ObjectiveTo investigate imaging features of the liver, portal vein and hepatic vein or transhepatic inferior venacava in patients with severe liver cirrhosisin multidetector row computed tomography ( MDCT), and assess the feasibility, safety and clinical significance of percutaneous transhepatic intrahepatic portosystemic shunt (PTIPS). MethodsFifty patients with severe liver cirrhosis confirmed by clinical data and imaging examination were enrolled in this study. Simulation of intrahepatic portosystemic shunt by percutaneous transhepatic approch is as follows. The right midaxillary line (the eighth or ninth intercostal space) was selected as puncture point A the right branch of portal vein was puncture point B,transhepatic inferior vena cava was puncture point C, and the distal part of right portal vein was D. A-B-C connection is simulated as percutaneous transhepatic puncture tract, C-B-D connection is simulated as portosystemic shunt tract.After tri-phase contrast-enhanced CT scanning, postprocessing images through multiple planner reconstruction ( MPR ) were obtained. The data were indicated statistically by x ± s. And 95％ confidence interval for mean was calculated.Anatomic relationship among the right portal vein,transhepatic inferior vena cava, hepatic artery and bile duct were analyzed for all patients. ResultsThe length of the needle (A-B-C) is ( 145. 7 ± 14. 8 ) mm. The curvature of the needle ( the angle of A-B line and B-C line) is ( 145.0 ±9.9)°. The length of transhepatic shunt tract (B-C) is (42.7 ±7.2) mm. The length of the shunt tract (C-B-D) is ( 117. 7 ±11.6 ) mm; The angle of the shunt tract ( the angle of B-C line and B-D line) is (1O8.5 ± 5.9)°. In 24/50 patients, transhepatic inferior vena cava locate in the dorsal of the right portal vein, in 26/50 patients they are in the same plane.In all patients, the right branches of hepatic artery and bile duct locate in the ventral of the right portal vein.Conclusion The procedure of PTIPS is feasible and safe. To quantify the length and angle of the needle and the length and angle of the shunt tract provides the anatomic basis for clinical application.

Objective:To investigate the effect of serum lipid level on prognosis of patients with small cell lung cancer (SCLC) at the initial treatment.Methods:The clinical data of patients with SCLC from 2012 to 2017 in our hospital were retrospectively analyzed. According to the standard of appropriate level and abnormal stratification of blood lipid in Chinese population, the lipids included total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDLC) and low-density lipoprotein cholesterol (LDLC) at the time of initial treatment were grouped. Then the relationship between different lipid levels and clinicopathological characteristics was analyzed. Finally, Cox proportional hazard model was used to analyze the independent prognostic factors of patients.Results:A total of 129 patients with SCLC were included in this study. At the time of initial treatment, there were 90 (69.8%) cases whose TC < 5.2 mmol/L, while 39 (30.2%) cases ≥5.2 mmol/L; 95 (73.6%) cases whose TG <1.7 mmol/L, while 34 (26.4%) cases ≥1.7 mmol/L; 27 (20.9%) cases whose HDLC <1.0 mmol/L while 102 cases (79.1%) ≥1.0 mmol/L; 90 (69.8%) cases whose LDLC <3.4 mmol/L while 39 cases (30.2%) ≥3.4 mmol/L. The patients′ triglyceride initial treatment was associated with their body mass index ( P<0.05). The median disease-free survival (PFS) of SCLC patients was related with their serum TC level and clinical stage ( P<0.05) and the overall survival (OS) was related with clinical stage of SCLC patients ( P<0.05). The median PFS of SCLC patients in the TC <1.7 mmol/L group at the initial treatment was 10.5 months, significantly longer than 8.8 months of the TC ≥1.7 mmol/L group ( P=0.024). The median OS of SCLC patients in the TG <1.7 mmol/L group at the initial treatment was 20.2 months, marginally longer than 15.6 months of the TG ≥1.7 mmol/L group ( P=0.097). Multivariate analysis result showed that, the TG level was an independent risk factor of SCLC progression at the time of initial treatment ( P=0.024). There was no significant correlation of TC, HDLC, LDLC and SCLC prognosis ( P>0.05). Conclusion:TG level is an independent risk factor for the progression of SCLC at the time of initial treatment, and the increase of TG level indicates rapid disease progression and poor prognosis.

Objective:To investigate the effect of serum lipid level on prognosis of patients with small cell lung cancer (SCLC) at the initial treatment.Methods:The clinical data of patients with SCLC from 2012 to 2017 in our hospital were retrospectively analyzed. According to the standard of appropriate level and abnormal stratification of blood lipid in Chinese population, the lipids included total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDLC) and low-density lipoprotein cholesterol (LDLC) at the time of initial treatment were grouped. Then the relationship between different lipid levels and clinicopathological characteristics was analyzed. Finally, Cox proportional hazard model was used to analyze the independent prognostic factors of patients.Results:A total of 129 patients with SCLC were included in this study. At the time of initial treatment, there were 90 (69.8%) cases whose TC < 5.2 mmol/L, while 39 (30.2%) cases ≥5.2 mmol/L; 95 (73.6%) cases whose TG <1.7 mmol/L, while 34 (26.4%) cases ≥1.7 mmol/L; 27 (20.9%) cases whose HDLC <1.0 mmol/L while 102 cases (79.1%) ≥1.0 mmol/L; 90 (69.8%) cases whose LDLC <3.4 mmol/L while 39 cases (30.2%) ≥3.4 mmol/L. The patients′ triglyceride initial treatment was associated with their body mass index ( P<0.05). The median disease-free survival (PFS) of SCLC patients was related with their serum TC level and clinical stage ( P<0.05) and the overall survival (OS) was related with clinical stage of SCLC patients ( P<0.05). The median PFS of SCLC patients in the TC <1.7 mmol/L group at the initial treatment was 10.5 months, significantly longer than 8.8 months of the TC ≥1.7 mmol/L group ( P=0.024). The median OS of SCLC patients in the TG <1.7 mmol/L group at the initial treatment was 20.2 months, marginally longer than 15.6 months of the TG ≥1.7 mmol/L group ( P=0.097). Multivariate analysis result showed that, the TG level was an independent risk factor of SCLC progression at the time of initial treatment ( P=0.024). There was no significant correlation of TC, HDLC, LDLC and SCLC prognosis ( P>0.05). Conclusion:TG level is an independent risk factor for the progression of SCLC at the time of initial treatment, and the increase of TG level indicates rapid disease progression and poor prognosis.