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Role of serum cystatin C in the prediction of contrast-induced nephropathy after intra-arterial interventions

Chinese Medical Journal 2020年第4期133卷 408-414页

作者： Zheng-Yu Wang Yong-Li Wang Jian Wei Long Jin Zhen-Chang Wang Department of Radiology Beijing Friendship HospitalCapital Medical UniversityBeijing 100050China Department of Interventional Radiology The Sixth People's Hospital South CampusShanghai Jiao Tong UniversityShanghai 201499China

Background:The diagnosis of contrast-induced nephropathy(CIN)is usually based on changes in serum creatinine(sCr).However,sCr has poor sensitivity as a biomarker of kidney *** aim of this study was to investigate the usefulness of serum cystatin C(sCysC)to predict CIN after intra-arterial ***:A total of 360 consecutive patients underwent intra-arterial procedures using digital subtraction ***,sCysC,and estimated glomerular filtration rate were measured at 1 to 2 days before and at 48,72 h,and 7 days after the ***:Thirty-one patients(8.61%)developed *** operating characteristic(ROC)curve analysis showed that preoperative sCysC levels had good discriminatory power(area under the curve[AUC]=0.634;95%confidence interval[CI]=0.526-0.743)for evaluating the risk of CIN after an endovascular procedure,with a sensitivity of 53.33%and specificity of 73.70%.ROC analysis showed that sCysC at 48 h after contrast medium administration was predictive of CIN after an endovascular procedure(AUC=0.735;95%CI=0.647-0.822)with satisfactory sensitivity of 74.20%and specificity of 63.90%.Diabetes mellitus was an independent risk factor for CIN(odds ratio=2.778;95%CI=1.045-7.382;P=0.040).Conclusions:SCysC is an appropriate biomarker to predict the occurrence of *** sCysC before an intervention is useful to obtain a preliminary estimate of the risk of CIN.A 48-h cut-off value of sCysC of 0.99 mg/L after an endovascular procedure may help to rule out patients at lower risk of CIN.

关键词： Contrast-induced nephropathy intra-arterial intervention Serum cystatin C Serum creatinine

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Combined intra-arterial chemotherapy and intravitreal melphalan for the treatment of advanced unilateral retinoblastoma

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International Journal of Ophthalmology(English edition) 2020年第2期13卷 257-262页

作者： Ting-Yi Liang Xiu-Yu Zhu Xu-Ming Hua Xun-Da Ji Pei-Quan Zhao Department of Ophthalmology Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghai 200092China Department of Neurosurgery Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghai 200092China

●AIM:To evaluate the efficacy and safety of combined intraarterial chemotherapy(IAC)and intravitreal melphalan(IVM)for the treatment of advanced unilateral retinoblastoma.●METHODS:This retrospective study involved 30 consecutive eyes from 30 Chinese patients with advanced unilateral *** patients were initially treated with IAC combined with *** clinical status and complications were recorded at each visit.●RESULTS:The International intraocular Retinoblastoma Classification groups were D in 23 eyes and E in 7 *** eyes showed severe cloud vitreous seeds at the first *** mean number of IAC cycles and intravitreal injections was 3.2(range,3-4)and 6(range,1-14),*** median follow-up time was 29 mo(range,7-36 mo).Treatment success with regression of the retinal tumor and vitreous seeds was achieved in 29 of 30 eyes(96.7%).Globe salvage was attained in 93.3%(28/30)eyes,and enucleation(n=2)was per formed due to neovascular glaucoma and persistent vitreous *** included retinal pigment epithelium(RPE)atrophy(n=13;43%),mild lens opacity(n=7;23%),vitreous hemorrhage(n=5;17%)and rhegmatogenous retinal detachment(n=1;3%).No extraocular tumor extension or metastasis occurred.●CONCLUSION:Combined IAC and IVM is effective and safe for the treatment of advanced unilateral retinoblastoma.

关键词： intra-arterial chemotherapy intravitreal chemotherapy melphalan retinoblastoma advanced stage unilateral disease

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Efficacy of intra-arterial contrast-enhanced ultrasonography during transarterial chemoembolization with drug-eluting beads for hepatocellular carcinoma

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World Journal of Hepatology 2018年第1期10卷 95-104页

作者： Kazue Shiozawa Manabu Watanabe Takashi Ikehara Shuhei Yamamoto Takashi Matsui Yoshinori Saigusa Yoshinori Igarashi Iruru Maetani Division of Gastroenterology and Hepatology Department of Internal Medicine Toho University Medical Center Ohashi Hospital Division of Gastroenterology and Hepatology Department of Internal Medicine Toho University Medical Center Omori Hospital

AIM To assess the usefulness of intra-arterial contrastenhanced ultrasonography(IAUS) during transarterial chemoembolization(TACE) with drug-eluting beads(DEB) for hepatocellular carcinoma(HCC).METHODS Thirty two patients with 39 HCC underwent DEB-TACE guided with IAUS, and examined by contrast-enhanced ultrasonography(CEUS) or dynamic CT after DEB-TACE were enrolled in this study. CEUS findings before DEBTACE and IAUS findings were compared. Treatments judged to be complete and incomplete for lesions were appropriate and insufficient, respectively. Findings on CEUS and/or dynamic CT performed 1, 3 and 6 mo after DEB-TACE were evaluated using m RECIST(CR/PR/SD/PD).RESULTS The treatments were complete and incomplete in 26 and 13 lesions, respectively. On imaging evaluation using CEUS and/or dynamic CT one month after treatment, 25 and 1 lesions were judged to be CR and PR, respectively, and at 6 mo after treatment, the results were CR, PR, SD and PD for 24, 1, 0 and 1 of these lesions, respectively, in the 26 completely treated lesions. Of the 13 lesions in which treatment was incomplete, the results on imaging at one month after treatment were CR, PR, SD and PD for 0, 6, 4 and 3 lesions, respectively. The overall CR rate at 6 mo after treatment was 61.5%(24/39).CONCLUSION A combination of DEB-TACE with IAUS can improve the therapeutic effects in patients with HCC.

关键词： Hepatocellular carcinoma Contrast-enhanced ultrasonography Drug-eluting beads Transarterial chemoembolization intra-arterial contrast-enhanced ultrasonography

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Successful Treatment of intra-arterial Peplomycin Infusion for Recurrent Oral Florid Papillomatosis

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Journal of Cosmetics, Dermatological Sciences and Applications 2019年第3期9卷 223-227页

作者： Atsushi Tanemura Madoka Takafuji Yuma Hanaoka Eiji Kiyohara Mari Wataya-Kaneda Manabu Fujimoto Department of Dermatology Osaka University Graduate School of Medicine Suita Osaka Japan

A 56-year-old woman had noticed the erosion of oral mucosa and tongue 8 years ago. The mucosal lesions had been initially diagnosed as oral lichen planus and resistant to various treatments with prednisolone, etretinate and mizoribine and so on. One year ago, rapidly growing verrucous lesion occurred on her upper lip. Although we administered intralesional radiation therapy, the tumor recurred and new whitish lesions on the buccal mucosa and hard palate occurred 9 months after treatment. We confirmed an anatomical blood supply to the tumors by a fluorescent real-time imaging system and subsequently administered the intra-arterial infusion of peplomycin through retrograde catheters from bilateral superficial temporal arteries under the final diagnosis as oral florid papillomatosis (OFP). The tumors were dramatically shrunk and did not recur 16 months after treatment. OFP is known as clinically multiple whitish and verrucous lesions over the oral cavity and lip and a subtype of SCC with high differentiation. We suppose that an intra-arterial infusion therapy of peplomycin should be considered as the curative treatment for OFP.

关键词： Oral Florid Papillomatosis Selective intra-arterial Infusion Peplomycin Sulfate

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Accidental intra-arterial Injection during Test Dose of Injection of Benzyl Penicillin: Complications and Management—A Case Report

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Case Reports in Clinical Medicine 2015年第6期4卷 222-226页

作者： Amarjit Singh Kuldip Singh Sidhu Shivaji Rai Department of Cardio-Thoracic and Vascular Surgery Government Medical College Amritsar India

An 18 years old female patient was given a test dose of Benzyl penicillin in the Antecubital Area on the right forearm by a staff nurse of the department. After the injection, the patient complained of severe pain in the right forearm distal to the injection site. This was followed by blanching of the right forearm and hand. She was immediately heparinised followed by other symptomatic treatments. After 12 hours, a bluish discoloration developed on the hand, both on dorsal and palmar aspect, sparing the thumb. This recovered with medication, except the late development of dry gangrene of the tip of distal phalanx of the little finger which got shrivelled later on. Color Doppler flow study, echocardiography, and CT angiography of the right upper limb were done. Understanding of the pathogenesis and prompt action can help in saving a limb. Education of the medical professionals involved in administering injection is necessary so that they become aware of abnormal course or anomalous anatomy of vessels of upper limb. This can help to prevent the complications.

关键词： intra-arterial Injection Gangrene Anomalous Anatomy

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Different effects of mechanical embolus removal and intra-arterial thrombolysis on neural functional recovery in patients with acute middle cerebral artery occlusion

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Journal of Hainan Medical University 2018年第16期24卷 30-33页

作者： Guo-Wei Wang Ya-Fei Wang Long-Wei Huo Bo Ma Zheng Cui Xuan-Yu Zhang Jiang-Feng Li Hu-Lin Zheng Neurosurgery Department No.2 Ward the First Hospital of Yulin Shaanxi ProvinceYulinShaanxi Province719000

Objective:To study the different effects of mechanical embolus removal and intra-arterial thrombolysis on neural functional recovery in patients with acute middle cerebral artery ***: Patients with acute middle cerebral artery occlusion who were treated in the First Hospital of Yulin between September 2013 and October 2017 were selected and retrospectively studied, and the differences in reperfusion therapies in history data were referred to divide them into study group A and study group B who underwent mechanical embolus removal and intra-arterial thrombolysis respectively. The levels of neurocyte damage markers, apoptosis markers and stress markers in serum as well as the expression of Wnt pathway molecules in peripheral blood were determined before treatment and 24 h after ***: Compared with those of same group before treatment, serum NSE, S100B, VILIP1, sFas, sFasL, ET-1 and MDA levels as well as peripheral blood GSK3β, LC3-II and Beclin1 expression intensity of both groups were decreasing whereas serum BDNF, NTF, sLivin and SOD levels as well as peripheral bloodβ-catenin and mTOR expression intensity were increasing, and serum NSE, S100B, VILIP1, sFas, sFasL, ET-1 and MDA levels as well as peripheral blood GSK3β, LC3-II and Beclin1 expression intensity of study group A after treatment were lower than those of study group B whereas serum BDNF, NTF, sLivin and SOD levels as well as peripheral bloodβ-catenin and mTOR expression intensity were higher than those of study group ***: Mechanical embolus removal for acute middle cerebral artery occlusion can be more effective than intra-arterial thrombolysis to reduce the nerve function damage as well as the corresponding oxidative stress and apoptosis.

关键词： Acute middle cerebral artery occlusion Mechanical embolus removal intra-arterial thrombolysis Oxidative stress Apoptosis

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Survival in unresectable sinonasal undifferentiated carcinoma treated with concurrent intra-arterial cisplatin and radiation

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World Journal of Clinical Cases 2015年第2期3卷 191-195页

作者： Sonal S Noticewala Loren K Mell Scott E Olson William Read Department of Radiation Medicine and Applied Sciences Center for Advanced Radiotherapy TechnologiesUniversity of California San Diego Division of Neurosurgery University of California San Diego Department of Hematology and Medical Oncology Emory University

We report the successful use of RADPLAT to treat a patient with an unresectable T4N0 sinonasal undifferentiated carcinoma. This patient received 4 cycles of weekly intra-arterial cisplatin together with thiosulfate infusion with concurrent radiation therapy. Radiation therapy was given in 28 daily fractions to 54 Gy using intensity-modulated radiation therapy followed by a hypofractionated stereotactic boost of 3 fractions to 13 Gy to a total dose of 67 Gy in 31 fractions to the nasal sinus and bilateral neck. intra-arterial cisplatin was administered using a bilateral approach due to the midline site of this tumor. Within days of the first intra-arterial cisplatin, there was an obvious decrease in tumor size. She has been followed with magnetic resonance imaging and positron emission tomography, and remains disease-free 47 mo post-treatment. Centers with expertise in intra-arterial chemotherapy could consider the RADPLAT approach for patients with unresectable sinonasal undifferentiated carcinoma.

关键词： Sinonasal undifferentiated carcinoma Radiation intra-arterial cisplatin Survival RADPLAT

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A clinical and long-term follow-up study of perioperative sequential triple therapy for gastric cancer

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World Journal of Gastroenterology 2000年第2期6卷 284-286页

作者： Zou SC Qiu HS Zhang CW Tao HQ Zhejiang Prov Peoples Hosp Dept Surg Hangzhou 310014 Zhejiang Peoples R China

INTRODUCTIONAlthough the long-term postoperative survival rateof gastric cancer(GC) patients has been improvedsignificantly since the local dissection of lymph nodewas widely used in China,yet the low curativeresection rate and the high recurrence rate fromperitoneal and hepatic metastases hinder it fromfurther *** alter the currentunsatisfactory status of GC treatment,a

关键词： stomach neoplasms/surgery stomach neoplasms/drug therapy intra-arterial chemotherapy intra-peritoneal chemotherapy curative resection survival rate

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Successful recanalization with multimodality endovascular interventional therapy in acute ischemic stroke

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World Journal of Clinical Cases 2014年第3期2卷 78-85页

作者： Amorn Jongsathapongpan Anuchit Raumthanthong Sombat Muengtaweepongsa Department of Cardiology Phyathai 2 Hospital (Bangkok Hospital Group) Department of Radiology Pramong-kutklao Hospital Department of Medicine Thammasat University

Stroke is an important cause of death and disability in adults. However, effective treatments for patients with acute ischemic stroke are limited. intravenous recombinant tissue plasminogen activator(iv rtPA) within 4.5 h after onset has been approved as a standard treatment for patients with acute ischemic stroke. However, due to time constraints, less than one percent of acute ischemic stroke patients in Thailand are able to obtain iv rtPA. Although endovascular interventional therapy has not yet been approved as standard treatment in acute ischemic stroke, it is the one of the potentially effective treatment options. There are several reliable methods of endovascular therapy for acute ischemic stroke patients. Endovascular interventional therapy has rarely been done in Thailand. We report seven patients with successful recanalization after endovascular treatment in acute large vessel stroke from a single stroke center in Thailand. Patient screening and selection with multimodal imaging protocol and multimodality methods of endovascular interventional therapy are described.

关键词： Acute ischemic stroke intra-arterial thrombolysis Endovascular therapy Mechanical thrombectomy

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Colorectal liver metastases:An update on multidisciplinary approach

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World Journal of Hepatology 2019年第2期11卷 150-172页

作者： Felix Che-Lok Chow Kenneth Siu-Ho Chok Department of Surgery Queen Mary Hospital Department of Surgery and State Key Laboratory for Liver Research the University of Hong Kong

Liver metastasis is the commonest form of distant metastasis in colorectal *** criteria for surgery and liver-directed therapies have recently been ***,resectability remains poorly *** biology is increasingly recognized as an important prognostic factor;hence molecular profiling has a growing role in risk stratification and management *** resection is the only treatment modality for curative *** most appropriate surgical approach is yet to be *** primary cancer and the hepatic metastasis can be removed simultaneously or in a two-step approach;these two strategies have comparable long-term *** patients with a limited future liver remnant,portal vein embolization,combined ablation and resection,and associating liver partition and portal vein ligation for staged hepatectomy have been advocated,and each has their pros and *** role of neoadjuvant and adjuvant chemotherapy is still *** biological agents and loco-regional therapies(thermal ablation,intra-arterial chemo-or radio-embolization,and stereotactic radiotherapy) further improve the already favourable *** recent debate about offering liver transplantation to highly selected patients needs validation from large clinical *** protocols are missing,and therefore optimal management of hepatic metastasis should be personalized and determined by a multi-disciplinary team.

关键词： Colorectal cancer Liver metastases Hepatic resection Neoadjuvant therapy Adjuvant chemotherapy intra-arterial therapy Precision medicine Multidisciplinary approach

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