1.Study of responsible arteries of duodenal ulcer hemorrhage and the significance of transcatheter arterial embolization
Qiang LI ; Liang WU ; Jijun TANG
Journal of Practical Radiology 2014;(12):2043-2046
Objective To study the responsible arteries of duodenal ulcer hemorrhage and the significance of transcatheter arterial embolization.Methods There were 1 7 patients of massive bleeding of duodenal ulcer,in which 1 6 patients were diagnosed and 8 ca-ses were treated by endoscope initially.DSAs were performed at gastr-oduodenal arteries or their ramus in all patients.DSA signs were analysed by two salted docters together.At first the responsible ar-teries for duodenal ulcer hemorrhage were affirmed,and then endo-vascular embolization was performed.Results The responsible arteries for duodenal ampulla ulcer hemorrhage were the ascending duodenal artery(ADA)、the pancreaticoduodenal trunk(PDT)、the supraduodenal artery(SDA)and the retroduodenal artery (RDA).The responsible arteries for descendant duodenum ulcer hemorrhage were the anterior superior pancreaticoduodenal artery (ASPDA)and the posterior superior pancreaticoduodenal artery(PSPDA).The positive rate of bleeding that showed the signs of bleeding was 100%,the s-uccess rate of the operations was 100%,the complete efficiency ra-te of hemostasis was 88.2%,the par-tial efficiency rate of hemostas was 1 1.8%.Conclusion The responsible arteries of duodenal ulcer hemorrhage are multiples,which is important for guiding transcatheter arterial embolization of the responsible arteries of duodenal ulcer hemorrhage accurately.
2.Stent implantation for the treatment of central venous obstruction in hemodialysis patients with arteriovenous fistula: analysis of its clinical value
Qiang LI ; Liang WU ; Jijun TANG ; Juan LI
Journal of Interventional Radiology 2017;26(8):744-748
Objective To discuss the feasibility and clinical value of percutaneous transluminal stenting (PTS) for the treatment of central venous obstruction (CVO) in hemodialysis patients with arteriovenous fistula (AVF).Methods The clinical data of 10 hemodialysis patients with AVF complicated by CVO were retrospectively analyzed.Clinically,all patients presented as swollen hand syndrome.Preoperative or intraoperative digital subtraction angiography (DSA) was performed to determine the obstruction site,and based on the disease condition the appropriate surgical approach was employed.For patients having thrombus formation,catheter-directed thrombolysis (CDT) was carried out first.For patients having severe stenosis or occlusion of veins,pre-expansion with small diameter balloon was employed before PTS.For the remaining patients,PTS was directly performed.All patients were regularly followed up after operation.Results DSA showed that brachiocephalic vein occlusion and/or occlusion or stenosis of subclavian vein,internal jugular vein and superior vena cava were observed in 5 patients who had history of internal jugular vein catheterization,while localized severe stenosis of medial segment of AVF-side subclavian vein was detected in the other 5 patients who had no history of internal jugular vein catheterization.The technical success rate of PTS was 100% (10/10).A total of 19 stents were implanted in the 10 patients.Seven months after the treatment,one patient developed in-stent re-stenosis,and PTS had to be carried out again.Primary patcncy rates at 6 months and 12 months after the treatment were 100% (8/8) and 75% (3/4) respectively.Conclusion In hemodialysis patients with AVF,CVO is mainly characterized by obstructive or severely stenotic lesions.PTS carries higher success rate with satisfactory short-term and mid-term effect,its complications are slight and mild,and the technique is safe and feasible.Therefore,PTS can be used as the preferred treatment method.
3.Effect of Paishitang Combined with Tamsulosin Hydrochloride on Upper Urinary Calculi after Extracorporeal Shock Wave Lithotripsy
Taisheng LIANG ; Xiangdong LUO ; Gang WU ; Botao TANG ; Yu DONG
Progress in Modern Biomedicine 2017;17(23):4491-4494
Objective:To explore the clinical effect ofpaishitang combined with tamsulosin hydrochloride on the patient with up per urinary calculi after extracorporeal shock wave lithotripsy (ESWL).Methods:120 cases with upper urinary calculi in our hospital from January 2015 to September 2016 were selected and divided into two groups according to the random number table,60 cases in each group.ESWL was given to both groups of patients and provided with tamsulosin hydrochloride postoperation,then paishitang were additionally given to the patients in the observation group.The clinical effect and changes of serum creatinine (Scr),neutrophil gelatinase as sociated lipocalin (NGAL),cystatin C (Cys-C) and glomerular filtration rate (GFR) levels before and after treatment were compared between two groups.Results:The total effective rate of observation group was 96.67%,which was 86.67% in the control group,no signifi cant difference was found in the total effective rate between the two groups(P<0.05).The stone discharge rate was 95.00% in the observation group,which was significantly higher than that of the control group (P<0.05);the incidence rate of renal colic was 6.67%,which was significantly lower than that of the control group(P<0.05),the stone discharge time and the duration of hematuria were significantly shorter than those in the control group (P<0.01).There was no significant difference in the recurrence rate between the two groups within one year (P>0.05).The serum NGAL and Cys-C levels of both groups were gradually increased while the GFR levels were gradually decreased on the 1st,2nd day postoperation,but all the index mentioned above gradually recovered on the 3rd day postoperation.The levels of NGAL and Cys-C in the observation group were significantly lower than those in the control group on the 1st,3rd day postoperation while the GFR was significantly higher in the observation group than those of control group on the 1st,3rd day postoperation(P<0.01).No significant difference was found in the Scr at different time points postoperation between two groups(P>0.05).Conclusion:Paishitang combined with tamsulosin hydrochloride had significant clinical effect on thpatient with upper urinary calculus after ESWL and could effectively improve the renal injury induced by ESWL.
4.Inhibitory effect of gefitinib combined with DNA vaccine targeting EGFR against mouse lung cancer Lewis cells
Dong LIU ; Jianyi WU ; Liang TANG ; Lisong TAN
Chinese Journal of Cancer Biotherapy 1996;0(04):-
Objective: To observe the inhibitory effect of gefitinib combined with DNA vaccine targeting EGFR against implanted Lewis tumors in mice.Methods: Chicken EGFR L2 domain and rabbit IgG Fc domain fusion pVAX1/cEGFR-rFc DNA vaccine was injected into mice and the titer of anti-EGFR in serum was determined by ELISA.The growth of Lewis cells was measured by MTT.Lewis lung cancer mouse models were established and were randomly divided into vaccine,gefitinib,gefitinib+vaccine,and control groups.The tumor volume and weight and survival of mice were examined in different groups.Results: The titer of anti-EGFR in mice vaccinated with pVAX1/cEGFR-rFc plasmid was 1∶1 000.The proliferation of Lewis cells in anti-EGFR combined with gefitinib was significantly inhibited compared with those in anti-EGFR and gefitinib groups(P
5.Biodegradation of a novel bionic scaffold with nanostructure in vivo
Jianhong CHEN ; Qian TANG ; Huanyou LIANG ; Ping WANG ; Jian WU
Chinese Journal of Tissue Engineering Research 2009;13(25):4977-4980
BACKGROUND: Bone implant materials have been previously reported to be not coincident between inducing velocity of new bone formation and degradation velocity itself; therefore, the materials could not be completely degraded but formed into foreign substances. A novel artificial bone implant material, characterizing by well biocompatibUity, biodegradation, and biomechanics, is focused in biomaterials field recently.OBJECTIVE: To study the biodegredation of a novel bionic scaffold with nanostructure, i.e., poly (3-hydroxybutyrate-co-3-hydroxyvalerata)/sol gel bioactive glass (PHBV/SGBG), in vivo. DESIGN, TIME AND SETTING: A controlled animal experiment was performed at Animal Experimental Center of the Third Hospital affiliated to Sun Yat-sen University from May 2005 to October 2006. MATERIALS: PHBV/SGBG was provided by Materials Institute of South China University of Technology, and ethylene oxide was sterilized for preparation.METHODS: Eight hybrid dogs were used to make models of Ubia diaphyseal defect, having two defects on both left and right sides. The tibia diaphyseal defects at proximal part were considered as the control group, and those were not performed with any treatment; while, the tibia diaphyseal defects at distal part were considered as the experimental group, and PHBV/SGBG was fully implanted into the defect regions. Every two dogs were sacrificed at different time points of 2, 4, 8, and 12 weeks, respectively. MAIN OUTCOME MEASURES: In vivo biodogradation and osteogenesis were monitored under optic microscopy and electron microscope.RESULTS: The PHBV/SGBG scaffold had well biodegradation and rapid degradation velocity, and it began to degrade at two weeks after operation. The PHBV/SGBG scaffold was almost replaced by new bone tissues at 8 weeks after operation and completely degraded at 12 weeks after operation. In addition, the PHBV/SGBG scaffold had a good ability to induce new bone formation from edge to center. Whereas, surface depression in the defect region was still visible in the control group, cortical bone was not formed in embedded region of soft tissue; furthermore, electron microscopy demonstrated that calcium salt deposition was increased in the bone defect region, and the structure was tight; however, the defect was not completely repaired, and some voids were still visualized.CONCLUSION: The novel bionic scaffold, PHBV/SGBG, degrades fast in vivo to generate new bone tissues. The new bone regenerate accompanied by a fitting degradation of the novel bionic scaffold that achieve complete repair.
6.Biopolymer poly hydroxybutyrate-hydroxyvalerate membrane
Jianhong CHEN ; Qian TANG ; Jian WU ; Huanyou LIANG
Chinese Journal of Tissue Engineering Research 2011;15(42):7817-7821
BACKGROUND: Poly hydroxybutyrate-hydroxyvalerate (PHBV) has been used to construct bioprosthetic heart valve. It remains unclear whether it can be used as membrane for guided bone regeneration. OBJECTIVE: To investigate the biocompatibility of PHBV membrane and evaluate its efficiency of promoting bone regeneration in vivo. METHODS: Effects of 100%, 75%, 50%, 25% PHBV extract solution on relative growth rate of dog bone marrow mesenchymal stem cells were measured by MTT method and cytotoxicity of the biomaterials was evaluated. Bone defects were made on distal bilateral tibias and treated with PHBV membrane; the proximal bilateral tibias undergoing reduction of periosteal flap and were used as control. RESULTS AND CONCLUSION: The toxicity gradation of PHBV membranes was grade 0-1. That is, they were not toxic to growth and proliferation of bone marrow mesenchymal stem cells. New bone regeneration was observed in the defects covered with PHBV membranes at week 2 post-surgery. The defects covered with PHBV membranes were filled with mature bone at week 12 post-surgery. The bone repair in experimental groups was earlier and better than that in control groups. Results demonstrated that PHBV membrane, which has no cytotoxicity to mesenchymal stem cells in a wide range of extract concentration, could be a promising biopolymer membrane for guided bone regeneration.
7.Clinical application of the Classification of acute pancreatitis-2012
Qing WU ; Zhihai LIANG ; Guodu TANG ; Wenjing CHEN ; Chunyun FANG
Chinese Journal of Pancreatology 2013;13(4):217-221
Objective To investigate the clinical value of the Classification of acute pancreatitis2012.Methods Medical records and clinical data of patients with acute pancreatitis (AP) who were admitted to First Affiliated Hospital of Guangxi Medical University between October 2009 and September 2012 were retrospectively reviewed and analyzed.Patients were divided into mild acute pancreatitis (MAP),moderately severe acute pancreatitis (MSAP),and severe acute pancreatitis (SAP) groups according to the Classification of acute pancreatitis-2012.The number of improved and cured patients,length of hospital stay,hospitalization costs,rate of ICU admission,length of ICU stay,incidence of SIRS,and length of SIRS continue,Ranson scores,APACHE Ⅱ scores,computed tomographic severity index (CTSI) scores among the 3 groups were compared.Results One hundred and sixty-six patients with AP (119 males and 47 females) were included,and 76 were MAP,65 MSAP and 25 SAP.The average interval between AP onset and hospital admission was (2.27 ± 1.46) d.The number of improved and cured patients,length of hospital stay,hospitalization costs,rate of ICU admission,length of ICU stay,incidence of SIRS,and length of SIRS continue,Ranson scores,APACHE Ⅱ scores,CTSI scores increased with the severity of AP.The corresponding values in SAP group were 21 cases (84.0%),(23.8 ± 13.6) d,(53900 ± 30260) Yuan,48.0% (12/25) and (5.76 ± 13.8) d,96.0% (24/25) and (5.00 ± 2.40) d,(3.76 ± 1.30) score,(8.52 ± 4.24) score,(5.44 ± 3.48) score.Seventy-nine patients developed local complications,among them 34 was acute peripancreatic fluid collection,45 was acute necrosis collection.The incidence of acute necrosis collection in SAP group was significantly higher than that in MSAP group (68.0% vs 44.6%,P =0.047),but the incidence of acute peripancreatic fluid collection in SAP group was significantly lower than that in MSAP group (16.0% vs 46.2%,P =0.016).Organ failure occurred in 42 patients,among them 35 cases were respiratory failure,2 cases were renal failure,and 5 cases were respiratary and renal failure.The incidence of organ failure in SAP and MSAP group was 100% and 26.2%,the difference between the two groups was statistically significant (P < 0.05).Conclusions Classification of acute pancreatitis-2012 is a simple and convenient system,which can predict the severity of AP and appropriate for clinical application.
8.The potential role of original fracture hematoma in fracture healing
Liang LIN ; Yahui TANG ; Luhan WU ; Zengru XIE
Chinese Journal of Tissue Engineering Research 2015;(46):7386-7390
BACKGROUND:In closed fractures, the initial hematoma that is inclined to remove is seldom considered as the important reasons for bone healing. OBJECTIVE:To observe the mechanism and potential role of original fracture hematoma in fracture healing. METHODS:Ninety-six patients with closed fractures of the long bones undergoing open reduction and internal fixation were randomly divided into experimental group (n=48) and control group (n=48). In the experimental group, original fracture hematoma, 1.0-2.0 mL, was first taken out during the internal fixation and placed into a special sterile plastic bag; then, 3-4 pieces of hematomas were filed into the fracture site and sutured layer by layer. On the contrary, original fracture hematomas from the control group were discarded. Blood samples were extracted to detect the biochemical indicators at 1 month after internal fixation. X-ray examination was done at 1, 3, 6 months after internal fixation for observation of fracture healing. RESULTS AND CONCLUSION: X-ray films showed that the healing rate at 3 months after operation was 95% in the experimental group and 78% in the control group, and there was a significant difference between the two groups (P < 0.05). Levels of bone glaprotein, I-type precolagen carboxy terminus peptide and serum bone alkaline phosphatase were significantly higher in the experimental group than the control group (P < 0.01 orP < 0.05). These findings indicate that the original fracture hematoma can accelerate calus formation, promote bone induction, provide nutrition to the fracture site, and participate in revascularization. Therefore, the original fracture hematomas is one of the effectively therapeutic methods for union and nonunion of fractures.
9.The application of three-dimensional computed tomography angiography during thoracoscopic complex pulmonary segmentectomy
Weibing WU ; Lijun TANG ; Quan ZHU ; Xinfeng XU ; Liang CHEN
Chinese Journal of Thoracic and Cardiovascular Surgery 2015;31(11):649-652
Objective Identification of anatomic structures are essential for totally thoracoscopic anatomic pulmonary segmentectomies, however sometimes the procedure are difficulty.This study was to assess whether three-dimensional computed tomography angiography(3D-CTA) could contribute to the preoperative arrangement of thoracoscopic complex segmentectomy.Methods Between September 2012 and August 2014, 29 patients were performed thoracoscopic complex segmentectomies under the guidance of preoperative 3D-CTA.The segmentectomies pattern were based on the nodules' diameter, location,and pathology.The targeted vessels and bronchus were marked in preoperative simulated segmentectomies.Results Of the 29 cases, 9 right upper lobe segmentectomies, 13 left upper segmentectomies, and 7 bibasilar segmentectomies were achieved, among which 6 subsegmentectomies were also inclued.The mean lesion diameter, operative time and intraoperative blood loss were(1.35 ± 0.80) cm, (190.53 ± 50.83) min, and (26.90 ± 32.24) ml respectively.Under the guidance of preoperative 3D-CTA , 8(27.5%) nodules were detected accurately, moreover 2(6.9%) aberrant arteries and 1 (3.4%) aberrant bronchus were observed.According to the marked vessels and bronchus preoperatively, 27 (93.1%) arteries, 25 (86.2%)veins,and 29(100%) bronchus were identified and dissected in the operation.Three cases converted to unplanned segmentectomies.No serious complications or death occurred.Conclusion 3D-CTA is an effective tool to enhance security and efficiency in thoracoscopic complex anatomical segmentectomy.