Objective To study the practical value of preoperative selective intra-arterial embolization in the surgical treatment of nasopharyngeal fibroangioma. Methods Digital subtraction angiogrophy(DSA) and selective arterial embolization were carried out in 15 cases of nasopharyngeal fibroangioma. The supplying arteries originated from the maxillary and the pharyngeal ascending branches arising from external carotid artery were embolized with gelatin sponge. Results 15 cases underwent operation after selective embolization of blood supplying arteries and the amount of bleeding in operation was thus reduced greatly in 13 cases, while the blood loss during the surgery of another 2 cases was still considerable because both external carotid artery and internal carotid artery supplied the tumor with only embolization of the external carotid artery. Optimum time for the operation was taken on 2-5 days after the embolization. Conclusions Preoperative intra-arteral embolization for nasopharyngeal fibroangioma is a valuable method of choice for the clinical treatment.

Objective To investigate the clinical effect and to summarize the experience of percutaneous radiofrequency ablation (RFA) of spleen together with splenic artery balloon block in treating hypersplenism due to cirrhosis and portal hypertension. Methods Under the situation of splenic artery occlusion with balloon, RFA of the spleen was performed in 15 patients with hypersplenism caused by cirrhosis and portal hypertension. The mean duration of RFA was (46.4±5.4) min. Routine blood tests were conducted at 3 days, one week, one, 3 and 6 months after the treatment, and abdominal CT angiography was performed one month after RFA. The results were analyzed. Results One patient developed massive bloody pleural effusion at left thorax three days after RFA, which was improved after hemostasis and thoracic drainage. No severe complications occurred in other patients. Abdominal CT angiography performed one month after RFA showed that the ablated extent by RFA was accounted for about 34.3%-71.8% proportion of the spleen, with a mean of (56.20 ±13.09)%. Preoperative blood tests indicated that the count of white blood cells, red blood corpuscles and blood platelets was (3.88±1.75)×109/L, (4.06±0.37) × 1012/L and (48.14± 11.33)×109/L, respectively. One month after RFA the count of white blood cells and blood platelets increased to (5.62±1.61) ×109/L and (132.29±33.20) ×109/L respectively. When compared with the preoperative data, the differences in the count of white blood cells and blood platelets were statistically significant (P<0.05). Conclusion For the treatment of hypersplenism due to cirrhosis and portal hypertension, percutaneous radiofrequency ablation of spleen together with splenic artery balloon block is quite safe and this technique has satisfactory short-term effect.

Objective To investigate the relationship of the activation of nuclear factor kappa B(NF-kB) with myocardial neutrophil infiltration and injury in human open heart surgery,and to observe the inhibiting effect on the activation of NF-kB and protecting effect on myocardium of the coenzyme Q10,a scavenger of oxygen free radicals.Methods Forty-seven adult patients undergoing open heart surgery were randomly divided into two groups,the control and the treatment.CoenzymeQ10 tablets were given to the treatment group 5 days before operation.Biopsy of right atrium for myocardial pathology,activated NF-kB detection and ultrastructure observation were done prior to cardiopulmonary bypass,45 minutes of ischemia and 45 minutes of reperfusion.The dynamic indexes,vasomotor drug dosage,and outcomes were observed postoperatively.Results Upon 45 minutes of ischemia and 45 minutes of reperfusion,in control group there were neutrophil accumulation and adhesion of vascular endothelium,ultrastructural damages,and positive expression of NF-kB both in nuclei and cytoplasm,in myocardium.In treatment group,there were only mild neutrophil infiltration and ultrastructural damages,and weak positive expression of NF-kB both in nuclei and cytoplasm.However,the dynamic indexes,vasomotor drug dosage,and outcomes of two groups were not significantly different.Conclusion NF-kB plays an important role in pathophysiological process of myocardial ischemia and reperfusion in open heart surgery.CoenzymeQ10 has obvious inhibiting effect on activation of NF-kB and protecting effect on myocardium.

Objective To investigate the changes in the serum level of vascular endothelial growth factor (VEGF) in experimental Wistar rats with hepatic alveolar echinococcosis (HAE) after hepatic arterial infusion (HAI) of bevacizumab treatment, and to discuss the efficacy of HAI of bevacizumab for hepatic alveolar echinococcosis. Methods Forty Wistar rats with successfully established HAE were randomly and equally divided into two groups with 20 rats in each group: the control group and the study group. Hepatic arterial infusion of saline was performed in the rats of the control group , while hepatic arterial infusion of bevacizumab was carried out in the rats of the study group. Before and 7, 14, 21 and 28 days after the treatment peripheral blood samples were collected from the tail vein, and the serum levels of VEGF, apartate aminotransferase (AST) and alanine aminotransferase (ALT) were determined by the quantitative sandwich enzyme-linked immunosorbent assay (ELISA). All the rats were sacrificed 28 days after the treatment. HAE samples were examined to evaluate the effect of bevacizumab on HAE lesions. Results Seven days after hepatic arterial infusion of bevacizumab, serum VEGF expression level in the study group became gradually decreased, and the difference was statistically significant when compared with the preoperative level or with that in the control group (P = 0.019). Fourteen days after the treatment, the serum VEGF expression level kept going down to its lowest point, and the difference in serum VEGF expression level was statistically significant when compared with the preoperative level (P < 0.01). Twenty-one days after the treatment, serum VEGF expression level started to rise and it returned to normal level in 28 days after the treatment. In the control group no significant changes in serum VEGF expression levels was observed after hepatic arterial injection of saline (P > 0.05). Conclusion In treating hepatic alveolar echinococcosis, hepatic arterial infusion of bevacizumab has certain inhibitory effect on angiogenesis. This therapy is safe and effective.

Objective To explore the clinical efficiency and safety of radiofrequency ablation combined with Tegafur,Gimeracil and Oteracil Porassium Capsules( S-1 capsules) for hepatocellular carcinoma.Methods Sixty HCC patients included in this study were underwent initial radiofrequency ablation and then they were di-vided into RFA+S-1 group and RFA control group according to the metronomic chemotherapy either with S-1 or not.The local tumor control and disease free survival outcome between the two groups were compared.Results Follow-up observation showed that the total control rate after 9 months′treatment was 93.3%in RFA+S-1 group vs.73.4%in RFA control group(P=0.038).During the 18 months of follow up,the median time for dis-ease free survival was 16.25 months in RFA+S-1 group vs.12.25 months in RFA control group( P<0.001) . One-year progression free survival rate in RFA group was 53.3%,which was significantly lower than the RFA+S-1 group(83.3%)(P=0.012).The major complication rate was 13.3%.No procedu rerelated death or severe complications occurred.Conclusion Metronomic chemotherapy with S-1 following initial radiofrequency ablation delays tumor progression and prolongs overall survival of patients with HCC tumors.

Objective To evaluate the long-term efficacy of transjugular intrahepatic portosystemic shunt(TIPS)with bare stents and Fluency covered stents in the treatment of portal hypertension,and to discuss its clinical value.Methods The clinical data of 29 patients with intractable ascites or esophagogastric fundus varices rupture and hemorrhage caused by cirrhotic portal hypertension,who received TIPS with bare stents and covered stents at the First Affiliated Hospital of Xinjiang Medical University of China(25 patients)and the Lishui Municipal Central Hospital of China(4 patients)between August 2012 and December 2017,were retrospectively analyzed.The patients were regularly followed up to check the survival status.The postoperative cumulative shunt patency rate and cumulative survival rate of the patients were analyzed by Kaplan-Meier method.Results The technical success rate of TIPS was 100％.The mean portal vein pressure was decreased from preoperative(40.21±3.24)cmH2O to postoperative(24.55±3.55)cmH2O(P＜0.05).The patients were followed up for 5.1-10.5 years.The postoperative 1-,3-,5-,7-year primary cumulative patency rates of the shunt were 89.7％,75.9％,75.9％ and 52.5％,respectively.The postoperative 5-,7-,9-and 10-year cumulative survival rates were 100％,66.9％,66.9％ and 33.4％,respectively.The incidence of hepatic encephalopathy was 13.8％(4/29).Conclusion Using bare stents combined with Fluency covered stents for TIPS is clinically safe and effective in the treatment of portal hypertension.This technique carries higher long-term shunt patency rate and low incidence of hepatic encephalopathy.Therefore,it can be used as a substitute for Viatorr stent when necessary.(J Intervent Radiol,2024,33:295-299)