Diese vergleichende Untersuchung uber Embolisation differenter hepatischer GefaBe bei Hunden mit Bletilla striata und Gelfoam ergab,d aB letilla striala als Embolisationsmaterial bessere Erfolge zeigt als Gelfoam.Die ...Diese vergleichende Untersuchung uber Embolisation differenter hepatischer GefaBe bei Hunden mit Bletilla striata und Gelfoam ergab,d aB letilla striala als Embolisationsmaterial bessere Erfolge zeigt als Gelfoam.Die Mechanismen der Embolisation mit Bletilla striata sind folgende :1)Bletilla striata wird nicht leicht von Geweben absorbiert;2)Bletilla striata bewirkt mechanische Blockierung;3)Bletilla striata beeinflt das Gerinnungssystem und dasAntikoagulationssystem;4)Bletilla siriata kann die Geafwandschadigen und dadurch sekundare Blockierung auslosen.展开更多
BACKGROUND: The management of complex pattern of bleeding associated with pelvic trauma remains a big challenge for trauma surgeons. We aimed to conduct a comprehensive meta-analysis to compare the outcomes of angioem...BACKGROUND: The management of complex pattern of bleeding associated with pelvic trauma remains a big challenge for trauma surgeons. We aimed to conduct a comprehensive meta-analysis to compare the outcomes of angioembolisation and pelvic packing in patients with pelvic trauma.METHODS: We conducted a systematic search of electronic information sources, including MEDLINE; EMBASE; CINAHL; the CENTRAL; the World Health Organization International Clinical Trials Registry; Clinical Trials.gov; ISRCTN Register, and bibliographic reference lists. The primary outcome was defined as mortality. Combined overall effect sizes were calculated using randomeffects models. Results are reported as the odds ratio(OR) and 95% confidence interval(CI).RESULTS: We identified 3 observational studies reporting a total of 120 patients undergoing angioembolisation(n=60) or pelvic packing(n=60) for pelvic trauma. Reporting of the Injury Severity Score(ISS) was variable, with higher ISS in the pelvic packing group. The risk of bias was low in two studies, and moderate in one. The pooled analysis demonstrated that angioembolisation did not significantly reduce mortality in patients with pelvic trauma compared to surgery(OR=1.99; 95% CI= 0.83–4.78, P=0.12). There was mild between-study heterogeneity(I^2=0%, P=0.65).CONCLUSION: Our analysis found no significant difference in mortality between angioembolisation and pelvic packing in patients with traumatic pelvic haemorrhage. The current level of evidence in this context is very limited and insufficient to support the superiority of a treatment modality. Future research is required.展开更多
Bone tumors include a variety of lesions, both primary and metastatic. The treatment modalities for bone tumors vary with the individual lesion, but in general surgical excision is the treatment of choice with other a...Bone tumors include a variety of lesions, both primary and metastatic. The treatment modalities for bone tumors vary with the individual lesion, but in general surgical excision is the treatment of choice with other adjunctive therapies. However, surgery for many bone tumors is complex due to several factors including tumor bulk, vascularity, vicinity to vital structures and potentially inaccessible location of the lesion. Transarterial Embolisation (TAE) is one of the important adjuvant treatment modalities and in some cases it may be the primary and curative treatment. Preoperative TAE has proved to be effective in both primary and metastatic bone tumors. It reduces tumor vascularity and intraoperative blood loss, the need for blood transfusion and associated complications, allows better definition of tissue planes at surgery affording more complete excision, and hence reduced recurrence. Preoperative chemoEmbolisation has also been shown to increase the sensitivity of some tumors to subsequent chemotherapy and radiotherapy. There are several techniques and embolic agents available for this purpose, but the ultimate aim is to achieve tumor devascularization. In this review, we discuss the techniques including the choice of embolic agent, application to individual lesions and potential complications.展开更多
Hematuria due to locally advanced or metastatic bladder cancer is a common condition and is often a management problem.Percutaneous embolisation is a mini-invasive option to handle this situation.We report a case of a...Hematuria due to locally advanced or metastatic bladder cancer is a common condition and is often a management problem.Percutaneous embolisation is a mini-invasive option to handle this situation.We report a case of a patient with a metastatic bladder cancer and who presented with an abundant hematuria and severe anemia.After failure of endoscopic resections and“flush”of radiotherapy haemostatic and refusal of cystectomy by the patient,he was treated by superselective embolisation of bilateral superior bladder arteries with excellent immediate results.The technique is safe and effective in the short term.The longterm effectiveness requires further investigation.展开更多
<b><span style="font-family:Verdana;">Introduction:</span></b><span style="font-family:Verdana;"></span><b> </b><span style="font-family:Verd...<b><span style="font-family:Verdana;">Introduction:</span></b><span style="font-family:Verdana;"></span><b> </b><span style="font-family:Verdana;">The risk of rupture of true renal artery aneurysms is low but when they are bigger than 2 -</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">2.5 cm it increases significantly, making treatment essential. The need to use alternatives to conventional</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">techniques in order to avoid predictable complications as coil migration is mandatory. <b></b></span><b><b><span style="font-family:Verdana;">Discussion:</span></b><span style="font-family:Verdana;"></span></b> <span style="font-family:Verdana;">Routinely-used techniques in interventional neuroradiology such as flow diverters or those</span></span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">assisted with an occlusion balloon or stent have are su</span><span style="font-family:Verdana;">itable alternatives for complex aneurysms. </span><span style="font-family:Verdana;"><b></b></span><b><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"></span></b></span><span style="font-family:Verdana;"> Interventional neuroradiology devices such as the Cascade Net stent (Perflow Medical and</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">Grupo Logsa) and Solitaire AB stent retriever (Medtronic) are valid and safe options</span><span style="font-family:Verdana;">. We describe the</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">technique of such devices.</span>展开更多
BACKGROUND Transcatheter arterial embolisation(TACE)is the primary treatment for intermediate-stage hepatocellular carcinoma(HCC)patients while some HCC cases have shown resistance to TACE.AIM To investigate the key g...BACKGROUND Transcatheter arterial embolisation(TACE)is the primary treatment for intermediate-stage hepatocellular carcinoma(HCC)patients while some HCC cases have shown resistance to TACE.AIM To investigate the key genes and potential mechanisms correlated with TACE refractoriness in HCC.METHODS The microarray datasets of TACE-treated HCC tissues,HCC and non-HCC tissues were collected by searching multiple public databases.The respective differentially expressed genes(DEGs)were attained via limma R package.Weighted gene co-expression network analysis was employed for identifying the significant modules related to TACE non-response.TACE refractoriness-related genes were obtained by intersecting up-regulated TACE-associated and HCC-associated DEGs together with the genes in significant modules related to TACE nonresponse.The key genes expression in the above two pairs of samples was compared respectively via Wilcoxon tests and standard mean differences model.The prognostic value of the key genes was evaluated by Kaplan-Meier curve.Multivariate analysis was utilised to investigate the independent prognostic factor in key genes.Single-cell RNA(scRNA)sequencing analysis was conducted to explore the cell types in HCC.TACE refractoriness-related genes activity was calculated via AUCell packages.The CellChat R package was used for the investigation of the cell–cell communication between the identified cell types.RESULTS HCC tissues of TACE non-responders(n=66)and TACE responders(n=81),HCC(n=3941)and non-HCC(n=3443)tissues were obtained.The five key genes,DLG associated protein 5(DLGAP5),Kinesin family member 20A(KIF20A),Assembly factor for spindle microtubules(ASPM),Kinesin family member 11(KIF11)and TPX2 microtubule nucleation factor(TPX2)in TACE refractoriness-related genes,were identified.The five key genes were all up-regulated in the TACE non-responders group and the HCC group.High expression of the five key genes predicted poor prognosis in HCC.Among the key genes,TPX2 was an independent prognostic factor.Four cell types,hepatocytes,embryonic stem cells,T cells and B cells,were identified in the HCC tissues.The TACE refractoriness-related genes expressed primarily in hepatocytes and embryonic stem cells.Hepatocytes,as the providers of ligands,had the strongest interaction with embryonic stem cells that provided receptors.CONCLUSION Five key genes(DLGAP5,KIF20A,ASPM,KIF11 and TPX2)were identified as promoting refractory TACE.Hepatocytes and embryonic stem cells were likely to boost TACE refractoriness.展开更多
Congenital hepatic arterio-venous malformations (AVM) are rare vascular anomalies and have rarely been reported in the presence of congeni-tal heart disease. The reported cases are mostly hemangiomas fed either by the...Congenital hepatic arterio-venous malformations (AVM) are rare vascular anomalies and have rarely been reported in the presence of congeni-tal heart disease. The reported cases are mostly hemangiomas fed either by the hepatic artery itself or by one of its branches. We present two unique hepatic AVM cases in the presence of congenital heart defects in which the AVM was not fed by the hepatic arterial system. Transcatheter coil embolisation was successfully carried out in both of them by using non-detachable Gianturco coils. Complete occlusion was achieved without any sequel.展开更多
Eine neue Technik mit Ballonkatheter bei der GefaBembolisation von einem Aneurysma und einer arterioportalen Fistel wird betrichtet. Es handelte sich um zwei Falle, bet denen ein Kobrakatheter als Embolisationskathe...Eine neue Technik mit Ballonkatheter bei der GefaBembolisation von einem Aneurysma und einer arterioportalen Fistel wird betrichtet. Es handelte sich um zwei Falle, bet denen ein Kobrakatheter als Embolisationskatheter und ein Dilatationskatheter als temporarer Okklusionskatheter zur Embolisation angewendet wurden. Durch diese Masnahme konnten die Aneurysmata und die arterioportale Fistel ohne Spiralreflux verschlossen werden. Die Anwendung von einem Kobrakatheter zusammen mit einem Dilatationskatheter zur GefaBembolisation ist effektiv. Komplikationen stud relativ selten.展开更多
Background: The introduction of pipeline embolisation device (PED) has improved the feasibility of endovascular treatment of intracranial aneurysms. The device allows for endoluminal reconstruction across the aneurysm...Background: The introduction of pipeline embolisation device (PED) has improved the feasibility of endovascular treatment of intracranial aneurysms. The device allows for endoluminal reconstruction across the aneurysm neck but is permeable enough that flow is preserved across the pressure gradients into sidebranch arteries. In spite of higher rates of aneurysm occlusion, there is lack of data concerning medium to long-term clinical and imaging results. Methods: This study was a prospective single center analysis of complications, imaging results, and medium term clinical outcomes after PED treatment of intracranial aneurysms. We included cases over a 17-month period in a tertiary interventional neuroradiology center. We collected data on demographics, vascular risk factors, clinical presentation, angiographic results post treatment, angiographic follow-up and clinical follow-up. Results: Thirty-three patients were included, 25 females and 8 males, with mean age of 55 years;3 presented with acute subarachnoid hemorrhage and 30 for elective treatment. Thirty-seven aneurysms were treated: 35 Internal Carotid Artery (ICA), 1 basilar trunk fusiform, and 1 vertebral artery intradural dissecting aneurysms. No deaths have occurred. Five patients suffered transient neurological complications (15%). Overall aneurysm occlusion was demonstrated in 85% of patients at the end of one year. Discussion:?Overall, the technique of flow diversion and endoluminal reconstruction differs greatly from the established endosaccular packing techniques of standard coiling, balloon remodeling, or stent assisted coiling. Our midterm follow-up confirms that, the rates of clinically significant complications compare favorably with published data on stent assisted coiling, potentially making these devices a truly revolutionizing technique.展开更多
Bleeding from renal angiomyolipoma in pregnancy can be catastrophic to both mother and fetus. Selective arterial embolisation is considered more superior than conventional surgery in these patients. Our case report ex...Bleeding from renal angiomyolipoma in pregnancy can be catastrophic to both mother and fetus. Selective arterial embolisation is considered more superior than conventional surgery in these patients. Our case report exemplifies how a bleeding angiomyolipoma was halted with embolisation in our pregnant patient.展开更多
Objective Single-stage surgery combining embolisation and microsurgery has been increasingly used as a stand-alone procedure to cure complex AVMs.This study aimed to investigate the learning curve and embolisation str...Objective Single-stage surgery combining embolisation and microsurgery has been increasingly used as a stand-alone procedure to cure complex AVMs.This study aimed to investigate the learning curve and embolisation strategy for single-stage surgery for AVMs.Methods This prospective cohort study used data from the nationwide Multimodality Treatment for Brain Arteriovenous Malformations(MATCH)registry in China,conducted between August 2011 and December 2023.A total of 213 complex AVMs were divided into two groups.Group 1 included the first 25 patients.The 188 cases in group 2 included patients numbered 26-213.A case-crossover design was employed to evaluate the influence of complications,unfavourable outcomes and worsening modified Rankin Scale(mRS)score.Cumulative summation analysis was performed to assess the learning curve.Results The rate of major complications decreased from 52.00%in group 1 to 34.57%in group 2(p=0.089),while the rate of unfavourable outcomes decreased from 44.00%in group 1 to 18.62%in group 2(p=0.004).The distribution of the three preoperative embolisation strategies was as follows:curative:72.00%and 19.15%,palliative:24.00%and 67.55%,and targeted:4.00%and 13.30%,respectively(p<0.001).Multivariable regression analysis showed that surgeon experience was associated with a lower rate of unfavourable outcomes(p=0.022,OR=0.333).The mean follow-up duration was 49.90±20.54 months.The follow-up mRS score of 5-6 decreased from 9.09%in group 1 to 0.8%in group 2(p=0.035).Conclusions Performing single-stage combined surgery in 25 AVM cases is necessary to achieve reproducibility.Rates of major complications and unfavourable outcomes decreased significantly after the first 50 procedures.Palliative and targeted embolisation strategies are associated with a lower rate of unfavourable outcomes.展开更多
Many patients with hepatocellular carcinoma are diagnosed with large tumours at an advanced stage.In addition,conditions such as liver fibrosis,cirrhosis,portal hypertension,viral load,and portal vein thrombosis due t...Many patients with hepatocellular carcinoma are diagnosed with large tumours at an advanced stage.In addition,conditions such as liver fibrosis,cirrhosis,portal hypertension,viral load,and portal vein thrombosis due to either non-neoplastic or portal vein tumour thrombus limit the indications for surgical management to a select subset of individuals(1).展开更多
Objective To summarize and analyze the morphology and distribution of embolus in patients suspected acute pulmonary embolism. Methods The CT pulmonary angiography(CTPA) imagings of 279 patients suspected acute pulmona...Objective To summarize and analyze the morphology and distribution of embolus in patients suspected acute pulmonary embolism. Methods The CT pulmonary angiography(CTPA) imagings of 279 patients suspected acute pulmonary embolism were analyzed retrospectively展开更多
Objective To investigate the expression of tissue factor and explore its clinical significances in pulmonary artery after acute pulmonary thromboembolism.Methods Thirty-four Japanese white rabbits(LevelⅡanimals)were ...Objective To investigate the expression of tissue factor and explore its clinical significances in pulmonary artery after acute pulmonary thromboembolism.Methods Thirty-four Japanese white rabbits(LevelⅡanimals)were randomly(random number)assigned into four groups:group A(specimen of pulmonary artery was taken 3 hours展开更多
目的比较经导管肝动脉栓塞术和腹腔镜手术对肝血管瘤患者肝功能的影响及安全性。方法回顾性分析2020年7月至2023年12月收治的85例肝血管瘤患者临床资料。按手术方案的不同分为两组,介入组40例,采用经导管肝动脉栓塞术(TAE);腹腔镜组45例...目的比较经导管肝动脉栓塞术和腹腔镜手术对肝血管瘤患者肝功能的影响及安全性。方法回顾性分析2020年7月至2023年12月收治的85例肝血管瘤患者临床资料。按手术方案的不同分为两组,介入组40例,采用经导管肝动脉栓塞术(TAE);腹腔镜组45例,采用腹腔镜瘤体剥除术。采集两组患者手术前后空腹静脉血,检测肝功能指标、凝血功能指标如凝血酶原时间(PT)、D-二聚体(D-D);观察比较两组患者手术操作时间、失血量、术后肛门排气时间、住院时间、治疗效果、并发症发生情况、术后12个月复发情况。结果介入组治疗总成功率为97.50%(39/40),与腹腔镜组的100.00%(45/45)比较,差异无统计学意义(P>0.05)。介入组的手术操作时间、失血量、肛门排气时间及住院时间均显著低于/短于腹腔镜组(P<0.05)。介入组术后2、6、12、24、48 h NRS评分低于腹腔镜组(P<0.05)。术后介入组AST、ALT显著低于腹腔镜手术组,ALB显著高于腹腔镜组(P均<0.05)。介入组术后并发症发生率为12.50%(5/40),显著低于腹腔镜组的33.33%(15/45)(P<0.05);两组远期(术后12个月)并发症总发生率及术后12个月复发率比较,差异均无统计学意义(P均>0.05)情况。结论经导管TAE术与腹腔镜手术均可有效治疗肝血管瘤,而介入术的安全性高于腹腔镜手术,且手术时间短、出血量少、术后恢复快,可作为不适宜腹腔镜手术患者及瘤体破裂风险较高患者的理想替代方法。展开更多
Group B Streptococcus(GBS;Streptococcus agalactiae)is a gram-positive coccus that colonizes the gastrointestinal and genital tracts in adults,as well as the upper respiratory tract in infants.While it has been thought...Group B Streptococcus(GBS;Streptococcus agalactiae)is a gram-positive coccus that colonizes the gastrointestinal and genital tracts in adults,as well as the upper respiratory tract in infants.While it has been thought that GBS only results in invasive disease in pregnant females and neonates,recent literature has suggested an increasing incidence of invasive GBS among non-pregnant individuals within the United States.展开更多
Pulmonary tumour thrombotic microangiopathy(PTTM)is a rare but under-recognised cause of rapidly progressive pulmonary hypertension(PH)and cor pulmonale,characterised by diffuse obstruction of small pulmonary arteries...Pulmonary tumour thrombotic microangiopathy(PTTM)is a rare but under-recognised cause of rapidly progressive pulmonary hypertension(PH)and cor pulmonale,characterised by diffuse obstruction of small pulmonary arteries by metastatic tumour cells.These tumour emboli lead to obstructive intimal proliferation and in situ thrombosis within the pulmonary vasculature,further compromising the overall permeability of the pulmonary vascular bed and exacerbating PH.[1]The clinical and imaging manifestations of PTTM often overlap with those of other causes of PH,including chronic thromboembolic PH,pulmonary veno-occlusive disease and pulmonary capillary haemangiomatosis,often leading to diagnostic delays.展开更多
文摘Diese vergleichende Untersuchung uber Embolisation differenter hepatischer GefaBe bei Hunden mit Bletilla striata und Gelfoam ergab,d aB letilla striala als Embolisationsmaterial bessere Erfolge zeigt als Gelfoam.Die Mechanismen der Embolisation mit Bletilla striata sind folgende :1)Bletilla striata wird nicht leicht von Geweben absorbiert;2)Bletilla striata bewirkt mechanische Blockierung;3)Bletilla striata beeinflt das Gerinnungssystem und dasAntikoagulationssystem;4)Bletilla siriata kann die Geafwandschadigen und dadurch sekundare Blockierung auslosen.
文摘BACKGROUND: The management of complex pattern of bleeding associated with pelvic trauma remains a big challenge for trauma surgeons. We aimed to conduct a comprehensive meta-analysis to compare the outcomes of angioembolisation and pelvic packing in patients with pelvic trauma.METHODS: We conducted a systematic search of electronic information sources, including MEDLINE; EMBASE; CINAHL; the CENTRAL; the World Health Organization International Clinical Trials Registry; Clinical Trials.gov; ISRCTN Register, and bibliographic reference lists. The primary outcome was defined as mortality. Combined overall effect sizes were calculated using randomeffects models. Results are reported as the odds ratio(OR) and 95% confidence interval(CI).RESULTS: We identified 3 observational studies reporting a total of 120 patients undergoing angioembolisation(n=60) or pelvic packing(n=60) for pelvic trauma. Reporting of the Injury Severity Score(ISS) was variable, with higher ISS in the pelvic packing group. The risk of bias was low in two studies, and moderate in one. The pooled analysis demonstrated that angioembolisation did not significantly reduce mortality in patients with pelvic trauma compared to surgery(OR=1.99; 95% CI= 0.83–4.78, P=0.12). There was mild between-study heterogeneity(I^2=0%, P=0.65).CONCLUSION: Our analysis found no significant difference in mortality between angioembolisation and pelvic packing in patients with traumatic pelvic haemorrhage. The current level of evidence in this context is very limited and insufficient to support the superiority of a treatment modality. Future research is required.
文摘Bone tumors include a variety of lesions, both primary and metastatic. The treatment modalities for bone tumors vary with the individual lesion, but in general surgical excision is the treatment of choice with other adjunctive therapies. However, surgery for many bone tumors is complex due to several factors including tumor bulk, vascularity, vicinity to vital structures and potentially inaccessible location of the lesion. Transarterial Embolisation (TAE) is one of the important adjuvant treatment modalities and in some cases it may be the primary and curative treatment. Preoperative TAE has proved to be effective in both primary and metastatic bone tumors. It reduces tumor vascularity and intraoperative blood loss, the need for blood transfusion and associated complications, allows better definition of tissue planes at surgery affording more complete excision, and hence reduced recurrence. Preoperative chemoEmbolisation has also been shown to increase the sensitivity of some tumors to subsequent chemotherapy and radiotherapy. There are several techniques and embolic agents available for this purpose, but the ultimate aim is to achieve tumor devascularization. In this review, we discuss the techniques including the choice of embolic agent, application to individual lesions and potential complications.
文摘Hematuria due to locally advanced or metastatic bladder cancer is a common condition and is often a management problem.Percutaneous embolisation is a mini-invasive option to handle this situation.We report a case of a patient with a metastatic bladder cancer and who presented with an abundant hematuria and severe anemia.After failure of endoscopic resections and“flush”of radiotherapy haemostatic and refusal of cystectomy by the patient,he was treated by superselective embolisation of bilateral superior bladder arteries with excellent immediate results.The technique is safe and effective in the short term.The longterm effectiveness requires further investigation.
文摘<b><span style="font-family:Verdana;">Introduction:</span></b><span style="font-family:Verdana;"></span><b> </b><span style="font-family:Verdana;">The risk of rupture of true renal artery aneurysms is low but when they are bigger than 2 -</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">2.5 cm it increases significantly, making treatment essential. The need to use alternatives to conventional</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">techniques in order to avoid predictable complications as coil migration is mandatory. <b></b></span><b><b><span style="font-family:Verdana;">Discussion:</span></b><span style="font-family:Verdana;"></span></b> <span style="font-family:Verdana;">Routinely-used techniques in interventional neuroradiology such as flow diverters or those</span></span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">assisted with an occlusion balloon or stent have are su</span><span style="font-family:Verdana;">itable alternatives for complex aneurysms. </span><span style="font-family:Verdana;"><b></b></span><b><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"></span></b></span><span style="font-family:Verdana;"> Interventional neuroradiology devices such as the Cascade Net stent (Perflow Medical and</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">Grupo Logsa) and Solitaire AB stent retriever (Medtronic) are valid and safe options</span><span style="font-family:Verdana;">. We describe the</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">technique of such devices.</span>
基金Guangxi Higher Education Undergraduate Teaching Reform Project,No.2021JGA142Guangxi Educational Science Planning Key Project,No.2022ZJY2791+1 种基金Guangxi Medical University Education and Teaching Reform Project,No.2021XJGA02Guangxi Zhuang Autonomous Region Health Commission Self-financed Scientific Research Project,No.Z20201147.
文摘BACKGROUND Transcatheter arterial embolisation(TACE)is the primary treatment for intermediate-stage hepatocellular carcinoma(HCC)patients while some HCC cases have shown resistance to TACE.AIM To investigate the key genes and potential mechanisms correlated with TACE refractoriness in HCC.METHODS The microarray datasets of TACE-treated HCC tissues,HCC and non-HCC tissues were collected by searching multiple public databases.The respective differentially expressed genes(DEGs)were attained via limma R package.Weighted gene co-expression network analysis was employed for identifying the significant modules related to TACE non-response.TACE refractoriness-related genes were obtained by intersecting up-regulated TACE-associated and HCC-associated DEGs together with the genes in significant modules related to TACE nonresponse.The key genes expression in the above two pairs of samples was compared respectively via Wilcoxon tests and standard mean differences model.The prognostic value of the key genes was evaluated by Kaplan-Meier curve.Multivariate analysis was utilised to investigate the independent prognostic factor in key genes.Single-cell RNA(scRNA)sequencing analysis was conducted to explore the cell types in HCC.TACE refractoriness-related genes activity was calculated via AUCell packages.The CellChat R package was used for the investigation of the cell–cell communication between the identified cell types.RESULTS HCC tissues of TACE non-responders(n=66)and TACE responders(n=81),HCC(n=3941)and non-HCC(n=3443)tissues were obtained.The five key genes,DLG associated protein 5(DLGAP5),Kinesin family member 20A(KIF20A),Assembly factor for spindle microtubules(ASPM),Kinesin family member 11(KIF11)and TPX2 microtubule nucleation factor(TPX2)in TACE refractoriness-related genes,were identified.The five key genes were all up-regulated in the TACE non-responders group and the HCC group.High expression of the five key genes predicted poor prognosis in HCC.Among the key genes,TPX2 was an independent prognostic factor.Four cell types,hepatocytes,embryonic stem cells,T cells and B cells,were identified in the HCC tissues.The TACE refractoriness-related genes expressed primarily in hepatocytes and embryonic stem cells.Hepatocytes,as the providers of ligands,had the strongest interaction with embryonic stem cells that provided receptors.CONCLUSION Five key genes(DLGAP5,KIF20A,ASPM,KIF11 and TPX2)were identified as promoting refractory TACE.Hepatocytes and embryonic stem cells were likely to boost TACE refractoriness.
文摘Congenital hepatic arterio-venous malformations (AVM) are rare vascular anomalies and have rarely been reported in the presence of congeni-tal heart disease. The reported cases are mostly hemangiomas fed either by the hepatic artery itself or by one of its branches. We present two unique hepatic AVM cases in the presence of congenital heart defects in which the AVM was not fed by the hepatic arterial system. Transcatheter coil embolisation was successfully carried out in both of them by using non-detachable Gianturco coils. Complete occlusion was achieved without any sequel.
文摘Eine neue Technik mit Ballonkatheter bei der GefaBembolisation von einem Aneurysma und einer arterioportalen Fistel wird betrichtet. Es handelte sich um zwei Falle, bet denen ein Kobrakatheter als Embolisationskatheter und ein Dilatationskatheter als temporarer Okklusionskatheter zur Embolisation angewendet wurden. Durch diese Masnahme konnten die Aneurysmata und die arterioportale Fistel ohne Spiralreflux verschlossen werden. Die Anwendung von einem Kobrakatheter zusammen mit einem Dilatationskatheter zur GefaBembolisation ist effektiv. Komplikationen stud relativ selten.
文摘Background: The introduction of pipeline embolisation device (PED) has improved the feasibility of endovascular treatment of intracranial aneurysms. The device allows for endoluminal reconstruction across the aneurysm neck but is permeable enough that flow is preserved across the pressure gradients into sidebranch arteries. In spite of higher rates of aneurysm occlusion, there is lack of data concerning medium to long-term clinical and imaging results. Methods: This study was a prospective single center analysis of complications, imaging results, and medium term clinical outcomes after PED treatment of intracranial aneurysms. We included cases over a 17-month period in a tertiary interventional neuroradiology center. We collected data on demographics, vascular risk factors, clinical presentation, angiographic results post treatment, angiographic follow-up and clinical follow-up. Results: Thirty-three patients were included, 25 females and 8 males, with mean age of 55 years;3 presented with acute subarachnoid hemorrhage and 30 for elective treatment. Thirty-seven aneurysms were treated: 35 Internal Carotid Artery (ICA), 1 basilar trunk fusiform, and 1 vertebral artery intradural dissecting aneurysms. No deaths have occurred. Five patients suffered transient neurological complications (15%). Overall aneurysm occlusion was demonstrated in 85% of patients at the end of one year. Discussion:?Overall, the technique of flow diversion and endoluminal reconstruction differs greatly from the established endosaccular packing techniques of standard coiling, balloon remodeling, or stent assisted coiling. Our midterm follow-up confirms that, the rates of clinically significant complications compare favorably with published data on stent assisted coiling, potentially making these devices a truly revolutionizing technique.
文摘Bleeding from renal angiomyolipoma in pregnancy can be catastrophic to both mother and fetus. Selective arterial embolisation is considered more superior than conventional surgery in these patients. Our case report exemplifies how a bleeding angiomyolipoma was halted with embolisation in our pregnant patient.
基金supported by the National Key Research and Development Program of China(Grant No.2021YFC2501101 and 2020YFC2004701 to XC)Natural Science Foundation of China(Grant no.82202244 to YC)Top Talent Support Program for Medical Experts Team of Wuxi Health Committee(Grant No.202109 to SW).
文摘Objective Single-stage surgery combining embolisation and microsurgery has been increasingly used as a stand-alone procedure to cure complex AVMs.This study aimed to investigate the learning curve and embolisation strategy for single-stage surgery for AVMs.Methods This prospective cohort study used data from the nationwide Multimodality Treatment for Brain Arteriovenous Malformations(MATCH)registry in China,conducted between August 2011 and December 2023.A total of 213 complex AVMs were divided into two groups.Group 1 included the first 25 patients.The 188 cases in group 2 included patients numbered 26-213.A case-crossover design was employed to evaluate the influence of complications,unfavourable outcomes and worsening modified Rankin Scale(mRS)score.Cumulative summation analysis was performed to assess the learning curve.Results The rate of major complications decreased from 52.00%in group 1 to 34.57%in group 2(p=0.089),while the rate of unfavourable outcomes decreased from 44.00%in group 1 to 18.62%in group 2(p=0.004).The distribution of the three preoperative embolisation strategies was as follows:curative:72.00%and 19.15%,palliative:24.00%and 67.55%,and targeted:4.00%and 13.30%,respectively(p<0.001).Multivariable regression analysis showed that surgeon experience was associated with a lower rate of unfavourable outcomes(p=0.022,OR=0.333).The mean follow-up duration was 49.90±20.54 months.The follow-up mRS score of 5-6 decreased from 9.09%in group 1 to 0.8%in group 2(p=0.035).Conclusions Performing single-stage combined surgery in 25 AVM cases is necessary to achieve reproducibility.Rates of major complications and unfavourable outcomes decreased significantly after the first 50 procedures.Palliative and targeted embolisation strategies are associated with a lower rate of unfavourable outcomes.
文摘Many patients with hepatocellular carcinoma are diagnosed with large tumours at an advanced stage.In addition,conditions such as liver fibrosis,cirrhosis,portal hypertension,viral load,and portal vein thrombosis due to either non-neoplastic or portal vein tumour thrombus limit the indications for surgical management to a select subset of individuals(1).
文摘Objective To summarize and analyze the morphology and distribution of embolus in patients suspected acute pulmonary embolism. Methods The CT pulmonary angiography(CTPA) imagings of 279 patients suspected acute pulmonary embolism were analyzed retrospectively
文摘Objective To investigate the expression of tissue factor and explore its clinical significances in pulmonary artery after acute pulmonary thromboembolism.Methods Thirty-four Japanese white rabbits(LevelⅡanimals)were randomly(random number)assigned into four groups:group A(specimen of pulmonary artery was taken 3 hours
文摘目的比较经导管肝动脉栓塞术和腹腔镜手术对肝血管瘤患者肝功能的影响及安全性。方法回顾性分析2020年7月至2023年12月收治的85例肝血管瘤患者临床资料。按手术方案的不同分为两组,介入组40例,采用经导管肝动脉栓塞术(TAE);腹腔镜组45例,采用腹腔镜瘤体剥除术。采集两组患者手术前后空腹静脉血,检测肝功能指标、凝血功能指标如凝血酶原时间(PT)、D-二聚体(D-D);观察比较两组患者手术操作时间、失血量、术后肛门排气时间、住院时间、治疗效果、并发症发生情况、术后12个月复发情况。结果介入组治疗总成功率为97.50%(39/40),与腹腔镜组的100.00%(45/45)比较,差异无统计学意义(P>0.05)。介入组的手术操作时间、失血量、肛门排气时间及住院时间均显著低于/短于腹腔镜组(P<0.05)。介入组术后2、6、12、24、48 h NRS评分低于腹腔镜组(P<0.05)。术后介入组AST、ALT显著低于腹腔镜手术组,ALB显著高于腹腔镜组(P均<0.05)。介入组术后并发症发生率为12.50%(5/40),显著低于腹腔镜组的33.33%(15/45)(P<0.05);两组远期(术后12个月)并发症总发生率及术后12个月复发率比较,差异均无统计学意义(P均>0.05)情况。结论经导管TAE术与腹腔镜手术均可有效治疗肝血管瘤,而介入术的安全性高于腹腔镜手术,且手术时间短、出血量少、术后恢复快,可作为不适宜腹腔镜手术患者及瘤体破裂风险较高患者的理想替代方法。
文摘Group B Streptococcus(GBS;Streptococcus agalactiae)is a gram-positive coccus that colonizes the gastrointestinal and genital tracts in adults,as well as the upper respiratory tract in infants.While it has been thought that GBS only results in invasive disease in pregnant females and neonates,recent literature has suggested an increasing incidence of invasive GBS among non-pregnant individuals within the United States.
文摘Pulmonary tumour thrombotic microangiopathy(PTTM)is a rare but under-recognised cause of rapidly progressive pulmonary hypertension(PH)and cor pulmonale,characterised by diffuse obstruction of small pulmonary arteries by metastatic tumour cells.These tumour emboli lead to obstructive intimal proliferation and in situ thrombosis within the pulmonary vasculature,further compromising the overall permeability of the pulmonary vascular bed and exacerbating PH.[1]The clinical and imaging manifestations of PTTM often overlap with those of other causes of PH,including chronic thromboembolic PH,pulmonary veno-occlusive disease and pulmonary capillary haemangiomatosis,often leading to diagnostic delays.
