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 To establish the pushing transmission model of tendon-sheath system (TSS) for endoscopic flexible instrument, and study the key influencing factors of transmission efficiency. Methods The force and displacement transmission models of TSS in pushing configuration were built and simulated. The tendon-sheath transmission testing platform was designed to validate the model. The influencing factors, such as transmission velocity, tendon-sheath diameter ratio, curvature radius, were explored using this setup. Results There were obvious nonlinear phenomenon in force and displacement transmission. The model simulation results accorded quite well with the experiment results. Transmission velocity, tendon-sheath diameter ratio, curvature radius all had great effects on pushing force transmission of endoscopic flexible instrument, while they had a smaller effect on displacement transmission. Conclusions The proposed model can be used for calculating pushing force transmission of tendon-sheath system for endoscopic flexible instrument, so as to provide the doctors with force feedback at the tip of the end effector, and ensure the safe operation and improve the surgical effects. For better design and control of endoscopic flexible instrument, the transmission velocity, tendon-sheath diameter ratio, curvature radius must be comprehensively considered.