Objective To identify various arteriographic manifestations and the curative effects of emergency embolization of renal hemorrhage after percutaneous nephrolithotomy.Methods Emergency arteriography was performed in 21 patients of renal hemor-rhage after percutaneous nephrolithotomy.Emergency embolotherapy was conducted by using different embolic agents such as gelat-in sponge,polyvinyl alcohol (PVA)particles and coils after bleeding arteries were identified.The arteriographic manifestations and the curative effects of the treatment for renal hemorrhage were retrospectively analyzed.Results Contrast extravasations were con-firmed in 21 patients,among them,4 contrast extravasations with arteriovenous fistulas(AVF)of renal artery;3 pseudoaneurysms of renal artery.The hemorrhage completely stopped after emergent embolotherapy in 21 cases.During follow-up,no rebleedings and severe complications occurred.Conclusion Emergency arterial embolization for renal hemorrhage after percutaneous nephrolithotomy is a safe and effective treatment.The key to successful treatment is to select embolization agent reasonably and embolize the bleeding arteries thoroughly and completely.

目的 探讨膈下动脉(IPA)参与供血的大咯血患者的动脉造影表现及急诊栓塞治疗的疗效.方法 回顾性分析15例IPA参与供血的大咯血患者的临床资料.选用明胶海绵条、聚乙烯醇(poly vinyl alcohol,PVA)颗粒及弹簧圈选择性栓塞供血的IPA,对动脉造影的表现及治疗结果进行总结及评价.结果 选择性IPA造影显示为IPA增粗,分支增多、紊乱及新生血管形成.IPA供血区对比剂外溢10例,肿瘤血管及肿瘤染色3例,IPA与肺动脉分流2例.本组患者均行供血的IPA栓塞术,同时栓塞支气管动脉5支、肋间动脉4支,胸廓内动脉4支,栓塞术后咯血停止.术后随访1～2年,所有患者无再次咯血.结论 IPA可参与大咯血的供血,漏栓IPA是栓塞治疗大咯血失败或复发大咯血的原因之一,行急诊IPA栓塞是一种安全、有效的治疗手段.

Objective To explore the strategy and clinical effect of CT angiography in embolotherapy of massive arterial haemorrhage.Methods 120patients of massive arterial haemorrhage underwent angiography before embolotherapy.All bleeding arteries were found and blocked one by one in embolotherapy.CTA was conducted after two week of embolotherapy in 88patients.The strategy and clinical effect of CTA in embolotherapy of massive arterial haemorrhage was analysed retrospectively.Results All 162bleeding arteries were found in 120patients underwent CTA before embolotherapy.178 bleeding arteries were located and embolized successfully in embolotherapy.Diagnostic accuracy of CTA before embolotherapy was 91.01%(162/178).CTA after embolotherapy confirmed the embolized bleeding arteries were blocked completely in 88patients.Conclusion CTA before embolotherapy can provide the effect of location for finding the bleeding arteries in embolotherapy.CTA after embotherapy is conducive to determine the efficacy of embolization.

Objective: To explore the curative effect of emergency transcatheter bronchial arterial embolization (BAE) on massive hemoptysis due to bronchial artery to pulmonary artery fistula. Methods: The angiographic manifestations of massive hemoptysis in 17 cases due to bronchial artery to pulmonary artery fistula and curative effect of emergency BAE were retrospectively analyzed. Emergency angiography was performed to locate the bleeding artery, and then embolization was done using polyvinyl alcohol (PVA) particles and gelfoam strips. The curative effect and complications of BAE, as well as recurrence of bleeding were observed. Results: In 17 cases, totally 29 bronchial arteries were located and embolized successfully. Hemoptysis stopped within 24 h after embolotherapy in 16 cases and 2 days later in 1 case. Five patients received surgical resection of primary lesions for radical cure after embolotherapy. There was no severe complication after embolotherapy. During 2-year follow-up, no rebleeding occurred. Conclusion: Emergency BAE is safe and effective in treatment of massive hemoptysis due to bronchial artery to pulmonary artery fistula. Copyright © 2013 by the Press of Chinese Journal of Medical Imaging Technology.

Objective: To discuss the different angiographic manifestations of acute renal hemorrhage and the appropriate embolization measures. Methods: During the period from January 2009 to December 2011, a total of 25 patients with acute renal hemorrhage who had failed to respond to the conservative treatment were admitted to authors' hospital. Referring to the angiographic manifestations, super - selective arterial embolization by using appropriate embolic agents, such as gelatin sponge, polyvinyl alcohol particles or steel coils, was carried out in all patients. The patients were followed up for 4-10 months, and the results were analyzed. Results: The renal angiography showed that contrast extravasation was seen in 20 cases. Of the 20 patients, coexisting pseudoaneurysm was found in 2, accompanied arteriovenous fistula in 2, artery - calyces fistula in one and ruptured pseudoaneurysm together with arteriovenous fistula in one. Tumor vasculatures were revealed in 5 patients. Based on the angiographic findings different embolic agents were employed in different patients. During the follow-up period no recurrent bleeding or severe complications occurred in all patients. Conclusion: Acute renal hemorrhage has different angiographic signs. Through carefully observing the angiographic manifestations and strictly selecting appropriate embolic agents, satisfactory clinical effectiveness can be achieved with embolization therapy. Superselective renal artery embolization can effectively stop the bleeding and preserve the renal function to the greatest possible advantage. Therefore, as a safe, effective and micro - invasive treatment for acute renal hemorrhage this technique should be recommended in clinical practice.

Objective: To explore clinical effect of renal artery Computed Tomography angiography(CTA) in embolotherapy for hemorrhage of renal tumour.Methods: Twenty-eight renal hemorrhage patients of renal tumour underwent renal artery CT angiography before embolotherapy.All feeding arteries of renal tumors were found and blocked one by one in embolotherapy.Renal artery CT angiography was conducted after a week of embolotherapy.The clinical effect of renal artery CT angiography in embolotherapy for renal tumor was analysed retrospectively.Results: All 32 feeding arteries of renal tumors were found in twenty-eight patients underwent renal artery CT angiography before embolotherapy.While 34 feeding arteries of renal tumors were located and embolized successfully in embolotherapy.Diagnostic accuracy of renal artery CT angiography before embolotherapy is 94.12%(32/34).Renal artery CT angiography after embolotherapy confirmed the embolized feeding arteries of renal tumors were embolized well.Conclusion: Renal artery CT angiography before embolotherapy can provide the effect of location for finding the feeding arteries of renal tumors in embolotherapy.

Background The association between Methylenetetrahydrofolate reductase (MTHFR) Ala222Val (rs1801133) has been implicated to alter the risk of bladder cancer, but the results are controversial. Methods A comprehensive databases of Pubmed, Embase, Web of Science, and the Chinese Biomedical Database (CBM) were searched for case–control studies investigating the association between MTHFR Ala222Val polymorphism and bladder cancer susceptibility. Odds ratios (OR) and 95% confidence intervals (95%CI) were used to assess this possible association. A χ 2 -based Q-test was used to examine the heterogeneity assumption. Begg’s and Egger’s test were used to examine the potential publication bias. The leave-one-out sensitivity analysis was conducted to determine whether our assumptions or decisions have a major effect on the results of the review. Statistical analysis was performed with the software program Stata 12.0. Results A total of 15 independent studies were identified, including 3,570 cases and 3,926 controls. Our analysis suggested that Ala222Val was not associated with bladder cancer risk in overall population under additive model (OR=0.96, 95%CI=0.76-1.21, P=0.731), dominant model (OR=1.00, 95%CI=0.87-1.15, P=0.975), recessive model (OR=0.92, 95%CI=0.79-1.07, P=0.279), and Ala allele versus Val allele (OR=0.96, 95%CI=0.86-1.07, P=0.427). In the subgroup analysis stratified by ethnicity and sources of controls, there were also no significant associations detected among different descent populations, population-based studies and hospital-based studies. Conclusion This meta-analysis showed the evidence that MTHFR Ala222Val polymorphism was not contributed to the development of bladder cancer. Virtual slide The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2117182849994994 .

Objective: To observe the efficacy of emergency transcatheter arterial embolization (TAE) in treatment of iatrogenic renal arterial bleeding. Methods: Totally 49 patients with iatrogenic renal hemorrhage underwent emergency TAE. After locating the bleeding artery, embolotherapy was performed with gelfoam strips, coils or polyvinyl alcohol (PVA) particles. Results: Extravasations of contrast agent was confirmed in 31 patients. There were 7 patients with arteriovenous fistulas (AVF) of renal artery, 4 pseudoaneurysms of renal artery, 5 pseudoaneurysm rupture with AVF of renal artery, 2 renal artery-calyces fistula (ACF). The hemorrhage completely stopped after emergency TAE in all 49 patients. No severe complications occurred. During 12-16 months follow-up, no rebleeding happened. Conclusion: Emergency TAE is safe and effective for iatrogenic renal arterial bleeding, which has good clinical application value. Copyright©2013 by the Press of Chinese Journal of Medical Imaging Technology.

Objective To analyse the manifestations of angiography and the curative effect of emergency transcatheter arterial embolisation(ETAE)in patients with massive hemoptysis due to bronchial artery to pulmonary vein fistula.Methods 11cases of massive hemoptysis due to bronchial artery to pulmonary vein fistula underwent emergency arteriography.After bleeding arteries were located,the patients were given embolotherapy with gelfoam strips and polyvinyl alcohol(PVA) particles.The arteriography manifestations and therapeutic outcome from all 11patients were retrospectively analysed.Results 26bronchial arteries were located and embolized successfully in 11patients.Hemoptysis of all patients was stopped in 3days after embolotherapy.During 16-month follow-up,there were no rebleedings and severe complications.Conclusion ETAE is a safe and effective treatment for the massive hemoptysis due to bronchial artery to pulmonary vein fistula.The premise of successful treatment is to locate the bleeding arteries accurately,and the key of successful treatment is to thoroughly and completely embolize the bleeding arterials.

原发性肝癌是世界性常见的恶性肿瘤之一,肝癌的早发现早治疗已成为临床研究的重点.射频消融术(RFA)在国内外已成为公认的对小肝癌治疗有效的一种手段,尤其对于直径小于3cm的小肝癌患者,治愈率已经达到甚至超过外科切除治疗.在治疗直径大于3cm的小肝癌患者,单一的RFA治疗复发率相对较高.肝动脉化疗栓塞(TACE)对小肝癌的治疗效果早已获得承认,但也存在一定的缺点.TACE术后改变了原有的动脉供血系统,侧支循环容易建立,病灶坏死率较低,复发率较高,多次TACE治疗会加重肝功能的损害.TACE与RAF联合能在小肝癌患者治疗中取长补短,提高治疗的安全性、有效性,以及对患者的远期疗效.本文主要对肝动脉化疗栓塞术联合射频消融术治疗小肝癌的现状及其进展做一综述.