Objective To evaluate the effectiveness and side effects of uterine arterial embolization with Pingyangmycin(a homogenous bleomycin) lipiodol emulsion(PLE) for symptomatic uterine fibroids. Methods Uterine arterial embolization with PLE was performed in 25 patients.The improvement of symptoms and uterine size changes were followed up in 3-18 months(mean 6 months) after the procedure. Results All but 2 cases were successfully treated bilaterally.Superselective angiography showed enlargement of uterine artery,accompanied by tortuous branches.The uterine size was increased.The uterus itself was significantly stained and emptied slowly. Coagulation necrosis was found in resected fibroids after embolization in 3 patients. One month after the procedure, a mean 40% reduction of uterine volume was obtained in 18 followed up cases.The clinical symptoms were relieved significantly. The main side effects were hypogastic pain(13/25),which was intense in 6 cases. Conclusion Uterine arterial embolization with PLE is a good non surgical therapy in symptomatic uterine fibroids with mild side effects.

Objective To investigate the stability of 1% lauromacrogol foam sclerosant prepared with different liquid-to-air ratio in order to find out the optimal liquid-to-air ratio. Methods According to Tessari technique, two 10 ml disposable plastic syringes and one three-way plastic stopcock were used to mix 1%lauromacrogol with room air, and liquid-to-air ratios from 1∶1 to 1∶9 were separately employed to make the preparation of the foam sclerosant. Each kind of liquid-to-air ratio was used to separately make bubbles for 5 times, the foam half-life time (FHT), the foam drainage time (FDT) and the foam coalescence time (FCT) were recorded, and their mean values were calculated. The optimal liquid-to-air ratio was defined as the intermediate values of all the above measured indexes. Results When the liquid-to-air ratio was 1 ∶ 1, 1 ∶2, 1 ∶ 3, 1 ∶ 4, 1 ∶ 5, 1 ∶ 6, 1 ∶ 7, 1 ∶ 8 and 1 ∶ 9, the FHT of 1% lauromacrogol foam sclerosant was 184.8, 169.3, 135.9, 110.8, 111.5, 92.6, 76.3, 74.7 and 49.9 seconds respectively; the FDT was 10.6, 17.8, 14.6, 13.7, 13.0, 12.3, 10.7, 11.5 and 12.6 seconds respectively; while the FCT was 108.4, 79.8, 41.8, 20.3, 10.4, 0, 0, 0 and 0 seconds respectively. Conclusion Based on Tessari technique, the indoor air, two 10 ml disposable plastic syringes and one three-way plastic stopcock are used to prepare 1%lauromacrogol foam sclerosant, and the optimal liquid-to-air ratio is 1 ∶ 2.

Objective To analyze the factors that might affect the therapeutic results of pingyangmycin-lipiodol emulsion intra-arterial sclerosing embolization (PLE-IASE) in treating symptomatic cavernous hemangioma of liver (SCHL). Methods PLE-IASE was performed in 89 patients with SCHL (32 males and 57 females). Before treatment the mean diameter of the hemangioma was (8.3±3.8) cm. Of 89 patients, 53 experienced anxiety, 35 suffered from right upper abdominal pain and the remaining one developed Kasabach-Merrit syndrome. Before PLE-IASE, the arteriographic classification was conducted based on hepatic arteriographic findings. Then pingyangmycin-lipiodol emulsion (PLE) was injected through the feeding artery. The dosage of pingyangmycin (PYM) was (9.8±4.4) mg and the dosage of lipiodol (LP) was (5.9±2.9) ml. The lipiodol deposition status was judged by the follow-up spot film taken immediately after PLE-IASE. The observations of the occurrence of complications, the relief of symptoms and the minification of SCHL were followed for 6-72 months after PLE-IASE. The linear regression analysis statistics was conducted by taking the minification as dependent variable and taking the arteriographic classification, lipiodol deposition status, the dosage of PYM, the dosage of lipiodol and the preoperative SCHL diameter as independent variable. Results Of all 89 cases of SCHL, hypervascular type was seen in 51, hypovascular type in 26 and arteriovenous shunt (AVS) type in 12. Good lipiodol deposition status was found in 64 patients and poor deposition in 25 patients after PLE-IASE. After PLE-IASE, the symptom of anxiety in 53 patients was relieved and the right upper abdominal pain was reduced in 33 cases although intermittent pain still remained in 2 patients. The blood platelet count of the patient with Kasabach-Merrit syndrome returned to normal after the treatment. The symptomatic relieve rate was 98.7%. No serious complications occurred in the follow-up period. The linear regression analysis showed that arteriographic classification, lipiodol deposition status and PYM dosage used in treatment had statistically significant impact on tumor minification, while the preoperative diameter of SCHL and lipiodol dosage used in treatment had no statistically significant impact on it. Conclusion PLE-IASE is an effective and safe interventional treatment for SCHL. Arteriographic classification, lipiodol deposition status and PYM dosage used in treatment have a significant correlation with the minification of SCHL, while the preoperative diameter of SCHL and lipiodol dosage used in treatment bear no relationship to the minification of SCHL.

Objective To evaluate the effectiveness, safety and clinical feasibility of long-term drainage following percutaneous transhepatic cholangiography and drainage (PTCD) for the treatment of ischemic-type biliary lesion (ITBL) after liver transplantation. Methods There were 11 patients with ITBL after liver transplantation. Of the 11 patients with a mean age of 42. 3, 10 were male and 1 female. All 11 cases were diagnosed by PTC or ERC (endocopic retiogiade cholangiogiaphy) before PTCD, and they responded poorly to medication or draining and stenting with ERCP. Long-term drainage following PTCD was performed, whereas adjuvant percutaneous aspiration through double guidewire technique was used for the patients with large quantities of chole mud. Results There were three types of ITBL: type Ⅰ (extrahepatic lesions, n=7), type Ⅱ (intrahepatic lesions, n= 1), and type Ⅲ (intra- and extra-hepatic alterations, n=3). PTCD was performed in all 11 patients successfully. The values of total bilirubin (TBIL) and direct reacting bilirubin (DBIL) were 206.70±54.18μmol/L, 170. 65±53. 97μmol/L and 90. 63± 13.00μmol/L, 63. 83± 13.61μmol/L before and 1 week after PTCD, respectively. The follow-up period was from 3 through 71 months (mean 20 months). During the follow-up, TBIL values ranged between 23.70 μmol/L and 241.0 μmol/L (mean 55.3±15.6 μmol/L), and DBIL values were between 8. 1 and 162.0 μmol/L (mean 32. 53±10. 21 μmol/L). Hepatic functions were good in 9 cases including 5 cases in which the drainage tube was withdrawn after long-time drainage (6～ 12 months, mean= 8.2 months) and 4 cases in which drainage continued. The other 2 cases received liver retransplantation for the grafts dyssynthesis of albumen after drainage for 3 and 8 months. Conclusion Long-term drainage following PTCD is an effective and safe approach for ITBL following liver transplantation.

Objective To analyse the recurrence rate of patients with Budd-Chiari syndrome (BCS) after radical correction.Method We retrospectively analyzed the clinical characters and follow-up of patients who underwent radical correction and suffered recurrence.Patency rate of inferior vena cava (IVC) and hepatic veins (HVs) were examined.We present the causes of recurrence and clarify risk factors for recurrence by survival analysis.Result Among the 102 patients undergoing radical correction,34 patients suffered from postoperative recurrence,including 32 cases of IVC lesions,21 cases of HVs lesions (19 patients suffered concurrently from IVC and HVs lesions).One patient received reoperation,16 patients received balloon angioplasty of IVC or HVs,3 patients received stent implantation,and 14 patients received conservative treatment.Conclusions The recurrence rate is high after radical correction for BCS.Once the abnormal syndrome recurs,the patients can be managed by radical correction,balloon or stent angioplasty.The main causes of recurrence are thrombosis of IVC,compression of caudate lobe,scar contracture,and the risk factors for recurrence are concurrent hypercoagulation status,too short period of postoperative anticoagulation (less than 6 months).

Objective To study the conditions of separation and regeneration of Poria cocos protoplast.Methods Separation and regeneration of P.cocos protoplast under different ages of hyphae,enzyme consistency,and enzymolysic time and stabillizer.Results The results showed that the yield of the protoplast was different under different ages of hyphae,enzyme concentration,enzymolysic time,and stabilizer.Conclusion For strain Z_(10-2),its optimal age of hyphae,enzyme concentration,and stabilizer is 72 h,3%,and 0.5 mol/L mannitol,respectively.The strain Z_(10-3) is 56 h,3%,and 0.6 mol/L mannitol.The frequency of regeneration of the two strains is the best and 7.5?10~(-3)(strain Z_(10-2)) and 1.3?10~(-2)(strain Z_(10-2)) separately when the stabilizer is 0.6 mol/L mannitol.

Objective To discuss the safety and efficacy of using ExoSealTM vascular closure device to obtain rapid hemostasis of puncture site in interventional procedure via retrograde femoral artery access.Methods The clinical data of 124 patients,who were admitted to authors' hospital during the period from March 2016 to April 2016 to receive interventional procedure via retrograde femoral artery access,were retrospectively analyzed.During the performance of intervention,ExoSealTM vascular closure device (ExoSealTM group,n=52) or manual compression (MC group,n=72) was employed to make femoral artery puncture point hemostasis.The time spent for hemostasis,the manual compression time,the limb immobilization time,the amount of blood loss during compression process,and the procedure-related complications were recorded and the results were compared between the two groups.Results Technical success rate in ExoSealTM group was 98.1％(51/52).In ExoSealTM group and MC group,the time spent for hemostasis was (0.28±0.08) min and (5.83±1.46) min respectively,the manual compression time was (2.65 ±0.57) min and (7.70± 1.88) min respectively,the limb immobilization time was (2.72±0.43) h and (6.15±0.69) h respectively;all the differences between the two groups were statistically significant (P＜0.01).In ExoSealTM group subcutaneous hemotoma occurred in one patient,while in MC group subcutaneous hemotoma occurred in 3 patients and pseudoaneurysm in one patient;the complication rates were 1.92％ (1/52) and 5.56％ (4/72) respectively,but the difference was not statistically significant (P＞0.05).In MC group the amount of blood loss during compression process was (1.11±0.86) ml,which was remarkably less than (7.83±2.08) ml in ExoSealTM group,the difference between the two groups was statistically significant (P＜0.01).Conclusion For hemostasis of puncture site in interventional management via retrograde femoral artery access,the use of ExoSealTM vascular closure device is safe and effective.

Objective To investigate the clinical applications of sandwich technique according to area calculation in endovascular aneurysm repair of patients with aorta and iliac artery lesions.Methods Six patients with aortoiliac artery disease confirmed by CT were treated using sandwich technique according to area calculation.The diameter of the main stent and two branches stents were chosen according to the area calculation.Technical success rate,patency of the stent graft and complications were observed.Results Technical success rate was 100％ (6/6),and no complications occurred in all the 6 patients.The clinical symptoms were significantly improved.Gutter endoleak was found in 1 patient 2 months after the procedure,and was managed by coil embolization successfully.No endoleak occurred in other patients during follow-up of 6-31 months.Conclusion For patients with special anatomy of aorta and iliac artery lesions,the application of area calculation in the sandwich technique provides a feasible approach in choosing the matching size of the main body stent and two side branches stents.

Aim To design and synthesize new phenyloxyisobutyric acid analogues as antidiabetic compounds. Methods Eight new target compounds were synthesized by combination of lipophilic moieties and acidic moiety with nucleophilic replacement or Mitsunobu condensation. The eight compounds were confirmed by 1H NMR, 13C NMR, IR and MS. Results In vitro insulin-sensitizing activity (3T3-L1adipocyte) demonstrated, that the cultured glucose concentration of up-clear solution detected with GODpioglitazone, compounds A and B were added to the insulin-resistant system. Conclusion In vitro insulin-sensitizing activity of target compound A is in between that of rosiglitazone and pioglitazone, and activity of target compound B is slightly less than that of pioglitazone.

Objective To investigate the causes and managements of dys-seal syndrome (DSS) developed after esophageal stent placement. Methods From June 2001 to June 2008, esophageal stenting was performed in 98 consecutive patients with malignant esophageal obstruction. A total of 99 metallic stents were used. Of 98 patients. gastroesophageal anastomosis stricture was seen in 19, preoperative radiotherapy history in 26 and tracheoesophageal fistula in 34. Results DSS occurred in 7 patients, with an occurrence rate of 7.14% ,which was significant higher than that in patients with preoperative radiotherapy history and in patients showing marked dilated esophagus proximal to the obstructed site (X~2=0.017, 0.005, P=0.036, 0.013, respectively). After treatment, such as fasting, IPN or nasogastric feeding,only 1 case retumed to semi-liquid diet. Among the rest 6 cases of DSS, an additional stent was employed in one (but in vain), nasogastric feeding tube was used in 2, and removal of the stent under endoscopic guidance was carried out in 3. Conclusion DSS is one of the complications developed after esophageal stent placement, its prognosis is rather poor. Removal of the inserted stent may be the optimal treatment. The prevention of DSS includes proper pre-operation evaluation, selection of suitable stent, enhancement of perioperative nutritional support, etc.