Radiofrequency ablation (RFA) is one of the most important methods for the treatment of liver cancer and has the advantages of small trauma,simple operation,and repeatability.However,for tumors in high-risk locations within 5 mm of the first and second branches of the hepatic portal vein,near the hepatic vein,the inferior vena cava,or the gallbladder,within 5 mm of the intestinal tract,under the Glisson's capsule,and in the diaphragm,RFA has the issues of a low complete ablation rate,a high local recurrence rate,and serious complications.This article introduces the complications of RFA for liver cancer in high-risk locations and their prevention and points out that with the promotion of individualized and standardized RFA,liver cancer in these high-risk locations is no longer a contradiction for RFA.

Objective To assess examinational methods of Multi-slice CT(MSCT)in diagnosis of palatine lesions. Methods 28 cases were performed MSCT examination with the conventional method,extending -tongue method,colliding-tongue method and pronouncing method. All images were reconstructed by means of multiplana reconstruction (MPR) and CT virtual endoscope (CTVE). Results Correct diagnosis were obtained through the complementarity of the methods. Conclusion Reasonable examination methods of MSCT is apt to display palatine lesions.

Objective To investigate the relationship between tumor necrosis factor-?(TNF-?) gene polymorphism and rheumatoid arthritis (RA). Methods Genomic DNA from 34 RA patients and 35 ethnically matched controls were typed for TNF-?(308) gene polymorphism by allele-specific polymerase chain reaction(AS-PCR). The concentration of their serum TNF-? was measured by ELISA. Results The TNF genotypes in RA patients were respectively TNF 1 homozygote 14 7%, TNF 2 homozygote 52 9%, and TNF 1 and TNF 2 heterozygote 32 4%. TNF genotypes in controls were respectively TNF 1 homozygote 68 6%, TNF 2 homozygote 2 8%, and TNF 1 and TNF 2 heterozygote 28 6%. The significant difference was found in the distribution of TNF-?(308) genotype between the two groups (? 2=27 71,P

Purpose To investigate the diagnostic value of high-resolution CT reconstruction techniques on the same slice in hypertrophy of transverse process of the fifth lumbar vertebra (HTPL5V), and to provide a basis for clinical diagnosis and treatment. Materials and Methods Twenty-two cases of clinically diagnosed HTPL5V and 20 normal adults were examined with GE LightSpeed 16-slice spiral CT (36 cases) and Philips iCT 256-slice (6 cases). L5 transverse process and the fifth lumber nerve were reconstructed and observed on the workstations. Results In 22 cases of HTPL5V, there were 26 pseudarthrosis formation and 2 sides with L5 transverse process touching the sacral ala. In 28 sides the iffth lumber nerve traveled through false foramina of the HTPL5V including 6 cases of bilateral compression and 16 cases of unilateral compression. In 21 cases, the nerve was compressed by hyperosteogeny on 27 sides (96.4%) and 1 side due to stenosis (3.6%). On 25 sides (89.3%) the compressed nerves were curved in shaper. There was bulging and/or herniated lumbar disc on 9 sides in 7 cases (32.1%). Conclusion High-resolution CT reconstruction techniques can demonstrate the iffth lumbar nerve of HTPL5V and provide evidence for clinical diagnosis and treatment.

Objective To explore the feasibility of the double venipuncture instead of central venous catheter as a temporary vascular access in hemodialysis.Methods The upper arm below the 1/3 was tied a tourniquet,and fistula needle directly punctured the vein in the middle of the elbow.After the success of the puncture,elastic bandage was replaced by a tourniquet,and the ball movement was done by imitating the blood donation member for blood donation at hand gripping a ball or elements as the artery blood lead.Another elbow vein or lower limb saphenous vein was punctured.Thirty patients using double venipuncture dialysis or central venous catheter dialysis 2 weeks or more were randomly selected into each group,and biochemical and renal function was measured before dialysis.Results All of 1 282 patients who were newly into the blood dialysis,mature arteriovenous fistula was in 8 patients (0.6％,8/1 282),deep venipuncture to insert the central venous catheter was in 542 patients(42.3％,542/1 282),using the double venipuncture was in 732 patients (57.1％,732/1 282).The flow of blood was 180-200 ml/min,the avalible time was 1-2 months.The serum creatinine,blood urea nitrogen,calcium,phosphorus and carbon dioxide combining power had no significant difference between two groups (P ＞ 0.05).Conclusions The majority of patients with double venipuncture blood flow can satisfy the need of dialysis.Because the operation is simple,no recycling and may reduce the deep venipuncture,it is an ideal temporary vascular access.

Objective To investigate the association between tumor necrosis factor ? (TNF ?) gene polymorphism and ankylosing spondylitis (AS).Methods Genomic DNA from 98 Chinese AS patients and 70 ethnically matched controls were typed for TNF(308) polymorphism by allele specific polymerase chain reaction (AS PCR).Results The TNF genotypes in AS patients were respectively TNF1 homozygote 37%,TNF2 homozygote 10% and TNF1 and TNF2 heterozygote 53%.While TNF genotypes in controls group were respectively TNF1 homozygote 67%,TNF2 homozygote 3% and TNF1 and TNF2 heterozygote 30%.Significant difference was found in the distribution of TNF 308 genotype between both groups ( ? 2=15 73, P

Objective To investigate the procedure,imaging features and clinical significance of CT virtual gastroscopy(CTVG) in the diagnosis of gastric carcinoma using bi-tilted CT scanning.Methods Thirty patients and ten normal volunteers had bitilted CT scan using helical CT(GE lightspeed 16 CT).The patients and yolunteers were given bubble-making powder by mouth and placed in a supine position on the CT table.CTVG and MPR images were obtained using the virtual dissection and reform of GE.Results The appearances of the inner lesion and normal wall of the stomach on CTVG were similar to those on fiberoptic gastroscopy.The CTVG and MPR features of gastric cancer were focal or diffuse mural thickening,soft tissue mass,stenosis of stomach,cancerous ulcer,infiltration to adjacent tissues,and lymph node and distant metastases.In comparison with fiberoptic gastroscopy(as the gold standard),CTVG showed a diagnostic accuracy of 92.5 %,a sensitivity of 93.3 %,a specificity of 90.0 %,a positive prediction value of 96.7 %,and a negative prediction value of 81.8 %.Conclusions CTVG is a safe,reliable,non-invasive method for demonstrating the structure of normal and abnormal stomach,and is a good complementory method to conventional fiberoptic gastroscopy.

Objective The aim of this prospective observational study was to analyze the prevalence and the predictive factors of hemorrhagic events after abdominal paracentesis in patients with acute-on-chronic liver failure (ACLF).Methods ACLF patients who received at least one episode of abdominal paracentesis were prospectively enrolled between January 2010 to December 2013. Prevalences of intraperitoneal and abdomen hemorrhage complications were examined. t test was performed for continuous variables and chi-square test was performed for categorical variables.Binary Logistic regression was used to analyze the risk factors of hemorrhage.Results A total of 525 abdominal paracenteses were carried out on 185 ACLF patients within a 4-year period,with 289 (55 .0%)for diagnostic purpose and 236 (45 .0%)for therapeutic purpose.A total of 16 (3.0%)hemorrhagic complications were identified, with 4 cases of abdominal wall hematomas and 12 cases of intraperitoneal hemorrhage.Patients were divided into hemorrhage group and non-hemorrhage group according to this complication.Age,gender, Child-Pugh score,volume of ascitic fluid removed,underlying cirrhosis,platelet count and thrombin time were not significantly different between two groups (all P > 0.05 ).Patients with bleeding events had lower fibrinogen levels and higher prothrombin time,international normalized ratio,activated partial thromboplastin time and model for end-stage liver disease score (all P <0.05).After adjustment of other factors,multivariate regression analysis indicated that low fibrinogen level was the only independent predictor of hemorrhagic complication (OR=0.105,95%CI :0.018-0.608,P =0.012).Conclusion Low fibrinogen level is the independent predictor of severe hemorrhagic complications following paracenteses in patients with ACLF.

Objective To investigate the association between interleukin-22 (IL-22) single nucleotide polymorphisms (SNPs) and the prognosis of hepatitis B virus related acute-on-chronic liver failure (HBV-ACLF).Methods The patients with HBV-ACLF from the First Affiliated Hospital of Fujian Medical University were retrospectively studied.Seven SNP genotypes of IL-22 gene,including rs2227478,rs2227491,rs1179251,rs1179249,rs2227473,rs2227484,and rs11611206,were detected using imLDRTM multiple SNP typing kit and the distribution features of SNP genotypes were described.The relationship between the distribution of SNP genotypes and alleles and the prognosis of ACLF was analyzed.Comparison of genotypes and allele frequencies between groups were performed by chi-square test of R × C table or Fisher's exact tests.Binary logistic regression analysis was used to analyze whether IL-22 gene polymorphisms was an independent prognostic factor for patients with ACLF.Results A total of 122 patients with HBV-ACLF were included in this study.Ninety-two (75.1％) were male and 30 (24.59 ％) were female.Patients were stratified as survival group (90 cases) and non-survival group (32cases) according to the Results of three months follow-up.The genotype distribution of rs2227484 of IL-22 gene was significantly different between the two groups (x2=6.128,P=0.033).The A allele frequency in the non-survival group (15.6％) was significantly higher than that in the survival group (5.6％) with statistically significance (OR=0.318,95％ CI=0.126-0.804,P=0.012).There was no significant difference in the other six SNP genotypes of IL-22 gene between the two groups (all P＞0.05).However,binary logistic regression showed that rs2227484 of IL-22 gene was not an independent risk factor for the short-term mortality in HBV-ACLF patients (adjusted OR=3.102,95％ CI:0.939-10.250,P=0.063).Conclusions The A allele and AA genotype of rs2227484 of IL-22 gene may be associated with a short-term prognosis in patients with HBV-ACLF.

Objective: To investigate the correlation between interleukin-6 (IL-6) single nucleotide polymorphism (SNP) and the occurrence and prognosis of hepatitis B virus-associated acute-on-chronic liver failure (HBV-ACLF). Methods: Patients with chronic hepatic diseases diagnosed as HBV infection in the Hepatology Center of the First Affiliated Hospital of Fujian Medical University from July 2012 to March 2018 were divided into HBV-ACLF and non-ACLF group. SNP genotyping of eight loci in IL-6 gene (rs1524107, rs1800795, rs1800797, rs2069827, rs2069830, rs2069837, rs2069840 and rs2069845) was determined by the improved multi-temperature ligase detection reaction (imLDRTM) technique. Simultaneously, case data were reviewed with the 3-months followed up survival condition of the ACLF group. Normally distributed data were expressed as arithmetic means and SDs, and t-test was adopted. Data with skewed distribution were expressed as medians with interquartile range, and were measured by non-parametric test. Multivariate logistic regression analysis was used to analyze the relative risk of genetic polymorphism and HBV-ACLF as well as the relationship between IL-6 SNPs with the occurrence and prognosis of HBV-ACLF. Results: Four hundred patients were included in the study, with 122 (30.5%) in the HBV-ACLF and 278 (69.5%) in the non-ACLF group. There were significant differences in total bilirubin, albumin, and white blood cell count, percentage of neutrophils, platelet count, alanine aminotransferase, aspartate aminotransferase, prothrombin time and international standardized ratio, creatinine and the model for end-stage liver disease score between the two groups (P < 0.001). The genotype of IL-6 genes (rs1800795, rs1800797, rs2069827, and rs2069830) of all subjects showed no mutation or the mutation rate under 1%. There was no significant difference in the genotype of IL-6 (rs1524107, rs2069837, rs2069840 and rs2069845) between the two groups (P > 0.05). Multivariate logistic regression analysis showed that the SNPs in the above four loci of IL-6 gene was not associated with HBV-ACLF risk, nor had significant correlation with the 3-months prognosis. Conclusion The SNP genotyping of eight loci in IL-6 gene (rs1524107, rs1800795, rs1800797, rs2069827, rs2069830, rs2069837, rs2069840 and rs2069845) is unrelated to the occurrence and short-term prognosis of HBV-ACLF.