Objective To compare the efficacy of transcatheter closure of patent ductus arteriosus by using Amplatzer occluder and a new home-made occluder.Methods Comparing the efficacy,complications and cost of 110 patients with home-made occluder and 96 patients treated with Amplatzer occluder.Results The case of complete closure:the home-made occluder group was 109(99.1%),the Amplatzer occluder group was 95(99.0%).The comparison of preoperatively clinical indexs,operative and exposure time,the rate of complete closure,hospital days and complication were not significantly different.The decrease of left ventricular diastolic and C/T have no significant difference.The total cost of the home-made occluder group was statistically lower than the Amplatzer occluder group.Conclusion Both groups have no significant difference in the efficacy and the rate of complication.The new home-made occluder is low cost and extensive applicative foreground in clinics.

BACKGROUND: High oxalic acid urine is a risk factor for stone formation. Constructing cel lines with high oxalate metabolic ability using genetic engineering and stem cel technology wil become the effective method to prevent and treat calcium oxalate stone. OBJECTIVE: To construct the adult bone marrow mesenchymal stem cel lines that can decompose the oxalic acid, through co-transfecting the oxalic acid degradation genes Frc and Oxc of oxalobacter formigenes into the normal adult bone marrow mesenchymal stem cells. METHODS: Frc and Oxc were amplified by PCR, and the eukaryotic expression vectors of pLEGFP-N1-myc-Frc and pBaBE-puro-flag-Oxc were constructed, then co-transfected into the normal adult bone marrow mesenchymal stem cells. The non-transfected bone marrow mesenchymal stem cells and the cells transfected with empty vectors were as control. Western blot was performed to detect the expression of the objective genes;the concentration of oxalate in the culture medium after transgenic was determined by ion chromatography. RESULTS AND CONCLUSION: Restriction enzyme digestion and sequencing results showed that the Frc and Oxc genes were successful y amplified, and the vectors of pLEGFP-N1-myc-Frc and pBaBE-puro-flag-Oxc were constructed. After tranfected into the bone marrow mesenchymal stem cells, the Western blot results showed that transfected bone marrow mesenchymal stem cells could stably express the target protein myc-formyl coenzyme A transferase enzyme and the flag-oxalyl coenzyme A decarboxylase; ion chromatography test results showed with the prolonging of the culture time, the concentration of oxalic acid in the human bone marrow mesenchymal stem cel culture medium transfected with target gene was decreased gradual y. While there was no target protein expression in the non-transfected human bone marrow mesenchymal stem cells as wel as the cells transfected with empty vectors. The cells had the ability of oxalate-degradation. The experiment successful y constructs the adult bone marrow mesenchymal stem cel lines that can decompose the oxalic acid, and the cel lines have the ability of oxalate-degradation and can stably express the oxalate decomposition proteins Frc and Oxc.

Objective To explore the clinical value of guide-wire shaping in subclavian vein catheter-ization.Methods Totally 400 patients requiring right subclavian vein catheterization were equally divided into two groups according to the clinic date: intervention group ( with guide-wire shaping , n =200 ) and control group (without guide-wire shaping, n=200).The catheterization was carried out by the same doctor .The rates of ectopic wire were compared between the two groups .Results The overall success rate of catheteriza-tion was 98.25%(393/400) [98.5% (197/200) in intervention group and 98.0% (196/200) in control group, P=0.500].The incidence of catheter displacement was 1.02%(2/197) in intervention group, which was significantly lower than that [7.14% (14/196)] in control group (P=0.002).Conclusion As a sim-ple procedure , guide-wire shaping can effectively prevent catheter displacement during catheterization .

Objective To evaluate the feasibility and safety of embedding the totally implantable venous access port (TIVAP) via the access of right brachiocephalic vein (BCV).Methods The clinical data of 493 patients,who underwent the placement of TIVAP by using right BCV route during the period from March 2013 to December 2015,were retrospectively analyzed.The patients included 137 males and 356 females,with a mean age of (47.3±13.2) years old (ranging from 29 to 78 years old).The puncture success rate and TIVAP indwelling procedure-related complications were analyzed.Results The technical success rate was 100％,the success rate of initial puncturing was 99％ (488/493).The mean operation time was (22.5± 8.3) minutes (range of 18-35 minutes).Mis-puncturing of artery happened in 3 patients (0.61％,3/493);and no severe complications such as hemothorax or pneumothorax occurred.After implantation,the patients carried TIVAP for 124-986 days,with a mean of (271.1±53.8) days.The incidence of complications was 2.25％ (11/488),including hemorrhage at port site (n=2),catheter-related infection (n=l),partial thrombosis (n=2),and formation of fibrous protein sheath (n=6).No serious complications such as displacement or rupture of catheter,or catheter pinch-off syndrome (POS),etc.were observed.Conclusion The implantation of TIVAP by using right BCV route has high puncturing success rate,the technique is safe and reliable,and it can provide another option of catheter access for the clinical performance of TIVAP implantation.

Objective: To study relationship between coronary heart disease (CHD) and dyslipidemia. Methods: A total of 302 CHD patients diagnosed by coronary angiography were enrolled as CHD group, and 218 healthy subjects without cardiovascular and cerebrovascular diseases by health examination were regard as healthy control group. Relative data were collected and levels of blood triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) were measured and compared between two groups. Results: Compared with healthy control group, there were significant increase in levels of blood TC [(4.03±0.97) mmol/L vs. (4.62±1.06) mmol/L] and LDL-C[(2.51±0.86) mmol/L vs. (3.76±1.07) mmol/L] in CHD group, P<0.01 both. Multiple factor Logistic regression analysis indicated that elevated LDL-C level was an independent risk factor for occurrence of CHD (OR=2.608, 95%CI = 1.268-5.366, P=0.009). Conclusions: The results show that levels of TC and LDL-C in patients with coronary heart disease are significantly higher than those of healthy control group. Elevated LDL level may be an independent risk factor for occurrence of coronary heart disease.

Objective To investigate the clinical efficacy and safety of transcatheter arterial chemoembolization(TACE) before percutaneous microwave ablation(MWA) on liver cancer in elderly patients.Methods Eighty elderly patients with primary liver cancer admitted into our hospital from January 2015 to December 2017 were randomly divided into the MWA group(n=32)and the MWA combined with TACE group(n=48).The MWA group received percutaneous microwave ablation,and the MWA combined with TACE group were treated with transcatheter arterial chemoembolization before percutaneous microwave ablation.The therapeutic effects were compared between groups.Results The total effective rate was increased in the MWA combined with TACE group vs.MWA group(79.2％ vs.56.3％,x2 =7.064,P =0.008).The proportion of patients who presented with serum AFP level ＞200 mg/L had no significant difference between the combination group and the MWA group(68.8％ vs.70.8％,x2 =0.040,P =0.842).While,after treatment,the proportion of patients who presented with serum AFP level decreased by ＞ 50％ was higher in the combination group than in the MWA group(79.2％ vs.56.3％,x2 =7.064,P =0.008).There was no significant difference in the incidences of adverse reactions between the two groups (P ＞ 0.05).Conclusions Compared with percutaneous microwave ablation,transcatheter arterial chemoembolization combined with percutaneous microwave ablation has a better efficacy and higher safety.

Objective:To investigate the diagnostic value of vaginal color Doppler flow parameters in patients with epithelial ovarian cancer in different FIGO staging.Methods:178 patients with ovarian tumors who were treated by surgery in Dingzhou People’s Hospital from Jul. 2016 to Jul. 2022 were selected, and they were divided into ovarian cancer group (65 cases) and ovarian cyst group (113 cases) according to the results of postoperative pathological diagnosis. According to FIGO staging standards, ovarian cancer was divided into FIGO stage I (18 cases) , FIGO stage II (16 cases) , FIGO stage III (16 cases) and FIGO stage IV (15 cases) . The blood flow parameters of vaginal color Doppler ultrasound were measured, including arterial pulsatility index (PI) , end diastolic flow velocity (EDV) , resistance index (RI) , peak flow velocity (PSV) , serum vascular endothelial growth factor (VEGF) and human epididymal epithelial secretory protein 4 (HE4) . The levels of PI, EDV, RI, PSV, VEGF and HE4 were compared between the two groups and patients with different FIGO stages, and the value of ROC analysis of vaginal color Doppler flow parameters in predicting the occurrence of ovarian cancer was analyzed. The correlation between FIGO stage and vaginal color Doppler flow parameters and serum VEGF and HE4 levels was analyzed by person coefficient.Results:PI and RI levels in ovarian cancer group were (0.79 ± 0.15) , and (0.39 ± 0.12) , lower than those in ovarian cyst group (1.51 ± 0.17) , (0.72 ± 0.16) ; EDV, PSV, HE4, VEGF levels were (13.88 ± 4.18) cm/s, (25.61 ± 4.53) cm/s, (283.92 ± 28.97) pmol/L, and (372.55 ± 38.96) ng/mL, higher than those in ovarian cyst group ( P<0.05) . According to ROC analysis, the best cutoff values of transvaginal color Doppler blood flow parameters for predicting the occurrence of ovarian cancer were PI<1.235, EDV≥10.985 cm/s, RI<0.580, PSV≥22.975cm/s, all P<0.05. The levels of PI and RI in patients with different FIGO stages showed a decreasing trend with the increase of the severity of the disease, while the levels of EDV, HE4 and VEGF showed an increasing trend ( P<0.05) . There was no significant difference in PSV levels between patients with different FIGO stages ( P>0.05) . The correlation analysis showed that FIGO stage was positively correlated with the blood flow parameters EDV and the levels of serum HE4 and VEGF. FIGO stage was negatively correlated with PI and RI ( P<0.05) . Conclusions:There were significant differences in the levels of PI, RI and EDV in patients with ovarian cysts and ovarian cancer at different FIGO stages. The levels of PI, RI and EDV are closely related to the malignant degree of ovarian cancer.

Objective To explore the value of C-arm CT in transjugular intrahepatic portosystemic shunt (TIPS).Methods Between June 2015 and October 2017,a total of 16 patients with cirrhosis complicated by upper gastrointestinal bleeding or massive ascites due to portal hypertention in our center were retrospectively enrolled in the study.Abdominal enhanced CT was routinely performed before surgery.Postprocessing images of portal vein were used as a guidance of TIPS in real time after integrated with intraoperative c-arm CT images during selective operations.Results The success rate of C-arm CT-guided TIPS was 100％.Portal vein angiography showed the position basically consistent with CT matched images reference position.No obvious abdominal hemorrhage,injury of biliary tract and other complications occurred in all patients.The mean number of needle passes was 2.1 ±0.9 passes(range of 1.0-4.0 passes),the mean time of portal vein entry was 4.3 ± 1.9 min (range of 2.0-8.0 min),the mean fluoroscopy period was 22.6 ± 4.8 min (range of 17.0-32.0 min),DAP was (256.2± 96.7)mGy/cm2.Conclusion C-arm CT-guided TIPS is technically feasible and safe.