OBJECTIVE:To provide reference for developing effective interventions to self-medication and promoting reason-able self-medication. METHODS:Questionnaires were designed based on the modified Anderson's behavioral model of health ser-vices. By using cluster sampling,residents were randomly selected from 4 districts of Wuhan city to analyze the self-medication be-havior and its influential factors. RESULTS:Totally 204 questionnaires were sent and 199 were recovered with effective rate of 97.5%. The result showed 47.7% residents who perceived discomfort within 2 weeks medicated themselves,and the rate was high-er thansee the doctor. Among self-medication residents,the rate of mild disease,general and serious disease was separately 50.5%,46.3% and 3.2%. The length of illness<7 d and the length of illness ≥7 d accounted for 95.8% and 4.2%,separately. Cold and cough was the highest cost disease for self-medication. The reasons for selecting self-medication were:no need tosee the doctor(43.2%),trouble-saving(23.1%),high medical costs(14.6%),no time to see the doctor(14.6%). 54.1% residents acquired basic medication knowledge from the past experience,25.5% from other's recommendation,and the other from the inter-net,newspaper and magazines. As for the effect of self-medication in the past one year,75.4% residents considered most were ef-fective. 18.6%had suffered from ADR due to self-medication;the incidence of ADR in the residents reading the instruction was sig-nificantly lower than those not reading the instruction(P<0.05);the ratio of reading the instruction in residents with low education level was significantly lower than that with high education level(P<0.05). Single factor analysis showed that residents'choice of self-medication were significantly influenced by the marital status,education,monthly income,medicare,accessibility of medical institutions,the severity of disease and duration of illness(P<0.05). The proportion of self-medication for married group was sig-nificantly higher than unmarried group;the proportion of self-medication for low education level group was significantly higher than high education level group;the proportion of self-medication for low monthly income group was significantly higher than high monthly income group;the proportion of self-medication for group with business medical insurance or self payment was significant-close to medical institutions;the proportion of self-medication for mild disease group was significantly higher than serious disease group;the proportion of self-medication for length of disease≥7 d was significantly lower than length of disease<7 d. Results of multivariate analysis showed that severity of disease and length of disease were the important influential factors for the choice of self-medication(P<0.05). CONCLUSIONS:Self-medication is common in Wuhan city,and mainly for general and chronic dis-ease. Residents don't pay enough attention to reading the drug instructions. Self-medication is affected by various factors which has a certain health risks.

Objective To investigate the efficacy and safety of percutanous transhepatic intrahepatic portosystemic shunt(PTIPS)for chronic portal vein occlusion and cavernous transformation with symptomatic portal hypertension.Methods The clinical and imaging data of 38 patients with chronic portal vein occlusion and cavernous transformation with symptomatic portal hypertension, who received PTIPS in our hospital from November 2009 to June 2016,were analyzed retrospectively.The differences of the portosystemic pressure gradient(PPG)measured before and after PTIPS procedure was analyzed by a paired samples t-test. All the patients were followed up and the curative effect and operation-correlated complications were observed.Results The PTIPS procedure was technically successful in 36 patients.The other two patients with unsuccessful PTIPS underwent medical treatment,and one of them died of recurrent variceal bleeding 25 months later. Effective portal decompression and free antegrade shunt flow were achieved in 36 patients with successful PTIPS.And the mean PPG was decreased from(25.2±2.9)to(13.2± 1.3) mmHg (1 mmHg=0.133 kPa) before and after PTIPS respectively and the difference was statistically significant(P<0.05).During the procedure,arterial hemorrhage occurred in two patients who subsequently underwent embolization. Biliary injury occurred in one case and percutanous transhepatic biliary drainage (PTBD)was then performed.The mean follow-up period of the 36 patients was(26.7±10.4)months(range from 3.0 to 74.0 months).Hepatic encephalopathy appeared in 4 cases,among which,3 patients recovered after receiving medical treatment, while 1 patient experienced Grade 3 hepatic encephalopathy and recovered after implanting a smaller cover-stent.Shunt dysfunction occurred in 10 cases,of which 8 cases recovered after shunt revision with stent implantation or ballon angioplasty, while 2 cases underwent anticoagulation by warfarin only. During follow-up period, 7 patients died of liver failure(n=4), hepatic cellular carcinoma(n=1), recurrent varicose vein bleeding(n=1), and renal failure(n=1). The other patients remained asymptomatic and shunt patency. Conclusions PTIPS is both safe and effective for the treatment of symptomatic portal hypertension caused by chronic portal vein occlusion and cavernous transformation.The technical success rate is high,and the short-term curative effect is satisfied.

Objective To investigate the safety and efficacy of interventional treatment for ischemic-type biliary lesion (ITBL)after liver transplantation (LT). Methods The clinical and imaging data of 76 patients with ITBL after LT,who received interventional treatment in the Department of Interventional Vascular Radiology of the Third Affiliated Hospital of Sun Yat-sen University from January 2006 to February 2014,were retrospectively analyzed. On the basis of the cholangiographic appearance,patients were classified into 3 groups:hilar biliary stricture group (n=28),multifocal biliary stricture group (n=42),and biloma group (n=6). The modalities of interventional treatment were percutanous transhepatic biliary drainage (PTBD), PTBD combined with balloon dilation,PTBD combined with balloon dilation and plastic stent implantation. The methods of biliary drainage included external drainage and external-internal drainage. All the patients were followed up after treatment. The curative effect and biliary complication was observed. Results The first successful rate of PTBD was 97% (74/76). The total curative rate,improvement rate and ineffective rate of interventional treatment were 21% (16/76),51% (39/76)and 28% (21/76). In hilar biliary stricture group,the cure,improvement and inefficacy rates were 36% (10/28),57% (16/28)and 7% (2/28).The efficacy rate was 93% (22/28 ). In multifocal biliary stricture group,the cure,improvement and inefficacy rates were 14% (6/42),50% (21/42)and 36% (15/42). The efficacy rate was 64% (27/42). In biloma group,2 cases (2/6)were cured and treatment of4 cases was ineffective. The efficacy ofhilar biliary stricture group was better than that of multifocal biliary stricture group (P<0.05 ). The efficacy of multifocal biliary stricture group was better than that of biloma group (P <0.001 ). The main biliary complication was biliary tract infection during drainage. The rates of bile tract infections were 20% (13/64) and 67% (8/12)in patients with external drainage and external-internal drainage,respectively. There was significant difference between these two items (P <0.001 ). Conclusions PTBD is a safe and effective therapeutic modality for ITBL after LT,which combined with balloon dilation and biliary stent implantation can improve patients’clinical symptoms,elevate patients’quality of life. The biliary external drainage can decrease the rate of biliary tract infection significantly.