晚期结直肠癌肝转移临床介入治疗分析

目的分析晚期结直肠癌肝转移临床介入治疗效果。方法选取该院2014年2月—2015年2月收治的晚期结直肠癌肝转移患者80例作为观察对象,按照随机数字表法将患者分为对照组(n=40)和综合组(n=40),对照组患者接受TACE单独介入治疗,综合组患者接受综合介入治疗,观察比较两组患者治疗前后肿瘤标志物CEA含量,近期疗效和生存状况,首次治疗前后免疫功能指标情况。结果综合组患者治疗缓解率、1年后生存率、2年后生存率分别为92.50%、95.00%、70.00%,对照组患者治疗缓解率、1年后生存率、2年后生存率分别为72.50%、72.50%、50.00%,综合组患者近期疗效、生存状况均优于对照组患者,(χ~2=5.541 1、7.439 7、4.177 9、P=0.019、0.00 6、0.04 1);经过治疗后综合组患者CD3+阳性细胞、CD4+阳性细胞、CD8+阳性细胞、CD4+/CD8+、CEA含量分别为(59.22±3.18)%、(39.35±3.10)%、(15.40±2.52)%、(2.42±0.41)、(10.50±8.60)μg/L,均显著优于对照组患者(P<0.05)。结论对晚期结直肠癌肝转移患者实施介入治疗效果显著,值得推广。

临床神经介入治疗脑血管疾病的临床效果

目的探讨临床神经介入治疗脑血管疾病的临床效果。方法 120例脑血管疾病患者,随机分为观察组(52例)和对照组(68例),观察组患者自愿接受临床神经介入治疗,对照组患者接受开颅手术治疗。对比两组患者的基本症状和并发症的恢复情况。结果观察组患者动脉血管改善率为92.3%,并发症发生率和病情复发率均为0;对照组患者动脉血管改善率为58.8%,并发症发生率为7.4%,病情复发率为8.8%;观察组动脉血管改善率高于对照组,并发症发生率和病情复发率低于对照组,差异均具有统计学意义(P<0.05)。观察组患者的满意度为96.15%,对照组患者的满意度为85.29%,观察组患者的满意度明显高于对照组,差异具有统计学意义(P<0.05)。结论临床神经介入治疗脑血管疾病具有良好的临床效果,可以促进患者的早日康复,提高患者的生活质量,可以进行临床推广。

腰大池引流引流术在神经介入治疗脑血管疾病的效果分析

分析腰大池持续引流在神经介入治疗脑血管疾病的效果。方法 样本限定为60例颅内动脉瘤破裂并蛛网膜下腔出血行介入颅内动脉瘤栓塞术的患者,时间为2022年5月到2023年5月,均分为对照组与干预组,分析腰大池引流引流术介入治疗的应用价值。结果 干预组达标率高于对照组(P<0.05);干预组并发症发生率低于对照组(P<0.05);干预组满意度高于对照组(P<0.05);干预组社会支持度、自理能力高于对照组(P<0.05);干预组生活质量高于对照组(P<0.05)。结论 在脑血管疾病治疗中,腰大池持续引流术临床神经介入治疗方案的开展进一步保证了患者病情干预效率的全面提升,并综合性优化了医疗干预阶段的手术质量,有效促进患者预后质量改善。

超声引导介入在临床介入中的应用体会

目的：对超声引导介入在各种囊实性肿物临床介入中的应用价值进行分析。方法：选取我院于2010年1月-2013年5月收治有囊实性肿物患者86例，回顾性分析患者临床资料及治疗过程。结果：86例患者均顺利完成临床介入治疗过程及活检，引导宫腔内手术9例，穿刺77例。其中成功穿刺75例，1次性成功穿刺患者64例，失败2例，穿刺成功率为97．40％，1次性穿刺成功率为83．12％，所有患者术后均无损伤、感染或出血等严重并发症发生。结论：在对有各种囊实性肿物患者展开临床介入治疗时，采用超声引导介入方法不会对患者造成较大创伤，具有安全性与可靠性特征，操作快速简便，值得在临床中推广。

研究外周血管介入治疗大咯血的临床疗效

分析外周血管介入治疗大咯血的临床疗效。方法:将本院2015年5月到2016年5月期间收治的58例大咯血患者作为研究对象,将患者按照所选择的治疗方式,划分为常规组与实验组(n=29)。常规组采用一般治疗方式,实验组采用外周血管介入治疗方式,对比两组患者的临床治疗效果以及不良反应发生率。结果:实验组与常规组患者的临床治疗总有效率分别为96.55%、79.31%,数据对比存在较大差异,具有统计学意义(p<0.05)。同时,实验组患者不良反应发生率3.45%相对低于常规组20.69%,差异比较存在显著差异(p<0.05)。结论:外周血管介入治疗大咯血的有效性与安全性相对较高,能够在保证临床治疗效果的同时,降低患者的不良反应发生率。

Three-dimensional Imaging of Multi-slice Spiral CT in Bronchial Artery Correlative Study on Blood Supply of Central Lung Cancer and Its Clinical Significance

Objective: To evaluate three-dimensional bronchial artery imaging charactersin central lung cancer and applied values with multi-slice spiral CT (MSCT) to provide theoreticalevidence on blood supply and intervention therapy. Methods: Eighteen patients with central lungcancer underwent MSCT with real time helical thin-slice CT scanning. Three-dimensional bronchialartery reconstruction was done at the console work-station. The space anatomical characters ofbronchial artery were observed through different rotations. Results: For 6 cases, thethree-dimensional images of bronchial artery (33.33%) could exactly show the origins, the routes(lung inner segment and mediatism segment) and the diameters of bronchial arteries. Vision rate ofbronchial arteries was the highest in pulmonary artery stricture and truncation groups, and thevessels' diameter became larger apparently. These characters demonstrated blood supply of this kindof central lung cancer come from bronchial artery. Volume rendering images were the best ones amongthree-dimensional images. Conclusion: Three-dimensional imaging with MSCT in bronchial artery canreveal the anatomical characters of bronchial artery and provide theoretical evidence on bloodsupply and intervention therapy of central lung cancer.

COMPLICATION ANALYSIS OF INTRACRANIAL ANEURYSM EMBOLIZATION WITH CONTROLLABLE COILS

Objective To explore the causes, prevention, and management of the complications during intra-cranial aneurysm embolization with controllable coils (mechanical detachable spiral, MDS; and Guglielmi detachable coil, GDC). Methods Retrospective review of 120 cases with 125 intracranial aneurysms embolized with con-trollable coils from March 1995 to July 1999 was conducted. The 20 accidents(in 18 cases) including aneurysm rupture, over-embolization, protrusion of coil end into the parent artery, and thrombosis of the parent artery were analyzed. Results Among the 20 accidents, there were 6 aneurysm ruptures, 6 over-embolizations (in 5 cases), 6 coil protrusions, and 2 thromboses (one was secondary to coil protrusion). The embolization-related mortality was 3.33% (4/120), the permanent neurological deficit was 1.67% (2/120), and the transitory neurological deficit was 3.33%(4/120). The occurrence and outcome of the complications were related to the embolizing technique, the pattern of aneurysm and its parent artery, the imperfection of embolic materials, and the observation and management during embolization. Conclusion Skilled embolizing technique, better understanding of the angio-anatomy of an aneurysm and its parent artery, correct judgement and management during embolization, and improvement of embolic materials are beneficial to the reduction of complications and to the melioration of the outcome of complications.

Clinical outcomes of elderly South-East Asian patients in primary percutaneous coronary intervention for ST- elevation myocardial infarction

Objective To evaluate the clinical characteristics and in-hospital outcomes of elderly South-East Asian patients undergoing primary pereutaneous coronary intervention （PPCI）. Methods From January 2009 to December 2012, 1268 patients （86.4% male, mean age of 58,4 ± 12.2 years） presented to our hospital for ST-elevation myocardial infarction （STEMI） and underwent PPCI. They were divided into two groups： elderly group defined as age _〉 70 years and non-elderly group defined as age 〈 70 years. Data were collected retrospectively on baseline clinical characteristics, door-to-balloon （D2B） time, angiographic findings, therapeutic modality and hospital course. Results The elderly group constituted 19% of the study population with mean age 76.6 ± 5.0 years. There was a higher proportion of female gender and ethnic Chinese patients in the elderly group when compared with the non-elderly group. The former was less likely to be smokers and have a significantly higher prevalence of hypertension. The mean D2B time was significantly longer in the elderly group. They also had a significantly higher incidence of triple vessel disease and obstructive left main disease. The use of radial artery access, glyeoprotein 2b/3a inhibitors and drug-eluting stents during PPCI were also significantly lower. In-hospital mortality was significantly higher in the elderly group. The rate of cardiogenic shock and inhospital complications were also significantly higher. Conclusions Our registry showed that in-hospital mortality rate in elderly South-East Asian patients undergoing PPCI for STEMI was high. Further studies into the optimal STEMI management strat- egy for these elderly patients are warranted.

Nine-year clinical outcomes of drug-eluting stents vs. bare metal stents for large coronary vessel lesions

Objectives To evaluate the very long-term safety and effectiveness of drug-eluting stents （DES） compared to bare-metal stents （BMS） for patients with large coronary vessels. Methods From April 2004 to October 2006, 2407 consecutive patients undergoing de novo lesion percutaneous coronary intervention with reference vessel diameter greater than or equal to 3.5 mm at Fu Wai Hospital in Beijing, China, were prospectively enrolled into this study. We obtained 9-year clinical outcomes including death, myocardial infarction （MI）, thrombosis, target lesion revascularization （TLR）, target vessel revascularization （TVR）, and major adverse cardiac events （MACE, the composite of death, MI, and TVR）. We performed Cox＇s proportional-hazards models to assess relative risks of all the outcome measures after propensity match. Results After propensity scoring, 514 DES-treated patients were matched to 514 BMS-treated patients. The patients treated with BMS were associated with higher risk ofTLR （HR： 2.55, 95%CI： 1.520-4.277, P = 0.0004） and TVR （HR： 1.889, 95%CI： 1.185-3.011, P = 0.0075）, but the rates of death/MI and MACE were not statistically different. All Academic Research Consortium definition stent thrombosis at 9-year were comparable in the two groups. Conclusions During long-term follow-up through nine years, use of DES in patients with large coronary arteries was still associated with significant reductions in the risks of TLR and TVR.

Comparison of clinical outcomes between culprit vessel only and multivessel percutaneous coronary intervention for ST-segment elevation myocardial infarction patients with multivessel coronary diseases

Background The clinical significance of complete revascularization for ST segment elevation myocardial infarction （STEMI） pa- tients during admission is still debatable. Methods A total of 1406 STEMI patients from the Korean Myocardial Infarction Registry with multivessel diseases without cardiogenic shock who underwent primary percutaneous coronary intervention （PPCI） were analyzed. We used propensity score matching （PSM） to control differences of baseline characteristics between culprit only intervention （CP） and multivessel percutaneous coronary interventions （MP）, and between double vessel disease （DVD） and triple vessel disease （TVD）. The major adverse cardiac event （MACE） was analyzed for one year after discharge. Results TVD patients showed higher incidence of MACE （14.2% vs. 8.6%, P = 0.01）, any cause of revascularization （10.6% vs. 5.9%, P - 0.01）, and repeated PCI （9.5% vs. 5.7%, P = 0.02）, as compared to DVD patients during one year after discharge. MP reduced MACE effectively （7.3% vs. 13.8%, P = 0.03）, as compared to CP for one year, but all cause of death （1.6% vs. 3.2%, P= 0.38）, Ml （0.4% vs. 0.8%, P = 1.00）, and any cause ofrevascularization （5.3% vs. 9.7%, P = 0.09） were comparable in the two treatment groups. Conclusions STEMI patients with TVD showed higher rate of MACE, as compared to DVD MP performed during PPCI or ad hoc during admission for STEMI patients without cardiogenic shock showed lower rate of MACE in this large scaled database. Therefore, MP could be considered as an effective treatment option for STEMI patients without cardiogenic shock.

Ischemic colitis and large bowel infarction:A case report

Ischemic bowel disease results from an acute or chronic drop in the blood supply to the bowel and may have various clinical presentations, such as intestinal angina, ischemic colitis or intestinal infarction. Elderly patients with systemic atherosclerosis who are symptomatic for the disease in two or more vascular beds have multiple comorbidities and are particularly at risk. The clinical evolution and outcome of this disease are difficult to predict because of its pleomorphic aspects and the general lack of statistical data. In this paper, we present the case of a patient who was monitored in our unit for six years. For this patient, we encountered iterative changes in the clinical pattern, beginning with chronic "intestinal angina" and finishing with signs of acute mesenteric ischemia after an episode of ischemic colitis. This evolution is particularly rare in clinical practice, and the case is instructive because it raises discussions about the natural history of the condition and the thera-peutic decisions that should be made at every stage of the disease. An important lesson is that ischemic bowel disease should always be considered in patients who have multiple risk factors for atherosclerosis and have experienced recurrent "indistinct" abdominal symptoms.In these cases, aggressive investigation and therapeutic decisions must be taken whenever possible. Despite an absence of standardized protocols, angiographic evaluation and revascularization procedures have beneficial outcomes. Current advances in endovascular therapy, such as percutaneous transluminal angioplasty with stenting, should be increasingly used in patients with chronic mesenteric ischemia. Such therapy can avoid the risks that are associated with open repair. However, technical difficulties, especially in severe stenotic lesions, frequently occur.

Clinical results and histological changes following preoperative interventional treatment of the aggressive subtype of endometrial cancer

Objective: The aim of the study was to evaluate the clinical value of preoperative intra-arterial infusion chemotherapy and embolization in treating the aggressive subtype of endometrial carcinoma with hysterectomy. Methods: Fifteen cases of endometrial carcinoma were performed intra-arterial chemotherapy and embolization before operation with carboplatin or cisplatin, epirubicin or ADM, and all the cases were performed the arterial chemoembolization with KMG or gel-foam particles mixed with 1/3 total drug dose after 2/3 total drug dose perfusion through the bilateral feeding arteries. Of 15 cases, there were 5 cases with uterine papillary serous carcinoma, 3 cases with endometrial clear cell carcinoma, and 7 cases with endometrial adenosquamous carcinoma. Results: Fifteen cases of endometrial carcinoma were performed operations after 3–4 weeks of intra-arterial chemotherapy and embolization. In these cases, 3 were found mass necrosis and lymphocyte cells infiltration in the tumor tissues but no carcinoma cells, which was noted as histological complete remission (HCR). After intra-arterial chemotherapy and embolization 3–4 weeks, the expression of proliferating cell nuclear antigen (PCNA) was obviously reduced (P < 0.001). Conclusion: The preoperative intra-arterial chemotherapy and embolization can improve the operability of resection in patients with aggressive subtype of endometrial carcinoma, reduce the expression of PCNA, adjust malignancy of endometrial carcinoma, and improve prognosis.

Red blood cell distribution width is worthwhile when interpreted with other inflammatory markers

To the Editor In a recent issue of Journal of Geriatric Cardiology, we read the article by LIU, et al. with interest.~lJ They aimed to investigate whether red cell distribution width （RDW） had a relationship with mortality in elderly patients after percuta- neous coronary intervention （PCI）. The authors concluded that, RDW is an independent predictor of the increased in- termediate-term all-cause mortality in elderly patients after PCI. The easy availability of testing for RDW at no addi- tional cost may encourage its broader use in clinical practice We would like to thank the authors for their comprehensive contribution.

Comparative Analysis of Intractable Postpartum Hemorrhage Intervention Treatments

Abstract： Objective： To explore the clinical efficacy of different treatment methods of intervention for intractable postpartum hemorrhage. Methods： From the accept and treat patients with intractable postpartum hemorrhage in our hospital from June 2013 to March 2014, 86 cases were chosen to be retrospectively analyzed, randomly divided into observation group and control group with 43 cases in each group. The control group was underwent gauze packing while observation group were packing gauze joint with improved uterine suture Cho, the two groups were observed therapeutic effects and complications. Results： The total efficiency of observation group is 93.02%, and the total efficiency of the control group is 62.79%, there is a significant better treatment effect for observed group than the control group （P 〈0.05）, and complication rate of observation group is significantly lower than the control group （P 〈0.05）. Conclusions： In refractory postpartum hemorrhage intervention therapy, the use of gauze packing combined with modified suture uterus Cho has better clinical treatment effect with high security, so it is worthy of clinical application.

基于损伤模式建立肝再生小鼠模型的研究进展

肝脏是一种具有出色再生潜力的实性器官,其再生能力与肝脏疾病密切相关。深入研究肝再生的机制对于理解肝脏生物学和发展再生医学具有重要意义。小鼠凭借其技术、经济及解剖学等优势成为当前最优候选动物。目前已有的肝再生小鼠模型包括部分肝切除、化学药物损伤模型和基因工程模型等,本综述比较其优缺点及应用前景,为后续研究提供参考。

Comparative Analysis of Intractable Postpartum Hemorrhage Intervention Treatments

Objective： To explore the clinical efficacy of different treatment methods of intervention for intractable postpartum hemorrhage. Methods： From the accept and treat patients with intractable postpartum hemorrhage in our hospital from June 2013 to March 2014, 86 cases were chosen to be retrospectively analyzed, randomly divided into observation group and control group with 43 cases in each group. The control group was underwent gauze packing while observation group were packing gauze joint with improved uterine suture Cho, the two groups were observed therapeutic effects and complications. Results： The total efficiency of observation group is 93.02%, and the total efficiency of the control group is 62.79%, there is a significant better treatment effect for observed group than the control group （P 〈0.05）, and complication rate of observation group is significantly lower than the control group （P 〈0.05）. Conclusions： In refractory postpartum hemorrhage intervention therapy, the use of gauze packing combined with modified suture uterus Cho has better clinical treatment effect with high security, so it is worthy of clinical application.

Integrated treatment for lower-limb stage Ⅱ thromboangiitis obliterans by interventional therapy and oral administration of Chinese medicine: a randomized controlled clinical trial

OBJECTIVE： To observe if integrated treatment is better than other therapies for lower-limb stage Ⅱ thromboangiitis obliterans （TAO）. METHODS： Ninety lower-limb stage Ⅱ or worse TAO patients were randomly divided into three groups： group A （30 cases） treated by intervention and oral administration of Chinese medicine; group B （30 cases） treated by intervention alone; and group C （30 cases） treated only with oral adminis- tration of Chinese medicine. Therapeutic effects were observed, including the cure rate; the recurrence rate after one month, three months, six months, nine months, and one year; the ankle brachial indexes; the incidence of complications; and the level of C-reactive protein and erythrocyte sedimentation rate.RESULTS： Group A had significantly better clinically curative effects, related indexes, and outcomes during the long-term follow-up survey, than that of groups B and C. CONCLUSION： Integrated treatment is more effective for treating lower-limb stage Ⅱ or worseTAO.