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Byline: Shao-Feng. Shui, Teng-Fei. Li*, Xin-Wei. Han, Ji. Ma, Dong. Guo Background and Purpose: This study aimed to investigate the efficacy and safety of balloon dilatation and thrombus extraction for [...]

Background: Anastomotic stenosis is an infrequent but life-threatening complication after gastrojejunostomy (Billroth II). Tubular or single tubular stents have limited efficacy due to the particular anatomy. Purpose: To assess the feasibility of a Y-shaped, fully-coated, self-expandable, metallic stent (SEMS) for anastomotic stenosis after gastrojejunostomy (Billroth II). Material and Methods: Between January 2008 and August 2014, 14 patients (10 with gastric carcinoma and four with duodenal ulcers) had anastomotic stenoses following Billroth II reconstructions. Eight patients with gastric cancer had tumor recurrence near the anastomosis; two had benign strictures. The four duodenal ulcer patients had benign stenoses. An integrated Y-shaped, fully coated SEMS was designed to accord with the anatomy of residual gastrojejunal anastomotic strictures. Fourteen stents were inserted under fluoroscopic control. Follow-up was at 1, 3, 9, and 12 months, and then annually. Results: All 14 stents were inserted successfully at the first attempt with a technical success rate of 100%. After stenting, abdominal symptoms resolved in all patients. All patients were followed up for 4-27 months (mean, 13.9 months). One of the eight recurrent cases died of multiple tumor metastases and liver failure after 7 months, without obstruction symptoms. In all six patients with benign anastomotic stenosis, the stents were removed successfully without complication and with no evidence of restenosis based on clinical evaluation and imaging. Conclusion: A Y-shaped, fully-coated SEMS proved to be a feasible and minimally invasive procedure for treating anastomotic stenosis after gastrojejunostomy (Billroth II). [ABSTRACT FROM AUTHOR]

Background: Obstructive jaundice (OJ) is insensitive to radiation and chemotherapy, and a pathologic diagnosis is difficult to make clinically. Percutaneous transhepatic cholangiobiopsy (PTCB) is simple to perform and minimally invasive, and clinical practice has shown it to be an accurate and reliable new method for bile duct histopathologic diagnosis. Purpose: To investigate the value of PTCB for pathologic diagnosis of causes of OJ. Material and Methods: From April 2001 to December 2011, PTCB was performed in 826 consecutive patients. Data on pathologic diagnosis, true positive rate, and complications were analyzed retrospectively. Patients with negative pathologic findings were diagnosed using clinical, imaging, laboratory, and prognostic data. The feasibility and safety of PTCB for OJ were evaluated and true positive rates for biliary carcinoma and non-biliary carcinoma compared. Results: PTCB was successful in all cases. Of 740 patients clinically diagnosed with malignant biliary stricture and 86 with benign biliary stricture, 727 received a positive pathologic diagnosis; in 99, the pathologic findings were considered false negative. The true positive rate for PTCB was 88.01% overall, differing significantly for biliary and non-biliary carcinoma (χ2 = 12.87, P < 0.05). Malignancy accounted for 89.59% of OJ cases; well, moderately, and poorly differentiated carcinoma represented 57.88%, 19.97%, and 22.15%. Biliary adenocarcinoma was the predominant malignant pathologic type (96.41%). Transient bilemia, bile leakage, and temporary hemobilia occurred in 47, 11, and 28 cases, respectively, with no serious complications. Conclusion: PTCB is safe, feasible, and simple, with a high true positive rate for definitive diagnosis of OJ causes. Well differentiated adenocarcinoma was the predominant pathologic type. [ABSTRACT FROM AUTHOR]

In this study, the effects of chrysin on cerebral ischemia by establishing middle cerebral artery occlusion (MCAO) in rat were investigated. In vivo experiments, the rats were orally administrated with clopidogrel or chrysin once daily for 7 days before the experimental of ischemia and the rats were divided into 5 groups: the sham group, the I/R group, I/R + clopidogrel group, I/R + chrysin (10 mg/kg), I/R + chrysin (20 mg/kg) group. Chrysin significantly ameliorated the I/R rats, evaluated by TTC staining, determination of brain wet to dry weight ratio and neurological deficits. Moreover, in serum and brain tissues of the I/R rats, chrysin also could effectively suppress the release of inflammatory cytokines, including levels of interleukin-6 (IL-6), interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α). In addition, chrysin could improve the SOD activity in the I/R rats. Mechanically, chrysin could activate the PI3K/Akt/mTOR pathway, inhibited inflammation and apoptosis. In oxygen-glucose deprivation and recovery (OGD/R)-induced SH-SY5Y cells in vitro. Chrysin markedly decreased the levels of TNF-α, IL-6 and IL-1β in supernatant of OGD/R-induced SH-SY5Y cells via activating PI3K/Akt/mTOR pathway. In conclusion, our study demonstrated that chrysin might be a potential therapeutic agent for cerebral ischemia. • Chrysin alleviates ischemia/reperfusion injury. • Chrysin has strong anti-inflammatory and anti-apoptosis effect. • Chrysin inhibits the PI3K/Akt/mTOR pathway. [ABSTRACT FROM AUTHOR]

Aim: Clinical treatment of multiple intracranial aneurysms remains challenging due its higher rate of rupture compared to a single aneurysm. We aimed to assess the efficacy of one-stage endovascular embolization for treatment of multiple intracranial aneurysms., Material and Methods: We treated 72 aneurysms from 33 patients with one-stage endovascular embolization from September 2010 to October 2015. Of these, 60 aneurysms were treated with coils, while 12 wide-neck aneurysms were embolized with the assistance of intracranial stents. Follow-up studies ranged from 3 to 28 months, and patient outcomes were assessed using the modified Rankin Scale (mRS) and digital subtraction angiography (DSA)., Results: All aneurysms were embolized successfully and no complications occurred. DSA immediately after procedure revealed that complete occlusion was achieved in 39 cases, neck remnant was observed in 27 cases, and a residual aneurysm remnant was observed in six cases. All patients achieved excellent clinical outcomes following embolization (27 patients with a mRS score of 0 and 6 with a mRS score of 1). Six months after the procedure, DSA was performed on 28 patients, revealing one case with a neck remnant, and two cases with completely occluded aneurysms. Despite these outcomes, there was no rupture or hemorrhage of these aneurysms throughout the six months., Conclusion: One-stage endovascular embolization is a safe and effective treatment for multiple intracranial aneurysms, but long-term outcomes should be further evaluated.