Objective To discuss the clinical value of interventional transcatheter arterial chemoembolization(TACE)combined with subsequent pelvic radiotherapy in treating patients with advanced cervical cancer.Methods According to the therapeutic scheme,195 patients with phase Ⅱb or beyond advanced cervical cancer were divided into two groups: (1)study group(n=99),treated with TACE combined with subsequent pelvic radiotherapy(I.e.combination group);(2)control group(n=96),treated with radiotherapy alone(I.e.radiotherapy alone group).The short-term and long-term clinical results as well as the occurrence of complications were compared between two groups.Results Different degrees of the tumor shrinkage were found in patients of both groups after treatment.The short-term remission rate of the study group was significantly higher than that of the control group,and the difference between two groups was statistically significant(P=0.012).After the procedure,the anaemia in patients of study group was markedly corrected.The difference in hemoglobin between preoperative levels and postoperative ones was significant(T-test,P＜0.01).Long-term follow-up for 3 years the survival rate of the study group was higher than that of the control group(P=0.032).Both the recurrence rate and metastatic rate at one and three years after the therapy in the study group were distinctly lower than that in the control group(P＜0.05).No significant difference in one-year,five-year survival rate and in five-year recurrent rate existed between two groups.The main short-term complications included digestive untoward reaction,bone marrow depression,hepatic and renal toxicity,etc.,which could be well relieved after active symptomatic medication.The longterm complications included radiodermatitis,radiocystitis and/or radioproctitis.The incidence of radiocystitis and radioproctitis in the study group was significantly lower than that in the control group(P＜0.05).Conclusion TACE combined with subsequent pelvic radiotherapy is an effective therapy for advanced cervical cancer,its clinical result is superior to simple radiotherapy.This therapy tan enhance both the short-term and the tong-term effects,relieve the clinical symptoms,reduce the occurrence of long-term complications,thus,improve the quality of life and prolong the survival time of patients.

Objective To evaluate the effect of transcatheter arterial chemoembolization(TACE)together with portal vein chemoembolization(PVCE)for the treatment of advanced liver carcinomas.Methods Forty-eight patients with liver carcinoma were randomly divided into two groups.Patients in study group(n=22)were treated with TACE together with PVCE,and patients in control group(n=26)were treated with TACE alone.Results Based on the postoperative CT findings and AFP levels,the effective rate of the study group was markedly higher than that of control group and the difference between two groups was statistically significant(P＜0.05).The volume of un-embolized liver tissue in the patients of study group was obviously increased after treatment. Conclusion TACE together with PVCE is superior to TACE alone in treating advanced hepatic carcinomas.The combination of TACE and PVCE can effectively increase the successful rate of surgical resection for the advanced hepatic carcinomas.

Objective To evaluate super-selective renal arterial embolization(SRAE)in treating severe renal hemorrhage when conservative treatment had failed. Methods SRAE was performed in 111 patients with severe renal hemorrhage who had failed to respond the conservative management.The clinical data,the way of embolization,the medication and the follow-up findings were retrospectively analyzed.Results Excellent results were obtained in all patients after SRAE and no serious complications occurred.The technical successful rate with single session was 95.5%(106/111).Gross hematuria disappeared within 1-4 days after the treatment.Two patients developed shock after renal embolization and had to receive surgery after the shock was controlled.Three patients had a recurrence of hematuria,the blood urine subsided after SRAE was employed again.A follow-up with a mean period of 37.4 months was carried out in 92 patients,and the follow-up checkups showed that the renal function was well preserved in all patients.Conclusion Super-selective renal artery catheterization and embolization is a safe and effective treatment for severe renal hemorrhage,it can maximally preserve the healthy renal parenchyma as well as the renal function.Therefore,this technique should be regarded as the treatment of first choice for patients with severe renal hemorrhage.

Objective To compare the short-term effects between interventional arterial embolization and iodine-131 therapy in treating Graves'disease.Methods A total of 84 patients with Graves'disease (GD),confirmed by clinical data and laboratory tests,were divided into two groups:interventional group(n=42)receiving arterial embolization and iodine-131 group(n=42)receiving iodine-131 therapy.Before and after the treatment thyroid angiography and SPECT/CT imaging were performed to determine the shape and size of the thyroid,and radioimmunoassay method was used to measure serum levels of FT3,VF4,TSH and TRAb at 3.6 and 12 months after the therapy.The results were compared and statistically analyzed.The occurrence of complications was observed. Results No statistically significant difference in short-term therapeutic effects was found between interventional group and iodine-131 group.The occurrence of early severe complication was much higher in interventional group than that in iodine-131 group,while the occurrence of hypothyroidism was obviously higher in iodine-131 group than that in interventionai group.Conclusion Both interventional embolization and iodine-131 therapy have reliable effect for the treatment of Graves'disease.Iodine-131 therapy may be used in patients who plan to receive initial treatment or in patients who failed to effectively respond to other kinds of therapies,while interventional embolization may be employed in patients who are not able to receive surgery or in patients who have failed to respond to antithyroid drug treatment,or in patients whose iodine-131 intake rate is too low to undergo iodine-131 therapy,especially in patients with refractory and intractable hyperthyroidism. Interventional embolization can be regarded as an alternative treatment for Graves'disease.

Objective To discuss the effects and the complications of partial splenic artery embolization with gelatin sponge or with lipiodol for hypersplenism,to provide scientific information helpful for the selection of embolization materials in clinical practice.Methods Partial splenic artery embolization with gelatin sponge was performed in forty patients with hypersplenism due to cirrhosis(gelatin sponge group)and partial splenic artery embolization with lipiodol was carried out in another thirty-nine patients(lipiodol group).The clinical data were retrospectively analyzed.The laboratory studies,complications and recurrence were observed and compared between two groups.Results No significant difference in the reduction of splenic size,in the hemoglobin levels and in the thrombocyte and leucocyte counts existed between two groups(P＞0.05).However,the platelet count in lipiodol group was obviously decreased three months after the treatment.The occurrence of complications in gelatin sponge group was much higher than that in lipiodol group(P＜0.05).The toxic reaction of the liver and gastrointestinal tract in lipiodol group was significantly slighter than that in gelatin sponge group.Conclusion Partial splenic artery embolization with lipiodol should be employed for the treatment of hypersplenism when the patient is elder and the disease is accompanied by poor liver function,massive ascites,severe dysfunction of blood coagulation and serious portal hypertension.

Objective To assess the respective value and limitation of cardioangiography and ultrasonography in interventional therapy for congenital heart disease in children,and to discuss the clinical significance of the combined use of both examinations. Methods A total of 162 children with congenital heart disease,screened by ultrasonography,were enrolled in this study.The disorders included VSD(n=50),PDA(n=96)and PS(n=16).Before the interventional therapy all the cases accepted cardioangiography and ultrasonography examinations,and the diameter of the abnormal passage was measured.The difference in the diameter between two examinations was compared and statistically analyzed by using paired t test.All the cases accepted both examinations after the interventional therapy to check the location of the occluder and the result of balloon dilatation.Results Both cardiovascular angiography and ultrasonography could make a definite diagnosis of congenital bean disease in children,and could well display the location and shape of the abnormalities.The diameter of VSD(n=50)measured by cardioangiography and ultrasonography was(4.93±2.73)mm and(5.66±2.77)mm respectively,with no significant statistical difference existing between two methods(P＞0.05).The diameter at the narrowest site of PDA(n=96)measured by cardioangiography and ultrasonography was(3.22±1.45)mm and(3.96±1.42)mm respectively,with a significant difference existing between two methods(P＜0.05).In 16 PS cases,the diameter of valvular ring determined on cardioangiogram and on ultrasonogram wag(16.16±4.26)mm and(17.94±5.50)mm respectively,with no significant difference between two groups(P＞0.05).During the operation of VSD,the monitoring ultrasonography revealed that the valvular opening and closing was interfered by the occluder in 9 cases,so the occluder was re-adjusted till it was fixed to proper position. After the interventional therapy for VSD and PDA,cardioangiography detected a small residual shunt in 7 cases,which completely disappeared 24 hours later on ultrasonography.After balloon dilation in all 16 children with PS the right ventricle-pulmonary artery pressure difference was reduced by more than 50%and the pressure figure reached the standard of clinical Cure.The interventional procedure was successfully completed in all patients except for three cases. Conclusion In treating children of congenital heart disease with interventional procedures,the determination of the lesion's diameter and the selection of the occluder should be based on cardioangiographic measurement,although ultrasonography is more helpful in making preoperative screening and postoperative evaluation.

Objective To discuss the curative effect of unremitting pump infusion of microdose urokinase(100 000 u/24 h)into the cerebral venous sinus in treating thrombosis in cerebral venous sinus which had anatomical variation. Methods Mechanical disruption of the thrombus and unremitting pump infusion of microdose urokinase(100 000 u/24 h)into the cerebral venous sinus for 48-96 hours were employed in 9 patients with thrombosis in anatomically varied cerebral venous sinus.After the procedure the original disorder was actively treated and the anticoagulant therapy was continued for 6 months.A follow-up of 6-12 months(mean 10 months) was conducted. Results Recanalization of the previously occluded cerebral venous sinus was obtained in all 9 patients.The dose of urokinase was 100 000 u/24 h in 8 patients.For the remaining one patient the dose of urokinase was 100 000 u/24 h in the first 48 hours,then the dose Was increased to 250 000u/24 h. Excellent result was obtained in all patients.Conclusion Unremitting pump infusion of microdose urokinase into the cerebral venous sinus can effectively treat the thrombosis in anatomically varied cerebral venous sinus.

Objective To compare the effects of different doses of adenosine(AD)on the left coronary blood flow(CBF)and left coronary flow reserve(CFR)in mini-swine.Methods By using Doppler flow wire and intracoronary ultrasound imaging catheter at the middle segment of LAD,coronary average peak flow velocity(APV)and lumen area were measured in 10 healthy mini-swines.CBF was calculated from the equation of 0.6 APV times 0.5 lumen area.Intracoronary bolus injection of different dose AD(12μg,18μg,24 μg and 36μg,separately)was used to induce maximal coronary hyperemic reaction.CFR was defined as the ratio of hyperemic CBF to resting CBF.Results Intracoronary bolus injection of 18μg AD level induced a maximal coronary vasodilation.Significant difference in the hyperemic CBF existed between 12 μg AD dose and 24μg or 36μg AD dose(P＜0.05).No significant difference in heart rate,blood pressure,rCBF and CFR was found among three different AD dose groups(18μg,24μg,and 36μg).Conclusion CBF and CFR in mini-swine can be effectively assessed by bolus injection of AD with the dose of(18～24)μg.

Objective To make a preliminary evaluation of the degradation of AZ31 bioabsorbable magnesium alloy stent implanted in the abdominal aorta of experimental rabbits.Methods Twelve AZ31 biodegradable magnesium alloy stents were separately deployed in the infrarenal abdominal aortas of twelve New Zealand white rabbits.Every three experimental rabbits were sacrificed each time at one,two,three and four months after the procedure of stenting.The stenting segment of the aortas were harvested,radiographod and sent for pathologic examination to observe the degradable performance of the stent.Results All animals survived form the operation in the scheduled follow-up period.Radiographically and pathologically,the stents were fully expanded with perfect shape one month after the procedure,and part of the stent struts began to be degraded and fractured in two months,resulting in the loss of its supporting function.Three months after the implantation most stents were corroded.and in four months all the stents become completely destroyed.The estimating time for producing complete degradation of AZ31 magnesium alloy stents in rabbit's aorta was 104.5 days.Conclusion AZ31 bioabsorbable magnesium alloy stents implanted in rabbit abdominal aorta will lose their radial force in two months.How to prolong the functioning time of the implanted stents is the next research target.

Objective To investigate the relationship between the liver pain and the short-term curative effect in patients with primary hepatocellular carcinoma(HCC)after transcatheter arterial chemoembolization(TACE).Methods According to the degree of liver pain,118 HCC patients after the initial TACE treatment were divided into two groups:group A(with no complaint of serious liver pain)and group B (complaining of severe liver pain).Short-term curative effects at the fourth and sixth week after initial TACE were compared between the two groups,and the factors related to the liver pain after TACE were analyzed.Results Four to six weeks after the initial TACE,CT scan was performed in all patients.Based on the RECIST criteria the short-term curative effects were evaluated.The CR,PR,SD,PD of group A and B were 0%.1.45%.88.41%,10.14%and 0%,14.29%.81.63%,4.08%,respectively.The difference in OR(CR +PR)between two groups was statistically significant(P=0.0087).The postoperative liver pain was probably related to the preoperative tumor blood supply pattern,the tumor capsule.the cirrhosis and the type of iodized oil deposit.The type of iodized oil deposit showed a negative correlation with the grade of liver pain (r=-0.539,P＜0.001).Conclusion The liver pain occurred after TACE is a useful suggestive sign,which indicates that a good curative result will be obtained.It is of clinical significance to make a full understanding of the relationship between the liver pain and the therapeutic effect.