Hepatocellular carcinoma (HCC)is a common malignant tumor in the world,and surgical resection and liver transplantation are two radical treatment modalities,but only 10%-20%of all patients can receive such treatments.In recent years,local therapies including radiofrequency ablation,microwave ablation,cryoablation,and the irreversible electroporation ablation which appeared recently have gradu-ally become the alternative therapies for the patients who are unable to undergo surgery.In addition to local tumor growth control and im-provement in survival outcomes,the ablation technology also helps to downgrade tumor for secondary resection.This article focuses on the re-search progress in radiofrequency ablation alone and in combination with other therapies in the treatment of HCC,compares radiofrequency ablation with other local ablative therapies,and briefly introduces the application of intelligent navigation technology in adjuvant ablation. With the development of medical imaging and progress in related fields,the ablation technology will be widely applied in clinical practice in the future.

Interventional techniques have been applicated extensively in the treatment of gynaecologic and obsterics diseases, such as the embolization therapy of the postpartum massive hemorrhage, uterine fibroids and adenomyosis, interventions of fallopian tube pregnancy etc. Though the advantages of interventional techniques in the treatment of gynaecologic and obsterics diseases are obviously revealed and accepted, the strict indication and regular maneuver to reduce the complications are still to be emphasized. (J Intervent Radiol, 2006, 15: 257-258)

Objective: To evaluate the feasibility of autoregressive integrated moving average with explanatory variables ( ARIMAX ) model including meteorological factors on the prediction of influenza-like illness ( ILI ), so as to provide a basis for the monitoring and early warning of influenza. Methods: The ILI data reported by four sentinel hospitals in Yuhang District of Hangzhou from the 1st week of 2014 to the 26th week of 2018 was collected, as well as the meteorological data during the same period. The ARIMAX model was established using the percentage of ILI cases in total outpatients ( ILI% ) data from the 1st week of 2014 to the 52nd week of 2017 and the meteorological factors selected by Lasso regression model. The ILI% from the 1st to 26th week of 2018 was predicted and compared with the actual values to verify the ARIMAX model. Results: From the 1st week of 2014 to the 26th week of 2018, a total of 60 419 cases of ILI were reported by the four sentinel hospitals of Yuhang District, with ILI% of 1.29%. Lasso regression analysis showed that there was a positive correlation between weekly average absolute humidity and ILI% ( r=27.769 ), and a negative correlation between weekly average temperature and ILI% ( r=-0.117 ). The ARIMAX (1, 0, 0) ( 1, 0, 0 )12 with weekly average temperature and absolute humidity was selected as the optimal model, with the Bayesian information criterion (BIC) value of 81.30 and the mean absolute percentage error (MAPE) value of 15.77%. The MAPE value of the ARIMAX model predicting the ILI% from 1st to 26th week of 2018 were 43.75%. Conclusion The ARIMAX model including meteorological factors can be used to predict the prevalence of ILI, but the accuracy needs to be promoted.

Objective To investigate the therapeutic value of embolization in severe hemorrhagic cystitis(HC) following allogeneic stem cell transplantation.Methods Six patients undergoing allogeneic stem cell transplantation developed severe HC with a median onset time of 33 days after transplantation.All these patients had been resistant to conservative managements and received the treatment of selective embolization of bilateral internal iliac arteries.Results Eight times of embolizations were performed for 6 patients.The HC was cured in 4 patients and the HC improved in 1 patient,yielding a response rate of 83 %.One patient didn't respond to this measure.For the patients with response,macroscopic hematuria disappeared 7 to 10 days after the treatments and microscopic hematuria vanished 20 to 30 days after the intervention therapy.Both procedures were tolerated well and no severe adverse effects were observed.Conclusions Selective embolization of internal iliac arteries seems to be a safe and effective treatment for severe HC.This measure can be proposed for patients undergoing refractory and persistent severe HC.

[Objective]To evaluate the application value of minimally invasive release operation about congenital vertical talus(CVT).[Method]All operation were operated with single method by author.Firstly,Achilles tendon,capsulotomy of the ankle and subtalar joint were released through a small straight posterior inside of Achilles tendon end point.Secondly,astragaloscaphoid and subtalar front joint were released bluntly through a straight posterior incision.Thirdly,based on circs subtalar joint were released through calcaneocuboid articulation outside foot.Then one K-wire were passed through the body of talus from its axis,and passed through instep after reposition of astragaloscaphoid joint.Two K-wires was passed through calcaneus to talus from planta.[Result]Eight cases were available for follow-up from 17 to 36 months(mean,28 months),follow-up results was evaluated by using a version of Adelaar and Kodros score,there were excellent result in 1 foot,good in 5,fair in 2.The presence of hindfoot valgus and forefoot abduce were noted in one foot,forefoot pronation was appeared in one foot.Two parameters-talar and calcaneus axis-first metalarsal base angles,calcaneus talus angles of eutopic and lateral radiograph were basally normal.[Conclusion]Operative reduction has been advocated as the only effective treatment for CVT,it is the best choice to use minimally invasive release operation for infant.

Objective To discuss the clinical application of lapraroscopic subtotal cholecystectomy in the acute cholecystitis with severe inflammatory and fibrous adhesions at calot triangle.Methods Retrospective analysis of the clinical data,surgical approaches,and short term and long term complications of 74 cases of acute cholecystitis in the period from January 2002 to September2005 in our hospital.Results In the 74 cases operated by subtotal cholecystectomy using laparoscopy,during laparoscopic procedure,71(95.9%) operations were successful;a case of Mirizzi syndrome could not be confirmed to have the residual stones in cystic duct and another case of the same syndrome was not confirmed to have the duodenum fistula.These two cases were then dealt with by conventional surgery and constituted 2.7% of the total cases.One case was dealtd with by second surgery because of the residual stones of cystic duct after lapraroscopic subtotal cholecystectomy and constituted 1.3% of the total cases.One case was found with minor bile leakage and constituted 1.3% of the total cases.Cholangiography was conducted 41 cases during operation,of whom,39 cases were normal and 2 cases failed.No death occurred with the operation of the lapraroscopic subtotal cholecystectomy.Conclusion It is safe and effective to apply laparoscopic subtotal cholecystectomy to treat acute cholecystitis with severe inflammatory and fibrous adhesions at calot triangle.

Objective To analyze the congenital anomalies of inferior vena cava (IVC) with their color Doppler and clinical features, and to evaluate the value of color Doppler ultrasound in the diagnosis of congenital anomalies of the IVC. Methods Between July 2009 and March 2012, 22 patients who were diagnosed as IVC anomalies by color and spectral Doppler ultrasound were retrospectively analyzed. After careful and comprehensive scanning on multiple planes, the final diagnosis was made based on the findings obtained on B-mode, color Doppler and spectral Doppler ultrasound. All the results obtained by sonography were compared with computerized tomography angiography, digital subtraction angiography, and other clinical examinations. Results There were 22 cases diagnosed as congenital anomalies of IVC, including 5 cases of the left IVC, 3 cases of the double IVC, 3 cases of membranous obstruction of the IVC (MOVC) and 11 cases of the anomalies of the left renal vein. In left IVC, the infrarenal left-sided IVC entered into the left renal vein, then crossed anterior to the aorta to join the right-sided suprarenal IVC. In double IVC, bilateral IVCs could be seen on both sides of the abdominal aorta, and the left IVC joined the right IVC over aorta then entered into the right atrium. Some patients of the left IVC and double IVC had left renal vein hypertension. All the cases of MOVC in our study presented as Budd-Chiari syndrome, in which B-mode ultrasonography showed the existence of the membranous obstruction in inferior vena cava at the level of entrance to the right atrium. On color Doppler lfow image (CDFI), reverse blood lfow into lumbar and ascending lumbar vein was found. Eleven cases of left renal vein malformations were also seen in present study, including 9 cases of retroaortic
left renal vein, 1 case of circumaortic left renal vein and 1 case of the left renal vein into the left common iliac vein. Among them, 9 cases were associated with left renal vein hypertension. Conclusion Color and spectral Doppler ultrasound can clearly identify the congenital anomalies of IVC with the evaluation of their hemodynamic modiifcation, and can be used as an important approach in the diagnosis of the anomalies of the IVC.

Objective: To analyze the current situation and problems of primary health care personnel since the new round of China's health care reform, and to provide a reference for stabilizing the primary health care personnel. Methods: This paper uses descriptive statistical analysis to calculate Gini coefficient and Theil index in order to ana-lyze the equity in headcount, structure and distribution of primary health care personnel among all health care institu-tions nationwide. Results: Between 2008 and 2013, the number of primary health care personnel significantly in-creased and their quality was improved. Moreover, although the Gini coefficient and Theil index of primary health care personnel continuously decreased in China's eastern, central and western provinces the difference inside the east-ern China is the main factor affecting the overall difference. Conclusions:Not only the problems of insufficient num-ber and loss of personnel still coexist in the primary health care personnel in China, but also there are other issues such as the structural imbalance of professional titles is especially prominent, the urban-rural and regional gaps are still large, etc. The main reasons for these issues are related to the irrational incentive mechanism, the inefficiency of the synergistic effects of administrative staffing policy and some reform measures, etc. This paper suggests further re-forming the income distribution system and improving primary governance capability in order to strengthen the policies to synergically attract and stabilize primary healthcare personnel.

OBJECTIVE:To observe therapeutic efficacy of Rhodiola wallichiana injection for swelling and pain in fracture pa-tients during perioperative period. METHODS:120 patients with closed fresh extremity long bones fracture were randomly divided into trial group and control group,with 60 cases in each group. Both groups received open reduction and plate fixation. Before and after op-eration,control group was given routine medicine and anti-inflammatory treatment;trial group was additionally given R. wallichiana in-jection 10 ml(250 ml added into 5%Glucose injection)intravenously,qd,on the basis of control group. A treatment course lasted for 10 d. The swelling degree before operation,1 d and 3 d after operation,pain degree on the day of operation and 1,2,3 and 7 d after operation,complication and average length of stay were observed and compared between 2 groups. RESULTS:The extent of swelling and pain,the incidence of complications and average hospitalization days of trial group were lower or shorter than control group,with statistical significance (P<0.05). CONCLUSIONS:R. wallichiana injection can promote blood circulation and remove blood stasis, ease the hydropsia and pain,relieve swelling and pain,reduce the incidence of complications and shorten hospitalization day.

The effects of spindle afferents activated by stretching gastrocnemius on the nociceptive responses of WDR neurons were recorded extracellularly with microelectrode and observed in paralyzed rats. The results indicated that in 51/80, the spindle afferent activity activated by stretching can inhibit nociceptive responses of neurons. 16 out of 80 neurons no effects can be observed, in 13/80 the effects of spindle afferent activity can excite the nociceptive responses of WDR neurons. Among 51 units, which have inhibitory effects induced by stretching muscle, the inhibitory effects induced by instance and bilateral stretching are stronger than that induced by continuous and unilateral stretching. These results suggested that spindle afferent activity is possesaed of analgesic effects.