Objective To emphasize the importance of embolization of nonbronchial systemic arteries in treatment of acute and life-threatening massive hemoptysis.Methods In a series of 146 patients with hemoptysis who underwent bronchial artery embolization,we found 12 cases whose blood supply were from 17 nonbronchial systemic arteries and hemoptysis was more than 300 ml blood within 24 hours.Embolic materials included absorbable gelatin sponge(GS),kelp micro gelatin(KMG),polyvinyl alcohol(PVA) particles and metal coils. Results In the 12 cases with 17 nonbronchial systemic arteries (4 were intercostal,3 internal mammary,3 thyrocervical trunk,3 inferior phrenic,1 left gastric,2 originated from the inferior aortic arch,and 1 originated from anterior abdominal aortic wall).Five cases were embolized by GS alone,2 cases by KMG,3 cases by GS+PVA,and 2 cases by GS+PVA+metal coils.Eight cases were performed embolization once,3 cases were performed twice and 1 case was performed three times.No significant complications developed related to embolization,except that 1 patient had transient eyesight decrease after embolization of thyrocervical trunk and 2 patients had chest pain after embolization of intercostal artery which resovled without any treatment.Conclusions During bronchial artery embolization for hemoptysis patients,all supplying artery should be searched and found.Even after successful embolization of bronchial arterys for hemoptysis patients,nonbronchial systemic arterial supply should still be taken into account.

Objective:Our aim was to study the relationship between factor v Leiden (FⅤL) mutation and Chinese Budd-Chiari syndrome (BCS). Methods:Twenty-nine BCS patients (25 patients with sporadic BCS,4 with familial BCS ),29 healthy persons were detected for FⅤL mutation with PCR-RFLP.Results: FⅤL mutation was detected in 3 of 4 patients with familial BCS. Two patients in A family and one patient in B family had FⅤL mutation. The mutation was heterozygous. The mutation frequency was 0.0517 in 29 pationts with BCS, 0.3750 in 4 with familial BCS.The frequency of FⅤL mutation in patients and healthy persons showed no statistical difference,but frequency of FⅤL mutation between patients with familial BCS and healthy persons showed significant difference.Conclusion:The FⅤL mutation was related to Chinese familial BCS, but not related to Chinese BCS.

Objective:This work aims to explore the application value of cervical exfoliated cell DNA (Cysteine dioxygenase type 1, CDO1 and CUGBP Elav-like family member 4, CELF4) methylation in the detection of endometrial cancer in women of childbearing age. Methods:From November 2021 to October 2022, a prospective study was conducted on a total number of 517 reproductive-age women with abnormal uterine bleeding who had surgical indications for hysteroscopy at the Xiangya Third Hospital of Central South University. The cervical exfoliated cells were collected for cytology, HPV (human papillomavirus) and gene methylation detection before operation. Clinical information of patients, level of tumor-related biomarkers, and endometrial thickness of transvaginal ultrasound (TVS) were also collected. Single factor regression method was used to analyze the high-risk factors of endometrial cancer. Receiver operating characteristic curve analysis was used to obtain the area under the curve(AUC), focusing on the screening efficacy of gene methylation test for endometrial cancer in women of childbearing age.Results:The age, body mass index (BMI)≥25 kg/m 2, endometrial thickness≥11 mm, CDO1 m ΔCt≤8.4, CELF4 m ΔCt≤8.8, and double gene methylation were associated with endometrial cancer in women of childbearing age, 1.16(1.08-1.25), 4.33(1.89-10.31), 9.49(3.88-26.69), 69.62(25.70-224.36), 23.64(9.66-63.99), 87.39(24.83-555.05), all P<0.05. The AUC was 0.90 (95% CI 0.83-0.97) of CDO1 m/ CELF4 m in diagnosing endometrial carcinoma was higher than others factors, with sensitivity and specificity of 91.7% (95% CI 80.6%-100%) and 88.8% (95% CI 86.0%-91.6%). TVS combined with DNA methylation detection further improved the sensitivity to 95.8% (95% CI 87.8%-100%), but could not improve the specificity 68.0% (95% CI 63.8%-72.1%). Conclusions:For women of childbearing age with abnormal uterine bleeding or abnormal vaginal discharge, the accuracy of cervical cytology DNA methyl detection of endometrial cancer is better than other non-invasive clinical programs. DNA methylation combined with TVS can improve the sensitivity of detection.