Objective To investigate effect of arterial embolization therapy in the mid-late pancreatic head carcinoma.Methods 13 cases with pancreatic head carcinoma were treated with superselective intra-arterial infusion of gemcitabine by superior pancreaticoduodenal artery followed by arterial embolization using sodium-iodinated oil and 200 mg gemcitabine.Clinical therapeutic effectiveness was evaluated by CT 4 weeks after treatment.Results The clinical symptoms of all patients had obvious improvement and the tumor's size was reduced.Conclusion The therapy of arterial embolization has good clinical effect for pancreatic head carcinoma,and it is one of the most effective therapy at present.

Purpose: To evaluate the diagnostic utility of detection of Cytokeratin 19 (CK19), b-100 protein and epithelial membrane antigen ( EMA) in thyroid papillary carcinoma, follicular carcinoma and papillary hyperplasia. Methods: 65 thyroid lesions were stained immunohistochemically for CK19, S-100 protein and EMA. Results: CK19, S-100 and EMA are negative in all papillary hyperplasia. CK19 expression was strong and diffuse in 100% of papillary carcinoma including the follicular variant of papillary carcinoma, and was positive in 22% of follicular carcinoma. S-100 and EMA were respectively present in 61% and 100% of classic papillary carcinoma, in 38% and 54% of follicular variant of papillary carcinoma and in 44% and 11 % of follicular carcinoma. Conclusions: Our observations suggest that the expression of CK19, in combination with S-100 and EMA expression, is helpful in the diagnosis of thyroid lesions. CK19 is a valuable marker in the distinction of papillary carcinomas from papillary hyperplasia.

Objective To identify the arteriographic manifestations of emergency uterine artery angiography and the efficacy of embolization treatment of postcesarean massive hemorrhage caused by placenta previa.Methods Emergency uterine artery angiogra-phy was performed in 35 patients with massive hemorrhage after cesarean section due to placenta previa.Emergency uterine arterial embolization (EUAE)was conducted using embolic agents such as tricacryl gelatin microsphere (TAGM)and gelatin sponge.Arte-riographic manifestations and effect of the emolotherapy were analyzed retrospectively.Results Contrast extravasations were con-firmed in 27 patients,and uterine artery pseudoaneurysms were in 8.The hemorrhage completely stopped after embolotherapy in all patients.A 12 month follow-up showed no recurrence hemorrhage and any severe complications were observed in all patients,such as necrosis of the uterus and ovary.Conclusion EUAE can be used as a safe,effective and minimally invasive therapeutic option for postcesarean massive hemorrhage caused by placenta previa.It is the key for the success of embolotherapy to choice and use reasona-ble embolic agents.

Objective To discuss the possibility of interventional diagnosis and treatment of uterine artery bleeding after curettage. Methods Select the emergent patients with uterine artery bleeding after curettage as the basis for study. Three women with uterine artery bleeding underwent femoral artery puncture and transcatheter uterine artery embolization. Bilateral selective artery angiographies were performed, and then underwent artery embolization after exhibiting the bleeding sites. Results Three patients were promptly and correctly diagnosed and arterial embolization were then attempted under DSA. No recurrence of bleeding during the angiographic and clinical follow up simultaneously with no serious complication. Conclusions Uterine arterial DSA and interventional embolization of uterine artery are effective in the diagnosing and treatting emergent uterine artery bleeding after curettage.

Background: Pancreatic tuberculosis is relatively rare in clinical practice, its clinical symptoms and imaging findings are lack of specificity, and is easily confused with pancreatic benign and malignant tumors. Aims: To summarize the clinical characteristics of pancreatic tuberculosis. Methods: Data of 19 patients with pancreatic tuberculosis from April 2010 to June 2019 at Xijing Hospital of Digestive Diseases, Air Force Medical University were retrospectively analyzed. Results: Among the 19 patients with pancreatic tuberculosis, 11 were male and 8 were female, median age was 33 years old. Clinical manifestations were mainly abdominal pain or upper abdominal discomfort, fever, night sweat, etc. Laboratory tests showed anemia in 11 patients, increased erythrocyte sedimentation rate in 13 patients, increased amylase in 7 patients, positive T-spot in 9 patients, positive PPD skin test in 3 patients and elevated bilirubin in 5 patients. Imaging examination showed that pancreatic tuberculosis was mainly located in pancreatic head. Ultrasound of the abdomen showed pancreatic mass, changes of internal echo in 8 patients, and pancreatic cystic or solid mass in 11 patients. CT showed significant enlargement of pancreatic head in 5 patients, solid pancreatic occupying lesion in 7 patients, cystic pancreatic occupying lesion in 4 patients, and enlargement of peripancreatic, mesenteric or retroperitoneal lymph nodes in 6 patients. Fourteen endoscopic ultrasound-guided fine-needle aspiration biopsy were performed in 8 patients; 5 patients underwent ultrasound-guided percutaneous biopsy of the occupying lesion. All the patients were given regular anti-tuberculosis treatment, and no relapse was found during the follow-up. Conclusions: For young patients with pancreatic space-occupying lesion, the possibility of pancreatic tuberculosis should be considered. Biopsy is still the current method of diagnosis, and regular anti-tuberculosis treatment is the main treatment for pancreatic tuberculosis.

Objective To identify various arteriographic manifestations and the curative effects of emergency embolization of renal hemorrhage after percutaneous nephrolithotomy.Methods Emergency arteriography was performed in 21 patients of renal hemor-rhage after percutaneous nephrolithotomy.Emergency embolotherapy was conducted by using different embolic agents such as gelat-in sponge,polyvinyl alcohol (PVA)particles and coils after bleeding arteries were identified.The arteriographic manifestations and the curative effects of the treatment for renal hemorrhage were retrospectively analyzed.Results Contrast extravasations were con-firmed in 21 patients,among them,4 contrast extravasations with arteriovenous fistulas(AVF)of renal artery;3 pseudoaneurysms of renal artery.The hemorrhage completely stopped after emergent embolotherapy in 21 cases.During follow-up,no rebleedings and severe complications occurred.Conclusion Emergency arterial embolization for renal hemorrhage after percutaneous nephrolithotomy is a safe and effective treatment.The key to successful treatment is to select embolization agent reasonably and embolize the bleeding arteries thoroughly and completely.

Objective To examine the reliability,validity and sensitivity of Montgomery-Asberg Depression Rating Scale (MADRS) for patients with current major depression disorder (MDD). Methods One hundred and twenty-two current MDD (DSM-Ⅳ) patients were administered with MADRS, Hamilton Rating Scale for Depression-17 item version (HAMD) and Clinical Global Impression of Severity (CGI-S) at baseline, 12 patients were selected to complete rater agreement test,and 47 patients receiving antidepressant treatment were followed up at 2,4,6 and 8 week and administered with MADRS and HAMD. Correlation analysis, reliability analysis and effect size (ES) calculation were used to determine the reliability,validity and sensitivity to changes during drug treatment. Results Intra rater reliability for MADRS was 0. 954. Baseline item-total score correlations were between 0. 445 and 0. 770 (P ＜ 0. 01 ), and the average correlation was 0. 629. The Cronbach α coefficient was 0. 847. The criterion related validity with HAMD and CGI-S was 0. 853 and 0. 672 (P＜0.01) ,respectively. The re-test reliability for MADRS at 2,4,6 and 8 week was 0. 737 ,0. 651,0. 543 and 0. 524 (P＜0. 01 ) ,respectively.MADRS had higher ES than HAMD when taken as clinical endpoint outcome measurement (0.41 vs 0.40,0.87 vs 0. 72,1.14 vs 0. 88,1.20 vs 0. 96 for 2nd,4th,6th and 8th week, respectively). Conclusion MADRS has good reliability and validity for patients with MDD. It is more sensitive to assess drug effect than HAMD.

To undertake retrospective analysis of the research and advancement of treating avascular necrosis of the femoral head.After comparing the superiority and inferiority of different treatments and the present therapeutic status many therapeutic methods for avascular necrosis of the femoral head have been performed,commonly according to the staging of necrosis.Conservative therapy is suitable for stage 0 ～Ⅰ,interventional therapy is suitable for stage Ⅱ～Ⅲ,operation is adapted for stage Ⅱ～ Ⅲ and femoral head collapse or degenerative changes.Avascular necrosis of the femoral head is a chronic and dysfunctional illness.Comprehensive treatment according to different stage is now the most popular.Interventional therapy is the study focus of the avascular necrosis of the femoral head meanwhile.(J Intervent Radiol,2006,15: 636-639)

BACKGROUND: Senile intertrochanteric fracture is characterized as aging, instability, more complications and high mortality, so choosing an appropriate internal fixation method is critical.OBJECTIVE: To compare the curative efficacy of proximal femoral nail anti-rotation and locking proximal femoral plate for senile osteoporotic patients with unstable intertrochanteric fractures.METHODS: Sixty elderly patients with unstable intertrochanteric fractures were enrolled, and the clinical data were collected. They were randomized into treatment and control groups (n=30 per group), and subjected to internal fixation using proximal femoral nail anti-rotation and locking proximal femoral plate, respectively. The operative indexes,functional recovery and complications were observed in the two groups RESULTS AND CONCLUSION: (1) The incision length, operation time, intraoperative blood loss and time of weight bearing in the treatment group were significantly less than those in the control group (P < 0.01). (2) Harris hip scores in the treatment group were significantly higher than those in the control group (P < 0.05). (3) The incidence of complications in the treatment group was obviously lower than that in the control group. (4) To conclude, the proximal femoral nail anti-rotation exhibits satisfactory treatment outcomes in the internal fixation of unstable intertrochanteric fractures.

Objective To explore clinical characteristics of patients with cerebral infarction(CI) complicated with metabolic syndrome(MS) and their correlation with severity of cerebrovascular stenosis. Methods A total of 585 cases with CI were retrospectively studied. The patients were catogorized in to groups with and without MS according to NCEP-ATPⅢ diagnostic criteria. Severity of cerebrovascular were evaluated by CT. ResultsTwo hundred ninty cases(49.6%) complicated with MS showed higher body mass index (BMI), waist circumference, blood pressure, serum total cholesterol(TC), triglyceride (TG), uric acid (UA), fasting blood glucose (FBG), two hours postprandial blood glucose (2 h PBG), glucosylated hemoglobin A1c(HbA1c), and lower high-densitylipoprotein-cholesterol(HDL-C) than those without MS. Larger size and multiple infarcts and more serious score of neurological deficit were shown in patients complicated with MS. Severity of cerebrovascular disease disclosed by CT was positively related to levels of waist circumferene, blood pressure, TC, TG, HbA1c, FBG and 2 h PBG while in versely related to the levels of HDL-C (r=-1.23, P