Esophageal cancer is a common malignant tumor. Most patients have already in the late stage of the disease when the diagnosis is confirmed and have lost the surgery chance. In recent years, esophageal stent has been widely applied in the treatment of esophageal stenosis caused by esophageal cancer. The clinical experience shows that the esophageal stent can effectively solve the problem of dysphagia. However, the ordinary esophageal stent has no therapeutic effect on the esophagus tumor. The esophageal stent loaded with ~(125)I seeds can not only solve the dysphagia problem but also can treat the primary esophagus cancer with its brachytherapy effect. This article aims to review the clinical application and the up-to-date research progress of the esophageal stent loaded with ~(125)I seeds.

Objective To investigate the value of transcatheter thrombolysis treatment of acute A V internal fistula thrombogenesis in hemodialysis patients. Methods The acute A V fistula thrombogenesis in 32 hemodialysis patients with chronic renal failure were treated with transcatheter pulse spray pharmacomechnical thrombolysis (PSPMT). Results Acute A V fistula thrombogenesis was verified in all 32 patients by angiography and treated with transcatheter PSPMT. The immediate clinical success rate of thrombolysis was achieved in 97% except for one case. The A V fistulas were proved to reopen by post treatment angiography. Recurrent thrombosis was found in 4 cases, reopenning with transcatheter PSPMT was achieved in 2 of them and the rest 2 cases were undergone PTA because of localized vascular stenosis. All the 32 A V fistulae, were reopened after treatment without serious complications such as hemorrhage, pulmonary embolism and others.Conclusions Transcatheter PSPMT is a safe, effective and microinvasive treatment for acute A V fistula thrombolysis with higher immediate reopenning rate. Transcatheter PSPMT combined with PTA and intravascular stent grafting can improve long term patency rate.

Objective To explore the feasibility of using rotating pliers system for treating lumbar disc herniation with concomitant prolapse.Methods Ex vivo incision experiment was performed on 8 lumbar discs of 2 pigs using rotating pliers. Clinical application included 12 patients of lumbar disc herniation shown by CT or MRI. 40% herniations excerted enough pressure on dural sac with concomitant prolapse of different degrees. The symptoms and image findings were concordant. The herniated nucleus pulposus were resected using rotaing pliers system, MacNab standard was applied for the clinical evaluation. Results The ex vivo experiments and clinical application were successful. Clinical application showed CR in 4 patients (33.3%), PR in 5 patients (41.7%) and NR in 3 patients (25.0%). CT demonstrated the herniated disk tissue retraction of different degrees in CR and PR patients, together with decrease in CT attenuation number, ranging from 8 30 HU, 18?5HU in average but no changes in NR patients.Conclusions Percutaneous lumbar diskectomy is safe and effective to treat lumbar disc herniation with concomitant prolapse by using rotating pliers systems and thus extending the PLD application.

Transcatheter renal sympathetic denervation with radiofrequency ablation has become a new treatment for refractory hypertension.Recent studies have showed that renal sympathetic denervation can also treat the diseases that are related to increased sympathetic nerve activity, such as metabolic diseases, cardiac disfunction, arrhythmia, obstructive sleep apnea syndrome, polycystic ovary syndrome, renal failure, etc. This paper aims to make a general review on the recent clinical research progress about renal sympathetic denervation with radiofrequency ablation.

Objective To assess the long-term outcomes as well as the living quality of the patients with lumbar disc herniation (LDH) after the treatment of percutaneous lumbar discectomy (PLD), and to discuss the influential factors related to the long-term effectiveness. Methods During the period of January 2000 to March 2002, PLD was performed in 129 patients with LDH. By using self-evaluation questionnaires of Oswestry disability index (ODI), Short Form-36 (SF-36) and Japanese Orthopaedic Association (JOA) through letter or telephone interviews as well as the patients' initial medical records, the related clinical data were collected. Statistical analysis was conducted by using Wilcoxon's rank sum test, Chi-square test. Results One hundred and eight patients (83.7%) were able to be followed up and 104 effective ques-tionnaires were collected. The mean follow-up time was (6.64 ± 0.67) years, the excellent rate (ODI score, 0 ～ 20%) was 71.15%. The average scores of the JOA and SF-36 was 23.66 ± 5.72 and 75.88 ± 25.57, respectively. The scores of quality of life were obviously improved in all follow-up subscales. Conventional operations were carried out subsequently in 9 patients as they failed to respond to PLD. No complications related to PLD occurred in this study. The age, course of the disease and the patient's condition at the time of discharge might bear a relationship to long-term effectiveness. Conclusion PLD is a safe and minimally-invasive technique for the treatment of LDH with quick and reliable effect, PLD can dramatically improve the quality of life. Many factors, such as the age, course of the disease and the patient's condition at the time of discharge, can affect the long-term outcomes.

A study of 10 cadavers and 100 CT scans of lumbar spine was performed to investigate the topographical anatomy of the posterolateral disc puncture in percutaneous lumbar discectomy.A way of the puncture at L_5-S_1 disc,with comparative plain films of lumbar spine in different positions were taken in 50 cases.The results showed that the pos- terolateral approach for percutaneous discectony was a safe way.However,it is important to have full knowledge of the regional topographical anatomy associated with the puncture tech- nique to avoid the potential neurovascular complications.The special position designed by authors for the puncture at L_5-S_1 disc is useful by lowering the position of iliac crest which hinders the entrance of needle,thus can raise the successful rate of the percutaneous discec- tomy 100% successful rate of the disc puncture at L_5-S_1 disc was obtained in 130 cases.The two puncture parameters of Chinese associated with percutaneous lumbar discectomy were first measured;and also the route including nearby structures,the complications were dis- cussed.

Selective salpingography and transvaginal catheter dilatation using a self- made coaxial catheter set were performed in 45 women with infertility and fallopian tube ob- struction.The successful catheterization rate was 95.5% for fallopian tubes and the recanal- ization rate proximal allogian tubes was 80%,Normal intrauterine pregnancy was achieved in total 15 women(33.3%)with in two years follow-up 50% and 17.4% pregnant rates were obtained in secondary infertility and primary infertility,respectively.The authors be- lieve that transvaginal catheter dilization is a useful method for female infertility with fallopi- an tube obstruction,especially for the secondary infertility and proximal fallopian tube ob- struction.The self-made coaxial catheter set holds the advantages of effectiveness,safety, and inexpensiveness.

Objective To explore the feasibility and value of treating esophageal thoracic fistula with covered esophageal stent through nasal esophagus drainage tube. Methods Seven patients with esophageal thoracic cavity fistula were enrolled and treated by 5F pigtail side-holes catheter inserting into thoracic cavity for drainage and then again through nasal esophagus and fistula, placing a covered stent in the esophagus to occlude the orifice of the fistula. The abscess cavities were washed and radiographied periodically through drainage tubes. Results The insertion of the drainage tube and the placement of covered stent were all successful. The drainage tubes were placed in abscess cavities for 12-22 days, average 15 days. The radiography through drainage tubes showed that the abscess cavities disappeared or shrank obviously with control of hydropneumothorax before the drainage tubes being pulled out. The esophagogram after withdrawal of the drainage tubes notified that the fistulae were occluded satisfactorily with stents expanded fully without displacement and stenosis. Conclusions Treating esophageal thoracic cavity fistula with covered esophageal stent through nasal esophagus drainage tube is feasible and safe with clinical efficiency.

Objective To assess the long-term outcomes as well as the living quality of the patients with lumbar disc herniation(LDH) after the treatment of percutaneous lumbar discectomy(PLD),and to discuss the influential factors related to the long-term effectiveness.Methods During the period of January 2000 to March 2002,PLD was performed in 129 patients with LDH.By using self-evaluation questionnaires of Oswestry disability index(ODI),Short Form-36(SF-36) and Japanese Orthopaedic Association(JOA) through letter or telephone interviews as well as the patients’ initial medical records,the related clinical data were collected.Statistical analysis was conducted by using Wilcoxon’s rank sum test,Chi-square test.Results One hundred and eight patients(83.7%) were able to be followed up and 104 effective ques-tionnaires were collected.The mean follow-up time was(6.64 ? 0.67) years,the excellent rate(ODI score,0 ～ 20%) was 71.15%.The average scores of the JOA and SF-36 was 23.66 ? 5.72 and 75.88 ? 25.57,respectively.The scores of quality of life were obviously improved in all follow-up subscales.Conventional operations were carried out subsequently in 9 patients as they failed to respond to PLD.No complications related to PLD occurred in this study.The age,course of the disease and the patient’s condition at the time of discharge might bear a relationship to long-term effectiveness.Conclusion PLD is a safe and minimally-invasive technique for the treatment of LDH with quick and reliable effect.PLD can dramatically improve the quality of life.Many factors,such as the age,course of the disease and the patient’s condition at the time of discharge,can affect the long-term outcomes.

Brachytherapy with 125I radioactive seed has the advantages of low dose-rate,comtinuous irradiation and repeated implantation to inhibit the replication of tumor cells,and the repeatable implantation.It has been widely used in the treatment for cervial cancer,and can also be applied to pelvic malignancies,including ovarian cancer,colorectal cancer,bladder cancer.Compared with external beam radiotherapy,it can improve the dose of target region to control tumor effectively.At the same time,it can protect the normal tissues and reduce the occurrence of complications.In this paper,we summarized the speciahy,function mechanism,complications and application status of radioactive 125I seed interstitial implantation in the treatment of pelvic malignancies.The application of three dimensional printing in brachytherapy with radioactive 125I seed was also introduced.This review can provide a reliable basis for future standardized seed implantation treatment for pelvic malignancies.