Abstract Rationale: Takotsubo syndrome (TTS) is characterized by transient and reversible left ventricular systolic dysfunction, which are often associated with acute physical or emotional stressors. Cancer is one of the comorbidities in TTS, and TTS is even considered as a paraneoplastic syndrome, but its mechanism remains unclear. We report a patient in whom cancer and untreated mental disorders triggered TTS. Patient concerns: A 59-year-old man was transferred to the Department of Cardiology because of acute onset of severe chest pain and dyspnea before cystoscopy. He presented with hematuria, had been diagnosed with a high-grade urothelial bladder cancer, and underwent transurethral resection of bladder tumors 4 months previously. He had severe anxiety regarding recurrence and death from cancer, especially after the hematuria recurred. Diagnosis: TTS and severe anxiety. Interventions: The results of coronary angiography, a left ventriculogram, echocardiography, and the clinical outcome led to the diagnosis of TTS. The patient was treated with extracorporeal membrane oxygenation support, mechanical ventilation, and drugs for heart failure and anxiety. Outcomes: Echocardiography showed normal wall motion on day 6 of symptom onset. Six months after symptom onset, the anxiety score was reduced from 12 to 11, and the patient had no episodes of any discomfort, and no evidence of cancer recurrence was observed. Lessons: Patients with cancer and TTS have a higher level of stress, and physicians need to pay more attention to early screening and early treatment of mental disorders in these patients. Prompt and effective multidisciplinary treatment, including psychological counseling and antianxiety drugs, can improve the prognosis in such cases.

Objective: To evaluate the tumor burden reducing efficacy and safety of transcatheter arterial embolization (TAE) combined with octreotide LAR on neuroendocrine tumor liver metastasis (NETLM). Methods: Twenty-nine NETLM patients treated in the First Affiliated Hospital of Sun Yat-sen University from October 2014 to August 2018 were retrospectively recruited, including 12 males and 17 females. The mean age was 25-69(50±11) years. All patients were histologically proved as well-differentiated NET liver metastasis. Seventeen patients underwent combined treatment of TAE plus octreotide LAR (combined group) and 12 patients treated with only octreotide LAR (control group). Response of hepatic lesions were assessed according to RECIST 1.1. Objective response rates (ORR) of two groups were compared and analyzed. Safety and tolerance to TAE were also evaluated. Results: There were 13 PR and 4 SD in combined group, but only 1 PR and 9 PD in the control group. The ORR between the two groups were significantly different (13/17 vs 1/12, P<0.01).The main complication post TAE was post embolization syndrome, including abdominal pain (12/17), vomiting (6/17), fever (4/17), elevated transaminase (8/17) and bilirubinemia (3/17). Tumor lysis syndrome was observed in one patient. Conclusion: Compared to administration of octreotide LAR, TAE combined with octreotide LAR can effectively reduce tumor burden in patients with NETLM. TAE is safe and well-tolerated.

Objective: To evaluate the efficacy and safety of transarterial chemoembolization (TACE) combined with cryoablation in patients with unresectable large hepatocellular carcinoma (HCC). Methods: A total of 122 patients with unresectable large HCC admitted to the First Affiliated Hospital of Sun Yat-sen University between November 2011 and July 2015 were retrospectively involved.The patients were divided into study group (58 patients who underwent TACE combined with cryoablation) and control group (64 patients who underwent TACE alone). Short-term effect of the initial treatment, long-term effect, prognostic factors for survival and adverse reactions were statistically analyzed. Result: There was no statistical difference in general information between two groups. The effective rates of the study and control group were 29.3% and 10.9% (P=0.011), and the control rates were 79.3% and 62.5% (P=0.042). The median survival time was 11.0 months (95% CI 7.4-14.6) for the study group and 5.0 months (95% CI 4.0-6.0) for the control group, the 6-, 12-, and 18-month overall survival rates for the study and control group were 84.5%, 49.5%, 26.8% and 48.1%, 17.8%, 11.1%, respectively (all P<0.01). On multivariate analysis, negative distant metastasis, Barcelona Clinic Liver Cancer B-stage, neutrophil-to-lymphocyte ratio ≤5, alpha fetoprotein<400 μg/L, combined treatment and effective initial treatment were independent protective factors for survival of patients with large HCC. Conclusions: The prognosis of patients with unresectable large HCC is affected by multiple factors. In comparison with TACE alone, TACE combined with cryoablation has advantage in both short-term and long-term effect with low incidence of serious adverse reactions, it is an effective and safe treatment option for patients with unresectable large HCC.

OBJECTIVE:To evaluate the expression and possible modulation of heme oxygenase-1 (HO-1) in nasal polyps of patients with chronic rhinosinusitis with nasal polyps (CRSwNP).METHODS:Nasal polyps and uncinate process tissues were collected from 25 CRSwNP patients and 19 healthy controls with nasal septal deviation. HO-1 expression was examined using qRT-PCR, immunohistochemistric staining and Western blot analysis. Moreover, additional uncinate process mucosal samples of 15 healthy controls with nasal septal deviation were harvested for nasal explant culture experiments. HO-1 expression was measured in cultured nasal explant in response to specific inflammatory and glucocorticoid stimulation. SPSS 20.0 software was used to analyze the data.RESULTS:The mRNA and protein expression of HO-1 was significantly increased in polyp tissues, 1.220±0.397 in mRNA and 1.409±0.701 in protein, compared with healthy controls 0.464±0.318 in mRNA and 0.017±0.1147 in protein (U=22.00 in mRNA and U=1.00 in protein, both P< 0.05). The immunohistochemical results showed that HO-1 was mainly distributed in the epithelial layer, submucosal glands and inflammatory cells in nasal tissues. Nasal explant culture experiments demonstrated that HO-1 mRNA was upregulated by IL-17A. The HO-1 mRNA level before the stimulation was 1.000, and 17.264±4.275 after the stimulation of 1 ng/ml IL-17A (U=0, P<0.05), 19.128±4.605 after the stimulation of 10 ng/ml IL-17A (U=0, P<0.05), but was significantly suppressed after stimulation with glucocorticoids (dexamethasone, DEX). The mRNA level after the glucocorticoids stimulation was 0.370±0.101 (U=0, P<0.05) and 0.316±0.167 (U=0, P<0.05) respectively. Furthermore, the HO-1 mRNA was inhibited by TGF-β1, the mRNA level was 0.217±0.322 (U=0, P<0.05), 0.070±0.070 (U=0, P<0.05), respectively.CONCLUSION:Increased HO-1 expression may play a role in the pathogenesis of CRSwNP, which may be considered as the therapeutic target.

We sought to investigate the characteristics, survival and risk factors for mortality in Chinese patients with connective tissue disease (CTD)-associated pulmonary arterial hypertension (APAH) in modern therapy era.129 consecutive adult patients who visited one of three referral centres in China with a diagnosis of CTD-APAH confirmed by right heart catheterisation during the previous 5 years were enrolled. The end-point was all-cause death or data censoring.Systemic lupus erythematosus was the most common underlying CTD (49%) and systemic sclerosis just accounted for 6% in this cohort. The overall survival at 1 and 3 years was 92% and 80%, respectively. Pericardial effusion, a shorter 6-min walk distance, lower mixed venous oxygen saturation, higher pulmonary vascular resistance (PVR) and alkaline phosphatase (ALP), and lower total cholesterol levels were all associated with a higher risk of death among the study population. Higher PVR and ALP were independent predictors of mortality.In conclusion, unlike in western patients, systemic lupus erythematosus is the most common underlying disease in Chinese patients with CTD-APAH. The survival of Chinese patients with CTD-APAH in the modern treatment era is similar to that in western countries. Elevated PVR and ALP are independent risk factors for poor outcomes.

胆肠吻合口狭窄是胆肠吻合术后常见并发症.经皮胆道介入技术可在经皮胆道造影术了解胆道情况后,针对不同狭窄类型行胆道引流、球囊扩张及支架置入等,可有效解除吻合口狭窄,保持胆汁引流通畅,可减轻黄疸.远期疗效因狭窄类型而定,恶性狭窄须积极治疗原发疾病.胆道介入治疗有胆道感染、出血等并发症,经处理后可缓解.胆肠吻合口狭窄介入治疗是安全、有效、微创、可靠的方法.

[ABSTRACT]AIM:ToobservehowfarnesoidXreceptor(FXR)functionedinconcanavalinA(ConA)-induced hepatitis (CIH) and the regulation of FXR-thyrotropin embryonic factor (TEF) pathway.METHODS:C57BL/6 mice were injected with Con A to induce hepatitis .The expression of FXR and TEF in the liver specimens was determined by qRT-PCR and Western blotting .The concentrations of serum ALT/AST and inflammatory cytokines IFN-γ, TNF-α, IL-4 and IL-2 in the blood samples were tested after Con A injection .RESULTS:FXR was down-regulated in CIH mice .TEF was up-regula-ted when FXR was activated by chenodeoxycholic acid (CDCA).Activation of FXR reduced the levels of aminotransferases and inflammatory cytokines IFN-γ, TNF-α, IL-4 and IL-2 in the CIH mice induced by Con A injection .CONCLUSION:FXR activation attenuates CIH mouse liver injury and reduces inflammatory cytokines .FXR activation results in TEF up-regu-lation.The FXR-TEF pathway may play a protective role in autoimmune hepatitis .

AIM: To observe how the activation of farnesoid X receptor(FXR) influences liver function in MRL/lpr lupus mice.METHODS: The expression of FXR at mRNA and protein levels was determined in the liver specimens of MRL/lpr mouse model.MRL/lpr mice and the control BALB/c mice received concanavalin A(ConA) to induce liver injury.The FXR agonist chenodeoxycholic acid(CDCA) was administered to MRL/lpr mice.Blood samples were taken at the time points of 0 h,4 h,8 h,12 h,16 h and 24 h after ConA injection for the detection of serum ALT,AST,IFN-γ,TNF-α and IL-6.RESULTS: FXR was down-regulated in the liver specimens of MRL/lpr mice.MRL/lpr mice were more susceptible to ConA than BALB/c mice to induce significantly higher levels of aminotransferases and inflammatory cytokines.Activation of FXR by CDCA significantly reduced the levels of aminotransferases and inflammatory cytokines IFN-γ,TNF-α and IL-6 caused by ConA injection in MRL/lpr mice.CONCLUSION: FXR activation ameliorates liver injury and suppresses the production of inflammatory cytokines,indicating that FXR protects the liver functions in lupus mice.

To investigate the expression and effect of farnesoid X receptor (FXR) on systemic lupus erythematosus (SLE) liver dysfunction and indicate its hepatoprotective role and the immunomodulatory property. mRNA and protein levels of FXR were determined on the liver specimens of SLE patients with liver injury as well as MRL/lpr rodent models. The FXR agonist chenodeoxycholic acid (CDCA) was administrated to MRL/lpr mice and the control BALB/C with concanavalin A (ConA)-induced liver injury. Blood samples were taken 0, 4, 8, 12, 16, and 24 h after ConA injection for the detection of serum ALT, AST, IFN-γ, TNF-α, and IL-6. FXR was down-regulated at both mRNA and protein levels in the liver specimens of SLE patients with liver injury as well as MRL/lpr mice. MRL/lpr was more susceptible to ConA than BALB/C indicated by significantly higher levels of aminotransferase and inflammatory cytokines. Activation of FXR by CDCA significantly reduced aminotransferase and inflammatory cytokines IFN-γ, TNF-α, and IL-6 caused by ConA injection in MRL/lpr mice. FXR was down-regulated in SLE patients as well as MRL/lpr lupus models with liver dysfunction. FXR activation ameliorated liver injury and suppressed inflammatory cytokines, thereby showing its protective function in SLE. Our findings raised the promising potential target for the treatment of SLE liver injury.

Objectives Pulmonary arterial hypertension (PAH) is a severe complication of connective tissue disease (CTD) with a poor prognosis. There have been sporadic reports with respect to the clinical features and survival of CTD associated PAH (CPAH), however, those in Chinese with CPAH are unknown yet. The purpose of this study is to investigate the baseline characteristics, survival and risk factors of mortality in Chinese with CPAH. Methods All consecutive adult patients who visited the three medical centres with confirmed diagnosis of CPAH between July 2006 and May 2011 were enrolled into the study. For all these patients, PAH was confirmed by right heart catheterisation. Results A total of 144 patients (40.6±12.6 years old) were included in the study and 44% of them were associated with SLE. The other underlying CTDs, in the descending rank order, are pSS (15%), Takayasu arteritis (12%), MCTD (10%), SSc (8%) and some others (RA 3%, PM/DM 2%, adult onset Still9disease 2%, UCTD 2%, primary APS 1%, and ANCA associated vasculitis 1%). The median duration between symptom onset and diagnostic catheterisation was 16.5 months. At diagnosis, 57.6% of patients were in WHO functional class III/IV. The 6-min walk distance was 377.0±99.7 m. Mean pulmonary artery pressure was 49.7±14.4 mm Hg. Eighty-five percent of patients received vascular-targeted therapy. One hundred and twenty-nine patients were followed up with a median duration of 15.8 months (ranged 1.1–55.1 months). The survival rates of these patients at 1 and 3 years were 87.8% and 53.8%. The survival rates of patients with SLE associated PAH at 1 and 3 years were 90.0% and 57.1%. K-M survival analysis showed there were no significant differences in the survivals among different connective tissue diseases. Univariate Cox analysis showed shorter 6-min walk distance, lower cardiac output, cardiac index and mixed venous oxygen saturation, higher pulmonary vascular resistance (PVR), alkaline phosphatase (ALP), total bilirubin and direct bilirubin, lower total cholesterol and low-density lipoprotein were associated with high risk of death (all p<0.05). Multivariate Cox analysis showed higher PVR and ALP were independent predictors of mortality (HR were 1.32 (1.03–1.68) and 1.70 (1.01–2.87) respectively, both p<0.05). K-M analysis demonstrated the survival rate in PVR<15 wood unit group was higher significantly than that in ≥15 wood unit group (p=0.009), and the survival rate in ALp<150 U/l group higher than that in ≥150 U/l group (p=0.012). Conclusions SLE was the most common underlying disease of CPAH in China; however, SSc-associated PAH was fewer in Chinese patients, which were much different from Caucasians. The survival of Chinese patients with CPAH at 1 and 3 years were 87.8% and 53.8%, which were similar with the data of Western countries. Furthermore, elevated PVR and ALP were independent risk factors of bad outcomes.

AIM: To explore the therapeutic potential of adipose tissue-derived stem cell(ADSC) transplantation via hepatic artery in concanavalin A(Con A)-induced autoimmune hepatitis in mice.METHODS: Forty mice with Con A-induced hepatitis were randomly divided into 4 groups: negative group,hepatic artery group,caudal vein,group and positive control group.The mice in hepatic artery group and caudal group were transplanted with ADSCs(2×106) via hepatic artery and caudal vein,respectively.Cyclophosphamide injection was taken as positive control.Inflammatory cytokines involved in Con A-induced hepatitis,liver function index,manifestations and pathological changes of the liver were observed before and after treatment.RESULTS: All animals survived after ADSC transplantation in hepatic artery group and caudal vein group.Compared with caudal vein transplantation group,ADSC transplantation via hepatic artery significantly reduced the release of inflammatory cytokines(IFN-γ,IL-4 and IL-5),and the serum levels of aspartate aminotransferase,alanine aminotransferase and alkaline phosphatase.Pathological changes of the livers showed that the extent of inflammatory infiltration after hepatic artery transplantation of ADSCs was similar to that in positive control group.The inflammatory cells and necrosis of hepatic cells were significantly reduced compared with those in caudal vein group.CONCLUSION: Transplantation of allogeneic ADSCs via hepatic artery attenuates Con A-induced autoimmune hepatitis in mice.ADSC transplantation may be the potential therapy for autoimmune hepatitis.

Objective To compare the therapeutic effects of transcatheter arterial chemoembolization (TACE) plus radiofrequency ablation(RFA) to TACE or RFA alone for unresectable hepatocellular carcinoma (UHCC). Methods All data of patients with UHCC underwent TACE+RFA versus TACE or RFA in randomized-controlled clinical trials (RCT) were collected from literature by electronic searching. Meta-analysis that recommended was done for the data of 8 researches enrolled in criteria by using RevMan 4.2 software in this study. Objects were survival and rate of complete tumor necrosis. Results TACE+RFA group had a statistically higher rate in 1-, 2-, 3-year survival compared with that of TACE group (all P<0.01). It also had a higher rate in 1-, 2-year survival than RFA group (P=0.03, P<0.01), but not in 3-year survival (P=0.16). As to the rate of complete tumor necrosis, combined therapy was better than either monotherapy (both P<0.01). Conclusions The local efficacy of TACE plus RFA for UHCC is better than either monotherapy. As to the prospective efficacy combined therapy can elevate the patients’ survival rate compared with that of TACE alone and prolong patients’ 1-, 2-year survival time compared with that of RFA alone. But there is no statistic different in 3-year patients’ survival rate when TACE plus RFA compared to RFA alone. Key words: Hepatocellular carcinoma; TACE; RFA.

[Objective]To explore the efficacy of different therapies on post-menopause osteoporosis retrospectively.[Methods]A total of 282 cases of post-menopause patients with osteoporosis were enrolled and 3 different therapies were found:A) caltrate + Vit D3;B) caltrate + Vit D3 + calcitonin;C) caltrate + Vit D3 + ibandronate.All patients were followed up for 1 year.BMD,quality of life based on SF-36,and VAS at baseline and 12th month were documented.[Results] Patients in group A improved in all the indexes above,though no significance was found in the assessment.Patients in group B improved significantly in BMD,quality of life and VAS when compared to baseline.Patients in group C improved significantly in all the indexes,and had better patient compliance.[Conclusion] Post-menopause osteoporosis should be treated with combined therapy.Calcitonin would provide rapid pain relieve.Ibandronate had better efficacy in BMD improvement,quality of life and VAS than calcitonin.

C-reactive protein (CRP) is an acute phase reactant and its level rises rapidly during inflammation. Recent studies have suggested the potential involvement of CRP in the pathogenesis of age-related macular degeneration (AMD). To delineate the functional roles of CRP in inflammatory response by the ocular posterior segments, the effects of CRP on ARPE-19, an immortalized human retinal pigment epithelia (hRPE) cell line, were investigated in the present study. Treatment of ARPE-19 cells with CRP resulted in enhanced NF-kB nuclear translocation and dose-dependent transient induction of IL-8 mRNA synthesis and protein secretion. Stimulated expression of VEGF, but not MCP-1 by CRP was also observed. The induced IL-8 expression was transient and peaked at 12h post stimulation. In the presence of inhibitors for NF-kB, p38, MEK and JNK, the CRP-induced IL-8 production was abolished by 99.5+/-2.3, 97.8+/-2.1, 55.3+/-2.5 and 37.3+/-1.3%, respectively. Neutralization of Fc gamma receptors by anti-CD32 and CD64 antibodies produced 39.9+/-1.6 and 59.5+/-2.6% reduction, respectively, of CRP-stimulated IL-8 secretion, whereas that by anti-CD16 antibody had no effect. This study suggests that the pro-inflammatory effects of CRP in ARPE-19 cells may contribute to the inflammatory retinal diseases by induction of pro-inflammatory cytokines such as IL-8. This induction is mediated by NF-kB and multiple MAPK pathways through Fc gamma receptors.

目的 探讨经动脉灌注化疗(transarterial chemotherapy,TAC)联合CT引导下的放射性125I粒子植入术治疗中晚期胰腺癌的临床疗效及应用价值.方法 将57例不能手术切除的中晚期胰腺癌患者随机分成2组,进行前瞻性随机对照研究,分别采用动脉灌注化疗联合CT引导下的放射性125I粒子植入术(30例)及全身静脉化疗(27例),比较TAC联合125I粒子植入和单纯静脉化疗治疗中晚期胰腺癌的效果,评价其疗效和安全性.结果 临床受益疗效治疗组为60.0%(18/30),而对照组为25.9%(7/27);肿瘤治疗客观有效率治疗组为36.6%(11/30),对照组为11.1%(3/27).中位生存期:治疗组为296 d,对照组为189 d.结论 TAC联合125I粒子植入术疗效明显优于较单纯静脉化疗,TAC联合125I粒子植入术是治疗中晚期胰腺癌较为有效的方法.

Objective To investigate the clinical factors related to radiological progression in rheumatoid arthritis(RA) and the role of radiology in the assessment of RA outcomes. Methods A total of 178 cases of active rheumatic arthritis were enrolled in a 2-year trial given radiological assessment at baseline and during follow up. These cases were classified into three groups, namely groups 1, 2 and 3 for mild,moderate and severe based on baseline X-ray images of joint damage. Radiological progression, clinical remission and Health Assessment Questionnaire (HAQ) were used in the two-year follow-up and analyzed for the correlation between each other. Results At the end point, groups 1 and 2 did not differ in radiological progression (P＞0.05). Significant difference was found between group 1 (15.4%, 12/78)and group 2 (30.0%,9/30) (P＜0.05) , as well as between group 3 (11.9% , 7/59) and group 3 (P＜0.05) , suggesting that radiological damages may deteriorate more in patients with higher level of bone erosion at baseline. After 2years of medications, the rate of clinical remission in all the cases was 85.0% (142/167) and was not different among the three groups (P＞0.05), which indicated that clinical remission had no relevance with radiological progression. Conclusion Female gender, positive rheumatoid factor, high HAQ scores and peri- articular lesions are risk factors for radiological progression in RA. Early use of disease-modifying antirheumatic drugs (within less than 6 months) is beneficial for patients with radiological progression. X-ray is sufficiently effective to confirm, re-evaluate and determine the articular erosion. Clinical remission may not necessarily indicate suspension of radiological progression and routine X-ray is required in the whole follow up process of RA in order to modify medications based on progression of articular lesions.

目的 评价螺旋CT在诊断肺动脉血栓栓塞症(PTE)中的临床价值.方法 回顾性分析10例PTE患者的CT征象,逐级、逐支观察肺动脉及其分支.结果 共观察到426支段及段以上、亚段肺动脉,累及各级肺动脉103支,叶动脉41支(39.8%),肺段动脉45支(43.6%),亚段肺动脉17支(16.5%).栓塞的肺动脉位于右肺67支(65.0%);位于下肺65支(63.1%);根据栓子形态分为4类:中心充盈缺损 21支;偏心性部分充盈缺损46支;附壁充盈缺损15支;完全充盈缺损型21支.结论 螺旋CT增强扫描能准确显示肺栓塞的部位、范围与分期,是目前肺动脉栓塞可靠的影像学检查方法.

AIM: To evaluate the therapeutic effect of adipose tissuederived mesenchymal stem cells transplanted through caudal or portal vein for the hepatic cirrhosis model of rats induced by CCl4.METHODS: Forty-five healthy SD rats were randomly divided into control group, portalvein group and caudal-vein group. All rats were subcutaneously injected carbon tetrachloride oily mixture continuously for 8 weeks. At the sixth week, portal-vein group and caudalvein group were transplanted with rat adipose tissue-derived mesenchymal stem cells 2×106 each rat, respectively from superior mesenteric vein and caudal vein. The control group was injected isometric cell culture media. Liver function of ratwas examined before and after cell transplan-tation. HE staining was performed on all liver specimen slices. The degeneration and necrosis of hepatic cells and the degree of liver fibrosis were observed under microscope, and further pathological evaluation was made according to observation results. All experiment data were analyzed by statistics. RESULTS: The liver function of portal-vein group and caudalvein group was improved signifi cantly in comparison with that of control group (AST: 142.2 ± 31.2 U/L, 167.9 ± 28.3 U/L vs 354.2 ± 26.4 U/L; ALT: 79.4 ± 18.9 U/L, 85.8 ± 21.4 U/L vs 456.7 ± 35.3 U/L; ALB: 26.3 ± 2.0 g/L, 24.5 ± 2.2 g/L vs 17.2 ± 1.7 g/L, all P < 0.05), but the level of TBIL wasn’t improved. The transplantation of adipose tissue-derived mesenchy-mal stem cells inhibited the degeneration and necrosis of hepatic tissue and improved liver f ibrosis of the rats. The difference of pathological evaluation between cell-transplanted group and control group was statistically significant (P < 0.05). CONCLUSION: The transplantation of adipose tissue-derived mesenchymal stem cells through portal and caudal vein has therapeutic effect for the hepatic cirrhosis model of rats. It can improve liver function and inhibit liver f ibrosis.

Addison’s disease is an autoimmune process. However, Addison’s disease associated with connective tissue diseases (CTD) is only occasionally reported. Here, we report six cases of Addison’s disease secondary to a variety of CTD, which include systemic lupus erythematosus, Takayasu arteritis, systemic sclerosis, ankylosing spondylitis (AS) and antiphospholipid antibody syndrome. The association of Addison’s disease with Takayasu arteritis and AS is reported for the first time. We also found high prevalence of hypothyroidism as concomitant autoimmune disorder. Our case series highlight the autoimmune features of Addison’s disease. Therefore, we suggest considering adrenal dysfunction in patients with CTD.

目的:探讨实验兔肝动脉插管的实验方法.方法:大耳白兔24只,随机等分为2组,实验组,经股动脉穿刺插管至肝动脉;对照组,剖腹下直视穿刺插管至肝动脉,比较2组的手术操作时间及手术成功率.结果:实验组的手术成功率为91.67%(11/12),对照组为75%(8/12),两者相比无显著性差异(P>0.05);实验组的手术操作时间为41.5±3.6min,对照组为58.6±5.4 min,两者相比有显著性差异(P<0.05).结论:实验兔进行股动脉穿刺插管进行肝动脉灌注的方法简单、容易掌握、成功率高,适用于研究药物或细胞悬液经肝动脉灌注对肝脏的作用.