Objective To discuss the clinical efficacy of stent treatment for the benign or malignant colorectal obstruction. Methods Under fluoroscopic and / or endoscopic guidance stent implantation was performed in 30 patients with colonic or rectal obstruction. The obstruction sites were located at rectum (n = 20), recto-sigmoid juncture (n = 2), sigmoid colon (n = 3), descending colon (n = 3) and transverse colon (n = 2). Results Thirty-one colorectal stents were implanted in total 30 patients, the technical success rate was 92% by once-through operation. The patients were immediately relieved of the symptoms of intestinal obstruction. No complications related to stent implantation occurred. The average survival time in patients with malignant obstruction was 271 days. Conclusion For colorectal obstruction, stent implantation through anus is a minimally-invasive, safe and effective treatment with few complications. The procedure can effectively relieve the patients of the intestinal obstruction symptoms and, thus, improve their living quality.

BACKGROUND:Cerebrovascular stent may destroy the vessel walls,which can lead to vascular restenosis.There are different versions about the safety,pathologic pharmacology reasons and clinical effect.OBJECTIVE:To evaluate the safety and short-term effect of endovascular stent implantation for symptomatic artery stenosis.METHODS:Totally 20 patients with total 22 lesions diagnosed symptomatic artery stenosis were treated with endovascular stenting.The vascular stenotic lesions involved middle cerebral artery in 6 cases,internal carotid artery in 6 cases,vertebral artery in 4 cases,basilar artery in 3 cases and vertebro-basilar artery in 3 cases.The length of vascular stenotic lesions was 3-10 mm with the average of 7 mm.Both balloon and self-expandable stents were used in 12 cases with embolus protection device.RESULTS AND CONCLUSION:All of the 22 stents in 20 patients were placed successfully in one time.After stent implantation,the vascular angiography showed that the vessels were reformed obviously with the degree of stenosis no more than 20%.The perfusion in cerebrum was improved in parenchymal phase and the symptom was also improved clearly.At 6-24 months follow-up,20 patients never had cerebral ischemia.With follow-up for 12-24 months in 7 patients,digital subtraction angiography displayed that intima hyperplasia was occurred in stent in one patient with no symptom.The stenotic vascular were unobstructed and no intima hyperplasia by transcranial Doppler examinations.The results demonstrated that endovascular stent implantation is a safe and effective treatment for intracranial symptomatic artery stenosis,while its long-term effect needs further study.

Objective To investigate the apoptosis-inducing effect and anti-proliferative effect of epigallocatechin-3-gallate (EGCG) on human pancreatic cancer cell SW1990 in vitro. Methods The effect of proliferation was evaluated by MTT after the SW1990 cells in vitro were incubated with different concentrations of EGCG (6.25, 12.5, 25, 50, 100 μg/ml). The apoptosis-inducing effect was determined by flow cytometry after the cells were treated with 25 μg/ml of EGCG. The cell cycle of SW1990 cells was detected by flow cytometry after the cells incubated with different concentrations of EGCG (0, 10, 20, 30, 40, 50 μg/ml).Results After SW1990 cell were treated with different concentrations of EGCG (0, 25, 50 μg/ml), the values of A492 were 0.46 ±0.04,0.42 ±0.04,0.27 ±0.03 at 24 h; 0.48 ±0.02, 0.31 ±0.03,0.16 ±0.02at 48 h; 0.51 ±0.01,0.24 ±0.04,0. 14 ±0.04 at 72 h. EGCG inhibited the proliferation of SW1990 in a doseand time-dependant manner(P ＜0.01 ). The apoptotic rates at 24, 48, 72 h were (8.33 ± 1.15 )%, (19.77 ±0.81 )%, (29.17 ± 0.75 )% in the EGCG treatment group; while the corresponding values were (2.77 ±0.45 ) %, (3.20 ± 0.26 ) %, (3.67 ± 0.35 ) % in the control group; and the difference was statistically significant (P ＜0.01 ). After 0, 20, 50 μg/ml of EGCG treatment for 24 h, the percentages of SW1990 cellsin G0/G1 stage were (57.59 ±0.97)%, (62.99 ± 1.91 )%, (68.87 ± 1.88)%, and the percentages of SW1990 cells in G0/G1 stage increased with the increase of concentrations of EGCG, while the percentages of SW1990 cells in G2/M stage decreased with the increase of concentrations of EGCG (P ＜0.01 ). Conclusions EGCG can significantly inhibit the proliferation of SW1990 cells. The mechanism may be related to the apoptosis-inducing effect and the regulation of the cell cycle of the SW1990 cells.

Objective To study the efficacy and safety of oral calcium carbonate suspension and proton pump inhibitors (PPI) in symptoms relief of acid related diseases.Methods The multi-center,randomized and controlled study was carried out.A total of 400 acid-related diseases patients from 14 to 70 years old with at least one of moderate or severe symptoms such as acid regurgitation,epigastric pain,epigastric discomfort,upper abdominal burning or distension were equally divided into two groups and treated with oral calcium carbonate suspension or omeprazole enteric-coated tablets.The onset of symptoms relief of all patients of the first time after taking medicine was observed.The relief of clinical symptoms at the third day and seventh day after taking medicine was also observed.The adverse events were recorded.Analysis of variance was performed for statistical analysis.Results The onset of symptoms relief of oral calcium carbonate suspension group in acid regurgitation,epigastric pain,epigastric discomfort,upper abdominal burning or distension of the first time after taking medicine were significantly faster than those of PPI group (F=4.866,8.142,41.366,6.955,35.252; all P＜0.05).At the third day after taking medicine,the treatment efficiency of oral calcium carbonate suspension group and PPI group were 69.50％ and 72.50％,and at the seventh day the treatment efficiency of oral calcium carbonate suspension group and PPI group were 92.00％ and 96.50％.There was no significant difference in treatment efficiency and comprehensive efficacy between two groups at day three and seven after taking medicine (both P＞ 0.05).There were 14 cases of mild adverse events and two cases of moderate adverse events in oral calcium carbonate suspension group.There were 10 cases of mild adverse events in PPI group.There was no significant difference between two groups (P＞0.05).Conclusion Oral calcium carbonate suspension provides faster symptom relief than PPI and can effectively improve the symptoms of acid-related diseases.

AIM: To investigate the expression of tissue factor(TF) induced by oxidized high density lipoprotein(oxHDL) in human umbilical vein cell line,ECV304,and the related mechanisms.METHODS: Four main groups were designed: the negative,the positive(ECV304 with histamine),the HDL group and the oxHDL group.Quantitative real-time polymerase chain reaction(RQ-PCR) and Western blotting were used to detect the expression level of TF.The specific inhibitors of MAPKs,SP600125(c-jun terminal NH2 kinase,JNK),SB203580(p38 MAP kinase,p38 MAPK),PD98059(extracellular signal-regulated kinase,ERK1/2) were used to investigate the underlying mechanisms.RESULTS: The TF expression in normal ECV304 cell line was not detected.Histamine administration resulted in a significant expression of TF in ECV304 cell line,with strongest effect after 1 h co-incubation at concentration of 1?10-5 mol/L histamine(about 4.8-fold higher expression of TF compared with that of 1?10-9 mol/L histamine).Expression level of TF was detected after stimulated with oxHDL in dose-and time-dependent manners.The highest expression of TF mRNA was found at 20 mg/L oxHDL and 6 h co-incubation,with 1.8-fold and 5.3-fold increase in TF expression,respectively,compared with that at 10 mg/L oxHDL and 2 h co-incubation.20 mg/L oxHDL also caused an apparent augmentation of TF protein expression,about 1.5-fold higher compared with that stimulated by 40 mg/L oxHDL.HDL co-incubation did not cause a detectable expression of TF protein.The mRNA levels of TF in ECV304 cell line induced by oxHDL were decreased by 95.0%,81.0%,87.0%,respectively(all P

OBJECTIVE:To observe clinical efficacy and safety of mesalazine combined with Kangfuxin solution retention en-ema in the treatment of active ulcerative colitis(UC). METHODS:A total of 120 patients diagnosed as active UC selected from gastroenterology department of our hospital during Mar. 2012 to Aug. 2014 were divided into observation group and control group according to random number table,with 60 cases in each group. Both groups received conventional treatment of active UC. Control group was additionally given Mesalazine enteric coated tablets 1 g,tid,on the basis of routine treatment.Observation group was ad-ditionally given Kangfuxin solution 30 mL diluted with normal saline 150 mL for enema,qd,on the basis of control group. Both groups were treated for 30 d. The serum levels of TNF-α,IL-1,IL-8,IL-10,SOD,NO and LPO were observed in 2 groups be-fore and after treatment;clinical efficacies,recurrence rates,colonoscopy efficacies and the occurrence of ADR were compared be-tween 2 groups. RESULTS:Before treatment,there was no statistical significance in the serum levels of TNF-α,IL-1,IL-8, IL-10,SOD,NO or LPO between 2 groups(P>0.05).After treatment,the serum levels of TNF-α,IL-1,IL-8,NO and LPO in 2 groups were decreased significantly,while the serum levels of IL-10 and SOD were increased significantly;the serum levels of TNF-α,IL-1,IL-8,NO and LPO in observation group were significantly lower than control group,while the serum levels of IL-10 and SOD were significantly higher than control group,with statistical significance(P<0.05). Clinical response rate,recur-rence rate and colonoscopy response rate of observation group were 83.3%,11.7% and 88.3%,which were significantly better than 66.7%,30.0%,70.0%of control group,with statistical significance(P<0.05).There was no statistical significance in the in-cidence of ADR between 2 groups(P>0.05). CONCLUSIONS:Mesalazine combined with Kangfuxin solution can effectively alle-viate inflammatory reaction in patients with active UC,and reduce oxygen free radical damage with good safety.

Objective To evaluate the clinical application value of serum high sensitive α-fetoprotein variant ratio (hs-AFP-L3％) in the diagnosis and treatment of hepatocellular carcinoma.Methods From October 2016 to March 2018,at Affiliated Hospital of Qingdao University,160 patients diagnosed with hepatocellular carcinoma,32 patients with intrahepatic cholangiocarcinoma (ICC),52 patients with post-hepatitis B liver cirrhosis,53 patients with chronic hepatitis B and 50 healthy controls were enrolled.The serum levels of hs-AFP-L3％ and α-fetoprotein were measured.Mann-Whitney U test,Spearman correlation analysis,Wilcoxon signed rank test and chi-square test were performed for statistical analysis.Results The serum levels of hs-AFP-L3％ and α-fetoprotein in hepatocellular carcinoma group were 24.90％ (4.68％ to 61.85％) and 113.45 μg/L (11.18 μg/L to 1 803.48 μg/L),respectively,which were higher than those in ICC group (0.50％,0.50％ to 0.50％;and 2.79 μg/L,1.72 μg/L to 4.04 μg/L),cirrhosis group (0.50％,0.50％ to 5.25％;and 18.35 μg/L,3.95 μg/L to 31.93 μg/L),chronic hepatitis group (0.50％,0.50％ to 4.25％;and 2.70 μg/L,1.80 μg/L to 17.00 μg/L),and healthy control group (0.50％,0.50％ to 0.50％;and 1.94 μg/L,1.46 μg/L to 2.63 μg/L),and the differences were statistically significant (U =461.00,1 485.50,1 141.00,625.00;401.50,2 207.00,1 254.00,266.00;all P ＜0.01).The sensitivity of hs-AFP-L3％ and α-fetoprotein in the diagnosis of hepatocellular carcinoma was 66.3％ and 70.0％,respectively;and the difference was not statistically significant (x2 =0.54,P ＞ 0.05).The sensitivity of the combined detection was 82.5％,which was higher than that of the separate detection,and the differences were statistically significant (x2 =24.04 and 18.05,both P ＜0.01).The specificity of hs-AFP-L3％ was 95.2％,which was higher than that of α-fetoprotein (68.6％),and the difference was statistically significant (x2 =26.04,P ＜ 0.01).The specificity of the combined detection of these two markers was 68.6％,which was lower than that of hs-AFP-L3％ alone (95.2％),and the difference was statistically significant (x2 =26.04,P ＜ 0.01).There was no statistically significant difference in the specificity between the combined detection and α-fetoprotein detection alone (68.6％,P ＞ 0.05).The sensitivity of hs-AFP-L3％ in the diagnosis of patients with α-fetoprotein-negative (α-fetoprotein ＜ 20 μg/L) hepatocellular carcinoma was 41.7％.The serum levels of hs-AFP-L3％ and α-fetoprotein were both positively correlated with tumor size and clinical stage (hs-AFP-L3％ r =0.272 and 0.436;α-fetoprotein r =0.375 and 0.458;all P ＜ 0.01).The reduction of serum hs-AFP-L3％ in 38 patients with hepatocellular carcinoma after operation was 82.2％,which was higher than that of oα-fetoprotein (69.2％),and the difference was statistically significant (U =532.50,P =0.049).There was no correlation between serum level of hs-AFP-L3％ and α-fetoprotein level (r =0.077,P ＞ 0.05).Conclusions The sensitivity of hs-AFP-L3％ is similar to that of α-fetoprotein in the diagnosis of hepatocellular carcinoma,while the specificity of hs-AFP-L3％ is higher than that of α-fetoprotein.The combined detection of the two markers can improve the diagnostic rate of hepatocellular carcinoma.The hs-AFP-L3％ has a high diagnostic value in α-fetoprotein-negative hepatocellular carcinoma.

Objective:To investigate the predictive value of systemic immune inflammation index (SII) for the overall survival of patients with pancreatic cancer by propensity score matching analysis.Methods:The clinical data of 457 patients with pancreatic cancer admitted to the Affiliated Hospital of Qingdao University from August 2000 to December 2019 were retrospectively analyzed. The age, gender, presence of jaundice, pancreatitis and diabetes, serum CA19-9, total bilirubin level, neutrophil count, platelet count, lymphocyte count in blood, presence of radical surgery, tumor TNM stage, tumor location and the like were recorded. The cut-off value of SII was determined by Youden index. The patients were divided into high and low SII groups accroding to the cut-off value. The propensity score matching was applied to reduce the selection bias of patients. Patients were 1∶2 matched and the caliper value was 0.1. The difference on overall survival between the two groups was compared. The prognostic factors were analyzed by univariate and multivariate Cox regression analysis. Kaplan-Meier was used to draw the overall survival curve to calculate the cumulative survival rate, and the differences between the curves were analyzed by Log-Rank test.Results:The cut-off value of SII was 765. There were statistically significant differences between the high SII group ( n=125) and the low SII group ( n=332) on the presence or absence of pancreatitis, the level of total bilirubin in blood, radical surgery, and TNM stage before the propensity score matching (all P value <0.05). After propensity score matching, there was no statistically significant difference between the high SII group ( n=113) and the low SII group ( n=182) on all the clinical parameters mentioned above except for CA19-9, indicating that the two groups were comparable. Univariate analysis showed that the level of CA19-9, SII, radical surgery and different TNM stage were all related to the overall survival of pancreatic cancer patients. Multivariate analysis showed that high CA19-9 level, high SII, no radical surgery, and worse TNM stage were independent risk factors for short overall survival, and high SII ( HR=1.882, 95% CI 1.446-2.450, P<0.001) was significantly associated with poor prognosis. The overall survival of patients with high SII was obviously shorter than the low SII group ( P<0.001), and the average survival time of patients with high and low SII were 8.86 and 11.38 months, respectively. Conclusions:SII is of great value in evaluating the overall survival of pancreatic cancer patients. Higher SII is associated with shorter overall survival.

Objective:To investigate the feasibility of reducing radiation dose in coronary CT angiography for patients with arrhythmia with absolute phase and narrow window in prospective electrocardiogram-gating.Methods:200 patients with arrhythmia underwent coronary CT angiography procedure with prospective electrocardiogram-gating adaptive sequence in dual source CT were randomly divided into 2 groups according to the scan mode. Group A was scanned with absolute phase and narrow window(250-450 ms) and group B uesd relative phase and wide window (30%-75%). The other parameters and injection protocol of contrast media were the same in 2 groups. Both image quality and radiation dose of the 2 groups were analyzed.Results:No significant difference of image quality was found between the 2 groups. CTDI vol, DLP, E of group A were all lower than those in group B [CTDI vol : (16.71±8.35) vs.(29.35±17.90)mGy , DLP: (231.04±114.86) vs.(398.27±238.40)mGy·cm , E: (3.23±1.60) vs.(5.57±3.33)mSv, t=-6.40, -6.32、-6.32, P<0.05] . The patients with repeat scan cycles in group A and group B were 81 vs. 22 for 0 cycle , 17 vs. 62 for 1 cycle, 2 vs. 10 for 2 cycles, 0 vs. 6 for 3 cycles( χ2=70.76, P<0.05). Conclusions:The prospective electrocardiogram-gating adaptive CCTA sequence with absolute phase and narrow window can reduce radiation dose while the image quality meets the requirementsfor patients with arrhythmia.

Objective:To explore the clinical application value of dynamic contrast-enhanced MRI (DCE) time-signal intensity curve (TIC) combined with diffusion weighted imaging (DWI) in the diagnosis of benign and malignant breast lesions.Methods:This study was a retrospective study. 95 patients with suspected breast cancer who were diagnosed and treated in the Beijing Huairou Hospital from October 2018 to October 2021 were taken as the study subjects. All patients received DCE-TIC and DCE-DWI examinations, and then underwent needle biopsy after imaging examination. We evaluated the diagnostic efficacy of DCE-TIC and DCE-DWI alone and in combination in benign and malignant breast lesions by collecting general clinical data and apparent diffusion coefficient (ADC) values of patients, using pathological examination results as the " gold standard" .Results:A total of 95 patients with suspected breast cancer were diagnosed as benign lesions in 25 cases and malignant lesions in 70 cases after biopsy. Compared with benign lesions, the tumor diameter and ADC value of malignant lesions were significantly different (all P<0.05). The eceiver operating characteristic (ROC) curve of subjects was drawn, and the area under the curve (AUC) of DCE-DWI diagnosis of breast cancer was 0.826. 95 suspected breast cancer patients were diagnosed by DCE-TIC in 28 cases of type Ⅰ, 27 cases of type Ⅱ, and 40 cases of type Ⅲ. With the pathological diagnosis results as the " gold standard", the accuracy, sensitivity, and negative predictive value of DCE-TIC combined with DCE-DWI in the diagnosis of breast cancer were higher than those of a single diagnosis, with a statistically significant difference (all P<0.05); The specificity and positive predictive value of combined diagnosis were not statistically significant compared to single diagnosis (all P>0.05). Conclusions:Both DCE-TIC and DCE-DWI can differentiate benign and malignant breast lesions, and the accuracy, sensitivity, and positive predictive value of combined diagnosis are higher than those of single diagnosis. The combination of DCE-TIC and DCE-DWI can help improve the differential efficiency of breast lesion properties.