The methods of diagnostic imaging for pulmonary embolism is diversified. However, the different characteristic features of diagnostic imaging and diagnostic accuracy impressive influenced the choice of selection by clinicians. Furthermore, the principle and indication of interventional therapy would have great impending force on the outcomings. This article presents a comprehension of diagnostic imagings and interventional therapy for pulmonary embolization.

Objective To investigate the effectiveness of interventional therapy for the atherosclerotic renal artery occlusion (ARAO). Methods During the period of June 2001-Dec. 2007, 16 patients with ARAO (total of 16 occluded arteries) underwent interventional managements, including percutaneous endovascular renal artery revascularization, balloon dilatation angioplasty and stent placement. Follow-up survey was made at regular intervals. The patent condition of the renal artery was evaluated with ultrasonography and digital subtraction angiography. The blood pressure and the renal function were determined and the data were statistically analyzed in order to assess the intermediate and long-term effect of the interventional therapy. Results Of 16 patients, technical success was achieved in 15 (93.8%) and failure occurred in one. During a follow-up period of 9 - 24 months, 3 patients died. According to the data obtained at each patient’s last follow-up survey, the hypertension fell to normal in 3 (25.0%), was improved in 7 (58.3%) and showed no marked change in 2 patients (16.7%), with a clinical efficacy of 83.3% (10 / 12). The renal function was improved in 2 (16.7%), stabilized in 6 (50%) and deteriorated in 4 patients (33.3%), with an effective rate of 66.7% (8 / 12). Conclusion For the treatment of atherosclerotic renal artery occlusion, the interventional therapy carries high successful rate and can effectively lower the blood pressure level, in addition, it can also protect the renal function in a certain degree.

Objective To evaluate the interventional treatment of Budd-Chiari syndrome (BCS)with regard to different types of the disease.Methods One hundred and fifty-nine consecutive cases with BCS underwent interventional treatments with regard to different types of the diseases,including percutaneous angioplasty (PTA),transcatheter thrombolysis,endovascular stent implantation and modified transjugular intrahepatic portosystemic shunt(MTIPS).Among them,147 cases that underwent complete follow-up were enrolled in this study.Simple obstruction of HV,membranous obstruction of IVC,membranous obstruction of IVC combined with thrombosis in the distal lumen and segmental obstruction of IVC constituted 13.6/(20),66.0/(97),6.1/(9)and 14.3/(21/147),respectively.The technical success rate of each type Was determined.They were followed up for(67.3±9.0)months (16 h-104 months).Overall primary patency rote was evaluated.The late effect on liver function Was analyzed according to the Child-Push score.Results The primary patency rate of PTA was 65.6/ (86/131)and the secondary pateney rate was 96.9/(124/128).The primary patency rate of stent implantation was 78.9/(15/19)and the secondary patency rate Was 92.3/(24/26).One patient of type Ⅲa that received recanalization,catheter-directed thrombolysis and PTA in IVC died of hemoptysis 72 h after the procedtire.One patients of type I b who received MTIPS died of DIC 16 hrs after the procedure.And one patient of type Ⅳb who received MTIPS died of hver failure 13 months after the procedure.Twelve patients died in 7-79 months after the interventional procedure due to unrelated causes.At the end of follow-up,the liver function of the patients Was improved. Conclusions Optimal application of various vascular interventional techniques has a satisfactory primary and secondary patency rate and improves the long-term liver function.

Objective To evaluate the safety and effect of percutaneous fenestration of intimal flap(FIF) and endovascular stent(ES) placement for aortic dissection. Methods Male patient, 54 years old. DeBakey Ⅲb aortic dissection, tear of intimal flap situated at the beginning of desconding aorta, developed to abdominal aorta and right iliac artery. The true lumen was 3 mm at narrowest locatation. Through femoral artery approach, percutaneous fenestration of intimal flap and ES placement are operated and four ES were placed. Results The blood flow of aortic true lumen and branches were resumed. The true lumen raised to 12 3 mm at the narrowest locatation. The clinical symptoms vanished. Conclusion Percutaneous fenestration and ES placement for aortic dissection feature little injure, high safety and effecacy. So, It is the first choice for certain aortic dissection.

Objective To determine whether the adjustment of the pusher of GTF was useful to decrease the degree of tilting of the femoral Ginther Tulip filter (GTF) in an in vitro caval model. Methods The caval model was constructed by placement of a 25 mm × 100 mm and two 10 mm ×200 mm Dacron graft inside a transparent bifurcate glass tube. The study consisted of two groups: left straight group (GLS) (n =100) and left curved group (GLC) (n = 100). In the GLC, a 10° to 20° angle was curved on the introducer.The distance (DCH) between the caval right wall and the hook was measured. The degree of tilting (DT) was classified into 5 grades and recorded. Before and after the GTF being released, the angle (ACM1, 2)between the axis of IVC and the metal mount, the distance (DCM1) between the caval right wall and the metal mount, the angle (ACF) between the axis of IVC and the axis of the filter and the diameter of IVC (DIVC) were measured. The data were analyzed with Chi-Square test, t test, rank sum test and Pearson correlation test. Results The degree of GTF tilting in each group revealed a divergent tendency. In group LC, the apex of the filter tended to be grade Ⅲ compared in group LS (x2 value 37. 491 ,P ＜0.01).The differences of most variables between GLS and GLC were considered as statistical significance(16. 60° vs.3.05°, 20.60° vs. 3.50°, -3.90°vs. -0.40°, 2.98 mm vs. 10.40 mm, - 10.95° vs. -0.485°,13. 17 mm vs. 10.06 mm, - 1.70° vs. 0.70°, t or Z values - 12. 187, - 12. 188, -8.545, -51.834,-11. 395,9. 562, -3. 596, P ＜ 0. 01). There exist significant positive correlation between ACM1 and ACF,ACM1 - ACM2 and DCH1 - DCH2 in each group, respectively(r values 0. 978,0. 344,0. 879,0. 627 ,P ＜0. 01),while significant negative associations are detected between DCH1 and ACF in each group , ACP and ACF in group LC(r values -0.974, -0.322, -0.702,P＜0.01). Conclusion The technique of adjusting the orientation of filter pusher had minimized the incidence and extent of GTF filter tilting in vitro.

Objective To evaluate the efficacy of interventional therapy of occlusive lesion in iliaco- femoral arteries. Methods During Feb 2001 to Feb 2006, 42 patients (30 male and 12 female) with arterial occlusive lesions in iliac artery and/or femoral artery accepted interventional therapies. The interventional therapeutic process included local thrombolytic therapy through endoarterial catheter, artery recanalization by guide wire, pereutaneous transluminal angioplasty (PTA) and stent. After interventional operation, patients were administrated anticoagulant and antibiotics one week. Follow-up interval ranged 2 years. Wilcoxon test and t test were used for statistics. Results Immediate technical successful rate was 97.6% (41/42),the secondary technical success rate was 100.0% (42/42). The arterial occlusions were resolved successfully (local thrombolytic therapy in 26 cases, recanalization by guide wire in 31 cases, PTA in 33 cases and 60 stents in 31 cases). There were no severe complications (such as angiorrhexis, perforation) during interventional procedure. The symptoms of lower limb ischemia were palliated or vanished in all patients after interventional therapy. The ankle-brachnial index(ABI) of diseased extremities increased from pre-operation 0.34±0.14 to past-operation 0.65±0.10 (t=25.924, P <0.01 ). During the follow-up, 11/42 (26.2%) iliac or femoral artery (treated with local intra-arterial thrombolysis, PTA and stent) occurred restenosis. After PTA and stenting, the restenosis arteries became fluent successfully. The primary patency rate was 92.8% (39/42)and the secondary patency rate was 100.0% (42/42)1 year after the procedure. Two years after the procedure, the primary patency rate was 71.4% (30/42) and the secondary patency rate was 97.6% (41/42). Conclusions Interventional therapy (including local thrombolysis, recanalization, PTA and stent) is an effective and safe therapy for occlusive lesion in iliaco- femoral arteries.

Adenocarcinoma, Follicular ; metabolism ; pathology ; Adenoma, Chromophobe ; metabolism ; pathology ; Adenoma, Oxyphilic ; metabolism ; pathology ; Angiomyoma ; metabolism ; pathology ; Biomarkers, Tumor ; metabolism ; Carcinoma, Papillary ; metabolism ; pathology ; Carcinoma, Renal Cell ; classification ; metabolism ; pathology ; ultrastructure ; Diagnosis, Differential ; Humans ; Kidney Neoplasms ; classification ; metabolism ; pathology ; ultrastructure ; Thyroid Neoplasms ; metabolism ; pathology

BACKGROUND: Recent studies have demonstrated that sterol regulatory element binding protein-2 (SREBP-2) plays a key role in osteoarthritis, but its exact pathogenesis remains incompletely understood yet. OBJECTIVE:To investigate the expression of SREBP-2 in the process of interleukin-1β-induced articular chondrocyte degenerationin vitro. METHODS: Articular chondrocytes obtained from C57BL/6J mice were culturedin vitro. After the second passage, cels were randomly divided into four groups: control group, and three experimental groups treated with 10 μg/L interleukin-1β for 24, 48 and 72 hours, respectively. RESULTS AND CONCLUSION:The cels became hypertrophic after being stimulated by interleukin-1β, and the staining of colagen X was positive at 72 hours. MTT assay demonstrated that the cel activity after stimulation with interleukin-1β decreased with time. Results of RT-PCR showed that the expression of SREBP-2 and SREBP cleavage activating protein mRNA was significantly increased after stimulation with interleukin-1βas compared with the control group and increased with time. On the contrary, the expression of aggrecan and colagen II mRNA was decreased with time. It is revealed that interleukin-1β could inhibit the proliferation of regular chondrocytes and the expression of its extracelular matrix, and furthermore, induce chondrocyte hypertrophy. The expression of SREBP-2 showed a negative relationship with key cartilage genes during this interleukin-1β-induced degeneration.

Objective To investigate the spectrum,diagnosis,time of therapy and management of the congeni-tal heart disease(CHD)in patients with Down′s syndrome(DS).Methods A retrospective report was undertaken of 96 cases in children with DS accompanied by CHD in Department of Pediatric Cardiology,Beijing Anzhen Hospital Af-filiated to Capital Medical University.Data were collected and analyzed about their clinical characteristics,and types of cardiovascular abnormalities,and the important laboratory examinations such as echocardiography and catheterization as well as the procedures of diagnosis and treatments were summarized.Then the interventions,complications and prognosis of different patients were estimated.Results (1)Single congenital heart disease was found in 33 cases (34.38%),a-mong which ventricular septal defect was the most common (14 cases,14.58%),followed by atrioventricular septal de-fect and atrial septal defect (equally,7 cases,7.29%).Multi -cardiovascular abnormalities were discovered in 63 ca-ses,and patent ductus arteriosus turned out to be the most common (42 cases,66.67%).(2)Cat-heterization was car-ried out in 18 cases of serious pulmonary arterial hypertension,and 8 cases were proved resistant pulmonary arterial hy-pertension without operation opportunity.The other 8 cases were estimated as high pulmonary arterial hypertension and medical therapy was suggested before reassessment to reduce surgical risks.(3)Operations were undertaken in 61 ca-ses,among which percutaneous interventional occlusion was performed in 7 cases and surgical interventions were per-formed in 54 patients,in which perioperation complications and death were found in 5 cases and 4 cases,respectively. Conclusions Operation interventions are practicable and most cases recovered well with systematic examinations and assessment in patients with DS and cardiovascular malformations.Early diagnosis and timely interventions are highly suggested.Also close attentions should be paid to follow -up and re -estimation after medical therapy.

400 ng/ml and in those the post-LT AFP level failed to decrease to ≤20 ng/ml within 2 months. The dynamic changes of AFP after LT were valuable in predicting post-transplant HCC recurrence.