Objective To evaluate the curative effect of percutaneous puncturing drainage in treating liver abscess,to analyze the factors affecting curative effect,and to discuss the methods ior reducing mortality and complication rate as well as for shortening hospitalization time.Methods Clinical data of 121 patients with liver abscess,who were admitted to authors' hospital during the period from January 2011 to January 2016,were retrospectively analyzed.For the patients with confirmed liver abscess,adequate antiinfective therapy was adopted,at the same time CT scan was performed to evaluate the liquefaction of lesion,and under CT guidance percutaneous puncturing drainage was carried out.The mortality,complication rate,hospitalization time and the factors affecting curative effect were analyzed.Results A total of 121 patients with liver abscess were enrolled in this study.Two patients died after percutaneous puncturing drainage,the mortality was 1.6％.The factors affecting mortality included old age,underlying disease,the diameter and solid components of abscess.Two patients developed peripheral hepatic abscess and abdominal wall abscess,the complication rate was 1.6％,and clinical cure was achieved after active treatment in these two patients.The main factor affecting complication rate was inappropriate surgical manipulation.Clinical cure was achieved in all 119 patients,with a cure rate of 98.3％,and the average hospitalization time was (15.1±6.0)days.The risk factors that affected hospitalization time included the number of abscess X6 (r=0.232,P=0.021),abscess size X7 (r=0.26,P=0.005) and white blood cell count X8 (r=0.238,P=0.009).Multiple linear regression equation analysis indicated that statistically significant correlation existed between the above influence factors and hospitalization time (P＜0.05).The multiple regression equation was as follows:Y=-3.438+3.055X6+0.527X7+0.297X8,F=5.819,R2=0.416.No statistically significant correlation existed between the hospitalization time and other factors,including gender,age,diabetes mellitus,pathogenic bacteria and location of abscess (P＞0.05).Conclusion Percutaneous puncturing drainage is an effective treatment for liver abscess,it carries lower mortality and lower complication rate,and its hospitalization time is short.(J Intervent Radiol,2017,

Objective:This study was to analyze the changes of CD4~+ T lymphocytes and their subtypes,Th1 and Th2 cells,in the peripheral blood of patients with pulmonary tuberculosis disease and to investigate their clinical significance in the pathologic process of pulmonary tuberculosis.Methods:For polarization measurement of T-helper cells,1∶100 diluted Ionomycin and 1∶10 diluted Monensin were added in sequence into the equivalent volume mixture of heparin anti-coagulated whole blood and RPMI-1640 culture liquid.After being well mixed,the mixture was incubated at 5% CO_2,37℃ for 4 hours or overnight.To 100 μl of the mixture and in sequence,the antibodies of CD3-PerCP,CD8-APC,mIgG1-FITC,Rat IgG1-PE,IL-4-PE or IFN-γ-FITC were added.The stained CD4~+ IL-4~+ (Th2) and CD4~+ IFN-γ~+ (Th1) were analyzed by flow cytometry.Results:Compared with those from healthy controls,the peripheral blood of pulmonary tuberculosis patients contained significantly fewer Th1 (P＜0.01) but significantly more Th2 cells (P＜0.05).Th1 cells in the peripheral blood of the patients with miliary pulmonary tuberculosis were obviously fewer (P＜0.05) than in infiltrative pulmonary tuberculosis patients.The amount of Th2 cells in the peripheral blood of the patients with miliary pulmonary tuberculosis was significantly more (P＜0.05) than in either infiltrative pulmonary tuberculosis or tuberculous pleurisy patients.The ratio of CD4~+/CD3~+ tended to decrease in all these patients,and it was much lower (P＜0.05) in the patients of miliary pulmonary tuberculosis than in infiltrative pulmonary tuberculosis patients.Patients suffering from both pulmonary tuberculosis and diabetes had significantly lower levels of Th1 cells and CD4~+/CD3~+ (P＜0.05) and more Th2 cells,compared with those of pulmonary tuberculosis patients without diabetes.Levels of Th1 and Th2 cells restored significantly (P＜0.05) in 15 severe pulmonary tuberculosis patients after receiving tuberculosis chemotherapy and microcalorie theropy for three months.Patients with positive sputum examination tended to have decreased Th1 and CD4~+/CD3~+ (P＞0.05) and significantly increased Th2 (P＜0.05).Conclusion:Immunosuppression existed,in different extents,in patients of infiltrative pulmonary tuberculosis,tuberculous pleurisy,miliary pulmonary tuberculosis as well as patients with both pulmonary tuberculosis and diabetes.Analysis of Th1,Th2 and CD4~+/CD3~+ may be benefit for the judgments of disease conditions and therapeutic effects.

ObjectiveTo explore the risk factors for upper gastrointestinal bleeding after craniocerebral trauma.MethodsTo retrospectively summarize the clinical features of 80 cases with craniocerebral truma and to analyze the risk factors for upper gastrointestinal bleeding.Results Upper gastrointestinal bleeding was present in 39 of the 80 cases(48.8％) .Twenty-one of the 39 cases with gastrointestinal bleeding died(53.8％)In the patients without gastrointestinal bleeding, 5 cases died (19.2％) .Among the factors affecting the gastrointestinal bleeding after craniocerebral trauma, Glasgow Coma Scale(GCS) score, septicemia, decerebration,hypotention, metabolic acidosis and hyperglucose were closely related risk factors(x2 = 13.96;x2 = 27.43;x2 =46.28 ;x2 = 27.33 ;x2 = 11.88 ;x2 =5.71 ,P ＜0.05 or P ＜0.01).ConclusionProphylaxis against related risk factors could reduce the incidence of gastrointestinal bleeding, improve the prognosis and decrease the mortality of craniocerebral trauma.

Objective To investigate the short term effect of licartin transarterial infusion in combination with chemoembolization (LTACE) and compare its effect with conventional transcatheter arterial chemoembolization (TACE) for advanced hepatocellular carcinoma (HCC).Methods Seventy-two cases of advanced HCC were included in this analysis.There were 50 males and 22 females with the average age of (58±12) yrs (range 34-86 yrs).Twenty-nine patients received LTACE treatment while the other forty three patients received conventional TACE treatment.Before intervention,there was no variation (P>0.05) in gender (X2 =0.202),Child-Pugh grading for hepatic function (X2=2.428),as well as in white blood cell count (t=1.101)and platelet count (t =0.080) between the two groups except for age and portal vein thrombosis.For LTACE group,30 minutes after the infusion of licartin (27.75 MBq/kg) into proper hepatic artery,an emulsion of 40 rag pharmorubicin and 30 ml uhrafluid lipidol was infused until hemostasis within target artery.For TACE group,only an emulsion of 40 nag pharmorubicin and 30ml uhrafluid lipidol was infused until hemostasis within target artery.Following these interventions,the two groups were given the same treatment to stabilize hepatic function and relief embolization-relating symptoms; Patients' follow-up included clinical symptoms and signs,hepatic and renal function,peripheral blood test,CT and radionuclide study(ECT).All data were analyzed with SPSS 11.5.Measurement data were expressed with mean and processed by t test; numeration data were processed by Chi square test and Fisher precise test; Kaplan-Meier analysis and log-rank test were applied for comparing the survival rate of the two groups.P <0.05 means the exist of a statistic variation.Results After treatment,there was no variation of Albumin,GPT,serum bilirubin,white blood cell,platelet and serum creatinine level between the two groups [t=0.250,0.907,0.629,0.005,0.250,0.453 (7 days) and 0.978,1.250,1.942,0.733,0.315,1.243 (14 days); P >0.05].ECT imaging demonstrated a 55.17% (16/29) uptake ratio of licartin within tumor areas by the time of 7-days follow-up study.The lesions in both LTACE and TACE groups exhibited a decrease in their size and statistically significant difference was demonstrated before and after treatment in either group( t=7.207,8.006,P <0.01).But between the two groups,the tumor size reduction showed no statistical difference,the tumor size in LTACE and TACE groups were( 1.68±0.32),(1.74±0.31)respectively (t =0.786,P>0.05)before treatment and(1.52±0.38),(1.61±0.36) respectively(t=0.891,P>0.05) after treatment.There was no variation between the two groups comparing the 6 months cumulative survival rate(LTACE 52%,TACE 76%,log-rank test,X2=3.080,P >0.05).Conclusion There was no statistically significant differences between LTACE and TACE groups concerning the short term effect and adverse reaction for treatment of advanced HCC.The long term outcomes should be established on the basis of a large-sample,multiconter,randomized trail.

Objective To observe the effects of inverse ratio ventilation on respiratory mechanics and postoperative pulmonary com-plications in morbidly obese patients during laparoscopic sleeve gastrectomy Methods A total of 62 morbidly obese patients for a laparo-scopic sleeve gastrectomy were scheduled(18-65 years old,BMI≥35kg/m2 in combination with diabetes,hypertension,hyperlipemia,and other metabolic diseases,or BMI≥40kg/m2,ASA Ⅱ or Ⅲ).Patients were randomly assigned to two groups:inverse ratio ventilation group(IRV)and control group(PVG).Two groups were adjusted with an actual tidal volume(VT)of 7-8ml/kg,and respiratory rates of 12 breaths/min.In the IRV group,the ratio of I∶E was 2∶1;in the control group,the ratio of I∶E was 1∶2.We recorded the indexes of respiratory mechanics and the blood gas at the baseline(T0),5min after anesthesia(T,),15min after pneumoperitoneum(T2),30min after pneumoperitoneum(T3),60min after pneumoperitoneum(T4)and the end of surgery(T5),and the occurrence of pulmonary com-plications on day 1,day 2 after operation was observed,and the cumulative incidence of PPCs at 7 days was counted.Results Compared to the control group,the dynamic lung compliance(Cdyn),mean airway pressure(Pmean),positive end expiratory pressure(PEEP),and the PaO2 at T,-T5 of the inverse ventilation group were increased significantly(P＜0.05),the Ppeak、Pplat at T2-T5 and dynamic lung compliance(VD/VT)at T3-T5 were decreased significantly(P＜0.05),and no difference in the PaCO2 and PETCO2 in the two groups.Grade 1 pulmonary complications occurred in both groups,and there was no difference in the total occurrence of pulmonary com-plications at 7 days.Conclusion Inverse ventilation effectively may improve respiratory mechanics and oxygenation in morbidly obese pa-tients undergoing laparoscopic sleeve gastrectomy.

Objective To explore the association between dyslipidemia and the level of 8-OHdG/Cr in urine among a population exposed to chronic arsenic.Methods Four hundred and seven subjects were randomly selected in an arsenic-affected area in Inner Mongolia.After blood biochemical examination,all the subjects were divided into 4 groups based on the results of total cholesterol (TC),triglycerides (TG),high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C).The groups consisted of hypercholesterolemia,HDL-C ratio anomaly,combined hypercholesterolemia and HDL-C ratio anomaly,as well as a normal lipid group.Urine samples were collected and 8-OHdG/Cr was measured using the ELISA method.A generalized linear mixed model was used to analyze the association between dyslipidemia and 8-OHdG/Cr.Results The levels of 8-OHdG/Cr as 55.73 (39.90-79.94) ng/mg,58.08 (44.94-69.91) ng/mg,65.28 (49.29-92.95) ng/mg and 51.43 (36.86-68.57)ng/mgin the HDL-C ratio anomaly,hypercholesterolemia,combined hypercholesterolemia and HDL-C ratio anomaly groups and the control group,respectively,which showed significant differences on the levels of 8-OHdG/Cr in the four groups (P=0.006).From the linear regression analysis results showed that the 8-OHdG/Cr level incombined hypercholesterolemia and HDL-C ratio anomaly group was higher (4.25 ± 0.55 ng/mg) than in the control group (3.96 ± 0.55 ng/mg) (P=0.018).After adjusting for important covariates,there was a linear trend between the levels of 8-OHdG/Cr and dyslipidemia (P=0.016).Conclusion Data from our study showed a linear relation between hypercholesterolemia,HDL-C ratio anomaly and the 8-OHdG/Cr level,suggesting that dyslipidemia was associated with oxidative DNA damage among those arsenic-affected people.

Objective To investigate the effect of dexmedetomidine combined with esketamine on the quality of postoperative recovery in patients undergoing laparoscopic gastric volume reduction surgery.Methods A total of 136 patients undergoing laparoscopic gastric volume reduction surgery,including 41 males and 95 females,aged 18-64 years,BMI 30-45 kg/m2,ASA physical status Ⅱ or Ⅲ,were random-ly divided into four groups:dexmedetomidine combined with esketamine group(group DE),esketamine group(group E),dexmedetomidine group(group D),and control group(group C),34 patients in each group.In groups DE and D,a loading dose of dexmedetomidine 0.5 μg/kg was infused intravenously over 10 minutes before induction,followed by a continuous infusion of 0.4 μg·kg-1·h-1 until 40 minutes before the end of surgery.In groups DE and E,a loading dose of esketamine 0.5 mg/kg was injected intra-venously at induction,followed by a continuous infusion of 0.1 mg·kg-1·h-1 until 40 minutes before the end of surgery.Equal volumes of normal saline were given to group C at the same time points.The 40-item quality of recovery scores(QoR-40)24 hours before surgery and 24 hours after surgery were recorded.The dosage of intraoperative propofol and remifentanil,the dosage of dezocine within 24 hours after surgery,ex-tubation time after surgery,the time of first getting out of bed and the time of first anal exhaust after surgery were recorded.The resting visual analogue scale(VAS)pain scores were recorded at the moment of extuba-tion,2,6,12,and 24 hours after surgery.The occurrence of postoperative adverse reactions such as nausea and vomiting,agitation,hypoxemia,and pneumonia were recorded.Results Compared with group C,the QoR-40 scores in groups DE,E,and D were significantly increased 24 hours after surgery(P<0.05),the dosage of intraoperative propofol and remifentanil,the dosage of dezocine within 24 hours after surgery were significantly reduced,the time of first getting out of bed and the time of first anal exhaust after surgery were significantly shortened in group DE(P<0.05),the resting VAS pain scores at the moment of extubation,2,6,and 12 hours after surgery were significantly decreased in groups DE and E(P<0.05),the resting VAS pain scores at the moment of extubation and 2 hours after surgery were significantly decreased in group D(P<0.05).Compared with group D,the QoR-40 scores were significantly increased 24 hours after sur-gery,the dosage of intraoperative propofol was significantly reduced,and the resting VAS pain scores 2,6,and 12 hours after surgery were significantly decreased in group DE(P<0.05).Compared with group E,the QoR-40 scores were significantly increased 24 hours after surgery,the dosage of intraoperative propofol was significantly reduced,and the resting VAS pain scores 2,6 hours after surgery were significantly de-creased in group DE(P<0.05).There were no statistically differences in resting VAS pain scores 24 hours after surgery,and the occurrence of postoperative adverse reactions among the four groups.Conclusion Dexmedetomidine combined with esketamine relieves postoperative pain,enhances the quality of postoper-ative recovery,and promotes rapid rehabilitation in patients undergoing laparoscopic gastric volume reduction surgery.