Transcatheter hepatic arterial chemoembolization (THACE)has been widely used in the treatment of advanced primary hepatic carcinoma (PHC)and metastatic hepatic carcinoma (MHC). Although the incidence of severe complications associated with THACE is unusual (0% ～ 5% ),its prognosis is generally worse and mortality is higher than that of postembolization syndrome.Therefore,to minimize the risk associated with THACE has to be achieved through the understanding of these severe complications related to the selection of indication,the use of chemoembolic agents and manipulation of a cathether or guide wire,etc. In this paper,according to the involved anatomic organs,these severe complications are divided into six categories as follows:(1)complications of the liver,including acute hepatic failure,liver infarction (necrosis),liver abcess and liver (or tumor)ruptrure;(2)complications of the celiac artery and its branches,included of iatrogenic dissection,stricture or occlusion,perforation or pseudoaneurysm and multiple intrahepatic aneurysms; (3)complications of intrahepatic biliary system,included of cholecystitis and gallbladder infarction,bile duct necrosis and intrahepatic biloma formation; (4)complications of extrahepatic structures,included of nontarget embolism or infarction of the brain,spinal cord,lung,spleen,gastroduodenum and pancreas; (5)bleeding of upper digestive tract; (6)the orthers. And the incidence,pathogenesis,predisposing factors,clinical and imaging manifestations of these complications are also discussed in detail,it may be of great advantage to its correct diagnosis promptly and appropriate management.

Fifty cases of HCC with 105 procedures of TAI/TAE performed by DSA system were analysed retrospectively.Improperly operative technique used in the procedure of TAI/TAE was found in sixteen cases of this series,included:unsuccessfully superselec- tive catheterization of the hepatic artery in 6 cases,resulting from the unskillful catheteriza- tion or the abnormality of target arteries,etc.Failure recatheterizations of the hepatic arter- ies in the initial or subsequent procedures of TAI/TAE were occurred in the other 6 cases. (because of the stenosis/obstruction of hepatic artery resulted from the intimal injury of the target artery by repeated catheterization,the infusion of anticancer drugs(MMC,5-Fu)and excessive embolization of hepatic artery with gelatine sponge,ete);In the remaining 4 cas- es,the tumor's parasitic vessels-inferior phrenic arterier were neglected due to no abdominal aortography was performed.The results of 16 cases with improperly operative technique of TAI/TAE showed that the decrease of tumor's size was frequently less than 50 per cent,or no change,and in few cases the size of tumor became larger than before.Comparing the de- crease rate of tumor in this 16 cases with the comparative group also confirmed the presence of the significant difference(P

The interventional lung volume reduction is developed from the lung volume reduction surgery and endoscopically non-surgical lung volume reduction. It is a X-ray guided transcatheter therapeutic technique, involving intra-bronchial embolization of the target pulmonary lobes with bleomycin(or pure alcohol)-lipiodol emulsion and the proximal target bronchial occlusion with PMMA simultaneously. A stable effect of pulmonary fibrosis and lung volume reduction could thus be obtained with the name of functional pulmonary lobectomy. Although this interventional therapeutic technique is now still on progress of animal experiment but having special potency of clinical application and fruitful furture.

Based on the review of development course of interventional radiology in China during the period of more than twenty years, to analyse emphatically the main problems impeding the continuous development of interventional radiology, included the branch position of "Interventional Radiology" not be defined clearly in the medicines, the professional association not to do its best in the management and guidance, the professional quality of the personnel not to be properly trained, as well as the insufficiencies of foundation and experimental studies, etc. And in this paper, the corresponding countermeasures of solving those problems have been primarily explored by the authors, and pointed out as follows: to improve perfectly the branch construction of the "Interventional Radiology" and the training system of special personnel; to raise the grade and function of the professional association and periodical; to lay stress on the foundation and experimental studies; to further deepen the clinical study and correctly deal with the relation between this branch and the other clinical departments, etc.

In this paper, all the intrahepatic arterioportal shunts (IHAPSs) that result from the functional redistribution of hepatic arterial and portal venous blood flow are defined as functional IHAPSs (F-IHAPSs) so as to make the differentiation from organic IHAPSs (O-IHAPSs) that result from the intrahepatic arterioportal fistula or direct communication, such as those IHAPSs that are associated with advanced hepatocellular carcinoma (HCC) and other malignant hepatic tumors as well as those IHAPSs that are accompanied by congenital hepatic vascular malformations, hereditary hemorrhagic telangioectasia (HHT) and liver trauma (including iatrogenic injury), etc. In F-IHAPSs, the most common one is formed by the compensatory (or secondary) increase of arterial blood flow that is caused by the decrease of hepatopetal portal blood flow due to a variety of reasons; its formation mechanisms can be divided into three categories:(1) trans-sinusoidal type, such as the F-IHAPSs that is associated with cirrhosis;(2) post-sinusoidal type, such as the F-IHAPSs that is accompanied with the acute stage of Budd-Chiari syndrome; and (3) pre-sinusoidal type, such as the F-IHAPSs that occurs along with the gastrointestinal hemorrhagic shock. Another kind of F-IHAPSs has been commonly seen in some hepatic diseases that have primary increase of hepatic arterial blood flow, including hypervascular hepatic cavernous hemangioma, small hepatocellular carcinoma that has rich blood supply, hepatobiliary inflammatory diseases, etc.;and in this paper they are all classified as F-IHAPSs category, however, the formation mechanisms of such F-IHAPSs vary with their basic diseases. Clinically, imaging diagnosis of F-IHAPSs can be made based on the following three signs:(1) all kinds of hepatic diseases that have concomitant intrahepatic arterioportal fistula or direct communication, as mentioned above, have been definitely excluded:(2) hepatic artery DSA reveals early visualization of portal vein in arterial phase, known as the characteristic sign of F-IHAPSs;and/or: (3) hepatic dynamic enhanced CT/MR scanning demonstrates transient enhancement of liver parenchyma in arterial phase, especially early visualization of portal vein is also present; in this case the diagnosis of F-IHAPSs can be undoubtedly confirmed. However, in making differential diagnosis, F-IHAPSs must be carefully differentiated from O-IHAPSs, local hepatic parenchymal perfusion caused by hepatic aberrant vein or by abnormal hepatopetal draining vein from systemic circulation, etc. In addition, when cirrhosis-related transient hepatic parenchymal enhancement presents as a solitary small nodule, differentiation with small HCC should be taken into consideration. In order to provide the readers with a complete and up-to-date understanding of F-IHAPSs, the relevant example illustrations, figures and graphics are accompanied with the text.

Objective To further explore the blood supply and interventional therapy of adult cavernous hemangiomas of the liver (CHL).Methods Recently some authors reported that a satisfactory effect resulted from transcatheter portal venous embolization was obtained in few cases of CHL with blood supply of portal vein,and raised an objection to the standpoint that CHL was commonly supplied by hepatic artery completely.In order to get a scientific and reasonable explanation for it,this paper reviewed the vascular embryology and histology of the liver,the pathologic features of CHL as well as the relative literature,and combined with the investigation results of blood dynamic changes of CHL that had been performed in 2000～2002 by us.Results CHL was caused by the arrested development of hepatic sinusoids at the embryonic stage.Pathologically,CHL was consisted of a lot of enlarged abnormal sinusoids,which were variant in size and closely related with the hemodynamic changes of CHL (in inverse proportion).The CHL consisted of even and tiny abnormal sinusoids (diameter less than 50 ?m) pathologically usually presented a high flow.During the hepatic artery angiography or CTHA,it was rapidly filled by the arterial blood containing contrast media and frequently showed dense opacification or enhancement.Simultaneously this could result in increased pressure of abnormal sinusoids.When the sinusoidal pressure exceeded that of the connecting portal venules,the arterial blood containing contrast media filled in the abnormal sinusoids could lead to retrograde flow in the portal venules.That was arterial-portal venous shunts (APVS).These appearances described as above could also occur in some CHL with intermediate flow,in which many tiny abnormal sinusoids located in the peripheral area were identified pathologically.On the contrary,the CHL consisted of larger abnormal sinusoids (diameter more than 500 ?m) pathologically usually presented a low flow.During the hepatic artery angiography or CTHA,it was filled very slowly by the arterial blood containing contrast media and was difficult to opacify or enhance.Simultaneously this could result in a low pressure of abnormal sinusoids.When the sinusoidal pressure was lower than that of the connecting portal venules,the portal venous blood containing contrast media could easily flow into the abnormal sinusoids and make it enhanced during the direct or indirect portography (or CTAP).Conclusion CHL is really a congenital venous malformation.All the CHL with high flow and some CHL with intermediate flow are surely supplied by the hepatic artery and drained primarily by the peripheral branches of portal vein.However,in few CHL with marked lower flow,the portal vein should become a primary supply vessel,so a direct or indirect portography (or CTAP) must often be taken to identify the diagnosis.Thereby,the technique of transcatheter embolization of CHL including the aim,indication,approach,and the used sclerotic or embolic drugs,etc,should also be reconsidered in order to improve its therapeutic efficacy.

This paper aims to make a comprehensive review about the new generation drug-eluting stents and their effects of anti-thrombosis to decrease stent thrombosis (ST), which are very helpful for interventional radiologists, especially for cardiologists who are engaged in percutaneous coronary interventional therapy. Based on the review of recently published academic papers and the investigation of the manufacturers and market of stent, the main factors related to ST complication which is associated with new generation drug-eluting stents are retrospectively and briefly analyzed. Besides, a variety of new generation drug-eluting stents with anti-thrombosis effect that are being successfully developed recently with new technology and new materials, including the renewal or improvement of the stent platform, loaded drug, carrier and its loading technology, etc. are comprehensively described in this paper in a combination way of vivid pictures with corresponding essay. In addition, the development and the prospect in clinical application of biodegradable drug-eluting stents are also briefly discussed in this paper.

Adult ; Haploidy ; Hematopoietic Stem Cell Transplantation ; Hemorrhage ; Humans ; Lung Diseases ; Male ; Pulmonary Alveoli

In order to study the effects of soman intoxication on hemodynamics,the left ventricular pressure(LVP),the maximal changing rate of LVP(?dp/dt max),the aortic pressure(AP),the pulmonary arterial pressure(PAP),the cardiac output(CO),the cardiac index(CD and the heart rate(HR)were determined in anesthetized,chest -opened and mechanically-ventilated dogs at a simulated high altitude of 4 000m before and after an intravenous injection of 10?g/kg of soman.It was found that the toxicity of soman on cardiac functions was more severe at high altitude than at sea level.

The role of free radicals in the precipitation of lung damage after hydrogen sulfide inhalation was investigated in rats, which were killed right after and in the 1st, 6th,12th, 24th, and 72nd hour after exposure to 100 and 220 ppm of hydrogen sulfide (H2S) for 3 hours respectively. Malondialdehyde(MDA) level in lung homogenate and in bronchoalveolar lavage fluid (BALF), protein content and the number of leucocytes and pulmonary alveolar macrophages (PAM) in BALF, superoxide dismutase(SOD),glutathione(GSH),and vitamin E(VE)level in lung tissue and blood were determined. It was found that H2S inhalation resulted in an increase of MDA level which occurred much earlier after exposure to 220 ppm than after exposure to 100 ppm. Protein content was increased in the 1st, 6th, and 12th hour after inhalation. The number of leucocytes and PAM were increased, which implies the existence of inflammatory response in the respiratory tract. SOD activity decreased in the early period after inhalation but significantly increased later. Both GSH and VE levels decreasedThese findings suggest that H2S inhalation induces an inflammatory response in the respiratory tract and an increase of free radical formation which in turn brings about exessive lipid peroxidation. It is concluded that free radical formation is a contributing factor of lung damages after H2S inhalation.