Objective To explore the relationship between the severity of coronary artery lesion and the level of serum bilirubin, uric acid in elder people. Methods 192 elder patients underwent coronary angiography were divided into 5 groups according to the severity of coronary lesion: normal(group A), vessel stenosis

Objective To analyze the association of blood uric acid level with the severity of coronary artery stenotic changes, metabolic syndrome (MS), and its components. Methods A total of 343 individuals ( male 223,female 120) who underwent coronary angiography and had complete data on MS and serum uric acid were collected. The severity of coronary artery disease (CAD) was assessed by the coronary stenesis index (CSI). MS was diagnosed according to the Guideline on Prevention and Treatment of Blood Lipid Abnormality in Chinese Adults. Results (1)The mean uric acid level was significantly lower in women than in men [ ( 306.3±76.9 vs 358.9±85.2 ) μmol/L, P＜0.01 ]. The prevalence of MS and its components showed no difference between men and women. (2) The uric acid level in women with 3 components was higher than those with1( P＜0. 01 ) or 2 ( P＜0.05 ) components of metabolic disorders, but not in men. (3) Quartiles of concentration of uric acid were computed. Compared with those in the lowest quartile of uric acid, women in the highest quartile had higher CSI score [ 7.0 (2.5-12.0) vs 2. 0( 0.0-6.0), P= 0. 025 ]. Moreover, the uric acid level was higher in women with multivessel lesions than nonCAD patients [ (327.0±81.9 vs 284.9±78.6) μmol/L, P = 0.033 ]. However, no correlation was found between uric acid level and the severity of coronary artery lesion in men. (4) Logistic regression showed that age (β=0.042, P=0. 007) and dyslipidemia(β=0.836, P=0. 037 ) were the independent risk factors of CAD in men, and hypertension(β=1. 127, P=0.039) and dyslipidemia(β=0.901, P=0.009)in women. Conclusions In women with higher uric acid level, the clustering of metabolic abnormalities was increased, and the coronary artery lesion was more severe. High uric acid level might be a marker of CAD for women.

Objective To explore the effectiveness,safety and influencing factors of arterial infusion of oxaliplatin for the treatment of colorectal l1iver metastases after surgery.Methods Totally 68 colorectal liver metastases after surgery patients pathologically confirmed received at least two course of arterial infusion of oxaliplatin combined with TACE.According to postoperative intravenous chemotherapy,the patients were divided into group A (no chemotherapy) and group B (chemotherapy).Survival time of patients were followed up.According to the efficacy of solid tumor evaluation criteria the objective effect was evaluated,the adverse reactions were compared between two groups.Cox regression analysis was performed to assess the possible factors influencing survival time.Results The median overall survival (OS) of all the 68 patients was 18 months,with complete remission 16 cases,partial remission 26 cases,stable diseasse 21 cases,stable diseasse 5 cases,the response rate (RR) was 61.76％ (42/68).The median progression-free survival (PFS) was 10 months.The RR,OS and PFS had no statistical difference (all P＞0.05).The variables that eventually entered the Cox regression model were tumor differentiation (P=0.003,hazard ratio 2.202).Conclusion Arterial infusion of oxaliplatin and TACE is effective in treating colorectal liver metastases after surgery,with high objective response rate.

Objective To investigate the effect of paclitaxel drug-coated balloon (DCB) dilatation in treating coronary in-stent restenosis (ISR) occurring after drug-eluting stent (DES) implantation,and to observe the long-term changes of the target vascular lumen area in order to clarify the curative effect of paclitaxel DCB in treating ISR.Methods Four patients with ISR whose clinical condition met the DCB indication were selected.According to the standard process,sufficient pre-expansion of ISR was performed first,then paclitaxel DCB dilatation was carried out to dilate the lesion segment of ISR,and no stent was implanted.Both coronary angiography and intravascular ultrasound (IVUS) were performed immediately after the treatment as well as 9 months to measure the minimum lumen area (MLA) and cross-sectional area (SA) of the stent,and the intimal hyperplasia was also been evaluated.Results In all 4 patients,angiography performed immediately after paclitaxel DCB dilatation showed that neither dissection of the dilated segment of the target artery nor obvious residual stenosis was observed.Angiography performed 9 months after the treatment revealed that all dilated segments of the target arteries were patent,and no pronounced restenosis of stent segment was seen.IVUS examination was indicated that MLA became enlarged,SA showed an increasing trend,and intimal hyperplasia showed a tendency to be inhibited.Conclusion For the treatment of ISR,pure paclitaxel DCB dilatation can obtain long-term lumen area enlargement,thus,repeated stent implantation can be avoided,which,in turn,can reduce the risk of ISR recurrence.Paclitaxel DCB dilatation can locally release paclitaxel,which has curative effect on the coronary artery wall to inhibit the excessive proliferation of intima.

Objective To investigate the risk factors of central airway stenosis after lung transplantation. Methods Clinical data of 155 recipients undergoing lung transplantation in Wuxi People's Hospital Affiliated to Nanjing Medical University from July 2016 to December 2017 were retrospectively analyzed. According to the incidence of central airway stenosis following lung transplantation, all recipients were divided into the stenosis group (n=36) and control group (n=119). The incidence of central airway stenosis after lung transplantation was summarized. The risk factors of central airway stenosis after lung transplantation were assessed by univariate and multivariate logistic regression analyses. Results Among 155 lung transplant recipients, 36 cases (23.2%) developed central airway stenosis. The average incidence time was (53±13) d after lung transplantation. Univariate analysis demonstrated that bilateral lung transplantation, grade 3 primary graft dysfunction (PGD), airway fungal infection, long cold ischemia time, long mechanical ventilation time and long intensive care unit (ICU) stay were the risk factors for central airway stenosis after lung transplantation (all P < 0.05). Multivariate analysis showed that airway fungal infection, long cold ischemia time and long mechanical ventilation time were the independent risk factors for central airway stenosis after lung transplantation (all P < 0.05). Conclusions Airway fungal infection after lung transplantation, long cold ischemia time and long mechanical ventilation time probably lead to central airway stenosis after lung transplantation. Active preventive measures and intimate monitoring should be taken to improve the quality of life of the recipients after lung transplantation.

Lung transplantation is the only effective treatment of most end-stage lung diseases. Airway anastomotic complications are the main obstacles affecting the postoperative survival and quality of life of lung transplant recipients. Airway anastomotic stenosis is the most common airway anastomotic complication after lung transplantation. In recent years, improvements in the recipient selection, organ preservation, surgical techniques, postoperative intensive care management, immunosuppression, antifungal and endoscopic treatment have decreased the incidence of airway anastomotic stenosis and improved the surgical efficacy of lung transplantation and the survival of the recipients. In this article, the pathogenesis, risk factors, diagnosis and treatment of airway anastomotic stenosis after lung transplantation were reviewed, aiming to provide novel ideas for clinical research, diagnosis and treatment of airway anastomotic stenosis following lung transplantation.

Objective:To compare the function and action pathways of VEGFA, VEGFB and VEGFC in VEGF family of mouse eye.Methods:Using the BXD mouse gene data in Genenetwork database as template to compare and study the similarities and differences of VEGFA, VEGFB and VEGFC molecular pathways or potential functions in the whole genome expression spectrum of BXD recombinant mouse inbred line population, with multiple analytical methods and statistical strategies were used, such as gene expression level, target genes comparison, top genes comparison associated to target genes, expression Quantitative Trait Loci (eQTL).Results:Matrix comparison showed strong positive correlation between two probes of VEGFC ( r=0.732, P<0.01), weak correlation between VEGFA 1420909 and VEGFC 1440739, VEGFA 1451959 and VEGFC 1451803, VEGFC 1419417959 and VEGFC 1439766, VEGFC 1451803 and VEGFC 1439766 ( P<0.05); there was no correlation between VEGFA 1420909 and four other genes except VEGFC 1440739, VEGFA 1451959 and VEGFC 1440739, VEGFB 1451803 and VEGFA 1420909/VEGFC 1419417/VEGFC 1440739 ( P >0.05). In the comparative analysis of the relevant Top 50 genes of each VEGF gene, most of the genes in BXD mouse were not significantly correlated with VEGFA, VEGFB and VEGFC except for the weak association of individual related genes. The results of eQTL analysis showed that each probe of VEGF gene was located on different chromosomes. Conclusions:The expression levels and positive and negative correlations of VEGFA, VEGFB and VEGFC were different in the VEGF family of mouse eye, suggesting that these genes may play their role through different pathways.

Objective To investigate clinical features and therapeutic strategies of invasive tracheobroncial aspergillosis (ITBA) in donation after citizen's death (DCD) for lung transplantation.Methods From January 2015 to June 2016,137 patients underwent lung transplantation from DCD donors.The clinical data were reviewed retrospectively.The diagnosis of ITBA was made by typical bronchoscopy findings,bronchial biopsy or bronchoalveolar lavage fluid glactomannan test.Results Twenty cases (14.60％) were diagnosed as having ITBA.The time for diagnosis of ITBA was (22.45 ± 17.70) days (7-70 days) posttransplant.Aspergillus fumigatus was the most common pathogen (n =19).The risk factors of ITBA included immunosuppressive agents (n =20),hypoproteinemia (n =6),basiliximab (n =3),preoperative aspergillus colonization (n =3),neutropenia (n.=1),aspergillus infection of the sinus (n =1).Therapeutic strategies included intravenous caspofungin,micafungin,voriconazole,posaconazole,amphotericin B,nebulized amphotericin B or amphotericin B liposome,gargled mycostatin,combined with interventional bronchoscopy.Five cases developed anastomotic or airway stenosis,one of them died,and two died due to non ITBA factors.The rest 17 cases recovered after treatment.No patient suffered from severe complications including anastomotic dehiscence,anastomotic fistula and invasive pulmonary fungal disease.Conclusion Bronchoscopy is the most important diagnostic method for ITBA.Bronchoalveolar lavage fluid glactomannan test helps to guide diagnosis.Safety needs to be taken into account in antifungal prophylaxis.Balloon dilatation should not be conducted prematurely as one important method of interventional bronchoscopy.

Objective To analyze the risk factors that affect the early recurrence (recurrence occurring within 3 months after surgical resection) of hepatocellular carcinoma (HCC), and to discuss the risk factors influencing the survival after hepatectomy. Methods The clinical data of 257 HCC patients, who were admitted to authors' hospital during the period from January 1, 2007 to March 31, 2014 to receive cTACE within 3 months after surgical resection of hepatocellular carcinoma, were retrospectively analyzed. According to DSA findings (lipiodol CT scan was performed in part of patients with undetermined diagnosis), the patients were divided into recurrence group and non-recurrence group. By using univariate analysis and multiple logistic regression analysis, the correlation of the clinical and pathological data with the early recurrence was analyzed. The patients were followed up, the survival time was recorded. The relationship between patient's clinical data and postoperative survival was evaluated. Results ① Of the 257 patients, early recurrence was detected in 150 patients (58. 4％, recurrence group) and no recurrence was observed in 107 patients (41. 6％, non-recurrence group). ②The presence of satellite nodules and the integrity of tumor encapsulation were two independent factors associated with the postoperative residual lesions. ③The maximum diameter of the tumor, Edmondson grade and the vascular cancer thrombus were the independent risk factors affecting survival. ④The median survival time of patients in recurrence group was markedly shortened than that of patients in non-recurrence group (39 months vs. 93 months). Conclusion The early recurrence (within 3 months after resection) of hepatocellular carcinoma is associated with the presence of satellite nodules and the integrity of tumor encapsulation. The survival of patients after hepatectomy is related to the maximum diameter of the tumor, Edmondson grade and the vascular cancer thrombus. The median survival time in patients having early recurrence is significantly shortened than that in patients having no early recurrence. (J Intervent Radiol, 2018, 27: 215-222)

Lung transplantation is an effective means of treating various end-stage lung diseases.However,compared with other solid organ transplants,the survival rate after lung transplantation is relatively low.The main reason is the numerous complications after lung transplantation,among which infection is one of the most common complications.Respiratory viral infections are an important type of infection after lung transplantation,which severely affect the survival time and quality of life of lung transplant recipients.Early identification,early prevention,and active diagnosis and treatment are of great significance in reducing the incidence and fatality of respiratory viral infections after lung transplantation.This article reviews the epidemiology,risk factors,prevention and treatment principles,and specific prevention and treatment progress of common viruses in respiratory viral infections after lung transplantation at home and abroad,in order to provide a reference for the prevention and treatment of respiratory viral infections after lung transplantation in clinical practice.