Budd-Chiari syndrome (BCS) is a rare disease. Because of lack of clear characteristic symptoms in the early stage, many patients are misdiagnosed or never diagnosed. Early diagnosis and prompt treatment play a key role in improving survival rates and quality of life for BCS patients. With the progress in imaging techniques, the radiological examination is playing more and more important role in the diagnosis and assessment of BCS. Ultrasound, computed tomography, magnetic resonance imaging and digital subtraction angiography are all helpful in evaluating the obstruction of hepatic vein and inferior vena cava. Thus, these imaging tests should be used rationally according to their features. On the other hand, the interventional therapy is the preferred method for the treatment of BCS. This paper intends to get a deeper understanding of BCS for clinicians, which is essential for patients to be diagnosed in time.

Objective To investigate the clinical effects of preoperative eye position training on femtosecond laser-assisted laser in situ keratomileusis(FL-LASIK)? Methods One hundred and sixty-eight myopia patients(328 eyes)scheduled for selective FL-LASIK were randomly divided into the experiment group of 85 cases(166 eyes)and the control group of 83 cases(162 eyes)?The patients in the control group were given the routine preoperative education and the patients in the experiment group received the preoperative intervention of eye position besides routine preoperative education? The two groups were compared in terms of intraoperative changes of eye position,corneal topography and the postoperative visual acuity? Results The frequency of eye position adjustment and machine stopping in the experiment group was significantly smaller than that of the control group(P < 0?001)? But no significant differences were found between the two groups in corneal topography and the postoperative visual acuity(P > 0?05)? Conclusion Preoperative training of eye position may maintain ideal eye position and reduce the frequency of downtime due to eye position adjustment during FL-LASIK,which may ensure the successful completion of FL-LASIK?

Objective To explore a way to establish a stable, ideal and handy intracranial aneurysm model for related studies. Methods Modified microsurgery technology was applied to establish sidewall, bifurcation, terminal and merged types of aneurysm (n=7 in each type). Two weeks after operation, color Doppler ultrasound, magnetic resonance imaging (MRI), magnetic resonance angiography (MRA) and intra-arterial digital subtraction angiography (IADSA) were performed and computational fluid dynamics (CFD) was used for simulation analysis of aneurysm models. Biomechanical properties of aneurysm wall tissues was analyzed by cell culture, then the above examinations were performed again after the aneurysm was embolized by micro coil (MC). Results All models were successfully established, and the MC embolization of aneurysm cavity achieved good efficacy. Vascular endothelial cells (VECs) proliferate well in vitro, and the VECs adhered to the sur?face of biodegradable polymeric materials successfully and grow into VEC layer structure. Hemodynamics analysis was per?formed in aneurysms model before and after embolization and relevant hemodynamic parameters was obtained. , Blood flow velocity are 2-7 cm/s in aneurysm and 8-26 cm/s in its parental artery. Conclusion A stable, ideal and handy intracranial aneurysm model was established and are essential in aneurysm related research.

Objective To study the clinical significance of the caudate lobe vein in patients with Budd-Chiari syndrome (BCS) by contrast-enhanced magnetic resonance imaging(MRI).Methods Contrast-enhanced MRI data of 46 patients with BCS, 30 patients with cirrhosis due to hepatitis B virus (HBV) and 49 healthy people in our institution were analyzed retrospectively.The presence and diameter of the caudate lobe vein among the three groups were measured.Among the BCS group, in which the caudate lobe vein could be seen, andpatients were divided into two groups according to disease duration and patency of inferior vena cava (IVC), respectively.And comparative study of diameter between two groups was performed.Results ①The caudate lobe vein was noted in 76.1% of patients with BCS, in 30.0% of patients with cirrhosis due to HBV,and in 36.7% of healthy subjects.The diameter of caudate lobe vein in BCS group was larger than that in both cirrhosis group and healthy group(P<0.01).There was no statistically difference between cirrhosis group and healthy group(P>0.05).②Among BCS group,the caudate vein was shown in 35 patients, with mean diameter of(4.21±1.66)mm.For 35 BCS,the diameter of caudate lobe vein in chronic group was larger than that in acute group(P<0.05).The diameter of caudate lobe vein in IVC obstruction group was larger than that in IVC open group(P<0.05).Conclusion The demonstration of the caudate lobe vein on contrast-enhanced MRI is of great significance in the diagnosis and treatment of BCS.

Objective To improve the understanding of cutaneous intravascular natural killer/T-cell lymphoma (CIVNKTC). Methods Clinical data on five cases of CIVNKTC were collected. The histopathological feature, treatment and prognosis of CIVNKTC were retrospectively analyzed and discussed. Results Of the 5 patients, 1 was male and 4 were female. The age of onset ranged from 38 to 83 years (average, 56.2 years). All the patients presented with multiple plaques and nodules as the primary symptoms. Histopathological examination revealed vasodilatation in the dermis and subcutaneous tissue, as well as atypical lymphoid cells with large hyperchromatic nuclei containing 1-2 small nucleoli in dilated veins. Immunohistochemical studies of tumor cells showed positive staining for CD3ε, cytotoxic proteins (including T cell-restricted intracellular antigen-1, granzyme B and perforin)and Epstein-Barr virus(EBV)-encoded microRNA, but negative staining for cytokeratin, CD20, CD79a, CD4 and CD8. Furthermore, the tumor cells stained positive for CD56 in two patients. Among the 5 patients, only 2 received chemotherapy and the remaining received no treatment. During a 24-month follow-up, 4 patients died, and only 1 survived with the tumor. Conclusion CIVNKTC is a rare extranodal Hodgkin′s lymphoma with distinct histologic manifestations and immunophenotypes, rapid and aggressive clinical course, and poor prognosis.

Objective To explore the clinical efficacy of 1251 stent implantation in treatment of malignant tracheal stenosis with the help of ventilation catheter under local anesthesia.Methods Totally 180 consecutive patients with malignant tracheal stenosis underwent 125I airway stent implantation were analyzed retrospectively.The anhelation grade,oxygen saturation and respiratory rate before and after operation were recorded and analyzed,125I stent situation,clinical symptoms and survival situation were followed up after operation.Results The success rate of 125I stent placement was 100％ (180/180),and the stent type was tubular stent in 132 cases,Y-shaped stent in 34 cases,and L-shaped stent in 14 cases.Dyspnea was significantly relived in all patients.Oxygen saturation and respiratory rate improved from (80.60±3.87)％ and (29.36± 3.20)times/min before operation to (94.31±3.40)％ and (19.29±2.19)times/min after operation (t=-30.52,35.09,both P＜0.01).Patients were followed up 3-13 mouth after operation,and stent restenosis were occurred in 6 patients.The lifetime was 49-401 days and the average lifetime was (182±94) days.The 60-day survival rate was 0.99 and the 180-day survival rate was 0.65.Conclusion 125I stent implantation in treatment of malignant tracheal stenosis with the help of ventilation catheter under local anesthesia is a safe and effective method.

Objective To evaluate the safety and feasibility of 125I seeds stent implantation with assistance of airway tube under local anesthesia in treating malignant tracheobronchial stenosis.Methods The clinical data of 24 patients with malignant tracheal and bronchial stenosis,who underwent the treatment of 125I seed stent implantation at authors' institute during the period from March 2014 to January 2015,were retrospectively analyzed.The primary lesions included tracheal and bronchial cancer (n=6),esophageal carcinoma (n=8),pulmonary cancer associated with mediastinal lymph node metastasis (n=9),and malignant mediastinal tumor (n=l).All patients had different degrees of shortness of breath,cough and other symptoms due to airway constriction caused by malignant tumors.Grade Ⅱ of breath shortness was seen in 2 patients,grade Ⅲ in 16 patients,and grade Ⅳ in 6 patients.First,a 4F single-curve catheter was placed into one of the main bronchi,which was used as the ventilation catheter,then implantation of 125I seed stent in the diseased trachea and bronchus was carried out,finally,after the implantation of 125I seed stent was successfully accomplished the ventilation catheter was removed.The technical success rate of 125l seed stent implantation,the procedure-related complications and the intraoperative patient tolerance were calculated and the results were analyzed.Results Successful implantation of 125I seed stent with single procedure was accomplished in all 24 patients and no severe operation-related complications occurred.The technical success rate was 100％.Under the assistance of ventilation catheter,the oxygen saturation maintained at the level around 92.9％ when the stent release device was passing through the airway stenotic site.Neither intraoperative asphyxia nor severe decrease in blood oxygen saturation occurred in all patients.After the treatment,6 patients had bloody sputum,2 patients developed irritable cough,and one patient complained of mild chest pain,these symptoms were relieved after symptomatic treatment.During operation,no events that caused the patients unable to cooperate with the treatment,such as severe cough,dysphoria,dyspnea,etc.,occurred.Conclusion For the treatment of malignant airway stenosis,125I seed stent implantation with assistance of airway tube under local anesthesia is safe and feasible.