The concept of far lateral lumbar disc herniation was firstly reported by Abdullah in 1974. The diagnosis of far lateral lumbar disc herniation is based on the discography findings as well as on clinical manifestations. Far lateral lumbar disc herniation is a special type of lumbar disc herniation. Clinically, far lateral lumbar disc herniation is less seen than other types of lumbar disc herniation, it accounts for 0.7%-11.7% of total lumbar intervertebral disc protrusion. Although the incidence of far lateral lumbar disc herniation is lower, its symptoms are usually heavier and its protrusion sites are specific. Its treatment methods are more complex, including mainly conservative treatment, minimally invasive interventional therapy and surgical management, etc. This paper aims to make a review about the recent progress in its corresponding treatment.

Objective To investigate the role of Wnt signal pathway related proteins in the tumorigenesis of sponta-neous breast cancer in TA2 mice. Methods Mammary glands were collected from tissues of normal 5 cases of TA2 mice. Spontaneous breast cancers and relevant mammary glands precancerous lesions were harvested from 5 cases of TA2 mice. Mammary tissue samples from normal TA2 mice, precancerous lesions and cancer tissues of spontaneous breast cancer-bearing TA2 mice were subsequently used to detect the expression of Wnt1,Wnt5a andβ-catenin via immunohistochemical staining. Results ① Results of immunohistochemical staining showed that the positive ex-pression of Wnt1 and Wnt5 a located in cytoplasm in spontaneous breast cancers and mammary gland precancerous lesions from TA2 mice. The normal mammary glands were negative for Wnt1 and Wnt5a staining. The cytoplasm of precancerous lesions showed higher expression for Wnt1 and Wnt5a than them in the breast cancer. β-catenin in breast cancer and precancerous lesions were abnormal cytoplasmic expression. The expression level in breast cancer was higher than in the precancerous lesions. In normal mammary gland, the positive expression ofβ-catenin mainly located in the cytomembrane. ② The positive expression rates of Wnt1, Wnt5a and β-catenin in normal breast group,precancerous group and breast cancer group were ( 4. 46 ± 3. 57 )%, ( 96. 50 ± 6. 30 )%, ( 90. 00 ± 1. 17 )%, ( 2. 27 ± 4. 55 )%, ( 96. 24 ± 6. 00 )%, ( 95. 90 ± 4. 32 )%, ( 4. 78 ± 3. 57 )%, ( 60. 59 ± 5. 63 )%, (84. 87 ± 2. 56)%,respectively. The positive expression rates of the three in precancerous group and breast cancer group were significantly higher than those in normal breast group(P<0. 01). The positive expression rates of Wnt1, Wnt5a in precancerous group were higher than those in the tumor group,and the differences of Wnt1 had statistical significance (P<0. 05) while Wnt5a did not (P>0. 05). Compared with breast cancer group,the precancerous group had lower positive expression rate of β-catenin and the differences also had statistical significance ( P <0. 05 ) . Conclusion Wnt1 , Wnt5 a and β-catenin promote the progression of spontaneous breast cancer in TA2 mice.

Trigeminal neuralgia (TN) is a common cerebral nerve disease. The common methods for treatment of TN include drugs, surgery and minimally invasive intervention. Minimally invasive techniques have been widely used in the treatment of TN for simple operation, definite curative effect, high safety and few postoperative complications, whereas there are diversities of technical levels in different areas. Through summarizing clinical experiences, referring to and absorbing new ideas reported from domestic and overseas in recent years, the clinical operational guidelines for minimally invasive interventional therapy for TN were compiled in this article, in order to standardize clinical treatment and improve therapeutic effect of TN.

Objective To investigate the clinical efficacy of ozone injection combined with radiofrequency ablation (RFA) for the treatment of far lateral lumbar disc herniation (FLLDH). Methods A total of 60 patients with FLLDH, who were admitted to authors’ hospital during the period from March 2013 to March 2014, were randomly and equally divided into the study group (n=30) and the control group (n=30). Simple ozone injection treatment was employed for the patients of the control group, while ozone injection combined with radiofrequency ablation was adopted for the patients of the study group. The same other adjunctive medication was used in both groups. All the patients were followed up at one week as well as at one, 3 and 6 months after the treatment. The clinical effect and the complications of both g roups were recorded. Results Successful operation was obtained in all 60 patients, no perioperative complications occurred, and the technical success rate was 100%. The excellent clinical results evaluated at one week, and one, 3 and 6 months after the treatment in the control group and in the study group were 73.3%, 76.7%, 70%, 60% and 70%, 76.7%, 83.3%, 90% respectively. The 3-month and 6-month clinical results of the study group were significantly better than those of the control group. Conclusion For the treatment of FLLDH, ozone injection combined with radiofrequency ablation is safe and effective. This technique should be recommended in clinical practice.

Objective To evaluate the clinical effect of uterine arterial embolization (UAE) as a treatment of symptomatic uterine fibroids(UF).Methods Twenty-six patients with clinic symptoms(menorrhagia, pelvic pain, bulk-related symptoms and anemia)caused by uterine fibroids underwent UAE.The embolization with a single catheter using the single-femoral artery approach to bilateral uterine artery was performed, injection of PVA 355～500 ?m and silk particles were used in 20 and 6 cases respectively.Results All cases were followed up for 6 to 18 months after treatment.The symptoma were noticeable improvement in 24 cases but 2 cases whom with injection silk particles.The tumors were marked diminution in size(45%～75%) sonographically after 2～6 months in 13 cases.No severe complication were discovered in all cases.Conclusion Uterine artery embolization is a safe and effective method for the management of symptomatic UF.Longer follow up is needed to evaluate the long term effects.

Objective: To observe the therapeutic effect of Angiojet thrombosis aspiration of lower extremity deep vein thrombosis (DVT) after ultrasound-guided antegrade vein puncture. Methods: Data of 63 patients with acute or subacute lower extremity DVT were retrospectively analyzed. Angiography of the lower extremity was followed by implantation of inferior vena cava filter. Ultrasound-guided Angiojet thrombosis aspiration and transcatheter thrombolysis were performed, and the effect and safety were observed. Results: Among 63 patients, 54 recycled filters and 9 permanent filters were implanted. The recovery rate of recycled filters was 88.89% (48/54), and the average recovery time was (5.48±2.10) days. The success rate of ultrasound-guided antegrade vein puncture was 100% (66/66) without complication. The excellent and good treatment rate was 84.13% (53/63). There were 9 cases of hemoproteinuria after thrombus aspiration and 7 cases of mucosal hemorrhage during thrombolysis, and the total incidence of complications was 25.40% (16/63). No serious complication occurred. During (22.74±6.21) months' follow-up, 7 cases were lost and 1 case died due to malignant tumor, and post-thrombotic syndrome occurred in 6 cases (6/55, 10.91%). Conclusion: Ultrasound-guided anterograde vein puncture combined with Angiojet thrombosis aspiration is effective and safe for treatment of lower extremity deep vein thrombosis.

Objective To investigate the effectiveness and safety of AngioJet rheolytic thrombectomy in the treatment of acute limb ischemia (ALI). Methods The clinical data of a total of 19 patients with ALI of lower limbs, who were treated with AngioJet rheolytic thrombectomy, were retrospectively analyzed. The patients included 14 males and 5 females, with a mean age of (77.7±6.8)years old (66-90 years old). The thrombus clearance rate ≥90％ was defined as grade Ⅲ, 50％-90％ as grade Ⅱ, and <50％ as grade I, which was used to evaluate the thrombus clearance effect. The postoperative device-related complication, amputation incidence and the mortality were recorded. Results In all the 19 patients, the technical success rate was 100％. The thrombus clearance rate after initial AngioJet rheolytic thrombectomy was >50％ in all patients, among them grade Ⅲ was obtained in 14 patients (73.7％) and grade Ⅱ in 5 patients (26.3％). The symptoms of lower extremity pain, ischemia, etc. were improved. In 5 patients, macroscopic hemoglobinuria occurred once after the treatment. No serious complications such as bleeding at puncture point, hemorrhage of digestive tract, renal function damage or death occurred. Limb salvage was achieved in17, with a limb salvage rate of 89.5％, the 6-month and one-year limb salvage rates were 84.6％ (11/13) and 80.0％ (8/10) respectively. Conclusion For the treatment of ALI of lower limbs, AngioJet rheolytic thrombectomy is safe and effective, it can rapidly recover arterial blood flow. AngioJet rheolytic thrombectomy is especially suitable for the elderly patients and the patients who have high risk for surgical operation or have contraindications for thrombolysis.

Transjugular intrahepatic portosystemic shunt (TIPS) has been widely used in the treatment of the complications of portal hypertension,and in recent years,with a deepened understanding of TIPS,covered stents have been further developed and applied in clinical practice,among which a special stent for TIPS,Viatorr covered stent,has become a focus of attention.This article reviews the application and effect of Viatorr stent and points out that Viatorr stent can establish intrahepatic shunt and thus significantly improve shunt patency rate.Meanwhile,it can reduce the risk of repeated intervention and rebleeding without increasing the incidence rate of hepatic encephalopathy and improve patients'quality of life.

Objective To explore the application of patient empowerment in early rehabilitation training for patients with lower extremity deep vein thrombosis(DVT)after receiving catheter-directed thrombolysis(CDT).Methods A total of 110 patients with lower extremity DVT,who were scheduled for CDT therapy,were enrolled in this study.Using random digital table method,the patients were divided into control group(n=55)and intervention group(n=55).Routine rehabilitation activities were implemented for patients of the control group,while patient empowerment-based early rehabilitation training program was carried out for patients of the intervention group.The compliance to rehabilitation exercise,difference of upper/lower patella leg circumference,incidence of complications,duration of catheterization and thrombolysis,and length of hospital stay in both groups were calculated.The Self-Efficacy for Managing Chronic Disease,Chinese version of the Readiness for Hospital Discharge Scale,and the VEnous INsufficiency Epidemiological and Economic Study(VEINES)Quality of Life scale were used to evaluate the rehabilitation results of the patients of two groups.Results There were no significant differences in the duration of catheterization and thrombolysis,incidence of complications,and length of hospital stay between the two groups(all P＞0.05).At the time of discharge,the difference of upper/lower patella leg circumference in the intervention group was remarkably smaller than that in the control group,and the compliance with rehabilitation exercise,the self-efficacy,the readiness for discharge,and the quality of life in 3 months after discharge in the intervention group were strikingly better than those in the control group(all P＜0.05).Conclusion The implementation of patient empowerment in early rehabilitation training for patients with lower extremity DVT after receiving CDT therapy can improve the compliance with rehabilitation exercise,self-efficacy,limb swelling,readiness for discharge,and quality of life after discharge from hospital.(J Intervent Radiol,2024,33:554-559)

Objective To investigate the clinical utility of iFlow color flow coding imaging technology in the diagnosis of lower extremity arteriosclerosis obliterans(LEASO).Methods A total of 106 patients diagnosed with LEASO between March 2022 and October 2023 were included as the LEASO group,while 80 volunteers without arterial disease but matched with LEASO were selected as the control group.Both groups underwent digital subtrac-tion angiography(DSA),and iFlow color flow coding imaging technology was employed to assess time to peak(TTP)in the femoral head and ankle regions.The difference value of TTP between these two regions was calculated,along with measurement of ankle-brachial index(ABI).Results There were no significant differences in age,sex,body mass index,smoking history,hypertension history,diabetes history,coronary heart disease history and TTP in the femoral head between the two groups(P＞0.05).However,the TTP in the ankle area and the difference values of TTP in the LEASO group were significantly higher than those in the control group(P＜0.05).The com-parison of TTP in the femoral head region among patients with different Rutherford classifications and between patients with left and right lesions in the LEASO group showed no statistical significance(P＞0.05).Furthermore,a negative correlation was observed between Rutherford classification and both TTP values in ankle joint region as well as TTP difference value(P＜0.05),indicating that higher Rutherford classification is associated with lower TTP values.Pearson test results revealed a significant negative correlation between TTP values and ankle joint region/TTP difference value of LEASO patients with ABI(P＜0.05).Receiver operating characteristic curve analysis demonstrated that both TTP values in ankle joint region and TTP difference value are effective diagnostic indicators for LEASO;moreover,Delong test indicated that area under ROC curve for TTP difference value was significantly higher than that for TTP value alone(P＜0.05)Conclusion iFlow color flow coding imaging technology enables quantitative assessment of both TPP values within ankle joint region as well as their differences which can be utilized for diagnosis of LEASO.