Objective: To analyze the influencing factors for residual lesions after radiofrequency ablation in elderly patients with liver cancer. Methods: Clinical data of 65 elderly patients with liver cancer treated by radiofrequency ablation in our hospital from January 2014 to December 2016 were retrospectively analyzed.The influencing factors on residual lesions after radiofrequency ablation were analyzed by univariate analysis and multivariate logistic regression. Results: Of 102 lesions in 65 elderly patients with liver cancer, 87 lesions were completely ablated at the first time, and the first complete ablation rate of lesion was 85.29%(87/102). All visible lesions were completely ablated in 56 patients at the first time, and the first complete ablation rate of cases was 86.15%(56/65). Fifteen lesions in 9 patients were incompletely ablated.Univariate analysis showed that gender(χ²=0.740, P=0.390), cirrhosis(χ²=0.745, P=0.388), hepatitis B(χ²=0.057, P=0.812)and type of liver cancer(χ²=0.171, P=0.682)had no significant effect on the residual lesions after radiofrequency ablation, but the number of lesions(χ²=6.694, P=0.010), the lesion size(χ²=14.382, P=0.000)and liver function classification(χ²=5.359, P=0.030)had statistically significant effects on residual lesions after radiofrequency ablation.Further multivariate logistic regression analysis showed that the number of lesions ≥ 3(OR=1.916, 95%CI: 1.326~2.571, P=0.029), the size of lesions≥3 cm(OR=2.362, 95%CI: 2.180~2.923, P=0.000)were risk factors for residual lesions after radiofrequency ablation. Conclusions Radiofrequency ablation has a better therapeutic effect on liver cancer in elderly patients.The number and size of lesions have a certain impact on the residual lesions after radiofrequency ablation.

Objective To study the effect of enhanced MK gene expression in hepatic carcinoma cells.Methods The recombinant plasmid pIRES2-EGFP-MK was transfected into SMMC 7721 cells.The mRNA and protein expression levels of MK gene in these cells were determined by real-time PCR,Western blotting and flow cytometry.The intracellular DNR accumulation of these cells was measured by flow cytometry.To investigate the effect of MK gene mediated multidrug resistance,MTT assay was employed to determine the cellular sensitivity of different chemotherapeutic drugs in MK-overexpressed SMMC 7721 cells.Results The mRNA and protein expression levels of MK gene significantly increased after the recombinant plasmid pIRES2-EGFP-MK transfected into SMMC 7721 cells,suggesting that the recombinant plasmid pIRES2-EGFP-MK can enhance the transcription of MK effectively.The DNR accumulation of MK transfected cells decreased significantly (4.06 ± 0.88,P ＜ 0.05),and IC50 of MK transfected cells to ADM/5-FU increased significantly (15 ± 3,27 ± 4,P ＜ 0.05).Conclusions After the recombinant plasmid pIRES2-EGFP-MK transfected into hepatic carcinoma cells,expression of midkine increased,enhancing the resistance of hepatic carcinoma cells to chemotherapeutic drugs.

Objective To investigate the risk factors of laparoscopic cholecystectomy (LC) in patients with previous gastrectomy.Methods This retrospective study reviewed a database of patients who underwent LC at our hospital during the period of Jan 2010 and May 2015.Results Comparesd with those of no history of gastrectomy the average operation time in patients with previous gastrectomy was longer (t =15.608,P ＜ 0.05) the intraoperative blood loss was higher (t =3.061,P ＜ 0.05),and the operation time of patients with a long interval (＞ 5 years) between gastrectomy and LC was shorter (t =6.405,P ＜ 0.01).The conversion rate did not differ between the two groups (P ＞ 0.05),but the conversion rate significantly reduced after a comprehensive preoperative evaluation procedure (x2 =15.282,P ＜ 0.01).Conclusion LC for benign gallbladder diseases is safe,effective and feasible in patients with a history of gastrectomy,if a comprehensive preoperative evaluation is adopted and in experinced hands.

3D visualization technology is the process of transforming two-dimensional image data into three-dimensional model with the help of computer software. 3D printing technology is the process of building organ solid model through 3D printing mechanism on the basis of 3D visualization. With the development of interventional technology for structural heart disease, 3D visualization and 3D printing technology have played a positive role in the understanding of cardiac anatomy and the formulation of personalized surgical plans. This paper will discuss the construction of 3D visualization model, review and analyze the application of 3D printing technology in interventional therapy of structural heart disease in recent years, discuss the future development in this field, and briefly analyze its existing problems.

Objective    To investigate the feasibility and safety of transcatheter aortic valve replacement (TAVR) through apical approach for aortic regurgitation of large annulus. Methods    From November 2019 to May 2020, 10 male patients aged 64.50±4.20 years with aortic valve insufficiency (AI) underwent TAVR in the Department of Cardiovascular Surgery, Xijing Hospital. The surgical instruments were 29# J-valveTM modified and the patients underwent TAVR under angiography. The preoperative and postoperative cardiac function, valve regurgitation, complications and left ventricular remodeling were summarized by ultrasound and CT before and after TAVR. Results    A total of 10 valves were implanted in 10 patients. Among them, 1 patient was transferred to the aortic arch during the operation and was transferred to surgical aortic valve replacement; the other 9 patients were successfully implanted with J-valve, with 6 patients of cardiac function (NYHA) class Ⅱ, 4 patients of grade Ⅲ. And there was a significant difference between preoperation and postoperation in left ventricular ejection fraction (44.70%±8.78% vs. 39.80%±8.48%, P<0.05) or aortic regurgitation (1.75±0.72 mL vs. 16.51±8.71 mL, P<0.05). After 3 months, the patients' cardiac function was good. Conclusion    TAVR is safe and effective in the treatment of severe valvular disease with AI using J-valve.