The aim of the present study was to evaluate the clinical value of 125I particles implantation in the treatment of recurrent bladder cancer. The study is a retrospective analysis of 32 patients with recurrent bladder cancer treated between May 2010 and January 2010. Of these, 16 cases (chemotherapy group) received conventional chemotherapy. A total of 16 patients (125I group) received radiotherapy with 125I particles, followed by conventional chemotherapy. By guidance of B ultrasound, 125I radioactive particles were implanted. All 32 patients were relieved after treatment, and the tumors were significantly reduced after 2 months. However, the tumors in the 125I group were significantly smaller than those in the chemotherapy group (P<0.05). The patients were followed-up for 1 year and no recurrence was found. Additionally, no complications occurred. Compared with the chemotherapy group, the tumor volume of the 125I group was significantly reduced (P<0.05). The disease-free survival and 5-year survival rates of the patients in the follow-up showed that the disease-free survival and 5-year survival rates of the patients in 125I group were significantly improved compared to those in the chemotherapy group. Therefore, the results have shown that 125I radioactive particles in the treatment of bladder cancer improve the symptoms of patients with bladder cancer in the short term, and continuously kill residual tumor and prevent recurrence.

OBJECTIVES:To describe and assess the localization of small peripheral pulmonary nodules prior to video-assisted thoracoscopic surgical (VATS) resection using the implantation of microcoils.METHODS:Ninety-two patients with 101 pulmonary nodules underwent computed tomography (CT)-guided implantation of microcoils proximal to each nodule. Patients were randomly assigned to undergo entire microcoil or leaving-microcoil-end implantations. The complications and efficacy of the two implantation methods were evaluated. VATS resection of lung tissue containing each pulmonary lesion and microcoil were performed in the direction of the microcoil marker. Histopathological analysis was performed for the resected pulmonary lesions.RESULTS:CT-guided microcoil implantation was successful in 99/101 cases, and the placement of microcoils within 1 cm of the nodules was not disruptive. There was no difference in the complications and efficacy associated with the entire implantation method (performed for 51/99 nodules) versus the leaving-microcoil-end implantation method (performed for 48/99 nodules). All nodules were successfully removed using VATS resection. Asymptomatic pneumothorax occurred in 16 patients and mild pulmonary haemorrhage occurred in nine patients. However, none of these patients required further surgical treatment.CONCLUSIONS:Preoperative localization of small pulmonary nodules using a refined percutaneous microcoil implantation method was found to be safe and useful prior to VATS resection.KEY POINTS:• An increasing number of small, indeterminate pulmonary lesions need to be characterized. • Entire microcoil and leaving-microcoil-end implantation methods were described for nodule localization. • Adjacent microcoil localization prior to video-assisted thoracoscopic surgical resection involved minimal intervention. • Preoperative microcoil localization facilitates the definitive resection of small pulmonary nodules.

目的 评价膝下经皮腔内血管成形术(PTA)治疗重症肢体缺血(CLI)的临床疗效.方法 回顾性分析48例(50条患肢)接受膝下PTA治疗的下肢CLI患者,统计PTA的技术成功率、围术期并发症、PTA术后的缺血症状缓解情况、治疗血管的通畅情况和大截肢情况.结果 共针对64条膝下动脉施行PTA,技术成功率为85.94％(55/64);围术期并发症发生率为12.50％(6/48).平均随访(16.25士2.65)个月;PTA术后1、3、6、12、24、36个月的1期血管通畅率分别为92.0％、85.7％、79.0％、75.8％、59.8％、29.9％;保肢率分别为92.0％、92.0％、89.7％、86.4％、82.1％、72.9％.50条患肢中,1、3、6个月时的缺血症状缓解率分别为42.00％(21/50)、70.21％(33/47)和86.36％(38/44).结论 膝下PTA治疗CLI技术可行,安全性高,能有效缓解CLI的静息痛症状、促进肢体溃疡的愈合,避免大截肢的发生.

Objective To evaluate and compare the value of uterine artery embolization (UAE) and UAE with methotrexate (MTX) chemotherapy in the treatment of ectopic pregnancy. Methods The clinical data of 34 patients with cervical pregnancy and cesarean scar pregnancy were retrospectively reviewed. The technique, clinical outcomes and complications of UAE and UAE along with the administration of MTX were evaluated. Results The fertility of all the patients were successfully preserved, and normal menses resumed within 1.0 to 4.5 months after UAE. The time to resolution of the serum β-hCG was not significantly different between the two groups (P>0.05). The duration of hospitalization was significantly longer in UAE+MTX group than in UAE group. Conclusions UAE with curettage is a saft and effective treatment for cervical and cesarean scar pregnancy. Key words: Pregnancy, ectopic; Uterine artery; Chemoembolization, therapeutic; Curettage

Objective To compare the short-time effect of 3 different regimens of neoadjuvant chemotherapy(NACT) in patients with FIGO stage Ⅰb2—Ⅱb cervical squamous carcinoma.Methods A total of 50 patients with FIGO stage Ⅰb2—Ⅱb cervical squamous carcinoma were divided into 3 groups: systemic chemotherapy group(n=13),trans-arterial chemotherapy group(TAC,n=19),trans-arterial chemoembolization group(TACE,n=18).After 1—3 periods of NACT,all patients received surgical operation.Tumor response and reduction ratio after NACT,side effects,hemorrhage volume in surgery and bad prognostic factors(including intraluminal tumor thrombi,pelvic lymph node metastasis,parametrial involvement,positive surgical margin,ovary metastasis) of operation sample were statistically analyzed.Results Tumor response,reduction ratio and hemorrhage volume in surgery were significantly better in TAC group and TACE group than those in systemic chemotherapy group(P0.05),but no significant difference was found between TAC group and TACE group(P0.05).The incidence rate of intraluminal tumor thrombi and lymph node metastasis was lower in TACE group than in systemic chemotherapy group and TAC group,but there was no statistical difference.No difference of parametrial involvement,positive surgical margin,ovary metastasis and side effects was found among 3 groups.Conclusion For stage Ⅰb2—Ⅱb cervical squamous carcinoma,preoperative TAC and TACE have more advantages than systemic chemotherapy.In comparison with TAC,TACE is expected to reduce the incidence rate of bad prognostic factors such as intraluminal tumor thrombi and pelvic lymph node metastasis.

目的 评价多层螺旋CT在诊断急性肠缺血、判断缺血程度及缺血病因中的价值.方法 回顾性分析32例确诊为急性缺血性肠病患者的CT资料.采用多层螺旋CT扫描,32例均行平扫,22例行双期增强扫描,所得图像均进行三维重建.结果 26例肠壁增厚,其中可逆性缺血19例,不可逆缺血7例.4例肠壁变薄者全部见于不可逆缺血.17例肠壁密度减低,15例肠壁密度增高.增强后,可逆性缺血中有9例肠壁强化增加,不可逆性缺血中7例肠壁强化减弱或不强化,4例非阻塞性肠缺血表现为部分强化.11例肠壁积气和9例肠管扩张均见于不可逆性肠缺血.28例有缆绳征.29例患者找到肠缺血之病因.结论 CT能准确诊断急性肠缺血,特别是在判断缺血程度和缺血病因上具有重要价值.

Objective To determine the technical feasibility and clinical efficacy of self-expandable metallic stents for palliation of obstructive jaundice caused by unresectable malignancies. Methods A total of 105 patients with unresectable malignant tumors involving the bile duct who presented with obstructive jaundice underwent transhepatic implantation of self-expandable metallic stents. The follow-up period of the patients was 3-755 days. Technical and clinical success,adverse events,patient survival,and duration of stent patency were analyzed. Results Percutaneous biliary stenting was performed on 105 malignant biliary obstructive patients with 129 self-expandable metallic stents. Technical successful rate was 94.3%,and clinical success rate was 78%. Thirty-day mortality after stenting was 7.6%,not procedure-related. Median survival time and stent patency of all patients were 189 days and 246 days. Primary patency rates were 92.1% and 64.5% at 3 and 6 months,respectively. Conclusion Self-expandable metal wall stenting for malignant obstructive jaundice provides good palliation with low,procedure-related morbidity and mortality in the long term. Further investigation to identify the subgroup of patients in whom stenting has no beneficial effect would be required.

患者女,50岁,因咳嗽、咳痰10个月入院.咳嗽呈阵发性,每日3～4次,伴咳大量白色黏痰及胸憋感,抗生素治疗效果不佳.病程中时有口干及食欲减退,无眼干、乏力、低热、盗汗及体重减轻等症状.

Renal vein thrombosis is one of the most common and severe complications of nephrotic syndrome(NS),which has a distinct tendency of hypercoagulable state.This review provides a brief overview of the pathophysiology of the hypercoagulable state associated with nephrotic syndrome and the directions on antithrombotic therapy.