Parameter changes and influencing factors in sixty patients with interventional surgery for liver cancer diagnoses

BACKGROUND The development of hepatocellular carcinoma(HCC)is influenced by multiple factors.Interventional therapy offers an effective treatment option for patients with unresectable intermediate-to-advanced HCC.Interventional therapy can induce electrocardiographic(ECG)abnormalities that may be associated with liver dysfunction,electrolyte disorders,and cardiac injury.AIM To explore the ECG alterations and determinants following interventional therapy in patients with HCC.METHODS Sixty patients undergoing interventional treatment for liver cancer were selected as study participants.According to the results of the dynamic ECG examination 1 day after surgery,the patients were divided into an abnormal group(n=21)and a nonabnormal group(n=39).With the help of dynamic ECG examination,the ECG parameters were compared and the baseline data of patients was recorded in the two groups.RESULTS The 24 hours QT interval variability,24 hours normal atrial polarization to ventricular polarization(R-R)interval(standard deviation),24 hours consecutive 5 minutes normal R-R interval,and 24 hours continuous 5 minutes normal R-R interval(standard deviation mean)were lower than patients in the nonabnormal group(P<0.05).The logistic analysis showed that age>60 years,liver function grade B,and postoperative body temperature 38°C were risk factors for abnormal dynamic electrocardiogram in patients with liver cancer intervention(P<0.05).CONCLUSION Interventional therapy for HCC can lead to ECG abnormalities,underscoring the clinical need for enhanced cardiac monitoring to mitigate myocardial complications.

Analysis of The Impact of Interventional Nursing on The Therapeutic Effect, Negative Emotions, and Quality of Life of Patients Undergoing Cardiovascular and Cerebrovascular Interventional Therapy

Objective: To explore the impact of interventional nursing on the therapeutic effect, negative emotions, and quality of life of patients undergoing cardiovascular and cerebrovascular interventional therapy. Methods: A total of 106 patients who underwent cardiovascular and cerebrovascular interventional treatment were collected and randomly divided into Group A (control) and Group B (observation), with 53 cases each. Group A received the routine nursing intervention and Group B received the interventional nursing intervention. The clinical efficacy, complications, negative emotions, quality of life, and nursing satisfaction of the two groups of patients were evaluated. Results: The total clinical effective rate of Group B (52/98.12%) was higher than that of Group A (45/84.91%) (χ^(2)= 4.371, P < 0.05). The total incidence of complications in Group B (2/3.78%) was lower than that of Group A (9/16.98%) (χ^(2)= 4.970, P < 0.05). The self-rating anxiety (SAS) score and self-rating depression (SDS) of Group B were lower than those of Group A (P < 0.001). The quality of life of Group B was significantly higher than that of Group A (P < 0.001). The nursing satisfaction of group B (51/96.22%) was higher than that of group A (43/81.13%) (χ^(2)= 6.014, P < 0.05). Conclusion: In the care of patients undergoing cardiovascular and cerebrovascular interventional therapy, interventional nursing intervention effectively improved the patient’s clinical efficacy, reduced the incidence of complications, reduced negative emotions, improved the quality of life, and increased nursing satisfaction.

Current interventional options for palliative care for patients with advanced-stage cholangiocarcinoma

Primary biliary tract tumors are malignancies that originate in the liver,bile ducts,or gallbladder.These tumors often present with jaundice of unknown etiology,leading to delayed diagnosis and advanced disease.Currently,several palliative treatment options are available for primary biliary tract tumors.They include percutaneous transhepatic biliary drainage(PTBD),biliary stenting,and surgical interventions such as biliary diversion.Systemic therapy is also commonly used for the palliative treatment of primary biliary tract tumors.It involves the administration of chemotherapy drugs,such as gemcitabine and cisplatin,which have shown promising results in improving overall survival in patients with advanced biliary tract tumors.PTBD is another palliative treatment option for patients with unresectable or inoperable malignant biliary obstruction.Biliary stenting can also be used as a palliative treatment option to alleviate symptoms in patients with unresectable or inoperable malignant biliary obstruction.Surgical interventions,such as biliary diversion,have traditionally been used as palliative options for primary biliary tract tumors.However,biliary diversion only provides temporary relief and does not remove the tumor.Primary biliary tract tumors often present in advanced stages,making palliative treatment the primary option for improving the quality of life of patients.

Lenvatinib,sintilimab combined interventional treatment vs bevacizumab,sintilimab combined interventional treatment for intermediate-advanced unresectable hepatocellular carcinoma

BACKGROUND Bevacizumab and sintilimab combined interventional treatment(BeSiIT)and L envatinib and sintilimab combined interventional treatment(LeSiIT)are two commonly used therapeutic regimens for intermediate-advanced hepatocellular carcinoma(HCC)in clinical practice.AIM To compare the clinical efficacy and safety of BeSiIT and LeSiIT for the treatment of intermediate and advanced HCC.METHODS Patients diagnosed with intermediate-advanced HCC and initially treated with BeSiIT or LeSiIT in the Tianjin Medical University Cancer Institute and Hospital between February 2020 and July 2021 were included.The primary endpoint was progression-free survival(PFS),and the secondary endpoints were overall survival(OS),objective response rate(ORR),disease control rate(DCR),conversion rate,and treatmentrelated adverse events.RESULTS Total 127 patients met the inclusion criteria and were divided into BeSiIT and LeSiIT groups.Twenty-eight and fifty patients in the BeSiIT and LeSiIT groups,respectively,were assessed after 1:2 propensity score matching.PFS and OS rates were not significantly different between the two groups.No significant variations were noted in ORRs or DCRs according to the Response Evaluation Criteria in Solid Tumors(RECIST),and modified RECIST.BeSiIT group showed a better conversion rate than the LeSiIT group(P=0.043).Both groups showed manageable toxicity profiles.Multivariate analysis showed that the independent factors associated with PFS were alphafetoprotein levels and carcinoembryonic antigen score.CONCLUSION In intermediate-to-advanced HCC,the BeSiIT and LeSiIT groups exhibited acceptable toxicities and comparable PFS,OS,and ORR.

Landscape of transarterial chemoembolization represented interventional therapy for hepatocellular carcinoma

This article discusses the article written by Tan et al.Transarterial chemoembol-ization(TACE)is one of the main treatment methods for advanced hepatocellular carcinoma(HCC).There are other vascular interventional therapies,including drug-eluting bead TACE,transarterial radioembolization,and hepatic arterial infusion chemotherapy.TACE combined with anti-angiogenesis therapy may improve tumor control and prolong progression free survival.The combination therapy of TACE and immunotherapy may improve the clinical efficacy of HCC.In future research,more basic and clinical studies are needed to explore the immunogenic intervention therapy.

Analysis of the Significance of Key Points of Patient Interventional Psychological Care and Pain Care

Interventional therapy has become increasingly popular in clinical practice due to advancements in medical technology.However,patients often experience psychological and physiological pressure due to its invasive nature.The management of patient discomfort and tension is crucial to ensure effective treatment.Psychological and pain management are essential components of interventional therapy,as they significantly impact patient recovery and prognosis.This article discussed the importance of interventional psychological and pain care for patients,starting with the development and spread of interventional therapy.The significance of providing high-quality nursing services to patients and improving their quality of life was also discussed.

The Effect of Predictive Nursing Intervention on Cardiac Function and Clinical Outcomes in CCU Patients with Acute Myocardial Infarction After Interventional Therapy

Objective:To evaluate the impact of predictive nursing on the care of acute myocardial infarction(AMI)patients in the Coronary Care Unit(CCU)after interventional therapy.Methods:From September 2021 to September 2023,84 AMI patients admitted to the CCU were randomly divided into two groups:the experimental group(42 patients)received predictive nursing,and the reference group(42 patients)received conventional nursing.Cardiac function and clinical outcomes were compared between the groups.Results:Before nursing,there was no difference in cardiac function between the two groups(P>0.05).After nursing,the cardiac function of the experimental group was better than that of the reference group(P<0.05).The clinical outcomes of the experimental group were better than those of the reference group(P<0.05).Before nursing,there was no difference in psychological scores between the two groups(P>0.05).After nursing,the psychological scores of the experimental group were lower than those of the reference group(P<0.05).Conclusion:Predictive nursing can improve the cardiac function and clinical outcomes of AMI patients after interventional therapy and can also regulate patients’negative psychological states.

The Impact of Patient Education on the Nursing Care of Perioperative Patients in the Interventional Catheterization Room

Objective:To explore and analyze the effect of implementing a precise education model on the nursing care of perioperative patients in the interventional catheterization room.Methods:We selected 70 patients who were going to undergo surgical intervention in our hospital from August 2020 to December 2022 as the subjects for this study through random sampling.The patients were divided into a control group and an observation group,with 35 cases in each group.The control group underwent basic nursing intervention,and the observation group was given precise patient education.The nursing effects of both groups were observed.Results:After the intervention,all compliance indicators of the observation group were better than those of the control group(P<0.05).Besides,the incidence of complications in the observation group(2.86%)was lower than that of the control group(17.14%)with P<0.05.Furthermore,the patient satisfaction of the observation group(97.14%)was higher than that of the control group(82.86%),with P<0.05.Conclusion:A precise propaganda and education model facilitates the nursing of perioperative patients in the interventional catheterization room.Therefore,this practice should be popularized.

The Interventional Capacity of Community Health Volunteers for Screening and Linkages of Non-Communicable Diseases in Nyeri County, Kenya

Non-communicable diseases (NCDs) account for 63% of mortalities. Approximately 80% of these NCD-related deaths occur in LMICs. A quasi-experimental study utilizing a non-equivalent pre-and post-test was conducted from May 2022 to March 2023 with 370 study participants. Multistage cluster and random sampling were used to select ten community units, and therefore, 150 CHVs were chosen for the control unit, and 150 were used to form the interventional group. Data was collected from the KOBO app. Six (6) homogenous FGDs comprised ten members, and 10 KII were conducted across study sites. Quantitative data was analyzed using SPSS version 28.0, and qualitative data was audio-recorded, transcribed, and analyzed via N-Vivo 12. The study shows that 59.3% of respondents have minimal information, and 92.7% (n = 139) have no clear understanding of NCDs, with a pre-intervention capacity of 48.8%. Independent sample t-test showed a significant difference in capacity from a pre-intervention average of 48.75 (SD ± 5.7)%, which increased to 68.28 (SD ± 7.6)%, p < 0.001. A well-designed community interventional model plays a pivotal role in grassroots healthcare delivery but requires optimization for NCD management.

Interventional Ultrasound in Ambulatory Urological Practice: Experience of the Medicis Clinic in Conakry

Introduction: Minimally invasive urological interventions have long been practiced blindly in our context. The popularization of ultrasound in urological practice has contributed to changing habits by making the procedures safer and more effective. The objective of this work was to study the technical aspects, indications and results of minimally invasive urological procedures guided by ultrasound. Material and methods: This was a prospective descriptive study lasting 1 year from January to December 2023 at the Médicis clinic in Conakry. Results: We carried out 126 ultrasound-guided urological interventions in one year, including 6 percutaneous nephrostomies (NPC), one renal cyst puncture-aspiration-sclerotherapy, 102 prostate biopsies, 5 drainages by transrectal aspiration of prostatic abscesses, 10 placements of cystostomy probes. Suprapubic, 2 puncture-aspiration-sclerotherapies for vaginal hydroceles. The average age of our patients was 69 years and the predominant age range was 61 - 70. The majority of our patients were male (97.61%) with a sex ratio of 41 men to one woman. Ultrasound-guided urological interventions were for diagnostic purposes (80.95%), for therapeutic purposes (15.77%) and for diagnostic and therapeutic purposes (3.96%). The indications for ultrasound-guided urological interventions were dominated by prostate pathologies (84.91%). The majority of interventions were performed rectally (84.92%) versus (13.43%) abdominally and only 1.58% scrotalally. All procedures were performed in B-ultrasound mode under local anesthesia and on an outpatient basis. For therapeutic interventions, the patients were seen again one month after the procedure, the clinical examination and ultrasound control found the evolution to be favorable. Conclusion: ultrasound is useful in urological practice for guiding minimally invasive interventions. The indications for ultrasound-guided procedures in urology are dominated by prostate pathologies. These procedures are safe and effective with fewer complications. Interventional ultrasound must be further integrated into the habits of urologists.

INTERVENTIONAL OR SEMI-INTERVENTIONAL TREATMENT FOR BUDD-CHIARI SYNDROME

Objective. Report the results of interventional or semi-interventional techniques for 173 patients with Budd-Chiari syndrome.Method. This group included 120 males and 53 females. The pathologic lesions composed of localized complete occlusion of inferior vena cava (IVC) (78), IVC stenosis (49), IVC membrane with a hole (37), membrane of hepatic vein (HV) (3), IVC thrombosis (4), IVC membrane with thrombosis (2) and IVC lesion with occlusion of HV (32). Treatment methods included that I: Percutaneous transinferior vena cava angioplasty (PTA) (76); II: IVC PTA with stent (59); III: Percutaneous transhepatic vein recanalization (3); IV: IVC thrombolysis through a catheter (4); V; Combined transcardiac and trans-femoral venous membranotomy and balloon dilation (22); VI: V and stent (17); VII; Stenting during radical surgery (3); VIII: Additional operation after intervention (23).Results. The immediate technique success rate for intervention was 90.1%, for the semi-intervention was 100%. The IVC pressure was reduced from 3 to 29 cmH20. Complications occurred in 8 cases. The death rate was 2.9%. A follow-up study showed the recurrence rates were 14.5% in IVC PTA group, 1.7% in IVC PTA with stent, 18.2% in combined technique without stent and no recurrence was found in other groups.Conclusion. The PTA is the first choice for localized lesions. When elastic recoil occurs, immediate stenting is suggested. The semi-interventional approach is advised for PTA failure and more complicated cases. For those with both IVC lesion and occlusion of HV, the additional operation is needed after IVC intervention.

Precision interventional radiology

The recent interest in precision medicine among interventionists has led to the establishment of the concept of precision interventional radiology(PIR).This concept focuses not only on the accuracy of interventional operations using traditional image-guided techniques,but also on the comprehensive evaluation of diseases.The invisible features extracted from CT,MRI,or US improve the accuracy and specificity of diagnosis.The integration of multi-omics and molecule imaging provides more information for interventional operations.The development and application of drugs,embolic materials,and devices broaden the concept of PIR.Integrating medicine and engineering brings new image-guided techniques that increase the efficacy of interventional operations while reducing the complications of interventional treatment.In all,PIR,an important part of precision medicine,emphasizing the whole disease management process,including precision diagnosis,comprehensive evaluation,and interventional therapy,maximizes the benefits of patients with limited damage.

Awareness of Radiologists and Radiographers toward Patient Care in the Interventional Radiology Department

Background: The hospitals and health care centres are organized around the patient, a model in which healthcare providers partner with patients and families to identify and satisfy patients’ needs and preferences. Providers respect patients’ values and preferences, address their emotional and social needs, and involve them and their families in decision making. According to the best of our knowledge, there is no evidence to prove, radiologists and radiographers are aware enough about the patient safety, care, and code of conduct with their patients in the interventional radiology department. Objective: This article aims to measure the awareness of radiologists and radiographers toward care and safety in an interventional radiology department. Material and Method: This study was carried in period from 15 February to 20 April 2022. One hundred sixty-four radiographers and radiologists participating in this study completed the questionnaire, which equals a response rate of approximately 82%. The questionnaire was fully completed by almost all responders;only a few of them gave partial answers. Results: The first question for radiographers and radiologists was “the sufficient awareness about the patient safety and care during the interventional radiology procedure. Also, the majority of the radiographers and radiologists are providing the patients with sufficient information when he/she ask for help or queries. A large number of radiographers and radiologists were participating in this study explaining the procedures to patients before starting the examinations in a structured way. Finally, the result shows both radiographers and radiologists respect the patient’s rights, privacy, and dignity and also kept the radiation protection during the interventional radiology procedures. Conclusion: This article summarizes the key categories of awareness of patient care issues in the provision of interventional radiology services, from the joint perspectives of radiographers and radiologists, and provides references for further reading in all major relevant areas.

Interventional treatment for unresectable hepatocellular carcinoma

Hepatocellular carcinoma(HCC) is the sixth most common cancer and third leading cause of cancer-related death in the world. The Barcelona clinic liver cancer classification is the current standard classification system for the clinical management of patients with HCC and suggests that patients with intermediate-stage HCC benefit from transcatheter arterial chemoembolization(TACE). Interventional treatments such as TACE, balloon-occluded TACE, drug-eluting bead embolization, radioembolization, and combined therapies including TACE and radiofrequency ablation, continue to evolve, resulting in improved patient prognosis. However, patients with advanced-stage HCC typically receive only chemotherapy with sorafenib, a multi-kinase inhibitor, or palliative and conservative therapy. Most patients receive palliative or conservative therapy only, and approximately 50% of patients with HCC are candidatesfor systemic therapy. However, these patients require therapy that is more effective than sorafenib or conservative treatment. Several researchers try to perform more effective therapies, such as combined therapies(TACE with radiotherapy and sorafenib with TACE), modified TACE for HCC with arterioportal or arteriohepatic vein shunts, TACE based on hepatic hemodynamics, and isolated hepatic perfusion. This review summarizes the published data and data on important ongoing studies concerning interventional treatments for unresectable HCC and discusses the technical improvements in these interventions, particularly for advanced-stage HCC.

Interventional treatment for symptomatic acute-subacute portal and superior mesenteric vein thrombosis

AIM: To summarize our methods and experience with interventional treatment for symptomatic acute-sub-acute portal vein and superior mesenteric vein throm-bosis (PV-SMV) thrombosis. METHODS: Forty-six patients (30 males, 16 females, aged 17-68 years) with symptomatic acute-subacute portal and superior mesenteric vein thrombosis were ac-curately diagnosed with Doppler ultrasound scans, com-puted tomography and magnetic resonance imaging. They were treated with interventional therapy, including direct thrombolysis (26 cases through a transjugular intrahepatic portosystemic shunt; 6 through percutane-ous transhepatic portal vein cannulation) and indirect thrombolysis (10 through the femoral artery to superior mesenteric artery catheterization; 4 through the radial artery to superior mesenteric artery catheterization). RESULTS: The blood reperfusion of PV-SMV was achieved completely or partially in 34 patients 3-13 d after thrombolysis. In 11 patients there was no PV-SMV blood reperfusion but the number of collateral vessels increased signif icantly. Symptoms in these 45 patients were improved dramatically without severe operationalcomplications. In 1 patient, the thrombi did not respond to the interventional treatment and resulted in intestinal necrosis, which required surgical treatment. In 3 patients with interventional treatment, thrombi reformed 1, 3 and 4 mo after treatment. In these 3 patients, indirect PV-SMV thrombolysis was performed again and was successful. CONCLUSION: Interventional treatment, including direct or indirect PV-SMV thrombolysis, is a safe and effective method for patients with symptomatic acutesubacute PV-SMV thrombosis.

The history of interventional therapy for liver cancer in China

In China interventional therapy of liver cancer started in the 1980s. It is well-known that Professor Lin Gui is the founding father of Interventional radiology. Under the leadership of Lin Gui and other professors, interventional therapy of liver cancer has swiftly progressed in China. Indeed, TAI, TAE, TACE and ablation therapy have witnessed great innovations in hardware facil ities, technical means, and therapeutic philosophy, while incorporating Chinese characteristics. As with the development of combined interventional therapy in China, interventional treatment of liver cancer has gradually started the process of precision and individualization. Actually, multidisciplinary, multimodal, and polymorphic treatments will be the most suitable pattern for liver cancer in the future, among which combination of interventional therapy with targeted, immunological treatments and information technology(IT) tools may bring a revolutionary breakthrough in liver cancer treatment.

Interventional radiology procedures in adult patients who underwent liver transplantation

Interventional radiology has acquired a key role in every liver transplantation(LT)program by treating the majority of vascular and non-vascular post-transplant complications,improving graft and patient survival and avoiding,in the majority of cases,surgical revision and/or re-transplantation.The aim of this paper is to review indications,technical consideration,results achievable and potential complications of interventional radiology procedures after deceased donor LT and living related adult LT.

Management of surgical splenorenal shunt-related hepatic myelopathy with endovascular interventional techniques

We present a case with hepatic myelopathy(HM) due to a surgical splenorenal shunt that was successfully treated by endovascular interventional techniques.A 39-year-old man presented with progressive spastic paraparesis of his lower limbs 14 mo after a splenorenal shunt.A portal venogram identified a widened patent splenorenal shunt.We used an occlusion balloon catheter initially to occlude the shunt.Further monitoring of the patient revealed a decrease in his serum ammonia level and an improvement in leg strength.We then used an Amplatzer vascular plug(AVP) to enable closure of the shunt.During the follow up period of 7 mo,the patient experienced significant clinical improvement and normalization of blood ammonia,without any complications.Occlusion of a surgically created splenorenal shunt with AVP represents an alternative therapy to surgery or coil embolization that can help to relieve shunt-induced HM symptoms.

Effect of nursing intervention based on Maslow's hierarchy of needs in patients with coronary heart disease interventional surgery

BACKGROUND It is very important to provide effective nursing programs to regulate the physical and mental state of patients and to improve treatment compliance after interventional surgery for coronary heart disease(CHD).AIM To explore the effect of a nursing intervention based on Maslow’s hierarchy of needs theory on patients with CHD undergoing percutaneous coronary intervention.METHODS Ninety-four patients with CHD undergoing interventional surgery in our hospital from January 2020 to February 2021 were randomly divided into a research group(n=47)and a control group(n=47).The control group received routine nursing,and the research group received a nursing intervention based on Maslow’s hierarchy of needs theory.The scores of self-efficacy,negative emotion[depression(SDS),anxiety(SAS)],intervention compliance(standardized medication,moderate exercise,healthy diet,and regular review),and nursing satisfaction were calculated before and after intervention for the two groups.RESULTS Before intervention,there was no significant difference in the scores of disease general management self-efficacy,disease management self-efficacy,and total self-efficacy between the two groups(P=0.795,0.479,and 0.659,respectively).After intervention,these three scores in the research group were higher than those in the control group(P<0.001).Before intervention,there was no significant difference in the scores of SAS and SDS between the two groups(P=0.149 and 0.347,respectively).After intervention,the scores of SAS and SDS in the research group were lower than those in the control group(P<0.001).The standardized drug use rate(97.87%),moderate exercise rate(97.87%),healthy diet rate(95.74%),and regular reexamination rate(97.87%)in the research group were higher than those in the control group(85.11%,82.98%,80.85%,and 87.23%,respectively)(P=0.027,0.014,0.025,and 0.049,respectively).Nursing job satisfaction in the research group(93.62%)was higher than that in the control group(78.72%)(P=0.036).CONCLUSION A nursing program based on Maslow’s hierarchy of needs theory can effectively alleviate negative emotion,enhance self-efficacy and intervention compliance,and ensure that the patients are highly satisfied with the nursing work.

Comparison of therapeutic effectiveness of combined interventional therapy for 1126 cases of primary liver cancer

AIM： To verify the effect of combined interventiona therapy for hepatocellular carcinoma （HCC）. METHODS： The clinical data of 1126 HCC patients who received combined interventional therapy for transcatheter arterial chemoembolization （TACE） before or after hepatectomy, TACE and radio-frequency ablation （RFA）, Chinese medicine treatment and biotherapy after TACE or transcatheter arterial infusion （TAI）, were reviewed according to the results of their liver function, alpha-fetoprotein, image data, color-ultrosonography finding and survival rate. RESULTS： A total of 874 patients were followed up for a period of 2 to 63 mo. The overall 1-, 3- and 5- year survival rates were 67.8%, 28.7% and 18.8% respectively. The 1- 3- and 5- year survival rates of patients who received TACE were 74.7%, 41.4%, 36.9% before hepatectomy and 78.9%, 40.4%, 37.5% after hepatectomy. The effective rate （PR ＋ NC） after TACE and RFA was 93.4%, the 1- and 3- year survival rates were 74.5% and 36.8% after TACE and RFA. The effective rate of PR ＋ NC after TACE was 83.2%. The 1-, 3- and 5- year survival rates were 69.3%, 21.7%, 8.4% after TACE. The effective rate of PR ＋ NC after TAI was 27.5%, the 1- and 2- year survival rates were 11.6% and 0% after TAI. The liver function, color-ultrosonography finding and alpha-fetoprotein after TACE ＋ RFA, TACE and TAI were compared. There was no significant difference in each index between TACE and RFA or TACE as well as in liver function between TACE and RFA or between TACE and TAI. CONCLUSION： The therapeutic effectiveness of TACE before or after hepatectomy is most significant, while the effect of TACE and RFA is better than that of TACE, and the effect of TAI is minimal.