1.The clinical investigation of radioactive 125I seeds implantation combined with percutaneous vertebroplasty for the treatment of spinal vertebra metastases
Yuefei CAI ; Sheng ZHONG ; Chongyang XIAN ; Xiaoming TAN ; Yanhua MA
Chinese Journal of Postgraduates of Medicine 2013;(8):33-36
Objective To study and evaluate the therapeutic efficacy of CT-guided radioactive 125Iseeds implantation combined with percutaneous vertebroplasty for spinal vertebra metastases.Methods Fifteen patients and 21 lesions were enrolled in this study.Based on the CT images,a computer-based treatment planning system (TPS) was used to determine the optimal seeds distribution.Under CT-guided,radioactive 125I seeds were implanted into the lesions.Based on the X-ray and CT image after the implantation,quality check was carried out with TPS.The ostalgia-relieving degree and the image alterations of the spinal vertebra metastases lesions were observed.Two months later,15 patients underwent percutaneous vertebroplasty with DSA guidance,bone cement was made according to the ratio methyl acrylic resin polymer/liquid methyl acrylic resin monomer/contrast as 3 ∶ 2 ∶ 1 in injecting paste form.The puncturation through pedicle of vertebral arch and lateral posterior body of vertebra was both adopted in thoracic and lumbosacral vertebrae site.After making sure that the puncturation was completed and there was no leakage in vertebral body,the bone cement was injected into vertebral body quickly.Results Accepted radioactive 125I seeds plantation,relief of pain was obtained.Among 15 patients,8 patients were powerful,6 patients were effective and 1 patient was inefficiency.After treatment,the pain grading significantly decreased.After treatment for 2 months,CT was used to recheck,7 lesions were local controlled,12 lesions had no changes,2 lesions were progress.The responsive rate was 90.5% (19/21).No serious side-effect happened.Conclusions Radioactive 125I seeds implantation can be a safe and effective method in treating spinal vertebra metastases and obtaining good clinical effects with minimal damage and few complications.Percutaneous vertebroplasty can strengthen the target and relief pain quickly.CT-guided radioactive 125I seeds implantation combined with percutaneous vertebroplasty for the treatment of spinal vertebra metastases has complementary advantages.
2.Super-selective embolization of renal artery for severe hemorrhage after minimally invasive percutaneous nephrolithotomy
Sheng ZHONG ; Yuefei CAI ; Yanhua MA ; Youzhi WANG ; Yan JIAN ; Xiaoming TAN
Chinese Journal of Postgraduates of Medicine 2014;37(8):44-46
Objective To evaluate the outcome of super-selective embolization of renal artery for severe hemorrhage after minimally invasive percutaneous nephrohthotomy (MPCNL) and its effect on renal function.Methods Super-selective embolization of renal artery were performed in 9 patients with kidney hemorrhage followed by MPCNL.Results Seven patients were cured after the first time of embolization and 2 patients were treated successful after the second time.The main renal function was reserved.There was no serious complication after intervention.Condusiom Super-selective embolization of renal artery is reliable and effective in the diagnosis and treatment of kidney hemorrhage followed by MPCNL and in keeping main function of the kidney.It' s a safe and effective method in the treatment of severe hemorrhage after MPCNL.
3.Observation of the clinical effects of ornithine aspartate and lactulose on the prevention and treatment of hepatic encephalopathy after modified transjugular intrahepatic portosystemic shunt treatment
Yuefei CAI ; Yanhua MA ; Youzhi WANG ; Sheng ZHONG ; Xiaoming TAN ; Junsheng LIANG
Chinese Journal of Postgraduates of Medicine 2013;36(26):9-11
Objective To observe the clinical effects of ornithine aspartate (OA) and lactulose on the prevention and treatment of hepatic encephalopathy for patients with portal hypertension after modified transjugular intrahepatic portosystemic shunt (TIPS).Methods Fifty-six patients with portal hypertension were treated by modified TIPS,OA and lactulose after the operation were given,the incidence of postoperative hepatic encephalopathy and the changes of blood ammonia were observed.Patients with hepatic encephalopathy after modified TIPS accepted therapeutic dosage of OA and lactulose,and the clinical effects of combined OA and lactulose on treatment of the hepatic encephalopathy after modified TIPS and changs of blood ammonia were evaluated as well.Results Prophylactic use of combined OA and lactulose after modified TIPS,there was no hepatic encephalopathy happened in 56 patients.Hepatic encephalopathy was seen in 5 patients after discontinuation of combined OA and lactulose,the incidence rate of hepatic encephalopathy was 8.93% (5/56).The level of blood ammonia in patients after modified TIPS was significanby higher than that before treatment [(88.2 ± 23.0) μ mol/L vs.(43.1 ± 19.2) μ mol/L,P < 0.05].Five patients with hepatic encephalopathy was improved quickly after given therapeutic dosage of OA and lactulose (the average treatment time was 7 d),and the level of blood ammonia was significantly lower than before treatment [(69.1 ± 14.1) p mol/L vs.(139.2 ± 15.8) μ mol/L,P< 0.05].Conclusion Combined OA and lactulose can effectively prevent and treat the hepatic encephalopathy after modified TIPS,its mechanism may be associated with reduction of blood ammonia level.
4.Expression and significance of heme oxygenase Ⅰ in gliomas
Leping OUYANG ; Kaishu LI ; Jiahao LIU ; Mingliang HE ; Wangqing CAI ; Yuefei DENG ; Anmin LIU
Chinese Journal of Neuromedicine 2017;16(6):559-563
Objective To investigate the expression and biological value of heme oxygenase I (HO-1) in gliomas. Methods Fifty-six patients with gliomas, admitted to and accepted surgery in our hospital from January 2010 to January 2015, were chosen in our study; WHO grade I was noted in 4 patients, grade Ⅱ in 16, grade Ⅲ in 10, and grade IV in 26 patients; patients with grade I and Ⅱ were as low-grade glioma group and patients with grade Ⅲ and IV were as high-grade glioma group. The HO-1 expression in the two groups was detected by immunohistochemistry. R-langrage survival tool was used to analyze the relation between HO-1 expression and prognosis of 1107 patients with gliomas selected from The Cancer Genome Atlas (TCGA) database. Results Significant differences of HO-1 expression were observed in different grades of gliomas (P<0.05), and HO-1 high-expression rate in the high-grade gliomas (75%) was significantly higher than that in the low-grade group (30%, P<0.05). HO-1 protein expression level in the high-grade gliomas was significantly higher than that in the low-grade group (P<0.05). Moreover, area under the curve (AUC) of the receiver operating characteristic curve was suggested that the HO-1 could be an ideal determine factor (AUC=0.747, P=0.002). Log rank analysis indicated that the accumulate survival rate in patients with low HO-1 expression was significantly higher than that in patients with high HO-1 expression (P<0.05). TCGA database analysis showed that simultaneous survival rate in patients with low HO-1 expression was significantly higher than that in patients with high HO-1 expression (P<0.05). Conclusion Expression of HO-1 is correlated with the malignant degrees and prognoses of gliomas, and it has potential to be a novel biological marker for the diagnosis and treatment of gliomas; furthermore, HO-1 could also be a target for the study and treatment of gliomas.