1.Value of endovascular stents placement for treating symptomatic spontaneous isolated dissection of splanchnic artery
Xiangjun HAN ; Xitong ZHANG ; Yonghui XIA ; Songnian LIANG ; Ke XU
Chinese Journal of Radiology 2014;(6):489-491
Objective To evaluate the safety and effectiveness of treating the endovascular stents placement for spontaneous isolated dissection of splanchnic artery ( SIDSA).Methods Sixteen consecutive patients with diagnosis of SIDSA through CTA and DSA were retrospectively analyzed .All patients had acute persistent abdominal pain and treated by endovascular stents placement.The serious complications and symptoms improvement were reviewed after the operation.The symptoms recurrence and repeated color doppler ultrasonography and CTA were also reviewed in the follow up.Results Twelve superior mesenteric artery ( SMA) dissection and four celiac artery ( CA) dissection were diagnosed among sixteen patients.The dissection length was 1.07 to 11.87 cm and the median length was 3.93 cm.The distance from the original dissection to the orifice of superior mesenteric artery or celiac artery was 0.50 to 6.44 cm and the median was 1.98 cm.Eight stent-grafts and 3 bare stents were successfully implanted in 11 patients.One case with celiac dissection was failed to treat because of the severe compression of true lumen and the guide wire cann′t cannulate to the distal true lumen.Four patients with superior mesenteric artery dissection gave up interventional therapy , Among these 4 patients , 2 patients had small tear site and small false lumen , 1 patient had extremely long dissection , and one case had blood supply of target organs from both true and false lumen.No severe complications such as hemorrhage , intestinal necrosis , hepatic failure and splenic necrosis occurred during the eleven successful endovascular interventions.The abdominal pain in 10 cases was disappeared or significantly relieved , 1 case with superior mesenteric vein thrombosis and severe intestinal ischemia before intervention underwent intestinal resection for necrosis.The follow up period was 1 to 74 months in eleven successful cases , and the median follow-up period was 16 months.One patient with SMA dissection after endovascular treatment was died of sudden stroke three months later .Others had satisfactory outcome and the repeated color doppler ultrasonography and CTA were normal .Conclusions Endovascular stents placement is a safe and effective therapy for symptomatic spontaneous isolated dissection of splanchnic artery.
2.Symptomatic splanchnic artery dissection:imaging diagnosis and interventional treatment
Dawei LIU ; Xitong ZHANG ; Xiangjun HAN ; Songnian LIANG
Journal of Interventional Radiology 2015;(7):582-587
Objective To summarize the experience in the diagnosis and treatment of symptomatic splanchnic artery dissection. Methods A total of 21 patients with symptomatic splanchnic artery dissection, who were admitted to the Affiliated First Hospital of China Medical University during the period from June 2006 to March 2014, were included in this study. Combined with the literature, the clinical data, including the diagnosis and treatment, were analyzed. Results Contrast-enhanced abdominal CT and CT angiography revealed superior mesenteric artery dissection in 15 cases, celiac artery dissection in 5 cases and splenic artery dissection in one case. Conservative therapy was employed in 5 patients; among them one was complicated with hepatic artery thrombosis. Of the 16 patients who received endovascular stent placement, additional intestinal resection was performed in 2 and transcatheter thrombolysis treatment in other 2. No procedure-related severe complications occurred in perioperative period. All the patients were followed up for 2-74 months (mean of 19.1 months). In patients who received endovascular stent placement, the abdominal pain and the bloody stool were relieved or disappeared, and no abdominal pain recurred. CT angiography showed that in-stent blood flow was fluent, the stent was in good position, and neither stenosis nor thrombosis was observed. One patient with superior mesenteric artery dissection died of stroke three months after the treatment. Conclusion It is very important to make early diagnosis and to adopt early treatment for symptomatic splanchnic artery dissection. CT angiography can confirm the diagnosis in most cases, but attention should be paid to some atypical manifestations. For the treatment of splanchnic artery dissection, endovascular stent placement is mini-invasive, safe and reliable.
3.Application value of kissing stenting for the treatment of bilateral brachiocephalic-superior vena cava obstruction
Xitong ZHANG ; Tang LIU ; Xiangjun HAN ; Wei ZHANG ; Dawei LIU ; Ke XU
Chinese Journal of Radiology 2014;48(2):143-145
Objective To evaluate the clinical value of the kissing stenting in bilateral brachiocephalic-superior vena cava obstruction syndrome.Methods Analysis the clinic effect in 17 patients who received interventional treatment retrospectively.All patients with bilateral brachiocephalic vein-superior vena cava obstruction were caused by malignant tumor.Each patient was implanted two stents by kissing stenting style.Among them,1 patient accompanied thrombosis in brachiocephalic vein was conducted with catheter-directed thrombolysis before stenting.The symptoms,pathological signs and complications were observed after the treatment,patients were underwent follow-up to see whether symptom recurred.Results All 17 patients received successful kissing stenting in bilateral brachiocephalic vein-superior vena cava.The symptoms and pathological signs eliminated after the operation.No serious complications occurred.Seventeen patients were underwent follow-up (1 to 16 months) with no obstructive symptom recurred including 5 patients died of the end-stage of malignant tumor.Conclusion Kissing stenting is a safe and effective methods for the treatment of bilateral brachiocephalic-superior vena cava obstruction.
4.Treatment of chronic hepatic cirrhosis with autologous bone marrow stem cells transplantation in rabbits
Yinghe ZHU ; Ke XU ; Jinling HAN ; Jue GAO ; Xitong ZHANG ; Gaomin DING
Chinese Journal of Radiology 2008;42(12):1321-1326
Objective To evalute the feasibility of treatment for rabbit model with hepatic cirrhosis by transplantation of autologous bone marrow-derived stem cells via the hepatic artery and evaluate the effect of hepatocyte growth-promoting factors (pHGF) in the treatment of stem cells transplantation to liver cirrhosis.To provide empirical study foundation for future clinical application.Methods Chronic hepatic cirrhosis models of rabbits were developed by subcutaneous injection with 50% CCl4 0.2 ml/kg.Twenty-five model rabbits were randomly divided into three experimental groups,stem cells transplant group (10),stem ceils transplant + pHGF group (10) and control group (5).Autologous bone marrow was harvested from tibia of each rabbit,and stem cells were disassociated using density gradient centrifugation and transplanted into liver via the hepatic artery under fluoroscopic guidance.In the stem cells transplant + pHGF group,the hepatocyte growth-promoting factor was given via intravenous injection with 2 mg/kg every other day for 20 days.Liver function tests were monitored at 4,8,12 weeks intervals and histopathologic examinations were performed at 12 weeks following transplantation.The data were analyzed using analysis of variance Results Following transplantation of stem cells,the liver function of rabbits improved gradually.Twelve weeks after transplantation,the activity of ALT and AST decreased from (73.0±10,6)U/L and(152.4± 22.8) U/L to (48.0±1.0)U/L and(86.7±2.1)U/L respectively; and the level of ALB and PTA increased from (27.5 ±1.8)g/L and 28.3% to (33.2 +0.5)g/L and 44.1% respectively.The changes did not have statistically significant difference when compared to the control group(P >0.05).However,in the stern cellstransplant + pHGF group,the activity of ALT and AST decreased to (43.3±0.6)U/L and (78.7±4.0)U/L respectively and the level of ALB and PTA increased to (35.7 ±0.4)g/L and 50.5% respectively.The difference was statistically significant when compared to the control group(F=47.38,23.52,52.27,174.45,P < 0.05).In pathohistology,the degeneration and necrosis of hepatic cells and the degree of fibrous hyperplasia in stem cells transplant group were less obvious than that of the control group.Hepatic pseudo-lobules persisted.The improvement of liver architecture in the stem cells transplant + pHGF group was more evident than that in stem cells transplant only group.In addition,there were more hepatic CD34 <'+> cells within liver tissue in the stem cells trasplant group when compared to the control group,and the most hepatic CD34<'+> cells were seen in the stem cells transplant + pHGF group.Conclusion Autologous bone marrow stem cells transplanted via the hepatic artery for the rabbit hepatic cirrhosis model is an effective method to treat hepatic cirrhosis.The hepatoeyte growth-promoting factor can help to enhance the results of treatment.
5.Effect of aeration and inulin concentration on ethanol production by Kluyveromyces marxinaus YX01.
Jiaoqi GAO ; Wenjie YUAN ; Lijie CHEN ; Xitong HAN ; Fengwu BAI
Chinese Journal of Biotechnology 2013;29(3):325-332
Consolidated bioprocessing technology can be used for Kluyveromyces marxianus YX01 to produce ethanol from Jerusalem artichoke, which is one of the potential processes to produce biofuel from non-cereal crops. In this study, we combined the aeration rate with the substrate concentration to conduct cross-over experiments for K. marxinaus YX01, and studied ethanol fermentation and the influence of inulin enzyme activity. The substrate concentration had a little repressive effect on ethanol productivity. When substrate concentration reached 250 g/L under anaerobic conditions, ethanol concentration was 84.8 g/L, and ethanol yield was reduced from 86.4% (50 g/L substrate concentration) to 84.7% of the theoretical value. Aeration rate could accelerate K. marxinaus YX01 ethanol fermentation, but reduced ethanol yield. When substrate concentration reached 250 g/L under aeration at 1.0 vvm, ethanol yield was reduced from 84.7% under anaerobic conditions to 73.3% of the theoretical value. With increased concentration of the carbon source and reduced aeration rate, the inulinase of K. marxinaus YX01 reduced and the concentration of glycerol increased, however, the acetic acid increased with the increased concentration of the carbon source and aeration rate. When substrate concentration reached 250 g/L under anaerobic conditions, inulinase activity was only 6.59 U/mL; when substrate concentration reached 50 g/L under aeration at 1.0 vvm, inulinase activity was 21.54 U/mL.
Ethanol
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metabolism
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Glycoside Hydrolases
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metabolism
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Inulin
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metabolism
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Kluyveromyces
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classification
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metabolism
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6.Myelodysplastic syndromes combined with mature plasmacytoid dendritic cells proliferation: report of one case and review of literature
Jing LIU ; Hongmin YAN ; Ling ZHU ; Xiaoli ZHENG ; Li DING ; Dongmei HAN ; Xitong TAN ; Hengxiang WANG ; Mei XUE
Journal of Leukemia & Lymphoma 2019;28(7):401-403
Objective To investigate the clinical features, diagnosis, treatment and prognosis of myelodysplastic syndromes (MDS) with mature plasmacytoid dendritic cells (PDC) proliferation. Methods The clinical data of one case of MDS with excess blasts (EB)﹣1 with mature PDC proliferation in Air Force Medical Center was retrospectively analyzed, and the literature was reviewed. Results The patient′s physical examination revealed anemia and thrombocytopenia. Bone marrow smears showed 0.064 of myeloblasts and 0.152 of dendritic cells. Immunophenotyping showed two groups of abnormal proliferation cells, namely, myeloblasts and mature PDC. Decitabine treatment was given, and the red blood cells and platelets were infused intermittently. The condition of patient was basically stable. Conclusions MDS with mature PDC proliferation is extremely rare. No special clinical manifestations are found, and the diagnosis is based on bone marrow cytology and immunophenotyping. There is no standard regimen for treatment of MDS with mature PDC proliferation, and the prognosis depends on the progression of MDS.