Objective To compare the efficacy and indications between the biliary bypass laparotomy surgery.and the two different kinds of biliary stent insertion surgery in the palliative alleviating jaundice of cholangiocarcinoma.Methods From March 2008 to March 2013,69 patients treated with palliative alleviating jaundice therapy of cholangiocarcinoma were included,who were all came from the Third Affiliated Hospital of Guangzhou Medical University.Including 17 patients who treated with the open biliary bypass surgery and 52 patients who treated with interventional therapy.We analysed the differences between these cases of biliary drainage operations in the recent jaundice reduction rate,average stay,mortality rate,the incidence of related complications,et al.Results All these different drainage ways had good effect in alleviating jaundice,incidence of alleviating jaundice have no obvious difference (P ＞ 0.05).Compared to the open biliary bypass surgery,interventional therapy had obvious advantages in the average stay and postoperative survival (P ＜ 0.05).The pancreatitis rate was lower in Percutaneous Group than that in Endoscopic Group (P ＜ 0.05).incidence of biliary tract infection and biliary tract bleeding have no obvious difference (P ＞ 0.05).There were no significant differences between the success rates of in biliary stent insertion operation in patients with each model cholangiocarcinoma (P ＞ 0.05).Conclusions Among the therapies of the palliative alleviating jaundice of cholangiocarcinoma,the internal biliary drainage of biliary stent insertion operation was superior to the treatment of the biliary bypass laparotomy.As to biliary stent insertion operations,endoscopic biliary stenting surgery should be the preferred choice.

Objective To investigate and evaluate the clinical signiifcance of lfexible ureteroscopy in computed tomography urography negative patients with upper urinary tract hematuria. To improve the diagnostic rate of patients with upper urinary tract hematuria. Methods We retrospectively reviewed the cases of 10 computed tomography urography negative patients with upper urinary tract hematuria. The age ranges from 38 to 75 years old, and the average of them is 45.2 years old. The patients consist of 7 male patients and 3 female patients. Among them, 4 cases were on the left upper urinary tract cases, 6 cases were right upper urinary tract. All patients received lfexible ureteroscopy to conifrm the diagnosis and take the relevant treatment. Results In the total of 10 patients, 3 patients (30%) were diagnosed with tumors of renal pelvis, a renal arteriovenous ifstula was found in 1 case (10%), 3 patients (30%) were considered non-specific inflammation, other 3 patients (30%) had no obvious abnormalities. Conclusions Flexible ureteroscopy has significantly clinical diagnosis in computed tomography urography negative patients with upper urinary tract hematuria.

Objective To investigate the expression of FBP1 in human renal clear cell carcinoma and paracancerous tissue and its effect and clinical significance in the carcinogenesis,progression and prognosis of renal cancer.Methods The paraffin sections from 118 patients with renal clear cell carcinoma treated by surgical resection and fresh specimens from 40 patients with renal clear cell carcinoma were selected.The expressions of FBP1 protein and mRNA in renal cancer and paracancerous tissues(negative incisal edge) were detected by adopting the immunohistochemistry(IHC),Western blot and RT-PCR.Its correlation with clinicopathologic characteristics and prognosis of the patients was analyzed.Results The IHC result,found that strong positive expression of FBP1 protein could be seen in 78.81％ (93/118) of cancer-adjacent tissues,while only 39.83％ (47/118) of renal cancer tissues had positive expression.Western blot found that the expression positive rate of FBP1 in renal cancer tissue was significantly decreased compared with corresponding cancer-adjacent tissues (P＜0.01).RT-PCR found that the FBP1mRAN expression level in cancer-adjacent tissues was also significantly higher than that in renal cancer tissue(P＜0.05).The FBP1 low expression was significantly correlated with the clinical stage,pathologic grade,UISS risk coefficient and recurrence(P＜0.05),and had no relation with the age,gender,symptoms,tumor size,location,tumor necrosis,vascular invasion and adrenal involvement(P＞0.05).The 5-year survival rate in renal cancer patients with FBP1 positive expression was higher than that in the patients with FBP1 negative expression(P＜0.05).Conclusion FBP1 and protein are lowly expressed in renal cancer tissue,are correlated with occurrence and development of renal cancer,and may become one of candidate markers of renal cancer prognosis.

A case of fibrosing alopecia in a pattern distribution (FAPD) and its clinicopathological, dermoscopic and TrichoScan features were reported to improve the understanding of FAPD. A 23-year-old male patient presented with progressive hair loss on the forehead and top of the head for 10 years, local hair thinning and softening, and occasional scalp itching. Skin examination showed diffuse sparseness of hair from the forehead to the top of the head, frontal hairline recession, focal thinning and softening of hair, some follicular keratotic papules and perifollicular erythema on the alopecic area, with no obvious scales. TrichoScan examination revealed markedly decreased hair density and increased proportions of vellus hairs. Dermoscopy showed loss of some follicular ostia and confluent white dots. Histopathological examination of the scalp showed lichenoid lymphocytic infiltration around the infundibulum and isthmus of hair follicles, concentrically layered perifollicular fibrosis, hair follicle destruction, formation of follicular micro-scars, markedly increased variation in the diameter of residual follicles, and some vellus hairs. The patient was diagnosed with FAPD. FAPD is easily misdiagnosed as androgenetic alopecia, and early diagnosis and treatment are needed.

Background::Coronavirus disease 2019 (COVID-19) has potential risks for both clinically worsening pulmonary hypertension (PH) and increasing mortality. However, the data regarding the protective role of vaccination in this population are still lacking. This study aimed to assess the safety of approved vaccination for patients with PH.Methods::In this national prospective cohort study, patients diagnosed with PH (World Health Organization [WHO] groups 1 and 4) were enrolled from October 2021 to April 2022. The primary outcome was the composite of PH-related major adverse events. We used an inverse probability weighting (IPW) approach to control for possible confounding factors in the baseline characteristics of patients.Results::In total, 706 patients with PH participated in this study (mean age, 40.3 years; mean duration after diagnosis of PH, 8.2 years). All patients received standardized treatment for PH in accordance with guidelines for the diagnosis and treatment of PH in China. Among them, 278 patients did not receive vaccination, whereas 428 patients completed the vaccination series. None of the participants were infected with COVID-19 during our study period. Overall, 398 patients received inactivated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine, whereas 30 received recombinant protein subunit vaccine. After adjusting for baseline covariates using the IPW approach, the odds of any adverse events due to PH in the vaccinated group did not statistically significantly increase (27/428 [6.3%] vs. 24/278 [8.6%], odds ratio = 0.72, P = 0.302). Approximately half of the vaccinated patients reported at least one post-vaccination side effects, most of which were mild, including pain at the injection site (159/428, 37.1%), fever (11/428, 2.6%), and fatigue (26/428, 6.1%). Conclusions::COVID-19 vaccination did not significantly augment the PH-related major adverse events for patients with WHO groups 1 and 4 PH, although there were some tolerable side effects. A large-scale randomized controlled trial is warranted to confirm this finding. The final approval of the COVID-19 vaccination for patients with PH as a public health strategy is promising.