Objective To observe the therapeutic efficacy of endoscopic pancreaticobiliary duct drainage for acute necrotizing pancreatitis. Methods 41 cases of acute necrotizi ng pancreatitis were randomly divided into pancreaticobiliary duct drainage (21 causes) group and control group (20 cases).Results The procedure was successful in all 21 cases. The difference bet ween the two groups was statistically significant including hospital stay 〔(2 8?12) days vs. (37?19) days,P

Objective To explore the feasibility of using rotating pliers system for treating lumbar disc herniation with concomitant prolapse.Methods Ex vivo incision experiment was performed on 8 lumbar discs of 2 pigs using rotating pliers. Clinical application included 12 patients of lumbar disc herniation shown by CT or MRI. 40% herniations excerted enough pressure on dural sac with concomitant prolapse of different degrees. The symptoms and image findings were concordant. The herniated nucleus pulposus were resected using rotaing pliers system, MacNab standard was applied for the clinical evaluation. Results The ex vivo experiments and clinical application were successful. Clinical application showed CR in 4 patients (33.3%), PR in 5 patients (41.7%) and NR in 3 patients (25.0%). CT demonstrated the herniated disk tissue retraction of different degrees in CR and PR patients, together with decrease in CT attenuation number, ranging from 8 30 HU, 18?5HU in average but no changes in NR patients.Conclusions Percutaneous lumbar diskectomy is safe and effective to treat lumbar disc herniation with concomitant prolapse by using rotating pliers systems and thus extending the PLD application.

Objective To assess the long-term outcomes as well as the living quality of the patients with lumbar disc herniation (LDH) after the treatment of percutaneous lumbar discectomy (PLD), and to discuss the influential factors related to the long-term effectiveness. Methods During the period of January 2000 to March 2002, PLD was performed in 129 patients with LDH. By using self-evaluation questionnaires of Oswestry disability index (ODI), Short Form-36 (SF-36) and Japanese Orthopaedic Association (JOA) through letter or telephone interviews as well as the patients' initial medical records, the related clinical data were collected. Statistical analysis was conducted by using Wilcoxon's rank sum test, Chi-square test. Results One hundred and eight patients (83.7%) were able to be followed up and 104 effective ques-tionnaires were collected. The mean follow-up time was (6.64 ± 0.67) years, the excellent rate (ODI score, 0 ～ 20%) was 71.15%. The average scores of the JOA and SF-36 was 23.66 ± 5.72 and 75.88 ± 25.57, respectively. The scores of quality of life were obviously improved in all follow-up subscales. Conventional operations were carried out subsequently in 9 patients as they failed to respond to PLD. No complications related to PLD occurred in this study. The age, course of the disease and the patient's condition at the time of discharge might bear a relationship to long-term effectiveness. Conclusion PLD is a safe and minimally-invasive technique for the treatment of LDH with quick and reliable effect, PLD can dramatically improve the quality of life. Many factors, such as the age, course of the disease and the patient's condition at the time of discharge, can affect the long-term outcomes.

Objective To assess the long-term outcomes as well as the living quality of the patients with lumbar disc herniation(LDH) after the treatment of percutaneous lumbar discectomy(PLD),and to discuss the influential factors related to the long-term effectiveness.Methods During the period of January 2000 to March 2002,PLD was performed in 129 patients with LDH.By using self-evaluation questionnaires of Oswestry disability index(ODI),Short Form-36(SF-36) and Japanese Orthopaedic Association(JOA) through letter or telephone interviews as well as the patients’ initial medical records,the related clinical data were collected.Statistical analysis was conducted by using Wilcoxon’s rank sum test,Chi-square test.Results One hundred and eight patients(83.7%) were able to be followed up and 104 effective ques-tionnaires were collected.The mean follow-up time was(6.64 ? 0.67) years,the excellent rate(ODI score,0 ～ 20%) was 71.15%.The average scores of the JOA and SF-36 was 23.66 ? 5.72 and 75.88 ? 25.57,respectively.The scores of quality of life were obviously improved in all follow-up subscales.Conventional operations were carried out subsequently in 9 patients as they failed to respond to PLD.No complications related to PLD occurred in this study.The age,course of the disease and the patient’s condition at the time of discharge might bear a relationship to long-term effectiveness.Conclusion PLD is a safe and minimally-invasive technique for the treatment of LDH with quick and reliable effect.PLD can dramatically improve the quality of life.Many factors,such as the age,course of the disease and the patient’s condition at the time of discharge,can affect the long-term outcomes.

Objective To explore the feasibility and value of treating esophageal thoracic fistula with covered esophageal stent through nasal esophagus drainage tube. Methods Seven patients with esophageal thoracic cavity fistula were enrolled and treated by 5F pigtail side-holes catheter inserting into thoracic cavity for drainage and then again through nasal esophagus and fistula, placing a covered stent in the esophagus to occlude the orifice of the fistula. The abscess cavities were washed and radiographied periodically through drainage tubes. Results The insertion of the drainage tube and the placement of covered stent were all successful. The drainage tubes were placed in abscess cavities for 12-22 days, average 15 days. The radiography through drainage tubes showed that the abscess cavities disappeared or shrank obviously with control of hydropneumothorax before the drainage tubes being pulled out. The esophagogram after withdrawal of the drainage tubes notified that the fistulae were occluded satisfactorily with stents expanded fully without displacement and stenosis. Conclusions Treating esophageal thoracic cavity fistula with covered esophageal stent through nasal esophagus drainage tube is feasible and safe with clinical efficiency.

A study of 10 cadavers and 100 CT scans of lumbar spine was performed to investigate the topographical anatomy of the posterolateral disc puncture in percutaneous lumbar discectomy.A way of the puncture at L_5-S_1 disc,with comparative plain films of lumbar spine in different positions were taken in 50 cases.The results showed that the pos- terolateral approach for percutaneous discectony was a safe way.However,it is important to have full knowledge of the regional topographical anatomy associated with the puncture tech- nique to avoid the potential neurovascular complications.The special position designed by authors for the puncture at L_5-S_1 disc is useful by lowering the position of iliac crest which hinders the entrance of needle,thus can raise the successful rate of the percutaneous discec- tomy 100% successful rate of the disc puncture at L_5-S_1 disc was obtained in 130 cases.The two puncture parameters of Chinese associated with percutaneous lumbar discectomy were first measured;and also the route including nearby structures,the complications were dis- cussed.

Objective : To learn the epidemiological characteristics of acute hepatitis B in Jiangxi Province from 2014 to 2021, so as to provide insights into perfecting hepatitis B prevention and control strategy. Methods: Data pertaining to acute hepatitis B was collected through the Chinese Disease Prevention and Control Information System. The temporal, spatial and population distributions of acute hepatitis B were analyzed using a descriptive epidemiological method. The trend in incidence of acute hepatitis B was analyzed using annual percent change (APC). Results: Totally 8 890 cases of acute hepatitis B were reported in Jiangxi Province from 2014 to 2021, with the reported incidence showing a tendency towards a decline (APC=-11.730%, P<0.05). The average annual reported incidence rate of acute hepatitis B was 2.42/105. Acute hepatitis B occurred all the year round, without obvious seasonal characteristics. The top three highest incidence rates were reported in Pingxiang City (7.12/105), Ganzhou City (3.12/105) and Fuzhou City (2.87/105). The lowest and highest incidence rates of acute hepatitis B were seen among residents aged under 10 years (0.30/105) and 20-29 years (3.86/105). The incidence rate of males was higher than that of females (3.25/105 vs. 1.55/105, P<0.05). Farmers were predominant population affected acute hepatitis B (5 764 cases, 64.84%). Conclusions The incidence of acute hepatitis B showed a downward trend in Jiangxi Province from 2014 to 2021, and the disease predominantly affected young males, farmers. Health education should be strengthened, and hepatitis B vaccination coverage should be promoted.

Objective To investigate the killing effect of polymethylmethacrylate (PMMA) on spinal metastasis of transplanted VX2 carcinoma in experimental rabbit models. Methods Spinal metastasis of transplanted VX2 carcinoma model was successfully established in 18 rabbits. The experimental rabbits were randomly and equally divided into three groups with 6 rabbits in each group. Under CT guidance , PMMA or saline was injected into the center of VX2 tumor; in group A 0.3 ml of PMMA was used, in group B 0.1 ml of PMMA was used and in group C (control group) 0.3 ml saline was used. Twenty-four hours after the injection, the animals were sacrificed. Four tissue samples were obtained from the sites at 1 mm , 5 mm, 10 mm and 15 mm away from the PMMA mass in each rabbit of group A and group B , while four tissue samples were collected from different four sites from the tumor ’s center to border in each rabbit of group C. TdT-mediated dUTP nick-end labeling (TUNEL) method was used to determine the tumor cell apoptosis rate. Results After successful establishment of rabbit model, injection of PMMA was performed in sixteen among the eighteen rabbits. Technical success rates were 83.3% in both group A and B, and the success rate was 100% in group C. The difference in technical success rate was not significant. The mean tumor cell apoptosis rates of spinal VX2 carcinoma at 1 mm, 5 mm and 10 mm away from the PMMA mass in group A were (65.75±18.81)%, (50.00±14.24)% and(14.95±8.98)% respectively. The mean apoptosis rate in the control group was (9.79 ±5.24)%; the differences between the group A and the control group were statistically significant (P<0.05). The mean tumor cell apoptosis rate of spinal VX2 carcinoma at 15 mm away from the PMMA mass in group A was (10.30 ±8.13)%, which was not significantly different with that of the control group. The mean tumor cell apoptosis rates of spinal VX2 carcinoma at 1 mm and 5 mm away from the PMMA mass in group B were (49.20±15.57)% and(17.75±9.28)% respectively, which was significantly different with that of the control group(P<0.05); the mean tumor cell apoptosis rates at 10 mm and 15 mm away from the PMMA mass in group B were not significantly different with those of the control group. Statistically significant differences in the mean tumor cell apoptosis rates determined at 1 mm, 5 mm and 10 mm away from the PMMA mass existed between group A and group B(P<0.001). Conclusion PMMA can promote the apoptosis of tumor cells, properly increasing the injected amount of PMMA can enlarge the extent of tumor cell apoptosis.

Objective To investigate the features and significance of pathologic changes in apoptosis of small bowel allograft during acute rejection in rats. Methods All 24 recipients were equally divided into four groups ; group A: nonoperative control; group B: allograft ; group C: isograft, group D: treatment control. The graft samples were harvested on day 3, 5, 7, 10 after transplantation, and subjected to histologic examination . Mucosal thickness, villous height and crypt depth were measured, and apoptotic cells of intestinal mucosa of grafts on day 3,5 and 7 after transplantation were examined. Results The mucosal structure was normal in group A; The degree of the inflammatory infiltrated cells ,intestinal mucosa cell apoptosis and structural injury of mucosa in group B were significantly severe compared with groups C and D. As the post-transplanted time increased, the number of musocal apoptotic cells and the degree of mucosal structural injury were significantly increased. The degree of mucosal structural injury in group C was milder than in group B. A few infiltrated cells and mild edema of mucosa occurred in group D , but no mucosal structural injury was found. Conclusions Inflammatory cell infiltration, mucosal epithelial cell apoptosis and mucosal structural damage are the main pathologic features of small bowel allograft during acute rejection. Dynamic observation of the pathologic changes and cell apoptosis of small bowel graft is of certain value in the diagnosis of acute rejection of small bowel graft and in assessment of the degree of small bowel injury.

Objective To investigate the value of positron emisson tomography-computed tomography ( PET-CT) in monitoring the residual lesions in lipiodol sedimentary region and extrahepatic metastastic lesions of hepatocellular carcinoma ( HCC) with alpha fetoproteins ( AFP) positive after interventional therapy. Methods The data of 20 cases with primary HCC confirmed by histopathology were retrospectively analyzed. Their AFP levels decreased to normal range after interventional treatments, but rose to abnormal high level during following-up. After the abdominal routine imaging examinations, the definite diagnosis of the residual lesions in lipiodol sedimentary region or extrahepatic lesions can't be made confidently. All cases were scanned by PET-CT, and according to their PET-CT results, the further treatments were given and the therapeutic results were monitored with radiology and AFP tests. Results In all 20 cases, 10 of them were detected to have the extrahepatic metastastic lesions by PET-CT, including 4 with abdominal wall metastasis upon the liver, 3 with solitary pulmonary metastasis with diameter less than 1 cm, 2 with mesenteric mestastasis, 1 with mestastasis of operative incisions, but these lesions were neglected by abdominal routine imaging examinations. Eight cases showed the uneven lipiodol sedimentary region in the primary lesion by CT or MRI examination, but can't be diagnosed whether it was residual lesion with other examinations including DSA. A definite diagnosis was obtained by PET-CT. In 2 cases, lymph nodes less than 1. 5 cm were found in the hepatic portal area(PHA) and retroperitoneum on CT images,which was determined to be metastatic by PET-CT. All the detected lesions were given further treatments of surgery or interventional therapy. Most patients showed decreased AFP levels except the 2 patients with lymph node metastasis. The imaging examinations also indicated that the treatments had a good effect on lesions. Conclusion In the patients with HCC and abnormal high levels of AFP, in addition to abdominal routine imaging examinations, PET-CT is beneficial for those who is suspected of residual lesions in lipiodol sedimentary region or extrahepatic metastasis.