Superselective angiography and embolization is one of the important methods in the management of acute hemorrhage, providing mini-invasion and high efficacy, etc. The implication of angiography and embolization on bleeding were reviewed and the embolic agents as well as the interventional procedures were commented in this article.

Percutaneous radiofrequency ablation (RFA) has been widely used in the treatment of malignant hepatic tumors and has achieved satisfactory effects.Complications after RFA have been taken seriously and the risk of the development of complications is closely associated with tumor location.It is a great challenge for physicians to perform RFA for hepatic tumors in high-risk locations due to related difficulties and risks.This article reviews the complications after RFA for hepatic tumors in high-risk locations and analyzes related control strategies.

AIM: Supercritical CO_2 extraction of Rhizoma Chuanxiong volatile oil was studied under conditions of extraction temperature between 33-48 ℃,pressure between 10-25 MPa and CO_2 flow rate between 2-4 L?min -1 .Influence of extraction conditions on solubility and mass transfer rate were analyzed. METHODS: Based on plug flow in fixed bed,experimental extraction curves were evaluated using a model put forward by Stastova.And the effects of extraction conditions on mass transfer coefficients were also analyzed. RESULTS: Coefficient of mass transfer was slowly increased as the extraction temperature elevated,and was in accord with flow and in contrast with pressure. CONCLUSION:The method has a practical use value in the extraction of Rhizoma Chuanxiong volatile oil.

Objective To investigate the diagnostic value of a fast gradient-echo(GRE) three-dimensional contrast-enhanced volumetric interpolated breath-hold examination(3D-VIBE) MR sequence in evaluating focal liver lesions.Methods Conventional spin-echo T2W,2D GRE T1W plain scan and Gd-enhanced 3D-VIBE multi-phasic(early arterial,late arterial and portal venous phases) acquisitions were prospectively performed for 51 consecutive patients suspected of having focal liver lesions on CT or ultrasound imaging.Native T2W and 2D GRE T1W were acquired first,then 3D-VIBE fast scanning at early arterial,late arterial and portal venous phases respectively.The SNR and CNR of the liver lesions on plain scan and the enhancement patterns on contrast-enhanced 3D-VIBE images were carefully observed with correlation of the clinical and surgical pathological findings.Results There exited certain differences in SNR,CNR,and the enhancement patterns of different kinds of focal hepatic lesions in plain scan and Gd-enhanced multi-phasic 3D-VIBE acquisitions.Conclusion 3D-VIBE MR sequence is helpful in the detection and characterization of focal liver lesions.

Objective:We clarify the relationship between dysfunction of gastric motility and the plasma motilin,in order to study the pathogenesis,diagnosis and therapy of the hepatocirrhosis with dyspepsia.Methods:The liquid gastric emptying (GE),electrogastrograpgy(EGG) and plasma motilin were examined in 51 patients with hepatocirrhosis.Results:The dysfunction of gastric motility is associated with the liver function,gastric rhythm and upper gastrointestinal symptom.The plasma motilin concentration increased significantly in patients with hepatocirrhosis as compared with that of controls (P<0.01).The sorbefacient prokinetic drug (prepulsid) can improve the function of gastric power,but the lever of motilin no change.Conclusion:The patients with hepatocirrhosis have the dysfunction of gastric motility,and gastric emptying delayed,and there is a relation between GE and the liver function.We evaluate that this disorder is associated with the low sensitivity about stomach to the plasma molitin in this case.We can judge the degree of the liver damage,gastric emptying delayed.gastric rhythm by testing the gastric motilin.Drug can deal it.

Objective To approach the protective effect of dexmedetomidine on mechanically ventilated patients with pulmonary contusion. Methods A prospective randomly controlled trial was conducted. 70 mechanically ventilated patients with pulmonary contusion from January 2010 to December 2012 in the Critical Care Medicine of Foshan Hospital of Traditional Chinese Medicine were divided into a control group and a therapy group by the difference in number odd or even,with 35 patients in each group. Based on the same principles of comprehensive treatment,the control group used midazolam,and the therapy group used dexmedetomidine for sedation. The measured parameters included oxygenation index(PaO2/FiO2),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6), and extra-vacular lung water index(EVLWI)for both groups on the1st and 5th day. The incidence of delirium,the time of mechanical ventilation,and the incidence of hypotension were observed in both groups. Results Compared with those on the 1st day,TNF-α,IL-6 and EVLWI on the 5th day were decreased significantly in both groups〔the control group TNF-α(ng/L):1.29±0.38 vs. 2.21±0.37,IL-6(ng/L):97.97±28.77 vs. 131.03±41.52,EVLWI (mL/kg):8.25±2.03 vs. 11.96±3.36;the therapy group TNF-α:1.06±0.33 vs. 2.32±0.37,IL-6:82.07±23.35 vs. 134.98±64.25, EVLWI(mL/kg):6.74±1.33 vs. 11.23±2.78, all P<0.05〕, PaO2/FiO2 was increased obviously〔mmHg(1 mmHg=0.133 kPa),the control group:285.80±30.65 vs. 213.00±33.70,the therapy group:315.00±34.50 vs. 229.50±37.00,both P<0.05〕,TNF-αand IL-6 had no significant difference compared between the therapy group and control group(TNF-α:1.06±0.33 vs. 1.29±0.38,IL-6:82.07±23.35 vs. 97.97±28.77), while EVLWI and PaO2/FiO2 in the therapy group had remarkable differences compared with those of the control group〔EVLWI(mL/kg):6.74±1.33 vs. 8.25±2.03,PaO2/FiO2(mmHg):315.00±34.50 vs. 285.80±30.65,both P<0.05〕. The incidence of delirium(8.57% vs. 22.86%)and time of mechanical ventilation(day:4.10±1.09 vs. 6.88±1.66)in the therapy group were decreased markedly compared with those of the control group,and the incidence of hypotension had no significant difference between treatment or control groups(17.14% vs. 14.29%,P>0.05). Conclusion Dexmedetomidine has protective effect on mechanically ventilated patients with pulmonary contusion, and it is an relatively ideal sedative drug for these patients.

Objective It is to observe the clinical effect of Wenxinkeli combined with metoprolol on frequent ventricular premature beat (FVEB).Methods234 patients with FVEB were randomly divided into the study group and control group.117 patients in the control group were treated with metoprolol combined with placebo, and 117 patients in the stduy group were treated with Wenxinkeli combined with metoprolol.4 weeks were a course of treatment.After four weeks, the heart rate variability, QT interval dispersion and 24h average heart rate of two groups were observed, and the clinical effect were evaluated.ResultsAfter 4 weeks of treatment, 5 cases in the study group and 7 cases in the control group were excluded.The efficiency of control group and study group were 89.29% and 79.09% (P<0.05), respectively.After treatment, the SDNN、SDANN、RMSSD and PNN50 of two groups were significantly higher than those before treatment(P<0.05), and the increase value of the study group was higher than that of the control group(P<0.05).After treatment, the QTd and QTcd of two groups were decreased than those before treatment(P<0.05), and the decreased value of the study group was higher than that of the control group(P<0.05).There was no significant change in the heart rate of the two groups before and after treatment.ConclusionWenxinkeli combined with metoprolol in the treatment of FVEB can prolong HRV, reduce QTd, improve the treatment effect, has no significant effect on the heart rate.

Objective: To study effect of small ubiquitin related modifier protein 1 (SUMO1) in inflammatory reactions mediated by tumor necrosis factor (TNF)-α and nuclear factor (NF)-κB in myocardial damage of rats with type 2 diabetes mellitus (T2DM). Methods: A total of 20 Goto-Kakizaki (GK) rats with spontaneous diabetes mellitus (DM) were randomly divided into group DM1 (pure DM group, n=10) and group DM2 (DM+high-fat diet group, n=10), and another 10 normal Wistar rats were regard as healthy control group. Expressions of SUMO1, TNF-α and NF-κB were measured by immunohistochemical method. Results: 1. Levels of blood glucose and TG in group DM1 and group DM2 were significantly higher than those of healthy control group, and those of DM2 group were higher than of DM1 group ,P<0.05 all; 2. Myocardial cells lined up in order and there was no hypertrophy in group DM1; but those in group DM2 showed cells loosely lined up and hypertrophy under light microscope; 3 Immunohistochemical assay indicated that expression of SUMO1 in group DM2 and DM1 group were significantly higher than those of healthy control group [(44.5±1.1) vs. (27.2±2.2) vs. (21.7±3.0)], and of group DM2 was significantly higher than that of DM1 group (P<0.01 all); expression of TNF-α in group DM2 and group DM1 were significantly higher than that of healthy control group [(27.5±1.5) vs. (20.2±2.7) vs. (13.1±1.6)], and of DM2 group was significantly higher than that of group DM1 (P<0.01 all)；expression of NF-κB in group DM2 and group DM1 were significantly higher than that of healthy control group [（30.1±1.7）vs.40.7±1.5）vs.（16.0±2.6）], but of group DM1 was significantly higher than that of group DM2 (P<0.01 all). Conclusion: There are obvious metabolic disorders of glucose and lipid in T2DM rats, and complicated morphological changes of myocardial tissues similar to myocardial lesions in DM humans; the expressions of SUMO1, NF-κB and TNF-α significantly increase, suggest SUMO1 takes part in inflammatory reaction mediated by NF-κB, TNF-α in myocardial lesion of rat with T2DM，and may inhibit NF-κB, possesses effect of protect myocardium.

Objective To analyze the reasons of perioperative hypoxia in Stanford A aortic dissection,and summarize its management strategies.Methods From Dec.2005 to Jul.2011,sixty four patients underwent surgery for acute type A aortic dissection,of which 9 cases were with chronic dissection and 55 cases with emergent ones.Preoperative oxygen fraction ratio( PaO2/FiO2 )in 51 cases was lower than 200 mm Hg.All of them underwent the surgery with the help of deep hypothermia cardiac arrest technique.Results Three cases died.Thirty-three cases could not live without ventilation during the first 72 h because of continuous hypoxia ( PaO2/FiO2 ＜ 200 mm Hg).One case underwent tracheotomy and auxiliary ventilation for 9 days.The rest were live without ventilation after auxiliary ventilator for 72 - 120 hrs.The data showed that postoperative hypoxia was related to preoperative hypoxia (oxygen fraction ratio ＜ 200 mm Hg),BMI,acute onset,hypothermia cardiac arrest time,and transfusion more than 3000 ml ( P ＜ 0.05 ).Conclusion Great attention should be paid to the perioperative hypoxia-related factors in Stanford A dissection,which will be helpful to improve prognosis.

Objective To investigate the CT imaging features of metastatic hepatic adenocarcinomas from the digestive tract by using multi-detector-row helical CT (MDCT) with pathological correlation. Methods CT and clinical data of 36 patients with pathologically proven metastatic hepatic adenocarcinomas from the digestive tract were retrospectively reviewed. The primary tumors included 10 cases of gastric cancer, 1 duodenal cancer, 18 colo- nic carcinoma, 7 rectal cancer. All patients underwent MDCT plain scan and contrast-enhanced dual-phase scanning of upper or whole abdomen. The appearances of hepatic metastatic lesions on MDCT images at various enhancement phases were carefully observed. Results On plain CT scan 32 cases (88.9%) presented multiple nodules of low density at different sizes, 3 cases (8.3%) showed a single low-density nodule, and 1 case presented with a cystic mass. On contrast-enhanced scan, 4 cases (11.1%) showed faintly enhanced rim around the nodules on arterial phase; on portal venous phase 29 cases (80.6%) presented slight ring-like enhancement at the periphery of the nodule while the nodule core was markedly hypodense with intermediate soft tissue density area in between, giving rise to the typical appearance of “bull’s-eye” sign. Three cases (8.3%) showed no enhancement on either phase images. Conclusion The ring-like enhancement and the appearance of “bull’s-eye” on portal venous phase was characteristic CT features of metastatic hepatic adenocarcinoma from digestive tract.