1.Intraluminal venous catheter-directed thrombolysis for lower limb acute deep venous thrombosis
Xiaozhong HUANG ; Jiwei ZHANG ; Wei LIANG ; Jiachang CHI
Journal of Interventional Radiology 2006;0(10):-
Objective To evaluate the efficacy of intraluminal catheter-directed thrombolysis in treatment of lower limb acute deep venous thrombosis(DVT).Methods Thirty-six consecutive patients with lower limb acute DVT underwent intraluminal cathter-directed thrombolysis with urokinase continuous infusion immediately.The circumferences of the normal and affected limbs were measured before and after lysis,the venous patency scores and the rates of patency improvement were observed by venograms,together with follow up record after 6 months.Results After lysis,the circumferencial differences in thigh and calf showed significant difference(P
2.The application of body surface localization by virtue of Innova CT reconstruction combined with DSA guidance in performing percutaneous fine needle biopsy of lung lesions
Ji WANG ; Jiong ZHU ; Jiachang CHI ; Jialin SHEN ; Jianrong XU
Journal of Interventional Radiology 2009;18(11):862-864
Objective To evaluate body surface localization by virtue of lnnova CT reconstruction combined with DSA guidance in performing percutaneous fine needle biopsy of lung lesions. Methods Twenty-one patients with solid lung lesions were enrolled in this study. Before percutaneous lung needle biopsy, DSA rotation scanning was performed. Based on the reconstructed lnnova CT images, precise puncture scheme was formulated. Then, under DSA guidance, pereutaneous fine needle biopsy of lung lesions was carried out. Results A total of 41 percutaneous fine needle biopsies was made, of which definite pathologic diagnosis was obtained in 40, with a positive rate of 97.6%. Pneumothorax occurred in one patient (4.8%). Conclusion Percutaneous lung needle biopsy with the help of body surface localization, which is determined by Innova CT reconstruction images, and DSA guidance is a safe and technically-simple procedure with high accuracy in localization. It is of great value in the diagnosis of pulmonary space-occupying lesions.
3.Molecular types of carbapenem-non-susceptible Escherichia coli isolates and their mechanism of drug resistance
Rong ZHANG ; Dan CHI ; Jiachang CAI ; Yanyan HU ; Hongwei ZHOU ; Wei YANG ; Huoyang LYU ; Gongxiang CHEN
Chinese Journal of Microbiology and Immunology 2014;(4):256-263
Objective To investigate the molecular types of carbapenem-non-susceptible Esche-richia coli ( E.coli) isolates and their mechanism of carbapenem resistance .Methods Twenty-two carbap-enem-non-susceptible E.coli strains were isolated from 3 hospitals in Hangzhou from 2007 to 2011.The mini-mum inhibitory concentrations ( MICs) of antimicrobials to those isolates were determined by agar dilution method and E-test.The molecular mechanisms of carbapenem resistance of E.coli isolates were analyzed by conjugation experiment,PCR and DNA sequencing.Pulsed-field gel electrophoresis (PFGE),multilocus se-quence typing ( MLST ) , and phylogenetic typing were performed to analyze the molecular epidemiology of those isolates.Results The MICs of imipenem and meropenem to 22 E.coli isolates were ranged from 1 μg/ml to 16 μg/ml,and the MICs of ertapenem were 2 μg/ml to 64 μg/ml.All E.coli isolates produced the KPC-2 carbapenemase and various β-lactamases , and some of them also produced plasmid-mediated AmpC enzymes.Carbapenem resistance was transferred by conjugation and transformation from 22 E.coli iso-lates to E.coli EC600 strains.The E.coli transconjugants or transformants acquired the blaKPC-2 gene and showed similar antibiotic susceptibility patterns in comparison with donor strains .Only a few isolates were in-distinguishable or closely related as indicated by PFGE .Four sequence types including ST131 (9 isolates), ST648 (5 isolates),ST38 (2 isolates) and ST405 (2 isolates) were identified by MLST.Phylogenetic analy-sis indicated that 9 ST131 isolates belonged to phylogenetic group B 2 and the other isolates belonged to group D (11 isolates),group B1 (1 isolate) and group A (1 isolate),respectively.Conclusion The sequence type of prevalent E.coli isolates producing KPC-2 from Hangzhou was ST131,which is an international epi-demic,multidrug-resistant clone,followed by ST648.
4.Endovascular intervention for late postpancreaticoduodenectomy hemorrhage
Yanmiao HUO ; Jiachang CHI ; Jianyu YANG ; Wei LIU ; Junfeng ZHANG ; Yongwei SUN ; Rong HUA
Chinese Journal of General Surgery 2019;34(3):208-212
Objective To evaluate the safety,efficacy of interventional treatment for late postpancreaticoduodenectomy hemorrhage (LPPH).Methods From Jan 2008 to Dec 2017,678 patients underwent pancreaticoduodenectomy (PD).33 patients (4.9%) suffered from LPPH.30 of these 33 patients underwent diagnostic angiography and endovascular treatment,either transcatheter arterial embolization (TAE,n =21) or covered stent placement (CSP,n =9),and the other 3 underwent laparotomy.Results The incidence of LPPH is 4.9% with a 12% motality.The most common presentation is bleeding from abdominal drainage (24.2%) and melena (24.2%).The incidence of sentinel bleeding (SB) is 45.5% and postoperative pancreatic fistula (POPF) is 69.7%.Intra-abdominal infection were identified in 24 patients (72.7%) and the most common pathogenic bacteria is pseudomonas aeruginosa (11/24,45.8%).The mean time between PD operation and LPPH was 17.4 days.In 21 patients receiving TAE,4 got liver damage and 2 with liver abscesses,1 died.The most common site of LPPH is GDA stump and re-bleeding occurred in 5 patients.9 patients by CSP got bleeding under control.In all 7 re-bleeding patients,2 were saved by CSP,1 was saved by TAE,while the other 4 died.Conclusion Early intervention plays an important role for LPPH.CSP is better than TAE.
5.Quantitative assessment of angiogenesis of rabbit liver tumors by using fiat detector CT in the angiography suite
Wei ZHOU ; Zhiguo ZHUANG ; Jiachang CHI ; Shiteng SUO ; Xun GUAN ; Jianrong XU
Journal of Interventional Radiology 2017;26(10):907-911
Objective To investigate the feasibility of quantitatively evaluating angiogenesis in liver tumors by using flat detector computed tomography (FDCT) in the angiography suite.Methods The VX2 liver tumor model was established in 25 rabbits,and then FDCT examination was performed for each animal.After reconstructing the blood volume (BV) perfusion map,BV values of the hepatic tumor and parenchyma were measured respectively.All experimental rabbits were sacrificed after FDCT,and the corresponding tumor specimens were collected for measuring microvessel density (MVD) and vascular endothelial growth factor (VEGF) expression level.The relationships of BV values with MVD and VEGF expression in liver tumors were analyzed.Results Of the 25 experimental rabbits,FDCT examination was successfully accomplished in 22(88.0%).Both the hepatic parenchyma and tumor lesions could be clearly visualized on BV perfusion map.The hepatic tumor was characterized by a hyperperfusion rim with a hypoperfusion center,known as rim-like enhancement pattern,on BV perfusion map.BV values bore a close relationship to both MVD grade and VEGF grade (P<0.05 in both),while MVD grade had a parallel relationship with VEGF grade (r=0.504,P< 0.001).Conclusion It is feasible to use FDCT in the angiography suite to quantitatively assess the angiogenesis of liver tumors.It may be helpful for interventional treatment of liver tumors.
6.Portal vein reconstruction in high risk infantile liver transplantation
Mingxuan FENG ; Chengpeng ZHONG ; Bijun QIU ; Ping WAN ; Lei XIA ; Yi LUO ; Lihong GU ; Jiachang CHI ; Yefeng LU ; Jianjun ZHANG ; Qiang XIA
Chinese Journal of Organ Transplantation 2019;40(7):396-399
Objective To explore the experience of infantile liver transplantation ,reconstructing portal vein (PV) and avoid the higher incidence of portal vein low flow and complications .Methods The clinical data were reviewed for 152 infantile liver transplantations performed by a single surgery group .And 114 cases with PV risk factors underwent customized PV reconstructions .All of them were diagnosed as cholestatic liver diseases and 106 (93% ) belonged to biliary atresia .Forty-two cases (36% ) had 2 or more risk factors .Results Most cases (n= 106 ,93% ) underwent living donor transplantations using lateral left graft while another 8 cases had deceased donor transplantations . Four types of PV reconstructions were adopted based upon individual conditions :left/right branch of PV trunk (n= 103) ,autogenous patch PV venoplastic reconstruction (n= 3) ,duct-to-duct of PV trunk (n= 5) and donor PV duct-to-recipient confluence of SMV/CV and SV (n= 3) .Graft size reduction was performed when GRWR > 4 .5% (n= 16) .During a median follow-up period of 6 .5 (1 .5-13) months ,there were 3 LPVF (2 .6% ) ,2PVS (1 .7% ) and 1 PVT (0 .8% ) .Three LPVF cases was corrected by PV stenting ,two cases of PVS were stable after anticoagulation therapy while one PVT case undergoing thromboectomy plus PV stenting resumed a normal PV flow .Conclusions PV reconstruction of high-risk infants require comprehensive risk evaluations ,precise surgical skills and customized strategies .For PV complications ,stenting is both safe and feasible .
7.Expert Consensus for Thermal Ablation of Pulmonary Subsolid Nodules (2021 Edition).
Xin YE ; Weijun FAN ; Zhongmin WANG ; Junjie WANG ; Hui WANG ; Jun WANG ; Chuntang WANG ; Lizhi NIU ; Yong FANG ; Shanzhi GU ; Hui TIAN ; Baodong LIU ; Lou ZHONG ; Yiping ZHUANG ; Jiachang CHI ; Xichao SUN ; Nuo YANG ; Zhigang WEI ; Xiao LI ; Xiaoguang LI ; Yuliang LI ; Chunhai LI ; Yan LI ; Xia YANG ; Wuwei YANG ; Po YANG ; Zhengqiang YANG ; Yueyong XIAO ; Xiaoming SONG ; Kaixian ZHANG ; Shilin CHEN ; Weisheng CHEN ; Zhengyu LIN ; Dianjie LIN ; Zhiqiang MENG ; Xiaojing ZHAO ; Kaiwen HU ; Chen LIU ; Cheng LIU ; Chundong GU ; Dong XU ; Yong HUANG ; Guanghui HUANG ; Zhongmin PENG ; Liang DONG ; Lei JIANG ; Yue HAN ; Qingshi ZENG ; Yong JIN ; Guangyan LEI ; Bo ZHAI ; Hailiang LI ; Jie PAN
Chinese Journal of Lung Cancer 2021;24(5):305-322
"The Expert Group on Tumor Ablation Therapy of Chinese Medical Doctor Association, The Tumor Ablation Committee of Chinese College of Interventionalists, The Society of Tumor Ablation Therapy of Chinese Anti-Cancer Association and The Ablation Expert Committee of the Chinese Society of Clinical Oncology" have organized multidisciplinary experts to formulate the consensus for thermal ablation of pulmonary subsolid nodules or ground-glass nodule (GGN). The expert consensus reviews current literatures and provides clinical practices for thermal ablation of GGN. The main contents include: (1) clinical evaluation of GGN, (2) procedures, indications, contraindications, outcomes evaluation and related complications of thermal ablation for GGN and (3) future development directions.
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