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Balloon-assisted catheter-directed thrombolysis: A novel approach for acute deep vein thrombosis in the lower extremities

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Journal of interventional Medicine 2020年第1期3卷 37-40页

作者： Zhi Li Chao Yang Baorui Fan Yonghai Jin Caifang Ni department of interventional radiology First Affiliated Hospital of Soochow UniversitySuzhouNo.188Shizi StreetJiangsuChina

Background:Deep vein thrombosis(DVT)is a common cardiovascular emergency that may have life-threatening complications,including pulmonary embolism(PE)and post-thrombotic syndrome(PTS).Conventional anticoagulant medication does not completely dissolve the clots and does not decrease the risk of DVT *** catheter-directed thrombolysis(CDT)is an approach that has been reported to reduce the reoccurrence of PTS during acute *** compared balloon-assisted CDT with routine CDT in the treatment of acute DVT and evaluated the clinical efficacy and safety of balloon-assisted ***:This retrospective cohort study included 94 patients diagnosed with a first episode of DVT in the lower extremities and treated from September 2008 to February *** patients underwent routine CDT(group A,n=50)or balloon-assisted CDT(group B,n=44)based on their enrollment *** obtained the circumference difference between the limbs,the degree of clot lysis,and the lysis rate as parameters for evaluating the two *** PE incidence and bleeding amount were *** also compared the total urokinase dose,treatment duration,and retrieval rate of optional ***:Swelling was significantly alleviated in both groups,as indicated by a reduction in the limb *** who underwent balloon-assisted CDT exhibited significantly lower thrombus scores compared with the routine group(S=1403.50,Z=-5.7702,P<0.0001).Additionally,the duration of balloon-assisted CDT was significantly shorter(6 vs.10 days[S=1039.0,Z=-8.0358,P<0.0001]).The mean urokinase usage per patient was decreased in the balloon-assisted group(P<0.0001).Bleeding occurred in both groups,with no statistical *** filter retrieval rate in the balloon-assisted group was significantly higher than that in the routine CDT group(Х~2=4.829,P=0.028).Conclusions:Balloon-assisted CDT is an effective,cost-efficient,and safe method for the treatment of acute *** exhibited advantages

关键词： balloon routine acute

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Brachiocephalic artery stenting through the carotid artery: A case report and review of the literature

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World Journal of Clinical Cases 2019年第17期7卷 2644-2651页

作者： Fang Xu Feng Wang Yong-Sheng Liu department of interventional Therapy The First Affiliated Hospital of Dalian Medical University

BACKGROUND As the population ages and people’s living standards gradually improve,the incidence of cerebrovascular disease in China is increasing annually,posing a serious threat to people’s *** incidence of brachiocephalic artery stenosis in ischemic cerebrovascular disease is relatively low,accounting for 0.5% to 2% of patients,but its consequences are very ***,we report a case of brachiocephalic artery stenting through the carotid *** SUMMARY The patient was a 66-year-old *** came to our hospital because of repeated dizziness and was diagnosed with ischemic cerebrovascular disease (stenosis at the beginning of the brachiocephalic artery).Cerebral angiography suggested that the stenosis of the brachiocephalic artery had almost occluded *** agent threaded a line through the stenosis,and there was reversed blood flow through the right vertebral artery to compensate for the subclavian steal syndrome in the right subclavian *** improve the symptoms,we placed an Express LD (8 mm × 37 mm) balloon expanding stent in the stenosis *** the operation,the patient’s dizziness significantly ***,after 6 mo,the patient was re-admitted to the hospital due to dizziness.A computed tomography scan of the head revealed multiple cerebral infarctions in bilateral basal ganglia and the right lateral *** auxiliary examination including computerized tomography angiography of the vessels of the head and cerebral angiography both showed severe stenosis in the brachiocephalic artery *** the operation,the guidewire and catheter were matched to reach the opening of the brachiocephalic ***,we decided to use a right carotid artery approach to complete the *** sutured the neck puncture point with a vascular stapler and then ended the *** the operation,the patient recovered well,his symptoms related to dizziness disappeared,and his right radial artery pulsation could be ***

关键词： Stenosis of the brachiocephalic artery Trans-carotid approach Vascular stapler Case report

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Retinal ganglion cell-inner plexiform and nerve fiber layers in neuromyelitis optica

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International Journal of Ophthalmology(English edition) 2018年第1期11卷 89-93页

作者： Sai-Jing Hu Pei-Rong Lu department of Ophthalmology the First Affiliated Hospital of Soochow University department of Ophthalmology the First Affiliated Hospital of Wenzhou Medical University

AIM： To determine the thickness of the retinal ganglion cell-inner plexiform layer（GCIPL） and the retinal nerve fiber layer（RNFL） in patients with neuromyelitis optica（NMO）.METHODS： We conducted a cross-sectional study that included 30 NMO patients with a total of 60 eyes. Based on the presence or absence of optic neuritis（ON）, subjects were divided into either the NMO-ON group（30 eyes） or the NMO-ON contra group（10 eyes）. A detailed ophthalmologic examination was performed for each group; subsequently, the GCIPL and the RNFL were measured using highdefinition optical coherence tomography（OCT）. RESULTS： In the NMO-ON group, the mean GCIPL thickness was 69.28±21.12 μm, the minimum GCIPL thickness was 66.02±10.02 μm, and the RNFL thickness were 109.33±11.23, 110.47±3.10, 64.92±12.71 and 71.21±50.22 μm in the superior, inferior, temporal and nasal quadrants, respectively. In the NMO-ON contra group, the mean GCIPL thickness was 85.12±17.09 μm, the minimum GCIPL thickness was 25.39±25.1 μm, and the RNFL thicknesses were 148.33±23.22, 126.36±23.45, 82.21±22.30 and 83.36±31.28 μm in the superior, inferior, temporal and nasal quadrants, respectively. In the control group, the mean GCIPL thickness was 86.98±22.37 μm, the minimum GCIPL thickness was 85.28±10.75 μm, and the RNFL thicknesses were 150.22±22.73, 154.79±60.23, 82.33±7.01 and 85.62±13.81 μm in the superior, inferior, temporal and nasal quadrants, respectively. The GCIPL and RNFL were thinner in the NMO-ON contra group than in the control group（P〈0.05）; additionally, the RNFL was thinner in the inferior quadrant in the NMO-ON group than in the control group（P〈0.05）. Significant correlations were observed between the GCIPL and RNFL thickness measurements as well as between thickness measurements and the two visual field parameters of mean deviation（MD） and corrected pattern standard deviation（PSD） in the NMO-ON group（P〈0.05）. CONCLUSION： The thickness of the GCIPL and RNFL, as measured using OCT, may indicate optic

关键词： neuromyelitis optica retinal nerve fiber layer thickness ganglion cell-inner plexiform layer optical coherence tomography

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Hemobilia with acute pancreatitis secondary to biliary tract infection

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Hepatobiliary & Pancreatic Diseases International 2019年第6期18卷 593-595页

作者： Dong-Bao Li Zu-Xiong Tang Jian-Xin Ye Zhi Li Xiao-Hua Yang Lei Qin Hua Zhao department of HBP Suzhou Dushuhu Public HospitalSuzhou 215006China department of General Surgery The First Affiliated Hospital of Soochow UniversitySuzhou 215006China department of Gastroenterology The First Affiliated Hospital of Soochow UniversitySuzhou 215006China department of Intervention The First Affiliated Hospital of Soochow UniversitySuzhou 215006China

Hemobilia is a rare medical condition with variety of *** them,two in thirds are *** combined with acute pancreatitis is *** we reported a case of hemobilia with acute pancreatitis secondary to biliary tract infection.A 76-year-old male patient had intermittent abdominal pain for 2 days,which was aggravated for 1 *** was admitted to the Emergency department on August 29,*** patient developed paroxysmal abdominal pain after consuming greasy foods,accompanied by *** physical examination revealed the following:temperature 37.0°C,pulse 76 bpm,respiratory rate 19 per minute,blood pressure 164/77 mmHg;no jaundice;abdominal distention;and mild total abdominal tenderness,mainly located in the left upper ***’s sign was *** abdominal ultrasound showed postprandial gallbladder emptying,gallbladder stones,unclear gallbladder cavity,and focal hepatic *** was *** intrahepatic bile duct was mildly dilated,and the abdominal and pelvic cavity showed no obvious accumulation of *** laboratory findings were as follows:serum amylase 922.1 U/L,white blood cell count 18.2×109/L(neutrophils,83.4%),and hemoglobin 13.8 g/dL.

关键词： pancreatitis cavity admitted

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Prospective observational study on the prognosis of ureteral lesions caused by impacted stones via dual-energy spectral computed tomography

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Asian Journal of Urology 2023年第4期10卷 534-540页

作者： Junjie Wang Ximing Wang Haozhou Zhong Wengui Xie Qilin Xi department of Urology The Sixth People's Hospital of ChengduChengduChina department of radiology The First Affiliated Hospital of Soochow UniversitySuzhouChina department of Urology The First Affiliated Hospital of Soochow UniversitySuzhouChina

Objective Ureteral lesions caused by impacted ureteral stones are likely to result in postoperative ureteral *** this basis,the study aimed to investigate if dual-energy spectral computed tomography can predict ureteral hardening caused by impacted stones and to explore the relationship between different types of ureteral lesions and the risk of ureteral *** This prospective study collected data of 93 patients with impacted stones from hospital automation system during January 2018 to October *** underwent an abdominal scan on a dual-energy spectral computed *** surgery,the operator used ureteroscopy to identify ureteral lesions,which were classified into four categories:edema,polyps,pallor,and *** months later,90 patients were reviewed for the degree of *** Endoscopic observations revealed 38(41%)cases of ureteral edema,20(22%)cases of polyps,13(14%)cases of pallor,and 22(24%)cases of *** were significant differences in hydronephrosis,the period of impaction,the calcium concentration of the ureter,and the slope of the spectral Hounsfield unit curve between the four *** that,we evaluated the factors associated with ureteral hardening and found that the calcium concentration of the ureter and hydronephrosis remained independent predictors of ureteral *** operating characteristic curve analysis showed that 5.3 mg/cm^(3)calcium concentration of the ureter is an optimal cut-off value to predict ureteral *** result of follow-up showed that 80 patients had complete remission of hydronephrosis,with a complete remission rate of 61.9%(13/21)in the hardening group and 97.1%(67/69)in the non-hardening group(p<0.001).Conclusion Calcium concentration of the ureter is an independent predictor of ureteral *** with ureteral hardening have more severe hydronephrosis after ureteroscopic *** the calcium concentration of the ureter is less

关键词： Ureteral lesions Impacted ureteral stone Dual-energy spectral computed tomography Ureteral stricture Ureteroscopic lithotripsy

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Agitation thrombolysis combined with catheter-directed thrombolysis for the treatment of non-cirrhotic acute portal vein thrombosis

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World Journal of Gastroenterology 2018年第39期24卷 4482-4488页

作者： Chao-Yang Wang Le-Qun Wei Huan-Zhang Niu Wan-Qin Gao Tong Wang Shun-Jun Chen department of interventional radiology The First Affiliated Hospitaland College of Clinical Medicine of Henan University of Science and Technolgy

AIM To evaluate the safety and efficacy of agitation thrombolysis(AT) combined with catheter-directed thrombolysis(CDT) for the treatment of non-cirrhotic acute portal vein thrombosis(PVT). METHODS Nine patients with non-cirrhotic acute PVT who underwent AT combined with CDT were analyzed retrospectively. Portography was carried out via the transjugular intrahepatic portosystemic(commonly known as TIP) or percutaneous transhepatic(commonly known as PT) route, followed by AT combined with CDT. Complications of the procedure, and the changes in clinical symptoms, hemodynamics of the portal vein and liver function were recorded. Follow-up was scheduled at1, 3 and 6 mo after treatment, and every 6 mo thereafter, or when the patients developed clinical symptoms related to PVT. Color Doppler ultrasound and contrast-enhanced computed tomography/magnetic resonance imaging were performed during the follow-up period to determine the condition of the portal *** AT combined with CDT was successfully performed. The portal vein was reached via the TIP route in 6 patients, and via the PT route in 3 patients. All clinical symptoms were relieved or disappeared, with the exception of 1 patient who died of intestinal necrosis 9 d after treatment. Significant differences in the changes in portal vein hemodynamics were observed, including the maximum lumen occupancy of PVT, portal vein pressure and flow velocity between pre-and posttreatment(P < 0.05). During the follow-up period, recurrence was observed in 1 patient at 19 mo after the procedure, and the portal vein was patent in the remaining *** AT combined with CDT is a safe and effective method for the treatment of non-cirrhotic acute PVT.

关键词： Agitation thrombolysis Catheter-directed thrombolysis Portal vein thrombosis

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Fluoroscopic removal of fractured,retained,embedded Z self-expanding metal stent using a guidewire lasso technique:A case report

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World Journal of Clinical Cases 2022年第8期10卷 2516-2521页

作者： Yong-Hua Bi Jian-Zhuang Ren Jin-Dong Li Xin-Wei Han department of interventional radiology The First Affiliated Hospital of Zhengzhou UniversityZhengzhou 450052Henan ProvinceChina department of Thoracic Surgery The First Affiliated Hospital of Zhengzhou UniversityZhengzhou 450052Henan ProvinceChina

BACKGROUND There are few reports of a fractured esophageal self-expanding metallic stent(SEMS)and the lasso retrieval technique,forming a guidewire loop by directing the guidewire back up the external stent for *** SUMMARY A 74-year-old man complained of dysphagia approximately 6 mo after radical resection of esophageal *** anastomotic stenosis was diagnosed,and a 20 mm in diameter and 60 mm in length esophageal covered SEMS was inserted after repeated balloon *** 13.5 mo after stenting,dysphagia recurred and esophagography showed severe stenosis above the proximal stent and stent removal was ***-third of the stent was removed and the fractured stent remained in the proximal esophagus.A suction tube was introduced through the guidewire and then the guidewire was grabbed,acting like a“lasso”on *** remaining fractured stent was successfully removed by slowly pulling back the guidewire,with no fragments of stent wires *** The guidewire lasso technique is a simple,effective method of removing esophageal SEMS in rare cases of stent fracture.

关键词： Self-expanding metallic stent Stenosis Guidewire lasso technique Stent removal Esophagus Case report

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Sustained release of Semaphorin 3A from a-tricalcium phosphate based cement composite contributes to osteoblastic differentiation of MC3T3-E1 cells

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Frontiers of Materials Science 2015年第3期9卷 282-292页

作者： Jin-Ning WANG Bin PI Peng WANG Xue-Feng LI Hui-Lin YANG Xue-Song ZHU department of Orthopaedic Surgery The first Affiliated Hospital of Soochow University Suzhou 215006 China

The reinforcement of calcium phosphate materials with silk fibroin （SF） has been one of the strategies to overcome the brittleness. However, the lack of osteoinductivity may still restrict their further use. This study aimed to investigate the biocompatibility and osteogenesis capacity of a novel Semaphorin 3A-loaded chitosan microspheres/SF/a-tricalcium phosphate composite （Sema3A CMs/SF/a-TCP） in vitro. Sema3A was first incorporated into CMs, and the Sema3A CMs/SF/a-TCP composite was then prepared. The morphology of the CMs was observed using SEM. The in vitro release kinetics, cytotoxicity, and cell compatibility were evaluated, and the real-time quantitative polymerase chain reaction （RT-qPCR） and activity of alkaline phosphatase （ALP） were used to evaluate the osteogenesis capacity of the composite. The in vitro release of Sema3A from the Sema3A CMs/SF/a-TCP composite showed a temporally controlled manner. The extract of the Sema3A CMs/SF/a-TCP composite presented no obvious side effect on the MC3T3-E1 cell proliferation, nor promote cell proliferation. The MC3T3-E1 cells were well-spread and presented an elongated shape on the Sema3A CMs/SF/a-TCP composite surface; the ALP activity and the osteogenic-related gene expression were higher than those seeded on the surface of the CMs/SF/a-TCP and SF/a-TCP composites. In conclusion, Sema3A CMslSF/a-TCP has excellent biocompatibility and contributes to the osteoblastic differentiation of MC3T3-E1 cells.

关键词： α-tricalcium phosphate (o-TCP) silk fibroin (SF) Semaphorin 3A osteo-blastic differentiation MC3T3-EI cell

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Nimbolide targeting SIRT1 mitigates intervertebral disc degeneration by reprogramming cholesterol metabolism and inhibiting inflammatory signaling

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Acta Pharmaceutica Sinica B 2023年第5期13卷 2269-2280页

作者： Yun Teng Yixue Huang Hao Yu Cenhao Wu Qi Yan Yingjie Wang Ming Yang Haifeng Xie Tianyi Wu Huilin Yang Jun Zou department of Orthopaedic Surgery the First Affiliated Hospital of Soochow UniversitySuzhou 215006China

Inflammation,abnormal cholesterol metabolism,and macrophage infiltration are involved in the destruction of the extracellular matrix of the nucleus pulposus(NP),culminating in intervertebral disc degeneration(IDD).Whether nimbolide(Nim),a natural extract,can alleviate IDD is *** this study,we demonstrated that Nim promotes cholesterol efflux and inhibits the activation of the nuclear factor kappa B(NF-κB)and mitogen-activated protein kinase(MAPK)signaling pathways by activating sirtuin 1(SIRT1)in nucleus pulposus cells(NPCs)during ***,Nim balanced matrix anabolism and catabolism of ***,the inhibition of SIRT1 significantly attenuated the effects of *** also found that Nim promoted the expression of SIRT1 in RAW 264.7,which enhanced the proportion of M2 macrophages by facilitating cholesterol homeostasis reprogramming and impeded M1-like macrophages polarization by blocking the activation of inflammatory *** on these results,Nim can improve the microenvironment and facilitate matrix metabolism equilibrium in ***,in vivo treatment with Nim delayed IDD progression by boosting SIRT1 expression,modulating macrophage polarization and preserving the extracellular *** conclusion,Nim may represent a novel therapeutic strategy for treating IDD.

关键词： Nimbolide SIRT1 Intervertebral disc degeneration Nucleus pulposus Macrophage polarization Cholesterol

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Preparation and properties of calcium sulfate bone cement incorporated with silk fibroin and Sema3A-Ioaded chitosan microspheres

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Frontiers of Materials Science 2015年第1期9卷 51-65页

作者： Peng WANG Bin PI Jin-Ning WANG Xue-Song ZHU Hui-Lin YANG department of Orthopedic Surgery the First Affiliated Hospital of Soochow University Suzhou 215006 China

To search for new bioactive materials which can be used as the substitute of bone repairing and drug carriers, Sema3A-Ioaded chitosan microspheres （SLCM） and silk fibroin （SF） were mixed with calcium sulfate cement （CSC）. SEM, particle size analysis and swelling rate determination were performed to study properties of the microspheres. The drug loading, encapsulation efficiency and drug release rate were determined by ELISA. Microspheres with different SLCM weight contents （0.5%, 1% and 5%） were prepared to determine which one has the strongest mechanical properties and the appropriate setting time. It was revealed that CSC/SF/0.5SLCM has satisfactory mechanical properties, and its in vitro biocompatibility was assessed by MTS. Chitosan microspheres （5-18 μm） were globular, the surface was smooth, and the swelling rate is （77.02 ± 5.57）%. With this formula, the setting time was increased with the addition of SLCM in CSCISF, and the cumulative drug release rate is 44.62% in 28 d. XRD results demonstrate that the main component is calcium sulfate. Also it was found that CSCiSFI 0.5SLCM supports the growth of MC3T3 cells. Thus the preparation of CSCISFIO.5SLCM was reliable, and the products had good structures, physical properties and biocompatibility, appearing to be a promising bone substitute material.

关键词： Sema3A chitosan microsphere sustained release silk fibroin (SF) bone cement

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