Objective To investigate therapeutic effects of continous regional arterial infusion with verapamil on preventing the progression of acute pancreatitis. Methods Forty-five patients with mild acute pancreatitis were randomly divided into three groups: conventional treatment group, intravenous treatment group and arterial infusion group. After admission, conventional treatments were performed in conventional treatment group. Reasonable fluid and verapamil were intravenously injected to the patients in intravenous treatment group, and fluid treatments and continous regional arterial infusion with verapamil were performed in arterial infusion group for 1－2 weeks. The levels of serum TNF-α, IL-1β, ICAM-1 and P-selectin were determined on the 1st, 4th and 7th day after treatment, respectively. Results On the 4th and 7th day after treatment, the levels of serum TNF-α and P-selectin significantly decreased in arterial infusion group compared with the other two groups （P＜0.05）, while the level of serum IL-1β significantly decreased in arterial infusion group and intravenous treatment group compared with the conventional treatment group （P＜0.05）. The level of serum ICAM-1 significantly decreased in arterial infusion group compared with the conventional treatment group （P＜0.05）.Conclusion Continous regional arterial infusion with verapamil could reduce the production of inflammatory cytokines and inhibit the up-regulation of adhesion molecules ICAM-1 and P-selectin, and prevent the progression of acute pancreatitis ultimately.
Objective To evaluate the effect of Fogarty balloon catheter embolectomy on arteriovenous graft thrombosis in hemodialysis patients. Methods We retrospectively analyzed the clinical data of 11 patients who underwent maintaining hemodialysis and arteriovenous graft thrombosis through Fogarty balloon catheter embolectomy between March 2010 and November 2014. The thrombosed graft was incised, and a 4 or 6 French catheter was placed in the venous and arterial limbs of the graft respectively. The Fogarty balloon was passed beyond the thrombus and pulled out after saline was infused into the balloon, and the thrombus was taken out. The procedure was considered unsuccessful if the blood flow was not re-established or if the graft re-thrombosed within hours. Results The treatment was successfully performed in all the patients. Of the 11 patients, 3 received balloon dilation due to stenosis of venous anastomosis, and 2 received angioplasty due to underlying arterial anastomosis lesion. After corresponding measures were taken, the thrombus of all the 11 patients were taken out, and blood flow was recovered. Two to seven days after surgery, low molecular weight heparin was used for anti-coagulation. The blood flow of all arteriovenous grafts reached over 250 mL/min. All the patients were followed up for 4 to 30 months. During the follow-up, the arteriovenous graft remained functional in 5 patients; 4 patients had re-thrombosis on day 2, 3, 25, and 71 after surgery respectively; one changed to undergo peritoneal dialysis due to rupture and infection of the graft, and one patient was transferred to another hospital in another area and was not followed up any longer. The therapy was successful in 81.8% of this group of patients. Conclusion Fogarty balloon catheter embolectomy is effective in restoring patency of thrombosed arteriovenous graft in hemodialysis patients, and more studies are needed.
【Abstract】ObjectiveTo study the effect of preoperative gastric arterial chemoembolization on apoptosis of lymph node metastasis of gastric cancer. MethodsForty patients with gastric cancer and lymph node metastasis underwent curative resection, among which there were 20 patients who received the preoperative gastric arterial chemoembolization, and they constituted the treatment group. The rest of the patients were included in the control group. The expressions of p53, CD95 and bcl-2 were examined by immunohistochemistry and apoptosis in the lymph node metastasis was examined by in situ terminal transferasemediated dUTP nick end labeling （TUNEL）. ResultsThe expression intensity of p53 and CD95 in lymph node metastasis of treatment group increased more significantly than that of control group, whereas the expression intensity of bcl-2 decreased in treatment group. There was a significantly positive correlation between the expressions of p53 and CD95 and the apoptosis.ConclusionPreoperative gastric arterial chemoembolization may affect the expressions of p53, CD95 and bcl-2 and may induce the apoptosis of lymph node metastasis. It may be helpful to improve the effect of curative resection of gastric cancer.