BACKGROUND Hepatocellular carcinoma(HCC)is a common tumor with a poor prognosis.Early intervention is essential;thus,good prognostic markers to identify patients who benefit from first transarterial chemoembolization(...BACKGROUND Hepatocellular carcinoma(HCC)is a common tumor with a poor prognosis.Early intervention is essential;thus,good prognostic markers to identify patients who benefit from first transarterial chemoembolization(TACE)are needed.AIM To investigate the efficacy of computed tomography(CT)radiomics in predicting the success of the first TACE in patients with advanced HCC and to develop an early prediction model based on clinical radiomics features.METHODS Data from 122 patients with advanced HCC treated with TACE were analyzed.Intratumoral and peritumoral areas on arterial and venous CT images were selected to extract radiomic features,which were screened in the training cohort using the minimum redundancy maximum correlation.Then,support vector machines were used to construct the model.To construct a receiver operating characteristic curve,the predictive efficacy of each model was evaluated on the basis of the area under the curve(AUC).RESULTS Among the 122 patients,72 patients were effectively treated via TACE,and in 50 patients,this treatment was ineffective.In the radiomics model,the areas under the curve of the venous phase model were 0.867(95%CI:0.790-0.940)in the training cohort and 0.755(0.600-0.910)in the validation cohort,indicating good predictive efficacy.The multivariate logistic regression results indicated that preoperative alpha-fetoprotein levels(P=0.01)were a risk factor for TACE.The screened clinical features were combined with the radiomic features to construct a combined model.This combined model had an AUC of 0.92(0.87-0.95)in the training cohort and 0.815(0.67-0.95)in the validation cohort.CONCLUSION CT radiomics has good value in predicting the efficacy of the first TACE treatment in patients with HCC.The combined model was a better tool for predicting the first TACE efficacy in patients with advanced HCC and could provide an efficient predictive tool to help with the selection of patients for TACE.展开更多
BACKGROUND Post-operative infection is a common and serious complication following drugeluting trans arterial chemo embolization(D-TACE)in patients with hepatocellular carcinoma(HCC),potentially compromising treatment...BACKGROUND Post-operative infection is a common and serious complication following drugeluting trans arterial chemo embolization(D-TACE)in patients with hepatocellular carcinoma(HCC),potentially compromising treatment efficacy and increasing morbidity.AIM To investigate the risk factors associated with post-operative infection in HCC patients undergoing D-TACE,and to provide evidence for clinical prevention and targeted intervention strategies.METHODS Clinical data of 77 primary HCC patients who underwent D-TACE in our hospital from January 2022 to December 2023 were retrospectively analyzed.Patient demographics,laboratory test results,tumor characteristics,and surgery-related parameters were collected.Univariate and multivariate logistic regression analyses were performed to identify risk factors for post-operative infection.RESULTS Post-operative infection occurred in 20 cases(25.97%)among the 77 patients.Univariate analysis showed that age≥65 years,Child-Pugh grade B,tumor diameter≥5 cm,operation time≥120 minutes,preoperative albumin<35 g/L,and comorbid diabetes were significantly associated with post-operative infection(P<0.05).Multivariate logistic regression analysis identified Child-Pugh grade B(OR=2.851,95%CI:1.426-5.698),operation time≥120 minutes(OR=2.367,95%CI:1.238-4.523),and preoperative albumin<35 g/L(OR=2.156,95%CI:1.147-4.052)as independent risk factors for post-operative infection.CONCLUSION Liver function status,operation time,and preoperative albumin level are significant factors affecting post-operative infection in HCC patients undergoing D-TACE.For high-risk patients,enhanced perioperative management,appropriate timing of surgery,and active improvement of nutritional status should be implemented to reduce the risk of post-operative infection.展开更多
Subtle changes have occurred in China, and interventional radiology has gradually become an independent specialty, separated from diagnostic radiology. This has been called "Interventionalogy", "interve...Subtle changes have occurred in China, and interventional radiology has gradually become an independent specialty, separated from diagnostic radiology. This has been called "Interventionalogy", "interventional medicine(IM)", or simply Intervention by our team,and "Interventional Radiology" is used no more. It has even been given the name "Third clinical Medicine" by us. Chinese intervention has established an independent association for interventional doctors, as well as independent interventional societies in many provinces. The national interventional society will likely be set up at some point in time. Chinese interve ntion has set up their own clinical wards, with much attention paid to a clinical, professional, and normalized direction for development, and established special nursing units. According to us, turf battle is meaningless. "The Third clinical Medicine" belongs to all human beings. It could also be predicted that interventional history will follow the same evolutionary rule as other disciplines, i.e., "long divided, must unite; long united, must divide".展开更多
Inflammatory bowel disease(IBD)is believed to be caused by various factors,including abnormalities in disease susceptibility genes,environmental factors,immune factors,and intestinal bacteria.Proton pump inhibitors(PP...Inflammatory bowel disease(IBD)is believed to be caused by various factors,including abnormalities in disease susceptibility genes,environmental factors,immune factors,and intestinal bacteria.Proton pump inhibitors(PPIs)are the primary drugs used to treat acid-related diseases.They are also commonly prescribed to patients with IBD.Recent studies have suggested a potential association between the use of certain medications,such as PPIs,and the occurrence and progression of IBD.In this review,we summarize the potential impact of PPIs on IBD and analyze the underlying mechanisms.Our findings may provide insights for conducting further investigations into the effects of PPIs on IBD and serve as an important reminder for physicians to exercise caution when prescribing PPIs to patients with IBD.展开更多
OBJECTIVE: To study the effects on self-efficacy and quality of life in patients undergoing coronary intervention, by traditional Chinese medicine nursing combined with refined nursing. METHODS: A total of 124 patient...OBJECTIVE: To study the effects on self-efficacy and quality of life in patients undergoing coronary intervention, by traditional Chinese medicine nursing combined with refined nursing. METHODS: A total of 124 patients, who needed to undergo coronary intervention in our hospital, were randomly divided into the fine group and the combined group, with 62 patients in each group. The two groups of patients were enrolled in the PCI routine nursing procedure, in which the fine group was given refined nursing, and the joint group, based on that, added the traditional Chinese medicine nursing. The self-management (self-management scale of coronary heart disease), self-efficacy (self-efficacy scale of coronary heart disease), quality of life score (Seattle angina questionaire (SAQ), TCM symptom score] of the two groups were observed before and after treatment. The incidence of postoperative complications after nursing intervention was recorded. RESULTS: After nursing intervention, each score and total scores of the self-administration scale of the combined group were higher than those of the fine group (P < 0.05). After the nursing intervention, each score and the total scores of the self-efficacy scale of the combined group were higher than the fine group (P < 0.05) After the nursing intervention, the SAQ score of the combined group was significantly higher than that of the fine group (P < 0.05). After the nursing intervention, TCM symptom score of the combined group was significantly lower than that of the fine group (P < 0.05). After nursing intervention, the postoperative complication rate of the combined group was 79.03%, which was lower than that of the fine group (59.68%)(P < 0.05). CONCLUSION: Patients with coronary intervention, who use traditional Chinese medicine combined with refined nursing, can improve their quality of life, clinical symptoms and postoperative complications by improving their self-management and efficacy, which is conducive to the recovery of patients' follow-up.展开更多
BACKGROUND Indentifying predictive factors for postoperative recurrence of hepatocellular carcinoma(HCC)has great significance for patient prognosis.AIM To explore the value of gadolinium ethoxybenzyl diethylenetriami...BACKGROUND Indentifying predictive factors for postoperative recurrence of hepatocellular carcinoma(HCC)has great significance for patient prognosis.AIM To explore the value of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid(Gd-EOB-DTPA)enhanced magnetic resonance imaging(MRI)combined with clinical features in predicting early recurrence of HCC after resection.METHODS A total of 161 patients with pathologically confirmed HCC were enrolled.The patients were divided into early recurrence and non-early recurrence group based on the follow-up results.The clinical,laboratory,pathological results and Gd-EOB-DTPA enhanced MRI imaging features were analyzed.RESULTS Of 161 patients,73 had early recurrence and 88 were had non-early recurrence.Univariate analysis showed that patient age,gender,serum alpha-fetoprotein level,the Barcelona Clinic Liver Cancer stage,China liver cancer(CNLC)stage,microvascular invasion(MVI),pathological satellite focus,tumor size,tumor number,tumor boundary,tumor capsule,intratumoral necrosis,portal vein tumor thrombus,large vessel invasion,nonperipheral washout,peritumoral enhancement,hepatobiliary phase(HBP)/tumor signal intensity(SI)/peritumoral SI,HBP peritumoral low signal and peritumoral delay enhancement were significantly associated with early recurrence of HCC after operation.Multivariate logistic regression analysis showed that patient age,MVI,CNLC stage,tumor boundary and large vessel invasion were independent predictive factors.External data validation indicated that the area under the curve of the combined predictors was 0.861,suggesting that multivariate logistic regression was a reasonable predictive model for early recurrence of HCC.CONCLUSION Gd-EOB-DTPA enhanced MRI combined with clinical features would help predicting the early recurrence of HCC after operation.展开更多
BACKGROUND Uridine diphosphate glucuronosyltransferase 1A1(UGT1A1)plays a crucial role in metabolizing and detoxifying endogenous and exogenous substances.However,its contribution to the progression of liver damage re...BACKGROUND Uridine diphosphate glucuronosyltransferase 1A1(UGT1A1)plays a crucial role in metabolizing and detoxifying endogenous and exogenous substances.However,its contribution to the progression of liver damage remains unclear.AIM To determine the role and mechanism of UGT1A1 in liver damage progression.METHODS We investigated the relationship between UGT1A1 expression and liver injury through clinical research.Additionally,the impact and mechanism of UGT1A1 on the progression of liver injury was analyzed through a mouse model study.RESULTS Patients with UGT1A1 gene mutations showed varying degrees of liver damage,while patients with acute-onchronic liver failure(ACLF)exhibited relatively reduced levels of UGT1A1 protein in the liver as compared to patients with chronic hepatitis.This suggests that low UGT1A1 levels may be associated with the progression of liver damage.In mouse models of liver injury induced by carbon tetrachloride(CCl_(4))and concanavalin A(ConA),the hepatic levels of UGT1A1 protein were found to be increased.In mice with lipopolysaccharide or liver steatosis-mediated liver-injury progression,the hepatic protein levels of UGT1A1 were decreased,which is consistent with the observations in patients with ACLF.UGT1A1 knockout exacerbated CCl_(4)-and ConA-induced liver injury,hepatocyte apoptosis and necroptosis in mice,intensified hepatocyte endoplasmic reticulum(ER)stress and oxidative stress,and disrupted lipid metabolism.CONCLUSION UGT1A1 is upregulated as a compensatory response during liver injury,and interference with this upregulation process may worsen liver injury.UGT1A1 reduces ER stress,oxidative stress,and lipid metabolism disorder,thereby mitigating hepatocyte apoptosis and necroptosis.展开更多
Objective:To explore the influence on liver function of hepatic artery interventional chemoembolization combined reduced glutathione therapy for elderly patients with advanced liver cancer.Methods:A total of 120 cases...Objective:To explore the influence on liver function of hepatic artery interventional chemoembolization combined reduced glutathione therapy for elderly patients with advanced liver cancer.Methods:A total of 120 cases of elderly patients with advanced liver cancer from digestive surgery in-patient department of our hospital during the period of January 2014 and January 2016 were selected as the research object, the patients were divided into two groups by using the random number table method,each for 60 cases.The control group were given conventional drugs chemotherapy, the study group were given hepatic artery interventional chemoembolization combined reduced glutathione therapy, serum liver function indexes of Direct Bilirubin(DBil), Total Bilirubin(TBil), Aspartate Transaminase(AST) and Alanineamino Transferase (ALT)were detected by using automatic biochemical analyzer. Results: The clinical remission rate of study group was significantly higher than the control group, the recurrence rate was obviously lower than the control group,compared between the two groups with statistically significant differences. The average survival time of study group (29.36±6.25) months, was significantly longer than the control group (18.02±4.16) months .Before the treatment, serum DBil, TBil, AST and ALT levels compared between the two groups with no statistically significant differences,after the treatment,the indexes of study group was significantly lower than the control group. The indexes levels compared between pre-therapy and post-therapy in study group with no statistically significant differences, while the indexes levels of post-therapy in the control group were significantly higher than those pre-therapy. Before the treatment, the life quality score compared between the two groups with no statistically significant differences, after treatment,the score of all patients were significantly higher than those pre-therapywhich the score of study group was significantly higher than the control group.The incidence rate of drug adverse reactions compared between the two groups with no statistically significant differences.Conclusion: The clinical efficacy of hepatic artery interventional chemoembolization combined reduced glutathione therapy for elderly patients with advanced liver cancer is satisfying, and helps to significantly improve liver function, improve life quality, it is worth popularization and application in the clinical practice.展开更多
Objective:To investigate the effect of arterial interventional chemotherapy before radical operation for gastric cancer on serum tumor markers and cell growth in the lesion.Methods:90 patients with primary gastric can...Objective:To investigate the effect of arterial interventional chemotherapy before radical operation for gastric cancer on serum tumor markers and cell growth in the lesion.Methods:90 patients with primary gastric cancer who underwent radical operation for gastric cancer in our hospital were chosen as the research subjects and divided into the control group (n=48) (did not receive preoperative arterial interventional chemotherapy) and the arterial interventional chemotherapy group (n=42) (received preoperative arterial interventional chemotherapy). The differences in tumor markers in serum as well as proliferation and apoptosis gene expression in gastric cancer tissues were compared.Results: Before surgery started, serum CA199, CA153, CA724 and AFP levels of arterial interventional chemotherapy group were significantly lower than those immediately after admission whereas serum CA199, CA153, CA724 and AFP levels of control group were not significantly different from those immediately after admission. After surgery, proliferation genes CUL4A and NTSR1 mRNA expression in gastric cancer tissues of arterial interventional chemotherapy group were lower than those of control group whereas DADS and FAM96B mRNA expression were higher than those of control group;apoptosis genes Livin and Bcl-2 mRNA expression were lower than those of control group whereas p53, p21 and Bax mRNA expression were higher than those of control group.Conclusion:Preoperative arterial interventional chemotherapy combined with radical operation for gastric cancer can more effectively inhibit the malignant degree of tumor and delay the growth of cancer cells.展开更多
BACKGROUND Intracranial arterial narrowing is a significant factor leading to brief episodes of reduced blood flow to the brain,known as transient ischemic attacks,or fullblown strokes.While atherosclerosis is commonl...BACKGROUND Intracranial arterial narrowing is a significant factor leading to brief episodes of reduced blood flow to the brain,known as transient ischemic attacks,or fullblown strokes.While atherosclerosis is commonly associated with intracranial arterial narrowing,it is frequently of a non-atherosclerotic nature in younger patients.CASE SUMMARY Here,we present the case of a young stroke patient with narrowing of the middle cerebral artery(MCA),characterized as non-atherosclerotic lesions,who experienced an ischemic stroke despite receiving standard drug therapy.The patient underwent digital subtraction angiography(DSA)to assess the entire network of blood vessels in the brain,revealing significant narrowing(approximately 80%)in the M1 segment of the right MCA.Subsequently,the patient underwent Drug-Coated Balloon Angioplasty to treat the stenosis in the right MCA's M1 segment.Follow-up DSA confirmed the resolution of stenosis in this segment.Although the remaining branches showed satisfactory blood flow,the vessel wall exhibited irregularities.A review of DSA conducted six months later showed no evident stenosis in the right MCA,with a smooth vessel wall.CONCLUSION The use of drug-coated balloon angioplasty demonstrated favorable outcomes in repairing and reshaping the blood vessel wall in young patients.Therefore,it may be considered a promising treatment option for similar cases.展开更多
BACKGROUND Predicting the pathological response of esophageal cancer(EC)to neoadjuvant therapy(NAT)is of significant clinical importance.AIM To evaluate the pathological response of NAT in EC patients using multiple m...BACKGROUND Predicting the pathological response of esophageal cancer(EC)to neoadjuvant therapy(NAT)is of significant clinical importance.AIM To evaluate the pathological response of NAT in EC patients using multiple machine learning algorithms based on magnetic resonance imaging(MRI)radiomics.METHODS This retrospective study included 132 patients with pathologically confirmed EC,were randomly divided into a training cohort(n=92)and a validation cohort(n=40)in a 7:3 ratio.All patients underwent a preoperative MRI scan from the neck to the abdomen.High-throughput and quantitative radiomics features were extracted from T2-weighted imaging(T2WI).Radiomics signatures were selected using minimal redundancy maximal relevance and the least absolute shrinkage and selection operator.Nine classification algorithms were used to build the models,and the diagnostic performance of each model was evaluated using the area under the curve(AUC),sensitivity(SEN),and specificity(SPE).RESULTS A total of 1834 features were extracted.Following feature dimension reduction,ten radiomics features were selected to construct radiomics signatures.Among the nine classification algorithms,the ExtraTrees algorithm demonstrated the best diagnostic performance in both the training(AUC:0.932;SEN:0.906;SPE:0.817)and validation cohorts(AUC:0.900;SEN:0.667;SPE:0.700).The Delong test proved no significance in the diagnostic efficiency within these models(P>0.05).CONCLUSION T2WI radiomics may aid in determining the pathological response to NAT in EC patients,serving as a noninvasive and quantitative tool to assist personalized treatment planning.展开更多
Biliary tract cancer(BTC)is a rare group of malignancies that develop from the epithelial lining of the biliary tree and have a poor prognosis.Although chemotherapy is the standard of care for patients with advanced B...Biliary tract cancer(BTC)is a rare group of malignancies that develop from the epithelial lining of the biliary tree and have a poor prognosis.Although chemotherapy is the standard of care for patients with advanced BTC in China,its clinical benefits are moderate.In recent years,the approval of targeted therapies and immunotherapies has provided new avenues for the management of advanced BTC.Nonetheless,the increasing number of personalized medicine approaches has created a challenge for clinicians choosing individualized treatment strategies based on tumor characteristics.In this article,we discuss recent progress in implementing precision medicine approaches for advanced BTC in China and examine genomic profiling studies in Chinese patients with advanced BTC.We also discuss the challenges and opportunities of using precision medicine approaches,as well as the importance of considering population-specific factors and tailoring treatment approaches to improve outcomes for patients with BTC.In addition to providing a comprehensive overview of current and emerging precision medicine approaches for the management of advanced BTC in China,this review article will support clinicians outside of China by serving as a reference regarding the role of patient-and population-specific factors in clinical decision-making for patients with this rare malignancy.展开更多
BACKGROUND Bletilla striata polysaccharides(BSP)have antioxidant,immune regulation,and anti-fibrotic activities.However,the therapeutic effect and mechanisms underlying the action of BSP in metabolic dysfunction-assoc...BACKGROUND Bletilla striata polysaccharides(BSP)have antioxidant,immune regulation,and anti-fibrotic activities.However,the therapeutic effect and mechanisms underlying the action of BSP in metabolic dysfunction-associated steatotic liver disease(MASLD)have not been fully understood.AIMTo investigate the therapeutic effects and mechanisms of BSP on MASLD by centering on the hepatocyte nuclearfactor kappa B p65(RelA)/hepatocyte nuclear factor-1 alpha(HNF1α)signaling.METHODSA mouse model of MASLD was induced by feeding with a high-fat-diet(HFD)and a hepatocyte model of steatosiswas induced by treatment with sodium oleate(SO)and sodium palmitate(SP).The therapeutic effects of BSP onMASLD were examined in vivo and in vitro.The mechanisms underlying the action of BSP were analyzed for theireffect on lipid metabolism disorder,endoplasmic reticulum(ER)stress,and the RelA/HNF1αsignaling.RESULTSHFD feeding reduced hepatocyte RelA and HNF1αexpression,induced ER stress,lipid metabolism disorder,andnecroptosis in mice,which were significantly mitigated by treatment with BSP.Furthermore,treatment with BSP orBSP-containing conditional rat serum significantly attenuated the sodium oleate/sodium palmitate(SO/SP)-induced hepatocyte steatosis by decreasing lipid accumulation,and lipid peroxidation,and enhancing theexpression of RelA,and HNF1α.The therapeutic effects of BSP on MASLD were partially abrogated by RELAsilencing in mice and RELA knockout in hepatocytes.RELA silencing or knockout significantly down-regulatedHNF1αexpression,and remodeled ER stress and oxidative stress responses during hepatic steatosis.CONCLUSIONTreatment with BSP ameliorates MASLD,associated with enhancing the RelA/HNF1αsignaling,remodeling ERstress and oxidative stress responses in hepatocytes.展开更多
AIM To evaluate the effectiveness and safety of combined ursodeoxycholic acid and percutaneous transhepatic balloon dilation for management of gallstones after expulsion of common bile duct(CBD) stones.METHODS From Ap...AIM To evaluate the effectiveness and safety of combined ursodeoxycholic acid and percutaneous transhepatic balloon dilation for management of gallstones after expulsion of common bile duct(CBD) stones.METHODS From April 2014 to May 2016, 15 consecutive patients(6 men and 9 women) aged 45-86(mean, 69.07 ± 9.91) years suffering from CBD stones associated with gallstones were evaluated. Good gallbladder contraction function was confirmed by type B ultrasonography. Dilation of the CBD and cystic duct was detected. Percutaneous transhepatic balloon dilation of the papilla was performed, ursodeoxycholic acid was administered, and all patients had a high-fat diet. All subjects underwent repeated cholangiography, and percutaneous transhepatic removal was carried out in patients with secondary CBD stones originating from the gallbladder. RESULTS All patients underwent percutaneous transhepatic balloon dilation with a primary success rate of 100%. The combined therapy was successful in 86.7% of patients with concomitant CBD stones and gallstones. No remaining stones were detected in the gallbladder. Transient adverse events include abdominal pain(n = 1), abdominal distension(n = 1), and fever(n = 1). Complications were treated successfully via nonsurgical management without long-term complications. No procedure-related mortality occurred. CONCLUSION For patients with concomitant CBD stones and gallstones, after percutaneous transhepatic removal of primary CBD stones, oral ursodeoxycholic acid and a high-fat diet followed by percutaneous transhepatic removal of secondary CBD stones appear to be a feasible and effective option for management of gallstones.展开更多
AIM To assess the feasibility and effectiveness of a novel application of percutaneous intraductal radiofrequency (RF) for the treatment of biliary stent obstruction. METHODS We specifically report a retrospective stu...AIM To assess the feasibility and effectiveness of a novel application of percutaneous intraductal radiofrequency (RF) for the treatment of biliary stent obstruction. METHODS We specifically report a retrospective study presenting the results of percutaneous intraductal RF in patients with biliary stent occlusion. A total of 43 cases involving biliary stent obstruction were treated by placing an EndoHPB catheter and percutaneous intraductal RF was performed to clean stents. The stent patency was evaluated by cholangiography and follow-up by contrast enhanced computed tomography or ultrasound after the removal of the drainage catheter. RESULTS Following the procedures, of the 43 patients, 40 survived and 3 died with a median survival of 80.5 (range: 30-243) d. One patient was lost to followup. One patient had the stent patent at the time of last follow-up. Two patients with stent blockage at 35 d and 44 d after procedure underwent percutaneous transhepatic drain insertion only. The levels of bilirubin before and after the procedure were 128 +/- 65 mu mol/L and 63 +/- 29 mu mol/L, respectively. There were no related complications (haemorrhage, bile duct perforation, bile leak or pancreatitis) and all patients' stent patency was confirmed by cholangiography after the procedure, with a median patency time of 107 (range: 12-180) d. CONCLUSION This preliminary clinical study demonstrated that percutaneous intraductal RF is safe and effective for the treatment of biliary stent obstruction, increasing the duration of stent patency, although randomized controlled trials are needed to confirm the effectiveness of this approach.展开更多
Objective:To investigate the clinical utility of ultrasound-guided balloon occlusion in cesarean section in patients with sinister placenta previa.Methods:The Interventional and Ultrasound Departments of the authors’...Objective:To investigate the clinical utility of ultrasound-guided balloon occlusion in cesarean section in patients with sinister placenta previa.Methods:The Interventional and Ultrasound Departments of the authors’center assisted obstetrics to complete cesarean section in cases of sinister placenta previa.A total of 130 patients with implanted sinister placenta previa were diagnosed using obstetrical ultrasound and magnetic resonance imaging(MRI).Before cesarean section,the balloon was positioned in the bilateral radial or abdominal aorta.Immediately after delivery of the fetus,the balloon was temporarily filled to transiently seal the target vessel.According to the obstetrician’s assessment of hemostasis,the balloon was withdrawn at the appropriate time.Among the 130 patients,there was one case of abdominal aortic occlusion,with 129 cases blocked by the bilateral common iliac artery.Results:All 130 cases were successfully blocked,with an average blocking time of<15 min,while intraoperative blood loss was 800–1500 ml.Conclusion:Ultrasound-guided balloon blocking treatment before cesarean section can mitigate the dangers of placenta previa and significantly reduce blood loss with no exposure to X-ray radiation.Thus,the technique merits serious consideration.展开更多
Background context:Metastatic spinal cord compression(MSCC)seriously affects the survival rate.Objective:The therapeutic effects of two treatment strategies for MSCC:percutaneous vertebroplasty(PVP)combined with radio...Background context:Metastatic spinal cord compression(MSCC)seriously affects the survival rate.Objective:The therapeutic effects of two treatment strategies for MSCC:percutaneous vertebroplasty(PVP)combined with radiofrequency ablation(RFA)and PVP combined with^(125)I particle implantation,were compared.Study design:Retrospective study.Patient sample:40 patients with MSCC were divided into two groups:19 cases in the RFA group and 21 cases in the^(125)I group.Method:All patients were accessed to determine the differences in pain,which was evaluated using the visual analog scale(VAS)at 1 week,1 month,and 3 months after the operation,and spinal stenosis rates(SSRs),which were measured at 1 and 3 months after the operation,between the two groups.Results:The VAS scores and SSRs at baseline were comparable between the RFA group and the^(125)I group(7.19±2.07 vs 7.42±1.95,37.7%±11.2%vs 41.1%±11.4%).The VAS scores and SSRs at 1 month and 3 months after the operation were significantly reduced in both groups,compared with those at baseline.The VAS scores and SSRs in the^(125)I group were lower than those in the RFA group at 3 months after the operation(1.09±0.97 vs 1.75±1.06 p=0.048 and 12.3%±6.4%vs 18.1%±10.1%p=0.034),while the VAS scores at1 week after the operation in the RFA group were lower than those in the^(125)I group(4.39±1.34 vs 5.05±1.82 p=0.049).Conclusion:PVP combined with RFA has a slight advantage in relieving pain in the short term,while PVP combined with^(125)I particle implantation may have a better effect in the relieving pain and decreasing the SSRs at 3 months after the operation.展开更多
BACKGROUND Implanted intravenous infusion port(IVAP)is indicated for patients undergoing chemotherapy,total parenteral nutrition and long-term antibiotic treatment.Among their complications,the rupture and migration o...BACKGROUND Implanted intravenous infusion port(IVAP)is indicated for patients undergoing chemotherapy,total parenteral nutrition and long-term antibiotic treatment.Among their complications,the rupture and migration of the catheter of an IVAP via internal jugular vein represents a very rare but potentially severe condition.CASE SUMMARY A 43-year-old woman was identified with a spontaneous fracture and migration of catheter of an IVAP via right internal jugular vein after adjuvant chemotherapy for left breast cancer.A computed tomography showed the fractured catheter of the IVAP in the pulmonary artery.Therefore,we conducted an emergency procedure to remove the catheter fragment by a pigtail catheter combined with a gooseneck trap.CONCLUSION When the fractured catheter of an IVAP was detected,the special shape of the pigtail catheter in combination with the gooseneck trap successfully facilitated the removal of the dislodged catheter.展开更多
Objective： Hepatocellular carcinoma （HCC） is a complex disease which associates with both environmental and genetic factors. The purpose of this study was to investigate whether the genetic polymorphisms of UDP-glu...Objective： Hepatocellular carcinoma （HCC） is a complex disease which associates with both environmental and genetic factors. The purpose of this study was to investigate whether the genetic polymorphisms of UDP-glucuronosyltransferase（UGT1A7）, an important phase II biotransformation enzyme, and X-ray repair cross-complementing group 1（XRCC1）, a pivotal DNA-repair gene, were related to the risk of HCC in Northeast China. Methods： One hundred and thirty six HCC patients and one hundred and thirty six frequency-matched controls were included in this hospital-based case-control study. Genotypes of UGT1A7 and XRCC1 were determined using allele-specific polymerase chain reaction （AS-PCR） and PCR-restriction fragment length polymorphism （RFLP）, and for which the odds ratio （OR） with 95% confidence interval （95% CI） were calculated. Results： The proportion of UGT1A7 low enzymatic allele （＊2 or ＊3） was higher in HCC patients than those in controls. The UGT1A7＊1/＊2 and ＊3/＊3 genotypes were associated with higher HCC risk （OR=2.09, 95%CI： 1.10-3.97; OR=5.67, 95%CI： 1.76-18.30, respectively）. The XRCC1 codon 399 Arg/Gln genotype could also elevate HCC risk （OR=2.16, 95% CI 1.29-3.61）. In addition to polymorphisms of UGT1A7 and XRCC1, multivariate logistic regression analysis demonstrated that other significant independent factors associated with HCC were HBV infection （OR=68.07, 95%CI： 28.03-165.26）, HCV infection （OR=30.97, 95%CI： 8.06-118.94） and family history of HCC （OR=10.62, 95%CI： 2.22-50.77）. Conclusion： The study shows that the polymorphisms of UGT1A7 and XRCC1 are associated with HCC risk. Determination of the polymorphisms of UGT1A7 and XRCC1 may provide an important clue to preventive measure against HCC.展开更多
Background:A ruptured hepatocellular carcinoma(HCC)is often fatal.In addition to surgery and transarterial embo?lization,radiofrequency ablation(RFA)might be another option for treating a ruptured HCC.Unfortunately,co...Background:A ruptured hepatocellular carcinoma(HCC)is often fatal.In addition to surgery and transarterial embo?lization,radiofrequency ablation(RFA)might be another option for treating a ruptured HCC.Unfortunately,conven?tional RFA has a limited ablation zone;as such,it is rarely used to treat ruptured tumors.Case presentation:This case was a 60?year?old man who had a large,ruptured HCC in which hydrochloric acid(HCl)?enhanced RFA successfully controlled the bleeding and made the tumor completely necrotic.Conclusion:Considering the effectiveness of HCl?enhanced RFA in achieving hemostasis and tumor ablation,it might be a new option for treating large,ruptured HCCs.展开更多
文摘BACKGROUND Hepatocellular carcinoma(HCC)is a common tumor with a poor prognosis.Early intervention is essential;thus,good prognostic markers to identify patients who benefit from first transarterial chemoembolization(TACE)are needed.AIM To investigate the efficacy of computed tomography(CT)radiomics in predicting the success of the first TACE in patients with advanced HCC and to develop an early prediction model based on clinical radiomics features.METHODS Data from 122 patients with advanced HCC treated with TACE were analyzed.Intratumoral and peritumoral areas on arterial and venous CT images were selected to extract radiomic features,which were screened in the training cohort using the minimum redundancy maximum correlation.Then,support vector machines were used to construct the model.To construct a receiver operating characteristic curve,the predictive efficacy of each model was evaluated on the basis of the area under the curve(AUC).RESULTS Among the 122 patients,72 patients were effectively treated via TACE,and in 50 patients,this treatment was ineffective.In the radiomics model,the areas under the curve of the venous phase model were 0.867(95%CI:0.790-0.940)in the training cohort and 0.755(0.600-0.910)in the validation cohort,indicating good predictive efficacy.The multivariate logistic regression results indicated that preoperative alpha-fetoprotein levels(P=0.01)were a risk factor for TACE.The screened clinical features were combined with the radiomic features to construct a combined model.This combined model had an AUC of 0.92(0.87-0.95)in the training cohort and 0.815(0.67-0.95)in the validation cohort.CONCLUSION CT radiomics has good value in predicting the efficacy of the first TACE treatment in patients with HCC.The combined model was a better tool for predicting the first TACE efficacy in patients with advanced HCC and could provide an efficient predictive tool to help with the selection of patients for TACE.
文摘BACKGROUND Post-operative infection is a common and serious complication following drugeluting trans arterial chemo embolization(D-TACE)in patients with hepatocellular carcinoma(HCC),potentially compromising treatment efficacy and increasing morbidity.AIM To investigate the risk factors associated with post-operative infection in HCC patients undergoing D-TACE,and to provide evidence for clinical prevention and targeted intervention strategies.METHODS Clinical data of 77 primary HCC patients who underwent D-TACE in our hospital from January 2022 to December 2023 were retrospectively analyzed.Patient demographics,laboratory test results,tumor characteristics,and surgery-related parameters were collected.Univariate and multivariate logistic regression analyses were performed to identify risk factors for post-operative infection.RESULTS Post-operative infection occurred in 20 cases(25.97%)among the 77 patients.Univariate analysis showed that age≥65 years,Child-Pugh grade B,tumor diameter≥5 cm,operation time≥120 minutes,preoperative albumin<35 g/L,and comorbid diabetes were significantly associated with post-operative infection(P<0.05).Multivariate logistic regression analysis identified Child-Pugh grade B(OR=2.851,95%CI:1.426-5.698),operation time≥120 minutes(OR=2.367,95%CI:1.238-4.523),and preoperative albumin<35 g/L(OR=2.156,95%CI:1.147-4.052)as independent risk factors for post-operative infection.CONCLUSION Liver function status,operation time,and preoperative albumin level are significant factors affecting post-operative infection in HCC patients undergoing D-TACE.For high-risk patients,enhanced perioperative management,appropriate timing of surgery,and active improvement of nutritional status should be implemented to reduce the risk of post-operative infection.
文摘Subtle changes have occurred in China, and interventional radiology has gradually become an independent specialty, separated from diagnostic radiology. This has been called "Interventionalogy", "interventional medicine(IM)", or simply Intervention by our team,and "Interventional Radiology" is used no more. It has even been given the name "Third clinical Medicine" by us. Chinese intervention has established an independent association for interventional doctors, as well as independent interventional societies in many provinces. The national interventional society will likely be set up at some point in time. Chinese interve ntion has set up their own clinical wards, with much attention paid to a clinical, professional, and normalized direction for development, and established special nursing units. According to us, turf battle is meaningless. "The Third clinical Medicine" belongs to all human beings. It could also be predicted that interventional history will follow the same evolutionary rule as other disciplines, i.e., "long divided, must unite; long united, must divide".
文摘Inflammatory bowel disease(IBD)is believed to be caused by various factors,including abnormalities in disease susceptibility genes,environmental factors,immune factors,and intestinal bacteria.Proton pump inhibitors(PPIs)are the primary drugs used to treat acid-related diseases.They are also commonly prescribed to patients with IBD.Recent studies have suggested a potential association between the use of certain medications,such as PPIs,and the occurrence and progression of IBD.In this review,we summarize the potential impact of PPIs on IBD and analyze the underlying mechanisms.Our findings may provide insights for conducting further investigations into the effects of PPIs on IBD and serve as an important reminder for physicians to exercise caution when prescribing PPIs to patients with IBD.
文摘OBJECTIVE: To study the effects on self-efficacy and quality of life in patients undergoing coronary intervention, by traditional Chinese medicine nursing combined with refined nursing. METHODS: A total of 124 patients, who needed to undergo coronary intervention in our hospital, were randomly divided into the fine group and the combined group, with 62 patients in each group. The two groups of patients were enrolled in the PCI routine nursing procedure, in which the fine group was given refined nursing, and the joint group, based on that, added the traditional Chinese medicine nursing. The self-management (self-management scale of coronary heart disease), self-efficacy (self-efficacy scale of coronary heart disease), quality of life score (Seattle angina questionaire (SAQ), TCM symptom score] of the two groups were observed before and after treatment. The incidence of postoperative complications after nursing intervention was recorded. RESULTS: After nursing intervention, each score and total scores of the self-administration scale of the combined group were higher than those of the fine group (P < 0.05). After the nursing intervention, each score and the total scores of the self-efficacy scale of the combined group were higher than the fine group (P < 0.05) After the nursing intervention, the SAQ score of the combined group was significantly higher than that of the fine group (P < 0.05). After the nursing intervention, TCM symptom score of the combined group was significantly lower than that of the fine group (P < 0.05). After nursing intervention, the postoperative complication rate of the combined group was 79.03%, which was lower than that of the fine group (59.68%)(P < 0.05). CONCLUSION: Patients with coronary intervention, who use traditional Chinese medicine combined with refined nursing, can improve their quality of life, clinical symptoms and postoperative complications by improving their self-management and efficacy, which is conducive to the recovery of patients' follow-up.
基金This study was reviewed and approved by the Meizhou People’s Hospital Institutional Review Board(Approval No.2022-C-36).
文摘BACKGROUND Indentifying predictive factors for postoperative recurrence of hepatocellular carcinoma(HCC)has great significance for patient prognosis.AIM To explore the value of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid(Gd-EOB-DTPA)enhanced magnetic resonance imaging(MRI)combined with clinical features in predicting early recurrence of HCC after resection.METHODS A total of 161 patients with pathologically confirmed HCC were enrolled.The patients were divided into early recurrence and non-early recurrence group based on the follow-up results.The clinical,laboratory,pathological results and Gd-EOB-DTPA enhanced MRI imaging features were analyzed.RESULTS Of 161 patients,73 had early recurrence and 88 were had non-early recurrence.Univariate analysis showed that patient age,gender,serum alpha-fetoprotein level,the Barcelona Clinic Liver Cancer stage,China liver cancer(CNLC)stage,microvascular invasion(MVI),pathological satellite focus,tumor size,tumor number,tumor boundary,tumor capsule,intratumoral necrosis,portal vein tumor thrombus,large vessel invasion,nonperipheral washout,peritumoral enhancement,hepatobiliary phase(HBP)/tumor signal intensity(SI)/peritumoral SI,HBP peritumoral low signal and peritumoral delay enhancement were significantly associated with early recurrence of HCC after operation.Multivariate logistic regression analysis showed that patient age,MVI,CNLC stage,tumor boundary and large vessel invasion were independent predictive factors.External data validation indicated that the area under the curve of the combined predictors was 0.861,suggesting that multivariate logistic regression was a reasonable predictive model for early recurrence of HCC.CONCLUSION Gd-EOB-DTPA enhanced MRI combined with clinical features would help predicting the early recurrence of HCC after operation.
基金the Science and Technology Research Foundations of Guizhou Province,No.QKHJC-ZK(2022)YB642Zunyi Science and Technology Plan Project,No.ZSKHHZ(2022)344,No.ZSKHHZ(2022)360,and No.ZYK160+2 种基金Hubei Province Central Leading Local Science and Technology Development Special Project,No.2022BCE030Changzhou Science and Technology Projects,No.CE20225054Bijie City Science and Planning Bureau,No.BKH(2022)8.
文摘BACKGROUND Uridine diphosphate glucuronosyltransferase 1A1(UGT1A1)plays a crucial role in metabolizing and detoxifying endogenous and exogenous substances.However,its contribution to the progression of liver damage remains unclear.AIM To determine the role and mechanism of UGT1A1 in liver damage progression.METHODS We investigated the relationship between UGT1A1 expression and liver injury through clinical research.Additionally,the impact and mechanism of UGT1A1 on the progression of liver injury was analyzed through a mouse model study.RESULTS Patients with UGT1A1 gene mutations showed varying degrees of liver damage,while patients with acute-onchronic liver failure(ACLF)exhibited relatively reduced levels of UGT1A1 protein in the liver as compared to patients with chronic hepatitis.This suggests that low UGT1A1 levels may be associated with the progression of liver damage.In mouse models of liver injury induced by carbon tetrachloride(CCl_(4))and concanavalin A(ConA),the hepatic levels of UGT1A1 protein were found to be increased.In mice with lipopolysaccharide or liver steatosis-mediated liver-injury progression,the hepatic protein levels of UGT1A1 were decreased,which is consistent with the observations in patients with ACLF.UGT1A1 knockout exacerbated CCl_(4)-and ConA-induced liver injury,hepatocyte apoptosis and necroptosis in mice,intensified hepatocyte endoplasmic reticulum(ER)stress and oxidative stress,and disrupted lipid metabolism.CONCLUSION UGT1A1 is upregulated as a compensatory response during liver injury,and interference with this upregulation process may worsen liver injury.UGT1A1 reduces ER stress,oxidative stress,and lipid metabolism disorder,thereby mitigating hepatocyte apoptosis and necroptosis.
文摘Objective:To explore the influence on liver function of hepatic artery interventional chemoembolization combined reduced glutathione therapy for elderly patients with advanced liver cancer.Methods:A total of 120 cases of elderly patients with advanced liver cancer from digestive surgery in-patient department of our hospital during the period of January 2014 and January 2016 were selected as the research object, the patients were divided into two groups by using the random number table method,each for 60 cases.The control group were given conventional drugs chemotherapy, the study group were given hepatic artery interventional chemoembolization combined reduced glutathione therapy, serum liver function indexes of Direct Bilirubin(DBil), Total Bilirubin(TBil), Aspartate Transaminase(AST) and Alanineamino Transferase (ALT)were detected by using automatic biochemical analyzer. Results: The clinical remission rate of study group was significantly higher than the control group, the recurrence rate was obviously lower than the control group,compared between the two groups with statistically significant differences. The average survival time of study group (29.36±6.25) months, was significantly longer than the control group (18.02±4.16) months .Before the treatment, serum DBil, TBil, AST and ALT levels compared between the two groups with no statistically significant differences,after the treatment,the indexes of study group was significantly lower than the control group. The indexes levels compared between pre-therapy and post-therapy in study group with no statistically significant differences, while the indexes levels of post-therapy in the control group were significantly higher than those pre-therapy. Before the treatment, the life quality score compared between the two groups with no statistically significant differences, after treatment,the score of all patients were significantly higher than those pre-therapywhich the score of study group was significantly higher than the control group.The incidence rate of drug adverse reactions compared between the two groups with no statistically significant differences.Conclusion: The clinical efficacy of hepatic artery interventional chemoembolization combined reduced glutathione therapy for elderly patients with advanced liver cancer is satisfying, and helps to significantly improve liver function, improve life quality, it is worth popularization and application in the clinical practice.
文摘Objective:To investigate the effect of arterial interventional chemotherapy before radical operation for gastric cancer on serum tumor markers and cell growth in the lesion.Methods:90 patients with primary gastric cancer who underwent radical operation for gastric cancer in our hospital were chosen as the research subjects and divided into the control group (n=48) (did not receive preoperative arterial interventional chemotherapy) and the arterial interventional chemotherapy group (n=42) (received preoperative arterial interventional chemotherapy). The differences in tumor markers in serum as well as proliferation and apoptosis gene expression in gastric cancer tissues were compared.Results: Before surgery started, serum CA199, CA153, CA724 and AFP levels of arterial interventional chemotherapy group were significantly lower than those immediately after admission whereas serum CA199, CA153, CA724 and AFP levels of control group were not significantly different from those immediately after admission. After surgery, proliferation genes CUL4A and NTSR1 mRNA expression in gastric cancer tissues of arterial interventional chemotherapy group were lower than those of control group whereas DADS and FAM96B mRNA expression were higher than those of control group;apoptosis genes Livin and Bcl-2 mRNA expression were lower than those of control group whereas p53, p21 and Bax mRNA expression were higher than those of control group.Conclusion:Preoperative arterial interventional chemotherapy combined with radical operation for gastric cancer can more effectively inhibit the malignant degree of tumor and delay the growth of cancer cells.
文摘BACKGROUND Intracranial arterial narrowing is a significant factor leading to brief episodes of reduced blood flow to the brain,known as transient ischemic attacks,or fullblown strokes.While atherosclerosis is commonly associated with intracranial arterial narrowing,it is frequently of a non-atherosclerotic nature in younger patients.CASE SUMMARY Here,we present the case of a young stroke patient with narrowing of the middle cerebral artery(MCA),characterized as non-atherosclerotic lesions,who experienced an ischemic stroke despite receiving standard drug therapy.The patient underwent digital subtraction angiography(DSA)to assess the entire network of blood vessels in the brain,revealing significant narrowing(approximately 80%)in the M1 segment of the right MCA.Subsequently,the patient underwent Drug-Coated Balloon Angioplasty to treat the stenosis in the right MCA's M1 segment.Follow-up DSA confirmed the resolution of stenosis in this segment.Although the remaining branches showed satisfactory blood flow,the vessel wall exhibited irregularities.A review of DSA conducted six months later showed no evident stenosis in the right MCA,with a smooth vessel wall.CONCLUSION The use of drug-coated balloon angioplasty demonstrated favorable outcomes in repairing and reshaping the blood vessel wall in young patients.Therefore,it may be considered a promising treatment option for similar cases.
基金Supported by Guangdong Medical Research Foundation,No.B2023272.
文摘BACKGROUND Predicting the pathological response of esophageal cancer(EC)to neoadjuvant therapy(NAT)is of significant clinical importance.AIM To evaluate the pathological response of NAT in EC patients using multiple machine learning algorithms based on magnetic resonance imaging(MRI)radiomics.METHODS This retrospective study included 132 patients with pathologically confirmed EC,were randomly divided into a training cohort(n=92)and a validation cohort(n=40)in a 7:3 ratio.All patients underwent a preoperative MRI scan from the neck to the abdomen.High-throughput and quantitative radiomics features were extracted from T2-weighted imaging(T2WI).Radiomics signatures were selected using minimal redundancy maximal relevance and the least absolute shrinkage and selection operator.Nine classification algorithms were used to build the models,and the diagnostic performance of each model was evaluated using the area under the curve(AUC),sensitivity(SEN),and specificity(SPE).RESULTS A total of 1834 features were extracted.Following feature dimension reduction,ten radiomics features were selected to construct radiomics signatures.Among the nine classification algorithms,the ExtraTrees algorithm demonstrated the best diagnostic performance in both the training(AUC:0.932;SEN:0.906;SPE:0.817)and validation cohorts(AUC:0.900;SEN:0.667;SPE:0.700).The Delong test proved no significance in the diagnostic efficiency within these models(P>0.05).CONCLUSION T2WI radiomics may aid in determining the pathological response to NAT in EC patients,serving as a noninvasive and quantitative tool to assist personalized treatment planning.
基金funded by MSD China.Editorial support for this manuscript was provided by Dr.Jake Burrell(Rude Health Consulting Limited)Dr.Christos Evangelou(on behalf of Rude Health Consulting Limited)and this support was funded by MSD China.
文摘Biliary tract cancer(BTC)is a rare group of malignancies that develop from the epithelial lining of the biliary tree and have a poor prognosis.Although chemotherapy is the standard of care for patients with advanced BTC in China,its clinical benefits are moderate.In recent years,the approval of targeted therapies and immunotherapies has provided new avenues for the management of advanced BTC.Nonetheless,the increasing number of personalized medicine approaches has created a challenge for clinicians choosing individualized treatment strategies based on tumor characteristics.In this article,we discuss recent progress in implementing precision medicine approaches for advanced BTC in China and examine genomic profiling studies in Chinese patients with advanced BTC.We also discuss the challenges and opportunities of using precision medicine approaches,as well as the importance of considering population-specific factors and tailoring treatment approaches to improve outcomes for patients with BTC.In addition to providing a comprehensive overview of current and emerging precision medicine approaches for the management of advanced BTC in China,this review article will support clinicians outside of China by serving as a reference regarding the role of patient-and population-specific factors in clinical decision-making for patients with this rare malignancy.
基金National Natural Science Foundation of China,No.32260089Science and Technology Research Foundation of Guizhou Province,No.QKHJC-ZK(2022)YB642+3 种基金Science and Technology Research Foundation of Hubei Province,No.2022BCE030Science and Technology Research Foundation of Changzhou City,No.CE20225040Science and Technology Research Foundation of Zunyi City,No.ZSKHHZ(2022)344 and No.ZSKHHZ(2022)360WBE Liver Fibrosis Foundation,No.CFHPC2025028.
文摘BACKGROUND Bletilla striata polysaccharides(BSP)have antioxidant,immune regulation,and anti-fibrotic activities.However,the therapeutic effect and mechanisms underlying the action of BSP in metabolic dysfunction-associated steatotic liver disease(MASLD)have not been fully understood.AIMTo investigate the therapeutic effects and mechanisms of BSP on MASLD by centering on the hepatocyte nuclearfactor kappa B p65(RelA)/hepatocyte nuclear factor-1 alpha(HNF1α)signaling.METHODSA mouse model of MASLD was induced by feeding with a high-fat-diet(HFD)and a hepatocyte model of steatosiswas induced by treatment with sodium oleate(SO)and sodium palmitate(SP).The therapeutic effects of BSP onMASLD were examined in vivo and in vitro.The mechanisms underlying the action of BSP were analyzed for theireffect on lipid metabolism disorder,endoplasmic reticulum(ER)stress,and the RelA/HNF1αsignaling.RESULTSHFD feeding reduced hepatocyte RelA and HNF1αexpression,induced ER stress,lipid metabolism disorder,andnecroptosis in mice,which were significantly mitigated by treatment with BSP.Furthermore,treatment with BSP orBSP-containing conditional rat serum significantly attenuated the sodium oleate/sodium palmitate(SO/SP)-induced hepatocyte steatosis by decreasing lipid accumulation,and lipid peroxidation,and enhancing theexpression of RelA,and HNF1α.The therapeutic effects of BSP on MASLD were partially abrogated by RELAsilencing in mice and RELA knockout in hepatocytes.RELA silencing or knockout significantly down-regulatedHNF1αexpression,and remodeled ER stress and oxidative stress responses during hepatic steatosis.CONCLUSIONTreatment with BSP ameliorates MASLD,associated with enhancing the RelA/HNF1αsignaling,remodeling ERstress and oxidative stress responses in hepatocytes.
基金Supported by the Natural Science Foundation of Shandong Province,No.ZR2014HM050the Youth Foundation of the Second Hospital of Shandong University,No.Y2014010047+1 种基金the Nature Science Foundation of Shandong Province,No.ZR2018PH032 and No.ZR2018PH033the National Natural Science Foundation of China,No.61671276
文摘AIM To evaluate the effectiveness and safety of combined ursodeoxycholic acid and percutaneous transhepatic balloon dilation for management of gallstones after expulsion of common bile duct(CBD) stones.METHODS From April 2014 to May 2016, 15 consecutive patients(6 men and 9 women) aged 45-86(mean, 69.07 ± 9.91) years suffering from CBD stones associated with gallstones were evaluated. Good gallbladder contraction function was confirmed by type B ultrasonography. Dilation of the CBD and cystic duct was detected. Percutaneous transhepatic balloon dilation of the papilla was performed, ursodeoxycholic acid was administered, and all patients had a high-fat diet. All subjects underwent repeated cholangiography, and percutaneous transhepatic removal was carried out in patients with secondary CBD stones originating from the gallbladder. RESULTS All patients underwent percutaneous transhepatic balloon dilation with a primary success rate of 100%. The combined therapy was successful in 86.7% of patients with concomitant CBD stones and gallstones. No remaining stones were detected in the gallbladder. Transient adverse events include abdominal pain(n = 1), abdominal distension(n = 1), and fever(n = 1). Complications were treated successfully via nonsurgical management without long-term complications. No procedure-related mortality occurred. CONCLUSION For patients with concomitant CBD stones and gallstones, after percutaneous transhepatic removal of primary CBD stones, oral ursodeoxycholic acid and a high-fat diet followed by percutaneous transhepatic removal of secondary CBD stones appear to be a feasible and effective option for management of gallstones.
基金Supported by the Youth Foundation of the Shanghai Public Health Bureau,No.20134Y195the Project of Medical Key Specialty of Shanghai Municipality,No.ZK2015A22
文摘AIM To assess the feasibility and effectiveness of a novel application of percutaneous intraductal radiofrequency (RF) for the treatment of biliary stent obstruction. METHODS We specifically report a retrospective study presenting the results of percutaneous intraductal RF in patients with biliary stent occlusion. A total of 43 cases involving biliary stent obstruction were treated by placing an EndoHPB catheter and percutaneous intraductal RF was performed to clean stents. The stent patency was evaluated by cholangiography and follow-up by contrast enhanced computed tomography or ultrasound after the removal of the drainage catheter. RESULTS Following the procedures, of the 43 patients, 40 survived and 3 died with a median survival of 80.5 (range: 30-243) d. One patient was lost to followup. One patient had the stent patent at the time of last follow-up. Two patients with stent blockage at 35 d and 44 d after procedure underwent percutaneous transhepatic drain insertion only. The levels of bilirubin before and after the procedure were 128 +/- 65 mu mol/L and 63 +/- 29 mu mol/L, respectively. There were no related complications (haemorrhage, bile duct perforation, bile leak or pancreatitis) and all patients' stent patency was confirmed by cholangiography after the procedure, with a median patency time of 107 (range: 12-180) d. CONCLUSION This preliminary clinical study demonstrated that percutaneous intraductal RF is safe and effective for the treatment of biliary stent obstruction, increasing the duration of stent patency, although randomized controlled trials are needed to confirm the effectiveness of this approach.
文摘Objective:To investigate the clinical utility of ultrasound-guided balloon occlusion in cesarean section in patients with sinister placenta previa.Methods:The Interventional and Ultrasound Departments of the authors’center assisted obstetrics to complete cesarean section in cases of sinister placenta previa.A total of 130 patients with implanted sinister placenta previa were diagnosed using obstetrical ultrasound and magnetic resonance imaging(MRI).Before cesarean section,the balloon was positioned in the bilateral radial or abdominal aorta.Immediately after delivery of the fetus,the balloon was temporarily filled to transiently seal the target vessel.According to the obstetrician’s assessment of hemostasis,the balloon was withdrawn at the appropriate time.Among the 130 patients,there was one case of abdominal aortic occlusion,with 129 cases blocked by the bilateral common iliac artery.Results:All 130 cases were successfully blocked,with an average blocking time of<15 min,while intraoperative blood loss was 800–1500 ml.Conclusion:Ultrasound-guided balloon blocking treatment before cesarean section can mitigate the dangers of placenta previa and significantly reduce blood loss with no exposure to X-ray radiation.Thus,the technique merits serious consideration.
文摘Background context:Metastatic spinal cord compression(MSCC)seriously affects the survival rate.Objective:The therapeutic effects of two treatment strategies for MSCC:percutaneous vertebroplasty(PVP)combined with radiofrequency ablation(RFA)and PVP combined with^(125)I particle implantation,were compared.Study design:Retrospective study.Patient sample:40 patients with MSCC were divided into two groups:19 cases in the RFA group and 21 cases in the^(125)I group.Method:All patients were accessed to determine the differences in pain,which was evaluated using the visual analog scale(VAS)at 1 week,1 month,and 3 months after the operation,and spinal stenosis rates(SSRs),which were measured at 1 and 3 months after the operation,between the two groups.Results:The VAS scores and SSRs at baseline were comparable between the RFA group and the^(125)I group(7.19±2.07 vs 7.42±1.95,37.7%±11.2%vs 41.1%±11.4%).The VAS scores and SSRs at 1 month and 3 months after the operation were significantly reduced in both groups,compared with those at baseline.The VAS scores and SSRs in the^(125)I group were lower than those in the RFA group at 3 months after the operation(1.09±0.97 vs 1.75±1.06 p=0.048 and 12.3%±6.4%vs 18.1%±10.1%p=0.034),while the VAS scores at1 week after the operation in the RFA group were lower than those in the^(125)I group(4.39±1.34 vs 5.05±1.82 p=0.049).Conclusion:PVP combined with RFA has a slight advantage in relieving pain in the short term,while PVP combined with^(125)I particle implantation may have a better effect in the relieving pain and decreasing the SSRs at 3 months after the operation.
文摘BACKGROUND Implanted intravenous infusion port(IVAP)is indicated for patients undergoing chemotherapy,total parenteral nutrition and long-term antibiotic treatment.Among their complications,the rupture and migration of the catheter of an IVAP via internal jugular vein represents a very rare but potentially severe condition.CASE SUMMARY A 43-year-old woman was identified with a spontaneous fracture and migration of catheter of an IVAP via right internal jugular vein after adjuvant chemotherapy for left breast cancer.A computed tomography showed the fractured catheter of the IVAP in the pulmonary artery.Therefore,we conducted an emergency procedure to remove the catheter fragment by a pigtail catheter combined with a gooseneck trap.CONCLUSION When the fractured catheter of an IVAP was detected,the special shape of the pigtail catheter in combination with the gooseneck trap successfully facilitated the removal of the dislodged catheter.
基金supported by the grant from Department of Education of Liaoning Province, China (No. 2008S232)
文摘Objective： Hepatocellular carcinoma （HCC） is a complex disease which associates with both environmental and genetic factors. The purpose of this study was to investigate whether the genetic polymorphisms of UDP-glucuronosyltransferase（UGT1A7）, an important phase II biotransformation enzyme, and X-ray repair cross-complementing group 1（XRCC1）, a pivotal DNA-repair gene, were related to the risk of HCC in Northeast China. Methods： One hundred and thirty six HCC patients and one hundred and thirty six frequency-matched controls were included in this hospital-based case-control study. Genotypes of UGT1A7 and XRCC1 were determined using allele-specific polymerase chain reaction （AS-PCR） and PCR-restriction fragment length polymorphism （RFLP）, and for which the odds ratio （OR） with 95% confidence interval （95% CI） were calculated. Results： The proportion of UGT1A7 low enzymatic allele （＊2 or ＊3） was higher in HCC patients than those in controls. The UGT1A7＊1/＊2 and ＊3/＊3 genotypes were associated with higher HCC risk （OR=2.09, 95%CI： 1.10-3.97; OR=5.67, 95%CI： 1.76-18.30, respectively）. The XRCC1 codon 399 Arg/Gln genotype could also elevate HCC risk （OR=2.16, 95% CI 1.29-3.61）. In addition to polymorphisms of UGT1A7 and XRCC1, multivariate logistic regression analysis demonstrated that other significant independent factors associated with HCC were HBV infection （OR=68.07, 95%CI： 28.03-165.26）, HCV infection （OR=30.97, 95%CI： 8.06-118.94） and family history of HCC （OR=10.62, 95%CI： 2.22-50.77）. Conclusion： The study shows that the polymorphisms of UGT1A7 and XRCC1 are associated with HCC risk. Determination of the polymorphisms of UGT1A7 and XRCC1 may provide an important clue to preventive measure against HCC.
基金supported by grants from the National Natural Science Foundation of China (No. 81371652)the Science and Technology Planning Project of Guangdong Province (No. 2012B031800120)
文摘Background:A ruptured hepatocellular carcinoma(HCC)is often fatal.In addition to surgery and transarterial embo?lization,radiofrequency ablation(RFA)might be another option for treating a ruptured HCC.Unfortunately,conven?tional RFA has a limited ablation zone;as such,it is rarely used to treat ruptured tumors.Case presentation:This case was a 60?year?old man who had a large,ruptured HCC in which hydrochloric acid(HCl)?enhanced RFA successfully controlled the bleeding and made the tumor completely necrotic.Conclusion:Considering the effectiveness of HCl?enhanced RFA in achieving hemostasis and tumor ablation,it might be a new option for treating large,ruptured HCCs.
