Objective To evaluate the value of covered self-expending metallic stent in the management of malignant esophageal and duodenal strictures or fistulas and explore the treatment for the associated common complications.Methods With interventional procedure under fluoroscopic guidance,95 self-expending mesh stents were implanted in 87 patients,including esophageal carcinoma(50 cases),esophagogastric anastomotic stenosis(23 cases),gastroduodenal malignant stenosis(5 cases),esophagobronchial fistula(3 cases),esophagogastric anastomotic fistula(6 cases).Results Stent placement was successful in all patients at the first trial,having no instant complication except one acute bleeding during the procedure and all of them with relief of stenostic complaint,restoration of clictelic function and closure of fistulas.The long-term curative effect showed something to do with different kind of disease,and the related treatment.Conclusion Self-expending metallic covered mesh stent is safe,effective and less complication;and could be further promoted with addition of radiotherapy and(or)chemotherapy.

Objective To evaluate the value of covered metallic stent and arterial embolization in the management of pseudoaneurysm of extremities or kidneys.Methods Endovascular covered stent graft was inserted for isolation of peripheral extremity pseudoaneurysm in 3 patients and intraarterial embolization was performed with gelfoam in 2 patients for pseudoaneurysm in kidney.Results All 5 pseudoaneurysms kept occluded after the treatment.Distal arterial pulse was normal in 2 patients treated with stent graft;new thrombosis formed within the stent during the procedure but disappeared after thrombolytic therapy through catheter in 1 case;and still another new pseudoaneurysm presented at puncture site in 1 other case due to other factors.Conclusions Pseudoaneurysms in extremities or kidneys can be effectively treated with interventional techniques of covered stent graft and percutaneous arterial embolization.The long-term investigation is needed.

Objective To evaluate the diagnostic and therapeutic value and safety of transcatheter arterial angiography and embolization in patients with endoscopic refractory gastrointestinal bleeding.Methods Thirty-one cases of endoscopic refractory gastrointestinal bleeding were performed DSA and treated with transcatheter arterial angiography and embolization.The safty and efficacy was evaluated.Results Angiographic positive rate of bleeding was 80.65％ (25/31);28 cases was treated with embolization.The success rate of first embolization was 75.00％ (21/28),and the total success rate was 82.14 ％ (23/28) by the second embolization.Seven patients received surgical resection after interventional therapy,including 2 cases of jejunal stromal tumors and 5 cases of gastric malignant tumors.Four cases of gastric cancer patients underwent rebleeding within 30 days after interventional therapy,of which 2 died of heart or lung function failure due to basic diseases.Except for 1 patient of anastomotic bleeding after gastrointestinal anastomosis occurred anastomotic fistula after embolization,who recovery with the support treatment,no other cases occurred serious gastrointestinal ischemic necrosis.Conclusion Interventional diagnosis and treatment for gastrointestinal bleeding hemostasis is effective and safety,and also can achieve good results especially for malignant gastric tumor hemorrhage,which can be used for endoscopic refractory gastrointestinal bleeding patients.

Objective To investigate the inhibitory effects of silencing expression ofEZH2 gene on the cell proliferation of human QBC939 cells and its mechanisms. Methods The targeting siRNA was designed and trans-fected into QBC939cells. The expressions of EZH2 mRNA and protein were detected by real-time qPCR and west-ern blotting,respectively. The ability of cellproliferationwas analyzed by MTT assay and plate clone formation assay. Cell apoptosis and cycle percentage weremeasured by flow cytometry. Cell senescence was assessed byβ-galactosi-dase dyeing.The expressions of H3K27me3,P14ARF,P16INK4a,P53,P21 and E2F1 proteinwere determined by West-ern blotting.Results Compared with the control group ,the expressions of mRNAand protein were significantly elevat-ed in experimental group. The ability of cellproliferation in the experiment group was significantly down regulated , which could also cause a rise of G1/S phase ,but not a marked variation of apoptosis rate. Silencing EZH2 would induce a obvious senescence phenotype in QBC939 cells. EZH2-siRNA transferredcould also down-regulate the expressions of H3K27me3 and E2F1 protein,while up-regulating the expressions of P14ARF,P16INK4a,P53 and P21 protein in QBC939 cells.Conclusions Silencing EZH2 could induce a significant inhibition on cell proliferation of QBC939 cells,the mechanism of which may be associated with the senescence pathway regulation.

Objective:To investigate the clinical efficacy of electrical stimulation, biofeedback, and radiofrequency therapy in combination for the treatment of pelvic floor dysfunction.Methods:A total of 144 patients with pelvic floor dysfunction who received treatment in Lianyungang Maternal and Child Health Hospital from June 2020 to June 2022 were included in this prospective randomized controlled study. They were randomly assigned to undergo electrical stimulation combined with biofeedback (electrical stimulation group, n = 48), treatment with a novel radiofrequency technique (radiofrequency therapy group, n = 48), or electrical stimulation, biofeedback, and treatment with a novel radiofrequency technique (combined group, n = 48). Pelvic floor dysfunction, stress urinary incontinence, and pelvic floor myofascial pain were compared among the three groups. Pelvic organ prolapse quantification was compared among the three groups before and after treatment. Quality of life was evaluated. Results:The effective rates of treatment against pelvic floor dysfunction, stress urinary incontinence, and pelvic floor myofascial pain in the combined group were 95.83% (46/48), 97.92% (47/48), and 93.75% (45/48), respectively, which were significantly higher than 79.17% (38/48), 79.17% (38/48), 77.08% (37/48) in the radiofrequency group, and 75.00% (36/48), 77.08% (37/48), 72.92% (35/48) in the electrical stimulation group ( χ2 = 8.40, 9.77, 7.66, all P < 0.05). After treatment, the severity of pelvic organ prolapse in the combined group was significantly milder than that in the novel radiofrequency technique group and electrical stimulation group (both P < 0.05). The scores of the pelvic floor dysfunction questionnaire and urinary incontinence questionnaire in the combined group were significantly lower than those in the radiofrequency therapy group and the electrical stimulation group (both P < 0.05). Conclusion:Electrical stimulation, biofeedback, and radiofrequency therapy in combination can greatly strengthen the muscle strength of the pelvic floor, relieve urinary incontinence, reduce pelvic floor myofascial pain, and improve the quality of life of patients with pelvic floor dysfunction.