1.Percutaneous endobiliary radiofrequency ablation combined with biliary stenting for the treatment of malignant obstructive jaundice:report of two cases
Dong LU ; Weifu Lü ; Jingkun XIAO ; Chunze ZHOU
Journal of Interventional Radiology 2014;(7):593-596
Objective To evaluate the safety and efficacy of percutaneous endobiliary radiofrequency ablation combined with biliary stenting in treating malignant obstructive jaundice. Methods Percutaneous endobiliary radiofrequency ablation combined with biliary stenting was carried out in 2 patients with malignant obstructive jaundice after they received percutaneous transhepatic biliary drainage. The curative effect, complications and stent patency at 50 days after the treatment were recorded. The results were analyzed. Results Successful endobiliary radiofrequency ablation and intraluminal stent implantation was accomplished in both patients, with a technical success rate of 100%. Segmental radiofrequency ablation procedure was employed. After the treatment the serum total bilirubin level was significantly decreased. No bile duct bleeding, perforation of bile duct, bile leakage or other serious complications occurred. The stent remained unobstructed during the follow - up period of 50 days. Conclusion As a new treatment for malignant obstructive jaundice, percutaneous endobiliary radiofrequency ablation combined with biliary stenting is clinically safe and effective, although its long - term efficacy needs to be further proved with randomized controlled trials.
2.Efficacy of transcatheter arterial chemoembolization combined with radiofrequency ablation in advanced hepatocellular carcinoma patients
Nan ZHU ; Dong LU ; Jingkun XIAO ; Weifu LYU
Chinese Journal of Interventional Imaging and Therapy 2017;14(4):195-199
Objective To investigate the efficacy of TACE combined with radiofrequency ablation (RFA) in treatment of advanced hepatocellular carcinoma.Methods A total of 72 patients with advanced hepatocellular carcinomas were analyzed retrospectively,including 35 patients underwent TACE combined with RFA (combined group),37 patients underwent single TACE (control group).After the operation,the short-term effect,the changes of liver function,serum alpha-fetoprotein (AFP) level,the complication and the long-term survival rates of the two groups were compared.Results The total effective rate of the combined group (29/35,82.86%) was significantly higher than that of control group (20/37,54.05%;P=0.009).In the combined group,the AFP reduced to (102.19±32.13)μg/L,and the control group reduced to (218.46±49.87)μg/L,which had statistical difference (P<0.001).The survival rates of 1-year,2-year and 3-year in the combined group were 82.86 %,54.29 %,34.29 % with a median survival time of 25 months;while in the control group those were 54.05%,32.43%,13.51% with a median survival time of 16 months;there were statistically significant differences in the survival rate between two groups (P=0.009).After treatment,the hepatic functions of both group had a transient change,and 2 weeks after the operation,there was no significant difference between the two groups (all P>0.05).Conclusion The combination of TACE and RFA is an effective method for the treatment of advanced hepatocellular carcinoma.
3.Application of Monte Carlo software in estimating patients' radiation dose during CCTA and confirmation by anthropomorphic phantom study
Xiao LIU ; Yongming ZENG ; Shengkun PENG ; Renqiang YU ; Jie WANG ; Jingkun SUN
Chinese Journal of Radiological Medicine and Protection 2014;34(2):152-154
Objective To evaluate the accuracy and efficiency of the Monte Carlo software in measuring the radiation dose to the patients who received the CCTA (Coronary Computed Tomography Angiography) examination.Methods A anthropomorphic chest phantom underwent CCTA using three scan parameters (tube voltage 80 kV,100 kV and 120 kV).Computer Software ImpactDose 2.0 was used to compute the chest organ dose on the basis of the three groups tube voltage CT scan characteristic,and the stimulation results of ImpactDose 2.0 software was verified by use of anthropomorphic phantom thermoluminescence dosimeter experiment method.Results For all the measured organs except for lung,the absorbed organ dose and effective dose of three groups of tube voltages of CCTA measured by the InpactDose 2.0 was lower than those as measured by anthropomorphic phantom study.The relative error of both methods was within ± 50%.Conclusions Monte Carlo software can be used to estimate the levels of radiation dose during CCTA examination with a tolerable error within the acceptable range.
4.Interventional chemoembolization for primary hepatocelluar carcinoma complicated by arteriovenous shunting:retrospective analysis of 62 cases
Jingkun XIAO ; Weifu LV ; Chunze ZHOU ; Xingming ZHANG ; Dong LU ; Changlong HOU ; Zhengfeng ZHANG ; Weiyu WANG
Journal of Interventional Radiology 2014;(8):683-687
Objective To retrospectively analyze the effect of interventional embolization for hepatocelluar carcinoma (HCC) associated with arteriovenous shunting (AVS), and to discuss the factors influencing the therapeutic results. Methods The clinical data of 62 cases with HCC associated with AVS , who were treated with interventional chemoembolization , were retrospectively analyzed. Based on the type and extent of AVS identified by angiographic manifestations, appropriate obstruction of the shunt and Lipiodol chemoembolization of HCC were conducted. The curative effect of the shunt embolization was assessed by DSA at one or two months after the treatment. The relevant factors influencing the prognosis of embolization were analyzed by using univariate and multivariate Cox regression analysis methods. Results Of the 62 patients, arterioportal shunting (APS) was detected in 44, hepatic arterio-venous shunting (HAVS) in 11, APS together with HAVS in 4, and hepatic artery-pulmonary artery shunting (HAPAS) in 3. Re-examination with DSA was carried out in 53 patients at 1 - 2 months after the treatment , which showed that the shunting disappeared in 18 cases, obvious reduction of the shunt flow was seen in 19 cases, the lesion remained stable in 9 cases and the disease became worse in 7 cases. Univariate analysis indicated that the kind of embolic material and the presence of tumor thrombus could affect the obstructive result of the shunt , while multivariate Cox regression analysis showed that portal tumoral thrombus was an independent risk factor. The embolization effect of polyvinyl alcohol (PVA) particles and Lipiodol-ethanol mixture, used as the embolic agents, was better than that of gelatin sponge particles. Conclusion To ensure a successful interventional chemoembolization for HCC combined with AVS the procedure should be individualized according to the type and extent of the arteriovenous shunting. The type of embolic materials used for embolization can affect the results to a certain degree.
5.Pharmacodynamic studies on cardioprotective function of Zhurihen dripping pills in experimental animals
Yunfeng XIAO ; Wenyan LI ; Shuang LIU ; Sibo XING ; Jingkun LU ; Shengsang NA
Chinese Journal of Biochemical Pharmaceutics 2015;37(4):24-27
Objective To study the cardioprotective function of Zhurihen dripping pills in experimental animals.Methods By hypoxia tolerance model and isoproterenol hydrochloride induced acute hypoxia model, measuring the time of death in mice.For rat serum LDH, CK, SOD and MDA were measured to observe protective effect of Zhurihen dripping pills on vasopressin-induced acute myocardial ischemia model.The effect of Zhurihen dripping pills on latency and durations were observed in acute arrhythmia induced by inhaled chloroform – epinephrine rabbits model.Results The hypoxia tolerance in mice and myocardial hypoxia tolerance significantly improved by Zhurihen dripping pill, and prolonged the survival time in mice.The serum level of LDH, CK, SOD and MDA significantly improved, and protected the impaired myocardial cell in rats.The latent period of arrhythmia was significantly prolonged and duration of arrhythmia was shortened in rabbits.Conclusion Zhurihen dropping pills an improve myocardial oxygen deficiency, anti-arrhythmia effect and protect myocardial cells.
6.Influence of various doses and injection rates of contrast agent on CT perfusion in rabbits' liver with deconvolution method
Jingkun XIAO ; Bin LIU ; Wanqin WANG ; Lei FANG ; Xingwang WU ; Yongqiang YU
Chinese Journal of Medical Imaging Technology 2010;26(4):612-615
Objective To study the influence of various doses and injection rates of contrast agent on CT perfusion in rabbits' liver with a deconvolution mathematical model. Methods Eight rabbits were enrolled in the experiment. Randomized block design was adopted. The treatment factor (contrast medium injection rate) was classified into 0.5, 1.0, 1.5 ml/s, while the subjects were divided into 3 blocks with contrast medium injection dose of 0.5, 1.0 and 1.5 ml/kg. The data obtained at CT perfusion imaging were then transferred to the workstation. Absolute values of 7 perfusion parameters (hepatic arterior fraction, blood flow, blood volume, permeability surface, mean transmit time, hepatic artery perfusion and portal vein perfusion) were measured with perfusion software (Perfusion 3). Results The dose of contrast medium had significant effect on peak enhancement of the aorta, the portal vein and liver tissue (P<0.05), whereas the injection rates had significant influence on the arrival time to peak enhancement of the aorta and the portal vein. However, the dose of contrast medium and injection rates had no significant effect on perfusion parameters (P>0.05). Conclusion CT perfusion imaging with a deconvolution mathematical model can quantify the hemodynamic functional status in liver with stable results. This technique does not need strict confinement to dose and injection rate of contrast medium, and has great potential value to be put into clinical use.
7.Establishment of pig avascular necrosis of femoral head model by transcatheter arterial embolization
Weifu LV ; Changlong HOU ; Dong LU ; Chunze ZHOU ; Weiyu WANG ; Jingkun XIAO ; Zhengfeng ZHANG ; Xingming ZHANG
Chinese Journal of Interventional Imaging and Therapy 2011;08(5):439-442
ObjectiveTo evaluate the technical feasibility of animal model of avascular necrosis of femoral head (ANFH)with transcatheter arterial embolization (TAE).MethodsTwenty experimental pigs were randomly divided into experimental group and control group (each n= 10).Experimental group:A 5F Cobra catheter was inserted into left femoral artery,and the feeding arteries of femoral head were superselectively inserted.The feeding arteries were embolismed through transcatheter arterial injecting the segments of silk measuring about 500μm.Control group:The arterial embolization was not performed,and the other treatment was identical to experimental group.The articulation of hip in all pigs underwent plain X-ray examination,CT and MR scanning 2 weeks and 4 weeks after treatment,respectively.Histological examination was made in 4 weeks to evaluate volume of bone trabecula (TBV) and percentage of bone lacuna (PBL) at unit area under microscope.The data were compared between the two groups.Results In experimental group,CT and MRI showed swolling in hip soft tissue and high T1 in hip joint cavity,while no obvious abnormalities were found in plain X-ray film 2 weeks after feeding arteries were embolized.Four weeks after feeding arteries embolization,plain X-ray film,CT and MR showed typical necrosis of femoral head in the experimental group,while no obvious abnormalities were found in control group.The histology examination revealed there were obvious karyopyknosis and anachromasis in the bone cells.The quantity of bone cells decreased obviously or disappeared.PBL increased and TBV decreased significantly compared with those of control group (P<0.05).ConclusionThe animal model of ANFH in pigs can be induced by TAE.It can preferably mimic the pathological situation of ANFH.
8.Application of Radiofrequency Ablation with Plasma Spot Excitation in Partial Resection of Vocal Fold in Pig
Jieyu LIU ; Xuping XIAO ; En ZHOU ; Jingkun LI ; Yu XIAO
Journal of Audiology and Speech Pathology 2024;32(6):536-540
Objective A porcine vocal cord injury model was established to analyze and compare the damage range of porcine vocal cords and the repair process after vocal cord injury caused by CO2 laser surgery and radiofre-quency ablation with plasma spot excitation technology.Methods Fifteen pigs,30 sides of vocal cords,were used in this study.The bilateral vocal cords of the same pig were divided into CO2 laser and radiofrequency coblation(RFC)groups respectively.CO2 laser and radiofrequency ablation with plasma spot excitation technology were used to perform ubligamental cordectomy.Three pigs were sacrificed after anesthesia on postoperative day 1 and postop-erative 3,6,9,and 15 weeks.The vocal cords were harvested for HE staining.The depth of edema degeneration zone and the fibrous tissue thickness were measured vertically in the two groups,and the postoperative vocal cord damage range and vocal cord repair process were compared between the two groups.Results The depth of edema degeneration zone in the CO2 laser group was deeper than that in the RFC group at 1 day postoperatively(P<0.01).There was no significant difference in the depth of the edema degeneration zone between the two groups at the 3rd,6th,and 9th weeks after operation(P>0.05).The depth of the edema degeneration zone at 3rd weeks postoperatively was less than that at 1 day postoperatively,and at 6th weeks postoperatively was less than that at 3rd weeks postoperatively for both operation modes(P<0.05).There was no statistically significant difference be-tween 9th weeks postoperatively and 6th weeks postoperatively(P>0.05).At the 15th week after operation,the fibrous tissue thickness of the vocal fold lamina propria in the RFC group was thinner than that in the CO2 laser group(P<0.01).Conclusion Radiofrequency ablation with plasma spot excitation technology causes less damage to porcine vocal fold than CO2 laser.There is no significant difference between the two operation modes in terms of postoperative repair process,while the fibrous tissue in the lamina propria of the vocal fold is thinner in the RFC group when a vocal fold scar is formed.
9.Desktop-Stereolithography 3D Printing of a Decellularized Extracellular Matrix/Mesenchymal Stem Cell Exosome Bioink for Vaginal Reconstruction
Wenxin SHI ; Jiahua ZHENG ; Jingkun ZHANG ; Xiaoli DONG ; Zhongkang LI ; Yanlai XIAO ; Qian LI ; Xianghua HUANG ; Yanfang DU
Tissue Engineering and Regenerative Medicine 2024;21(6):943-957
BACKGROUND:
3D-printing is widely used in regenerative medicine and is expected to achieve vaginal morphological restoration and true functional reconstruction. Mesenchymal stem cells-derived exosomes (MSCs-Exos) were applyed in the regeneration of various tissues. The current study aimed to explore the effctive of MSCs-Exos in vaginal reconstruction.
METHODS:
In this work, hydrogel was designed using decellularized extracellular matrix (dECM) and gelatin methacrylate (GelMA) and silk fibroin (SF). The biological scaffolds were constructed using desktop-stereolithography.The physicochemical properties of the hydrogels were evaluated; Some experiments have been conducted to evaluate exosomes’ effect of promotion vaginal reconstruction and to explore the mechanism in this process.
RESULTS:
It was observed that the sustained release property of exosomes in the hydrogel both in vitro and in vitro.The results revealed that 3D scaffold encapsulating exosomes expressed significant effects on the vascularization and musule regeneration of the regenerative vagina tissue. Also, MSCs-Exos strongly promoted vascularization in the vaginal reconstruction of rats, which may through the PI3K/AKT signaling pathway.
CONCLUSION
The use of exosome-hydrogel composites improved the epithelial regeneration of vaginal tissue, increased angiogenesis, and promoted smooth muscle tissue regeneration. 3D-printed, lumenal scaffold encapsulating exosomes might be used as a cell-free alternative treatment strategy for vaginal reconstruction.
10.Desktop-Stereolithography 3D Printing of a Decellularized Extracellular Matrix/Mesenchymal Stem Cell Exosome Bioink for Vaginal Reconstruction
Wenxin SHI ; Jiahua ZHENG ; Jingkun ZHANG ; Xiaoli DONG ; Zhongkang LI ; Yanlai XIAO ; Qian LI ; Xianghua HUANG ; Yanfang DU
Tissue Engineering and Regenerative Medicine 2024;21(6):943-957
BACKGROUND:
3D-printing is widely used in regenerative medicine and is expected to achieve vaginal morphological restoration and true functional reconstruction. Mesenchymal stem cells-derived exosomes (MSCs-Exos) were applyed in the regeneration of various tissues. The current study aimed to explore the effctive of MSCs-Exos in vaginal reconstruction.
METHODS:
In this work, hydrogel was designed using decellularized extracellular matrix (dECM) and gelatin methacrylate (GelMA) and silk fibroin (SF). The biological scaffolds were constructed using desktop-stereolithography.The physicochemical properties of the hydrogels were evaluated; Some experiments have been conducted to evaluate exosomes’ effect of promotion vaginal reconstruction and to explore the mechanism in this process.
RESULTS:
It was observed that the sustained release property of exosomes in the hydrogel both in vitro and in vitro.The results revealed that 3D scaffold encapsulating exosomes expressed significant effects on the vascularization and musule regeneration of the regenerative vagina tissue. Also, MSCs-Exos strongly promoted vascularization in the vaginal reconstruction of rats, which may through the PI3K/AKT signaling pathway.
CONCLUSION
The use of exosome-hydrogel composites improved the epithelial regeneration of vaginal tissue, increased angiogenesis, and promoted smooth muscle tissue regeneration. 3D-printed, lumenal scaffold encapsulating exosomes might be used as a cell-free alternative treatment strategy for vaginal reconstruction.