A 64-year-old man was admitted to our hospital with hematemesis and melena.Six years ago,he had undergone total gastrectomy with Roux-en-Y esophagojejunostomy for gastric cancer.Endoscopic examination revealed varicos...A 64-year-old man was admitted to our hospital with hematemesis and melena.Six years ago,he had undergone total gastrectomy with Roux-en-Y esophagojejunostomy for gastric cancer.Endoscopic examination revealed varicose veins at the anastomotic sites with cherry-red spots and hemorrhage.Abdominal computed tomography showed that the varices were supplied by a dilated jejunal vein.Transjugular intrahepatic portosystemic shunt(TIPS)and variceal embolization were performed.There were no major complications or episodes of bleeding during the three-month follow-up.We conclude that TIPS in combination with varices obliteration is an effective alternative method for treatment of ruptured esophagojejunal varices after total gastrectomy.展开更多
Objective: To estimate the safety and efficacy of transcatheter arterial embolization(TAE) in the treatment of refractory hematuria of prostatic origin(RHPO).Methods: This retrospective study included 23 patients who ...Objective: To estimate the safety and efficacy of transcatheter arterial embolization(TAE) in the treatment of refractory hematuria of prostatic origin(RHPO).Methods: This retrospective study included 23 patients who underwent TAE for RHPO between May 2013 and August 2021. Technical and clinical success rates were calculated, and arteriogram findings and complications were detected.Results: Embolization was performed 24 times in 23 patients. Technical success was achieved in 24/24(100%)embolization procedures. Contrast agent extravasation was detected during 2 of the 24 angiographic procedures.Bilateral embolization was performed in 23(95.8%) of the 24 procedures. The clinical success rate was 21/23(91.3%), and hematuria stopped 1–4 days after TAE. No serious complications were observed.Conclusion: TAE is a safe and effective minimally invasive technique for treating patients with RHPO.展开更多
Heart failure resulting from myocardial infarction(MI)is a leading global health concern.Current revasculari-zation therapies cannot fully restore the infarcted myocardium or prevent maladaptive ventricular remodeling...Heart failure resulting from myocardial infarction(MI)is a leading global health concern.Current revasculari-zation therapies cannot fully restore the infarcted myocardium or prevent maladaptive ventricular remodeling.Traditional Chinese medicine with its multitarget regulation and favorable biosafety shows a promising thera-peutic potential.Tanshinone IIA(TIIA)and formononetin(FM),two bioactive compounds derived from Salvia miltiorrhiza and Astragalus membranaceus,respectively,exhibit antioxidant,anti-inflammatory,and proangio-genic effects.Herein,a neutrophil-targeted nanomedicine(TF-5NP)was developed to deliver TIIA and FM to the infarcted myocardium for mitigating oxidative damage and promoting angiogenesis.TF-5NP was synthesized by coassembling bis-5-hydroxytryptamine-modified 1,2-distearoyl-sn-glycero-3-phosphoethanolamine-poly-ethylene glycol-carboxylic acid with cholesterol and lipid 1,2-distearoyl-sn-glycero-3-phosphoglycerol,which binds to troponin in the infarcted myocardium.This nanomedicine reduces inflammation and cardiomyocyte damage and improves cardiac function in porcine MI models,with therapeutic effects lasting for~28 d.These findings suggest that TF-5NP use is a promising approach for treating post-MI maladaptive remodeling and heart failure.展开更多
Aim:The transjugular intrahepatic portosystemic shunt(TIPS)procedure has been performed in China for 30 years,but our understanding of the status and difficulties associated with the use of TIPS for portal hypertensio...Aim:The transjugular intrahepatic portosystemic shunt(TIPS)procedure has been performed in China for 30 years,but our understanding of the status and difficulties associated with the use of TIPS for portal hypertension is incomplete.This study aims to investigate the current situation of the use of TIPS for portal hypertension,which should aid the development of TIPS in China.Methods:This study involved a questionnaire survey,initiated by the China Portal Hypertension Alliance(CHESS)to investigate the use of TIPS for portal hypertension in China.Questionnaires were released on the Internet between August 16,2022 and September 16,2022.Detailed information was collected from 545 hospitals contracted by the CHESS in China,which performed TIPS surgery in 2021.Results:The 545 hospitals covers the majority of hospitals in China that conduct TIPS intervention.In the survey,a total of 13,527 TIPS interventions were carried out with 94.1%(498/545)of them had a system of routine follow‐up after TIPS.The majority(42.6%[232/545])believed that the main indication of TIPS was the control of acute bleeding.Overall,48.1%(262/545)carried out early or pre‐emptive TIPS,53.0%(289/545)carried out TIPS for cavernous transformation of the portal vein,and 81.0%(441/545)chose routine embolization of collateral circulation during operation.Most used coils(97.0%[475/490])and biological glue(72.0%[353/490])as embolic materials,and 78.5%(428/545)routinely performed intraoperative portal pressure gradient measurements.When selecting TIPS stents,57.1%(311/545)chose viator‐specific stents,and 57.2%(312/545)chose conventional anticoagulation after TIPS.Conventional anticoagulation after TIPS is over a time interval of 3–6 months(55.4%[173/312]).The limitation of TIPS surgery is mainly its cost(72.3%[394/545])and insufficient understanding of the procedure by doctors in other related departments(77.4%[422/545]).Most of the hospital teams accept the use of domestic instruments in TIPS surgery(92.7%[505/545]).Conclusions:This survey shows that TIPS is an essential part of the treatment of portal hypertension in China.TIPS is widely used in Chinese patients with portal hypertension,and this survey presents a more comprehensive picture of the options and difficulties encountered in the implementation of TIPS.In the future,it is necessary to promote TIPS technology and further standardize surgical indications,routine operations,and instrument application.展开更多
文摘A 64-year-old man was admitted to our hospital with hematemesis and melena.Six years ago,he had undergone total gastrectomy with Roux-en-Y esophagojejunostomy for gastric cancer.Endoscopic examination revealed varicose veins at the anastomotic sites with cherry-red spots and hemorrhage.Abdominal computed tomography showed that the varices were supplied by a dilated jejunal vein.Transjugular intrahepatic portosystemic shunt(TIPS)and variceal embolization were performed.There were no major complications or episodes of bleeding during the three-month follow-up.We conclude that TIPS in combination with varices obliteration is an effective alternative method for treatment of ruptured esophagojejunal varices after total gastrectomy.
基金the National Natural Science Foundation of China (82072023)the Fujian Province Natural Science Fund Project (2020J011096 and 2020J011064)。
文摘Objective: To estimate the safety and efficacy of transcatheter arterial embolization(TAE) in the treatment of refractory hematuria of prostatic origin(RHPO).Methods: This retrospective study included 23 patients who underwent TAE for RHPO between May 2013 and August 2021. Technical and clinical success rates were calculated, and arteriogram findings and complications were detected.Results: Embolization was performed 24 times in 23 patients. Technical success was achieved in 24/24(100%)embolization procedures. Contrast agent extravasation was detected during 2 of the 24 angiographic procedures.Bilateral embolization was performed in 23(95.8%) of the 24 procedures. The clinical success rate was 21/23(91.3%), and hematuria stopped 1–4 days after TAE. No serious complications were observed.Conclusion: TAE is a safe and effective minimally invasive technique for treating patients with RHPO.
基金supported by the National Natural Science Founda-tion of China(Grant Nos.82274271&82104962&82004112)Guang-dong Basic and Applied Basic Research Foundation(Grant Nos.2024B1515020033&2024A1515011686&2023A1515220029)+6 种基金Outstanding Young Talents Youth Program of Guangdong Hospital of Chinese Medicine(Grant No.SZ2023QNO1)Guangzhou Science and Technology Fund(202201020565)Major Science and Technology Projects of Chinese Medicine in Guangzhou Region(2025CX010,2025QN010)the 2023 Young Top Talent Cultivation“Unveiling the List of Commander-in-Chief”Project Program of Guangzhou University of Chinese Medicine(to Shuai MAO)Project of State Key Laboratory of Dampness Syndrome of Chinese Medicine,The Second Affiliated Hos-pital of Guangzhou University of Chinese Medicine(SZ2024KF01)Guangzhou Science and Technology Plan(2024A04J3304)Guangzhou Municipal Science and Technology Bureau-Academia Joint Funding Program(2024A03J0062).
文摘Heart failure resulting from myocardial infarction(MI)is a leading global health concern.Current revasculari-zation therapies cannot fully restore the infarcted myocardium or prevent maladaptive ventricular remodeling.Traditional Chinese medicine with its multitarget regulation and favorable biosafety shows a promising thera-peutic potential.Tanshinone IIA(TIIA)and formononetin(FM),two bioactive compounds derived from Salvia miltiorrhiza and Astragalus membranaceus,respectively,exhibit antioxidant,anti-inflammatory,and proangio-genic effects.Herein,a neutrophil-targeted nanomedicine(TF-5NP)was developed to deliver TIIA and FM to the infarcted myocardium for mitigating oxidative damage and promoting angiogenesis.TF-5NP was synthesized by coassembling bis-5-hydroxytryptamine-modified 1,2-distearoyl-sn-glycero-3-phosphoethanolamine-poly-ethylene glycol-carboxylic acid with cholesterol and lipid 1,2-distearoyl-sn-glycero-3-phosphoglycerol,which binds to troponin in the infarcted myocardium.This nanomedicine reduces inflammation and cardiomyocyte damage and improves cardiac function in porcine MI models,with therapeutic effects lasting for~28 d.These findings suggest that TF-5NP use is a promising approach for treating post-MI maladaptive remodeling and heart failure.
文摘Aim:The transjugular intrahepatic portosystemic shunt(TIPS)procedure has been performed in China for 30 years,but our understanding of the status and difficulties associated with the use of TIPS for portal hypertension is incomplete.This study aims to investigate the current situation of the use of TIPS for portal hypertension,which should aid the development of TIPS in China.Methods:This study involved a questionnaire survey,initiated by the China Portal Hypertension Alliance(CHESS)to investigate the use of TIPS for portal hypertension in China.Questionnaires were released on the Internet between August 16,2022 and September 16,2022.Detailed information was collected from 545 hospitals contracted by the CHESS in China,which performed TIPS surgery in 2021.Results:The 545 hospitals covers the majority of hospitals in China that conduct TIPS intervention.In the survey,a total of 13,527 TIPS interventions were carried out with 94.1%(498/545)of them had a system of routine follow‐up after TIPS.The majority(42.6%[232/545])believed that the main indication of TIPS was the control of acute bleeding.Overall,48.1%(262/545)carried out early or pre‐emptive TIPS,53.0%(289/545)carried out TIPS for cavernous transformation of the portal vein,and 81.0%(441/545)chose routine embolization of collateral circulation during operation.Most used coils(97.0%[475/490])and biological glue(72.0%[353/490])as embolic materials,and 78.5%(428/545)routinely performed intraoperative portal pressure gradient measurements.When selecting TIPS stents,57.1%(311/545)chose viator‐specific stents,and 57.2%(312/545)chose conventional anticoagulation after TIPS.Conventional anticoagulation after TIPS is over a time interval of 3–6 months(55.4%[173/312]).The limitation of TIPS surgery is mainly its cost(72.3%[394/545])and insufficient understanding of the procedure by doctors in other related departments(77.4%[422/545]).Most of the hospital teams accept the use of domestic instruments in TIPS surgery(92.7%[505/545]).Conclusions:This survey shows that TIPS is an essential part of the treatment of portal hypertension in China.TIPS is widely used in Chinese patients with portal hypertension,and this survey presents a more comprehensive picture of the options and difficulties encountered in the implementation of TIPS.In the future,it is necessary to promote TIPS technology and further standardize surgical indications,routine operations,and instrument application.
