Interventional therapy is an important treatment for biliary stenosis.The treatment methods are different ac cording to the different causes.Conventional interventional therapy include biliary drainage,balloon dilatation and stent implantation.There are some new treatment methods such as radiofrequency catheter ablation and biliary stent loaded with 125I seeds.The applications of interventional therapy in biliary stenosis were reviewed in this article.

Objective To research and prepare the individualized knee in vitro guided plate by 3D printing technique and to investigate the feasibility of its application in 8-plate epiphysiodesis.Methods Twelve children patients with knee varus or valgum in our hospital from January 2014 and November 2016,7 boys and 5 girls,average age of 8.2 years old,were performed the lower extremity continuous spiral CT scanning in the knee straight position.The Dicom format stored CT data were imported into software Mimics 15.0 for reconstructing the knee joint 3D model.The knee joint data after reconstruction were guided into software Geomagic1 1.0 with the.stl format.According to the demand that screws without perforating epiphyseal and joint surface,paralle ling to the epiphyseal and locating in the anterior-posterior median line of epiphyseal,the 8-plate placing screw navigation template was designed and printed by using the 3D printing technique;the 8-plate plate and screw internal fixation was conducted by intraoperative template location.The placed screw position was evaluated by postoperative CT.Results The imaging identification showed that 8-plate epiphysiodesis by using 3D printing individualized in vitro guided plate had accurate screw placement.The cases were followed from 6 months to 2 years,the satisfactory orthopedic effect was obtained in all cases.Conclusion Preparing the individualized knee in vitro guided plate by applying 3D printing technique in assisted 8-plate epiphysiodesis for treating child knee varus or valgum has accurate screw position and satisfactory effect.

Objective To detect anti-clinically amyopathic dermatomyositis (CADM)-140 antibody in patients with dermatomyositis (DM) or CADM,and to estimate its clinical correlation.Methods Serum samples were collected from 22 patients with DM,16 patients with CADM,46 patients with other connective tissue diseases complicated by interstitial lung disease(including 8 cases of polymyositis,15 cases of systemic lupus erythematosus,5 cases of systemic sclerosis,6 cases of Sj(o)gren syndrome,6 cases of mixed connective tissue disease,6 cases of idiopathic pulmonary fibrosis),and 5 normal human controls.Enzyme-linked immunosorbent assay (ELISA) was performed with the recombinant melanoma differentiation-associated gene 5(rMDA)as a substrate to measure the anti-CADM-140 antibody in these serum samples.Clinical manifestations were compared between patients with anti-CADM-140 antibody and those without.Results The anti-CADM-140antibody was found in 43.8% (7/16) of patients with CADM and 9.1%(2/22) of patients with DM(P<0.05),but absent in the patients with other connective tissue diseases and in the normal human controls.A significant incroase was observed in anti-CADM-140 antibody-positive patients with DM/CADM in the incidence of cutaneous ulceration and necrosis,interstitial lung disease and rapidly progressive interstitial lung disease (8/9 vs.6.9%,P<0.01;9/9 vs.48.3%,P<0.01;5/9 vs.0,P<0.05),serum lactate dehydrogenase level(328.3±104.2 vs 241.1±100.3 IU/L P<0.05),erythrocyte sedimentation rate(40.8±23.1 vs.22.5±16.8 mm/1 h,P<0.05),high resolution computed tomography score(122.9±54.8 vs.70.0±59.8,P<0.05)compared with anti-CADM-140 antibody-negative patients with DM/CADM.The ereatine kinase level was significantly lower(156.3±260.8 vs.1806.2±3737.1 IU/L P<0.05)in anti-CADM-140 antibody-positive patients with DM/CADM than in anti-CADM-140 antibody-negative patients with DM/CADM,while no significant difference was noted in the positivity rate of antinuclear antibodies or incidence of malignancies between the antibody-positive and-negative patients with DM/CADM.Conclusions Anti-CADM.140 antibody not only is useful for the diagnosis of interstitial lung disease in patients with DM/CADM,but also may serve as a serum marker for rapidly progressive interstitial lung disease.Monitoring of serum anti-CADM-140 antibody might help to predict the progression of interstitial lung disease in patients with DM/CADM.

Objective: To replace esophageal defects with artificially composed biodegradable materials and non-biodegradable materials. Met hods: A two-layered tube consisting of a collagen-chitosan sponge and an inner polyurethane stent was used to replace 5 cm esophageal segmental defect s in 15 dogs. The inner polyurethane stent was removed endoscopically at weekly intervals from 2 or 4 weeks. Results: Partial regeneration of es ophageal epithelia was observed in 5 dogs at week 2, and progressing constricti on occurred and the dogs became unable to swallow within 1 month. In the 10 dog s that the polyurethane stent was removed at week 4, regenerated esophageal tiss ue successfully replaced the defects, and complete epithelization was observed 1 month after surgery. Complete regeneration of esophageal mucosa structures, inc luding mucosal smooth muscle and mucosal glands were observed 3 months after surgery, and partial regeneration of esophageal muscle tissue was also observed 6 months after surgery. Conclusion: Our artificial prosthesis i n reconstruction of the cervical esophagus segment in dogs is feasible. Through temporary polyurethane tube, collagen-chitosan sponge provides a three-dimensi onal structure suitable for the regeneration and sufficient degradation time for the complete regeneration of esophagus.

Objective: To analyze the information of patients with acute myocardial infarction (AMI) in a single center during last 6 years, and to distinguish the clinical differences of patients between TakoSTubo cardiomyopathy (TTC) and ST-segment elevation myocardial infarction (STEMI). Methods: A total of 1042 consecutive patients with primarily diagnosed acute anterior ST-segment elevation (STEMI) admitted in our hospital from 2008-01 to 2014-04 were retrospectively enrolled. The relevant patients were studied in 2 groups:TTC group, the patients with coronary angiography (CAG) and the contrast study of left ventricle corrected TTC diagnosis, n=10, and STEMI group, the patients received CAG within 6 hours of on set with conifrmed left anterior descending singlevessel disease at the same period of time as TTC patients,n=32. The basic clinical characteristics, levels of blood lipids, MI related biomarkers, the incidence rate of pathological Q wave, QTc interval and negative T wave in 12-lead ECG were compared between 2 groups. Results: The percentage of corrected TTC diagnosis in patients with primarily diagnosed STEMI was 1.06%. The female gender in TTC group and STEMI group was 100% vs 9%,P<0.01, TTC group had more patients with stress history before on set than that in STEMI group (70% vs 22%,P=0.02), lower levels of MI related biomarkers as CK (486 ± 249) U/L vs (716 ± 132) U/L, CK-MB (13.5 ± 17.1) mg/L vs (47.5 ± 21.9) mg/L, cTnI (22.8 ± 16.3) ng/mL vs (56.4 ± 24.0) ng/mL, allP<0.01. The age of morbidity, the ratios of hypertension, diabetes mellitus and blood lipids were similar between 2 groups. The frequency of abnormal Q-wave in ECG was similar between 2 groups, while the QTc interval was different in TTC group and STEMI group (630 ± 117) ms vs (540 ± 62) ms,P=0.001, the negative T waves in ECG leads II, III, aVF, aVR and V6 were as (100.00% vs 3.13%), (60.00% vs 6.25%), (90.00% vs 3.13%), (100.00% vs 21.88%), (100.00% vs 46.88%), allP<0.05. Conclusion: TTC patients with the main presentation as ST-segment elevation are usually having emotional or physical stress before on set, with obviously prolonged QTc interval and more frequency of negative T waves in ECG.

Objective To compare the kinematics of the knee joint of normal Chinese people and people after fixed-bearing posterior stabilized total knee arthroplasty while doing weight-bearing deep knee-bending using fluoroscopy analysis.Methods From June to December 2010,ten volunteers and ten patients with fixed-bearing posterior stabilized total knee arthroplasty (TKA) were required to perform weight-bearing deep knee-bending activity under surveillance of roentgenization,motion between femur and tibia was analyzed with interval of 15° according to two-to three-dimensional (2D-3D) registration technique.Results During weight-bearing deep knee-bending,the average weight-bearing maximal flexion was 136° in the normal group,which was significantly higher than the 125° in the TKA group.All 10 normal knees present posterior translation of femoral condyle during deep knee-bending,posterior translation of the lateral condyle was greater than medial condyle,thereby creating a medial pivot type of axial rotational pattern in which the tibia internally rotates relative to the femur as flexion increased.The average amount of posterior femoral translation of the medial condyle was 7.3±1.2 mm,whereas the lateral condyle translated posteriorly 19.3±3.1 mm.All knees experienced tibia rotated internally during progressive flexion,and the average amount of axial rotation for the ten subjects from 0° to 135° was 23.8±3.4°.From extension to maximal flexion,the average amount of posterior translation of medial condyle was 1.4±0.6 rmm,whereas the lateral condyle translated 6.4±1.7 mm in the posterior direction in the fixed-bearing posterior-stabilized TKA.The average amount of tibial internal rotation was 8.5°±3.4°.Conclusion In normal Chinese people,during knee flexion activities the lateral condyle experiences significantly more amount of posterior translation than the medial condyle,leading to the tibia present medial pivot internal rotation relative to the femur,and the PFC-Sigrna fixed-bearing posterior stabilized designs has the similar kinematics with normal knee,but the posterior condylar translation and tibial axial rotation are much less than the normal.

Objective To explore clinic value of nuclear myocardiac perfusion imaging (MPI) in perioperative coronary risk assessment in patients with heart diseases planning arthroplasty,and compare the conformity and effect on surgery planning between MPI and coronary computed tomography angiogram (CTA).Methods Prospectively collect clinical data of 228 patients with heart diseases planning joint arthroplasty,all patients had MPI and CTA test to assess perioperative coronary risk.The conformity and effect on surgery planning between the MPI and CTA was analyzed,and the occurrence of cardio-vascular complication was recorded.Results MPI showed that 215 patients had no myocardial ischemia except for 13.CTA showed that 113 cases had no coronary stenosis,51 cases had light coronary stenosis,39 cases had middle coronary stenosis and 12 cases had severe coronary stenosis in patients with no myocardial ischemia.CTA also found that 3 cases had no coronary stenosis,4 cases had light coronary stenosis,3 cases had middle coronary stenosis and 3 cases had severe coronary stenosis in patients with myocardial ischemia.The conformity between MPI and CTA was low.222 patients had completed operation except for 6 cases.MPI rather than CTA had conspicuous effect on surgery planning.There was no angina,myocardial infarction or cardiac death associated with myocardial ischemia.The postoperative cardio-vascular complications included 6 cases of heart failure,4 cases of atrial fibrillation and 1 case of cerebral infarction.Conclusion MPI is a direct index to judge blood supply of the myocardium,which can exactly predict the risk of perioperative myocardial ischemia and the prognosis.It's helpful for preoperative planning,reducing risk of perioperative complications through screening and excluding high-risk patients.

Objective To explore the influence of peritumoral edema (PTE) on the tendency of recurrent location and morphological character after total resection using MRI. Methods MRI data was collected from 43 patients with recur-rent brain glioma after total resection from four clinical centers and then the influence of of PTE on recurrence patterns af-ter total resection was retrospectively analyzed based on the T2 weighted image. Results The PTE had a significant influ-ence on the recurrent patterns of brain gliomas after total resection. When PTE was mild, the shapes of recurrent gliomas tended to be focal (6/8) and the recurrent locations tended to be local (5/8). When PTE was severe, the shapes of the recur- rent gliomas tended to be spread(30/35 and the recurrent locations tended to be distant (25/35), followed by marginal (7/35), In addition, the morphological patterns and locations of recurrent gliomas were significantly different among different PTE types (all P<0.001). When PTE was ring shape, the shapes of recurrent gliomas tended to be focal (7/9) and the recur-rent locations tended to be local (6/9), followed by marginal (2/9) and distant (1/9). When PTE was irregular shape, most of recurrent locations tended to be distant (25/34), followed by marginal (7/34) but rarely local (2/34). Conclusions The de-grees and the types of brain glioma PTE can significantly influence the locations and morphological patterns of recurrent gliomas after total resection.

Objective To evaluate the diagnostic value and safety of endobronchial ultrasoundguided transbronchial needle aspiration (EBUS-TBNA) in elderly patients with bronchogenic carcinoma.Methods From August,2013 and July,2014,31 patients aged 65 years and over with space-occupying mass and enlarged mediastinal lymph nodes detected by CT or positron emission tomography-computed tomography (PET-CT) underwent EBUS-TBNA.Rapid onsite cytology evaluation was not performed.Results There were 26 males and 5 females in this study,aged 65-77 years (70.1 years old on average).In 31 patients,70 samples were obtained from lymph nodes (LNs) and 4 samples were obtained from intrapulmonary lesions.29 cases were diagnosed as lung cancer,and 2 cases had false-negative diagnoses.The sensitivity and specificity rates of EBUS-guided TBNA method were 93.6％ and 100.0％,respectively.No major complications were observed in this series.Conclusions EBUS-TBNA is an safe and effective method in diagnosing bronchogenic carcinoma in elderly patients.

Objective To investigate the promotion effect of human transcriptional positive cofactor 4 (PC4) overexpression on lymphatic metastasis in lung adenocarcinoma .Methods 96 samples of lung adenocarcinoma tissue were collected .The immuno‐histochemistry(IHC) and real‐time quantitative polymerase chain reaction (qRT‐PCR) were adopted for detecting the expression levels of PC4 protein and mRNA .The correlation of PC4 expression with lymphatic metastasis and TNM stage was analyzed .Re‐sults The expression of PC4 protein was positively correlated mRNA in lung adenocarcinoma (r=0 .63 ,P<0 .01);the expression of PC4 protein was positively correlated with lymph node metastasis (χ2 =8 .29 ,P<0 .01) and TNM stage (χ2 =4 .71 ,P<0 .05);the expression of PC4 mRNA was also positively correlated with lymph node metastasis (χ2 = 8 .40 ,P< 0 .01) and TNM stage (χ2 =5 .10 ,P<0 .05) .Conclusion PC4 overexpression is found to be closely associated with the lymph node metastasis and TNM stage .PC4 may facilitate the lymph node metastasis of lung adenocarcinoma .