In order to advance the standardization of emergency care for patients with hemorrhagic shock, enhance treatment success rates, and improve patient prognosis, the Haemorrhage Professional Committee of Chinese Research Hospital Society and the Nursing Expert Committee of the China Haemorrhage Center Alliance have led and united domestic medical professionals in related fields. They discussed principles of emergency diagnosis and treatment for patients with hemorrhagic shock, emergency nursing strategies, efficacy evaluation, and other relevant aspects to formulate an expert consensus on emergency nursing for hemorrhagic shock.

To evaluate the efficacy and safety of Tiaogan Lipi granules (TGLPG) on postembolization syndrome (PES) induced by transcatheter arterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC).

This study was a multi-center, randomized, double-blind, placebo-controlled trial. 124 HCC patients were randomly divided into the experimental group and the placebo group at a 1:1 ratio. In the experimental group, the patients received TGLPG in addition to the standard treatment. And in the control group, the patients received the placebo. The PES was measured as the primary outcome, and traditional Chinese medicine (TCM) symptom scale and quality of life were measured as secondary outcomes. The hematological test, renal function, and electrocardiogram were used as the safety index in clinical trials.

There was no significant difference between the two groups at baceline. At postoperative day 7, the TCM scale in the study group was significantly improved compared to that in the control group (P < 0.05). The symptoms of PES, including nausea, fever, and pain, were found to be relieved significantly by TGLPG (P < 0.05).

TGLPG may be an effective modality to relieve PES and improve the quality of life in patients with HCC after TACE.

Magnetic Particle Imaging (MPI) is a new generation of molecular imaging technology derived from Magnetic Resonance Imaging (MRI).It adopted complex combinations of rotary variable gradient magnetic field that can directly detect the Superparamagnetic Iron Oxide nanoparticles (SPIO) in vivo with high sensitivity of the Moore level. MPI is characterized by high temporal spatial resolution, high sensitivity, no scanning depth limitation and no ionizing radiation, etc. It has been applied in cell tracer,angiography,tumor imaging and treatment and other preclinical fields. Since its emergence in 2005, MPI has developed rapidly in software algorithms, hardware development, tracer design, and preclinical applications. Therefore, on the basis of briefly describing the history and basic principles of MPI, this article would summarize the research progress of MPI in cell tracer, blood vessel, tumor and other preclinical fields in recent years, and prospect the clinical transformation of MPI.

Hepatocellular carcinoma (HCC) is one of the most common malignant tumors in China, and most patients with advanced HCC have lost the opportunity of surgical resection. At this time, TACE is by far the preferred treatment. It has better clinical efficacy, but its adverse reactions are also the problem that clinicians must face. Traditional Chinese medicine (TCM) is mild in nature and has few toxic and side effect, and it can reduce the dosage of chemotherapy drugs and improve the immunity of the body. Therefore, TACE combined with TCM for the treatment of HCC has been gradually promoted by clinicians. The purpose of this paper is to review the application and advantages of TACE combined with TCM such as Kanglaite, Elemene, Huaier and Ganfule.

TTo evaluate the effect of percutaneous transluminal stenting (PTS) in treatment of central venous stenosis (CVS).

Clinical data of 29 patients who were diagnosed as CVS, manifested by imaging examination, and treated by PTS were collected and reviewed retrospectively. Follow-up was performed at the first, third and sixth month after discharge. The imaging examination, clinical results, complications, and second treatment were reviewed.

36 treatment of PTS were performed in the patients. The technical success rate was 97.2%, and clinical effective rate was 94.4%. A total of 48 stents were implanted, including 36 bare stents and 12 covered stents. There was no complication observed among these cases. After 3-38 months of follow-up, restenosis of the stent occurred in 10 patients after PTS, and re-intervention was performed. The restenosis rate of bare stent after PTS (45.8%) was significantly higher than that of covered stent (10.0%) (χ²=3.852, P=0.046). Moreover, the restenosis rate after PTS was 57.1% in patients with chronic renal failure (CRF) undergoing hemodialysis through autologous arteriovenous fistula, and 19.0% in non-CRF patients, with significant difference (χ2=5.256, P=0.022). Compared with patients with post-operative regular anticoagulant therapy, the restenosis rate of stent in patients without regular anticoagulant therapy was higher (26.67% vs 100%, χ2=8.311, P=0.004).

PTS was effective in treatment of patients who suffered with CVS.The restenosis rate when performed with covered stent was lower than that with bare stent; however, the restenosis rate following PTS was higher in patients with CRF receiving hemodialysis treatment. Moreover, post-operative regular anticoagulant therapy was critical.

To evaluate the feasibility and efficacy of transjugular intrahepatic portosystemic shunt (TIPS) for variceal rebleeding after splenectomy.

33 patients with variceal rebleeding after splenectomy underwent TIPS in our hospitalfrom December 2010 to December 2016 were enrolled in this retrospective study. Success rates, efficacy, and complications were evaluated.

TIPS was successfully performed in 31 patients and failed in 2. Mean portosystemic pressure gradient (PPG) fell from 23.5±5.9 mmHg to 12.1±3.3 mmHg after successful TIPS procedure (P<0.05). One patient died due to septic shock during perioperative period. The median follow-up of 62.5 months in 30 cases. Shunt dysfunction appeared in 10 cases with4 rebleeding and 1 of them died due to rebleeding, while 1 case suffered massive ascites and 1 case suffered acute mesenteric vein thrombosis followed by intestinal obstruction. Overt hepatic encephalopathy appeared in 10 cases. Four of them recovered after receiving medical treatment and 1 experienced grade 3 hepatic encephalopathy, while the other 5 died from liver failure due to severe cirrhosis. There were 2 more death due to pulmonary disease and 1 death due to hepatocellular carcinoma after procedure. The other patients remained asymptomatic and shunt patency. The average level of serum total bilirubin and serum albumin 6 months after procedure were better than those before procedure (P<0.05).

TIPS is safe and effective on controlling variceal rebleeding after splenectomy in portal hypertension.

To investigate the preliminary efficacy and safety of drug-eluting beads transarterial chemoembolization (DEB-TACE) for the treatment of liver metastasis of neuroendocrine tumors (NEN-LM).

The clinical data of 27 patients with NEN-LM treated in Interventional Department from March 2019 to January 2020 were analyzed retrospectively, including 20 pancreas of primary site, 3 duodenum, and 4 rectum. All patients were diagnosed by pathology. Twelve patients underwent treatment of DEB-TACE (DEB-TACE group) and 15 patients were treated with Lipiodol (cTACE group). Response of hepatic lesions were assessed according to mRECIST. Objective response rates (ORR) and safety were compared of the two groups. Follow-up period ranged from 9 to 15 months.

The ORRs of 1, 3, 6 and 12 months were 91.7%, 83.3%, 58.3% and 54.5% respectively in DEB-TACE group, but 86.7%, 66.7%, 40.0% and 14.3% respectively in cTACE group. The ORR of 12 months in DEB-TACE group was significantly higher than that in cTACE group (P = 0.043). The main complication of the two groups was post-embolization syndrome, and there was no significantly difference (P > 0.05). No serious complications occurred.

Compared to cTACE, DEB-TACE can effectively reduce tumor burden in patients with NEN-LM, which is safe and well-tolerated.

To explore the long-term globe salvage rate,life survival rate and the risk factors affecting the globe salvage in retinoblastoma (RB) patients treated with Intra-arterial chemotherapy (IAC).

The retrospective cohort study was conducted among patients with RB underwent IAC in Guangzhou woman and children hospital from April 2009, to April 2016. The clinical characteristics,treatment situation, globe salvage rate and life survival rate were analysis. The Kaplan Meier survival curve was used to estimate globe survival time and life survival time for patient and univariate analysis was performed to explore the relationship between globe salvage rate and gender, IIRC, age, preoperative treatment history. Cox proportional hazard model was conducted to identify the determinants of prognosis for patients with RB.

A total of 320 cases were included. The median follow-up time of 307 surviving patients (374 eyes) after IAC was 40 months (1 to 130 months), There were 1299 IAC (average 3.47 times per eye). From the last IAC treatment, the shortest globe salvage time for RB children was 1 month, and the longest globe salvage time was 130 months. 284 patients' eyeball was not removed due to stable disease. The overall globe salvage rate was 75.9%. The globe salvage rate in stage A (n=1), stage B (n=23), stage C (n=25), stage D (n=258), stage E (n=67) were 100%, 95.7%, 100%, 80.6%, 41.8%, respectively. Univarite analysis showed that the salvage rate was significantly associated with IIRC. Multivariate analysis of Cox proportional hazard model showed that IIRC (RR 72.7) were independent determinant for RB globe salvage rate.13 patients died due to the disease progression during follow-up( survival rate 96.0%).

Intra-arterial chemotherapy is safe and effective for management of retinoblastoma in the long term. IIRC can be used for the assessment of prognosis.

In recent years, much progress has been made on the territory of biodegradable magnesium alloy scaffolds in Vascular system. As a biodegradable material, magnesium alloy scaffolds has certain advantages over iron base alloy and zinc base alloy. The degradation of magnesium is too rapid to match the rates of tissue healing and it exhibits the non-uniform corrosion mechanism.Therefore, researchers optimized the bimetallic properties of biodegradable magnesium alloy scaffolds from the surface modification, forging process and composition ratio. And scaffolds were applied to preclinical experiments and clinical research. This review focuses on the following topics: the development history at home and abroad and the characteristics of biodegradable magnesium alloy scaffolds. Furthermore, this review also covers research carried out in the field of development prospect of the stent.

Lower limb varicose veins is a common disease in clinic, which is related to the pathogenesis of multiple factors ,mainly including hemodynamic abnormalities,and seriously affects people's life and health.So far, radiofrequency ablation (RFA) is likely to replace traditional surgery as a commonly used minimally invasive surgical treatment for lower limb varicose veins.The main advantages of RFA are small trauma, quick recovery, reliable curative effect and few complications,whereas the main deficiency are skin burn and nerve injury.Currently, radiofrequency ablation is mostly combined with local stripping, selectively combined with foam sclerotherapy,transilluminated powered phlebectomy,endovenous microwave ablation and electrocoagulation.

To determine the influence of diabetes on histological profile of lower limb veins, and to explore the mechanism of the effects of high-glucose medium in the viability and Collagen expression of venous smooth muscle cells (SMCV).

Diabetic rat model was established with intraperitoneal injection of streptozotocin. Hematoxylin-eosin (HE) and Masson staining were performed to observe the histological changes of great saphenous veins (SV). SMCVs were cultured in medium of high (DM group) or normal (NC group) levels of glucose, and the SMCVs viability was evaluated by cell counting kit-8 (CCK-8). The levels of TypeⅠ Collagen (COLⅠ), Type Ⅲ Collagen (COL Ⅲ), Metalloproteinase 2 (MMP2), Tissue inhibitor of metalloproteinase 1 (TIMP1) protein and mRNA expression in the cells were detected by Western Blot (WB) and Real-time quantitative Polymerase Chain Reaction (RT-qPCR). The contents of COLⅠ and COL Ⅲ in the cellular supernatant were detected using ELISA kit.

Vein samples acquired from the diabetic rats showed lower medial thickness (P<0.05), larger luminal area (P>0.05) and lower collagen content (P>0.05). The viability of VSMCs was significantly declined in the DM group (P<0.05). There was no significant difference in the expression of COLⅠ mRNA between groups. The levels of COL Ⅲ mRNA was decreased in the DM group (P<0.05), followed by an ascending level of TIMP1 mRNA (P<0.05) and a declined level of MMP2 mRNA (P<0.05). WB analysis demonstrated that high-glucose treatment decreased the expression of COLⅠ and TIMP1 in SMCVs, accompanied with an increased expression of MMP2. ELISA showed that the expression of COLⅠ (P<0.05) and the ratio of COLⅠ / COL Ⅲ (P<0.05) in the cellular supernatant of DM group were also decreased.

The lower limb veins in diabetes presented histological changes as a lower medial thickness, larger luminal area and lower collagen content. High glucose treatment decreased the expression of COLⅠ and TIMP1 of SMCVs, and increased the expression of MMP2, which may suggest that high glucose inhibit the collagen expression of SMCVs via the regulation of MMP2/TIMP1 expression.