Objective To evaluate the safety and therapeutic effect of covered expandable metallic stent placement combined with interventional chemotherapy in treating malignant esophago-tracheal fistulae. Methods A total of 60 patients with esophago-tracheal fistula were enrolled in this study. The patients were randomly divided into control group (n=28) and study group (n=32). Patients of the control group were treated with covered stent implantation only, while patients of the study group were treated with combination use of covered stent implantation and interventional chemotherapy. All the patients were followed up regularly, the short-term and long-term results were determined, and the effect rate, median survival time and complications were statistically analyzed. Results Among the 60 patients, successful obstruction of the fistula was obtained in 58 with a success rate of 96.7%. The median survival time of the 58 patients was 5.8 months. The median survival time of the control group and the study group was 3.6 months and 8.7 months respectively, the difference between the two groups was statistically significant (P<0.05). The one-month, 3-month and 6-month effect rates were 78.1%, 68.8% and 62.5% respectively. The incidence of esophageal stent re-stenosis in the study group was much lower than that in the control group. Conclusion The combination use of covered stent implantation and interventional chemotherapy can effectively improve the median survival time of patients with malignant esophago-tracheal fistula, and reduce the occurrence of stent-related complications. Therefore, covered expandable metallic stent placement combined with interventional chemotherapy is an effective and safe treatment for malignant esophago-tracheal fistulae.

Objective: To evaluate the feasibility and efficiency of a low dose imaging protocol on reducing X-ray dose level in pediatric supraventricular tachycardia (SVT) ablation procedure. Method: Data were collected from 103 patients who underwent catheter ablation for SVT in Children′s Hospital of Fudan University from January 2014 to October 2016 in terms of body weight, body surface area (BSA), SVT types, accessory pathway location, fluoroscopy time and the radiation dose (including AIR KERMA and dose area product) in a case observational study.The fluoroscopy protocols were operated at 36 nGy/frame and 10 frames/s (Standard group, n=47) from January 2014 to September 2015, 36 nGy/frame and 10 frames/s with removal of the grid (Grid-out group, n=24) from October 2015 to April 2016, as well as 23 nGy/frame and 4.0-7.5 frames/s without the grid (Grid-out plus low dose group, n=32) from May 2016 to October 2016, respectively.Comparisons among groups were performed by independent-sample t-test or one-way analysis of variance for normally distributed continuous variables, and χ² test for categorical variables. Result: The average body weight, BSA, fluoroscopy time and AIR KERMA of the three groups was (34±14) kg, (1.14±0.33) m^2, (11±8) minutes and (12.97±12.43) mGy, respectively.No significant differences in body weight (F=2.551), BSA (F=2.359), SVT types (χ²=6.15), and accessory pathway location (χ²=3.438) were observed among these three groups (P>0.05). Images acquired by low dose protocol could provide enough information for procedures, and no complication occurred.The acute success rates were 100% in all of these three groups, and there was no significant difference in mean fluoroscopy time (F=0.004, P>0.05) among them.However, the radiation dose (AIR KERMA) in the Grid-out plus low dose group was much lower than that in the Standard group ((7.54±7.31) mGy vs. (16.25±12.08) mGy, F=6.112, P<0.01)). Conclusion The new strategy of combination of low dose fluoroscopy protocol with removal of grid markedly reduced radiation exposure to children undergoing supraventricular tachycardia ablation while maintaining procedural efficacy and safety.

Stress cardiomyopathy (SC) is an acute cardiomyopathy caused by intense mental stimulation or physical stress. Currently, few interventions are effective in reducing mortality, improving prognosis, or preventing recurrence in acute or chronic stages of SC. Therefore, it is particularly important to establish a reliable and effective SC animal model to study the pathogenesis and prevention of SC. In this paper, the preparation methods and evaluation indexes of SC models at home and abroad were reviewed, including the operation details of catecholamine hormone injection method, binding method, binding combined with electroshock method, binding combined with dehydration method, vagus nerve electrical stimulation and other modeling methods, as well as evaluation indexes such as open field test, cardiac ultrasound, electrocardiogram and ELISA, striving to provide useful reference for model selection and establishment of SC research.

OBJECTIVE：To discuss the mechanism of synovitis of knee osteoarthritis （KOA）relieved by “Sanse powder ” volatile oil based on the activation of Nod-like receptor family 3（NLRP3）inflammasome. METHODS ：“Sanse powder ”volatile oil was extracted by distillation- condensation process and the components of it were analyzed by GC-MS. Fibroblast-like synovial cells（FLS）were extracted from the knee joint of male SD rats. The effects of 10，25，50，100，250，500，1 000 μg/mL“Sanse powder”volatile oil on the viability of FLS were examined by CCK-8 assay. KOA inflammatory cell model was induced by lipopolysaccharide for 12 h. The effects of 10，250 μg/mL“Sanse powder ”volatile oil on the protein and mRNA expression of NLRP3，caspase-1 and apoptosis-associated speck-like protein （ASC）were detected. The levels of IL- 1β and IL-18 in supernatants of FLS were determined . RESULTS ：Totally 0.51-0.61 g volatile oil with yellow clear and unique aromatic odor were extracted from“Sanse powder ”，and the extraction rate was 0.33％-0.41％（n＝9）. A total of 41 chemical components were isolated ，and 30 of them were identified and their peak area accounted for 90.073 6％ of the total peak area. The components with high relative content were gingerol flavonoids （17.573 9％），δ-junionene（15.434 5％），gingerol（11.509 5％），etc. When the concentration of volatile oil was 10-250 μg/mL，there was no significant effect on survival rate of FLS （P＞0.05）. Compared with blank group ，the relative protein and mRNA expression of NLRP 3，caspase-1 and ASC and the levels of IL- 1β and IL-18 in supernatant were significantly increased in model group （P＜0.05）. Compared with model group ，relative expression or levels of above indexes were all decreased significantly in FLS and supernatant of “Sanse powder ”volatile oil 10 and 250 μg/mL groups（P＜0.05）. CONCLUSIONS：“Sanse powder ”volatile oil can inhibit NLRP 3 inflammasome activation in FLS and reduce the downstream inflammatory cascade response ，thus exerting its efficacy in ameliorating synovial inflammation of KOA.