Objective:To investigate the clinical significance of changes of platelet count after splenectomy in patients with cirrhosis and portal hypertension.Methods:In this study,from January 2002 to January 2006,the platelet count and liver function in 153 splenomegaly and hypersplenism due to cirrhosis patients who had been carried out splenectomy were selected.The change tendency of platelet count was observed,the relationship of changes of platelet count and liver function was analysed,and compared with patients of spleen trauma.Results:Postoperative platelet count was higher than preoperatively in most patients with cirrhosis,the portion did not elevate,even decreased.The change tendency of platelet count was correlated with the liver function.The change in cirrhosis patients is not more than patients of spleen trauma.Conclusions:The reason of thrombocytopenia in patients with cirrhosis may be correlated with the change of liver function besides the splenomegaly.

China is the rank 1st of gastric cancer in the world,and the incidence and mortality of gastric cancer rank the 3rd among various malignant tumors in China.It has been found that tumor cells have their own energy metabolism characteristics.Even in the presence of sufficient oxygen,tumor cells are more inclined to use glycolysis to produce energy,also known as"aerobic glycoly-sis".Aerobic glycolysis can lead to an increase in lactate,promoting the acceleration of tumor cell proliferation and invasiveness,and the key enzyme driving this phenomenon is lactate dehydrogenase(LDH).LDH levels are significantly elevated in patients with gas-tric cancer,and LDH can contribute to the occurrence and development of gastric cancer in many ways.This article will discuss the role of LDH in tumor glycolysis,which is correlated with gastric cancer as well as its clinical application value.It will also discuss the research progress of LDH in targeted therapy for gastric cancer.

Objective:To study the use of three-dimensional (3D) visualization in diagnosis and interventional treatment of patients with Budd-Chiari syndrome (BCS) presenting with inferior vena cava obstruction and dangerous collateral branches.Methods:The data of 28 patients with BCS presenting with inferior vena cava obstruction and dangerous collateral branches treated at the Affiliated Hospital of Xuzhou Medical University from September 2018 to January 2021 were retrospectively analyzed. There were 11 males and 17 females with a mean age of 49.0 years. Enhanced MR images of these 28 patients were used to build 3D visualization of inferior vena cava. Anteroposterior and left lateral digital subtraction angiography (DSA) of inferior vena cava were performed. The inferior vena cava of these patients was recanalized under guidance of 3D visualization, and patency of inferior vena cava was determined on follow up.Results:3D visualization of inferior vena cava was successfully constructed in all the 28 patients, and 51 dangerous collateral branches were displayed. One, 2, 3 and 4 dangerous collateral branches were found in 13, 8, 6 and 1 patients, respectively. The average angle between the preoperative planning puncture route and the long axis of the proximal end of inferior vena cava was 22.2°. The orifices and courses of the dangerous collaterals and the shape of inferior vena cava could be clearly displayed on 3D visualization in all the 28 patients (100.0%), which were significantly better than the 6 patients (21.4%) using DSA obtained in the anteroposterior and left lateral positions (χ 2=20.045, P<0.05). The inferior vena cava was successfully recanalized in all the 28 patients without complications. On follow up of these patients for 2 to 30 months (mean 18.4 months), the inferior vena cava was patent in 25 patients. Three patients developed inferior vena cava re-obstruction at 3, 4 and 14 months after interventional treatment, respectively. Conclusion:3D visualization was useful in the diagnosis and interventional treatment of patients with BCS presenting with inferior vena cava obstruction and dangerous collateral branches.

Objective:To investigate the clinical features of JAK2V617F gene mutation and non-mutation in patients with Budd-Chiari syndrome (BCS).Methods:17 and 127 BCS cases with JAK2V617F gene mutation (mutation group) and non-gene mutation (non-mutation group) who were continuously treated with interventional therapy between January 2016 to December 2020 in the Affiliated Hospital of Xuzhou Medical University were selected as the research object for a comparative study. The hospitalization and follow-up data of the two groups were analyzed retrospectively, and the deadline for follow-up was June 2021. Quantitative data group differences were analyzed using the independent sample t-test and Wilcoxon rank sum test. Qualitative data group differences were analyzed with χ2 test or Fisher's exact test. Mann-Whitney U test was used to analyze the differences between groups in rank data. Kaplan-Meier method was used to calculate the patient survival and recurrence rate. Results:Age [(35.41±17.10) years vs. (50.09±14.16) years, t=3.915, P<0.001], time of onset (median duration: 3 months vs. 12 months), and the cumulative survival rate (65.5% vs 95.1%; χ2=5.21, P=0.022) were lower in mutation than non-mutation group. Aaspartate aminotransferase, alanine aminotransferase, prothrombin time, Child-Pugh score, Rotterdam score, Model for End-stage Liver Disease score, hepatic vein thrombosis incidence, and the cumulative recurrence rate after intervention were higher in mutation than non-mutation group. The above all indexes had statistically significant differences ( P<0.05) between the groups. Conclusion:Younger age, acute onset, severe liver injury, high incidence of hepatic vein thrombosis, and poor prognosis are the features of patients with BCS with JAK2V617F gene mutation than non-mutation.