Objective To discuss the efficacy and safety of transjugular intrahepatic portosystemic shunt(TIPS)for portal hypertension with portal vein thrombosis(PVT).Methods A total of 31 patients with portal hypertension complicated by PVT,who underwent TIPS at the Chinese PLA General Hospital between December 2017 and October 2022,were enrolled in this study.The clinical data,including preoperative laboratory tests,operation pattern,intraoperative portal vein pressure(PVP),postoperative follow-up ultrasound or enhanced CT examination findings,and the presence or absence of hepatic encephalopathy(HE),were collected.Paired t-test was used to compare the differences in PVP before and after stenting,Kaplan-Meier curve was used to analyze the postoperative shunt patency rate,rebleeding rate,incidence of HE,and survival rate.Log-rank test was used to analyze the differences in follow-up results between the patients having cavernous transformation of portal vein(CTPV)and the patients having no CTPV.Results The technical success rate of TIPS procedure was 93.55％(29/31).In the 29 patients with successful surgery,the mean PVP value decreased from preoperative(30.15±4.61)mmHg to postoperative(20.84±5.57)mmHg,the difference was statistically significant(t=8.975,P＜0.05).The postoperative median follow-up time was 22.90 months(range of 4.50-61.80 months).During the follow-up period,24.14％of patients(7/29)developed shunt tract dysfunction,17.24％of patients(5/29)developed rebleeding,17.24％of patients(5/29)developed HE,and 5 patients(5/29,17.24％)died.Ten patients(10/29,34.48％)with PVT were complicated by CTPV,among them 5 patients had shunt dysfunction,3 patients had rebleeding,one patient developed HE,and 3 patients died.Of the 19 patients who having no coexisting CTPV,shunt dysfunction was seen in 2,rebleeding in 2 and HE in 4,and 2 patients died.The incidences of shunt tract dysfunction and rebleeding in the patients having CTPV were obviously higher than those in the patients having no CTPV(both P＜0.05),while no statistically significant differences in the incidences of HE and death existed between the two groups(both P＞0.05).Conclusion TIPS can effectively reduce the PVP in patients with PVT.The incidences of shunt tract dysfunction and rebleeding in the PVP with coexisting CTPV are remarkably higher than those in the PVT patients with no coexisting CTPV.(J Intervent Radiol,2024,33:537-542)

Objective:To investigate the histopathological and immunohistochemical changes of gastric fundus and duodenum after bariatric embolization of left gastric artery and gastroduodenal artery in obesity New Zealand rabbit models.Methods:Twenty obesity New Zealand rabbit models were successfully established and divided into two groups using stratified randomization. Left gastric artery and gastroduodenal artery were embolized with gelatin sponge (350-560 μm) in experimental group, left gastric artery and gastroduodenal artery were perfused with normal saline in control group. All animals were sacrificed for pathological, immunohistochemical examination and Western Blot analysis 4 weeks post embolization, the density of ghrelin producing cells and the gray ratio of ghrelin protein band were measured and compared by the independent sample t test. Results:Macropathological examination showed ulceration in the anterior wall of the gastric body in one rabbit, histopathological examination showed mucosa ulceration in the gastric body in 3 rabbits in experimental group. Immunohistochemical examination showed that the ghrelin producing cells of gastric fundus and duodenum in the experimental group were significantly less than those in the control group (10.0±5.1 vs.27.7±3.4, t=12.35, P<0.05;5.6±2.6 vs. 12.3±2.1, t=4.73, P<0.05). Western Blot analysis showed that the gray ratio of ghrelin bands of gastric fundus and duodenum in the experimental group were significantly lower than that in the control group (0.65±0.05 vs.1.12±0.09, t=9.62, P<0.05;0.55±0.03 vs. 0.94±0.08, t=7.98, P<0.05). Conclusions:Immunohistochemical and Western Blot analysis showed that the ghrelin-producing cells of gastric fundus and duodenum in the experimental group were significantly less than those in the control group after bariatric embolization, histopathologic analysis indicated that bariatric embolization was a safe technique.

Objective:To determine whether the transepidermal water loss rate (TEWL) is correlated with the stratum corneum (SC) hydration level.Methods:Healthy children aged ≤ 17 years were enrolled from Medical Center for Public Health of Puning, 2 kindergartens and 2 primary schools, from October 2021 to June 2022. TEWL and SC hydration levels were measured on the left forearm and right anterior shank using a device for measuring skin physiological funcitons. Pearson correlation analysis was used to determine the correlations between TEWL and SC hydration levels in children of different ages and genders.Results:A total of 1 396 healthy children were enrolled, aged from 1 month to 17 years. Among them, 783 were male children and 613 were female children. In children aged 1 to < 12 months, no correlation was observed between TEWL and SC hydration levels on the forearms of male children, while TEWL was positively correlated with SC hydration levels on the anterior shanks of male children, as well as on the forearm and anterior shanks of female children ( r = 0.283, 0.404, 0.420, respectively, all P < 0.05) . In children aged 1 to 2 years, positive correlations were observed between the above two indicators on the anterior shanks of male children and forearms of female children ( r = 0.370, 0.419, respectively, both P < 0.01) , while there were no correlations between the two indicators on the anterior shanks of female children or forearms of male children. Positive correlations were observed between TEWL and SC hydration levels on both the forearms and anterior shanks of female children and the forearms of male children aged 3 to 5 years and 6 to 11 years ( r values ranging from 0.172 to 0.293, all P < 0.05) , but not on the anterior shanks of male children aged from 6 to 11 years. The group aged 12 to 17 years exhibited significantly positive correlations between TEWL and SC hydration levels on both the anterior shanks and forearms of male and female children ( r values ranging from 0.269 to 0.485, all P < 0.001) . Conclusion:SC hydration levels are positively correlated with TEWL on the anterior shanks and forearms of healthy children, and the degree of correlation tends to increase with age.

Objective To compare the effectiveness and safety of two different treatment methods for patients with polycystic liver disease using super selective hepatic arterial embolization. Methods This retrospective study enrolled 41 patients with polycystic liver disease treated from June 2008 to June 2016 in the First Medical Center of Chinese PLA General Hospital. The patients underwent transcatheter super-selective hepatic arterial embdization (TAE). There were 5 men and 36 women. The age ranged from 36 to 68 years. The patients were divided into the observation group (n=14) and the control group ( n=27). The observation group underwent treatment using an emulsion of iodized oil and bleomycin and N-butyl-2-cyanoacrylate. The control group underwent iodized oil and N-butyl-2-cyanoacrylate. The clinical symptoms, operative complications, volumes of intrahepatic cysts, hepatic parenchyma volumes of pre-TAE and post-TAE at 3, 6 months and every 6 monthly were compared. Results TAE was technically successful in all the patients. The follow-up periods ranged from 24 to 72 months. The clinical symptoms improved re-markably in the observation group at 3 month, 6 months, 12 months, and 24 months, being 92. 9% (13/14), 92. 9% (13/14), 92. 9% (13/14), 92. 3% (12/13), respectively. One patient was lost to follow-up 24 months after operation. The clinical symptoms improved remarkably in the control group at 3 month, 6 months, 12 months, and 24 months, being 88. 9% ( 24/27 ), 85. 2% (23/27), 84. 6% ( 22/26 ), 81. 8% (18/22), respectively. One patient was lost to follow-up 12 months after operation and five patients were lost to follow-up 24 months after operation. Compared with preoperative, the abdominal circumference of two groups had decreased, the total volume of intrahepatic cyst and liver decreased at 6 months, 12 months, and 24 months after surgery (P＜0. 05). Conclusions TAE was a safe and effective treatment for polycystic liver disease. Patients in the observation group had more effective treatment outcomes on follow-up.

Objective To evaluate the safety and efficacy of transcatheter arterial embolization (TAE) in the management of refractory hematuria of prostatic origin (RHPO). Methods This retrospective study from 6 hospitals in china consisted of 31 patients (mean age 75.0±7.5 years, range 58 to 84 years) who underent transcatheter arterial embolization (TAE) for RHPO between February 2011 and January 2017. Patients with RHPO who had complete imaging and clinical data were enrolled. Patients with incomplete clinical data, inability to assess hemostasis, and contraindications to TAE were excluded. The cause of RHPO was benign prostatic hyperplasia (BPH) in nine patients, prostate cancer in twelve, transurethral resection of prostate in four, open prostatectomy in two and prostatic sarcoma in four. Superselective arterial embolization, non-superselective arterial embolization or intra-arterial infusion chemotherapy was performed according to the etiology and angiography. Angiographic findings, technical success rate, clinical success rate, complications were recorded. Results Of the 31 patients, 6 patients (19.4％) were with active bleeding, 4 (12.9％) with aneurysm and 27 (87.1％) with abnormal neovascularization on the angiogram. The 31 patients underwent a totle of 37 TAE, the technical success rate was 100.0％(37/37) and the recent hemostasis success rate was 90.3％(28/31). The incidence of mild complications was 38.7％(13/31), there was no serious complication associated with TAE. Conclusion TAE is a safe and effective method for the treatment of refractory hematuria of prostatic origin.

Cirrhosis is an advanced stage of liver fibrosis that causes fatal complications and and threats human health.Liver transplantation is the preferred treatment method of cirrhosis patients,but the therapeutic effect of liver transplantation is limited.In recent years,researchers at home and abroad have proposed the concept of cell replacement therapy for liver cirrhosis.Among them,mesenchymal stem cells (MSCs) have a wide range of sources,the MSCs can inhibit immunity and reduce the infiltration of inflammatory cells and release of pro-inflammatory cytokines,and they can also be induced to differentiate into hepatocytes to mitigate fibrosis,which become the preferred drug of cell replacement therapy for cirrhosis.Here,we mainly reviewed the mesenchymal stem cells from the features,the mechanisms of treatment for cirrhosis,and recent experimental studies and clinical trials.

Raman spectroscopy is amplified by surface-enhanced Raman scattering nanoparticles(SERS-NPs),and Raman signal can be enhanced by SERS-NPs,which can achieve high-resolution imaging of tumors.Meanwhile,SERS-NPs have high molecular specificity and sensitivity,showing a good prospect of tumor diagnosis and treatment.The advantages of SERS-NPs and its application in tumor diagnosis and treatment,and related experimental studies are reviewed in this article.

Severe frostbite (grade Ⅲ to Ⅳ) is a common disease accompanied with high disability rate in cold regions, especially for military training and disaster events in cold regions. The treatment of severe frostbite mainly includes rapid rewarming in the early stage and amputation in the later stage; while the damage of vascular endothelial cells, microvascular thrombosis, and decreased tissue perfusion secondary to severe frostbite are important factors affecting prognosis. Transcatheter arterial thrombolysis is a new technique for the treatment of severe frostbite. It has the advantages of minimally invasive, high safety, and significantly reduced amputation rate. We reviewed the advances in the research of transcatheter arterial thrombolysis for the treatment of severe frostbite.

Objective To evaluate the effectiveness and safety of prostatic arterial embolization as a primary treatment for patients with lower urinary tract symptoms as a result of large benign prostatic hyperplasia.Methods This was a prospective,single-center study enrolling 64 patients with prostates>80 ml from January 2010 to December 2013.Prostatic arterial embolization was carried out using a combination of 50 μm and 100 μm particles.Clinical follow up was carried out using the International Prostate Symptom Score, quality of life, peak urinary flow, postvoid residual volume, International Index of Erectile Function Short Form, prostate-specific antigen, and prostatic volume at 1, 3, 6 month following embolization, the parameters were compared by using t test. Results Prostatic arterial embolization was technically successful in 60 of 64 patients (93.8%). Follow-up data were available for 60 patients with a mean of 18 months,a total of 42 patients had completed the follow up at 24 months after prostatic arterial embolization. A clinical improvement,defined as reduction of International Prostate Symptom Score and increase of peak urinary flow, at 1 month, 3 months, 6 months, 12 months and 24 months, was achieved in 95.0%(57/60), 95.0%(57/60),93.3%(56/60),92.6%(50/54) and 90.5%(38/42), respectively. There was an improvement in terms of mean International Prostate Symptom Score, mean quality of life, mean peak urinary flow, mean post-void residual volume and prostatic volume were significantly different with respect to baseline(all P<0.05).No serious complications occurred.Conclusion Prostatic arterial embolization appears to be a safe and effective treatment method for patients with lower urinary tract symptoms as a result of large benign prostatic hyperplasia.

Objective To investigate weight, ghrelin changes following transcatheter left gastric artery embolization in rabbit model of obesity, and evaluate its safety. Methods Thirty New Zealand rabbits were randomly divided into three groups, ten New Zealand rabbits in each group, group A:left gastric artery embolization using gelatin sponge, group B:left gastric artery and gastroduodenal artery embolization using gelatin sponge, group C (control group): left gastric artery and gastroduodenal artery perfusion using normal saline. Ghrelin, weight and liver and kidney function were measured at preoperative and postoperative 1, 2, 3, 4 weeks. T test was used to compare the differences in the levels of preoperative and postoperative average ghrelin, weight, alanine transaminase (ALT), aspartate transaminase (AST), creatinine and urea in each group. The ANOVA of repeated measurement was used to compare the difference of preoperative and postoperative each time points between the three groups. Results The preoperative and postoperative ghrelin levels in group A were (4057±61)and (3708±141) pg/ml with statistically significant differences (t=4.5, P<0.05). The preoperative and postoperative ghrelin levels in group B were (4137 ± 89) and (3608 ± 239) pg/ml with statistically significant differences (t=6.8, P<0.05). The preoperative and postoperative ghrelin levels in the control group were (3986 ± 82)and (4044 ± 72) pg/ml with no statistically significant differences (t=0.7, P>0.05). The level of ghrelin in group B decreased significantly compared with group A and the difference was statistically significant (t=3.8, P<0.05). There was a statistically significant difference in postoperative ghrelin levels between the three groups (F=15.6, P<0.05). The preoperative and postoperative weight in group A were (6.12±0.38)and (5.66±0.39) kg with statistically significant differences (t=2.7, P<0.05). The preoperative and postoperative weight in group B were (5.99 ± 0.57)and (5.24 ± 0.61) kg with statistically significant differences (t=3.1, P<0.05). The preoperative and postoperative weight in the control group were (5.94 ± 0.45)and (6.24 ± 0.42) kg with no statistically significant differences (t=1.2, P>0.05). The weight loss of group B was significantly greater than that of group A and the difference was statistically significant (t=5.2, P<0.05). There was a statistically significant difference in postoperative weight between the three groups (F=5.1, P<0.05). There were no statistically significant differences in ALT, AST, creatinine and urea levels at preoperative and postoperative each time points in each group (P>0.05). Conclusion Left gastric artery embolization can become a safe and effective minimally invasive treatment for obesity and left gastric artery and gastroduodenal artery embolization at the same time could achieve more weight loss.