Self-expandable metal stents (SEMS) are routinely used in malignant colorectal obstruction (MCO) for palliation or as a bridge to surgery. However, the association between treatment intent and complication risk, as well as the potential role of clinical success as an intermediate procedural endpoint, remains unclear. We retrospectively analyzed 413 patients with MCO who underwent SEMS placement between 2014 and 2024. Patients were categorized by therapeutic intent (palliation vs. bridge to surgery), and complication rates were compared. Mediation analysis was performed using the Sobel test, structural equation modeling (SEM), and bootstrap-based causal mediation to assess whether clinical success mediated the relationship between therapeutic purpose and complications. Complications occurred in 60 patients (14.5

(1) Background: Drug-eluting bead transarterial chemoembolization (DEB-TACE) is increasingly used for unresectable colorectal liver metastases (CRLM), yet individualized prognostic tools are lacking. We developed and internally validated nomograms predicting overall survival (OS) and hepatic progression-free survival (hPFS). (2) Methods: In this single-center retrospective cohort, reported per the TRIPOD guideline, OS and hPFS were estimated by Kaplan–Meier methods, and independent predictors from multivariable Cox regression were assembled into nomograms. Internal validation combined 1000-sample bootstrap optimism-corrected concordance indices (C-index), a uniform shrinkage factor, a bootstrap calibration slope, and a LASSO–Cox sensitivity analysis. (3) Results: Among 63 patients (44 deaths; 42 intrahepatic-progression events), median OS was 10.9 months and median hPFS was 5.8 months. Independent OS predictors were baseline CEA, high liver tumor burden (≥10 lesions), CEA decline (protective), and second-line-or-beyond interventional therapy (corrected C-index: 0.796). Independent hPFS predictors were high liver tumor burden, CEA decline, and age (corrected C-index: 0.718). Nomogram-defined high-risk groups had markedly shorter OS (5.3 vs. 22.8 months) and hPFS (3.3 vs. 8.6 months; both p < 0.001). Grade ≥3 toxicity occurred in 6%. (4) Conclusions: In real-world DEB-TACE-treated CRLM, liver tumor burden and CEA dynamics dominated prognosis; the internally validated nomograms provide individualized estimates and risk stratification, pending external validation.

Objective Catheter-related thrombosis (CRT) is a common complication in colorectal cancer patients undergoing chemotherapy, significantly impacting patient outcomes. However, effective predictive tools for identifying high-risk patients are currently lacking. This study aimed to develop and validate a predictive model, the TD score, to identify patients at high risk of CRT based on clinical parameters. Methods This single-institutional retrospective study included 730 colorectal cancer patients with intravenous catheters, divided into training (n = 624) and test sets (n = 106). The primary endpoint was CRT, diagnosed via imaging. Multivariable logistic regression analysis was used to identify independent predictors of CRT, and a predictive model (TD score) was developed based on T stage and duration of intravenous catheter use. The model's performance was evaluated using receiver operating characteristic (ROC) curve analysis. Results The TD score demonstrated good diagnostic performance, with areas under the ROC curve of 0.732 in the training set and 0.749 in the test set. Survival analysis revealed that patients with lower T stages had longer durations of non-CRT status. The study identified T stage and duration of intravenous catheter use as independent predictors of CRT. Conclusions The TD score is a promising tool for identifying high-risk patients for CRT. It may improve patient risk stratification and guide targeted prophylactic interventions. Future validation studies involving larger and more diverse patient cohorts are needed to confirm the clinical utility of the TD score and evaluate its performance across different TNM stages.

Aim This study aimed to comprehensively evaluate the clinical outcomes of self-expandable metal stent (SEMS) placement for malignant obstructive jaundice (MOJ), with a specific focus on efficacy, safety, stent patency, and complication rates in patients with either primary or metastatic malignancies. Methods We retrospectively analyzed data from 108 consecutive patients with MOJ who underwent fluoroscopy-guided SEMS placement at our institution between February 2013 and December 2024. Patients were stratified into primary (n = 53) and metastatic (n = 55) MOJ cohorts based on the etiology of biliary obstruction. Demographic, pathological, procedural, and outcome variables were collected, including technical success, clinical success, stent patency duration, reintervention rate, and procedure-related complications. Results Fluoroscopy-guided SEMS placement achieved 100% technical success in both the primary and metastatic cohorts. The overall clinical success rate was 88.9%, with 90.6% (48/53) in the primary group and 87.3% (48/55) in the metastatic group (p = 0.590). The mean stent patency duration was 112.0 ± 227.2 days in the primary group and 86.6 ± 120.1 days in the metastatic group, with no statistically significant difference (p = 0.470). Post-procedural fever or infection occurred in 15 (28.3%) patients in the primary group and 18 (32.7%) in the metastatic group, all managed conservatively with antibiotics. No major procedure-related complications (e.g., cholangitis, stent migration, severe bleeding, pancreatitis) were observed. Reintervention rates due to stent occlusion were 20.8% (11/53) in the primary group and 23.6% (13/55) in the metastatic group, respectively (p = 0.722). A significantly higher proportion of patients in the metastatic group received subsequent chemotherapy compared to the primary group (56.4% vs. 34.0%, p = 0.019), which was associated with prolonged stent patency (123.7 vs. 38.6 days, p = 0.004). Conclusions Fluoroscopy-guided SEMS placement is a safe and effective palliative intervention for both primary and metastatic MOJ. Stent performance in terms of patency and safety is independent of the underlying tumor etiology. Subsequent chemotherapy significantly improves stent patency in patients with metastatic MOJ. Therefore, a combined strategy of biliary stenting followed by systemic chemotherapy is recommended to optimize palliative outcomes in patients with metastatic disease.

Severe intrauterine adhesions (IUA) represent a profound failure of endometrial regeneration, characterized by excessive fibrosis and vascular insufficiency. Mesenchymal stem cell-based therapies show regenerative potential, but clinical evidence is inconsistent, and optimal delivery routes and localized microvascular mechanisms of action in human endometrium remain unclear. This prospective, randomized controlled trial was conducted from July 2020 to December 2024. A total of 60 women with severe intrauterine adhesions (IUA) were randomly assigned (1:1) to receive targeted uterine artery infusion of bone marrow-derived MSCs (BMSCs) plus hormone replacement therapy (HRT), or HRT alone. The primary outcome was endometrial thickness, with secondary outcomes including clinical pregnancy rate, miscarriage rate, and live birth rate. Histological, transcriptomic, and in vitro functional assays were performed as exploratory analyses to characterize treatment-associated tissue and vascular remodeling. Compared with the control group, the BMSC group showed a greater increase in endometrial thickness (0.79 ± 0.66 mm vs. 0.20 ± 0.44 mm, P < 0.001). In the exploratory per- protocol analysis among participants who underwent embryo transfer, the BMSC group showed a higher clinical pregnancy rate than the control group (50.0

BACKGROUND:This study aims to enhance the explainability and predictive accuracy of the Random Survival Forest (RSF) algorithm in predicting stent patency risk for patients with malignant colonic obstruction. METHODS:The RSF algorithm was applied to clinical prognostic data of 109 patients with malignant colonic obstruction who underwent self-expandable metallic stent (SEMS) procedures between September 2014 and October 2023. We combined the RSF variable importance and Least Absolute Shrinkage and Selection Operator (Lasso) regression to identify the final predictive variables. And the performance of the RSF model was compared with the Cox Proportional Hazards (CPH) model using both global and local explanation methods. RESULTS:The RSF model demonstrated superior predictive performance, with higher time-dependent AUCs and lower Brier scores compared to the CPH model across various time points. Significant predictors of stent patency identified by the RSF and Lasso models included Diabetes, CA199, Pre-Chemotherapy and Length of obstruction. The partial dependence plots highlighted CA199 and Length of obstruction as critical variables, with SHAP (SHapley Additive exPlanations) and LIME (Local Interpretable Model-agnostic Explanations) analyses further revealing the dynamic, time-varying impact of these variables on individual patient outcomes. CONCLUSIONS:The RSF algorithm, supplemented with comprehensive feature importance analyses and advanced interpretability techniques, offers a robust and reliable framework for predicting stent patency risk in patients with malignant colonic obstruction.

Aim:The purpose of this study was to assess the efficacy and safety of self-expandable metal stents (SEMS) in treating anastomotic obstruction associated with recurrent gastric cancer. Methods:Ten patients with anastomotic obstruction in recurrent gastric cancer were treated by SEMS implantation under fluoroscopic guidance. All patients presented with refractory nausea, vomiting and complete inability to tolerate oral intake before stent placement, requiring total parenteral nutrition (TPN). Clinical data were retrospectively analyzed the technical and clinical success rates, stent patency and complication rates. Results:SEMS was successfully implanted in all patients, and clinical success rate was 100%. The operations were subtotal gastrectomy with Billroth-II reconstruction (n = 3), radical distal gastrectomy (n = 3), total gastrectomy with esophagojejunostomy (n = 3), and palliative gastrojejunostomy (n = 1). Three patients developed stent occlusion due to intrastent tumor ingrowth secondary to disease progression after initial anastomotic stent placement, and underwent secondary stent implantation with successful maintenance of patency postoperatively. One patient developed stent obstruction due to food impaction on postoperative day 10, which was managed endoscopically with successful restoration and maintenance of luminal patency. The mean stent patency was 78 d (range, 8-225 d). No serious complications, such as anastomotic leakage, stent migration and bleeding were observed in these patients. Conclusions:Fluoroscopically-guided SEMS placement represents a technically safe and clinically effective intervention for managing anastomotic obstructions in recurrent gastric cancer. SEMS placement offers rapid symptom relief, shorter hospital stays, and improved quality of life compared to surgical alternatives in this patient population. Thus, based on its technical feasibility and clinical outcomes, this method warrants primary consideration in palliative treatment algorithms.

To develop and validate a predictive model for stent patency following a palliative self-expandable metallic stent (SEMS) for primary malignant colonic obstruction. Patients with primary malignant colonic obstruction who underwent SEMS treatment were included in this study. One retrospective set (N = 121) was used to develop and validate the predictive model. The clinical features were collected and subjected to Cox regression analyses. The final predictive model was displayed as a nomogram, which was validated in an independent set (N = 36). The clinical prognostic model was composed of pre-chemotherapy (P < 0.001), time of obstruction (P = 0.005), and post-chemotherapy (P < 0.001). The time-dependent area under the curve were 0.898 at 30-day, 0.778 at 90-day, 0.728 at 180-day, and 0.844 at 360-day in the training set; and 0.654 at 30-day, 0.745 at 90-day, 0.777 at 180-day, and 0.740 at 360-day in the validation set. Moreover, this easy-to-use and individualized nomogram was exclusively applied to predict stent patency and showed a favorable prognostic performance in the training and validation sets. The nomogram developed in this study accurately predicts stent patency and shows promise for personalized SEMS management. However, external validation must be prioritized before clinical implementation to ensure generalizability and safety.

ObjectiveIn patients with occlusion or severe stenosis of the internal jugular vein, the retrieval of temporary inferior vena cava (IVC) filters often proves technically challenging. This study was designed to evaluate the feasibility and safety of the right subclavian vein (SCV) as an alternative access route for retrieving temporary IVC filters.MethodsPatients treated with inferior vena cava (IVC) filters were included in a retrospective analysis between August 2023 and May 2025. A total of 87 eligible patients were divided into two separate groups based on the puncture route; right subclavian vein (SCV) group and internal jugular vein (IJV) group. A retrospective analysis was performed on their patient demographics, operative duration, radiation dose, costs, and postoperative recovery time.ResultsNotable statistical disparities were detected between the two groups in primary disease, operative time, fluoroscopy time, and radiation dose. Compared with the internal jugular vein (IJV) group, the right subclavian vein (SCV) group exhibited a higher prevalence of primary malignant diseases, along with a mean 7.35-min increase in operative time, 127-s longer fluoroscopy time, and 14.11-mGy higher radiation dose. Follow-up CT assessments revealed sustained patency of the subclavian veins in the right subclavian vein (SCV) group, with no instances of thrombosis or stenosis observed during the postoperative period, or any life-threatening pneumothorax or bleeding was detected.ConclusionsThe right subclavian vein (SCV) approach is suggested as a safe and effective alternative, especially when the internal jugular vein (IJV) is severely stenosed or occluded. For temporary inferior vena cava (IVC) filter retrieval, the conventional internal jugular vein (IJV) route is recommended; however, the right subclavian vein (SCV) may be considered a clinically appropriate alternative in specific indications, without significantly increasing procedural difficulty or surgical costs.

OBJECTIVES:To evaluate the effectiveness and safety of transcatheter arterial embolization (TAE) with N-butyl-2 cyanoacrylate (NBCA) versus without NBCA for the treatment of iatrogenic renal haemorrhage (IRH) in patients with normal coagulation profiles. METHODS:Forty-nine participants with normal coagulation profiles were divided into 2 groups: NBCA (n = 12) and non-NBCA (n = 37). The primary outcome assessed was the primary clinical success rate, with secondary analyses conducted on technical success rate, secondary clinical success rate, procedure duration and cost, angiographic results, and adverse events. RESULTS:Patients exhibited a near-normal coagulation condition (98.4%, 50/51). Technical success was attained in all patients, with no statistically significant differences observed between primary clinical success rate (P > .99), secondary clinical success rate (P > .99), procedure time (P = .469), and surgical costs (P  = .057) when comparing the sides. In the non-NBCA group, negative angiographic findings were more prevalent compared with the NBCA group (43.2% vs 0, P = .012). No significant differences were found in serum creatinine and urea levels before and after treatment in both the groups (P > .05). Minor complications were observed after the TAE procedure, with a higher percentage in the NBCA group compared with the non-NBCA group (P = .088). CONCLUSIONS:TAE has been shown to be a safe and effective treatment for IRH in patients with normal coagulation conditions, regardless of the use of NBCA glue. ADVANCES IN KNOWLEDGE:There were no significant differences in procedure time or costs between the NBCA group and other treatment modalities. However, these findings require validation in large-scale randomized controlled trials.

Background Oxaliplatin resistance usually leads to therapeutic failure and poor prognosis in colorectal cancer (CRC), while the underlying mechanisms are not yet fully understood. Metabolic reprogramming is strongly linked to drug resistance, however, the role and mechanism of metabolic reprogramming in oxaliplatin resistance remain unclear. Here, we aim to explore the functions and mechanisms of purine metabolism on the oxaliplatin-induced apoptosis of CRC. Methods An oxaliplatin-resistant CRC cell line was generated, and untargeted metabolomics analysis was conducted. The inosine 5ʹ-monophosphate dehydrogenase type II (IMPDH2) expression in CRC cell lines was determined by quantitative real-time polymerase chain reaction (qPCR) and western blotting analysis. The effects of IMPDH2 overexpression, knockdown and pharmacological inhibition on oxaliplatin resistance in CRC were assessed by flow cytometry analysis of cell apoptosis in vivo and in vitro. Results Metabolic analysis revealed that the levels of purine metabolites, especially guanosine monophosphate (GMP), were markedly elevated in oxaliplatin-resistant CRC cells. The accumulation of purine metabolites mainly arose from the upregulation of IMPDH2 expression. Gene set enrichment analysis (GSEA) indicated high IMPDH2 expression in CRC correlates with PURINE_METABOLISM and MULTIPLE-DRUG-RESISTANCE pathways. CRC cells with higher IMPDH2 expression were more resistant to oxaliplatin-induced apoptosis. Overexpression of IMPDH2 in CRC cells resulted in reduced cell death upon treatment with oxaliplatin, whereas knockdown of IMPDH2 led to increased sensitivity to oxaliplatin through influencing the activation of the Caspase 7/8/9 and PARP1 proteins on cell apoptosis. Targeted inhibition of IMPDH2 by mycophenolic acid (MPA) or mycophenolate mofetil (MMF) enhanced cell apoptosis in vitro and decreased in vivo tumour burden when combined with oxaliplatin treatment. Mechanistically, the Wnt/β-catenin signalling was hyperactivated in oxaliplatin-resistant CRC cells, and a reciprocal positive regulatory mechanism existed between Wnt/β-catenin and IMPDH2. Blocking the Wnt/β-catenin pathway could resensitize resistant cells to oxaliplatin, which could be restored by the addition of GMP. Conclusions IMPDH2 is a predictive biomarker and therapeutic target for oxaliplatin resistance in CRC.

ObjectiveTo evaluate the safety and efficacy of partial splenic embolization (PSE) in treating chemotherapy-induced thrombocytopenia (CIT) in patients with colorectal cancer who failed to respond to platelet growth factor therapy.Methods56 patients who underwent PSE were retrospectively analyzed. Based on the inclusion and the exclusion criteria, 29 patients were eligible for the study, of whom one underwent twice PSE procedures due to recurrent thrombocytopenia. The clinical characteristics were retrospectively analyzed with respect to efficacy, safety and outcome.Results60.0% of patients restarted antineoplastic therapy after PSE. There was a positive correlation between difference value of platelet count and embolization material size (Eta Squared = 0.252, p < 0.05). The correlation between the absolute volume of spleen embolized and postoperative complications was analyzed, with a statistically significant result (p < 0.001). The mean preoperative spleen volume, the preoperative platelet count, postoperative platelet count and difference value of platelet count in the non-cirrhotic group were larger than those in the cirrhotic group (p < 0.001). The mean overall survival was 47.7 ± 7.7 months.ConclusionPSE is safe and effective in the treatment of CIT patients with colorectal cancer. The larger the embolized particle, the more platelets grew. The severity of complication was also positively correlated with the absolute volume of spleen embolized. Therefore, large particle embolization materials can be used to improve the efficacy of PSE and reduce complications. For CIT patients with cirrhosis, PSE was less effective in improving platelet count than those without cirrhosis.

BACKGROUND: Microwave ablation (MWA) is becoming an effective therapy for inoperable pulmonary metastases from colorectal cancer (CRC). However, it is unclear whether the primary tumor location affects survival after MWA. OBJECTIVE: This study aims to investigate the survival outcomes and prognostic factors of MWA based on different primary origins between colon and rectal cancer. METHODS: Patients who underwent MWA for pulmonary metastases from 2014 to 2021 were reviewed. Differences in survival outcomes between colon and rectal cancer were analyzed with the Kaplan-Meier method and log-rank tests. The prognostic factors between groups were then evaluated by univariable and multivariable Cox regression analyses. RESULTS: A total of 118 patients with 154 pulmonary metastases from CRC were treated in 140 MWA sessions. Rectal cancer had a higher proportion with seventy (59.32% ) than colon cancer with forty-eight (40.68% ). The average maximum diameter of pulmonary metastases from rectal cancer (1.09 cm) was greater than that of colon cancer (0.89 cm; p = 0.026). The median follow-up was 18.53 months (range 1.10 – 60.63 months). The disease-free survival (DFS) and overall survival (OS) in colon and rectal cancer groups were 25.97 vs 11.90 months (p = 0.405), and 60.63 vs 53.87 months (p = 0.149), respectively. Multivariate analyses showed that only age was an independent prognostic factor in patients with rectal cancer (HR = 3.70, 95% CI: 1.28 – 10.72, p = 0.023), while none in colon cancer. CONCLUSIONS: Primary CRC location has no impact on survival for patients with pulmonary metastases after MWA, while a disparate prognostic factor exists between colon and rectal cancer.

Colorectal cancer (CRC) is the third most malignant tumour worldwide, with high mortality and recurrence. Chemoresistance is one of the main factors leading to metastasis and poor prognosis in advanced CRC patients. By analysing the Gene Expression Omnibus data set, we found higher hexokinase 2 (HK2) expression levels in patients with metastatic CRC than in those with primary CRC. Moreover, we observed higher enrichment in oxaliplatin resistance-related gene sets in metastatic CRC than in primary CRC. However, the underlying relationship has not yet been elucidated. In our study, HK2 expression was significantly elevated in CRC patients. Gene set enrichment analysis (GSEA) revealed multi-drug resistance and epithelial-mesenchymal transition (EMT) pathways related to high HK2 expression. Our results showed that knockdown of HK2 significantly inhibited vimentin and Twist1 expression and promoted TJP1 and E-cadherin expression in CRC cells. Additionally, transcriptional and enzymatic inhibition of HK2 by 3-bromopyruvate (3-bp) impaired oxaliplatin resistance in vitro and in vivo. Mechanistically, HK2 interacts with and stabilized Twist1 by preventing its ubiquitin-mediated degradation, which is related to oxaliplatin resistance, in CRC cells. Overexpression of Twist1 reduced the apoptosis rate by HK2 knockdown in CRC cells. Collectively, we discovered that HK2 is a crucial regulator that mediates oxaliplatin resistance through Twist1. These findings identify HK2 and Twist1 as promising drug targets for CRC chemoresistance.

Platelet-derived growth factor C (PDGF-C) is a member of the PDGF/VEGF (vascular endothelial growth factor) family, which includes proteins that are well known for their mitogenic effects on multiple cell types. Glycosylation is one of the most important forms of posttranslational modification that has a significant impact on secreted and membrane proteins. Glycosylation has many well-characterized roles in facilitating protein processing and contributes to appropriate folding, conformation, distribution, and stability of proteins that are synthesized intracellularly in the endoplasmic reticulum (ER) and Golgi apparatus. Although the general process and functions of glycosylation are well documented, there are most likely others yet to be discovered, as the glycosylation of many potential substrates has not been characterized. In this study, we report that the PDGF-C protein is glycosylated at three sites, including Asn25, Asn55, and Asn254. However, we found that mutations at any of these sites do not affect the protein expression or secretion. Similarly, disruption of PDGF-C glycosylation had no impact on its progression through the ER and Golgi apparatus. However, the introduction of a mutation at Asn254 (N254 A) prevents the activation of full-length PDGF-C and its capacity for signaling via the PDGF receptor. Our findings reveal that glycosylation affects PDGF-C activation rather than the protein synthesis or processing. This study characterizes a crucial modification of the PDGF-C protein, and may shed new light on the process and function of glycosylation.

BACKGROUND AND GOALS:Acute non-variceal gastrointestinal bleeding (NVGIB) is one of the most common medical emergencies, leading to significant morbidity and mortality without proper management. This study was to analyze the causes of NVGIB and to evaluate the safety, efficacy, and feasibility of transcatheter arterial embolization (TAE) for the treatment of NVGIB. STUDY:From November 2012 to October 2018, 158 patients with NVGIB underwent digital subtraction angiography, and TAE was performed for confirmed gastrointestinal bleeding. Patient characteristics, cause of bleeding, angiographic findings, technical and clinical success rates, complication rates, and outcomes were retrospectively analyzed. RESULTS:Bleeding was confirmed in 71.5% (113/158) of performed angiographies, and 68 patients had visible contrast extravasation on angiography, with the other 45 patients having indirect signs of bleeding. Among the 113 patients with confirmed gastrointestinal bleeding, TAE was technically successful in 111 patients (98.2%). The mean procedure time required for TAE was 116 ± 44 min (ranging from 50 to 225 min). The primary total clinical success rate of TAE was 84.7% (94/111). The primary clinical success rates of TAE for vascular abnormality, neoplastic disease, and iatrogenic condition were 84.5% (49/58), 84.1% (37/44), and 88.9% (8/9), respectively. Intestinal necrosis and perforation were found in two patients after TAE. CONCLUSIONS:The causes of NVGIB are complex and the onset, location, risk, and clinical presentations are variable. NVGIB can be generally divided into three types: vascular abnormality, neoplastic disease, and iatrogenic condition. TAE is a safe, effective, and fast procedure in the management of gastrointestinal bleeding.

Oligodendroglioma is an important type of lower-grade glioma (LGG), which is a slowly progressing brain tumor. Many LGGs eventually transform into a more aggressive or malignant type. Enhanced angiogenesis is a characteristic of malignantly transformed oligodendroglioma (m-oligodendroglioma). However, the pathogenesis and signaling pathways associated with angiogenesis and proliferation in m-oligodendroglioma are not well understood. In this study, we identified that Insulin Gene Enhancer Protein (ISL2) and its angiogenic capacity were inversely related to survival according to LGG patient data from an online database, and this was further confirmed with pathological LGG patient samples, including malignantly transformed samples, by detecting the expression of ISL2, the angiogenic markers vascular endothelial growth factor (VEGFA) and CD31 and the proliferation marker Ki-67. We then established novel oligodendroglioma patient tumor-derived orthotopic xenograft mouse models and cell lines to verify the role of ISL2 in regulating angiogenesis to promote oligodendroglioma growth and malignant transformation. Furthermore, ISL2 regulated ANGPT2 transcription by binding to the ANGPT2 promoter. Then, ANGPT2, a downstream gene, activated angiogenesis through VEGFA to promote oligodendroglioma malignant transformation. Finally, combining AAV-ISL2-shRNA with temozolomide suppressed oligodendroglioma progression more effectively than either monotherapy in vivo and in vitro. Thus, hypoxia-induced ISL2 regulated ANGPT2, which subsequently induced angiogenesis to promote oligodendroglioma growth and malignant transformation. Malignancy was accompanied by worsened hypoxia inside the tumor mass, creating a positive feedback loop. In conclusion, this study suggests that ISL2 is a biomarker for oligodendroglioma progression and that anti-ISL2 therapy may offer a potential clinical strategy for treating m-oligodendroglioma.

The aim of the present study was to explore the classification of the internal iliac artery (IIA) and the diagnostic value of the pelvic tumour-feeding artery by multislice computed tomography angiography (MSCTA) compared with digital subtraction angiography (DSA). A total of 43 patients with pelvic tumours were enrolled between January 2013 and August 2017. The classification of the IIA and the quality of the feeding artery of the pelvic tumours were analysed by Yamaki's classification (Groups A-D according to IIA branching) and the 5-point scoring system. The degree of feeding artery stenosis, caused by tumour compression or invasion, was analysed by a 4-point scoring system. The Wilcoxon signed-rank test was used to determine the vascular diagnostic quality identified by MSCTA and DSA. MSCTA of the pelvic arteries was successfully performed in all patients. The main classifications of the IIA were Group A, followed by Group C, then Group B and with no cases of Group D. There was no significant difference in the classification of the IIA between the left and right sides on MSCTA and DSA. The visualization quality of the IIA and its main branches showed excellent consistency, but the difference in the terminal branches of the feeding arteries in the pelvic tumours was statistically significant between MSCTA and DSA. MSCTA has great advantages in evaluating the classification of the IIA, the imaging quality evaluation of the IIA and its main branches, and in the evaluation of the pelvic tumour-feeding artery. However, in the display of the terminal arterial branches of the pelvic tumours, DSA remains irreplaceable, particularly in cases of interventional embolization.

OBJECTIVE: To investigate the clinical efficacy and safety of fluoroscopic guided percutaneous antegrade ureteral stents placement used for treatment of malignant ureteral obstruction. METHODS: Between April 2016 and March 2018, fluoroscopic guided percutaneous ureteral stents was performed in 25 patients, including 7 patients (28%) with bilateral obstruction. The most common cancer diagnoses were cervical cancer (28%), rectal cancer (24%) and colon cancer (16%) among these patients. Clinical data were retrospectively analyzed with respect to the efficacy, safety and outcome of this treatment method. RESULTS: Percutaneous antegrade placement of ureteral stents was performed in all cases, including 12 ureters that failed in the initial retrograde ureteral stents placement. The median stent patency time for the antegrade ureteral stents were 10.4 (95% CI: 8.3-12.6) months. The primary complications included mild flank pain and discomfort (44%), hematuria (44%), urinary tract infection (8%), bladder irritation symptoms (4%), and arterial bleeding (4%). CONCLUSION: Fluoroscopic guided percutaneous ureteral stents placement is a safe, efficient procedure and has a high success rate in patients with malignant ureteral obstruction.

The aim of the present study was to investigate the safety and efficacy of long intestinal tube placement under fluoroscopic guidance for the treatment of malignant bowel obstruction (MBO). The cases of 74 patients with MBO who underwent long intestinal tube placement under fluoroscopic guidance during the period between June 2015 and October 2017 were reviewed. The clinical characteristics were retrospectively analysed with respect to efficacy, safety and outcome. Long intestinal tube placement was successfully completed in all 74 patients. The mean time required for tube placement was 31.09±16.25 min and the mean insertion depth of the tube was 153±39 cm. In 58 cases, the symptoms of abdominal pain, abdominal bloating and vomiting were greatly improved following 1-3 days of tube decompression. The symptoms of the remaining 16 patients were not effectively relieved following decompression. No serious complications were observed in any patients. Overall, for patients with severe MBO, long intestinal tube placement under fluoroscopic guidance appears to be an effective and safe treatment, and it may improve quality of life.