Objective To investigate the hemodynamic changes of the proper hepatic artery (PHA) in hepatocellular carcinoma (HCC) and portal stem vein tumor thrombus.Methods Sixty HCC and portal stem vein tumor thrombus patients were divided into partial occlusion group and completely occlusion group with 30 patients each.Eighty HCC patients without portal stem vein tumor thrumbus were in HCC group and 20 health cases were in control group.Color Doppler ultrasound was used to measure the diameter of PHA (PHA-D),systolic maximal velocity (Vmax) and resistant index (RI) of PHA.Results PHA-D in control group,HCC group,partial occlusion group and completely occlusion group was (0.33 ±0.05),(0.44 ±0.04),(0.45±0.04),(0.61±0.07)cm,Vmax was (31.32±9.31),(66.76±20.34),(68.16±21.96),( 132.65 ± 38.84 ) cm/s,RI was 0.75 ± 0.08,0.68 ± 0.13,0.65 ± 0.11,0.55 ± 0.10,respectively.The levels of PHA-D,Vmax and RI in HCC group,partial occlusion group and completely occlusion group had significant difference compared with those in control group (P ＜ 0.01 or ＜ 0.05 ).The levels of PHA-D,Vmax and RI in completely occlusion group had significant difference compared with those in HCC group,partial occlusion group(P＜ 0.01 ). Conclusions The blood flux obviously ascends compensatorily in HCC with portal stem vein tumor thrombus,RI obviously descends.But it is the occlusive nature of the tumor thrombus that is crucial to the hemodynamic change of the proper hepatic artery.

Objective To explore the prenatal sonographic diagnosis of congenital vascular rings.Methods Eight fetuses with congenital vascular rings diagnosed in Affiliated Hospital of Weifang Medical College from January 9,2010 to November 25,2012 were retrospectively analyzed.All cases underwent threevessel trachea view to observe the position of aortic arch,its branches and the ductus arteriosus.The sonographic features were summarized.Results The eight cases were diagnosed at 22 to 28 gestional weeks,with an average of (25±2) weeks.They were 21 to 35 years old,with an average of (28±5) years.Seven cases were diagnosed by cardiac ultrasonography,and one induction case was diagnosed by autopsy.Among the eight cases,there were seven of right aortic arch with vagus left subclavian artery and left ductus arteriosus,and one case was complicated with double aortic arch.The former seven cases showed U-shape vascular ring surrounding the trachea composed of right aortic arch,vagus left subclavian artery and left ductus arteriosus.The other side of this U-shape was the heart structure,showing a complete vascular ring.In the latter one case,the O-shape vascular ring was composed of left and right sides of the aortic arch.Conclusion The U-shape,or O-shape vascular ring in three-vessel trachea view is the typical sonographic features of congenital vascular ring.Cardiac ultrasound examination should be performed on those suspected cases.

Objective:To investigate the effects of educational level on smoking cessation in patients with moderate to severe tobacco dependence, explore effective individualized smoking cessation methods, and increase smoking cessation rate.Methods:A total of 480 patients with moderate to severe tobacco dependence who were willing to quit smoking and received treatment in the Department of Respiratory and Critical Care Medicine, Shengli Oilfield Central Hospital from January to December 2020 were included in this study. They were divided into four groups ( n = 120/group) according to their educational level: group A (elementary school and below), group B (junior high school and senior high school), group C (technical secondary school or college), and group D (university and above). All patients were randomly assigned to undergo "5A" intervention alone or "5A" intervention combined with varenicline intervention (combined intervention). Patients' awareness of the health risks of tobacco smoking was compared among the four groups. The smoking cessation rate measured at different time points was compared between different intervention strategies. Results:The scores of health risk of tobacco smoking in groups D, C, B, and A were (806.5 ± 35.7) points, (710.8 ± 26.2) points, (643.6 ± 43.4) points, and (512.4 ± 30.1) points, respectively. Patients with high education levels had high awareness of the health risk of tobacco smoking ( F = 1 543.26, P < 0.001). At 1, 3, and 6 months, the smoking cessation rate of combined intervention was higher than that of "5A" intervention alone in each group (group A: χ2 = 3.85, 4.23, 4.10, group B: χ2 = 4.30, 4.09, 4.60, group C: χ2 = 6.81, 4.30, 4.03, group D: χ2 = 6.71, 6.51, 4.73, all P < 0.05). The smoking cessation rate after 6 months of "5A" intervention alone or combined intervention in group D was 60.0% and 78.3% respectively, which were significantly higher than 41.7% and 60.0% in group C, 23.3% and 41.7% in group B, and 20.0% and 36.7% in group A ( χ2 = 26.59, 26.12, both P < 0.001). At different time points, the smoking cessation rates of the "5A" intervention alone in group D were significantly higher than those of combined intervention in groups A and B ( χ2 = 9.25, 25.04, 7.29, all P < 0.05). Conclusion:Awareness of the health risks of tobacco smoking is related to a patient's educational level, and affects smoking cessation. Individualized smoking cessation interventions based on a patient's educational level can increase the rate of smoking cessation.