To evaluate the safety and efficacy of transarterial followed by transvenous catheter directed thrombolysis for acute treating mixed-type lower extremity deep vein thrombosis (LEDVT).

Clinical data of 26 patients with acute mixed-type LEDVT were retrospectively analyzed. All patients were performed insertion of inferior vena cava filter before operation. The left brachial artery was punctured to place thrombolysis catheter into the affected side iliac artery. After 2-3 days, angiography review was evaluated, and the affected popliteal vein was punctured to give percutaneous intraluminal angioplasty & percutaneous mechanical thrombectomy & catheter directed thrombolysis (PTA&PMT&CDT). The thrombus clearance, the decrease of the circumference of the affected lower extremity and complications were observed.

After transarterial thrombolysis, 24 cases (92.31%) had the thrombosis dissolved in the popliteal vein and the veins below the knee. The PTA+PMT+CDT treatment was performed once in 17 cases (65.39%), 2 times in 7 cases (26.92%) and 3 times in 2 cases (7.69%) followed by iliac vein stents placement. The thrombus clearance rate was grade Ⅲ in 22 cases (84.62%), grade Ⅱ in 2 cases (7.69%), and grade I in 2 cases (7.69%). Before treatment, the difference of the upper knee circumference between the affected side and the healthy side was (5.02±2.29) cm, and after treatment the difference was (0.74±0.18) cm, and there was a statistically significant difference (t=7.601, P<0.001). There were no serious complications during thrombolysis.

For acute mixed-type LEDVT, transarterial CDT via iliac artery followed by popliteal vein PTA+PMT+CDT is safe and effective.

To summarize the nursing experience of a teenager with traumatic liver rupture combined with hepatic artery-portal vein fistula underwent double interventional therapy.

Comprehensive risk assessment and treatment of bleeding, pain nursing and psychological nursing for adolescents were carried out.

After 5 days of treatment and nursing in HICU, the patient was stable and transferred to the general ward to continue treatment, and recovered and discharged after 2 days.

Traumatic liver rupture with hepatic artery-portal vein fistula in adolescent has multiple risks of bleeding. Double interventional therapy and personalized nursing can ensure the safety of patients and promote rapid recovery of patients, which is worthy of promotion.

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.

To observe the clinical effect of uterine artery embolization (UAE) in the treatment of uterine arteriovenous malformation.

19 patients with uterine arteriovenous malformation underwent UAE in our hospital from April 2014 to December 2019 were selected to evaluate the therapeutic effect and prognosis.

15 of the 19 patients were successfully treated with one-time UAE. The patients complained of mild pain and discomfort in the right lower abdomen after operation. The symptoms disappeared 2-5 days after operation.There were still bleeding in the remaining 4 cases, of which 2 cases were converted to surgery, and the other 2 cases were improved after conservative treatment. No serious complications occurred in 19 patients.

Although uterine arteriovenous malformation is rare in clinical practice, it is easy to cause serious consequences. UAE is a minimally invasive, efficient and repeatable treatment for uterine arteriovenous malformation, which can be the first choice for those without contraindications

To investigate the safety and effectiveness of catheter-directed thrombolysis (CDT) in the treatment of inferior vena cava (IVC) thrombus.

The clinical data and imaging features of 21 patients with IVC thrombus underwent CDT therapy were analyzed retrospectively.

A total of 21 patients with lower limb deep vein thrombosis (DVT) were diagnosed as IVC thrombus by venography. The reasons of IVC thrombus were lower limb DVT in 18 cases and IVC filter in 3 cases. CDT was performed successfully under the protection of IVC filter in all cases, besides, 7 of them underwent stent placement for iliac vein compression syndrome. During 3-48 months of follow-up, recurrence of lower limb DVT occured in one patient with cancer two weeks after treatment, and improved after anticoagulation therapy. There were no serious complications.

Both of IVC filter and lower limb DVT can cause IVC thrombus. CDT is a safe and effective treatment for IVC thrombus.

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 summarize and analyse the short-term efficacy and safety of transarterial embolization (TAE) on low-to-intermediate grade neuroendocrine neoplasm liver metastasis (NENLM) with hypovascular pattern.

From January 2016 to December 2019, at the First Affiliated Hospital of Sun Yat-sen University, among the patients with different primary site of low-to-intermediate grade NENLM after the treatment of TAE, 42 cases were selected whose preoperative imaging findings for lack of blood supply. All cases had completed postoperative imaging evaluation. Respectively according to RECIST 1.1 and mRECIST criteria to evaluate the curative effect, the objective response rate (ORR) and disease control rates (DCR) were calculated within 1-3 months after the operation. Recorded the postoperative adverse events according to Common Terminology Criteria for Adverse Events (CTCAE) v5.0.

TAE has a significant debulking effect on low-to-intermediate grade NENLM with hypovascular pattern, which was evaluated according to RECIST 1.1, ORR was 66.7%, DCR was 92.9%. And according to mRECIST criteria, ORR was 85.7%, DCR was 92.9%, and CR rate was 16.7%. The major complications were fever (88.1%), hepatic pain (78.6%) and transient liver dysfunction [elevated liver enzymes (40.5%), elevated bilirubin (19.1%)], which can be alleviated after symptomatic treatment. There is no serious postoperative complications.

Although some low-to-intermediate grade NENLM is characterized by lack of blood supply in imaging, its ORR is still significant after TAE. TAE is safe and effective in reducing burden in NENLM with hypovascular pattern.

To investigate the feasibility and safety of 3D printed template and CT-guided trans-pararectal ¹²⁵I seed brachytherapy for prostate cancer.

An old patient with prostate cancer in our hospital was enrolled. He was treated by radiotherapy but did not finish the whole course because of the complication of the rectum. 3D printed template guided brachytherapy was used for a dose boost. An enhanced CT was performed after the patient was fixed in a prone position by a vacuum pad. The 3D printed template was made after the dose parameter in pre-plan was satisfied. During the procedure, the template was fixed on the surface of the patient's hip when the patient was fixed by the vacuum pad in the same prone position as before. The needles were inserted into the prostate through the skin and both sides of the rectum after local anesthesia. ¹²⁵I seeds were implanted into prostate according to pre-plan when CT showed all the needles were in the right place.

All the needles can be inserted into the right location according to pre-plan under the guidance of 3D printed template. The seeds location and dose parameter post-implant were the same with that in pre-plan. Complications such as hemorrhage, injury of the urethra and rectum were not found. The PSA reduced from preoperative 10.16 ng/ml to 6.93 ng/ml 2 month after the procedure and the tumor was stable disease evaluated by CT scan.

Trans-pararectal ¹²⁵I seeds implantation guided by 3D printed template and CT under local anesthesia was a safe and time-saving way for prostate cancer.

To analyze preoperative hemorrhagic complications and management on endovascular treatment of intracranial aneurysms in 942 cases.

From January 2011 to April 2019, 942 patients with intracranial aneurysms (1 055 aneurysms) in our center were collected to investigate the clinical perioperative hemorrhagic complications and their management.

Among the 942 patients 12 (1.27%) experienced preoperative hemorrhagic complications, consisting of intraoperative hemorrhage in 9 aneurysms (9/942, 0.96%) and postoperative hemorrhagic complications in 3 patients (3/942, 0.32%) . Nine intraoperative hemorrhages with no mortality and disability, of which 6 cases due to coil injury in the aneurysm wall, 2 cases due to microcatheter injury in the aneurysm wall, 1 case due to micro-guide wire injury in distal small arterial branch. Nine patients had a good prognosis, and the mRS score before discharge was not increased compared with admission. 3 patients with postoperative hemorrhagic complications were fatal, of which two cases were related to incomplete embolization or postoperative general heparinization, and one case might due to the acute fluctuation of blood pressure.

No preoperative heparinization and dual antiplatelet medicine can reduce the fatal intraoperative hemorrhage. Intraoperative rupture complications can achieve favorable prognosis via timely screening and reasonable treatment. Although the low incidence rate of postoperative hemorrhagic complications, the outcome will be fatal. Preoperative prevention measures, densely embolization and prudent anticoagulation usage can improve the prognosis.

To investigate the value and safety of CT-guided percutaneous lung biopsy for the diagnosis of pulmonary diseases.

The clinical and imaging data of 861 patients underwent CT-guided percutaneous lung biopsy from Central Hospital of Zibo Mining Group and Chinese People's Liberation Army General Hospital from January 2017 to July 2018 were retrospectively analyzed.

All the 861 patients were successfully completed the puncture operation. There were 296 cases of nodular lesions, 405 cases of mass lesions, 77 cases of pulmonary consolidation lesions, 83 cases of ground-glass lesions. There were 736 cases of malignant lesions were diagnosed by pathology, with a definite diagnosis rate of 90.7%, a suggestive diagnosis rate of 6.3%, and a non-specific diagnosis rate of 3%. Among 125 cases of benign lesions, the definite diagnosis rate was 49.6%, the suggestive diagnosis rate was 21.6%, and the non-specific diagnosis rate was 28.8%. Complications included pneumothorax in 77 cases (8.9%) , with the highest incidence in nodular lesions (15.2%) , pulmonary hemorrhage in 103 cases (11.9%) , with the highest incidence in ground-glass lesions (20.4%) , pleural reactions in 17 cases (1.9%) and two cases of intracardiac gas (0.2%) .

CT-guided percutaneous lung biopsy is safe and practical with fewer complications. It is helpful to make a definite diagnosis as early as possible. The diagnostic rate of malignant lesions is higher than that of benign lesions.