Objective To explore the methods of embolism in simple and complex arteriovenous malformation of body.Methods Ten cases with the body arteriovenous malformations treated with interventional embolization were retrospectively analysed. Coil or detached bollon were used in simple arteriovenous malformations which could be embolized directly, while IBCA were used in complex ones, which could embolize the abnormal vascular group, blocking blood supply of multiple arteries and preventing construction of collateral circulation which could lead to recur. Results The abnormal vasculars were embolized completely in all ten cases, and there were no recurrent followed-up for 1～6 years.Conclusion Interventional embolization is a simple and credible therapeutic method for arteriovenous malformations of body , and it should be the primary plan.

Objective To investigate the difference in occurrence of pneumothorax and bleeding under lung biopsy between the elderly and the non-elderly. Methods A total of 297 consecutive patients were involved in the study and divided into non- elderly group (＜ 60 yrs,122 cases),and elderly group (≥60 yrs,175 cases).Eighteen gauge (18G) cutting needles were used for biopsy with computed tomography (CT) guidance. Biopsy samples were detected by histology and cytology pathology. Results Pneumothorax occured in 108 of 297 biopsies (36.4％),pneumothorax rate was higher in elderly group (76 cases,43.4％) than in non-elderly group(32 cases,26.2％) (x2=9.19,P＜0.01).No statistical significance was found in different degrees of pneumothorax between the two groups.Perifocal hemorrhage occured in 156 of 297 biopsies (52.5％),higher frequency of hemorrhage occurred in elderly group (105 cases,60.0％) than in non-elderly group(51 cases,41.8％)(x2=9.55,P＜0.01),and the more flake bleeding vas found in elderly group than in nonelderly group(x2 =20.28,P＜0.01). Conclusions In CT guided coaxial cutting needle biopsy,the incidence of pneumothorax and considerably bleeding are higher in the elderly than in non-elderly.

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OBJECTIVE To demonstrate a rare case of hepatic abscess caused by amebiasis and to discuss the reason of misdiagnosis.METHODS A fifty years old male patient with amebic liver abscess,misdiagnosed as hepatic(carcinoma),was studied.RESULTS The patient with a huge hepatic mass lesion was misdiagnosed as hepatic(carcinoma) and received interventional therapy four times within 13 months.Amebae were found in the(aspiration) of the lesion and in patient′s sputum.The temperature of the patient returned to normal range after(antibiotics) and anti-amebic therapy.CONCLUSIONS Amebic abscess is a clinically rare encountered pathology now.When to make the diagnosis,hepatic carcinoma should be carefully considered and differentiated.

Anti-angiogenic drugs such as bevacizumab can effectively alleviate the patients′brain edema and clinical symptoms and improve the patients′life quality by reducing vascular permeability and the blood-brain barrier damage.Bevacizumab has got positive efficacy in the clinical,so that it is considered as an effective and safe treatment for malignant brain edema.

Objective:To analyze the causes and risk factors for failure of internal fixation with proximal femoral nail antirotation (PFNA) in the treatment of femoral intertrochanteric fractures.Methods:A retrospective analysis was conducted of the 568 patients with femoral intertrochanteric fracture who had been treated with PFNA fixation at Department of Orthopaedic Surgery, The Fifth Central Hospital of Tianjin from March 2013 to March 2018. They were 348 males and 220 females, aged from 44 to 93 years (average, 74.6 years). According to the fracture stability classification, the patients were divided into a stable group of 424 cases and an unstable group of 144 cases. According to the AO classification, the stable group had type 31-A1 and type 31-A2.1 while the unstable group type 31-A2.2, type 31-A2.3 and type 31-A3. The 2 groups were compared in terms of reduction quality, rate of internal fixation failure, and function of the affected hip. Single factor and multi-factor binary logistic regression analyses were conducted to determine the risk factors responsible for failure of PFNA fixation of femoral intertrochanteric fracture.Results:There were no significant differences in the preoperative general data between the 2 groups, showing comparability between groups ( P> 0.05). Internal fixation failure occurred in 19 cases, which was caused by spiral blade withdrawal in 13 cases, femoral neck shortening in 17 cases, hip varus in 14 cases, and spiral blade cut-out in 14 cases. The failure rate for the stable group was 1.2% (5/424), significantly lower than that for the unstable group [9.7%,(14/144)] ( P<0.05). The Harris hip score at the last follow-up for the stable group [98(95,100)] was significantly higher than that for the unstable group [84 (82, 87)] ( P<0.05). There was no significant difference in reduction quality between the 2 groups ( P>0.05). The multivariate analysis showed that osteoporosis ( OR=7.283, 95% CI: 1.626 to 32.623, P=0.009) and unstable fracture ( OR=11.607, 95% CI: 4.039 to 33.355, P<0.001) were risk factors responsible for the failure of PFNA fixation of femoral intertrochanteric fracture. Conclusions:PFNA fixation for unstable intertrochanteric fracture can lead to a high failure rate. It forms a lever like structure so that the main stress is shifted to the internal fixation. Its lever fulcrum is located at the angle of intramedullary fixation so that a long arm forms at the load-bearing side, leading to a high failure rate. The weight-free time should be longer for patients with osteoporosis and unstable fracture after operation.

Radiation therapy is one of the important comprehensive treatment strategies for thoracic neoplasms,but it also can cause radiation-induced heart disease (RIHD) which can affect the quality of life and even endanger the lives of patients while killing tumor.With the development of comprehensive treatment for cancer,the patients achieve better survival outcomes.And the study reported about RIHD increased as well,which made RIHD became an important complication of thoracic neoplasms' treatment.Though modem radiotherapy techniques and new therapeutic principles have significantly made the incidence of RIHD decreased,the harm of RIHD should not be ignored.In this article,we review the research progress of RIHD.

Objective To investigate mesenchymal stem cells genetically modified by nerve growth factor to repair acute spinal cord injury in rats. Methods Fifty six Wistar rats of inbred strain were randomly divided into sham operation group cell transplantation group and simple injury group. The spinal cord injury model was prepared according to the modified Allen's method. NGFβ (hNGFβ) and GFP genes were transfected into MSCs by replication-deficient recombinant adenovirus vector (Ad-hNGFβ) and replication-deficient recombinant retrovirus vector (Rt-GFP) respectively. GFP positive MSCs were transplanted into intradural space of injured spinal cord at 7 days after spina coral injury. Spinal cord was dissected at 24 h, 1 and 2 weeks after transplantation. To observe the expression of GFAP and nestin and the distribution of MSCs after transplantation following the spina corol injury. Results MSCs migrated to the injured parenchyma In transplantation group, the expression of GFAP and NGF protein was higher than in the control group (P<0.05), the BBB score in transplantation group was higher than that in the control group (P<0.05). Conclusion The MSCs transplantation repaired the injured spinal cord to some extent.

Objective To investigate the correlation among expression of serum VEGF without operation between pre-and post-chemoradiotherapy in non-small cell lung cancer (NSCLC) patients, to explore the correlation of markers on prognosis and effect. Methods The serum vascular endothelial growth factor (VEGF) were detected in 50 patients without operation between pre-and post-chemoradiotherapy with NSCLC by ELISA method. The group t-test was played into before concurrent chemoradiotherapy and normal control. The paired t-test was played into before and after concurrent chemoradiotherapy. Results The prechemoradiotherapy serum VEGF ( 241.09 ± 52.45 ) ng/L in NSCLC patients was significantly higher than those in normal control patients (103.72 ± 39. 22) ng/L (t = 2. 50,P ＜0. 05 ). The pre-chemoradiotherapy serum VEGF in NSCLC patients was closely related to pTNM stage, distant metastasis, grade of cell differentiation and the size of the primary tumors ( t = 9. 61 - 14. 94, all P ＜ 0. 05 ), but not to the histological classification, type of the tumor, lymph node status, age, gender of the patients or smoking or not (t =0. 58 - 1.84, all P ＞ 0. 05 ). The pre-chemoradiotherapy serum VEGF ( 24 1.09 ± 52. 45 ) ng/L was significantly higher than that of the post-chemoradiotherapy ( 133.64 ± 33.62) ng/L ( t = 12. 20, P ＜ 0. 01 ). The post-chemoradiotherapy serum VEGF decreases to the pre-was the biggest in the CR patients (( 92.35 ± 37.48ng/L) ,t =3.79,P ＜0. 01 ) ,the smallest in the PA patients ( (276.32 ±47.98) ng/L,t = 1.32,P ＞0. 05) ) ,and bigger in the PR patients and the NC patientspatients ( ( 113.10 ± 39. 20) ng/L,t = 13.58,P ＜0. 01 and ( 198.10 ± 42.68 ) ng/L, t = 4. 78, P ＜ 0. 05 ) ), respectively. Conclusions Elevation of serum VEGF exists in patients with NSCLC . The serum VEGF in patients with NSCLC might be helpful to evaluate the biological behavior of lung cancer. Detection of VEGF expression maybe helpful for predicting the prognosis of NSCLC patients.

Objective To investigate the efficacy and side-effect of docetaxel and cisplatin induction chemotherapy followed by concurrent chemoradiotherapy in locally advanced non-small cell lung cancer (NSCLC).MethodsEighty-six patients with histologically confirmed locally advanced NSCLC were randomized into induction chemotherapy followed by concurrent chemoradiotherapy (ICCRT)arm or concurrent chemoradiotherapy (CCRT) arm. Both arms were treated with intensity-modulated radiation therapy. Induction and concurrent chemotherapy regimen consist of docetaxel and cisplatin. Results Follow-up rate of the whole group is 100％.The response rate in the CCRT arm and ICCRT arm is 70％ and 80％ ( χ2 =1.26,P =0.261 ),respectively; and 1-,2-,3-year survival rate is 65％ and 85％,40％ and 50％,33％ and 44％ (χ2 =3.90,P=0.048),respectively; the median survival time and time to progression is 17.5 and 22.0 months and 14.0 and 19.0 months respectively.Major adverse effects are leukopenia (43 and 32 cases,χ2 =3.48,P =0.062),radiation esophagutis (26 and 20 cases,χ2 =0.12,P =0.730),anemia (26 and 16 cases,χ2 =2.34,P =0.126) and radiation pneumonitis (13 and 9 cases,χ2 =0.37,P =0.541 ).ConclusionsICCRT for locally advanced NSCLC can improve the overall survival rate and time to progression,induction chemotherapy did not increase side-effects.There was no difference in response rate between CCRT and ICCRT arm.