variety of mental disorders that affect rehabilitation. At present, mental problems of liver transplant patients are more concentrated in post-transplantation research, while patients waiting for liver transplantation do not get enough mental assessment and intervention.
OBJECTIVE:To investigate the suitable mode of cognitive-behavioral therapy for liver transplant recipients waiting for donor liver and to evaluate the effect to improve patient’s physical and mental state.
METHODS:Twelve liver transplant patients who underwent pre-transplantation assessment were randomly divided into experimental group and control group, each group with six cases. The control group received conventional treatment. The experimental group received cognitive-behavioral therapy in addition to conventional treatment. Self-rating anxiety scale (SAS) and vital signs were measured in the two groups on admission, 1 week and 3 weeks after admission.
RESULTS AND CONCLUSION:The SAS score of the experimental group was lower than that of the control group at 1 and 3 weeks after admission, and SAS score decreased as the intervention extended. The systolic blood pressure of the experimental group was lower than that of the control group at 3 weeks after admission, but there was no significant difference in diastolic blood pressure between two groups. The heart rate of the experimental group was lower than that of the control group at 1 and 3 weeks after admission. The respiratory rate of the experimental group was lower than that of the control group at 3 weeks after admission. Cognitive-behavioral therapy can reduce the level of anxiety and keep vital signs stable with good feasibility and effectiveness in patients waiting for liver transplantation.

Objective To explore the clinical features,electroneurophysiology,neuroimaging and gene characteristics of one juvenile dentatorubral-pallidoluysian atrophy (DRPLA) pedigree with an onset of epilepsy.Methods The clinical data of the elder sister and younger brother in a family with juvenile DRPLA were collected.Furthermore,their clinical manifestations,electroneurophysiology results,neuroimaging characteristics and atrophin-1 gene CAG repeat numbers were detected and analyzed in detail.Results There were four patients in this family in total.The probands were two siblings,and they both had the onset manifestation of epilepsy.The younger brother had frequently epileptic seizure,marked cerebellar ataxia,involuntary movement and mental retardation.Compared with her younger brother,the sister had light symptoms such as mild memory deterioration without ataxia and involuntary movement,and she could undertake some simple work.The spike wave and sharp wave complex can be detected in electroencephalogram (EEG) examination,the cortical center segment lesions pathological changes were revealed in somatosensory evoked potentials (EP),and the latency period of P300 was prolonged in the both siblings.Magnetic resonance imaging (MRI) showed that the younger brother had marked atrophies in the cerebral cortex,brainstem and cerebellum.Furthermore,MRI showed that the elder sister had only mild atrophies in the cerebral cortex,brainstem and cerebellum,and that on the contrary some abnormally high signals were observed in cerebral cortex but not white matter.DRPLA gene detection revealed that the numbers of CAG repeats were 15/68 (the younger brother) and 15/64 (the elder sister),respectively.Conclusions Epilepsy,especially the myoclonus,is a common clinical manifestation for juvenile DRPLA,and many other types of epileptic seizures may arise with the development of DRPLA.DRPLA has diverse clinical heterogeneity.EEG,EP and brain MRI examination are great for DRPLA diagnosis and differential diagnosis,and the specific gene detection can be helpful for a definitive diagnosis.

Objective:Our aim was to study the relationship between factor v Leiden (FⅤL) mutation and Chinese Budd-Chiari syndrome (BCS). Methods:Twenty-nine BCS patients (25 patients with sporadic BCS,4 with familial BCS ),29 healthy persons were detected for FⅤL mutation with PCR-RFLP.Results: FⅤL mutation was detected in 3 of 4 patients with familial BCS. Two patients in A family and one patient in B family had FⅤL mutation. The mutation was heterozygous. The mutation frequency was 0.0517 in 29 pationts with BCS, 0.3750 in 4 with familial BCS.The frequency of FⅤL mutation in patients and healthy persons showed no statistical difference,but frequency of FⅤL mutation between patients with familial BCS and healthy persons showed significant difference.Conclusion:The FⅤL mutation was related to Chinese familial BCS, but not related to Chinese BCS.

OBJECTIVETo evaluate the clinical value of various kinds of interventional techniques in the treatment of Budd-Chiari syndrome (BCS).

METHODSMultiple techniques such as recanalization of the inferior vena cava (IVC) under the guidance of marker and multi-angled fluoroscopy, recanalization of the hepatic vein with a transjugular approach, PTA, Z-expandable metallic stent (Z-EMS) implantation and modified TIPSS were used to treat 103 patients with BCS.

RESULTSOf 103 patients with BCS, 59 patients with obstruction of IVC were treated using recanalization of IVC. Seventeen patients with hepatic vein obstruction had their hepatic veins recanalized. The rest of the patients were given other methods of interventional treatment. Of all the subjects, 101 successfully underwent their procedures, with a success rate of 98.06%; and only 2 failed to recanalization of the IVC. Fifty-three patients were treated using PTA for the first time, with a success rate of 100%. In the 48 patients undergoing Z-EMS implantation for the first time, the success rate was 95.8%. Five patients were treated with modified TIPSS. After these interventional treatments, the success rate was 100%. Two patients died 16 h and 72 h respectively after operation because of DIC and severe hemoptysis. Seventy-two patients were followed up for 1 - 94 months (with a mean of 42.3 months). The mean follow-up of a BCS patient treated with PTA was 52.1 months, resulting in a primary patent rate of 59.4% and a restenosis rate of 40.6%. The mean follow-up of BCS treated with stenting was 33.5 months, with a primary patent rate of 87.5% and a restenosis rate of 12.5%. Eight patients died 7 - 64 months after the interventional procedure.

CONCLUSIONRecanalization of IVC or the hepatic vein transjugularly, PTA, Z-EMS implantation and modified TIPSS can be regarded as safe and effective micro-invasive methods in the treatment of BCS.

Adolescent ; Adult ; Angioplasty, Balloon ; Budd-Chiari Syndrome ; therapy ; Female ; Hepatic Veins ; surgery ; Humans ; Male ; Middle Aged ; Portasystemic Shunt, Transjugular Intrahepatic ; Stents ; Vena Cava, Inferior ; surgery