The goal of this study is to present our experience of transarterial embolization for the treatment of hemangioma racemosum of the mandibular region of the face. 6 cases of hemangioma racemosum, confirmed by digital subtraction angiography (DSA), the feeding vessels were found to be the external carotid artery. Further angiographic examination was performed to determine whether an arterial-venous fistula was present. If there was a a-v fistula, the feeding vessel was occluded by a coil. If there was no fistula, the feeding vessel was occluded by superselective transarterial injection of gelfoam granules and/or coils until all the feeding vessels were embolized. Excellent clinical and angiographic results were obtained, with obliteration of arteriovenous shunt in all patients. Angiography after embolization showed almost complete obliteration of hemangioma racemosum. There were no serious complications such as embolism to other organs and necrosis of a large area in the embolized tissue. Only slight swelling and pain in the embolized area were present. They gradually disappeared by expectant treatment. No recurrence of the symptoms was occurred in a follow-up evaluation 7～29 months later. Transarterial gelfoam granule and/or coil embolization may be a safer and more effective method in the treatment of mandibular and facial hemangioma racemosum.

The diagnosis of the rupture of the fibular collateral ligament of the ankle following varus injury can be made by inversion test film and anterior drawer test which s similar to the examination of the instability of the anterior cruciate ligament at at the knee.In order to evaluate the value of the anterior drawer test for the diagnosis of this lesion, the radiological evidences of the anterior and varus stress viewa were observed by dividing different fasciulus of the lateral ligament in 21 fresh cadaveric and amputated ankles.The effects of the applied weight and plantar flexion and the muscular tension of the lower leg on the antrior Subluxation of the talus i.e. positve anterior drawer sign were investigated.The clinical assessments were then made in 20 injuried ankles of 20 patients who were suffered from varus sprains.All injuried ankles of these patients were treated by surgery and the ligmentous injuries were verified. Then a comparision was made between the two stress views obtained before operation. The positive anterior drawer sign was demonstrated to be more common than varus tilt of the talus.Therefore, it is suggested that the antrior drawer test is very valuble in the diagnosis of the rupture of the anterior talofibular ligament.In this article the various factors which influenced the measured value of the anterior drawer test were discussed and the method of the examination and the diagnostic criteria were proposed.

Objective To evaluate the benefit of three dimensional (3D) reconstruction images with rotational digital subtraction technique for the clinical applications Methods Conventional two dimensional digital substraction angiography ( 2D DSA ) was obtained on A P and lateral view. Three dimensional digital subtraction angiography ( 3D DSA ) images were obtained by reconstruction of a rotational acquisition on a C arm (LCV+, GE Medical Systems) spinning at 40 degrees per second 53 cases of cerebral angiographies were performed (32 men and 21 women; the age ranged from 19 to 72 years, mean 46 3 years) Results In this series of 53 cases of cerebral angiographies, 5 cases of arteriovenous malformation were all correctly diagnosed by 3D DSA and 2D DSA . Seven cases were misdiagnosed as intracranial aneurysms at conventional 2D DSA but confirmed to be kinking of the vessel by 3D DSA . 41 cases were confirmed to be intracranial aneurysms Of the 41 cases, 5 cases were diagnosed as normal at 2D DSA but confirmed to be intracranial aneurysms at 3D DSA . The total consistency rate of 3D DSA and 2D DSA for the diagnosis of intracranial aneurysm is 77 4% (41/53) The consistent test shows that there was consistency between the two modalities (chi square test, ? 2=5 267, P

Objective: To investigate postoperative recurrent pattern of the thoracic esophageal squamous cell carcinoma (TESCC), aiming to provide a basis for the delineation of postoperative radiotherapy volume for TESCC. Methods: Clinical data of 66 TESCC patients who recurred after the radical esophagectomy in Zhongnan Hospital of Wuhan University from 2011 to 2017 were retrospectively analyzed. According to the AJCC 8^th edition-defined classification of esophageal carcinoma, regional lymph node stations 1 to 8M were defined as the upper-middle mediastinum region (UMMR), and stations 8Lo, 9 and 15 were defined as the inferior mediastinum region (IMR), stations 16 to 20 were regarded as the upper abdominal lymph node region (UAR). Results: Among all 66 patients, 41 cases (62%) experienced loco-regional recurrence alone, 25 cases (38%) presented with distant metastasis alone. A total of 54 patients with 148 lymph node recurred after treatment. The highest risk region of lymph node recurrence was UMMR (118/148, 80%), after that, followed by UAR (24/148, 17%). With regard to 9 cases of UAR, 6 patients had lower TESCC, and 8 patients (89%) were graded as ≥ pathological stage Ⅲ. Conclusions The highest risk region of lymph node recurrence is UMMR in TESCC patients undergoing radical esophagectomy, which should be considered as the target volume in postoperative radiotherapy. For patients with lower TESCC ≥ pathological stage Ⅲ, UAR might be the target volume with cautions. Anastomosis and IMR are probably not the routine treatment volumes.

Objective: To evaluate the effect of depth of remission of induction chemotherapy on the overall prognosis of limited stage small cell lung cancer (L-SCLC). Methods: The study was a retrospective, L-SCLC patients who contained complete imaging data and underwent consecutive standardized treatments at the Department of Thoracic Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University between January 2013 and June 2021 were included. To delineate the volume of tumor before and after induction chemotherapy and to calculate the depth of remission caused by the induced chemotherapy. The time receiver operating characteristic (timeROC) method was used to determine the optimal predictors for prognosis, multi-factor analysis using Cox risk proportional model. Results: A total of 104 patients were included in this study. The median PFS and OS of this cohort were 13.7 months and 20.9 months, respectively. It was observed by timeROC analysis that residual tumor volume after induction chemotherapy had the optimal predictive value of PFS at 1 year (AUC=0.86, 95% CI: 0.78~0.94) and OS at 2 years (AUC=0.76, 95% CI: 0.65~0.87). Multivariate analysis showed residual tumor volume after induction chemotherapy was the independent prognostic factor to PFS (HR=1.006, 95% CI: 1.003~1.009, P<0.01) and OS (HR=1.009, 95% CI: 1.005~1.012, P<0.001). For those whose residual tumor volume remitted to less than 10 cm(3) after induction chemotherapy, the favorable long-term outcomes could be achieved, regardless of their initial tumor load. Conclusion: The depth of remission of induction chemotherapy could be a promising prognostic predictor to the L-SCLC and provide the individualized treatment guidance.
Humans ; Small Cell Lung Carcinoma/pathology* ; Lung Neoplasms/pathology* ; Induction Chemotherapy ; Retrospective Studies ; Neoplasm, Residual ; Prognosis

Alcoholic liver disease (ALD) results from continuous and heavy alcohol consumption. The current treatment strategy for ALD is based on alcohol withdrawal coupled with antioxidant drug intervention, which is a long process with poor efficacy and low patient compliance. Alcohol-induced CYP2E1 upregulation has been demonstrated as a key regulator of ALD, but CYP2E1 knockdown in humans was impractical, and pharmacological inhibition of CYP2E1 by a clinically relevant approach for treating ALD was not shown. In this study, we developed a RNAi therapeutics delivered by lipid nanoparticle, and treated mice fed on Lieber-DeCarli ethanol liquid diet weekly for up to 12 weeks. This RNAi-based inhibition of Cyp2e1 expression reduced reactive oxygen species and oxidative stress in mouse livers, and contributed to improved ALD symptoms in mice. The liver fat accumulation, hepatocyte inflammation, and fibrosis were reduced in ALD models. Therefore, this study suggested the feasibility of RNAi targeting to CYP2E1 as a potential therapeutic tool to the development of ALD.

Vacuum sealing drainage (VSD) is frequently used in abdominal surgeries. However, relevant guidelines are rare. Chinese Trauma Surgeon Association organized a committee composed of 28 experts across China in July 2017, aiming to provide an evidence-based recommendation for the application of VSD in abdominal surgeries. Eleven questions regarding the use of VSD in abdominal surgeries were addressed: (1) which type of materials should be respectively chosen for the intraperitoneal cavity, retroperitoneal cavity and superficial incisions? (2) Can VSD be preventively used for a high-risk abdominal incision with primary suture? (3) Can VSD be used in severely contaminated/infected abdominal surgical sites? (4) Can VSD be used for temporary abdominal cavity closure under some special conditions such as severe abdominal trauma, infection, liver transplantation and intra-abdominal volume increment in abdominal compartment syndrome? (5) Can VSD be used in abdominal organ inflammation, injury, or postoperative drainage? (6) Can VSD be used in the treatment of intestinal fistula and pancreatic fistula? (7) Can VSD be used in the treatment of intra-abdominal and extra-peritoneal abscess? (8) Can VSD be used in the treatment of abdominal wall wounds, wound cavity, and defects? (9) Does VSD increase the risk of bleeding? (10) Does VSD increase the risk of intestinal wall injury? (11) Does VSD increase the risk of peritoneal adhesion? Focusing on these questions, evidence-based recommendations were given accordingly. VSD was strongly recommended regarding the questions 2-4. Weak recommendations were made regarding questions 1 and 5-11. Proper use of VSD in abdominal surgeries can lower the risk of infection in abdominal incisions with primary suture, treat severely contaminated/infected surgical sites and facilitate temporary abdominal cavity closure.
Abdomen ; surgery ; China ; Drainage ; methods ; Evidence-Based Medicine ; Humans ; Practice Guidelines as Topic ; Societies, Medical ; organization & administration ; Surgical Wound Infection ; prevention & control ; Traumatology ; organization & administration ; Vacuum