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.

Minimally invasive interventional therapy for pain

Pain interventional therapy,known as the most promising medical technology in the 21st century,refers to clinical treatment technology based on neuroanatomy,neuroimaging,and nerve block technology to treat pain diseases.Compared with traditional destructive surgery,interventional pain therapy is considered a better and more economical choice of treatment.In recent years,a variety of minimally invasive pain interventional therapy techniques,such as neuroregulation,spinal cord electrical stimulation,intervertebral disc ablation,and intrasheath drug infusion systems,have provided effective solutions for the treatment of patients with post-herpetic neuralgia,complex regional pain syndrome,cervical/lumbar disc herniation,and refractory cancer pain.

Magnesium metal and its corrosion products:Promising materials for tumor interventional therapy

Magnesium is generally known to degrade in aqueous environments by an electrochemical reaction.The corrosion products of magnesium include hydrogen gas,Mg^(2+),and Mg(OH)_(2).Here,we summarize the published literature describing the corrosion characteristics of magnesium,and the antitumor properties of magnesium-associated corrosion products,aiming to induce the therapeutic properties of magnesium and magnesium alloys in solid tumors.The therapeutic potential of corrosion products of magnesium is enormous.Hydrogen gas exhibits antioxidant and anti-inflammatory properties,which amount to potential anti-tumor characteristics.Mg(OH)_(2),which creates a localized alkaline microenvironment,represents a second approach for anti-tumor therapy with magnesium metal.Upregulated concentrations of Mg^(2+)ions in the local tumor microenvironment remodelling are considered a third approach for anti-tumor therapy.Therefore,we speculate about the different physical forms of magnesium that could create an anti-tumor microenvironment upon tumor interventional therapy,a technique that precisely places anti-tumor implants like particles and stents.Finally,we present our viewpoints on the potential use of magnesium in diverse solid tumor therapies to inhibit tumor progression.

Pathologically successful conversion hepatectomy for advanced giant hepatocellular carcinoma after multidisciplinary therapy:A case report and review of literature

BACKGROUND Hepatocellular carcinoma(HCC)is one of the leading causes of death due to its complexity,heterogeneity,rapid metastasis and easy recurrence after surgical resection.We demonstrated that combination therapy with transcatheter arterial chemoembolization(TACE),hepatic arterial infusion chemotherapy(HAIC),Epclusa,Lenvatinib and Sintilimab is useful for patients with advanced HCC.CASE SUMMARY A 69-year-old man who was infected with hepatitis C virus(HCV)30 years previously was admitted to the hospital with abdominal pain.Enhanced computed tomography(CT)revealed a low-density mass in the right lobe of the liver,with a volume of 12.9 cm×9.4 cm×15 cm,and the mass exhibited a“fast-in/fast-out”pattern,with extensive filling defect areas in the right branch of the portal vein and an alpha-fetoprotein level as high as 657 ng/mL.Therefore,he was judged to have advanced HCC.During treatment,the patient received three months of Epclusa,three TACE treatments,two HAIC treatments,three courses of sintilimab,and twenty-one months of lenvatinib.In the third month of treatment,the patient developed severe side effects and had to stop immunotherapy,and the Lenvatinib dose had to be halved.Postoperative pathological diagnosis indicated a complete response.The patient recovered well after the operation,and no tumor recurrence was found.CONCLUSION Multidisciplinary conversion therapy for advanced enormous HCC caused by HCV infection has a significant effect.Individualized drug adjustments should be made during any treatment according to the patient's tolerance to treatment.

Medical and interventional therapy of Kasabach-Merritt phenomenon associated with Kaposiform hemangioendothelioma:A case report

An infant with Kasabach-Merritt Phenomenon(KMP)presented with a giant subcutaneous mass in the right lower limb,severe hypofibrinogenemia,and thrombocytopenia.Glucocorticoids,along with supportive treatments including transfusion of blood products and clotting factors,were administered to reverse fatal disseminated intravascular coagulation and acute hemolysis.The glucocorticoid dose was tapered slowly,and sirolimus was added to treat the hemangiomas.The patient subsequently underwent interventional therapy.After 6 months of medical and interventional therapy,the patient was doing well with a normal platelet count,the tumor volume was markedly reduced,and the primary cutaneous lesion became pale pink.Currently,the patient remains on sirolimus,and no recurrence of thrombocytopenia or further growth of the mass was observed after six months of follow-up.

A Case of Target Immunotherapy Combined with Interventional Therapy for Massive Liver Cancer

This article reports a case of massive hepatocellular carcinoma. After intervention combined with targeted and immunotherapy, it was successfully cured by surgical resection, which provides some experience for the comprehensive treatment of liver cancer, and also improves the understanding of systematic treatment of liver cancer, so as to improve the understanding and diagnosis of the disease.

Efficacy of hepatic arterial infusion chemotherapy and its combination strategies for advanced hepatocellular carcinoma:A network meta-analysis

BACKGROUND With the rapid progress of systematic therapy for hepatocellular carcinoma(HCC),therapeutic strategies combining hepatic arterial infusion chemotherapy(HAIC)with systematic therapy arised increasing concentrations.However,there have been no systematic review comparing HAIC and its combination strategies in the first-line treatment for advanced HCC.AIM To investigate the efficacy and safety of HAIC and its combination therapies for advanced HCC.METHODS A network meta-analysis was performed by including 9 randomized controlled trails and 35 cohort studies to carry out our study.The outcomes of interest comprised overall survival(OS),progression-free survival(PFS),tumor response and adverse events.Hazard ratios(HR)and odds ratios(OR)with a 95% confidence interval(CI)were calculated and agents were ranked based on their ranking probability.RESULTS HAIC outperformed Sorafenib(HR=0.55,95%CI:0.42-0.72;HR=0.51,95%CI:0.33-0.78;OR=2.86,95%CI:1.37-5.98;OR=5.45,95%CI:3.57-8.30;OR=7.15,95%CI:4.06-12.58;OR=2.89,95%CI:1.99-4.19;OR=0.48,95%CI:0.25-0.92,respectively)and transarterial chemoembolization(TACE)(HR=0.50,95%CI:0.33-0.75;HR=0.62,95%CI:0.39-0.98;OR=3.08,95%CI:1.36-6.98;OR=2.07,95%CI:1.54-2.80;OR=3.16,95%CI:1.71-5.85;OR=2.67,95%CI:1.59-4.50;OR=0.16,95%CI:0.05-0.54,respectively)in terms of efficacy and safety.HAIC+lenvatinib+ablation,HAIC+ablation,HAIC+anti-programmed cell death 1(PD-1),and HAIC+radiotherapy had the higher likelihood of providing better OS and PFS outcomes compared to HAIC alone.HAIC+TACE+S-1,HAIC+lenvatinib,HAIC+PD-1,HAIC+TACE,and HAIC+sorafenib had the higher likelihood of providing better partial response and objective response rate outcomes compared to HAIC.HAIC+PD-1,HAIC+TACE+S-1 and HAIC+TACE had the higher likelihood of providing better complete response and disease control rate outcomes compared to HAIC alone.CONCLUSION HAIC proved more effective and safer than sorafenib and TACE.Furthermore,combined with other interventions,HAIC showed improved efficacy over HAIC monotherapy according to the treatment ranking analysis.

Progress in the Early Mobilization of Patients after Cardiac Intervention

Early activity has a positive effect on the rehabilitation process of patients after cardiac intervention. This paper summarizes the concept and significance of early activity after cardiac intervention, the best time and mode of different types of early activity after cardiac intervention, and the factors affecting early activity, aiming to provide a basis for clinical medical staff to provide safe and effective guidance of early activity after cardiac intervention.

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.

Effect of medical care linkage-continuous management mode in patients with posterior circulation cerebral infarction undergoing endovascular interventional therapy

BACKGROUND Acute cerebral infarction is a severe type of ischemic stroke that can be divided into anterior circulation cerebral infarction and posterior circulation cerebral infarction(PCCI).PCCI affects the structure of the posterior circulation brain,because posterior part of the brain,which has more complex anatomical structures and more prone to posterior circulation vascular variation.Therefore,improving the prognosis of PCCI patients is necessary.AIM To explore the effect of medical care linkage-continuous management mode(MCLMM)on endovascular interventional therapy(EIT)for PCCI.METHODS Sixty-nine patients with PCCI who received EIT and conventional nursing intervention were selected as the control group,and 78 patients with PCCI who received EIT and MCLMM intervention were selected as the observation group.The incidence of postoperative complications,compliance and disease selfmanagement behavior after six months of intervention,modified Rankin scale(mRS)and Barthel index(BI)scores in the acute phase and after one year of intervention,and recurrence within one year were compared between the two groups.RESULTS The total incidence rate of postoperative complications in the observation group(7.69%)was lower than that in the control group(18.84%)(P<0.05).The scores for medical compliance behavior(regular medication,appropriate diet,and rehabilitation cooperation rates)and disease self-management behavior(self-will,disease knowledge,and self-care ability)in the observation group were higher than those in the control group(P<0.05).After one year of intervention,in the observation group,the mRS score was significantly lower,and the BI score was significantly higher than those in the control group(P<0.05).The recurrence rate within one year in the observation group(3.85%)was significantly lower than that in the control group(13.04%)(P<0.05).CONCLUSION MCLMM can reduce the incidence of complications after EIT for PCCI,improve patient compliance behavior and disease self-management ability,and promote the recovery of neurological function.

Composite Configuration Interventional Therapy Robot for the Microwave Ablation of Liver Tumors

The existing interventional therapy robots for the microwave ablation of liver tumors have a poor clinical applicability with a large volume, low positioning speed and complex automatic navigation control. To solve above problems, a composite configuration interventional therapy robot with passive and active joints is developed. The design of composite configuration reduces the size of the robot under the premise of a wide range of movement, and the robot with composite configuration can realizes rapid positioning with operation safety. The cumulative error of positioning is eliminated and the control complexity is reduced by decoupling active parts. The navigation algo- rithms for the robot are proposed based on solution of the inverse kinematics and geometric analysis. A simulation clinical test method is designed for the robot, and the functions of the robot and the navigation algorithms are verified by the test method. The mean error of navigation is 1.488 mm and the maximum error is 2.056 mm, and thepositioning time for the ablation needle is in 10 s. The experimental results show that the designed robot can meet the clinical requirements for the microwave ablation of liver tumors. The composite configuration is proposed in development of the interventional therapy robot for the microwave ablation of liver tumors, which provides a new idea for the structural design of medical robots.

Role of interventional therapy in hepatic artery stenosis and non-anastomosis bile duct stricture after orthotopic liver transplantation

AIM： To analyze the clinical manifestations and the effectiveness of therapy in patients with orthotopic liver bansplantation （OLT）-associated hepatic artery stenosis （HAS） and non-anastomosis bile duct stricture.METHODS： Nine cases were diagnosed as HAS and non-anastomosis bile duct stricture. Percutaneous transluminal angioplasty （PTA） was performed in four HAS cases, and expectant treatment in other five HAS cases, percutaneous transhepatic bile drainage, balloon dilation, stent placement were performed in all nine cases.RESULTS： Diffuse intra- and extra-bile duct stricture was observed in nine cases, which was associated with bile mud siltation and biliary infection. Obstruction of the bile duct was improved obviously or removed. Life span/ follow-up period was 13-30 mo after PTA of four HAS cases, 6-23 mo without PTA of other five cases.CONCLUSION： Progressive, non-anastomosis, and diffuse bile duct stricture are the characteristic manifestations of HAS and non-anastomosis bile duct stricture after OLT. These are often associated with bile mud siltation, biliary infection, and ultimate liver failure. Interventional therapy is significantly beneficial.

Studies on Lung Cancer Angiogenesis-Application of Interventional Therapy (A Report of 56 Cases)

OBJECTIVE To investigate the significance of angiogenesis of lung cancer, in order to provide a scientific basis for interventional therapy. METHODS Double-phase enhancementscanning spiral CT and DSA were performed in 56 pathologically confi rmed lung cancer cases, in order to evaluate angiogenesis of the tumors. The patients included 36 males and 20 females, with ages ranging from 33 to 76 years (average of 53). Assessments and indexes for SCT and DSA examinations were as follows: a) Peak value (PV) of the cancerous focus was the difference between the maximum CT value after enhancement and the CT value of a plain scan; b) The abnormally distorted and expanded new vessels of the cancerous focus which could be macroscopically discriminated; c) DSA staining of the focus of cancer was sparse, grid-like and dense. Chemotherapy and embolotherapy via the bronchial artery (interventional therapy) were conducted. Radiotherapy was added for some of the solid tumors with a diameter exceeding 4 cm. RESULTS a) There were 25 cases with a central-type lesion, among which 4 were small cell lung cancers (SCLC) and 21 non-small cell lung cancers (NSCLC). The cases with a peripheral location accounted for 31 of the total, with a maximum diameter of 1.5 to 13.5 cm and a median of 4.2 cm, including 5 small cell lung cancers and 26 NSCLC cases. b) The reinforced PVs of the cancerous foci were as follows: The PV ranged from 45 to 70 Hu in 34 cases, 25 to 45 Hu in 19, and 10 to 25 Hu in 3. Sparse DSA staining occurred in 3 cases, there was uneven grid-like staining in 22 and dense staining in 31; c) The interventional therapy via the bronchial artery was con-ducted twice in 5 cases with the SCLC, and three times in 4 SCLC cases. For 3 of the latter cases, a dose of 5,000 to 7,000 cGy radiation therapy was added during the interventional treatment. Complete remissions (CR) were seen in 88.9% of the cases (8/9) and partial remission (PR) in 11.1% (1/9). Interventional therapy was conducted twice in 8 cases with NSCLC and three times in 30 with NSCLC and four times in 9 cases. Among the total cases, 13 received radiotherapy during interventional therapy, with a radiation dose of 5,000-7,000 cGy; The CR rate was 78.7% (37/47), PR was 14.9% (7/47) and the rate of non-remission was 6.4% (3/47). CONCLUSION Using imaging technology, analysis of angiogenesis of lung cancers was employed to accurately detect and quantify angiogenesis. This analysis was combined for interventional therapy, using embolizing agents and large doses of the anti-tumor drugs and angiogenesis inhibitors. The agents were selectively delivered into the tumor vessels to eliminate the primary tumor, in order to depress distant metastases and thus enhance the curative effect of the therapy.

In advanced pancreatic cancer: The value and significance of interventional therapy

Pancreatic cancer is famous as“the king of cancer”due to its high degree of malignancy,rapid course of disease development,and poor prognosis.Relevant epidemiological studies have indicated that with improvement in people’s standard of living,the morbidity and mortality of pancreatic cancer has increased.At the same time,the disease shows an obvious upward trend worldwide.Pancreatic cancer has become a major public health problem that seriously affects the life and health of people.The present review focuses on the recent advances in interventional therapy such as transcatheter arterial infusion,radiofrequency ablation,microwave ablation,and irreversible electroporation of pancreatic cancer.

Expert consensus on interventional therapy for traumatic splenic bleeding

This study aims to introduce the diagnosis and treatment processes of traumatic splenic bleeding and explain its emergency,medical,interventional,and surgical treatments.Furthermore,this study aims to summarize the indications and contraindications of splenic artery embolization,interventional procedures,and precautions of complications.

Efficacy and Safety of Transdermal Fentanyl(TDF)in Treatment of Pain Caused by Interventional Embolization Therapy

Objective： Interventional embolization therapy is well accepted in cancer treatment, but patient may suffer from a moderate-to-severe pain after therapy and its quality of life （QoL） is influenced, this study is to observe the efficacy and safety of transdermal fentanyl （TDF） in the management of pain caused by interventional embolization therapy. Methods： Morphine 10mg and TDF 25μg/h were immediately used in 52 patients who had moderate-to-severe pain complicated by interventional embolization therapy, the pain intensity was evaluated by visual analogue scale （VAS）. If VAS≥4 at t2 h after treatment, the dosage of TDF added into 50 μg/h. At 0h, 12h, 24h, 72h, 1 week, 2 weeks after TD, the vas and adverse events were observed respectively. Result： There was an obvious decrease in VAS at 12h after TDF treatment in the patients of which only 9 patients used 50ug/h dosage after partial splenic embolization （PSE） therapy. Most patients got satisfactory pain relief both the TDF 25 μg/h and TDF 50 μg/h group （VAS 0-1）. The adverse events were nausea, vomiting and dizzy, especially in the TDF 50 μg/h group. No respiratory depression was observed and only one patient got retention of urine. Conclusion： TDF was effective and safe in the treatment of moderate-to-severe pain after interventional embolizafion therapy.

Interventional therapy for chronic simple atherosclerotic occlusive disease of lower extremity

Objective： To explore the efficacy of interventional therapy for chronic atherosclerotic occlusive disease of the lower extremity. Methods： Fifty-six cases of simple atherosclerotic occlusive disease of lower extremity were divided into 3 types according to the location of occhision, including 17 cases of abdominal aorta-iliac artery, 18 cases of iliac-femoral artery, and 21 cases of inferior popliteal artery. Catheter and guide wire combined with blunt dissection and subtle banding were used to dredge the occluded vessels, and stents were implanted when interlayer appeared. Results： After the treatment, 46 cases of occlusion were dredged （82.1%）, 6 cases remained occluded with the same symptoms （10.7%）, and 4 cases had severer symptoms （7.1%）. Among the 46 successful cases, there were 16 cases of abdominal aorta-iliac artery （94.1%）, 16 cases of iliac-femoral artery （88.9%） and 14 cases of inferior popliteal artery, artery （66.6%）. There was no statistical difference between the abdominal aorta-iliac artery cases and iliac-femoral artery cases （P〉0.05）, but there was statistical difference between these two types and the inferior popliteal artery cases （P〈0.05）. In the successful cases, 9 cases of abdominal aorta-iliac artery （52.9%）, 10 cases of iliac-femoral artery （55.5%） and 10 cases of inferior popliteal artery （33.3%） had 5-10 cm of occlusion, with no statistical difference between the first two types （P〉0.05）, but with statistical difference between the first two types and the third type （P〈0.05）. Compared with the 14 dredged cases （71.4%）, the 7 cases （33.3%） of inferior popliteal artery cases had richer compensatory circulation （P〈0.05）. Conclusion： It＇s safe and effective to treat simple atherosclerotic occlusive disease of the lower extremity with interventional therapy. The location and length of occlusion and the abundance of compensatory circulation had effect on the therapy.

Interventional Therapy for Cerebral Aneurysms Under the Guidance of 3D Printing Technology

Objective:To explore the clinical method and effect of 3D printing in the treatment of cerebral aneurysms.Methods:The authors research work on the hospital,work time in February 2019-February 2020,this study selected patients of cerebral aneurysms,this period are selected for treatment of 100 cases of patients,randomly divided into two groups,a group to give simple intervention,named as the control group,another group for the interventional therapy under the guidance of 3 D printing,named as experimental group,analyze the effect of two groups of patients with clinical intervention.Results:The length of hospital stay in the experimental group was shorter than that in the control group.Meanwhile,the incidence of complications and adverse reactions in the experimental group and the control group were 6.00%and 18.00%,the experimental group was better(P<0.05).Conclusion:3D printing technology can be applied in the treatment of patients with cerebral aneurysms to provide guidance for interventional surgical treatment.It has significant effect,can reduce the incidence complications in patients,has significant clinical effect,and can be popularized.

Lessons learned from the TIMI trials in rescue interventions for elderly patients after failed fibrinolytic therapy:look beyond the TIMI flow

In ST-segment elevation myocardial infarction (STEMI), acute reperfusion of the infarct-related artery (IRA)is the main goal in the early minutes after the patient seeks medical attention. Fibrinolytic therapy (FT) and/or primary coronary intervention (PCI) were proven to be effective in opening the IRA.

Clinical Analysis of Transcatheter Arterial Chemoembolization Sequential Microwave Ablation Combined with Targeted Therapy and Immunotherapy in the Treatment of Large Hepatocellular Carcinoma

Objective: To investigate the safety and efficacy of Transcatheter Arterial Chemoembolization (TACE), sequential Microwave Ablation (MWA) combined with targeted therapy and immunotherapy versus TACE combined with targeted therapy and immunotherapy in the treatment of large hepatocellular carcinoma (defined as tumor diameter > 5 cm). Methods: The prospective cohort study was conducted, with 81 patients with large hepatocellular carcinoma who were admitted to Jingzhou Central Hospital from 2018 to 2022, they were divided into two groups, 41 patients received TACE sequential MWA combined with targeted therapy and immunotherapy (observation group), and 40 patients received single TACE combined with targeted therapy and immunotherapy (control group). The short-term efficacies after 3 months of treatment, the Disease Control Rate (DCR), the Overall Survival (OS), adverse drug reactions and complications were compared and analyzed between the two groups. Results: The Objective Response Rate (ORR) of the observation group was significantly higher than that of the control group (ORR: 85.4% vs 57.5%, P = 0.005), The median Progression-Free Survival (PFS) and median OS of the observation group were better than those of the control group (mPFS: 16 months vs 10 months, P = 0.004;mOS: 39 months. vs 24 months, P = 0.008). The 1-, 2- and 3-year progression-free survival rates of the observation group were 72.9%, 50.4%, and 25.6%, and those of the control group were 30.4%, 11.0%, and 3.7%. The 1-, 2- and 3-year overall survival rates of the observation group were 78.9%, 71.7%, and 65.2%, and those of the control group were 65.1%, versus 42.1% and 36.9%. There was no significant difference in the incidence of adverse drug reactions and complications between the two groups. In this study, the adverse drug reactions were mild in Grades 1 - 2. Conclusion: TACE sequential MWA combined with targeted therapy and immunotherapy has efficacy and safety.