Endovascular treatment of ruptured internal carotid pseudoaneurysm with bleeding after radiotherapy for nasopharyngeal carcinoma / 介入放射学杂志

Objective To discuss the methods,efficacy,and safety of endovascular treatment for ruptured pseudoaneurysm hemorrhage of internal carotid artery(ICA)after radiotherapy for nasopharyngeal carcinoma(NPC).Methods The clinical data of 21 patients with ruptured pseudoaneurysm hemorrhage of ICA after radiotherapy for NPC,who were admitted to the Affiliated Union Hospital,Fujian Medical University of China,were retrospectively analyzed.The patient's surgical strategies were analyzed,the therapeutic results and the clinical and imaging follow-up results were summarized.Of the 21 patients,covered stent implantation was carried out in 8,stent-assisted coil embolization was employed in 6,and direct occlusion of parent artery was adopted in 7.Results Successful endovascular treatment was accomplished in all the 21 patients.Excellent hemostatic effect was obtained immediately after surgery.Aneurysm neck residue was observed in 2 patients,and aneurysm body residue was seen in one patients.Postoperative bleeding recurred in 5 patients,in 4 of them the bleeding stopped after once more occlusion of the parent artery,and one patient developed internal leakage after covered stent implantation and the bleeding stopped after balloon dilation,and this patient died of unknown cause one month later.One patient developed coma after covered stent implantation,CT scan demonstrated subarachnoid hemorrhage and brain swelling,and this patient showed no improvement after treatment and was self-discharged from hospital.ICA occlusion was seen in 3 patients during follow-up period,and 2 patients did not receive a postoperative follow-up visit.In the 19 patients who were followed up,the mRS score was 0 point(n=9),1 point(n=6),2 points(n=2),5 points(n=1),and 6 points(n=1).Conclusion For the ruptured pseudoaneurysm hemorrhage of ICA after radiotherapy for NPC,endovascular treatment is highly safe with reliable efficacy.The covered stent implantation carries good short-term efficacy,but there are also problems such as aneurysm recurrence,internal endoleak,etc.The direct occlusion of parent artery may have more reliable long-term efficacy.(J Intervent Radiol,2024,33:304-308)

Renal sympathetic denervation in treatment of chronic kidney disease: A review / 第二军医大学学报

The effectiveness and safety of renal denervation for treating resistant hypertension have been demonstrated by previous studies; meanwhile its potential therapeutic role for chronic kidney disease has also been indicated. Recent clinical and animal studies have confirmed that renal denervation did not cause further damage to renal function of patients with chronic kidney disease; conversely, it may have potential benefits for the patients. In this paper, we reviewed the application and effect of renal denervation in chronic kidney disease.

Prognostic significance of tumor size in T3 gastric cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the impact of tumor size on the prognosis of patients with T3 gastric cancer.</p><p><b>METHODS</b>D2 curative resection was performed on 408 patients with T3 gastric cancer. Cox proportional hazards model was used to identify the optimal cut-off of tumor size. Potential prognostic factors were evaluated by univariate and multivariate analysis. Multivariate analysis was performed to evaluate the prognostic factors stratified by tumor size.</p><p><b>RESULTS</b>Among 408 patients with T3 gastric cancer, Cox proportional hazards model showed that 8 cm was the optimal cut-off of tumor size. There were 85 patients with tumor size ≥8 cm(large size group), and 323 patients with tumor size <8 cm(small size group). The 5-year survival rate was significantly lower for patients with small size tumor(33.8% vs. 52.2%, P<0.05). Cox proportional hazards model showed that lymph node metastasis, tumor size, and Borrmann type were independent prognostic factors for the entire cohort. Borrmann type IIII( and N2-3 nodal metastasis were independent prognostic factors for the large size group. Lymph node metastasis was independent prognostic factor for the small size group.</p><p><b>CONCLUSIONS</b>Tumor size is an independent prognostic factor in patients with T3 gastric cancer. Lymph node metastasis is a significant predictor for the prognosis regardless of tumor size. Furthermore, Borrmann classification is associated with the prognosis in patients with tumor size ≥8 cm.</p>

The combined fixation with splints and plaster after closed reduction for the treatment of distal fractures of radius in elderly patients / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the effects of combined fixation with splints and plaster after closed reduction for the treatment of distal fractures of radius in elderly patients</p><p><b>METHODS</b>From January 2009 to January 2011, 122 patients with distal fractures of radius were treated by the united fixation with splints and plaster after closed reduction. There were 43 males and 79 females, ranging in age from 60 to 86 years with an average of 74 years. Among the patients, traffic accident injury was in 12 cases and fall injury was in 109 cases; all fractures were closed, the time form injury to visit was for 30 min to 7 days. The X-rays, wrist pain, functional status, range of motion and grasp force of patients were observed at follow-up. Cooney modified Green-O'Brien standard was used to evaluate the clinical effects.</p><p><b>RESULTS</b>All the patients were followed up from 3 months to 2 years with an average of 15.4 months. Re-displacement occurred in 8 cases (including 4 cases radial displacement, 3 cases dorsal displacement, 1 case palmaris displacement) and re-reduction occurred in 4 cases, surgical treatment was in 2 cases, refused to reset or surgical treatment in 2 cases. Radial shorten in 13 cases middle-later period. All fractures obtained healed. According to the Green-O'Brien standard, 46 cases got excellent results, 65 good, 6 fair, and 5 poor.</p><p><b>CONCLUSION</b>The combined fixation with splints and plaster after closed reduction is a effective method in treatment of distal fractures of radius in elderly patients, which can more overcome redisplacement of distal fractures of radius, recover function of wrist joint.</p>

Combined use of extended-release niacin and atorvastatin: safety and effects on lipid modification / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Cholesterol-lowering therapy with statins has been reported to reduce the morbidity and mortality of cardiovascular diseases. This study aimed to investigate the effects of combined application of extended-release niacin and atorvastatin on lipid profile modification and the risks of adverse events in patients with coronary artery disease.</p><p><b>METHODS</b>Consecutive 108 patients with coronary artery disease and serum total cholesterol (TC) > or = 3.5 mmol/L were randomized into two groups: group A using atorvastatin and group B using extended-release niacin (niacin ER) and atorvastatin. Plasma lipid profile, glucose, and adverse events were assessed at the hospitalization, and 6 and 12 months after treatment. In addition, clinical cardiovascular events were evaluated after 12 months of treatment.</p><p><b>RESULTS</b>The levels of TC, low density lipoprotein cholesterol (LDL-C) were significantly decreased (P < 0.05) in groups A and B, but the levels of high density lipoprotein cholesterol (HDL-C) and ApoA increased by 29.36% and 40.81% respectively after 12 months of treatment in group B (P < 0.01). The medications were generally well tolerated in the two groups. No significant difference of adverse events was found between the two groups (group A: 3.2% vs group B 5.1%, P > 0.05).</p><p><b>CONCLUSIONS</b>Combined use of extended-release niacin with atorvastatin was superior to atorvastatin monotherapy alone in lipid profile regulation. Combination therapy with niacin ER and atorvastatin was well tolerated and safe in patients with coronary artery disease.</p>