Objective:To observe the complications caused by radiofrequency ablation (RFA) after RFA via the lumen of bile duct in hilum hepatis and the pathological progress of the tissue in ablation zones. Methods: Fourteen healthy dogs were randomly divided into 2 groups with 7 dogs each group. RFA by inserting a 13 mm non-insulated mono-electrode into the lumen of bile duct was performed under general anesthesia on 10 W power output, 4 min ablation duration in group Ⅰand on 5 W power output, 8 min ablation duration in group Ⅱ. After RFA, 2 dogs were sacrificed in 3 days and 1 dog in 9 days and 4 dogs in 14 days respectively in each group. The complications concerning RFA such as bile leakage, cholelithiasis, hepatic artery thrombosis, portal vein thrombosis, hepatic vein thrombosis1 and vena cava thrombosis were observed. Results: Portal vein thrombosis, hepatic vein thrombosis and vena cava thrombosis occurred in one dog. Cholelithisis occurred in one dos. No hepatic artery thrombosis occurred in all dogs. No bile leakage caused by RFA occurred in all dogs. Obvious necrosis of the mucosal and submucosal layers of the wall of bile duct and hepatic tissue in coagulation zones occurred in 3 days after RFA. The infiltration of inflammatory cells and partial fibrosis of the mucosal and submucosal layers of bile duct and hepatic tissue occurred in 9 days after RFA. Obvious fibrosis of the wall of bile duct and hepatic tissue occurred in 14 days after RFA. Conclusions: The complications caused by RFA occur seldom after RFA via the lumen of bile duct. The necrosis, the infiltration of inflammatory cells and gradual fibrosis of the mucosal and submucosal layers of bile duct and hepatic tissue occur in ablation zone.

Objective To provide a dimension calculating method of metacarpal and phalange bones with individual character for surgery and prosthesis design.Methods 102 X-ray films of pairs of healthy adult hands(52 male and 50 female) were measured and a mathematical relation model were described.Another 30 hands were put in a practice for further research.All of the data were analyzed by SPSS software.Results It was found that 98.98% items were positive correlation and their correlations were significant(r=0.157 ~0.925,P

Objective To observe the clinical effects on prevention of alveolar bone absorption by site preservation after tooth extraction due to periodontitis.Methods The experimental group consisted of 40 patients with 45 extracted teeth due to periodontitis.The fresh sockets were immediately grafted and filled with Bio-oss collagen and Bio-Gide after minimally invasive tooth extraction,while 40 teeth of control group were only treated with cotton balls bitten tightly over the socket for half an hour.Two groups were observed for changes in alveolar bone density by X-ray and cone beam CT (CBCT)after 6 months.Results There were the wound healing and no infection in extraction site of all patients with or without site preservation operation.The gingiva of extraction site was pink and tough in all groups.The alveolar bone loss in regular extraction patients significantly increased in horizontal and vertical aspects by X-ray and CBCT,while site preservation improved the alveolar bone defects (P<0.05).After site preservation for 6 months,CBCT analysis showed that the density of new alveolar bone markedly enhanced compared with regular extraction group.Conclusion The technique of site preservation after tooth extraction due to periodontitis is a method which can prevent and reduce disuse atrophy absorption of the alveolar ridge so that the height and width of the alveolar bone can meet aesthetic requirements.

ABSTRACT:Objective To investigate the effects of berberine on matrix metalloproteinases/tissue inhibitors of matrix metalloproteinases (MMPs/TIMPs) in rat periodontitis .Methods Adult male Sprague‐Dawley rats were subjected to thread ligation and porphyromonas gingivalis ( P . gingivalis ) inoculation resulting in periodontitis . Berberine [150 mg/(kg · d)] or vehicle was administered by oral gavage for 4 weeks .Alveolar bone loss and soft‐tissue destruction were determined by micro‐computed tomography (μ‐CT) and HE staining .The contents of tumor necrosis factor‐α(TNF‐α) and interleukin‐1β(IL‐1β) of gingival tissue were examined by ELISA .The expressions of MMP‐2 ,MMP‐9 and TIMP‐2 as well as the phosphorylation of P38 MAPK and NF‐κB were determined by Western blot .Results Significant increases were observed in alveolar bone loss and periodontal soft‐tissue destruction with higher levels of TNF‐α, IL‐1β and MMP‐2/9 expressions and the activities of P38 MAPK and NF‐κB in the experiment periodontitis group .Berberine of [150 mg/(kg · d)] not only improved the periodontal tissue and decreased alveolar bone loss ,but also reduced the contents of TNF‐α,IL‐1βand MMP‐2/9 and increased TIMP‐2 .In addition ,berberine inhibited the phosphorylation of P38 MAPK/NF‐κB .Conclusion Berberine protects against periodontal tissue damage via decreasing MMP‐2 and MMP‐9 expressions but increasing TIMP‐2 expression , which may be induced by inhibition of P38 MAPK/NF‐κB and the anti‐inflammatory effect on rat periodontitis .

Objective To evaluate the immune reconstitution of HIV-1 infected individuals after long-term highly antiretroviral therapy (HAART). Methods Twenty-five HIV-1 infected individuals receiving HAART, 17 without HAART and 15 healthy controls were included in the study. CD4 +T, CD8 +T,CD8/human leukocyte antigen DR (HLADR) + T, CD8/CD38 +T cells, and the expression of CD127 on CD3 +T cells from peripheral blood samples were measured by flow cytometry. IL-7 in peripheral blood was measured by enzyme-linked immunosorbort assay (ELISA) in HAART group. t test was performed to compare the measurement data among the groups. Results Before HAART, the count of CD4 + T cells in HIV-1 infected group was lower than that of the healthy control (t =9. 12, P ＜0. 01 ), while the counts of CD8 + T,CD8/HLADR+T, and CD8/CD38 +T cells were higher than those of the healthy control (t = 4.48, 4.89 and 3.88, P＜0. 01 ). Ater 7 years' antiviral therapy, CD4 +T cells increased, CD8 +T cells decreased, but both of them didn' t reach to the normal levels ( t = 2.66 and 2.43, P ＜ 0.05 ). While the counts of CD8/HLADR+T cells and CD8/CD38 +T cells almost reached to the normal levels (t = 0. 86 and 1.39, P ＞0.05). Before HAART, the concentration of IL-7 in HIV-1 infected group was higher than that in healthy controls (t =5.31, P ＜0.01 ). It decreased with HAART, but was still higher than the normal level (t =2. 81, P ＜ 0. 05 ). The expression of CD127 on CD3 + CD8 + T cells in non-HAART group was significantly lower than that in healthy control ( t =- 6.01, P ＜ 0.01 ), while that in HAART group was higher ( t = 2.32,P ＜0.05), but still not reached to the normal level ( t = 4.49, P ＜ 0. 05 ). CD127 expression on ( CD45RA + ) CD3 + CD8 + T cells almost increased to the normal level ( t= 0. 28, P ＞ 0. 05 ), while that on ( CD45RO + ) CD3 + CD8 + T cells was still remarkably lower than the normal ( t = 4. 86, P ＜ 0. 05 ). Conclusion Long-term HAART can partially restore the count and function of lymphocyte subsets in HIV-1 infected individuals, and the abnormal immune activation can be inhibited.

Objective To investigate the influence of diameter of liver outflow vein on portal hypertension and artificial blood vessel (ABV) patency rate in Budd-Chiari syndrome (BCS) patients undergoing atrial caval shunting (ACS).Methods We recruited 209 patients,who had undergone ACS for Ⅱ type of BCS.Those patients with unobstructed liver outflow vein were included into group A and the patients with stenosed liver outflow vein into group B.Free portal pressure (FPP) was measured before and after ABV opening.Portal vein velocity (Vpv),liver function,spleen volume and function,esophagogastric varices and ABV patency were evaluated postoperatively.Results After ABV opening,FPP decreased significantly in group A than group B (t =10.45,P ＜ 0.05).Vpv accelerated significantly in group A 2 weeks after operation than group B (t =12.81,P ＜ 0.05).Apparent improvement of liver function,spleen function and esophagogastric varices and reduction of spleen volume were observed in group A patients than group B patients (P ＜ 0.05).Reduction of esophagogastric varices in group A was better than in group B (x2 =44.73,P ＜ 0.05).By postoperative follow up,ABV patency of group A was higher than group B (P ＜ 0.05).Conclusions Patency status of liver outflow vein significantly influences postoperative portal vein pressure and closely correlats to ABV patency rate after ACS.

Objective To investigate the change of inferior vena cava pressure (IVCP) in type Ⅱ Budd-Chiari syndrome patients undergoing atrial caval shunting and its relationship with postoperative artificial blood vessel (ABV) patency rate.Methods We recruited 209 patients who had undergone atrial caval shunting for type Ⅱ Budd-Chiari syndrome and evaluated IVCP,right atrial pressure (RAP) and free portal vein pressure (PFP) before and after ABV opening.Presure changes were compared by t-test.These patients were followed up by color Doppler ultrasonograthy for ABV patency.The correlation between IVCP and postoperative ABV patency were analyzed By Kaplan-Meier test.Results IVCP (t =0.56,P ＜ 0.05)and PFP (t =0.72,P ＜ 0.05) decreased and RAP increased significantly after ABV opening (t =0.52,P ＜ 0.05).Follow up result showed that ABV patency rate was lower in patients with IVCP descent ＜ 1 kPa than those with IVCP descent ＞ 1 kPa (P ＜ 0.05).Conclusions Significant IVCP descent correlates with high ABV patency rate after atrial caval shunting in type Ⅱ Budd-Chiari syndrome patients.

Objective: To categorize and summarize the clinical and mechanism studies of the past 30 years on the treatment of Hashimoto’s thyroiditis (HT) with moxibustion, moxibustion plus medication, and acupuncture plus medication, etc., and to analyze the current problems. Methods: The clinical and laboratory studies related to the treatment of HT with acupuncture-moxibustion therapies published before June 2015 were retrieved from MEDLINE, Excerpta Medica Database (EMBASE), China National Knowledge Infrastructure (CNKI), Wanfang Academic Journal Full-text Database (Wanfang) and Chongqing VIP Database (CQVIP). Results:Moxibustion, moxibustion plus medication, and acupuncture plus medication can produce certain therapeutic effects in treating HT. Conclusion:The research on the treatment of HT with acupuncture-moxibustion therapies is rather limited in the amount and content. In the future, standardization should be fortified, specific moxibustion research needs deepening, and the action mechanism of moxibustion should be emphasized.

Objective To investigate the effects and adverse reactions of apatinib in advanced gastric cancer patients.Methods Two hundred and forty cases of advanced gastric cancer patients who had failed chemotherapy were collected from January 30,2016 to November 1,2017 in the First Hospital of Zibo City of Shandong Province and the Central Hospital of Zibo City of Shandong Province.All patients took oral apatinib mesylate,850 mg/time,1 time/d,and 28 d as 1 cycle of treatment,during which clinical efficacy,adverse reaction and progression free survival (PFS) and overall survival period (OS) were evaluated.Adopting Cox regression model to analyze risk factors of PFS and OS.Results Of all 240 patients,no patient reached complete response (CR) standard,25 patients (10.4％) reached partial response (PR) standard,113 patients (47.1％) reached stable disease (SD) standard,and 102 patients (42.5％) reached progressive disease (PD) standard.Objective response rate (ORR) and disease control rate (DCR) were 10.4％ (25/240) and 57.5％ (138/240) respectively.When apatinib was taken as a 2nd line treatment,ORR and DCR were 62.5％ (5/8) and 75.0％ (6/8) respectively;as 3rd line treatment,the result came to 13.9％ (20/144) and 67.4％ (97/144);as 4th line treatment,it was 0 and 52.4％ (33/63);as 5th line treatment,it was 0 and 8.0％ (2/25).Among the various adverse effects of apatinib,the most common ones observed were skin lesion (65.8％,158/240),fatigue (57.9％,139/240),gastrointestinal reaction (45.4％,109/240),and hypertension (38.8％,93/240).Cox multivariate analysis showed that the change of treatment time (HR =5.028,95％CI:1.130-15.771,P =0.005) and body mass index (HR =21.069,95％CI:4.521-127.116,P ＜ 0.001) were the independent risk factors of PFS.BMI change (HR =6.550,95％ CI:1.080-38.455,P =0.039) was independent risk factor of OS.Conclusion For patients with advanced gastric cancer who failed with 2nd line and above chemotherapy,oral atatinib still obtain certain DCR and survival gain.Apatinib adverse reactions are various,involving a wide range of organ systems,however are generally controllable.

Objective:To establish the risk prediction models for postoperative delirium (POD) in elderly patients undergoing non-cardiac surgery and to evaluate the predictive efficacy.Methods:A total of 685 patients of both sexes, aged 65-90 yr, of American Society of Anesthesiologists (ASA) physical status Ⅰ-Ⅳ, who underwent non-cardiac elective surgery requiring tracheal intubation during general anesthesia in general surgery, orthopedics, urology, hepatobiliary and pancreatic surgery in our hospital from January 2020 to December 2020, were selected.Patients were assigned to the training set and validation set at a ratio of 7∶3 using a simple random sampling method.The clinical data of patients in the perioperative period were collected, and the patients were followed up within 1-7 days after operation (or before discharge), and the occurrence of POD was recorded.Univariate and multivariate logistic regression analysis was used to identify the independent risk factors for POD.The risk prediction model for POD was established based on the results of multivariate logistic regression analysis of the training set, a nomogram and receiver operating characteristic (ROC) curve were drawn, and the area under the curve (AUC) was calculated.The validation set was used to verify the prediction model and assess the efficacy of the risk prediction model for POD.Results:A total of 653 patients were enrolled in this study, 139 patients developed POD, and the incidence was 21.3%.The results of multivariate logistic regression analysis showed that advanced age, high ASA physical status classification, low preoperative Mini-Mental State Examination score, complication with diabetes mellitus, low years of education, high preoperative Pittsburgh Sleep Quality Index scale score, long anesthesia time and high numerical rating scale score after operation were independent risk factors for POD in elderly patients undergoing non-cardiac surgery.The risk prediction model for POD was established based on the independent risk factors mentioned above.The AUC of the training set was 0.981, the Youden index was 0.881, the sensitivity was 95.95%, and the specificity was 92.92%; the AUC of the validation set was 0.939, the Youden index was 0.795, the sensitivity was 94.44%, and the specificity was 85.09%.Conclusion:The risk prediction model for POD established based on age, ASA physical status classification, history of diabetes melittus, years of education, preoperative Mini-Mental State Examination score, preoperative Pittsburgh sleep quality index scale score, anesthesia time and postoperative numerical rating scale score has good predictive efficacy in elderly patients undergoing non-cardiac surgery.