Objective To observe the inhibition of LipofectamineTM2000 (LF2000)mediated pSUPER recombinant plasmid expressing small interference RNA targeting hypoxia-induced factor (HIF)-1alpha;(pSUPERsiHIF-1alpha;) on retinal neovascularization in mice. Methods pSUPERsiHIF-1alpha; recombinant plasmid was created. Forty-eight (seven-day-old) C57BL/6J mice were randomly divided into a normal group, the control group, empty vector group and gene therapy group with 12 mice in each group. Mice in the normal group were kept in normal room air, while the other three groups retinal neovascularization was induced by hypoxia. The mice in control group were not treated. The mice in the vector group received intravitreous injection of pSUPER and LF2000 (1 mu;l), and the gene therapy group received pSUPERsiHIF-1alpha; and LF2000 (1 mu;l)one day before being returned to normal room air．Fluorescent angiography was used to assess the vascular pattern. The proliferative neovascular response was quantified by counting the nuclei of new vessels extending from the retina into the vitreous in cross-sections．HIF-lalpha;and vascular endothelial growth factor (VEGF) levels in retinas were measured by immune histochemical staining method and reverse transeriptase-polymerase chain reaction (RT-PCR). Results Fluorescent angiography showed radial branching pattern vessels in the normal group and distorted large vessels, obstructed capillaries, many neovascular tuffs, fluorescence leakage in the peripheral retina in the control group and vector group. The gene therapy group demonstrated a significant reduction in neovascular tufts and fluorescence leakage compared with the control group and the vector group. The number of vascular cell nuclei extending breaking through the internal limiting membrane(ILM) of control group and vector group increased significantly compared with normal group (F=5850.016,P＜0.05), while obviously decreasing in the gene therapy group compared with control group (F=3012.469,P＜0.05). Immunohistochemical staining showed the expression of HIF-1alpha; protein in nucleus and VEGF protein in cytoplasm. The expression of HIF-1alpha; protein in retina was negative, while VEGF protein was weakly positive in normal group. The expression of HIF-1alpha; and VEGF protein were both positive in control group and vector group, while weakly positive in gene therapy group. The Results of RT-PCR showed that the expression of HIF-1alpha; mRNA in retina was increased significantly in control group and vector group as compared with normal group (F=3102.326,P＜0.05), while decreasing significantly in gene therapy group as compared with control group (F=3336.425,P＜0.05). Conclusion Retinal neovascularization in the mice is significantly inhibited by intravitreal injection of LF2000-mediated recombinant plasmid pSUPERsiHIF-1alpha;.
Objective To investigate the safety and feasibility of transcatheter arterial chemoembolization (TACE) assisted by transradial approach and cone beam computed tomography (CBCT) three-dimensional vascular reconstruction in the treatment of primary liver cancer. Methods The clinical data of 124 patients with primary liver cancer who underwent precision TACE via radial artery in our hospital from May 2018 to December 2019 were retrospectively collected. Results Among the 124 patients, 118 patients were successfully punctured through the left radial artery and completed the TACE operation. The operation time was (109.57±31.32) min, and the median of postoperative hospitalization was 3 d. One patient changed to the right radial artery to complete TACE due to chronic renal failure and left brachial artery and vein puncture and catheterization before operation. The operation time was 119 minutes, and the patient was discharged after 5 days of hospitalization. After successful puncture of the left radial artery in one patient, the forearm artery was twisted into a loop and the guide wire catheter failed to pass, and the right femoral artery was used to complete TACE. The operation time was 123 minutes, and the patient was discharged after 4 days of improvement. The radial artery puncture was unsuccessful in four patients, and the right femoral artery approach was used to complete the operation; the operation time was (111.66±32.77) min, and the median of postoperative hospitalization was 3 d. One of the patients successfully completed up to 5 consecutive TACE via the radial artery. All patients underwent precision TACE with superselective cannulation assisted by CBCT three-dimensional vascular reconstruction. No vascular injury andocclusion, urinary retention, subcutaneous hemorrhage, and other complications occurred in all patients. Conclusions Trans-radial arterial precision TACE is safe and effective, which can be repeated many times and has few complications and high patient comfort. It can be used as one of the routine approaches of TACE.
ObjectiveTo explore the safety and feasibility of retrolaparoscopy in treatment of severe acute pancreatitis complicated with infected pancreatic necrosis. MethodsClinical data of 20 patients with severe acute pancreatitis complicated with infectious pancreatic necrosis who received retrolaparoscopy treatment in our hospital from May 2017 to May 2022 were retrospectively collected. ResultsAmong the 20 patients, 18 patients underwent percutaneous catheter drainage, 1 pregnant patient with severe acute pancreatitis underwent laparotomy drainage in the first phase, and 1 patient underwent laparotomy drainage in the first phase from another hospital. All patients underwent successful retroperitoneal drainage, microscopic debridement and drainage were performed. The operation time was 68–106 minutes, (89.8±11.7) minutes; intraoperative bleeding was 100–300 mL, (171.3±61.0) mL; hospitalization was 28–62 d, with median time of 48 d. After the operation, the systemic poisoning symptoms of the patients were quickly relieved. One patient underwent twice retroperitoneoscopic debridement surgeries, and the remaining patients underwent only once retroperitoneoscopic debridement drainage surgery. There were no complications in 17 patients, but 1 patient was complicated by colonic fistula after surgery, 2 patients suffered from abdominal bleeding. After the operation, 20 patients were interviewed, and the follow-up time was 6–62 months, with the median of 31 months. During postoperative follow-up period, the patients’ symptoms completely disappeared and there was no recurrence. ConclusionThe retrolaparoscopic approach in treatment of severe acute pancreatitis complicated with infected pancreatic necrosis is safe and effective, and has few complications.
ObjectiveTo introduce an innovative technique, the "balance-shaped sternal elevation device" and its application in the subxiphoid uniportal video-assisted thoracoscopic surgery (VATS) for anterior mediastinal masses resection. MethodsPatients who underwent single-port thoracoscopic assisted anterior mediastinal tumor resection through the xiphoid process at the Department of Thoracic Surgery, West China Hospital, Sichuan University from May to June 2024 were included, and their clinical data were analyzed. ResultsA total of 7 patients were included, with 3 males and 4 females, aged 28-72 years. The diameter of the tumor was 1.9-17.0 cm. The operation time was 62-308 min, intraoperative blood loss was 5-100 mL, postoperative chest drainage tube retention time was 0-9 days, pain score on the 7th day after surgery was 0-2 points, and postoperative hospital stay was 3-12 days. All patients underwent successful and complete resection of the masses and thymus, with favorable postoperative recovery. ConclusionThe "balance-shaped sternal elevation device" effectively expands the retrosternal space, providing surgeons with satisfactory surgical views and operating space. This technique significantly enhances the efficacy and safety of minimally invasive surgery for anterior mediastinal masses, reduces trauma and postoperative pain, and accelerates patient recovery, demonstrating important clinical significance and application value.