Objective To investigate the methodology,technical considerations,and precautions of transcatheter arterial emboliza-tion(TAE)using medical adhesive as the primary embolic agent for visceral artery aneurysm(VAA).Methods A total of 14 patients with VAA treated with medical adhesive-based TAE were retrospectively analyzed.Among the 14 patients,6 cases were hepatic artery pseudoaneurysms,4 cases were true gastroduodenal aneurysms,3 cases were gastroduodenal pseudoaneurysms,and 1 case was renal artery pseudoaneurysm.Among the 14 patients,medical adhesive alone was used in 12 cases,while the other 2 cases were employed medical adhesive combined with supplemental coil embolization.Follow-up assessments including abdominal computed tomography angiography(CTA)and laboratory tests were conducted at 3,6,and 12 months post-procedure.Results Technical success was achieved in all cases with mean procedure duration of(60.4±8.2)min and average hospital stay of(8.9±2.1)d.No recanalization,aneurysm enlargement,or non-target embolization were observed during follow-up.Conclusion Medical adhesive-based TAE demonstrates high technical success when performed by experienced interventionists,with low complication rate,low recurrence rate,and low pro-cedure-related mortality,representing a cost-effective preferred treatment for VAA.

Objective To investigate the methodology,technical considerations,and precautions of transcatheter arterial emboliza-tion(TAE)using medical adhesive as the primary embolic agent for visceral artery aneurysm(VAA).Methods A total of 14 patients with VAA treated with medical adhesive-based TAE were retrospectively analyzed.Among the 14 patients,6 cases were hepatic artery pseudoaneurysms,4 cases were true gastroduodenal aneurysms,3 cases were gastroduodenal pseudoaneurysms,and 1 case was renal artery pseudoaneurysm.Among the 14 patients,medical adhesive alone was used in 12 cases,while the other 2 cases were employed medical adhesive combined with supplemental coil embolization.Follow-up assessments including abdominal computed tomography angiography(CTA)and laboratory tests were conducted at 3,6,and 12 months post-procedure.Results Technical success was achieved in all cases with mean procedure duration of(60.4±8.2)min and average hospital stay of(8.9±2.1)d.No recanalization,aneurysm enlargement,or non-target embolization were observed during follow-up.Conclusion Medical adhesive-based TAE demonstrates high technical success when performed by experienced interventionists,with low complication rate,low recurrence rate,and low pro-cedure-related mortality,representing a cost-effective preferred treatment for VAA.

Objective To analyze the risk factors and effective predictive indicators for postpartum hemor-rhage(PPH)in pregnant women with severe pre-eclampsia(sPE)in singleton pregnancies.The findings will serve as a valuable reference for the clinical prevention and management of PPH in these patients.Methods A retrospective analysis was conducted on 932 pregnant women with sPE at two tertiary hospitals in Guangzhou from January 1,2016,to December 31,2022.Among these,95 cases were complicated by PPH.A comparative analysis was performed between the sPE group and the sPE with PPH group.Results(1)The incidence of assisted reproductive technology,intrapartum blood loss,placental abruption,elevated D-dimer levels,increased monocyte counts,and higher SIRI levels were significantly higher in the PPH group,whereas platelet counts were significantly lower(P<0.05).(2)The results indicated that intrapartum blood loss,D-dimer levels,and platelet counts were inde-pendently associated with PPH in pregnant women with sPE.(3)The area under the curve(AUC)for intrapartum blood loss,D-dimer,and platelet counts were 0.805,0.717,and 0.571,respectively.The optimal cutoff value for D-dimer was determined to be 2.295 μg/mL.The combined AUC for intrapartum blood loss and D-dimer was 0.859.(4)Intrapartum blood loss values were significantly higher in the PPH group for both vaginal delivery and cesarean section(P<0.001).The corresponding optimal cutoff values were 285 mL and 375 mL,respectively.Conclusions Intrapartum haemorrhage,D-dimer levels,and platelet count were identified as independent risk factors for PPH in pregnant women with sPE.Specifically,pregnant women with sPE who experienced blood loss exceeding 285 mL during vaginal delivery or 375 mL during caesarean section,along with a D-dimer level greater than 2.295 μg/mL,demonstrated an increased likelihood of developing PPH.Therefore,it is crucial to enhance clinical monitoring of these relevant indicators in high-risk populations.

Objective:To investigate the impact of early invasive arterial blood pressure (IBP) monitoring on survival and neurological outcomes in out-of-hospital cardiac arrest (OHCA) patients undergoing extracorporeal cardiopulmonary resuscitation (ECPR).Methods:This retrospective cohort study analyzed 44 OHCA patients receiving ECPR between January 2021 and January 2023. Patients were divided into: Early intervention group : IBP established within 3 min of ECMO initiation; Late intervention group : IBP established after ICU admission. Baseline characteristics, ECMO parameters, and clinical outcomes were compared. Multivariable logistic regression (adjusted for age, initial rhythm, etc.) and Spearman's correlation were used.Results:This study included a total of 44 patients treated with OHCA and ECPR, divided into an early intervention group of 23 cases and a late intervention group of 21 cases. The early intervention group showed significantly higher: Survival to discharge (43.5% vs. 9.5%, P<0.05), Good neurological recovery (CPC 1-2: 34.8% vs. 9.5%, P<0.05).Early intervention independently predicted survival (adjusted OR=18.84, 95% CI:1.97-179.98, P=0.01). Stratified analysis by pH (cutoff 7.0) demonstrated consistent benefits in both pH>7.0 ( aOR=0.392, 95% CI:0.106-0.678) and pH≤7.0 subgroups ( aOR=0.385, 95% CI: 0.075-0.695; interaction P=0.183). Early IBP positively correlated with CPC scores ( ρ=0.40, P=0.007). Conclusions:Early IBP monitoring significantly improves survival and neurological outcomes in OHCA-ECPR patients, supporting its integration into standardized protocols.

Objective To investigate clinical therapeutic value of combined posterior nasal nerve and anterior ethmoidal nerve ablation in patients with nasal septal deviation and moderate to severe persistent allergic rhinitis.Methods A total of 47 patients diagnosed with nasal septal deviation and moderate to severe persistent allergic rhinitis from April to December 2024 were divided into two groups.The control group(n=22)underwent septoplasty and bilateral inferior turbinate out-fracture,with postoperative symptom control managed by budesonide nasal spray.The experimental group(n=25)received the same septoplasty and turbinate surgery,supplemented by bilateral posterior nasal nerve and anterior ethmoidal nerve ablation.Symptom improvement was compared between groups by using the Visual Analogue Scale(VAS)and Rhinoconjunctivitis Quality of Life Questionnaire(RQLQ)scores preoperatively and3 months postoperatively.Results The operation time of the control group was(36.3±5.9)min,significantly shorter than that of the experimental group[(59.4±6.6)min,t=12.496,P=0.000].Both groups of patients showed significant improvement in VAS and PQLQ scores for nasal symptoms such as nasal congestion,runny nose,sneezing,and itching at 3 months after surgery compared to preoperative levels(all P=0.000).The mean VAS score of the four symptoms in the control group was(4.6±0.9)points at3 months after surgery,which was significantly lower than that before surgery[(6.3±1.1)points,t=9.796,P=0.000].The mean VAS score of the four symptoms in the experimental group was1.0(0.3-4.3)points at3 months after surgery,which was significantly lower than that before surgery[7.0(4.5-9.0)points,Z=-4.376,P=0.000].The improvement rate of the VAS score in the experimental group was(82.4±14.2)%,significantly higher than that in the control group[(26.9±11.7)%,t=14.510,P=0.000].At3 months after surgery,the RQLQ score of the control group[(2.3±0.8)points]was significantly lower than that before surgery[(3.3±0.8)points,t=10.055,P=0.000].The RQLQ score of the experimental group after surgery was 1.4(0.8-3.5)points,which was significantly lower than the preoperative score[3.6(1.5-6.1)points,Z=-4.373,P=0.000].The improvement rate of RQLQ score in the experimental group was(53.0±14.6)%,significantly higher than that in the control group[(30.2±13.4)%,t=5.555,P=0.000].Conclusion Postnasal nerve and anterior ethmoidal nerve ablation combined with nasal septal deviation correction can significantly improve nasal symptoms and quality of life in patients with nasal septal deviation complicated with moderate to severe allergic rhinitis compared with simple nasal septal deviation correction,but the operation time is prolonged.

Objective To analyze the risk factors and effective predictive indicators for postpartum hemor-rhage(PPH)in pregnant women with severe pre-eclampsia(sPE)in singleton pregnancies.The findings will serve as a valuable reference for the clinical prevention and management of PPH in these patients.Methods A retrospective analysis was conducted on 932 pregnant women with sPE at two tertiary hospitals in Guangzhou from January 1,2016,to December 31,2022.Among these,95 cases were complicated by PPH.A comparative analysis was performed between the sPE group and the sPE with PPH group.Results(1)The incidence of assisted reproductive technology,intrapartum blood loss,placental abruption,elevated D-dimer levels,increased monocyte counts,and higher SIRI levels were significantly higher in the PPH group,whereas platelet counts were significantly lower(P<0.05).(2)The results indicated that intrapartum blood loss,D-dimer levels,and platelet counts were inde-pendently associated with PPH in pregnant women with sPE.(3)The area under the curve(AUC)for intrapartum blood loss,D-dimer,and platelet counts were 0.805,0.717,and 0.571,respectively.The optimal cutoff value for D-dimer was determined to be 2.295 μg/mL.The combined AUC for intrapartum blood loss and D-dimer was 0.859.(4)Intrapartum blood loss values were significantly higher in the PPH group for both vaginal delivery and cesarean section(P<0.001).The corresponding optimal cutoff values were 285 mL and 375 mL,respectively.Conclusions Intrapartum haemorrhage,D-dimer levels,and platelet count were identified as independent risk factors for PPH in pregnant women with sPE.Specifically,pregnant women with sPE who experienced blood loss exceeding 285 mL during vaginal delivery or 375 mL during caesarean section,along with a D-dimer level greater than 2.295 μg/mL,demonstrated an increased likelihood of developing PPH.Therefore,it is crucial to enhance clinical monitoring of these relevant indicators in high-risk populations.

Objective:To investigate the effect of ginsenoside octanoate(Rh2-O)on inducing immunogenic cell death in hepa-tocellular carcinoma cells and its molecular mechanism.Methods:Effects of ginsenoside caprylate(Rh2-O)and autophagy inhibitor 3-MA on the activity of hepatocellular carcinoma cells were detected by CCK-8 assay.The effect of Rh2-O on CRT membrane eversion in Hepa1-6 cells were detected by immunofluorescence assay.Rh2-O treated mouse hepatocellular carcinoma cells were used to pre-pare a tumor vaccine for in vivo vaccination experiments in mice.Extracellular ATP levels were detected in real-time.The expression of autophagy-related genes and proteins were measured by real-time fluorescence PCR and Western blot,and the mitochondrial morphol-ogy and co-localization with autophagy proteins were observed by laser confocal microscopy.Results:Rh2-O showed strong cytotoxicity to Hepa1-6 cells[cell viability:(58.54±3.56)%]at a concentration of 150 μmol/L,and a large amount of CRT was observed on the surface of the cell membrane.The tumor emergence rate was 36.36%in the vaccinated group and 100%in the control group.The tumor vaccine prepared by Rh2-O effectively protected mice from the same type of tumor attack;Rh2-O induced an increase in the level of cellular secreted ATP(P<0.05),the mRNA of autophagy-related genes ATG3,p62,LC3 expression levels and autophagy-associated proteins LC3A and LC3B expression levels were increased(P<0.05),and co-localization of mitochondria with autophagy proteins was significantly increased(P<0.05).In addition,Rh2-O action on 3-MA pretreated hepatocellular carcinoma cells resulted in a signifi-cant decrease in extracellular ATP levels(P<0.001).Conclusion:Rh2-O may induce immunogenic cell death by inducing autophagy in hepatocellular carcinoma cells.

Objective:To improve the awareness of Beh?et′s disease with ventricular neoplasm.Methods:A case with fever, thrombosis, and right ventricular neoplasm was described. The diagnosis and treatment were analyzed and discussed.Results:A young male with genital ulcers and oral ulcers, ocular, skin, and vascular lesions presenting as large venous thrombus, was diagnosed with Beh?et′s disease. Pathological results of space-occupying lesion in right ventricle revealed inflammation and necrotic substance. Endocarditis was considered. Glucocorticoids and cyclophosphamide was given, together with warfarin. During one-year follow-up, the patient remained stable.Conclusion:It is difficult to distinguish between Beh?et′s disease with cardiac neoplasm and infective endocarditis or cardiac tumor based on clinical manifestations and imaging only. Multidisciplinary management is a valuable approach for the diagnosis and treatment.

PURPOSE: To investigate the protective effect of sub-hypothermic mechanical perfusion combined with membrane lung oxygenation on ischemic hypoxic injury of yorkshire brain tissue caused by traumatic blood loss. METHODS: This article performed a random controlled trial. Brain tissue of 7 yorkshire was selected and divided into the sub-low temperature anterograde machine perfusion group (n = 4) and the blank control group (n = 3) using the random number table method. A yorkshire model of brain tissue injury induced by traumatic blood loss was established. Firstly, the perfusion temperature and blood oxygen saturation were monitored in real-time during the perfusion process. The number of red blood cells, hemoglobin content, NA⁺, K⁺, and Ca²⁺ ions concentrations and pH of the perfusate were detected. Following perfusion, we specifically examined the parietal lobe to assess its water content. The prefrontal cortex and hippocampus were then dissected for histological evaluation, allowing us to investigate potential regional differences in tissue injury. The blank control group was sampled directly before perfusion. All statistical analyses and graphs were performed using GraphPad Prism 8.0 Student t-test. All tests were two-sided, and p value of less than 0.05 was considered to indicate statistical significance. RESULTS: The contents of red blood cells and hemoglobin during perfusion were maintained at normal levels but more red blood cells were destroyed 3 h after the perfusion. The blood oxygen saturation of the perfusion group was maintained at 95% - 98%. NA⁺ and K⁺ concentrations were normal most of the time during perfusion but increased significantly at about 4 h. The Ca²⁺ concentration remained within the normal range at each period. Glucose levels were slightly higher than the baseline level. The pH of the perfusion solution was slightly lower at the beginning of perfusion, and then gradually increased to the normal level. The water content of brain tissue in the sub-low and docile perfusion group was 78.95% ± 0.39%, which was significantly higher than that in the control group (75.27% ± 0.55%, t = 10.49, p < 0.001), and the difference was statistically significant. Compared with the blank control group, the structure and morphology of pyramidal neurons in the prefrontal cortex and CA1 region of the hippocampal gyrus were similar, and their integrity was better. The structural integrity of granulosa neurons was destroyed and cell edema increased in the perfusion group compared with the blank control group. Immunofluorescence staining for glail fibrillary acidic protein and Iba1, markers of glial cells, revealed well-preserved cell structures in the perfusion group. While there were indications of abnormal cellular activity, the analysis showed no significant difference in axon thickness or integrity compared to the 1-h blank control group. CONCLUSIONS Mild hypothermic machine perfusion can improve ischemia and hypoxia injury of yorkshire brain tissue caused by traumatic blood loss and delay the necrosis and apoptosis of yorkshire brain tissue by continuous oxygen supply, maintaining ion homeostasis and reducing tissue metabolism level.
Animals ; Perfusion/methods* ; Disease Models, Animal ; Brain Injuries/etiology* ; Swine ; Male ; Hypothermia, Induced/methods*

[This corrects the article DOI: 10.11909/j.issn.1671-5411.2017.08.005.].