Objective To assess the therapeutic effect of thermochemotherapy infusion combined with chemoembolization in the treatment of primary hepatocellular carcinoma.Methods Ninty six patients with hepatic carcinoma were randomly diveded into two groups.In A group,the patients underwent thermochemotherapy infusion combined with chemoembolization.In B group,chemotherapy infusion was done combined with chemoembolization.Before the therapy,the basic examinations of patients were improved,including liver function,renal function,immune function.At the same time,each patient was performed with enhanced CT scan.Three days and a month after treatment,main outcome measures,containing liver function,renal function,and immune function were examined,the volumes of tumor were measured on CT.Repeat treatment were performed between four and six weeks.Follow-up was performed after the third treatment,patients survival periods were observed.Results A and B groups of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were higher than pre-treatment after 3 days (all P ＜ 0.05),but the ALT and AST in group B were both higher than those in group A (P =0.001,P =0.002),there were no changes after 30 days.No significant difference of renal function were found in the both groups.In the A group,the total efficiency was 75.00 ％ (36/48),and that of the B group was 39.58 ％ (19/48),showing statistically significant difference (P ＜ 0.01).In the A group,the immunity state of patients were improved after treatment.In the A group,the median survival time was 24.0 months (95 ％ CI was 20-29 months).In the B group,the median survival time was 18.9 months (95 ％ CI was 18-20 months).There was significant difference between the two groups (P ＜ 0.01).Conclusion The gemcitabine transcatheter arterial heated chemotherapy combined carboplatin with transcatheter arterial chemoembolization is effective treatment for primary hepatocellular carinoma.

Objective To observe the therapeutic effects of arsenic trioxide combined with transcatheter arterial chemoembolization on treatment of primary liver cancer with pulmonary metastases.Methods Sixty patients were randomly divided into two groups:group A (treatment group,n =30) and group B (control group,n =30).Group A was received periodic transcatheter arterial chemoembolization (TACE) and 10 mg arsenic trioxide by intravenous infusion for 5 hours per day,3 days after TACE.Each cycle consisted of 14 days' administration,and repeated after 2 weeks.Each patient was received 3-4 successive cycles.Group B was received periodic TACE alone.Objective efficiency,benefit rate,quality of life and the correlates with metastatic tumor size and number in the both groups were recorded.Results The objective efficiency was 26.7％ (8/30),and the benefit rate was 60.0％ (18/30) in group A,while they were 0 and 16.7％ (5/30) in group B with significant statistics differences (x2 =7.067,P =0.008;x2 =11.915,P =0.001).The quality of life was improved in 4 patients and stable in 18 of group A,while no patient was improved and 13 were stable in group B (x2 =9.669,P =0.008).There was a significantly positive correlation between the tumor burden and therapeutic effect (Kendall r =-0.765,P ＜ 0.001 ;Spearman r =-0.821,P ＜ 0.001).Conclusion Arsenic trioxide combined TACE is an effective treatment method in treating primary liver cancer with pulmonary metastases.

Objective To assess the therapeutic value of transcatheter arterial chemoembolization combined 125iodine seed implantation for primary hepatic carcinoma with portal vein tumor thrombus.Methods The data of 23 patients ranging from 34 to 70 years old [ average age ( 56 ± 8) years ] with primary hepatic carcinoma with portal vein tumor thromhosis of type Ⅱ and type Ⅲ were retrospectively collected.The tumor number of liver parenchyma ranged from 1to 15 ( median number 4).The average diameter of tumor thrombus was (20.5 ± 1.5 ) mm and average length was ( 37.4 ± 2.6 ) mm.All of the tumors of liver parenchyma in 23 patients were treated by transcatheter arterial chemoembolization (TACE) and tumor thrombus were treated with 125iodine seed implantation.Before the 125iodine seed implantation,the formula dosage,the number,the spatial distribution,the intensity of radioactivity and the matched peripheral dosage of seed were calculated by treatment planning system (TPS).Then the 125iodine seeds were implanted in different levels and locations of port vein thrombosis under CT guided.Results The follow-up period ranged from 1to 26 months.The times of transcatheter arterial chemoembolization were 1to six times (median time 3.1±0.4) and the 125iodine seed implantation in the port vein thrombosis were 1to 2 times ( median time 1.4 ± 0.5 ).The numbers of implanted 125iodine seeds were 4 to 17 ( median number 7.0 ± 1.0).The median survival time was 18.0 months (3-24 months).The 3,6 and 12 months survival rates were 91.3％ ( 21/23 ),69.6％ ( 16/23 ),and 60.9％ ( 14/23 ).There was no severe side-effect related to therapy.Conclusions Transcatheter arterial chemoembolization combined 125iodine seed implantation for portal vein tumor thrombosis could significantly prolong the median survival time of patient with primary hepatic carcinoma with portal vein tumor thrombosis.

Objective:By analyzing the relationship between postoperative pathology and lymph node metastasis of the adenocarcinoma of esophagogastric junction patients to explore the effect of surgical resection and lymph node cleaning scope on prognosis in different Siewert type patients.Methods:A retrospective analysis was made on 350 cases of esophageal gastric junction adenocarcinoma at Tumor Hospital of Shanxi Province from July 2014 to May 2018. Patients clinical data such as lymph node metastasis and tumor diameter, differentiation degree, infiltration depth were studied. The value of the third leg of lymph node cleaning in cardia cancer radical were discussed. Risk factors of lymph node metastasis were analyzed by Logistic regression model.Results:A total of 6 718 lymph nodes were dissected in 350 patients with adenocarcinoma of esophagogastric junction, including 1 613 positive lymph nodes, with a metastasis rate of 24.01%. The metastatic rate of Siewert type Ⅰ lymph nodes was 23.30%, 20.16%, 41.90% and 20.87% in the first, second, third and seventh groups, respectively, which was significantly higher than that of other groups. Siewert Ⅱ and Ⅲ focus on the abdominal cavity. with the increase of tumor infiltration depth, the rate of peripheral lymph node metastasis increased, and the difference was statistically significant ( P<0.01). The rate of lymph node metastasis was 83.1% in the low-differentiation group and 58.4% in the middle-high differentiation group, respectively ( P<0.01). When the tumor diameter ≥4 cm, the rate of lymph node metastasis in the patients increased significantly, and the difference was statistically significant ( P<0.05). The rate of lymph node metastasis at the third station was correlated with the depth of invasion of the gastric wall, the longest diameter of the tumor body, and the degree of differentiation of the tumor. Conclusions:The longest diameter of tumor body, the depth of infiltration and the degree of differentiation are independent risk factors for lymph node metastasis in AEG patients. For patients with type AEG Ⅰ, the mediastinal and lower esophageal lymph nodes should be thoroughly dissected during radical surgery, and the abdominal lymph nodes in groups 1, 2, 3 and 7 should be dissected. The remaining groups may have to be examined for enlarged lymph nodes to determine whether to dissect. For type Ⅱ and Ⅲ patients, splenoprotective total gastrectomy and D 2 lymph node dissection are recommended when the tumor invades the full layer of the gastric wall, the longest diameter ≥4 cm, and the differentiation degree is low.

BACKGROUND:Diabetic foot patients with wound infections constitute a large patient population,and there is currently no satisfactory treatment approach. OBJECTIVE:To investigate the clinical efficacy of a modified tibial cortex transverse transport combined with antibiotic-loaded bone cement for treating refractory diabetic foot ulcers. METHODS:A total of 46 diabetic foot ulcers patients,27 males and 19 females,with an average age of 64.37 years,were selected from Beijing Chaoyang Hospital,Capital Medical University and Beijing Chaoyang Integrative Medicine Rescue and First Aid Hospital from January 2020 to January 2023.All of them underwent the modified tibial cortex transverse transport combined with antibiotic-loaded bone cement treatment.Ankle-brachial index,WIFi(Wound/Ischemia/Foot infection)classification,pain visual analog scale score,and ulcer area were recorded before and 3 months after surgery. RESULTS AND CONCLUSION:(1)The mean ulcer healing time for the 46 patients was(58.07±24.82)days.At 3 months postoperatively,there were significant improvements in ankle-brachial index,pain visual analog scale score,ulcer area,and WIFi classification in 46 patients,as compared to the preoperative values,with statistically significant differences(P<0.05).Two patients experienced pin-tract infections,without infection or ulcer recurrence during the follow-up period.(2)These findings indicate that the modified tibial cortex transverse transport combined with antibiotic-loaded bone cement effectively alleviates patients'pain,improves lower limb circulation,controls infections,and promotes ulcer healing.

Diabetic peripheral neuropathy is a common diabetic complication.Presently,our understanding of its pathogenesis is incomplete,and there are no effective treatment options.In-depth research requires the use of animal experiments.The criteria for modeling success and the evaluation method for peripheral nerve function recovery are critical for carrying out animal experiments into type 2 diabetic peripheral neuropathy.However,but there has been a lack of systematic interrogation and analysis of the evaluation method used with type 2 diabetic peripheral neuropathy models.Therefore,the author reviewed the recent data,summarized and analyzed the evaluation method used for animal models of type 2 diabetic peripheral neuropathy of small and large nerve fibers,and proposed future directions for development,providing a reference for related research.

Chronic Urticaria(CU)is a common skin disease involving autoimmunity and allergies,which brings a heavy burden to patients and society.The theory of traditional Chinese medicine"the Lung is combined with the Large Intestine,and the symptoms of large intestine can be reflected from the skin"has long shown that there is a close physiological and pathological relationship between the function of the Large Intestine and the skin.With the modern advancement of the"gut-skin axis"theory,the correlation between gut microbiome and CU has gradually become an emerging focus of research.Adjusting the imbalance of gut microbiome would be a new trend in the clinical treatment of CU.Acupuncture has a beneficial effect of regulating the gut microbiome,and the definite curative effect on CU.Therefore,this article summarized the research progress between the gut microbiome and CU in recent years,in order to discuss the feasibility of acupuncture to treat CU by regulating the gut microbiome,and provide a new idea for the mechanism research of acupuncture in the treatment of CU from the perspective of"treating skin from intestine".