Purpose:To evaluate the safety and efficacy of percutaneous transhepatic retrieval of dysfunctional plastic biliary stent (PBS). Materials and Methods:In this retrospective, single-center study, clinical and procedural data of 36 patients who underwent percutaneous transhepatic retrieval of dysfunctional PBS between January 2015 and April 2021 were analyzed. The primary outcomes were technical success, clinical success, complications, procedure time, and radiation exposure. The secondary outcomes were biochemical indicators (total bilirubin [TB], direct bilirubin [DB], glutamic transaminase [ALT], and CA-19-9) measured before treatment and two weeks posttreatment. Results:Technical and clinical success were both 100%. Minor complications occurred in 4 cases (11.2%), including 3 hemobilia (Grade 1) and 1 mild cholangitis (Grade 2). The mean procedure time was 39.22 ± 9.34 minutes, with no statistical significance between benign and malignant disease groups ([40.52 ± 9.0] min vs. [38.91 ± 9.5], p = 0.68). The mean radiation exposure was 326.13 ± 206.06 mGy, with no statistical significance between benign and malignant groups ([353.64 ± 258.93] mGy vs. [319.49 ± 196.15] mGy, p > 0.75). Liver functions parameter improved significantly after 2 weeks (TB: [168.31 ± 53.07] vs. [41.70 ± 7.29] μmol/L, DB: [133.51 ± 46.42] vs. [25.39 ± 7.26] μmol/L, ALT: [94.67 ± 38.06] vs. [47.41 ± 13.69] U/L, and CA-19-9: [479.11 ± 160.14] vs. [150.72 ± 105.72] U/mL) (all p = 0.01). Conclusion:This study suggests that percutaneous transhepatic retrieval of dysfunctional PBS appears to be a safe and effective alternative when ERCP is not feasible. However, given the retrospective single-center design, limited sample size, and short follow-up, larger multicenter studies with longer observation are needed to validate these findings.

Critical-size bone defects remain a significant clinical challenge. The lack of endogenous stem cells with osteogenic differentiation potential in the defect area, combined with the inflammatory responses induced by scaffold implantation, highlights the need for biomaterials that can deliver stem cells and possess inflammatory regulation properties. In this study, we developed a 3D bioprinted gelatin methacrylate (GelMA) hydrogel scaffold modified with luteolin-loaded ZIF-8 (LUT@ZIF-8) nanoparticles, designed to deliver bone marrow mesenchymal stem cells (BMSCs) to the defect site and release bioactive components that promote osteogenesis and modulate the immune microenvironment. The LUT@ZIF-8/GelMA hydrogel scaffolds demonstrated excellent physical properties and biocompatibility. The sustained release of luteolin and zinc ions from the LUT@ZIF-8 nanoparticles conferred antibacterial, osteoinductive, and inflammatory regulation effects. The immune microenvironment modulated by LUT@ZIF-8/GelMA hydrogel scaffolds facilitated osteogenic differentiation of BMSCs. Furthermore, in vivo experiments confirmed the osteogenic and inflammatory regulation capabilities of the LUT@ZIF-8/GelMA hydrogel scaffolds. In conclusion, the 3D bioprinted LUT@ZIF-8/GelMA hydrogel scaffolds exhibit osteoimmunomodulatory properties, presenting a promising strategy for the treatment of bone defects.

Objectives To evaluate the safety and effectiveness of computed tomography (CT)-guided radioactive 125 I seeds brachytherapy (RISB) for lung oligometastases (LO) from colorectal cancer (CRC). Methods Data for 144 LOs from 70 CRC patients who underwent CT-guided RISB were retrospectively analyzed. The primary endpoints were progression-free survival (PFS) and overall survival (OS), and the secondary endpoints were technical success, local control rate (LCR), and complications. Kaplan–Meier method was used for survival analysis. Cox model was used to identify the independent predictors of poor prognosis. Results The RISB procedures were successfully performed in all patients, and the success rate was 100%. The median follow-up was 27.8 months. The median PFS was 10.0 months (95% CI: 8.9–11.1) and the 1- and 2-year PFS rates were 32.9% and 5.9%, respectively. On multivariate analysis, serum carcinoembryonic antigen (CEA) ≤ 15 ng/ml ( P = 0.048), middle-high differentiated pathological classification ( P = 0.015), primary TNM stages I-III ( P = 0.001), LO number ≤ 2 ( P < 0.001) and cumulative gross tumor volume (GTV) ≤ 40 cm 3 ( P < 0.001) showed superior PFS. The median OS was 30.8 months (95% CI : 27.1–34.4) and the 1-, 2-, and 3-year OS rates were 95.7%, 67.4%, and 42.5%, respectively. On multivariate analysis, serum CEA ≤ 15 ng/ml ( P = 0.004), middle-high differentiated pathological classification ( P < 0.001), primary TNM stages I-III ( P < 0.001), LO number ≤ 2 ( P < 0.001), cumulative GTV ≤ 40 cm 3 ( P < 0.001) and system treatments combined with chemotherapy and target therapy ( P < 0.001) showed superior OS. The LCR for 3, 6, and 12 months was 97.9%, 91.0%, and 83.6%, respectively. There were 4 cases of pneumothorax at 5.7% that required drainage. Conclusions RISB for LO from CRC is safe and effective, and serum CEA, TNM stage, LO number, cumulative GTV, and system treatments should be emphasized for long OS.

PURPOSE:To evaluate the feasibility of percutaneous transluminal ureteral biopsy (PTUB) combined with percutaneous nephroureteral stent placement for ureteral obstruction under fluoroscopy. MATERIALS AND METHODS:From September 2011 to July 2021, 37 patients (27 men and 10 women; median age, 65.0 years) who experienced ureteroscopic biopsy failure or refused or were unable to undergo ureteroscopic biopsy underwent PTUB for ureteral obstruction during nephroureteral stent placement under fluoroscopic guidance. Data on technical success, early adverse events, and radiation dose were collected. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy (OA) of PTUB were analyzed. RESULTS:The technical success of PTUB was 89.2%, with a mean irradiation dose of 76.9 mGy·cm2 ± 12.2. A total of 67.6% (25/37) of the cases were correctly diagnosed with malignancy, whereas 8 cases were confirmed to be true negatives. There were 4 false negatives and no false positives. PTUB had a sensitivity, specificity, PPV, NPV, and OA of 86.2% (25/29), 100% (8/8), 100% (25/25), 66.7% (8/12), and 89.2% (33/37), respectively. Eleven patients (29.7%) experienced Grade 1 adverse events (transient aggravated hematuria). CONCLUSIONS:PTUB appears to be a safe and effective alternative to ureteroscopic biopsy for ureteral obstruction.

Background: The most common loadable chemotherapeutic drugs in drug-eluting bead transarterial chemoembolization (DEB-TACE) include doxorubicin, epirubicin, etc. CalliSpheres ® beads have exhibited efficient loadability and eluting characteristics for raltitrexed as well as in vitro and animal experiments. However, the efficacy and safety of raltitrexed-loaded DEB-TACE in patients with intermediate-stage hepatocellular carcinoma (HCC) remain unclear. Objectives: To assess the efficacy and safety of raltitrexed-loaded DEB-TACE in patients with intermediate-stage HCC. Design: The study was conducted as a single-arm prospective study. Methods: This study was a prospective, single-arm trial conducted between June 2019 and June 2022. CalliSpheres ® beads loaded with raltitrexed were used in the DEB-TACE procedure. The follow-up lasted for at least 1 year or until death. The primary endpoint was overall survival (OS), and the secondary endpoints were time to progression (TTP), progression-free survival (PFS), objective response rate (ORR), and adverse events (AEs). Results: The 6-month ORR and disease control rates were 90.1% and 93.8%, respectively. The median OS was 33.0 months. The 1-, 2-, and 3-year survival rates were 95.1%, 82.1%, and 43.6%, respectively. Child–Pugh class and bilobar disease occurrence were identified as independent OS predictors. The median TTP and PFS were 22.7 and 19.8 months, respectively. Eleven (11.5%) patients experienced at least one grade 3 AE, and serious AEs were reported in five participants (5.2%). No patient experienced grade 4 or 5 AEs. Conclusion: Raltitrexed-loaded DEB-TACE is feasible, safe, and effective in patients with intermediate-stage HCC. Trial registration: This trial was registered at www.chictr.org.cn under the identifier: 1900024097 on 25 June 2019.

Background Refractoriness to surgical resection and chemotherapy makes intrahepatic cholangiocarcinoma (ICC) a fatal cancer of the digestive system with high mortality and poor prognosis. Important function invests circRNAs with tremendous potential in biomarkers and therapeutic targets. Nevertheless, it is still unknown how circRNAs contribute to the evolution of ICC.Methods CircRNAs in paired ICC and adjacent tissues were screened by circRNAs sequencing. To explore the impact of circRNAs on ICC development, experiments involving gain and loss of function were conducted. Various experimental techniques, including quantitative real-time PCR (qPCR), western blotting, RNA immunoprecipitation (RIP), luciferase reporter assays, RNA pull-down, chromatin immunoprecipitation (ChIP), ubiquitination assays and so on were employed to identify the molecular regulatory role of circRNAs.Results Herein, we reported a new circRNA, which originates from exon 9 to exon 15 of the SLCO1B3 gene (named circSLCO1B3), orchestrated ICC progression by promoting tumor proliferation, metastasis and immune evasion. We found that the circSLCO1B3 gene was highly overexpressed in ICC tissues and related to lymphatic metastasis, tumor sizes, and tumor differentiation. Mechanically, circSLCO1B3 not only promoted ICC proliferation and metastasis via miR-502-5p/HOXC8/SMAD3 axis, but also eradicated anti-tumor immunity via suppressing ubiquitin-proteasome-dependent degradation of PD-L1 by E3 ubiquitin ligase SPOP. We further found that methyltransferase like 3 (METTL3) mediated the m6A methylation of circSLCO1B3 and stabilizes its expression. Our findings indicate that circSLCO1B3 is a potential prognostic marker and therapeutic target in ICC patients.Conclusions Taken together, m6A-modified circSLCO1B3 was correlated with poor prognosis in ICC and promoted ICC progression not only by enhancing proliferation and metastasis via potentiating HOXC8 expression, but also by inducing immune evasion via antagonizing PD-L1 degradation. These results suggest that circSLCO1B3 is a potential prognostic marker and therapeutic target for ICC.

BACKGROUND: Gastro-tracheal fistula (GTF) is one of the most serious complications after esophagogastrostomy and radiotherapy, with very high disability and mortality rates. To evaluate the effectiveness and safety of ventricular septal occluder devices (VSOD) for the treatment of Gastro-tracheal fistula (GTF). METHODS: From January 2020 to May 2022, 14 patients with GTF underwent VSOD under real-time fluoroscopy. The technical success, complications, quality of life (QoL), Eastern Cooperative Oncology Group (ECOG) score, Karnofsky score, and median overall survival (mOS) were recorded and analyzed. RESULTS: Technical success, and major complication rates were 71.4%, and 14.3%, respectively. Both the ECOG and the Karnofsky score showed significant improvement at the 2-month evaluation compared with the pretreatment value (p<0.05). For QoL, general health, physical function, vitality, role physical, and social function all improved at the 2-month evaluation (p<0.05), but bodily pain, role emotion, and mental health showed no significant difference (P>0.05). During the mean follow-up of 9.6 months, eight patients were alive, and the mOS was 11.4 months (95% CI, 8.5-14.3). CONCLUSIONS: VSOD is a simple and safe technique for GTF treatment, but long-term observation is needed at multiple centers to confirm our findings. (c) 2024 Published by Elsevier Ltd on behalf of The Royal College of Radiologists.

Background: The most common loadable chemotherapeutic drugs in drug-eluting bead transarterial chemoembolization (DEB-TACE) include doxorubicin, epirubicin, etc. CalliSpheres ® beads have exhibited efficient loadability and eluting characteristics for raltitrexed as well as in vitro and animal experiments. However, the efficacy and safety of raltitrexed-loaded DEB-TACE in patients with intermediate-stage hepatocellular carcinoma (HCC) remain unclear. Objectives: To assess the efficacy and safety of raltitrexed-loaded DEB-TACE in patients with intermediate-stage HCC. Design: The study was conducted as a single-arm prospective study. Methods: This study was a prospective, single-arm trial conducted between June 2019 and June 2022. CalliSpheres ® beads loaded with raltitrexed were used in the DEB-TACE procedure. The follow-up lasted for at least 1 year or until death. The primary endpoint was overall survival (OS), and the secondary endpoints were time to progression (TTP), progression-free survival (PFS), objective response rate (ORR), and adverse events (AEs). Results: The 6-month ORR and disease control rates were 90.1% and 93.8%, respectively. The median OS was 33.0 months. The 1-, 2-, and 3-year survival rates were 95.1%, 82.1%, and 43.6%, respectively. Child–Pugh class and bilobar disease occurrence were identified as independent OS predictors. The median TTP and PFS were 22.7 and 19.8 months, respectively. Eleven (11.5%) patients experienced at least one grade 3 AE, and serious AEs were reported in five participants (5.2%). No patient experienced grade 4 or 5 AEs. Conclusion: Raltitrexed-loaded DEB-TACE is feasible, safe, and effective in patients with intermediate-stage HCC. Trial registration: This trial was registered at www.chictr.org.cn under the identifier: 1900024097 on 25 June 2019. Keywords beads , chemoembolization , DEB-TACE , hepatocellular carcinoma , raltitrexed , transarterial

Malignant central airway obstruction (MCAO) resulting from tumor metastasis and compression severely impairs respiration, posing life-threatening risks. To address this, we employed a synergistic modification strategy, combining cisplatin (CIS) and silver nanoparticles (AgNPs). Polycaprolactone (PCL) served as a drug carrier, enabling the preparation of a functional CIS@AgNPs@PCL fiber membrane-covered airway stent via electrospinning. This approach aimed to enhance the patency rate of MCAO. Characterization via ATR-FTIR, scanning electron microscope-energy-dispersive spectroscopy, and transmission electron microscope confirmed successful immobilization of CIS and AgNPs onto the stent surface. CIS@AgNPs@PCL substantially suppressed non-small cell lung cancer cells (A549), causing DNA damage, ultrastructural disruption, and over 50% apoptosis in 48 h. It also displayed potent antibacterial activity against Staphylococcus aureus, Pseudomonas aeruginosa, and Candida albicans biofilms. A mouse subcutaneous tumor recurrence model assessed anti-cancer efficacy. CIS@AgNPs@PCL fiber-covered stents significantly inhibited lung cancer tissue and enhanced anti-cancer effects by up-regulating caspase-3 and Bax, while down-regulating Bcl-2. This study's functional airway stent provides a proof-of-concept for an integrated anti-cancer and antibacterial strategy. It promptly restores the lumen, inhibits biofilm formation, prevents tumor progression, and improves postoperative MCAO patency.

Background: The sampling of vascular obstruction diseases remains a challenge in clinical practice. This retrospective study aimed to evaluate the feasibility, accuracy, and safety of intravascular forceps biopsy (IVFB) for the diagnosis of vascular obstructive diseases. Methods: From January 2015 to January 2022, of the total of 35 patients who underwent IVFB (21 male, 14 female; mean age 60 +/- 11 years; range, 39-81 years), 32 (91.4%) did so during interventional planned revascularization procedures and 3 (8.6%) did so due so due to inaccessible or failed percutaneous access. The outcomes of technical success, biopsy times, patient radiation dose (PRD), complications, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy rate (AR) were analyzed. Results: The technical success of IVFB was 100%. The median number of biopsies taken per biopsy session and PRD were 4.0 (range, 3-6) and 712.6 mGy (range, 383.4-1,450.8), respectively. The sensitivity, specificity, PPV, NPV, and AR of IVFB were 87.5% (21/24), 100% (11/11), 100% (21/21), 78.6% (11/14), and 91.4% (32/35), respectively. There were no complications related to IVFB. Conclusions: IVFB is a technically feasible and safe technique with good diagnostic value. The procedure should be considered in patients who are not suitable for percutaneous access, show indistinct imaging characteristics, or are scheduled to undergo revascularization procedure.

目的 分析经颈静脉门体分流术(TIPS)在自身免疫性肝病合并食管胃静脉曲张破裂出血中应用的安全性及有效性.方法 回顾性分析 21 例采用TIPS治疗的自身免疫性肝病合并食管胃静脉曲张破裂出血患者,其中 14 例为自身免疫性肝炎(AIH),6 例为原发性胆汁性胆管炎(PBC)-自身免疫性肝炎重叠综合征,1 例为 PBC.16 例患者表现为呕血和黑便症状,4 例患者仅出现黑便症状,1 例患者仅表现为呕血.结果 技术成功率 100%,手术成功止血率 95.23%,围术期死亡率 4.76%.随访期间(2～96 个月)1 例患者因肝衰竭死亡,无患者再发消化道出血.2 例患者术后发生分流道失功能.分流道 1 年初始通畅率 95.23%,2 年初始通畅率 90.48%.结论 TIPS治疗自身免疫性肝病合并食管胃静脉曲张破裂出血是安全和有效的.

Objective: To compare the clinical efficacy of single/double 125I-seed strands combined with biliary stents in the treatment of malignant obstructive jaundice. Methods: Totally 67 cases of patients with malignant obstructive jaundice who received single/double125I-seed strands combined with biliary stents implantation from September 2018 to December 2021 were analyzed retrospectively. Among them, 36 patients received single 125I-seed strands combined with biliary stents (single strand group) and 31 patients received double 125I-seed strands combined with biliary stents(double strands group). The technical success rate, clinical success rate, complications, biochemical and tumor indexes at 8 weeks after operation [total bilirubin (TB), direct bilirubin (DB), alanine transaminase (ALT), aspartate transaminase (AST), carbohydrate antigen 19-9 (CA19-9)], stent patency time (SP), median progression-free survival time (mPFS) and median survival time (mOS) were analyzed. Results: There was no significant difference (P>0.05) in technical success rate (100% vs 100%), clinical success rate (97.2% vs 96.8%) and major complications (5.6% vs 6.5%) between single strand group and double strands group. There were significant differences in TB, DB, ALT, AST and CA19-9 indicators between the two groups before and 8 weeks after operation (all P<0.05), but there was no significant difference in the difference value of preoperative and postoperative 8-week indicators between the two groups (all P>0.05).The SP and mPFS of double-stranded stents were longer than those of single-stranded stents.[8.6 months (95%CI:6.9-10.4) vs 6.2 months (95%CI:5.8-6.6), 3.2 months (95%CI:3.0-3.4) vs 3.0 months (95%CI:2.9-3.1), all P<0.05]. The mOS of single and double strands groups was 11.2 months (95%CI:8.3-14.1) and 13.4 months (95%CI:9.9-16.9) respectively, with no statistical difference (P=0.137). Conclusion: Compared with single 125I-seed strands, double 125I-seed strands can prolong biliary SP and mPFS, but the long-term survival index still needs further observation.

目的 评价新型部分覆膜式分支一体化T/Y型支架治疗肝门部胆管恶性梗阻的可行性和安全性.方法 纳入2018年10月至2019年10月接受新型部分覆膜式母子分支一体化T/Y型支架植入术治疗肝门部胆管恶性梗阻患者16例.记录技术成功率、临床成功率、并发症、6个月和12个月支架通畅率和总生存率,比较术前、术后1个月患者的血常规、肝功能、肾功能和CA199水平.结果 16例患者均获得技术成功和临床成功.早期并发症和晚期并发症分别为3例和2例,无大出血、重度感染、胆瘘、穿孔等严重并发症.平均随访时间358.9 d,6个月和12个月支架通畅率分别为66.7％和16.7％,总生存率分别为93.3％、75.0％.术后1个月ALT、AST、TBil、CA199水平较术前明显下降(P<0.01),而WBC、Hb、PLT、Cr、BUN较术前无明显变化(P>0.05).结论 新型部分覆膜式分支一体化T/Y型支架治疗肝门部胆管恶性梗阻安全可行,有待进一步研究其远期疗效.

目的 探讨组织胶栓塞脾动脉治疗脾功能亢进(脾亢)的可行性.方法 回顾分析 17 例肝硬化合并脾亢患者的临床资料,采用组织胶栓塞脾动脉以纠正脾亢,评价技术成功率、栓塞体积、并发症发生率及血小板(PLT)和白细胞(WBC)动态变化规律,比较术前、术后 30 d PLT、WBC、谷丙转氨酶(ALT)、总胆红素(TBIL)的变化.结果 本组患者技术成功率 100%,脾栓塞比率平均为 46.8%,轻微并发症发生率为 29.4%,未见严重并发症发生.PLT和 WBC均表现为逐渐升高,14 d达峰,30 d略降低.术前PLT和 WBC分别为(20.2±5.8)×109/L 和(1.3±0.4)×109/L,术后 30 d 为(103.1±14.3)×109/L 和(3.8±0.6)×109/L,术前、术后比较差异有统计学意义(P<0.05),术前、术后 30 d ALT[(35.8±12.9)U/L vs(31.5±8.2 U/L)]和 TBIL[(17.3±7.2)μmol/L vs(16.3±6.9)μmol/L)比较差异均无统计学意义(P>0.05).结论 组织胶栓塞脾动脉治疗脾亢安全、可行、有效.

Purpose An assessment is being conducted to determine the safety and effectiveness of using Cone-beam computed tomography (CBCT)-guided transcatheter arterial chemoembolization (TACE) and microwave ablation (MWA) sequentially to treat small hepatocellular carcinomas (HCCs) located in the hepatic dome. Materials and methods Fifty-three patients with small HCCs in the hepatic dome who underwent TACE combined with simultaneous CBCT-guided MWA were studied. Inclusion criteria were a single HCCs ≤ 5.0 cm or a maximum of three. The safety and interventional-related complications were monitored, and local tumor progression (LTP), overall survival (OS), and prognostic factors for LTP/OS were evaluated. Results The procedures were successfully accomplished in all patients. According to Common Terminology Criteria for Adverse Events (CTCAE), adverse reactions and complications are mainly Grade 1 or 2 (mild symptoms, no or local/noninvasive intervention indicated). Liver and kidney function and alpha-fetoprotein (AFP) levels remained within a reasonable range after 4 weeks of treatment (both p < 0.001). The mean LTP was 44.406 months (95% CI: 39.429, 49.383) and the mean OS rate was 55.157 months (95% CI: 52.559, 57.754). The combination treatment achieved 1-, 3-, and 5-year LTP rates of 92.5%, 69.6%, and 34.5%, respectively; and 1-, 3-, and 5-year OS rates of 100.0%, 88.4%, and 70.2%, respectively. Results from both univariate and multivariate Cox regression analyses showed that the tumor diameter (< 3 cm) and the distance to the hepatic dome (≥ 5 mm, < 10 mm) had a significant impact on the patient’s LTP and OS, and were related to better survival. Conclusion CBCT-guided TACE combined with simultaneous MWA was a safe and successful treatment of HCCs located under the hepatic dome.

Background: Applying 3D printed bioink to bone tissue engineering is an emerging technology for restoring bone tissue defects. This study aims to evaluate the application of 3D printing bioink in bone tissue engineering from 2010 to 2022 through bibliometric analysis, and to predict the hotspots and developing trends in this field. Methods: We retrieved publications from Web of Science from 2010 to 2022 on 8 January 2023. We examined the retrieved data using the bibliometrix package in R software, and VOSviewer and CiteSpace were used for visualizing the trends and hotspots of research on 3D printing bioink in bone tissue engineering. Results: We identified 682 articles and review articles in this field from 2010 to 2022. The journal Biomaterials ranked first in the number of articles published in this field. In 2016, an article published by Hölzl, K in the Biofabrication journal ranked first in number of citations. China ranked first in number of articles published and in single country publications (SCP), while America surpassed China to rank first in multiple country publications (MCP). In addition, a collaboration network analysis showed tight collaborations among China, America, South Korea, Netherlands, and other countries, with the top 10 major research affiliations mostly from these countries. The top 10 high-frequency words in this field are consistent with the field’s research hotspots. The evolution trend of the discipline indicates that most citations come from Physics/Materials/Chemistry journals. Factorial analysis plays an intuitive role in determining research hotspots in this sphere. Keyword burst detection shows that chitosan and endothelial cells are emerging research hotspots in this field. Conclusion: This bibliometric study maps out a fundamental knowledge structure including countries, affiliations, authors, journals and keywords in this field of research from 2010 to 2022. This study fills a gap in the field of bibliometrics and provides a comprehensive perspective with broad prospects for this burgeoning research area.

目的 探讨C臂CT引导的肾穿刺活检联合肾动脉栓塞在高出血风险肾肿物诊疗中的安全性和有效性.方法 回顾性分析 2011 年 1 月至 2021 年 10 月郑州大学第一附属医院介入科行C臂CT引导的肾穿刺活检同步肾动脉栓塞术 17 例患者的临床资料.均于C臂CT引导的肾穿刺活检同步肾动脉栓塞术后 24 h 内,完成血常规和凝血功能检查,并与术前指标对比.结果 17 例患者中,男 11 例,女6 例,年龄为(66.5±7.0)岁.所有患者均为影像学诊断为肾癌,14 例出现远处转移,3 例因严重合并症无法耐受手术.高出血风险原因:9 例有心脑血管疾病合并症需行抗血小板或抗凝治疗且无法停药,8 例合并严重的凝血功能障碍.17 例患者均成功取材,病理结果示 16 例为肾透明细胞癌,1 例为乳头状肾细胞癌.术中 15 例患者出现肾动脉出血需行栓塞辅助治疗,均成功止血.术前术后血红蛋白、红细胞比容、血肌酐、血尿素氮比较,差异均无统计学意义(t=1.97、0.77、0.57、-0.88,均P＞0.05).结论 C臂CT引导的肾穿刺活检联合肾动脉栓塞是一种安全有效的方法.

To evaluate the clinical efficacy of celiac plexus block (CPB) combined with 125I seeds implantation (ISI) for refractory epigastric pain from abdominal malignancies. The data of 81 patients with refractory epigastric pain [visual analog scale (VAS) score ≥ 4] from abdominal malignancies were collected in this retrospective case–control study. Group A (n = 40) was treated with CPB alone, while Group B (n = 41) underwent CPB combined with ISI. The primary study endpoints were the VAS score, quality of life (QoL), and local tumor control (LTC) rate. The secondary endpoints were complications, progression-free survival (PFS), and overall survival (OS). The VAS scores at week 2 (T2), week 4 (T4), week 8 (T8), and week 12 (T12) in both groups were significantly lower compared with the pretreatment values (all P < 0.01). VAS scores in Group B showed a sustained decrease, especially for “mild pain” and “moderate pain,” while the VAS scores in Group A rebounded at T8 and T12 (both P < 0.01). The QoL in Group B improved significantly from T4 until T12, which better than that at T12 in Group A (all P < 0.01). The LTC rates at T8 were 35.0

乳糜胸(chylothorax)是由于胸导管及其分支损伤或阻塞后局部压力升高导致乳糜液积存于胸膜腔.创伤性病因可分为颈、胸、腹部手术的医源性损伤和外伤、分娩、剧烈呕吐等突发腹压升高的非医源性损伤;非创伤性病因包括先天性胸导管畸形或发育不全、纵隔恶性肿瘤、自身免疫性疾病和炎症等,其中医源性损伤在临床上最为常见[1].临床发现外科病史伴乳白色胸腔积液,甘油三酯浓度＞110 mg/dl或脂蛋白电泳发现乳糜微粒,可确诊为乳糜胸[2,3].

Purpose:To evaluate the clinical results of nasal feeding nutritional tube (NFNT)-loaded iodine-125 (125I) seeds in intra-luminal brachytherapy (ILBT) for esophageal carcinoma (EC) patients with a 3/4 dysphagia score.Material and methods:From January 2019 to January 2020, 26 patients (female/male: 17/9, mean age: 75.3 years, dysphagia score 3/4: 6/20, mean Karnofsky score: 58.4) with EC underwent NFNT-loaded 125I seed placement for both nutrition and brachytherapy. Technical and clinical success, D90 (radiation dose received by 90% of tumor volume) and organ at risk (OAR) dose, complications, dysphagia-free time (DFT), and overall survival (OS) time were documented. Local tumor diameter, Karnofsky score, dysphagia score, and quality of life (QoL) were compared before and 6 weeks after tube placement.Results:Technical and clinical success rates were 100% and 76.9%, respectively. The D90 and OAR doses were 39.7 Gy and 2.3 Gy, respectively. Eight cases (30.8%) experienced mild complications, but no seed loss, fistula, and massive bleeding were observed. Median DFT and OS were 3.1 months and 13.7 months, respectively. Tumor diameter and dysphagia score significantly decreased (p < 0.05), Karnofsky score significantly improved (p < 0.05), and QoL scores related to physical function, physical functioning, general health, vitality, and emotional functioning improved (p < 0.05).Conclusions:NFNT-loaded 125I brachytherapy for ILBT is technically a safe and effective strategy for EC patients with low Karnofsky scores, and can be a bridging therapy for advanced anti-cancer treatment.