Objective To study the correlation between the coagulation factor Ⅶ (F Ⅶ) and progressive hemorrhage after brain contusion in mice and provide the experimental evidence for the clinical application of recombinant human FⅦa.Methods Twelve male BALB/c mice were given liposomeencapsulated FⅦsiRNA via tail vein at doses of 1,3,5 and 10 mg/kg with 3 mice per dosage.The other 3 mice received equivalent volume of normal saline as controls.Two days after the injection,mice blood sampling was used to detect FⅦ mRNA expression in liver using real-time PCR,level of plasma FⅦ using ELISA method,and activity of plasma FⅦ using chromogenic substrate assay.The optimal dose at which F Ⅶ expression was inhibited was determined.Thirty BALB/c male mice were assigned to two groups (n =15 per group) according to the random number table:FⅦ-suppressing group,mice were injected with FⅦsiRNA at the optimal dose and control group,mice were injected with same volume of negative control vector.The model of brain contusion was established in both groups.Volume of hemorrhage following brain contusion was measured at 3,24 and 72 h postinjury,and hematoma volume at 24 and 48 h postinjury.Results Liposome-encapsulated siRNA delivery down-regulated FⅦ expression in the mouse liver.Level and activity of plasma FⅦ were also reduced significantly.The optimal siRNA dose was 3 mg/kg.At 3,24 and 72 h postinjury,relative volume of brain hemorrhage in FⅦ-suppressing group was 1.46 ± 0.10,1.82 ± 0.23 and 2.28 ± 0.15 respectively,significantly higher than that in control group (1.00 ± 0.25,1.20 ± 0.31 and 1.20 ± 0.22 respectively) (P ＜ 0.05).At 24 and 48 h postinju-ry,volume of hematoma in FⅦ-suppressing group was (6.7 ± 1.5)mm3 and (9.8 ± 1.0) mm3,significantly higher than that in control group [(5.2 ± 1.2) mm3 and (5.5 ± 1.5) mm3] (P ＜0.01).Conclusions Level of FⅦ in vivo relates closely to the progressive hemorrhage of brain contusion in mice.Administration of FⅦ is effective to reduce the incidence of progressive hemorrhage.

Objective To explore the techniques and strategies for the retrieval of the retractable inferior vena cava filter (IVCF).Methods Celect IVCF retrieval was not removed successfully with Gtünther Celect recovery device in 9 cases and exchange-wire-loop removal of inferior vena cava filter method were applicated.Results The longest implanted time of 9 patients was 142 days,the shortest implanted time was 37 days,and the average time was (88.67±33.85)days.Eight fil ters were successfully removed and one failed due to severe bending of inferior vena cava.Filter retrieval rate was 88.89％ (8/9).The average retrieval time was (69.89± 12.12)min (57-162 min).No perforation of the wall and contrast agent were found in all patients after the inferior vena cava angiography.Conclusion For the retrieval of the hook heavily atta ched to the IVCF,the retrieval technique of using the exchange wire into the loop method can effectively improve the retrieval rate and has a certain clinical value.

Objective ToevaluatetheefficacyandsafetyofCT-guidedmicrowaveablation (MWA)forstageIVlungcanceraccompanied withcontrolledsingleintracranialmetastasis.Methods From November2011toOctober2016,78patientsinourhospitaldiagnosed withstageIVnon-smallcelllungcanceraccompaniedwithcontrolledsingleintracranialmetastasiswerestudied.Patientsweredividedintotwo groupsaccordingtowhethertheywerewillingtoacceptlocalMWAtreatmentornot:thegeneralgroup (groupA)with42cases, and MWAgroup(groupB)with36cases.Aftertheintracranialmetastasiswascontrolled,patientsingroupAweretreatedwithGP regimenforsimplechemotherapy,whilepatientsingroupB weretreatedwithlocalMWAcombinedwithGPregimen(gemcitabine combinedwithcisplatin).Allthepatientswerefollowed-upevery3monthsafterthesurgerytoassesstheefficacyandsafetyofthe correspondingtreatment.Thedeadlineofthefollow-upwasJune2017orwhenthetumorrestarteditsdevelopment.Results Thesuccessrateof theMWAofthe39lesionsinthe36patientsingroupBwas100%.TheKaplan-Meiersurvivalanalysisofthefollow-updataofthe twogroupsshowedthattheaverageprogressionfreesurvival(PFS)ofgroupA was(9.9 ± 0.8)monthsandthemedianPFSwas (8.0±0.5)months,whilethePFSofgroupB was (14.1±1.1)monthsandthe medianPFS was (15.0±1.5)months.The Log Rank testshowedthatχ2=8.780andP=0.03<0.05,whichreflectedthatthereweresignificantdifferencesinsurvivaltimebetweenthe twogroups.Theoverallsurvival(OS)ofgroupA was(20.5±1.1)months,andthemedianOSwas(21.0±1.3)months.TheOSof group B was (24.1±1.5)months,andthe median OS was (25.0±3.6)months.The Log Rank testshowedthat χ2=10.57and P=0.02<0.05, whichprovedthattheOSdifferencesbetweenthetwogroupshadstatisticalsignificance.ThemainadverseeffectsofMWA werepain,pleural effusion,pneumothorax,hemoptysis,infectionandsoon.There werenoseriouslife-threateningcomplicationsingroupB.Conclusion LocalMWAtreatmentforstageⅣnon-smallcelllungcancer withcontrolledsingleintracranialmetastasisisasafeandeffective method.Itisworthyofporularizing.

Objective To discuss the feasibility of the establishment of a Y-shaped channel with windowing technique in treating the stent shunt obstruction occurring after transjugular intrahepatic portosystemic shunt (TIPS).Methods From February 2012 to December 2016,puncture windowing technique was employed in 7 patients to establish a Y-shaped channel in order to treat the stent shunt obstruction complicated by gastric varices bleeding or ascites due to recurrent portal hypertension.The preoperative Child-Pugh scores of liver function ranged from 5 to 10 points,with a mean of (6.85±1.56) points.The blood flow in both the portal vein and the shunt was determined before operation as well as at 5 days and 1,3,6months after operation;the post operative results were compared with preoperative ones.Results Y-shaped channel was successfully reconstructed in all 7 patients.The patients were followed up for a mean of 11months.Neither death nor hepatic encephalopathy occurred.Conclusion For the treatment of post-TIPS stent shunt obstruction,Y-shaped channel reconstruction within the occluded stent by using windowing technique is safe and effective,the operation is simple and easy.Therefore,this technique has certain clinical value.