Objective To evaluate the clinical value of transarterial catheterization C-arm CT perfusion scanning technique during prostatic artery embolization(PAE)for benign prostatic hyperplasia(BPH).Methods The clinical data of 46 patients with BPH received PAE were analyzed retrospectively.All patients underwent prostatic artery(PA)digital subtraction angiography(DSA)and C-arm CT perfusion scanning to identify PA and prevent non-target organ embolization.The final recognization of PA was consulted by three senior doctors.After C-arm CT confirmation,PA was embolized with 100-300 μm polyvinyl alcohol(PVA)particles or microspheres under fluoroscopy.The postoperative complications and 3-month clinical efficacy were observed.Results A total of 106 vessels were angioraphed in 46 patients,with 83 PA vessels and 23 non-PA vessels.PA was identified by DSA and C-arm CT with sensitivity of 81.9%(68/83)and 100%(83/83),respectively,which showed significance(χ2=22.3,P<0.01).Non-PA was identified by DSA and C-arm CT with specificity of 73.9%(17/23)and 100%(23/23),which showed significance(χ2=9.2,P=0.02).No serious complications were observed and 3-month clincial efficacy was 91.3%.Conclusion Transarterial catheterization C-arm CT perfusion scanning technique can accurately identify PA,reduce PA leakage and prevent non-target organ embolization.

Objective To evaluate the efficacy of microwave ablation(MWA)synchronously with biopsy for pulmonary nodules.Methods The data of 64 patients with MWA combined with biopsy were analyzed retrospectively.Thirty-one patients(non-synchronous group)were treated with ablation following biopsy in turn to identify malignant tumors,and 33 patients(synchronous group)were treated by ablation and biopsy synchronously.The technical success rate,operation time,complications,hospitalization time and expenses were compared between non-synchronous group and synchronous group.Results The technical success rate,pneumothorax,and pleural effusion rate showed no significance between the two groups(P>0.05).There were all significant differences in operation time(42.00 min vs 54.26 min),hospitalization time(5.09 days vs 9.26 days),hospitalization expenses(26 840.61 yuan vs 32 527.26 yuan),lung hemorrhage(27.27%vs 87.10%)and hemoptysis(3.03%vs 19.35%)between synchronous group and non-synchronous group,respectively(P<0.05).Conclusion MWA synchronously with biopsy for pulmonary nodules is safe and feasible,which can reduce intraoperative bleeding,shorten treatment period and reduce hospitalization expenses.

Objective To explore the efficiency and safety of trans-sheath intraluminal forceps biopsy under digital subtraction angiography(DSA)guidance for assisting diagnosis of pulmonary artery obstructive diseases.Methods Data of 16 patients who underwent trans-sheath intraluminal forceps biopsy for pulmonary artery obstructive diseases were retrospectively analyzed,and the clinical manifestations were recorded.The technical success of biopsy was defined as tissue obtained met the needs of pathology diagnosis.For patients with malignant pathology results,the final diagnosis was malignant,for those with benign pathology results after biopsy and no obvious changes after 6-month or longer follow-up,or benign pathology results after surgical resection,the final diagnosis was benign,otherwise was no clear diagnosis.The operation time,technical success rate,diagnostic efficiency,complications and changes of pulmonary artery pressure before and after the biopsy were observed.Results Among 16 patients,9 complained of intermittent chest tightness,4 complained of chest pain with chest tightness,2 complained of chest pain but 1 denied any symptoms.The lesions located in the left lung in 10 cases and in the right lung in 6 cases,all with enhanced CT showed filling defects of the involved branch of pulmonary artery.Totally 16 trans-sheath intraluminal forceps biopsies were performed in 16 patients,with an average operation time of(31.02±6.02)min and technical success rate of 100%.Malignant tumors were finally diagnosed in 10 cases,including 1 case of lung cancer with false-negative biopsy result,while biopsy correctly diagnosed benign lesions in the other 6 cases.Transient worsening chest pain with chest tightness occurred in 2 cases and relieved after symptomatic treatments.No statistically significant difference of pulmonary artery pressure was found before([53.38±14.28]mmHg)and after([53.69±14.15]mmHg)biopsy(P＞0.05).Conclusion DSA-guided trans-sheath intraluminal forceps biopsy was relatively safe and valuable for assisting diagnosis of pulmonary artery obstructive diseases.

Objective To observe the feasibility and effectiveness of fluoroscopy-guided Fustar adjustable bent sheath clamp biopsy for diagnosing obstructive esophageal diseases.Methods Totally 29 patients with esophageal or esophagogastric junction obstruction who failed to complete endoscopic biopsy were retrospectively analyzed.Real-time fluoroscopy-guided clamp biopsy of lesion areas were performed through 10F Fustar adjustable bent sheath under local anesthesia.The technical success rate,operation time,radiation dose were recorded,and the complications were evaluated.Results Clamp biopsy of lesion areas were successfully performed in all 29 cases,with technical success rate of 100%(29/29),the average operation time of(29.81±10.05)min and the average radiation dose of(127.14±100.36)mGy.No serious complication such as esophageal perforation nor massive bleeding occurred.After biopsy,22 cases(22/29,75.86%)were preliminarily diagnosed as positive,among them 2 cases underwent surgical operation,and the postoperative pathological results were consistent with biopsy.Negative biopsy results were found in 7 cases(7/29,24.14%),among them 2 cases underwent clamp biopsy again 3 months later which showed positive results.Conclusion Fustar adjustable bent sheath clamp biopsy was feasible and effective for diagnosing obstructive esophageal diseases,which could be regarded as the substitution and supplementation of endoscopic clamp biopsy.

Objective:To evaluate the fluoroscopy-guided percutaneous transhepatic forceps biopsy (PTFB) in the diagnosis of biliary strictures.Methods:Literatures on diagnosis of biliary strictures by PTFB published from January 2001 to August 2022 were obtained by searching the databases of PubMed, Embase, Web of Science, the Cochrane Library, China National Knowledge Infrastructure (CKNI), Wanfang, VIP, and China Biology Medicine disc (CBM). Literature inclusion and exclusion criteria were established and the retrieved literature was screened. The quality of the included literature was evaluated using the quality assessment of diagnostic accuracy studies (QUADAS-2). Statistical analysis was performed by using Meta-disc software and Stata software.Results:Eighteen articles involving 1 935 patients were finally included. The heterogeneity test suggested no threshold effect, but there was non-threshold heterogeneity in sensitivity and negative likelihood ratio due to other reasons, so a random-effects model was used, and a fixed-effects model were used for the remaining outcome indexes used due to low heterogeneity. The results showed that the pooled sensitivity of fluoroscopy-guided PTFB for the diagnosis of biliary strictures was 0.796 (95% CI: 0.776-0.814), the pooled specificity was 1.000 (95% CI: 0.985-1.000), the pooled positive likelihood ratio was 21.532 (95% CI: 11.281-41.098), the pooled negative likelihood ratio was 0.234(95% CI: 0.169-0.323), the pooled diagnostic odds ratio was 94.321(95% CI: 46.744-190.320), and the area under the summary receiver operating characteristic curve was 0.929. The pooled complication rate was 9.2% (95% CI: 6.4%-12.0%). Conclusion:Fluoroscopy-guided PTFB may be a superior diagnostic tool for biliary strictures.

Objective:To explore the effect of situational behavior record reflection training on the listening ability of newly recruited clinical nurses.Methods:From March to September 2020, cluster sampling was used to select 116 newly recruited clinical nurses from the First Affiliated Hospital of Zhengzhou University as the research object. According to the entry order, nurses were divided into the observation group ( n=58) and the control group ( n=58). The nurses in the control group were trained in accordance with our hospital's regular standardized training system, while the observation group used situational behavior record reflection training method. Before the intervention and 6 months after the intervention, the Hodgetts Listening Performance Scale and the Patient Satisfaction with Nursing Care Questionnaire were used to compare the listening ability and patient satisfaction of the two groups of newly recruited clinical nurses. A total of 116 questionnaires were distributed and 113 valid questionnaires were returned with the valid response rate of 97.41%. Results:Before the intervention, there was no statistically significant differences in the scores of the Hodgetts Listening Performance Scale and the Patient Satisfaction with Nursing Care Questionnaire between the two groups of nurses ( P>0.05). After the intervention, the scores of the Hodgetts Listening Performance Scale and the Patient Satisfaction with Nursing Care Questionnaire of the two groups of nurses were higher than those before the intervention, and those of the observation group were higher than those of the control group, and the differences were statistically significant ( P<0.01) . Conclusions:Situational behavior record reflection training can improve the listening ability and patient satisfaction of newly recruited clinical nurses, which is conducive to alleviating the nurse-patient relationship and improving the quality of nursing care.

This report is about the application of interventional therapy for bladder rectal residual fistula in a patient whose postoperative rectal stump tumor invaded the bladder and underwent radiotherapy and chemotherapy, resulting in urinary fistula, which seriously affected the quality of life. Referring to the treatment experience of visicovaginal fistula, the patient successfully adopted double percutaneous nephrostomy combined with ureter occlusion stent and achieved good palliative treatment effect.

Objective: To observe the effect of 125I on T24 transitional cell carcinoma of nude mouse. Methods: Totally 40 T24 transplanted tumor nude mice were divided into high, medium, low activity and control groups (each n=10), and 125I seeds with activity of 0.9 mCi (33. 3 MBq), 0.6 mCi (22. 2 MBq), 0.3 mCi (11. 1 MBq) and 0 mCi (nuclide free) were implanted in the tumor center, respectively. The 90% target absorbed dose (D90), tumor inhibition rate (IR), radiation reaction grade (RRG) of HE staining, apoptosis index and B-cell lymphoma-2 (Bcl-2) protein expression were analyzed and compared among groups 10 days and 20 days after implantation. Results: D90 and IR of nude mice with high, medium and low activity groups decreased gradually 10 and 20 days after 125I seed implantation (all P<0.05). The necrosis was obvious within 5 mm around the tumor, and the higher the seed activity, the longer the time, the wider the ranges of necrosis. RRG of high activity group 10 and 20 days after 125I seed implantation were higher than that in low activity group and control group (all P<0.05). Meanwhile, the apoptotic index of high, medium and low activity groups gradually decreased, the expression of Bcl-2 protein gradually increased (all P<0.05). Conclusion: 125I seeds can significantly inhibit the growth of T24 metastatic cell carcinoma in nude mouse. Promoting the apoptosis of tumor cells may be one of the mechanisms.

Objective: To observe the effect of integrated gastrointestinal nutritional tube loaded with double 125I strands applied in esophageal cancer with grade dysphagia. Methods: Interventional catheter technology was used to open the occlusive segment of esophagus in 10 patients with esophageal cancer and grade dysphagia. Then the new integrated tube was fed along the guide wire with 125I segment needs crossing the esophageal occlusion segment for brachytherapy. The technical success rate and clinical success rate were counted. The dosimetry parameters were recorded and compared before and 3 days after operation, while the therapeutic effect were estimated according to Karnofsky score and Neuhaus dysphagia grading 2 months after operation. The patients were followed up for 6 months to observe the prognosis. Results: All 10 patients underwent successful tube insertion. The technical success rate was 100%, and the clinical success rate was 70%. No serious complication occurred. There was no statistically significant difference of 90% of gross tumor volume (GTV) received dose (D90%), GTV minimum peripheral dose (mPD), GTV received 200% and 100% of the prescribed dose volume percentage (V200%, V100%), conformal index (CI) nor external index (EI) before and after operation (all P>0.05). Karnofsky score and Neuhaus grading were significantly improved 2 months after operation (both P<0.01), and the local tumor control rate was 70%. During 6 months' follow-up, dysphagia reoccurred in 1 case, 2 cases died, while no relapse was found in 7 patients. Conclusion: The integrated gastrointestinal nutritional tube loaded with double 125I strands can achieve gastrointestinal nutrition and brachytherapy at the same time,which is effective and safe for treating esophageal cancer and grade dysphagia.

Objective: To explore the feasibility of 3.0T closed MR-guided microwave ablation for liver metastases. Methods: Totally 14 patients with 23 liver metastases were treated with 3.0T closed MR-guided microwave ablation. The technical success rate, ablation parameters, procedures time and complications were recorded, and the local ablation effects were evaluated 1 month later. Results: The technical success rate was 100%. The ablation power was (65.65±4.11)W, the ablation time of single lesion was (13.92±6.36)min, and the total operation time was (68.48±19.50)min. No severe complication such as liver abscess, diaphragmatic perforation nor jaundice occurred, while small amount of pleural effusion was obserevd in 2 cases (2/14, 14.29%). One month later, the complete ablation rate was 91.30% (21/23). Conclusion: 3.0T closed MR-guided microwave ablation is safe and effective for treating liver metastases.