1.Digital subtraction angiography manifestation and interventional therapy of arteriovenous shunting in primary hepatocellular carcinoma of advanced stage
Journal of Peking University(Health Sciences) 2004;0(02):-
Objective:To explore the appearances o f digital subtraction angiograph y (DSA) and therapeutic efficacy of interventional therapy of hepatic carcinoma accompanied with arteriovenous shunting (AVS). Methods: To retro spectively analy ze clinical material of 97 patients with hepatocellular carcinoma with hepatic artery-portal vein shunting(HA-PVS) , of whom, 16 had upper gastrointestinal hemorrhage, 51 had middle to l arge amounts of ascites, and 53 had varices of esophagus and fundus gastricus . All the patients were treated with transcatheter arterial chemoembolization (TACE) or transcatheter arterial infusion chemotherapy (TAI). Shunts were embolized by lipidol i n 40 patients, by lipidol and spon-gia gelatinosa particle in 34 patients, and by coi l in 6 patients. The remaining 17 were treated only with TAI. Results:Twelve (12.4%) case s had hepatic artery-hepatic vein shunting (HA-HVS),while 32 (33%)cases had portal vein tumor thrombosis (PVTT). In 70(72.2%) patients, all shunts we r e completely closed successfully, in 15(15.5%) patients, the shunts were partly closed, and in 12(12.3%)patients, the shunts were not closed. In 12 patients, the shunts reopened in later therapy, their blood flow was smaller than before and they were closed after second embolization. In 17 patients, new shunts emerged. After TACE therapy,the tumors were smaller in 57(58.7%),bi gger in 24 (24.7%),and 16(16.5%) were the same in size before and after TACE. Ascit es disappeared in 29 patients, decreased in 18 patients and had no change in 4 pati ents. Five patients who had upper gastrointestinal hemorrhage pre-operation had n ew hemorrhage. Of the 47 patients who had diarrhea, 23 improved. In 67 alph a fetoprotein (AFP) positive patients, degree of AFP in 53 patients decreased. Eighty-one patients died and their Corresp onding author’s e-mail, renjieyang2007@163.commiddle survival period was 12.9 months. No serious dama ge to hepatic function due to the treatment was observed in most patients. Concl usion:Primary hepatic carcinoma with AVS increases difficulty of interv entional therapy,but as long as we take active and proper treating measure,we could ac quire satisfactory curative effect without serious syndrome. DSA can demonstrate the type, the site and the degree of AVS completely and directly, thus having import ant value in treating primary hepatic carcinoma and improving prognosis.
2.Imaging characteristics and intervention therapy for hepatic artery-portal vein shunts in patients with primary liver carcinoma
Lijun CHEN ; Renjie YANG ; Linzhong ZHU ; Xu ZHU
Chinese Journal of Clinical Oncology 2015;42(11):570-575
Objective:To investigate the onset of hepatic artery-portal vein shunts (HAPVS) in primary liver cancer (PLC) pa-tients through digital subtraction angiography (DSA) and to devise a suitable strategy for treating both lesions and shunt tracts. In the process, the therapeutic effect on such patients can be enhanced. Methods:A total of 769 PLC patients who accepted transarterial che-moembolization (TACE) were analyzed retrospectively. We examined the image characteristics of 112 cases with HAPVS based on shunt type. For patients with middle or severe fistula, we initially attempted to overpass the fistula. Then, we either embolized the tumor lesions or merely provided chemotherapy to the patients. For patients with mild peripheral fistula, we embolized the tumor and fistula si-multaneously. Then, the accompanying arterial-vein shunt and portal vein tumor thrombus (PVTT) were handled at the same time. Re-sults: DSA findings showed that portal veins were observed in the early stage of angiography. A total of 52 of the 112 cases with HAPVS involved mild shunts, 34 exhibited moderate shunts, and 26 reported severe shunts. Among these cases, 31 involved central-and central peripheral-type artery-portal vein fistula, whereas 81 involved peripheral-type artery-portal vein fistula. Seven cases were examined in combination with hepatic artery-liver vein shunts, and 50 cases were investigated in conjunction with PVTT. Tumor embo-lization was successful in 101 cases (90.1%). Moreover, catheters successfully overpassed shunt tracts and embolized the tumors in 48 cases (42.9%). Shunt tracts were successfully closed in 74 cases (66.1%), and no serious complication was observed. Conclusion:Pe-ripheral-type artery-portal vein fistula and mild-to-moderate shunts were easier to close than central-type artery-portal vein fistula and severe shunts were. Tumor embolization and shunt closure were successful in most patients. Therefore, TACE is a safe and reliable method for treating HAPVS in PLC.
3.Combination of epristeride and terazosin for treatment of benign prostatic hyperplasia
Boyong HU ; Jin QIU ; Ming HAN ; Renjie GONG ; Honggang ZHU
Chinese Journal of Postgraduates of Medicine 2008;31(20):16-18
Objective To evaluate the security and efficacy of combination of epristeride and terazosin for treatment of benign prostatic hyperplasia (BPH). Method One hundred and eighty-four patients with BPH were treated by epristeride for 6 months and terazosin for 1 month, the efficacy and complication were observed. Results After 6 months treated, compared with before treated, the common symptoms improved, the residual urine decreased 20.74ml, maximum flow rate increased 3.76 ml/s, prostate volume grown downwards 6.70cm3 and the quality of life raised apparently(Pall<0.05 ). Condusion Combinationof epristeride and terazosin for treatment of BPH is safe and effective.
4.Interferin-γ and interleukin-10 levels in expressed prostatic secretion of chronic prostatitis/chronic pelvic pain syndrome
Boyong HU ; Ming HAN ; Renjie GONG ; Jin QIU ; Honggang ZHU
Chinese Journal of Postgraduates of Medicine 2010;33(26):24-26
Objective To investigate the levels of pro-inflammatory cytokine interferon (IFN)-γand anti-inflammatory cytokine interlenkin (IL)-10 in expressed prostatic secretions (EPS) of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and their clinical significance. Methods The levels of IFN-γ and IL-10 in EPS of 20 patients with CP (type Ⅲ A, group A ), 20 patients with CPPS (type Ⅲ B,group B) and 10 healthy men (control group) were measured using enzyme-linked immunosorbent assay (ELISA). The results were analyzed comparatively with NIH-chronic prostatitis symptom index (NIH-CPSI).Results The levels of IFN-γ in EPS of group A and group B were ( 14.92 ± 7.85 ), ( 13.74 ± 5.96) ng/L respectively, which were higher than that in control group [(7.47 ± 1.40) ng/L] (P < 0.05 ). And the levels of IL-10 in EPS of group A and group B were (216.40 ± 33.65 ), (223.70 ± 45.21 ) ng/L respectively, which were higher than that in control group [( 162.10 ± 43.81 ) ng/L] ( P < 0.05 ). There was no statistically significant difference between group A and group B. No correlation between NIH-CPSI and IFN- γ,IL-10 levels in EPS(P > 0.05 ). Conclusion IFN-γ and IL-10 have a very important role in etiology of CP/CPPS and they can be the objective parameters in the diagnosis of CP/CPPS.
5.Methodological Experimental Study on Percutaneous Regional IsolatedHepatic Perfusion Combined with Charcoal Hemoperfusion
Shichen LIU ; Renjie YANG ; Hongzhi ZHANG ; Linzhong ZHU
Journal of Practical Radiology 1991;0(03):-
Objective To investigate methods and feasibility of percutaneous regional isolated hepatic perfusion combined with charcoal hemoperfusion(PRIHP-CHP).Methods Four out of 12 dogs underwent the procedure of routine transhepatic arterial infusion(TAI) as control group, 8 underwent PRIHP-CHP as experimental group. Adriamycin was used in our study, the concentration of plasma in hepatic vein and systemic vein was detected in both groups. Results All the procedures were successful in the PRIHP-CHP group eight, but 1 dog died because of air embolization. The average procedure duration for each was (132.3?15.3) minutes. The peak level of adriamycin concentration in hepatic vein and systemic in TAI were (3709.676?385.723) ng/ml and (1576.140?226.933) ng/ml respectively. In PRIHP-CHP, the peak level were (4653.420?430.204) ng/ml and (433.612?40.501) ng/ml. There were statistically significant differences between TAI and PRIHP-CHP (?
6.Clinical Evaluation of the Efficacy of Azithromycin vs Erythromycin in the Treatment of Acute Infections
Yunping JIANG ; Renjie ZENG ; Yi ZHONG ; Bing ZHU ; Guang XU
China Pharmacy 2001;0(08):-
OBJECTIVE:To evaluation of the efficacy and safety of azithromycin in the treatment of acute infections METHODS:A randomized controlled multicenter clinical study was used to compare the clinical efficacy of azithromycin(200mg q d for 3~5 days) with erythromycin(500mg b i d for 5 days) RESULTS:The cure rate,effective rate,and bacterial clearance rate were 76 7%,95 0%,and 94 3% respectively for azithromycin group and were 48 3%,76 7%,and 77 4% respectively for erythromycin group with a side-effect incidence of 10 0% for azithromycin group and 39 3% for erythromycin group CONCLUSION:Azithromycin is superior to erythromycin in clinical efficacy,safety and side-effect incidence
7.Application and evaluation of laryngeal mask airway in neonatal resuscitation
Bingchun LIN ; Xiaoyu ZHU ; Jinqiong SU ; Hongmao YE ; Renjie YU
Chinese Journal of Perinatal Medicine 2010;13(5):379-383
Objective To study the feasibility, efficacy and safety of laryngeal mask airway (LMA) in neonatal resuscitation. Methods Totally, 369 neonates requiring positive pressure ventilation at birth were randomized into two groups by offering either LMA resuscitation (205 cases) or bag-mask ventilation (BMV) resuscitation (164 cases). The effect in the two groups were observed. Results (1) No significant difference was observed in Apgar scores at 1 min between LMA group and BMV group, but the neonates having higher Apgar scores at 5 min in LMA group were more than in BMV group (x2 =-3. 39,P=0. 001). The successful resuscitation rate of LMA group was higher than that of BMV group (99.02%vs 84. 15% ,x2 =28. 76, P<0. 01), the total ventilation time of LMA group was shorter than that of BMV group [(36.4±23.7) s vs (66.2±35.4) s] (t=-8.66, P<0. 01). Among severe asphyxia neonates,seven of nine were successfully resuscitated by LMA, while in BMV group six neonates with severe asphyxia were all switched to endotracheal intubation ventilation. In neonates with Apgar score of 4 to 5 at 1 min after birth, the successful resuscitation rate of LMA group was higher than that of BMV group (100% vs 42. 86%, x2 =23.04, P<0.01), the ventilation time of LMA group was shorter than that of BMV group [(54.6±33.6) s vs (136.4±42.0) s] (t= -4. 45, P<0.01). In neonates with Apgar score of 6 to 7 at 1 min after birth, there was no significant difference in the successful resuscitation rate between LMA and BMV group. (2) The successful rate of LMA insertion at first attempt was 98.54% (202/205) and the average insertion time was (7.8 ± 2. 2) s. The adverse effects included vomiting(4 cases)and regurgitation (3 cases). Conclusions In neonatal resuscitation, LMA can be easily inserted. Compared to BMV, LMA is a better choice in resuscitation for neonates with moderate or severe asphyxia and preferable for those medical staffs who are unfamiliar with endotracheal intubation, or even as a substitute of endotracheal intubation ventilation.
8.Evaluation on the chemosensitivity of hepatocellular carcinoma during mimetic transcatheter arterial embolization
Qiang LI ; Linzhong ZHU ; Renjie YANG ; Hu LIN ; Guokun AO
Chinese Journal of Hepatobiliary Surgery 2015;21(10):695-698
Objective To investigate whether 5 different chemotherapeutic drugs and their combination of either two drugs could further promote the inhibition on the cell growth of HCC cell line (HepG2) in vitro in the hypoxic and hyponutritional culture medium (HHCM) mimicking the different scenarios of transcatheter arterial chemoembolization (TACE).Methods The cells were treated by 5 drugs for 2 h, 4 h,6 h and 24 h, which include epirubicin (EPI), cisplatin (DDP), mitomycin-C (MMC), oxaliplatin (OXA) and 5-fluorouracil (5-FU) in four concentrations of HHCM (5%, 10%, 25% and 50%) mimicking the scenarios during TACE and the cell viability was assessed using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay.The combinations of dual drugs treated for 24 h were also tested.Results The sensitive drugs with inhibition rates more than 30% were EPI, MMC and OXA in 4 different concentrations of HHCM.The sensitivity of the drugs treated for 24 h was significantly increased compared with that for 2 h in 5%, 10% and 25% HHCM.The dual combinations did not increase the chemosensitivity of HepG2 cells.Conclusions EPI, MMC and OXA exhibited cytotoxic activity against HepG2 cells in various hypoxia and hyponutrition states.Prolonging the exposure time could increase the sensitivity of drug in HHCM, and the combination of dual drugs cannot enhance the cytotoxic effect.
9.Effect of the combination ambroxol hydrochloride and co-xuanju capsule in treatment of semen liquefaction
Ming HAN ; Boyong HU ; Renjie GONG ; Jin QIU ; Bing YAO ; Honggang ZHU
Chinese Journal of Postgraduates of Medicine 2010;33(17):16-18
Objective To compare the effect of using ambroxol hydrochloride combined with co-xuanju capsule,co-xuanju capsule and ambroxol hydroehloride in the treatment of semen liquefaction.Methods Sixty semen liquefaction patients were divided randomly into three groups.Clinical trials involving 20 who received ambroxol hydrochloride+co-xuanju capsule(group A),20 co-xuanju capsule(group B) and 20 ambroxol hydrochloride(group C),were carried out for 3 months.The changes of semen liquefaction time and semen quality were measured and assayed before and after treatment Results Compared withpretherapy,various parameters in the semen quality and semen liquefaction time after treatment all had a significantly difference in every group,and the patients of semen liquefaction time less than 60 minutes were 17 in group A,11 in group B and 14 in group C respectively.The results of semen liquefaction time andsemen quality in group A were significandy higher than the other groups(P<0.05),but the results between group B and group C had no significant difference.Conclusion The combination of ambroxol hydrochlorideand co-xuanju capsule can eridently improve the semen liquefaction time and semen quality and is an effective method in treating male infertility.
10.Evaluation of cone-beam CT hepatic angiography in detecting the tumor-feeding arteries during the performance of TACE for HCC
Jungang HU ; Xiaodong WANG ; Xu ZHU ; Guang CAO ; Hui CHEN ; Renjie YANG
Journal of Interventional Radiology 2015;(6):481-487
Objective To accurately judge the tumor-feeding artery is the most important basis for a successful treatment of hepatocellular carcinoma (HCC) with super-selective hepatic arterial chemoembo lization therapy. This study aims to assess the clinical value of cone-beam CT hepatic arteriography (CBCT-HA) in detecting tumor-feeding arteries during the performance of conventional transarterial chemoembo lization (TACE), and to compare the diagnostic effects between CBCT-HA and non-selective hepatic DSA. Methods Twenty-three consecutive patients with inoperable HCC were enrolled in this study. TACE was carried out in all patients. During the performance of TACE, the DSA-HA, CBCT-HA, Lipiodol-TACE and Lipiodol-CBCT were performed separately. The imaging materials, including DSA-HA and CBCT-HA, were analyzed by two experienced interventional physicians together to judge the tumor-feeding arteries. Statistic analysis was conducted by using chi square test. Results Tumor stain and lipiodol accumulation were regarded as the “gold standard” of the presence of tumor-feeding artery, based on which the tumor-feeding artery was confirmed in 75 lesions. DSA-HA demonstrated positive tumor-feeding artery in 40 lesions, among which true-positive tumor-feeding artery was seen in 32 and false-positive one in 8. CBCT-HA showed positive tumor-feeding artery in 72 lesions, which included true-positive tumor-feeding artery in 68 and false-positive one in 4. The sensitivity of CBCT-HA in judging tumor-feeding artery was 90.7% (68/75), which was much higher than that of DSA-HA (42.6%, 32/75), the difference was statistically significant(P<0.001). The positive predictive value of CBCT-HA in detecting tumor-feeding artery was also higher than that of DSA-HA (94.4% vs. 80.0%; P=0.040). Conclusion Cone-beam CT hepatic arteriography is obviously superior to DSA hepatic arteriography in identifying tumor-feeding arteries, which is very helpful in guiding super-selective TACE for HCC.