The earliest and the most common metastasis of hepatocellular carcinoma (HCC) occur in the intrahepatic portal venous system, which indicates its worst prognosis. In 28 HCC patients with intraportal tumor thrombus, we employed 2 procedures, ie. the transcatheter hepatic arterial embolization(THAE), transcatheter superior mesenteric or splenic arterial infusion (TSAI) and portal vein embolization (PVE) in 12 cases, and THAE alone in 16 cases. In the former group, tumor size reduced more than 50% in 8 cases (partial remission PR), in particular tumor thrombus disappeared in 3 and decreased in size in 8; whereas in the latter group, PR was achieved in 3 only, without change size of the intraportal tumor thrombus in all 16 cases (P

BackgroundFew studies have compared change in the health-related quality of life (HRQL) following treatment of non-ST-elevation acute coronary syndrome (NSTE-ACS) with either percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). This study is tocompare changes in HRQL six months after hospital discharge between NSTE-ACS pa-tients who underwent either PCI or CABG.Methods HRQL was assessed using the Seattle angina questionnaire at admission and six months after discharge in 1012 consecutive patients with NSTE-ACS. To assess associations of PCI and CABG with HRQL changes, logistic regression models were constructed treating changes in the score of each dimension of the Seattle angina question-naire as dependent variables.Results Although both the PCI and CABG groups experienced angina relief and other improvements at 6-month follow-up (P<0.001), the CABG relative to PCI group showed more significant improvements in angina frequency (P= 0.044) and quality of life (P= 0.028). In multivariable logistic analysis, CABG also was an independent predictor for both im-provement of angina frequency (OR: 1.62, 95%CI: 1.09-4.63,P= 0.042) and quality of life (OR: 2.04, 95%CI: 1.26-6.92,P= 0.038) relative to PCI.Conclusions In patients with NSTE-ACS, both PCI and CABG provide great improvement in disease-specific health status at six months, with that of CABG being more prominent in terms of angina frequency and quality of life.

Objective To explore the clinical significance of cerebrospinal fluid neuropeptide Y in epileptic patients with intelligence disturbance.Methods The Full Intelligence Quotient (FIQ) of 78 cases of epileptic patients were assessed by WAIS-RC.The subjects were divided into intelligence disturbance group and non-intelligence disturbance group.Their cerebrospinal fluid neuropeptide Y Was tested by using radio immunoassay.Results The content of neuropeptide Y in intelligence disturbance group Was obviously higher than that in non-intelligence disturbance group (P<0.01).Conclusion Intelligence disturbance in epileptic patients is related to the increased Neuropeptide Y.Neuropeptide Y may reflect the intelligence condition in epileptic patients.

] AIM: To investigate the expression of the urotensin Ⅱ (UⅡ) receptor GPR14 in the aorta of apoE knockout mouse. METHODS: The expression of GPR14 in the aorta of apoE knockout C57BL/6J mice at various ages (18 weeks, 28 weeks, and 38 weeks old, respectively) was determined with competitive RT-PCR. A binding assay of [ 125 I]-UⅡ on the aortic tissue was also performed in 28 weeks group. RESULTS: We found significant upregulation of GPR14 mRNA at all three ages. Compared with wild type group at the same age, the GPR14 mRNA level in apoE knockout mice increased 54.2% in 18 week group (P

BACKGROUND:Studies have shown that anterolateral approach for repairing the hip joint capsule has great effects on dislocation after hip replacement, but it remains unclear at present. OBJECTIVE: To study the impact of anterolateral approach for repairing the hip joint capsule on dislocation after artificial hip joint replacement. METHODS: 480 patients, who received artificial hip joint replacement in the First People’s Hospital of Qinzhou from January 2010 to January 2014, were enroled in this study. They were divided into the control group (January 2010 to January 2012) and the observation group (February 2012 to January 2014) according to the order of their admission, each of 240 cases. The control group was subdivided into the total hip replacement group (A1 group) and the femoral head replacement group (A2 group), each of 120 cases; and the observation group was also subdivided into the total hip replacement group (B1group) and the femoral head replacement group (B2 group), each of 120 cases. A1group and A2 group were subjected to artificial hip joint replacementvia anterolateral approach. B1 group and B2 group were subjected to artificial hip joint replacementvia anterolateral approach and the repair of the joint capsule. The postoperative early dislocation rate was analyzed in patients of A1 group and B1 group. Postoperative early dislocation rate was analyzed in patients of A2 group and B2 group. RESULTS AND CONCLUSION: The rate of early postoperative dislocation was 6.7% in A1 group, and 0.8% in the B1 group. The rate of early postoperative dislocation was significantly higher in the A1group than in the B1 group (P < 0.05). The rate of early postoperative dislocation was 3.3% in the A2 group and 0.8% in the B2 group. No significant difference was found between the A2 and B2 groups (P > 0.05). Results showed that anterolateral approach in repairing the hip joint capsule can effectively reduce the incidence of postoperative dislocation after the total hip replacement, but does not obviously impact postoperative dislocation.

Objective: To investigate whether Schisandrin B (Sch B) could improve cardiac structure and function in myocardial infarction (MI) mice and related mechanisms. Methods: Male C57BL/6J mice were randomized into sham (n=8), MI+ Sch B (n=24, 80 mg·kg^-1·d^-1 per gavage) or MI+ vehicle (n=24, equal volume). After treatment for 3 weeks, cardiac function was detected by echocardiography measurement.Infarction size was measured by Evans blue and TTC staining.HE and Masson trichrome staining were used to observe the myocardial inflammation, structure and fibrosis.TNF-α, TGF-β, IL-1β were detected by ELISA. The apoptosis index of ischemic myocardial cells was detected by immunofluorescence. NF-κB, Bcl-2, Bax, Akt phosphorylated Akt(p-Akt), eNOS, phosphorylated eNOS (p-eNOS) were detected by Western blot. Results: Three weeks after operation, survival rate (83.33% vs. 54.17%, P<0.05), LVEF((51.77±8.50)% vs.(40.23±8.30)%, P<0.05), LVFS((26.44±5.15)% vs. (19.53±4.56)%, P<0.05)were significantly higher; LVEDD ((4.13±0.40) mm vs.(4.44±0.46)mm, P<0.05), LVESD((3.07±0.39) mm vs. (3.46±0.52)mm, P<0.05), the heart weight/body weight ratio((0.59±0.06)% vs. (0.68±0.10)%, P<0.05)was significantly lower and infarct size ((23.4±2.36)% vs. (39.4±2.06)%, P<0.05) was significantly reduced in MI+ Sch B group than those in MI+ vehicle group. In MI+ vehicle group, HE staining showed a large number of inflammatory cells in the peri-infarctl region, and the permutation structure was very disorganized, while above changes were significantly reduced in the MI+ Sch B group. Masson staining results showed that the degree of myocardial fibrosis in MI+ Sch B group was significantly less than that of MI+ vehicle group.Moreover, Sch B could down-regulate some inflammatory cytokines, like NF-κB、TGF-β、TNF-α and IL-1β, activate Akt-eNOS pathway, upgrade Bcl-2 and downgrade Bax and reduce cell apoptosis as compared with MI+ vehicle group (all P<0.05). Conclusions Our results demonstrate that Sch B can reduce inflammation, inhibit apoptosis, and attenuate cardiac remodeling and improve cardiac function in this mice MI model.Sch B might serve as a potential novel therapeutic agent for ischemic heart disease.

Objective To report the modified liver mobilization technique in management of renal cell carcinoma with intrahepatic inferior vena cava thrombus. Methods 10 cases (7 men and 3 women at the average age of 49 years) of renal cell carcinoma with intrahepatic inferior vena cavs thrombus were reviewed.The operations were carried by using father clamp to control inferior vena cava,combined with hepatic portal blocking. Results There was no postoperative complication.The average blood loss was 800 ml.The mean hospital stay was 13 days.The time of follow-up ranged from 1 to 48 months. Conclusions The technique of using father clamp to control suprahepatic inferior vena cava combined with hepatic portal blocking is feasible for the treatment of the renal cell carcinoma with intrahepatic inferior vena cava thromhosis.

Objective To understand the current status of social support among the elderly,aged ≥60 years,as well as to identify influencing factors and to provide a reference for relevant health care services.Methods Publications about social support of the elderly were collected by searching the database of CNKI,VIP,Wanfang Data,Pubmed,and Web of Science.A random effects model was employed according to the results of heterogeneity (I2＞50％) to pool the extracted data.Results Thirty-two articles were included,with a total sample of 21 763 articles.Total scores of social support and three dimensions were low,with social support of 34.047 (95％CI:32.532-35.563),subjective support of 19.218 (95％CI:17.589-20.846),objective support of 7.787 (95％CI:7.483-8.091),and support utilization of 7.075 (95％CI:6.884-7.266).Scores of elderly with character of high age (aged 80:30.907,95％CI:28.378-33.436),female (32.512,95％CI:30.723-34.300),low education (illiteracy:32.088,95％CI:30.944-33.231;primary school:32.709,95％CI:30.069-35.349),country side (33.780,95％CI:31.523-36.038),empty nest (32.301,95％CI:27.061-37.542) and incomplete marriage (discoverture:27.044,95％CI:24.652-29.437;divorced:29.159,95％CI:24.520-33.791) was lower than the others.Conclusions The current status of social support is not optimistic.Scores of social support and its dimensions were relatively low,and a significant difference was found between elderly of different character,indicating that health interventions should be implemented based on character.

Objective:To evaluate the relationship between sleep arousal, ambulatory blood pressure and new-onset heart failure(NOHF)in elderly patients with obstructive sleep apnea(OSA).Methods:A total of 584 elderly patients with OSA who were diagnosed and treated in our hospital between March 2015 and March 2019 were prospectively and consecutively selected, with a mean age of(70.1±7.2)years.Polysomnography(PSG)results were obtained at baseline, and the arousal index(AI)was calculated.Based on the quartiles of AI, patients were divided into 4 groups: a low-level group(AI<18.4/h, 186 cases), a low-medium level group(18.4-29.1/h, 177 cases), a medium-high level group(29.2-41.2/h, 137 cases)and a high-level group(>41.2 /h, 84 cases). Participants were followed up for 18 months, the results of ambulatory blood pressure were recorded and compared, and the relationship between AI and the risk of NOHF was analyzed.Results:Compared with the low-level group, patients in the low-medium, medium-high, and high-level groups were older(70.1, 70.3, 73.3 vs.68.7 years, F=2.726, P=0.043)and had more smokers(43.8%, 49.6%, 54.8% vs.38.2%, χ2=8.809, P=0.032), a larger body mass index(26.3, 26.7, 27.6 vs.25.4 kg/m 2, F=2.731, P=0.042), a higher Epworth sleepiness scale score(7.83, 8.50, 9.91 vs.7.64, F=5.124, P=0.018), a higher apnea hypopnea index(23.5, 34.8, 52.7 vs.17.6, F=5.632, P=0.007), lower nocturnal oxygen saturation(80.2, 75.3, 72.1 vs.83.7 mmHg, F=4.811, P=0.024), and higher N-terminal pro-B-type natriuretic peptide(NT-proBNP)levels(317.5, 337.5, 359.2 vs.267.5 pg/L, F=4.307, P=0.033). At the median follow-up(18 months, 14-24 months), the results of ambulatory blood pressure monitoring showed that 24-hour systolic blood pressure(24 h SBP)(147.3, 148.6, 156.2 vs.143.8 mmHg, F=5.4311, P=0.013), 24-hour diastolic blood pressure(24 h DBP)(80.1, 79.5, 83.7 vs.76.5 mmHg, F=5.679, P=0.011)in the low-medium, medium-high and high-level groups were higher than those in the low-level group.The results of survival analysis showed that there were 75(12.8%)cases of NOHF, mostly with preserved ejection fraction(47 cases)or mid-range ejection fraction heart failure(20 cases). The incidences of NOHF were 6.5%, 12.4%, 16.1% and 22.4%, respectively for the low level, low-medium, medium-high and high-level groups, and the risk of NOHF in the low-medium, medium-high and high-level groups was significantly higher than in the low level group(log-rank χ2=11.624, P=0.007). Variables with P<0.2 in the univariate analysis, age and sex were included in the multivariate Cox regression analysis.The results showed that age( HR=1.724, 95% CI: 1.216-3.135), diabetes( HR=1.514, 95% CI: 1.127-3.058), NT proBNP( HR=1.517, 95% CI: 1.232-2.366), nocturnal diastolic blood pressure( HR=2.004, 95% CI: 1.332-4.638), and middle-high AI level( HR=1.611, 95% CI: 1.204-2.967)and high AI level( HR=1.863, 95% CI: 1.272-3.538)were independent factors of NOHF in elderly OSA patients. Conclusions:Sleep arousal in elderly patients with OSA increases blood pressure levels and the risk of NOHF.

Objective:To analyze the factors which may influence postoperative early ambulation in patients with fresh fracture so as to further optimize the perioperative protocol based on the concept of enhanced recovery after surgery (ERAS).Methods:A retrospective analysis was conducted of the patients who had been treated for a single fresh fracture at the extremity, pelvis or acetabulum from May 2019 to July 2019. Collected were the data concerning basic features of patients, perioperative ERAS management and surgery, as well as early ambulation on the day of surgery or the first day after surgery. The patients were divided into an early ambulation group and a non-early ambulation group according to the time of ambulation. Statistical analyses were performed of the relationships between early ambulation and 20 potential factors concerning basic features of patients, perioperative ERAS management and surgery. Logistic correlation analysis was performed to identify risk factors for postoperative early ambulation.Results:A total of 306 patients were included, including 96 upper limb, 203 lower limb, 5 acetabular and 2 pelvic fractures. Of them, 150 ambulaed from bed on the day of surgery or the first day after surgery while 156 did not. Significant differences were observed between the 2 groups in fracture site, intake of carbohydrate liquids the night before surgery and the day of surgery, catheter indwelling, intraoperative liquid transfusion volume and postoperative complications ( P < 0.05). Logistic correlation analysis of the relationship between the above factors and postoperative early ambulation found that fracture site and intraoperative liquid transfusion volume were significantly correlated with postoperative early ambulation ( P < 0.05). Conclusions:About half of the patients with a single fresh fracture may ambulate early after surgery. Fracture site and intraoperative liquid transfusion volume may be significantly correlated with postoperative early ambulation.