Tianjin, China
Tianjin, China

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Fan Y.,University of Ulsan | Fan Y.,Haihe Hospital | Song H.-Y.,University of Ulsan | Kim J.H.,University of Ulsan | And 4 more authors.
American Journal of Roentgenology | Year: 2011

OBJECTIVE. The purpose of this article is to investigate the incidence and management of esophageal rupture caused by balloon dilation in patients with benign esophageal strictures. MATERIALS AND METHODS. Fluoroscopically guided esophageal balloon dilation was performed on 589 patients with benign esophageal strictures during an 18-year period. The strictures had a range of causes: postoperative anastomotic stricture, corrosive stricture, postradiation stricture, esophageal achalasia, esophageal reflux, congenital stricture, esophageal web, esophageal ulcer, medication fibrosis, chronic inflammation, and posttraumatic stricture (in descending order of frequency). Esophageal rupture was assigned to one of three categories: type 1 was intramural, type 2 was transmural with a contained leak, and type 3 was transmural with an uncontained mediastinal leakage. RESULTS. A total of 1421 procedures were performed in 589 patients, with each patient undergoing 1-29 procedures. The technical success rate was 99.8%, and the clinical success rate was 91.7%. Patients with corrosive stricture underwent the highest number of procedures (mean, 4.38 procedures). The incidence of esophageal rupture was 14.7%. All esophageal ruptures were detected immediately after the procedure. Most ruptures (98.6%) were types 1 and 2 and were successfully managed conservatively. Only 1.4% of the ruptures were type 3 and required active management. One of the type 3 ruptures was successfully treated with a retrievable covered stent. Two patients with type 3 ruptures (0.96% of ruptures) underwent surgery and were successfully treated. The rupture rate was not statistically related to the diameter of balloon used. CONCLUSION. The incidence of esophageal rupture after fluoroscopically guided esophageal balloon dilation was 14.7%. Almost all ruptures were type 1 or 2 and were successfully managed conservatively. Only 1.4% of the ruptures were type 3 and required active management. There was no procedure-related mortality in any patient. Therefore, in spite of the high incidence of ruptures, fluoroscopically guided balloon dilation is a safe procedure, particularly if a rupture is identified early and managed appropriately. © American Roentgen Ray Society.

Yu M.,Tianjin Medical University | Yu M.,Haihe Hospital | Qiu N.-H.,Haihe Hospital
Chinese Journal of Tissue Engineering Research | Year: 2015

BACKGROUND: The treatment of lumbosacral tuberculosis with multi-segmental vertebral destruction is complex. Besides, debridement and relief of spinal cord compression, it is necessary to restore spine vertebral body height and stability of the spine. OBJECTIVE: To investigate the surgical treatment effect of multi-segmental lumbosacral tuberculosis by posterior vertebral pedicle fixation and anterior debridement with autologous iliac bone graft. METHODS: A total of 25 cases of L2 -S2 vertebral tuberculosis with various degrees of damage, who were treated from March 2005 to December 2012, were selected in this study. After regular anti-tuberculosis treatment for 2-4 weeks, first-phase posterior pedicle screw fixation with anterior debridement and autologous iliac bone graft was performed. Postoperative X-ray and CT scan were conducted to assess bone fusion and deformity correction. Adverse events and material host reaction were recorded. RESULTS AND CONCLUSION: After repair, average 16-month follow-up was performed. 23 cases of postoperative wound were totally healed, with 2 cases of incisions delaying healing, no sinus formation. After surgery, the lumbago and leg pain disappeared in all patients. During follow-up, graft displacement had no slippage, broken nails or broken rods. Within 6 months, bony fusion occurred. At 1 year after operation, there was no recurrence of tuberculosis with normal erythrocyte sedimentation. X-ray films showed lesion vertebra turned out to be bony union. Postoperative lumbosacral angle was 16°-36°, averagely 26°, and 15°-30° during final follow-up, averagely 20°. These results confirmed that one-stage debridement for multi-segmental lumbosacral tuberculosis and concomitant posterior pedicle fixation system for kyphosis correction therapy, which could reconstruct lumbosacral stability, and restore sagittal plane balance. Autologous iliac bone graft improved fusion rate and obtained satisfactory outcomes. © 2015, Journal of Clinical Rehabilitative Tissue Engineering Research. All rights reserved.

Fan Y.,University of Ulsan | Fan Y.,Haihe Hospital | Song H.-Y.,University of Ulsan | Kim J.H.,University of Ulsan | And 5 more authors.
American Journal of Roentgenology | Year: 2012

OBJECTIVE. The objective of this study was to investigate the incidence of esophageal complications associated with balloon dilation and their management in patients with malignant esophageal strictures. MATERIALS AND METHODS. Fluoroscopically guided esophageal balloon dilation was performed in 89 patients with malignant esophageal strictures during a period of 15 years. Inclusion criteria were patients with unresected esophageal or gastric carcinoma showing short-segment stricture (≤ 4 cm) at the esophagogastric junction; patients who had previously received chemotherapy, radiation therapy, or both to manage malignant strictures; or patients who were scheduled for chemotherapy or radiation therapy to manage malignant strictures. Of these patients, 72 had esophageal cancer and 17 had stomach cancer. Esophageal rupture was categorized as intramural, transmural, or transmural with mediastinal leakage. RESULTS. A total of 120 procedures were performed, with each patient undergoing one to four procedures. Esophageal rupture occurred in 13 patients (15%): eight with intramural rupture, four with transmural rupture, and one with transmural rupture with mediastinal leakage. Improvements in dysphagia score were observed in 76 of 89 patients (85%) after balloon dilation. All esophageal ruptures were detected immediately after the procedure. Intramural and transmural ruptures were treated conservatively, whereas transmural rupture with mediastinal leakage was treated by temporary stent placement. CONCLUSION. The overall prevalence of esophageal rupture was 15%. All intramural and transmural ruptures were successfully managed conservatively, whereas transmural rupture with mediastinal leakage was treated by temporary stent placement. We found no relationship between rupture incidence and balloon diameter. © American Roentgen Ray Society.

Lee Y.J.,University of Ulsan | Kim J.H.,University of Ulsan | Song H.-Y.,University of Ulsan | Park J.-H.,University of Ulsan | And 4 more authors.
CardioVascular and Interventional Radiology | Year: 2012

Purpose: To evaluate the clinical effectiveness of self-expandable metallic stents in seven patients with malignant gastroduodenal obstruction caused by inoperable hepatocellular carcinoma (HCC). Methods: Seven patients with gastroduodenal obstruction caused by advanced HCC underwent metallic stent placement from 2003 to 2010. These patients had total dysphagia (n = 5) or were able to eat only liquids (n = 2) before stent placement. Patients had Eastern Cooperative Oncology Group performance scores of 2 or 3, and Child-Pugh classification B or C. Results: Stent placement was technically successful in all seven patients (100%) and clinically successful in six (86%). Five patients could eat a soft diet, and one patient tolerated regular diet after stent placement. Stent-related obstructive jaundice occurred in one patient. One patient had hematemesis 11 days after stent placement. Overall mean survival was 51 days (range, 10-119 days). Stent patency was preserved in six patients with clinical success until death. Conclusion: Placement of a covered self-expandable metallic stent may offer good palliation in patients with gastroduodenal obstruction due to advanced HCC. © 2011 Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE).

Li Y.,Haihe Hospital | Wu Q.,Haihe Hospital | Chen Y.,Haihe Hospital
Acta Cardiologica | Year: 2012

ST-elevation acute myocardial infarction (AMI) is a critical illness with a high mortality rate. Cases of AMI accompanied by active tuberculosis are rarely reported. Percutaneous coronary intervention (PCI) is an important procedure in the treatment of ST-elevation AMI; it can significantly improve the prognosis and quality of life and reduce mortality. Anticoagulants and antiplatelet medications are administered before, during, and after PCI. However, for patients with ST-elevation AMI accompanied by active tuberculosis, anticoagulation and antiplatelet therapy may lead to pulmonary haemorrhage, haemoptysis, and serious treatment difficulties. Some authors even regard pulmonary tuberculosis as a contraindication of PCI. In this study, we have reported 3 patients with ST-elevation AMI accompanied by active tuberculosis who underwent PCI at our hospital between July 2007 to September 2010, and obtained satisfactory outcomes.

Kim E.-Y.,University of Ulsan | Song H.-Y.,University of Ulsan | Kim J.H.,University of Ulsan | Fan Y.,Haihe Hospital | And 4 more authors.
Radiology | Year: 2013

Purpose: To investigate the efficacy of an IN-1233-eluting covered stent in preventing tissue hyperplasia in a rabbit esophageal model. Materials and Methods: The local animal research committee approved all experiments. Esophageal stents were placed in 40 male New Zealand rabbits (weight range, 2.8-3.2 kg). The drug group (D) received IN-1233-eluting covered stents (n = 20); the control group (C) received polyurethane-covered stents (n = 20). Drug loading of IN-1233-eluting covered stent was 10%. Four study groups were formed: C and D animals sacrificed at 4 (D4, C4) and 8 (D8, C8) weeks after stent placement (n = 10). Esophagography was used to assess the percentage of diameter stenosis. Histologic findings of the drug and control stents were compared. The Mann-Whitney U test was used to evaluate differences. Results: The mean percentage ± standard deviation of diameter stenosis was significantly lower in D groups than in C groups at both 4 (C4 = 36.15% ± 12.63, D4 = 7.83% ± 8.12 [P < .001]) and 8 (C8 = 50.21% ± 20.43, D8 = 27.78% ± 14.40 [P = .019]) weeks. Percentage of granulation tissue area (C4 = 33.07% ± 19.11, D4 = 21.59% ± 18.22 [P = .028]; C8 = 44.70% ± 21.71, D8 = 31.97% ± 22.54 [P = .131]), number of epithelial layers (C4 = 4.77 ± 1.55, D4 = 3.37 ± 1.73 [P = .002]; C8 = 5.50 ± 1.38, D8 = 4.50 ± 1.63 [P = .057]), and thickness of submucosal fibrosis (C4 = 2.42 mm ± 1.08, D4 = 1.62 mm ± 0.77 [P = .006]; C8 = 2.89 mm ± 1.00, D8 = 2.07 mm ± 0.71 [P = .007]) were lower in D than in C groups. Inflammatory cell infiltration was significantly higher in D than in C groups (C4 = 2.63 ± 0.81, D4 = 3.33 ± 1.09 [P = .032]; C8 = 2.20 ± 0.81, D8 = 3.00 ± 0.95 [P = .012]). Conclusion: The use of an IN-1233-eluting covered stents decreased tissue hyperplasia secondary to stent placement in a rabbit esophageal model. © RSNA, 2013.

Shi L.-X.,Haihe Hospital | Li L.,Haihe Hospital | Sun X.,Haihe Hospital
Journal of Practical Oncology | Year: 2011

Objective: To evaluate the efficacy and safety of bronchoscopic argon plasma coagulation (APC) combined with cryotherapy in treatment of tracheal and bronchial malignant tumors. Methods: Seven patients with airway constriction caused by tracheal and bronchial malignant tumors were treated with endoscopic APC combined with cryotherapy. The therapeutic effect and complications were observed. Results: Among the 7 cases, 3 received 1 therapy, 3 received 2 therapies and 1 received 3 therapies. The symptoms including irritable cough and dyspnea were relieved to different extent: marked improvement in 4 cases and improvement in 3 cases. There was no death related to the therapy. Conclusion: Bronchoscopic APC is effective for airway constriction caused by tracheal and bronchial malignant tumors.

Feng S.,Haihe Hospital | Du Y.-Q.,Haihe Hospital | Zhang L.,Haihe Hospital | Zhang L.,Institute for Hepatology of the Third Center Hospital | And 2 more authors.
Chinese Medical Journal | Year: 2015

Background: Tuberculosis (TB) is a chronic wasting inflammatory disease characterized by multisystem involvement, which can cause metabolic derangements in afflicted patients. Metabolic signatures have been exploited in the study of several diseases. However, the serum that is successfully used in TB diagnosis on the basis of metabolic profiling is not by much.Methods: Orthogonal partial least-squares discriminant analysis was capable of distinguishing TB patients from both healthy subjects and patients with conditions other than TB. Therefore, TB-specific metabolic profiling was established. Clusters of potential biomarkers for differentiating TB active from non-TB diseases were identified using Mann–Whitney U-test. Multiple logistic regression analysis of metabolites was calculated to determine the suitable biomarker group that allows the efficient differentiation of patients with TB active from the control subjects.Results: From among 271 participants, 12 metabolites were found to contribute to the distinction between the TB active group and the control groups. These metabolites were mainly involved in the metabolic pathways of the following three biomolecules: Fatty acids, amino acids, and lipids. The receiver operating characteristic curves of 3D, 7D, and 11D-phytanic acid, behenic acid, and threoninyl-γ-glutamate exhibited excellent efficiency with area under the curve (AUC) values of 0.904 (95% confidence interval [CI]: 0863–0.944), 0.93 (95% CI: 0.893–0.966), and 0.964 (95% CI: 0.941–0.988), respectively. The largest and smallest resulting AUCs were 0.964 and 0.720, indicating that these biomarkers may be involved in the disease mechanisms. The combination of lysophosphatidylcholine (18:0), behenic acid, threoninyl-γ-glutamate, and presqualene diphosphate was used to represent the most suitable biomarker group for the differentiation of patients with TB active from the control subjects, with an AUC value of 0.991. Conclusion: The metabolic analysis results identified new serum biomarkers that can distinguish TB from non-TB diseases. The metabolomics-based analysis provides specific insights into the biology of TB and may offer new avenues for TB diagnosis. © 2015, Chinese Medical Journal. All rights reserved.

Wu L.-P.,Nankai University | Wu L.-P.,Tianjin University of Traditional Chinese Medicine | Zhang Z.-P.,Nankai University | Guo Y.,Tianjin University of Traditional Chinese Medicine | And 2 more authors.
Gaodeng Xuexiao Huaxue Xuebao/Chemical Journal of Chinese Universities | Year: 2011

Glutaraldehyde cross-linked chitosan microspheres(CS) were prepared by inverse phase suspension reaction. Low generations(Gn, n≤3) hexanediamine-contained PAMAM dendrimers were supported to chitosan microspheres. Bilirubin adsorption on the above microspheres was carried out in 0.05 mol/L phosphate buffer solution(pH=7.2-7.4) at 37°C. The results show that the equilibrium adsorption percentage of CS-G2.0, CS-G3.0, CS-G1.0, CS-G0 and CS microspheres are 94.61%, 93.44%, 92.97%, 86.47% and 52.38%, respectively. The adsorption percentage of CS-G1.0-CS-G3.0 microspheres is over 70% at 0.5 h and arrived to the equilibrium at about 1 h. The adsorption capacity is up to 42.78 mg/g. All the moderations(CS-G0-CS-G3.0) are much better than CS microspheres for bilirubin adsorption. The effects of temperature, pH, bilirubin initial concentration, ion strength and bovine serum albumin(BSA) on the adsorption properties for bilirubin were studied. It was shown that adsorption percentage increased at higher temperature. Adsorption properties were the best at near neutral solutions of pH≈7. PAMAM dendrimers supported in chitosan microspheres had satisfactory competitive abilities with BSA for bilirubin adsorption though adsorption percentage decreaed to a certain extent in the presence of BSA.

Li H.,Tianjin Medical University | Wu Q.,Haihe Hospital | Xu L.,Haihe Hospital | Li X.,Haihe Hospital | And 5 more authors.
Molecular Medicine Reports | Year: 2015

Chronic obstructive pulmonary disease (COPD) is a major public health problem, and cigarette smoke (CS) is the primary risk factor. The pathology is often observed in the lung, but COPD is also associated with intestinal barrier disruption, although the underlying mechanisms are poorly understood. To address this, a CS-exposed rat model was evaluated in the present study by analyzing small intestinal gene expression using reverse transcription-quantitative polymerase chain reaction. CS exposure caused upregulation of the nicotinamide adenine dinucleotide phosphate-oxidase subunits nox2 and p22phox in the small intestine, while the antioxidative enzyme superoxide dismutase was downregulated. CS exposure also increased bax expression and decreased bcl-2 expression. This was associated with an elevation of hypoxia-inducible factor (HIF)-1α. Claudin-1 was decreased and claudin-2 increased, indicating a loosening of small intestinal tight junctions (TJs). These data suggest that during the development of COPD, HIF-1α expression is altered in the small intestine, which may be associated with the increased oxidative stress and apoptosis, eventually resulting in disruption of the intestinal TJs.

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