This paper reports 5 cases of itrogenic massive hemobilia.The bleeding of all the patients was successfully controlled via transcatheter arterial embolization. Our experience has again proved that emergency arteriography is the best method to determine the bleeding site. Transcatheter arterial embolization is easy, rapid, safe, reliable and with minor complication method, and thus should be first choice for treating hemobilia. The embolization should be contraindicated in patients with long-term shock without correction. The contraindicatious include severe hepatic cirrhosis accompanied by liver dysfunction, portal hyperfension with flow impedance.

A 30-year-old woman presented with a 5-year history of recurrent nodular lesions in the left subaxillary region,which had rapidly grown for 7 weeks.Five years prior to the presentation,she received breast conservation surgery and radiotherapy for left breast cancer,thereafter,chronic radiation dermatitis developed in the left subaxillary region.Two years after the operation,three soybean-sized bright red nodules appeared in the lesions of radiation dermatitis,and slowly enlarged.Subsequently,the nodules were resected,but a local recurrence was observed 3 weeks after the resection.The recurrent masses underwent accelerated growth during her pregnancy,and the growth was obviously inhibited after the termination of pregnancy.Physical examination revealed a quasi-elliptic,dark or bright red plaque measuring about 18 cm × 14 cm with a smooth surface in left subaxillary region,and in the center of the plaque was a bright red,hemispheric,elevated lesion measuring 10 cm × 9 cm × 5 cm with erosions or pitchy crusts on the surface.Histopathology of the lesions showed that the tumor was located in the dermis and consisted of densely packed uniform spindle-shaped cells arranged in a characteristic storiform or whirlpool pattern.Some cell nuclei showed atypia,and few mitoses were observed.In some parts of the lesion,tumor cells were arranged in a herringbone pattern.Immunohistochemistry revealed that the tumor cells stained positive for vimentin(strongly)and actin(weakly),but negative for CD34.Based on these findings,a diagnosis of postradiation dermatofibrosarcoma protuberans(fibrosarcoma type)was made.

Transnasal endoscopical biliary catheterization was done successfully in 44 cases,23 cases with complete data were reported.These cases consisted of decompression and drainage of benign and malignant biliary obstruction (12 cases),dissolution and irrigation treatment of remnants of ascaris in the biliary tract (5 cases),dissolution of gallstone (2 cases),irrigation for biliary calculi (2 cases),hemos-tasis after endoscopic sphincterotomy (EST,1 case),and the examination and culture of the bile ( 1 case).The results were satisfactory without complication.Problems concerning EST was discussed,and endoscopic retrograde biliary drainage (ERBD) and percutaneous transhepatic biliary drainage (PTBD) were compared.

Objective:To observe the clinical effect of combining acupuncture, Chinese medicine and rehabilitation training for subacute stroke. Methods:A total of 120 subacute stroke cases were randomly allocated into a treatment group (n=60) and a control group (n=60). Patients in the control group received standard rehabilitation therapy alone, whereas patients in the observation group received additional acupuncture and Chinese medicine. Before treatment, after 30-day and 60-day treatments, and 3 months after treatment, the neurologic deficit severity was evaluated using the National Institute of Health stroke scale (NIHSS); the motor function was evaluated using the Fugl-Meyer assessment scale (FMA); the activities of daily living (ADL) was evaluated using the Barthel index (BI); and the changes of traditional Chinese medicine (TCM) symptoms were evaluated according to TCM symptom scores. Results:After 30-day, 60-day treatments, and 3 months after treatment, the NIHSS, FMA, BI and TCM symptoms scores were statistically different from those before treatment in both groups (allP<0.05); and there were between-group statistical differences at same time points (allP<0.05). Conclusion:Combining acupuncture, Chinese medicine and rehabilitation training can improve neurologic deficit, motor function and ADL in subacute stroke patients and its efficacy is better than rehabilitation therapy alone.

ObjectiveTo compare the efficacies between heat-sensitive moxibustion and warm needling in treating cervical spondylosis of vertebroarterial type.MethodTotally 120 patients with cervical spondylosis of vertebroarterial type were randomized into a heat-sensitive moxibustion group and a warm needling group, 60 in each group. In addition to acupuncture at bilateral Fengchi (GB20), Wangu (GB12), Tianzhu (BL10), Dazhui (GV14) and Baihui (GV20), the heat-sensitive moxibustion group was given mild moxibustion to the heat-sensitive points in cervical and scapular regions, while the warm needling group was given regular moxibustion.ResultGenerally, after 20 treatment sessions, efficacy wasfound in both groups, and there were significant differences in both groups after intervention (P<0.05), while the improvements of integral score, dizziness, cervical and shoulder pain, and the recovery and markedly-effective rate in the heat-sensitive moxibustion group were significantlysuperiorto that in the warm needling group (P<0.05).ConclusionCompared to warm needling treatment, heat-sensitive moxibustion can more significantly improve dizziness and pain in patients with cervical spondylosis of vertebroarterial type, and thus enhance the therapeutic efficacy.

Objective To observe the clinical efficacy of acupuncture plus rehabilitation training in treating post-stroke depression.Method Forty-one patients with post-stroke depression were randomized into a treatment group of 22 cases and a control group of 19 cases. In addition to the basic internal medicine treatment, the treatment group received acupuncture plus rehabilitation training, while the control group was intervened by rehabilitation training alone. The Hamilton Depression Scale (HAMD) and National Institutes of Health Stroke Scale (NIHSS) were observed and compared before and after treatment.Result The HAMD and NIHSS scores in the two groups were significantly changed respectively after 4-week and 8-week treatment (P<0.05,P<0.01). Respectively after 4-week and 8-week treatment, the HAMD and NIHSS scores in the treatment group were significantly different from that in the control group (P<0.05,P<0.01).Conclusion Acupuncture plus rehabilitation training is an effective approach in treating post-stroke depression.