A Comparative Study of Conservation, Endovascular Embolization Therapy, and Surgery for Blunt Renal Trauma.

BACKGROUND In this study, we evaluated the advantages and disadvantages of angioembolization in patients with Grade III-V blunt renal trauma compared with other treatments. MATERIAL AND METHODS We prospectively collected data on patients hospitalized for Grade III-V blunt renal trauma. Organ damage was graded according to the American Association for the Surgery of Trauma (AAST) criteria. Initial grouping was then performed according to the hemodynamics and "initial treatment". The eligible patients were divided into 3 groups: conservative treatment group (Group A), arterial embolization group (Group B), and surgical group (Group C). The success rate, significance, and follow-up renal function were evaluated. RESULTS In Group B of Grade IV, estimated glomerular filtration rate (eGFR) and serum creatinine (Scr) levels were slightly decreased and increased, respectively, after embolization compared with before embolization (P=0.002, P=0.039). In Grade V, the eGFR of Group B after embolization was lower than before embolization (P=0.041); The levels of serum urea (Urea) and Scr in Group B after treatment were higher than those before treatment (P=0.042, P=0.024). Conservative treatment and angioembolization were better than exploration in protecting renal function of Grade IV (P=0.035 and P=0.047, respectively). CONCLUSIONS The success rate of angioembolization was high and protected renal function to the greatest extent, and there were no differences in renal function at long-term follow-up. However, it is difficult to manage renal vessel laceration or avulsion by embolization alone, and various endovascular therapies are required to protect the function of residual kidneys.

Comparative Study of Drug-eluting Beads versus Conventional Transarterial Chemoembolization for Treating Peculiar Anatomical Sites of Gastric Cancer Liver Metastasis.

BACKGROUND This study aimed to assess the relative safety and short-term efficacy of drug-eluting bead transarterial chemoembolization (DEB-TACE) and conventional transarterial chemoembolization (c-TACE) for treating peculiar anatomical sites of gastric cancer liver metastasis. MATERIAL AND METHODS Of the 68 patients with gastric cancer liver metastases confirmed by imaging and pathology, 35 were treated with DEB-TACE and 33 with c-TACE. The DEB-TACE group comprised 26 males and 9 females aged 28-75 years (56.8±6.3), and the c-TACE group included 19 males and 14 females aged 33-77 (60.2±9.4) years. Liver functions of the 2 groups were compared between pre-TACE and 1-week and 1-month after TACE. Computed tomography and magnetic resonance imaging were reexamined at 1, 3, and 6 months after TACE, and short-term efficacy was assessed based on modified response evaluation criteria in solid tumors. RESULTS One month following DEB-TACE and c-TACE, the number of cases with objective response (OR) was 29 cases (29 out of 35 cases, 82.9%) and 20 cases (20 out of 33 cases, 60.6%) and disease control (DC) in the 2 groups was 33 cases (33 out of 35 cases, 94.3%) and 26 cases (26 out of 33 cases, 78.8%) respectively (P=0.041, P=0.031). Alanine transaminase (ALT) and Aspartate transaminase (AST) significantly increased in the DEB-TACE and c-TACE groups 1 week later (P<0.001). There were no serious complications in the 2 groups; incidences of nausea and vomiting were significantly lower, but instances of fever were markedly elevated in the DEB-TACE group (P=0.023, P=0.016, respectively). CONCLUSIONS The safety, feasibility, and short-term efficacy of DEB-TACE and c-TACE in the treatment of gastric cancer liver metastasis are clear. DEB-TACE leads to less incidences of nausea and vomiting but more incidences of fever than c-TACE.

Value of Angioembolization in the Treatment of Iatrogenic Renal Vascular Injury Assisted by 3-Dimensional Digital Subtraction Angiography.

BACKGROUND This study was conducted to investigate the reliability and efficacy of polyvinyl alcohol combined with coils in the embolization of iatrogenic renal vascular injury with the assistance of 3-dimensional digital subtraction angiography (3D-DSA). MATERIAL AND METHODS Twenty-six patients with minimally invasive renal bleeding who underwent transarterial embolization from January 2012 to January 2019 in our hospital were included in the study. We obtained demographic data from these patients, as well as information on clinical presentation, renal procedures used for treatment, and perioperative details. The changes in renal function tests, serum hemoglobin, serum hematocrit, and technetium Tc 99m dimercaptosuccinic acid (99mTc-DMSA) levels pre- and postembolization were compared. In addition, the embolic area and the technical and clinical success rates were analyzed. Finally, an angiographic manifestation of the renal artery, 3D-DSA, and the effect of embolization were analyzed retrospectively. RESULTS All patients achieved technical and clinical success after embolization (100%, 26/26). There were no significant differences between pre- and postoperative estimated glomerular filtration rate, serum parameters, and 99mTc-DMSA. The embolic area was 12%±10%. Patients did not exhibit severe complications during the follow-up period. CONCLUSIONS Proximal embolization technique assisted by 3D-DSA for renal iatrogenic hemorrhage and vascular lesions is both safe and efficacious, offering high rates for both clinical and technical success. It maximizes the protection of the kidney and reduces the rate of renal resection.

Identification of serum exosomal lncRNA MIAT as a novel diagnostic and prognostic biomarker for gastric cancer.

BACKGROUND: Accumulating evidence has demonstrated that long non-coding RNAs (lncRNAs) MIAT is significantly upregulated in many cancer types including gastric cancer (GC). However, the potential clinical significance of serum exosomal MIAT in GC is unknown. METHODS: In this study, a total of 109 GC patients, 48 gastric adenoma patients, and 50 healthy individuals were recruited. Serum exosomal MIAT levels were detected in all participants using quantitative real-time reverse transcription-polymerase chain reaction (qRT-PCR). RESULTS: The exosomes we extracted from the serum samples were positive for TSG101, CD63, and Flotillin-1, which were known exosome markers. Serum exosomal MIAT levels were significantly higher in GC patients than in gastric adenoma patients and healthy controls. Interestingly, gastric adenoma patients with higher serum exosomal MIAT expression were more prone to develop GC. In addition, serum exosomal MIAT levels were significantly decreased in post-treatment blood samples compared to pre-treatment samples, while markedly increased in the cases suffering recurrence. Moreover, serum exosomal MIAT upregulation was significantly associated with worse clinical variables and shorter survival. Furthermore, serum exosomal MIAT was identified as an independent prognostic factor for GC. CONCLUSIONS: Collectively, serum exosomal lncRNA MIAT might serve as a promising novel biomarker for monitoring the progression of GC.

The causal effects of intelligence and fluid intelligence on Parkinson's disease: a Mendelian randomization study.

Background: Parkinson's disease (PD) is a chronic neurodegenerative disease that affects the central nervous system, primarily the motor nervous system, and occurs most often in older adults. A large number of studies have shown that high intelligence leads to an increased risk of PD. However, whether there is a causal relationship between intelligence on PD has not yet been reported. Methods: In this study, Mendelian randomization (MR) analysis was performed with intelligence (ebi-a-GCST006250) and fluid intelligence score (ukb-b-5238) as exposure factors and PD (ieu-b-7) as an outcome, which the datasets were mined from the IEU OpenGWAS database. MR analysis was performed through 3 methods [MR Egger, weighted median, inverse variance weighted (IVW)], of which IVW was the primary method. In addition, the reliability of the results of the MR analysis was assessed via the heterogeneity test, the horizontal polytropy test, and Leave-One-Out (LOO). Finally, based on gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) databases, the genes corresponding to intelligence and fluid intelligence score related to SNPs were enriched for functional features and pathways. Results: The results of MR analysis suggested that elevated intelligence indicators can increase the risk of PD [p = 0.015, Odd Ratio (OR) = 1.316]. Meanwhile, fluid intelligence score was causally associated with the PD (p = 0.035), which was a risk factor (OR = 1.142). The reliability of the results of MR analysis was demonstrated by sensitivity analysis. Finally, the results of GO enrichment analysis for 87 genes corresponding to intelligence related SNPs mainly included regulation of synapse organization, developmental cell growth, etc. These genes were enriched in the synaptic vessel cycle, polycomb expressive complex in KEGG. Similarly, 44 genes corresponding to SNPs associated with fluid intelligence score were used for enrichment analysis. Based on the GO database, these genes were mainly enriched in regulation of developmental growth, negative regulation of neuron projection development, etc. In KEGG, 44 genes corresponding to SNPs associated with fluid intelligence score were enriched in signaling pathways including Alzheimer's disease, the cellular senescence, etc. Conclusion: The causal relationships between intelligence and fluid intelligence scores, and PD were demonstrated through MR analysis, providing an important reference and evidence for the study of PD.

RPARP-AS1/miR125a-5p Axis Promotes Cell Proliferation, Migration and Invasion in Colon Cancer.

BACKGROUND: It was reported that long-noncoding RNAs (lncRNAs) had been identified as a novel class of regulators related to various cancers. RPARP-AS1, a differentially-expressed gene, was found in analysis of the gene expression profile of CRC from GEO database. However, its function has not been clear. METHODS: RPARP-AS1 expression was determined by qPCR and Startbase3 analysis. Knockdown of RPARP-AS1 in CRC cell lines was performed by RNAi technology, named si-RPARP-AS1 HCT116 and si-RPARP-AS1 LoVo. Cell proliferation was examined by CCK8 and colony formation assay. RNA pull-down and Luciferase reporter assay were performed to confirm the interaction between RPARP-AS1 and miR-125a-5p. RESULTS: In the study, we found that the expression of RPARP-AS1 was significantly up-regulated in CRC tissues and multiple CRC cell lines, which was closely related to poor prognosis of CRC patients. Loss-of-function studies indicated that knockdown of RPARP-AS1 inhibited CRC cell proliferation, migration and invasion in HCT116 and LoVo cell lines. Results of research on the mechanisms showed that RPARP-AS1 functioned as a competitive endogenous RNA (ceRNA) to sponge miR-125a-5p, therefore promoting CRC procession. CONCLUSION: In summary, these results indicated that RPARP-AS1/miR-125a-5p axis played a positive role in promoting cell proliferation, migration and invasion in CC. It may be as a biomarker used to evaluate CRC prognosis.

Imaging features of Vertebral Aneurysmal Bone Cyst and the clinical value of interventional embolization.

The current study aimed to investigate the imaging manifestations of vertebral aneurysmal bone cyst (ABC), and examine the clinical value of interventional embolization. Imaging examinations of 5 patients with pathologically confirmed spinal ABC were analysed and arterial angiography and embolization were performed prior to surgery. The cases in this cohort exhibited different degrees of intrusion into the vertebral arch and spinous and transverse processes. Lesions that protruded into the spinal canal resulted in compression of the thecal sac and spinal cord. Enlargement of arteries was detected by digital subtraction angiography and decreased significantly following embolization. Blood loss during surgery was also significantly reduced. Preoperative embolization of ABC reduces bleeding and allows for easy access to tissue, which is of great clinical value.

Application of interventional embolization in the treatment of iatrogenic pseudoaneurysms.

The present study aimed to investigate the clinical effectiveness and safety of endovascular embolization for the treatment of pseudoaneurysm secondary to previous abdominal and pelvic surgery or radiological percutaneous abdominal procedure. A retrospective review was performed on all patients with abdominal and pelvic pseudoaneurysm confirmed by CT angiography or digital subtraction angiography and treated with endovascular embolization. Different techniques of embolization with coils were applied and the outcomes, including clinical effectiveness and safety, were assessed. A total of 31 patients with a total of 32 pseudoaneurysms were included in the present study. Of these pseudoaneurysms, 23 were from the main trunks and branches of the gastroduodenal artery, 5 were from the splenic artery, 2 were from the common hepatic artery, 1 was from the right hepatic artery and 1 was from the right internal iliac artery. There were no serious complications observed and there was no occurrence of re-bleeding following embolization. The embolization of the pseudoaneurysms was successful in all patients. In conclusion, endovascular embolization is a safe and effective method for the treatment of secondary iatrogenic pseudoaneurysm in the abdomen and pelvis.

Clinical efficacy of coil embolization in treating pseudoaneurysm post-Whipple operation.

The present study aimed to evaluate the clinical efficacy and safety of angiography and coil embolization for pseudoaneurysm post-pancreatoduodenectomy (PD). A total of 17 patients with gastrointestinal or abdominal hemorrhage after PD were included in the present study. Angiography was performed on the celiac artery, common hepatic artery, splenic artery, gastroduodenal artery and superior mesenteric artery to determine the size of the pseudoaneurysm, the parent artery and its collateral branches. A variety of embolization techniques have been applied to embolize pseudoaneurysm, including the sac packing technique, proximal embolization, exclusion technique and sandwich technique. Different techniques with coils were used for embolization and the clinical effects of embolization were analyzed. A total of 18 pseudoaneurysms were identified in 17 patients. In 2 patients, severe technical complications occurred, including migration of the coil and rupture of pseudoaneurysm, and one of them died, which may have been associated with this complication. No serious clinical complications were observed in the other patients. A total of 7 patients had mild clinical complications, including mild abdominal and dorsal pain, which were alleviated after symptomatic management. A total of 15 patients with definite pseudoaneurysm were successfully embolized without re-bleeding and complications. The clinical success rate was 94.1% (16/17). In conclusion, a variety of embolization techniques may be applied for the treatment of pseudoaneurysm after PD, which have high technical and clinical success rates and small trauma. It is recommended in emergency situations, but care should be taken to avoid serious technical complications.

Long non-coding RNA bladder cancer-associated transcript 2 contributes to disease progression, chemoresistance and poor survival of patients with colorectal cancer.

Colorectal cancer (CRC) is one of the leading causes of cancer-associated mortality worldwide. Long non-coding RNAs (lncRNAs) have been revealed to modulate various biological cell processes, and are involved in the initiation and progression of different diseases, including CRC. However, the role of lncRNA bladder cancer-associated transcript 2 (BLACAT2) in CRC has not been defined. The present study aimed to investigate the role of BLACAT2 in CRC. The present study measured the expression levels of BLACAT2 in CRC cells and tissues by reverse-transcription-quantitative polymerase chain reaction, and associations among BLACAT2 expression levels, important clinicopathological parameters and patient survival were statistically evaluated. The functional role of BLACAT2 in metastasis, proliferation and drug resistance was also detected. BLACAT2 was overexpressed in CRC cells and tissues, and high BLACAT2 expression was associated with larger tumor size, and more advanced lymph node (N), metastasis (M) and tumor-NM stages. Additionally, survival analysis demonstrated that patients with high BLACAT2 expression exhibited poor overall survival. Notably, high BLACAT2 expression was identified as an independent risk factor for overall survival. Migration and invasion assays revealed that BLACAT2 promoted migration and invasion, respectively. In addition, overexpression of BLACAT2 increased colony numbers and optical density values of CRC cells in a colony formation assay and an MTT assay, respectively. Furthermore, BLACAT2 levels were significantly increased in 5-fluorouracil-resistant cells, and overexpression of BLACAT2 was markedly associated with a low cell inhibition rate. In conclusion, BLACAT2 overexpression may contribute to the metastasis, proliferation and chemoresistance of CRC cells, and high BLACAT2 expression may be a promising prognostic marker for patients with CRC.

The Changes of HIF-1α and VEGF Expression After TACE in Patients With Hepatocellular Carcinoma.

As a common malignant tumor, hepatocellular carcinoma (HCC) has a high prevalence and is a serious threat to human health. The surgical resection rate of HCC is low, and the prognosis is poor. Although transarterial chemoembolization (TACE) is the main treatment for HCC patients who are not candidates for surgical resection, it is not considered a curative procedure. For HCC, poor TACE efficacy or TACE failure may be related to tumor angiogenesis of the residual disease. Among the many regulatory factors in tumor angiogenesis, hypoxia-inducible factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF) play vital roles in this process. In this paper, we conducted a review of the dynamic change and relevance of HIF-1α and VEGF levels after TACE of HCC patients.

A Novel Two-Step Technique for Retrieving Fractured Peripherally Inserted Central Catheter Segments Migrating into the Heart or the Pulmonary Artery.

Objective. To report the experience of a percutaneous technique for retrieving fractured peripherally inserted central catheter (PICC) segments migrating into the heart or the pulmonary artery. Method. From April 2013 to July 2015, we performed percutaneous retrieval of fractured PICC segments migrating into the heart or the pulmonary artery in five cancer patients who had undergone chemotherapy via PICC. The fractures were diagnosed with chest plain radiography. The patients included three cases of breast cancer, one case of rectal cancer, and one case of lower limb Ewing's tumor. The fractures were retained in the vessels of the patients for 1 to 3 days. All the fractures were retrieved by using a novel two-step technique in the digital subtraction angiography (DSA) suite. This two-step technique involves inserting a pigtail catheter to the heart or the pulmonary artery to grasp the fractured catheter fragment and bring it to the lower segment of the inferior vena cava, followed by grasping and removing the catheter fragment with a retrieval loop system of the vena cava filter retrieval set. Result. The fractured PICC segments were removed successfully in all five patients via unilateral (four patients) or bilateral (one patient) femoral vein access. No complications occurred during the interventional procedure. Conclusion. Percutaneous retrieval can be a safe, convenient, and minimally invasive method for the removal of fractured PICC segments. The technique reported in this paper will be applicable for the retrieval of fractured PICC segments and other catheter fragments migrating into the heart or the pulmonary artery.