Objective To evaluate the clinical application of segmental RAE for treating renal arteriovenous malformation(RAVM) and fistula (RAVF).Methods 4 cases of RAVM or RAVF were treated by segmental RAE,Embolic material was permanent embolism.Results 4 cases RAE operations were performed successfully,After 12～14 months follow-up,3 cases were no evidence of recurrence,1 case clinical symptom was relieved.Conclusion Segmental RAE is an effective and safe approach to the treating RAVM and RAVF.

Objective To sum up the experience of embolization uterine aterial to treat uterine leiomyoma and to discuss how to prevent and manage the complications.Methods 103 patients with uterine leiomyoma have treated by uterine aterial embolized.Postembolization syndrome and 18 accidents out of 16 patients were reviewed.Results Postembolization syndrome were treated by conservation therapy,among the 18 accidents,there were 6 aterial rupture,after embolization the rupture aterial,no serious complications occurred;6 uterine aterial spasm,4 were cured after treated,1 aterial false embolized,1 embolized uterine aterial with Gelfoam particle;3 patients fibroids extrusion,the fibroids was detached easily,all were cured after conservation treated;1 had amenorrheal after embolization;1 case urine bladder aterial was embolized,there was not complication after conservation treat;1 case had uterine infection,no serious complications occurred after hysterectomy.Conclusion The correct management of the complications may helpful to increase the cure rate.

Objective To compare the image quality and radiation dose between prospective ECG-trigering and retrospective ECG gating technique in coronary artery imaging. Methods 33 patients suspected coronary artery disease were included in this study and divided into experimental group (prospective ECG-triggering coronary artery imaging, heart rate < 65 bpm, 16 patients)and control group (retrospective ECG gating coronary artery imaging, heart rate < 75 bpm, 17 patients). Radiation dose was recorded for statistical analysis. At the same time, image quality was evaluated. Results There were no significant differences in image quality 3.2 msy. Effective dose reduced 76.47 %. Conclusions Prospective ECG gating coronary artery imaging can obtain the similar image quality compared with prospective ECG gating coronary artery imaging but the effective dose reduced 76.47 %. Prospective ECG gating coronary artery imaging has clinical value to peoples who are able to not accept high radiation dose and with low heart rate.

Objective To study the mechanism of hyperintensed signal at interpeduncle region in meseneephalon on DWI with diffusion sensitive gradient(Gd)applied perpendicular to the slice direetion (DWIs).Methods MRI scanning was centered at interpeduncle region.and the protocols were as follows:(1)With electrocardiograph(ECG)triggering,DWIs was acquired during systole or diastole periods respectively.(2)To observe the shape of hyperintense signal,DWIs with various slice directions was applied,which was set parallel to skull base,along Y axis,or along the oblique line between Y and Z axis with 30°to Z axis.(3)Fiber tracking was performed with the hyperintense signal as"seed"region,fractional anisotropy(FA)and ADC were derived from(multiple directions diffusion weighted imaging,MDDW).FA and ADC of hyperintease region were compared with those of the nearby fiber by using pair t-tesL Results Signal intensitv of hyperintense region on DWIs were 2296.28±38.19 and 153.81±37.91 for b=0 and b=1000 at systole period.while they were 295.36±38.84 and 154.03±37.52 at diastole period.No staffstical difference wag demonstrated between them(t=1.34,0.62,P＞0.05).The ADC valus on DWIs acquired during systole and diastole periods were(6.07±2.20)×10-4and(6.69±1.44)×10-4 mm2/s respectively.There was rio statistical difference between them(t=0.94,P＞0.05).DTI fiber tracking verified that the hyperintense region located at the decussation of superior eerebelum peduncle(SCP)in mesencephalon.It was in long and narrow heart shape or rectangular shape on DWIs.The shape depended on the direction of Gd The ADC value derived from MDDW at hyperintense region and the fiber below were(10.61±3.42)×10-4 and(9.24±2.21)×10-4 mm2/s respectively.No statistical difference was demonstrated between them(t=0.61.P＞0.05).While,the FA at hyperintensed region 0.43±0.13 was less than that of the fiber below 0.61±0.08(t=8.32.P＜0.05).Conclusions The shape of the hyperintense region on DWIs depends on the direction of Gd.The cardiac period has no effects on the hyperintense signal at peduncles,which may be attributed to the anisotropy of SCP decussation in mesencephalon.

Objective To investigate the effect of recombinant human endostatin(rh-Endostatin) combined with transcatheter arterial chemoembolization(TACE) on the growth and metastasis of the implanted hepatic tumor in rabbits.Methods Thirty New Zealand white rabbits were randomly divided into three groups (10 in each group)and VX_2 carcinomas were implanted in the left lobes of the livers. Fourteen days later, a catheter was inserted into the hepatic artery of rabbits with VX2 hepatic tumor and infusion was performed via the hepatic artery using physiological saline (group A), TACE (group B) and rh-Endostatin combined with TACE (group C),respectively. Five weeks later, all ribbits were sacrificed, the body weight and liver weight of animals were assessed, the hepatic index(HI) was calculated, the volume and necrotic area of the implanted tumor were measured. The presence of metastases in the liver, lungs were recorded. Results Five weeks after inoculation, the body weight of all animals decreased, the liver weight increased, His were 10.2±2.8, 8.5±6.1and 6.2±4.4 in groups A, B and C, respectively. The mean volume and necrostic areas of the implanted tumor were (36.2±3.4) cm~3 and (52.0±2.3)% in group A, (23.6±4.5) cm~3 and (63.6±3.5)% in group B, (10.9±5.1) cm~3 and (78.6±4.8)% in group C, respectively. There were statistical significance about tumor volume and necrostic areas of the tumors between group C and group A,B ( P<0.01). The numbers of metastases in the lungs were 50.3±31.3,53.6±35.1 and 16.8±18.4 , and the diameters of metastases in the lungs were (3.6±1.4) mm, (3.8±0.6) mm and (1.2±0.6) mm in groups A, B and C, respectively, the difference between group C versus other groups( P<0.01) was statistically significant. The differences of opportunity, tumor numbers and size of metastases in the liver were statistically significant. (P<0.01).Conclusion Treatment with rh-Endostatin combined with TACE can suppress the growth of tumor and tumor's metastases in lungs inVX2 implanted tumors of rabbits.

Objective:To investigate the renal injury of portal hypertensive rat after one hour of occlusion of portal vein and inferior vena cava.Methods:Healthy male Wistar rats were taken randomly as normal control、portal hypertensive control and trial group.The recoverable portal hypertensive model was induced firstly.Three weeks later ,15 model rats were taken randomly as portal hypertensive control group,others had another operation and were divided randomly into 0,6h,12h,24h,48h,72h,7d group according to different reperfusion time after 1 hour of occlusion of portal vein and inferior vena cava.At the corresponding time points after reperfusion,the examinations below were done:serum ALT,TBIL,BUN,Cr concentrations;mor-phological changes of liver and kidney,the ultrastructure of renal tissue.Results:Serum and Cr in trail group reached their peak value 12~24 hours after reperfusion,then decreased gradually,and returned to normal 72 hours after reperfusion.The main injury of kidney was located in proximal tubular epithelial cell ,it peaked at 12 hours and 24 hours after reperfusion,the sporadic karyopyknosis and karyorrhexis could be seen,but the basement membrane preserved well.48 hours later,the restoration could be seen.7 days later it restored obviously.Conclusion:There are obvious injury in tubular epithelial cell in the portal hypertensive rat after 1 hour of occlusion of portal vein and inferior vena cava.But the injury of kidney is reversible.

Objective To explore the feasibility and efficacy of selective arterial embolization for the treatment of hemobilia occurred after biliary tract surgery.Methods The clinical data of 16 patients with massive hemobilia after biliary tract operation,who were treated in our hospital during the period from March 1989 to August 2009,were retrospectively analyzed.Conservative treatment of hemobilia was initially adopted in all patients,and,if it failed,interventional management was carried out.Emergent artery angiography was performed in all patients,which was followed by selective arterial embolization of the bleeding arteries with Gelfoam particles and coils.Results Of the total 16 cases,15 received selective arterial embolization therapy and the remaining one died.No re-bleeding occurred during a follow-up period of 8 months to 3 years.Conclusion For the treatment of arterial hemobilia occurred after biliary tract surgery,selective arterial embolization with Gelfoam particles and coils is a safe,mini-invasive and effective therapy with few complications.

ObjectiveTo investigate the surgical method, experience, and skills in clipping anterior communicating artery aneurysm (ACoAA) via supraorbital keyhole approach.MethodsThe ACoAA case data of selectively clipping via non-dominant supraorbital keyhole approach according to the A2 open plane formed by the anterior communicating artery and the bilateral A2 segments were analyzed retrospectively.The surgical method and experience were analyzed.The indications and advantages and disadvantages of this method were summarized.ResultsACoAA in 12 patients were completely clipped via supraorbital keyhole approach from the side of non-dominant A1, and the dominant A1 segment arteries were well exposed.The patients were followed up for 4-29 months after procedure.No recurrence or rupture of the aneurysms was found.The Glasgow Outcome Scale score was 5 in 11 patients and 4 in 1 patient.Conclusions ACoAA can be completely clipped via supraorbital keyhole approach from the side of non-dominant A1.It is a minimally invasive surgical approach with good efficacy.

Objective To investigate the serum concentrations of protein-bound uremic toxins of hippuric acid ( HA) , indoxyl sulfate ( IS ) , p-cresyl sulfate ( PCS ) and 3-carboxy-4-methyl-5-propyl-2-furanpropionic acid ( CMPF ) in patients with chronic kidney disease(CKD) 3-5 stages(CKD3-5) and to assess the correlation between renal function and pro-tein-bound uremic toxin concentrations in CKD3-5 patients.Methods Serum concentrations of HA, IS, PCS, and CMPF from 60 healthy volunteers and 112 CKD3 -5 patients were measured by liquid chromatography mass spectrometry/mass spectrometry ( HPLC-MS/MS ) .Correlation analysis was conducted between the levels of HA, IS, PCS, CMPF and the estimated glomerular filtration rate( eGFR) .Results Compared with healthy subjects, serum concentrations of these four solutes were significantly increased in CKD3-5 patients (all P<0.01).The serum levels of HA,IS and PCS in CKD3-5 patients were significantly increased (all P<0.05),while those of CMPF did not significantly change (P>0.05).Linear correlation analysis showed that HA, IS, PCS and CMPF were in significantly negative correlation with eGFR.The curve regression analysis showed that the curvilinear regression fitting equation was Y=-46.171lnX+209.464(R2 =0.601,P<0.01)for HA and eGFR, Y=-62.570 lnX+279.537(R2 =0.633,P<0.01)for IS and eGFR, Y=-84.297 lnX+383.172(R2 =0.529,P<0.01)for PCS and eGFR, and was Y=-7.648 lnX+53.546(R2 =0.172,P<0.01)for CMPF and eGFR .Conclusion The levels of the four types of protein-bound toxins in CKD3-5 patients increase significantly compared to healthy subjects.The serum levels of HA,IS and PCS are increased when the renal function decreases, but the level of CMPF changes little.Renal dysfunction can lead to significantly elevated levels of HA,IS and PCS in CKD3-5 patients, but has little effect on CMPF.

Objective To investigate the changes of plasma adrenodullin(ADM) and C-type natriuretic peptide(CNP) level in children with chronic heart failure(CHF) and its clinical implications.Methods Forty-two children with CHF were collected.The patients suffered from dilated cardiomyopathy,congenital heart defects,and other heart diseases.According to a modified scoring system described by Ross and Reithman,16 patients were classified as class Ⅱ,14 as class Ⅲ,and 12 as class Ⅳ.Plasma levels of ADM and CNP were measured by radioimmunoassay assay in these patients and 11 healthy children.Echocardiography was performed to measure left ventricular function and the ratio of E/A.Results Plasma ADM and CNP levels of CHF patients were significantly elevated as compared with those of the control subjects [(218.27?106.53) ng/L vs(74.39?53.99) ng/L,P=0;(190.27?108.38) ng/L vs(92.59?(59.46) ng/L),P0.05).ADM levels were elevated with the advancing severity of CHF determined by a modified scoring system described by Ross.However,the plasma CNP levels in the normal state wasn′t significantly different from those observed in class Ⅱ.Likewise,the plasma CNP level in the class Ⅲ was not significantly different from that observed in class Ⅱ.Conclusions ADM and CNP might play a compensatory and defensive roles in the pathophysiology of the pediatric CHF.ADM may be a biochemical marker for evaluation the severity of the chronic heart failure in children,but also a new prognostic indicator of this syndrome.