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Objective@#To evaluate the feasibility, safety, and effectiveness of CT-guided microcoil localization of solitary pulmonary nodules (SPNs) for guiding video-assisted thoracoscopic surgery (VATS). @*Materials and Methods@#Between June 2016 and October 2019, 454 consecutive patients with 501 SPNs who received CTguided microcoil localization before VATS in our institution were enrolled. The diameter of the nodules was 0.93 ± 0.49 cm, and the shortest distance from the nodules to the pleura was 1.41 ± 0.95 cm. The distal end of the microcoil was placed less than 1 cm away from the nodule, and the proximal end was placed outside the visceral pleura. VATS was performed under the guidance of implanted microcoils without the aid of intraoperative fluoroscopy. @*Results@#All 501 nodules were marked with microcoils. The time required for microcoil localization was 12.8 ± 5.2 minutes. Microcoil localization-related complications occurred in 179 cases (39.4%). None of the complications required treatment. A total of 463 nodules were successfully resected under the guidance of implanted microcoils. VATS revealed 38 patients with dislocated microcoils, of which 28 underwent wedge resection (21 cases under the guidance of the bleeding points of pleural puncture, 7 cases through palpation), 5 underwent direct lobectomy, and the remaining 5 underwent a conversion to thoracotomy. In 4 cases, a portion of the microcoil remained in the lung parenchyma. @*Conclusion@#CT-guided microcoil localization of SPNs is safe and reliable. Marking the nodule and pleura simultaneously with microcoils can effectively guide the resection of SPNs using VATS without the aid of intraoperative fluoroscopy.
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Objective@#To evaluate the feasibility, safety, and effectiveness of CT-guided microcoil localization of solitary pulmonary nodules (SPNs) for guiding video-assisted thoracoscopic surgery (VATS). @*Materials and Methods@#Between June 2016 and October 2019, 454 consecutive patients with 501 SPNs who received CTguided microcoil localization before VATS in our institution were enrolled. The diameter of the nodules was 0.93 ± 0.49 cm, and the shortest distance from the nodules to the pleura was 1.41 ± 0.95 cm. The distal end of the microcoil was placed less than 1 cm away from the nodule, and the proximal end was placed outside the visceral pleura. VATS was performed under the guidance of implanted microcoils without the aid of intraoperative fluoroscopy. @*Results@#All 501 nodules were marked with microcoils. The time required for microcoil localization was 12.8 ± 5.2 minutes. Microcoil localization-related complications occurred in 179 cases (39.4%). None of the complications required treatment. A total of 463 nodules were successfully resected under the guidance of implanted microcoils. VATS revealed 38 patients with dislocated microcoils, of which 28 underwent wedge resection (21 cases under the guidance of the bleeding points of pleural puncture, 7 cases through palpation), 5 underwent direct lobectomy, and the remaining 5 underwent a conversion to thoracotomy. In 4 cases, a portion of the microcoil remained in the lung parenchyma. @*Conclusion@#CT-guided microcoil localization of SPNs is safe and reliable. Marking the nodule and pleura simultaneously with microcoils can effectively guide the resection of SPNs using VATS without the aid of intraoperative fluoroscopy.
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ObjectiveThe mechanism of histone phosphorylation modification in oocyte meiosis is less studied. This study is designed to investigate the pattern of histone H3 phophorylation and regulation of maturation process in the porcine oocytes.MethodsThe histone H3Ser10 (H3S10) phosphorylation expression was examined on the porcine oocyte meiotic process. The porcine cumulus oocyte complexes (COCs) were divided into four groups, one group was cultured as control group, and the other 3 groups were supplemented with 5, 10, and 30 μmol/L ZM447439, and cultured in vitro for 27 h, respectively, 5, 10, and 30 μmol/L ZM4474349 treatment group. The proportion of each meiotic stage was counted. The phosphorylation pattern of histone H3S10 and the expression level of protein kinase Aurora B were detected at the porcine oocytes.ResultsCompared with histone H3S10 phosphorylation level of oocyte GVBD phase, the MI and AI phases were significantly increased (P<0.05), and H3S10 phosphorylation level of AI phase was remarkedly higher than that of MII phase (P<0.05). Compared with the control group, the proportion of oocytes at the GVBD phase in the 10 and 30 μmol/L ZM4447439 treatment group [(32.14±0.51)%, (95.34±0.59)%]was higher than that of the control group [(2.56±0.03)%, P<0.05], the proportion of oocytes at the MI phase [(66.88±0.13)%, (4.66±0.04)%] significantly decreased than that of the control group [(87.42±0.14)%, P<0.05], and the proportion of oocytes at the AI stage [(1.01±0.03)%, (0.000±0.00)%] significantly decreased compared with the control group[(10.02 ± 0.21)%, P<0.05]. Compared with the control group (0), oocytes H3S10 dephosphorylation modification ratio in the 10 μmol/L and 30 μmol/L ZM4474349 treatment group [(35.2±0.39)%, (95.4±0.65)%]significantly increased (P<0.05). Compared with the control group, the relative expression level of Aurora B in the 10 and 30 μmol/L ZM4447439 treatment group was significantly reduced (P<0.05).ConclusionHstone H3S10 phosphorylation plays arolein the maturation of mammalian oocytes. AuroraB kinase inhibitors (ZM447439) treatment can reduce H3S10 phosphorylation and Aurora B expression level and lead to oocytesmaturation disorder.
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OBJECTIVE: To meta-analytically compare combined transarterial chemoembolization (TACE) plus radiofrequency ablation (RFA) and surgical resection (SR) for the treatment of hepatocellular carcinoma (HCC) within the Milan criteria. MATERIALS AND METHODS: PubMed, Medline, Embase, and Cochrane Library were searched for studies comparing these two therapies that were published between January 2006 and August 2017. Overall survival rate (OS), recurrence-free survival rate (RFS), major complications and the average length of hospital stay were compared between these two therapies. Meta-analytic pooled odds ratio (OR) was calculated using TACE plus RFA as the base category. RESULTS: Seven case-control studies and one randomized trial were identified. Meta-analytic results revealed that, compared with SR, TACE plus RFA had significantly higher 1-year OS (OR for survival = 0.50, p = 0.009) and lower major complications (OR = 1.88, p = 0.02) after therapy. Three studies reported on the length of hospital stay. The average length ± standard deviation reported in individual studies for SR and TACE plus RFA groups was 19.8 ± 8.4 days and 7.4 ± 2.2 days, respectively; 18.7 ± 4.9 days and 11.5 ± 6.9 days, respectively; and 16.6 ± 6.7 days and 8.5 ± 4.1 days, respectively (p < 0.0001 for all studies). Three or 5-year OS and 1-, 3-, or 5-year RFS did not significantly differ between the two therapies. CONCLUSION: Combined TACE plus RFA may be an alternative to SR for the treatment of patients with HCC within Milan the criteria. Non-randomized design in most of the original studies was a limitation.
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Humans , Carcinoma, Hepatocellular , Case-Control Studies , Catheter Ablation , Length of Stay , Odds Ratio , Survival RateABSTRACT
OBJECTIVE@#To evaluate the differences of plaquecomposition and volume between symptomatic and asymptomatic patients with carotid artery stenosis by multi-detector computed tomography angiography (MDCTA).@*METHODS@#The consecutive patients with internal carotid artery stenosis≥70% diagnosed by digital subtraction angiography (DSA) were retrospectively analyzed from July 2011 to December 2015 in Peking University China-Japan Friendship School of Clinical Medicine. The symptomatic patients were defined as those who experienced nondisabling ischemic stroke or transient cerebralis chemic symptoms, including hemispheric events oramaurosis fugaxin the last 6 months. Otherwise, the patients were considered as a symptomatic. A total of 78 patients were enrolled in the study. Of these patients, there were 35 asymptomatic patients (44.9%) and 43 symptomatic patients (55.1%). All the patients received MDCTA before DSA. According to the plaque analysis of post processing work station, carotid plaques were divided into lipid-rich necrotic coreplaques (HU≤60), fibrous plaques (60 to 130 HU) and calcified plaques (HU≥130) through the different value sthreshold of HU. The plaque volume and proportion were all calculated. The differences between the two groups were compared by statistical methods.@*RESULTS@#The proportion of calcified plaques in asymptomatic patients was significantly higher than in symptomatic patients (t=2.760, P=0.007).And the proportion of LRNC plaqueswas lower than that in symptomatic patients (Z=2.009, P=0.044). There was statistical significance between the asymptomatic and symptomatic patients. Multivariate analysis showed that there was a positive correlation between the proportion of calcified plaques and asymptomatic carotid artery stenosis (OR=0.949; 95%CI: 0.915 to 0.985; P=0.005). The proportion of LRNC plaques showed a negative correlation with asymptomatic carotid artery stenosis (OR=1.068; 95%CI: 1.021 to 1.117; P=0.004). For the symptomatic patients, when the LRNC plaque proportion was greater than 30.3%, the specificity was 94.3%, and the sensitivity was 37.2%. There was no significant difference in plaque volume and fibrous plaque proportion in both groups.@*CONCLUSION@#Compared with symptomatic carotid plaques, the proportion of asymptomatic calcified plaques increased but the proportion of LRNC plaques decreased. Plaque LRNC 30.3% of the total volume may represent a clinically useful cutoff. For the patients with carotid artery stenosis, MDCTA may help noninvasively risk-stratify patients.
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Humans , Carotid Arteries , Carotid Stenosis/diagnostic imaging , China , Computed Tomography Angiography , Plaque, Atherosclerotic/diagnostic imaging , Retrospective StudiesABSTRACT
Objective To evaluate the efficacy and safety of endovascular repair with covered stent in treating ruptured carotid artery pseudoaneurysms.Methods The clinical data of 15 patients with ruptured carotid artery pseudoaneurysm,who were admitted to Sun Yat-Sen Memorial Hospital of Zhongshan University during the period from July 2009 to July 2015 to receive emergency rescue with endovascular covered stent implantation,were retrospectively analyzed.Of the 15 patients,the rupture of common carotid artery pseudoaneurysm caused by direct trauma was seen in one and caused by cervical operation was observed in one,the rupture of internal carotid artery pseudoaneurysm caused by cervical operation was found in 3,and the rupture of internal carotid artery pseudoaneurysm due to radiotherapy for nasopharyngeal carcinoma was seen in 10.Results Successful rescue with endovascular repair using covered stent implantation was obtained in all 15 patients.No immediate procedure-related complications or death occurred.The mean follow-up time was 11 months.During the follow-up period,no re-bleeding or cerebral ischemic complications occurred.Conclusion For the treatment of ruptured carotid artery pseudoaneurysms,endovascular repair with covered stent is minimally invasive,safe and effective with less complications;and along with the occlusion of carotid artery rupture,the blood supply of the head and neck returns to normal.However,further clinical researches with larger samples are needed before its long-term efficacy can be completely clarified.
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<p><b>OBJECTIVE</b>To evaluate mesenteric vascular anatomy using 256 multi-slice computed tomography (MSCT) before laparoscopic colorectal surgery.</p><p><b>METHODS</b>Eleven patients with colorectal cancer underwent 256 MSCT from February 2010 to December 2010. The evaluation items were visualization of mesenteric artery and vein by 3-dimensional CT angiography, which was compared with findings on laparoscopic surgery.</p><p><b>RESULTS</b>Three-dimensional CT angiography correctly demonstrated variations of the mesenteric artery and vein and were consistent with laparoscopic findings. Of the 3 patients undergoing right hemicolectomy, ileocolic artery (ICA) ran ventrally to the superior mesenteric vein(SMV) in 1 patient, whereas ICA ran dorsally to the SMV in 2 patients; the right colic artery (RCA) branched directly from superior mesenteric artery(SMA) in 2 patients; RCA was absent and the left branch of middle colic artery(MCA) fed the tumor in 1 patient. In the patients who had transverse colon resection, MCA branched from SMA. In 2 of 3 patients who underwent sigmoidectomy, sigmoid artery (SA) branched from left colic artery(LCA); in 1 of 3 patients of sigmoid resection, SA branched from inferior mesenteric artery(IMA). In 4 patients with rectal cancer, the superior rectal artery (SRA) fed the tumor.</p><p><b>CONCLUSION</b>The 256 MSCT is effective for evaluating mesenteric vascular anatomy variation before laparoscopic surgery for colorectal cancer.</p>
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Aged , Female , Humans , Male , Middle Aged , Angiography , Methods , Colorectal Neoplasms , Diagnostic Imaging , Imaging, Three-Dimensional , Laparoscopy , Mesenteric Arteries , Diagnostic Imaging , Mesenteric Veins , Diagnostic Imaging , Mesentery , Tomography, Spiral ComputedABSTRACT
Objective To study the normal angiographic anatomy and variations of rabbit hepatic vessels,and explore the optimal method for hepatic artery catheterization.Methods 30 rabbits were divided into two groups randomly.Modified surgical method and interventional method were used to catheterize hepatic artery respectively,and followed by angiography to demonstrate the normal anatomy and variations of rabbit celiac artery,hepatic artery and portal vein.Results The route and distribution of rabbit celiac artery and hepatic artery were very different from human's.The commonly seen variation showed the differences in branching bifurcation of hepatic-gastric artery,with the incidence of 13.3%.The rates of successfully hepatic artery catheterization with surgical and interventional methods were 86.6%(13/15)and 80%(12/15)respectively (P＞0.05).The surgical method will not be successful,whenever there's variation.Conclusion The normal anatomy and variation of rabbit celiac artery and hepatic artery are quite different from human's.Both surgical and interventional catheterizations could be rather successful but possessing advantages and disadvantages of each its own.