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Transarterial chemoembolization with PD-(L)1 inhibitors plus molecular targeted therapies for hepatocellular carcinoma(CHANCE001)

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Signal Transduction and Targeted Therapy 2023年第3期8卷 1198-1207页

作者： Hai-Dong Zhu Hai-Liang Li Ming-Sheng Huang Wei-Zhu Yang Guo-Wen Yin Bin-Yan Zhong Jun-Hui Sun Zhi-Cheng Jin Jian-Jian Chen Nai-Jian Ge Wen-Bin Ding Wen-Hui Li Jin-Hua Huang Wei Mu Shan-Zhi Gu Jia-Ping Li Hui Zhao Shu-Wei Wen Yan-Ming Lei Yu-Sheng Song Chun-Wang Yuan Wei-Dong Wang Ming Huang Wei Zhao Jian-Bing Wu Song Wang Xu Zhu Jian-Jun Han Wei-Xin Ren Zai-Ming Lu Wen-Ge Xing Yong Fan Hai-Lan Lin Zi-Shu Zhang Guo-Hui Xu Wen-Hao Hu Qiang Tu Hong-Ying Su Chuan-Sheng Zheng Yong Chen Xu-Ya Zhao Zhu-Ting Fang Qi Wang Jin-Wei Zhao Ai-Bing Xu Jian Xu Qing-Hua Wu Huan-Zhang Niu Jian Wang Feng Dai Dui-Ping Feng Qing-Dong Li Rong-Shu Shi Jia-Rui Li Guang Yang Hai-Bin Shi Jian-Song Ji Yu-E Liu Zheng Cai Po Yang Yang Zhao Xiao-Li Zhu Li-Gong Lu Gao-Jun Teng Center of interventional Radiology&vascular Surgery Department of RadiologyZhongda HospitalMedical SchoolSoutheast UniversityNanjing 210009China department of Minimally invasive intervention The Affiliated Cancer Hospital of Zhengzhou UniversityZhengzhou 450008China department of interventional Radiology the Third Affiliated HospitalSun Yat-Sen UniversityGuangzhou 510630China department of interventional Radiology Union Hospital of Fujian Medical UniversityFuzhou 350001China department of interventional Radiology Jiangsu Cancer Hospital&Jiangsu Institute of Cancer Research&The Affiliated Cancer Hospital of Nanjing Medical UniversityNanjing 210009China department of interventional Radiology The First Affiliated Hospital of Soochow UniversitySoochow UniversitySuzhou 215006China Hepatobiliary and Pancreatic interventional Treatment Center Division of Hepatobiliary and Pancreatic SurgeryThe First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China department of interventional Radiology Eastern Hospital of Hepatobiliary SurgeryNavy Medical University(Second Military Medical University)Shanghai 200438China department of interventional Radiology Nantong First People’s HospitalNantong 226001China department of interventional Radiology Yancheng Third People’s HospitalYancheng 224008China department of Minimally Invasive interventional Therapy Sun YatSen University Cancer CenterGuangzhou 510060China department of vascular Surgery Southwest HospitalThird Military Medical University(Army Medical University)Chongqing 400038China. department of interventional Radiology Hunan Cancer HospitalChangsha 410031China department of interventional Oncology The First Affiliated Hospital of Sun Yat-sen UniversityGuangzhou 510080China department of interventional Radiology The Hospital of Nantong UniversityNantong 226001China department of interventional Therapy Shanxi Tumor HospitalTaiyuan 030001China department of interventional Radiology Tibet Autonomous Region People’s

There is considerable potential for integrating transarterial chemoembolization(TACE),programmed death-(ligand)1(PD-[L]1)inhibitors,and molecular targeted treatments(MTT)in hepatocellular carcinoma(HCC).It is necessary to investigate the therapeutic efficacy and safety of TACE combined with PD-(L)1 inhibitors and MTT in real-world *** this nationwide,retrospective,cohort study,826 HCC patients receiving either TACE plus PD-(L)1 blockades and MTT(combination group,n=376)or TACE monotherapy(monotherapy group,n=450)were included from January 2018 to May *** primary endpoint was progression-free survival(PFS)according to modified *** secondary outcomes included overall survival(OS),objective response rate(ORR),and *** performed propensity score matching approaches to reduce bias between two *** matching,228 pairs were included with a predominantly advanced disease *** PFS in combination group was 9.5 months(95%confidence interval[CI],8.4-11.0)versus 8.0 months(95%CI,6.6-9.5)(adjusted hazard ratio[HR],0.70,P=0.002).OS and ORR were also significantly higher in combination group(median OS,19.2[16.1-27.3]vs.15.7 months[13.0-20.2];adjusted HR,0.63,P=0.001;ORR,60.1%vs.32.0%;P<0.001).Grade 3/4 adverse events were observed at a rate of 15.8%and 7.5%in combination and monotherapy groups,*** results suggest that TACE plus PD-(L)1 blockades and MTT could significantly improve PFS,OS,and ORR versus TACE monotherapy for Chinese patients with predominantly advanced HCC in real-world practice,with an acceptable safety profile.

关键词： hepatocellular targeted matching

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Etiology,treatment,and classification of Budd-Chiari syndrome

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Chinese Medical Journal 2007年第2期120卷 159-161页

作者： ZHANG Xiao-ming LI Qing-le department of vascular Surgery Peking University People＇s Hospital Beijing 100044 China

Since Professor WANG Zhong-gao＇s creative work on thesystemic treatment of the Budd-Chiari syndrome（BCS）, this debilitating disease has been more and more widely recognized in China. Several large-scale studies of surgery or intervention strategies for treating BCS have been reported. However, much controversy still remains regarding many aspects of this disease, including its etiology, treatment, and classification. This review explores these controversies with emphasis on areas that merit further study.

关键词： Budd-chiari syndrome hepatic veins hepatic vein thrombosis inferior vena cava

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Transcriptional regulation of endothelial dysfunction in atherosclerosis:an epigenetic perspective

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The Journal of Biomedical Research 2014年第1期28卷 47-52页

作者： Yong Xu Key Laboratory of Cardiovascular Disease and Molecular intervention Department of PathophysiologyNanjing Medical University

Atherosclerosis is a progressive human pathology that encompasses several stages of development. Endothelial dysfunction represents an early sign of lesion within the vasculature. A number of risk factors for atherosclero- sis, including hyperlipidemia, diabetes, and hypertension, target the vascular endothelium by re-programming its transcriptome. These profound alterations taking place on the chromatin rely on the interplay between sequence specific transcription factors and the epigenetic machinery. The epigenetic machinery, in turn, tailor individual transcription events key to atherogenesis to intrinsic and extrinsic insults dictating the development of atheroscle- rotic lesions. This review summarizes our current understanding of the involvement of the epigenetic machinery in endothelial injury during atherogenesis.

关键词： Atherosclerosis transcriptional regulation endothelial injury epigenetics

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Future of robotics in vascular surgery

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Chinese Medical Journal 2013年第3期126卷 550-553页

作者： Celia Riga Nicholas Cheshire vascular Surgery department Imperial College St Marys Campus London United Kingdom

For over a decade, there has been a paradigm shift to an endovascular, minimally invasive approach whilst treating diseases of the aorta and its branches, with clear advantages in terms of morbidity and mortality in certain vascular beds, especially in patients with multiple co-morbidities that would otherwise be deemed unsuitable for traditional open surgical approaches. Endovascular intervention however, has certain momhological and anatomical constraints.

关键词： robotic vascular surgery endovascular

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Treatment of six cases of left renal nutcracker phenomenon: surgery and endografting

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Chinese Medical Journal 2003年第11期116卷 1782-1784页

作者：张鸿坤张楠李鸣金炜潘松龄汪忠镐封华 department of vascular Surgery First Affiliated Hospital College of Medicine Zhejiang University Hangzhou 310003 China department of vascular Surgery Sir Run Run Shaw Hospital College of Medicine Zhejiang University Hangzhou China

Objective A retrospective study was undertaken to examine therapeutic strategies used in 6 patients with left renal venal nutcracker phenomenon.Methods Three patients underwent surgical transposition of the superior mesenteric artery. Three patients underwent endograft stent implantations with intervention.Results All 6 cases were completely relieved of left renal vein compression after the operations, leading to improved clinical symptoms and normal urine tests.Conclusions Transposition of the superior mesenteric artery is a feasible method, but leads to complications and great trauma. Treating left renal venal nutcracker phenomenon with endografting techniques is minimally invasive in certain cases, and seems to have a prospective future.

关键词： nutcracker phenomenon ·surgery · endograft

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Giant vascular malformations invading the skull:A case report

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World Journal of Clinical Cases 2024年第16期12卷 2869-2875页

作者： Ming-Chen Xie Fu-Xu Wang Jian Xu department of Neurosurgery The Affiliated Hospital of Qingdao UniversityQingdao 266000Shandong ProvinceChina

BACKGROUND vascular malformations(VMs)arise as a result of errors in the process of angiogenesis and are usually present at birth,but may not become apparent until after ***,giant VMs of the head and face are uncommon,with few reported cases,and the prognosis for their surgical intervention is *** SUMMARY A 12-year-old girl was admitted to the hospital with findings of an enlarged right temporal *** admission,computed tomography(CT)angiography of cerebral ateries showed a right occlusal gap and a right temporal artery venous ***,cerebral angiography showed a right temporal lobe VM with multiple vessels supplying *** patient underwent surgery to remove the malformed vessels and the eroded *** hours after the surgery,the patient's right pupil was dilated,and an urgent CT scan of the skull showed a right subdural haematoma under the incision,which was urgently removed by a second *** surgery,we gave continuous antibiotic anti-infection treatment,and the patient recovered well and was discharged two weeks *** Surgical removal of giant haemangiomas is risky and adequate preoperative(including interventional embolisation)and intraoperative preparations should be made.

关键词： Giant vascular malformation Early intervention Surgical intervention interventional embolization Case report

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Pulmonary embolism with septicemia after N-butyl-2-cyanoacrylate injection for bleeding gastric varices

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Chinese Medical Journal 2014年第16期127卷 3030-3031页

作者： Ireneusz Nawrot Tomasz Cieciura Bartlomiej Morawski Piotr Malkowski Jerzy Zurakowski Magdalena Durlik department of General Vascular and Transplant Surgery Medical University of Warsaw Poland. department of Transplantation Medicine and Nephrology Transplantation Institute Medical University of Warsaw Poland. department of General and Transplant Surgery Transplantation Institute Medical University of Warsaw Poland. department of General Transplant and Liver Surgery Medical University of Warsaw Poland. department of General and oncological Surgery Independent Public Healthcare Institution Plock Poland

Despite many advances in the treatment of gastric variceal bleeding in the two past decades, its management continues to present a clinical challenge. Various treatment modalities have been proposed and since the first report in 1986 endoscopic injection sclerotherapy with cyanoacrylate tissue adhesives has become widely established in many countries as the treatment of choice for bleeding gastric varices. Severe complications of the treatment are infrequent.

关键词： gastric varices N-butyl-2-cyanoacrylate portal hypertension

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How to identify which patients with asymptomatic carotid stenosis could benefit from endarterectomy or stenting

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Stroke & vascular Neurology 2018年第2期3卷 92-100页

作者： Kosmas I Paraskevas Frank J Veith J David Spence department of vascular and Endovascular Surgery Royal Free HospitalLondonUK department of vascular Surgery New York University Langone Medical CenterNew YorkUSA department of vascular Surgery Cleveland ClinicClevelandOhioUSA Stroke Prevention&Atherosclerosis Research Centre Robarts Research InstituteWestern UniversityLondonCanada

Offering routine carotid endarterectomy(CEA)or carotid artery stenting(CAS)to patients with asymptomatic carotid artery stenosis(ACS)is no longer considered as the optimal management of these *** suboptimal,however,is the policy of offering only best medical treatment(BMT)to all patients with ACS and not considering any of them for prophylactic *** the last few years,there have been many studies aiming to identify reliable predictors of future cerebrovascular events that would allow the identification of patients with high-risk ACS and offer a prophylactic carotid intervention only to these patients to prevent them from becoming *** patients with ACS should receive *** present article will summarise the evidence suggesting ways to identify these high-risk asymptomatic individuals,namely:(1)microemboli detection on transcranial Doppler,(2)plaque echolucency on Duplex ultrasound,(3)progression in the severity of ACS,(4)silent embolic infarcts on brain CT/MRI,(5)reduced cerebrovascular reserve,(6)increased size of juxtaluminal hypoechoic area,(7)identification of intraplaque haemorrhage using MRI and(8)carotid *** evidence suggests that approximately 10%-15%of patents with asymptomatic stenosis might benefit from intervention;this will become more clear after publication of ongoing studies comparing stenting or endarterectomy with best medical *** the meantime,no patient should be offered intervention unless there is evidence of high risk of ipsilateral stroke,from modalities such as those discussed here.

关键词： patients carotid stenosis

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Stent-grafting for unfavorable abdominal aortic aneurysm： a practical challenge

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Chinese Medical Journal 2009年第7期122卷 787-792页

作者： HU Zuo-jun CHANG Guang-qi LI Xiao-xi HUANG Xue-ling YIN Heng-hui WANG Shen-ming department of vascular Surgery First Affiliated Hospital of SunYat-sen University Guangzhou Guangdong 510080 China

Background The endovascular treatment of abdominal aortic aneurysm （AAA） has improved greatly in the last 15 years. The present study aimed to evaluate the endografting experience for the treatment of unfavorable abdominal aortic aneurysm （uAAA）. Methods During December 2001 and December 2007, 41 patients with uAAA were treated with endografting using concomitant techniques. Patients were followed up for 1 to 48 months （mean 20.5 months）. Results Technical success rate was 97.6% （40/41） with 1 failure converted to open surgery for an unaccessed iliac stenosis. Nine （22.5%） type Ⅰ endoleaks （5 proximal and 4 distal） were observed on the completion angiograms and successfully corrected with aortic cuffs and iliac extensions during the procedure. Twenty-two of the planed adjunctive procedures were concomitantly performed just before endograft-implantation. There were 2 （5.0%） type Ⅰ endoleaks at 30 days; one type Ⅰ patient was treated by open conversion, another type Ⅰ patient died from a rupture before treatment in the ward, causing a 2.5% of initial mortality. The two type Ⅱ endoleaks were observed without aneurismal expansion. No buttock or leg claudication or ischemic colitis occured. During late follow-up, one additional death occurred from stroke. One new type Ⅰ endoleak was encountered from thrombocytopenia, which caused a 2.6% secondary endoleak that converted to an open surgery in the third month after a failed transabdominal banding of the aortic neck in the second month. All type Ⅱ endoleaks had disappeared in the third and sixth month. The Endografts did not present signs of material fatigue and no other type of endoleak formed. One patient presented with left limb ischemia, which underwent percutaneous transluminat angioplasty. There was no additional aneurysm rupture or any endograft imgration. Conclusion The endografting with concomitant procedures is a feasible and efficient alternative for managing unfavorable AAAs, achieving low morbidity and mort

关键词： aortic aneurysm, abdominal endovascular repair stent-grafi concomitant intervention outcome analysis

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Morphologic evolution of recent small sub-cortical infarcts and adjacent white matter in the basal ganglia in a Chinese cohort

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Chinese Medical Journal 2020年第19期133卷 2302-2307页

作者： Sha-Sha Wang Sen Wei Bo Song Yu-Ming Xu department of Neurology the First Affiliated Hospital of Zhengzhou UniversityZhengzhouHenan 450052China department of Neurological intervention the First Affiliated Hospital of Zhengzhou UniversityZhengzhouHenan 450052China.

Background:Data on the evolution of recent small sub-cortical infarcts are limited,especially in the *** studies have reported a large heterogeneity in cavitation and infarct location;therefore,the present study assessed the morphology of small subcortical infarcts in the basal ganglia in a Chinese ***:Patients who had experienced a recent,single,small sub-cortical infarct in the basal ganglia and received at least one follow-up magnetic resonance imaging(MRI)scan were retrospectively identified from January 2014 to June *** to followup imaging,baseline infarct size,vascular risk factors,and other clinical data,as well as the morphologic changes of the index infarct and surrounding white matter were ***,clinical and MRI characteristics were respectively compared among three groups(white matter hyper-intensitie[WMH]*** ***)and between with and without new WMH formation *** addition,logistic regression analyses were performed in investigating the determinate independent predictors for new WMH ***:Seventy-eight subjects were included with a median follow-up time of 304 days(range:124–552 days).We found a significant reduction in infarct size at follow-up:46 of 78(59.0%)infarctions showed some degree of cavitation,19 of 78(24.4%)index lesions resembled non-cavitated WMH,and 13 of 78(16.7%)infarcts had disappeared at follow-up *** factors were found to be associated with differential outcomes of the *** addition,8 of 78(10.3%)patients demonstrated new WMH formation surrounding the index infarct;white matter progression(odds ratio=15.95,95%confidence interval=1.65–153.99;P=0.017)was an independent risk factor of new WMH ***:More than half of the small sub-cortical infarcts in the basal ganglia progressed to cavities,demonstrating that these infarcts can be reduced and go *** presence of new WMH around the infarct may be indicative of the worsening p

关键词： Cerebral small vessel disease Recent small sub-cortical infarct Stroke White matter hyper-intensity

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