ObjectiveTo investigate the feasibility and isolation efficiency of percutaneous selective isolated hepatic perfusion chemotherapy(PSIHP). MethodsSix pigs underwent the procedure of routine transhepatic arterial infusion(HAI) and 6 underwent PSIHP.5-FU was used in this study. The drug(5-FU) (concentration) of blood from hepatic and systemic veins of both groups was observed. Liver tissue was (investigated) for pathologic changes. ResultsThe peak level of 5-FU concentration in blood from right (hepatic) vein and systemic vein in HAI group was(4082.530415.213)mg/L and (1682.230216.834)mg/L respectively.In PSIHP group, the peak level(5-FU) was(5321.711517.318)mg/L and(510.83452.518)mg/L, respectively.There was a statistically significant difference between HAI group an PSIHP group(P

Ninety-five patients with acute myocardial infarction (AMI) treated in our hospital from January 2015 to December 2017 were enrolled. According to thrombolysis in myocardial infarction (TIMI) risk score, 95 patients were divided into high group (TIMI>4, n=46) and low group (TIMI≤4, n=49) . According to platelet/lymphocyte ratio (PLR), 95 patients were divided into low PLR group (PLR≤170, n=60) and high PLR group (PLR>170, n=35) . The correlation of PLR with short-term and long-term prognosis in patients with acute myocardial infarction was analyzed. The results showed that there were no significant differences in red blood cell count (RBC), hemoglobin (HB), white blood cell count (WBC), neutrophil ratio (NEU), percentage of intermediate cells (MON), lymphocyte count (LYM), basophils (Bas), red blood cells distribution width (RDW), eosinophils (EO) between high and low TIMI groups ( P>0.05) . The platelet count (PLT) and PLR in high TIMI group was significantly higher than that in low TIMI group ( t=42.196, 10.053; P<0.05) . The in-hospital mortality and all-cause mortality of high PLR group were significantly higher than those of low PLR group [1.67%(1/60) vs. 14.28%(5/35), χ 2=5.949, P=0.02; 3.33%(2/60) vs. 17.14%(6/35), χ 2=5.466, P=0.04]; while there was no significant difference in 1-year re-hospitalization rate, interventional therapy and thrombolytic therapy between the two groups ( P>0.05) . Pearson correlation analysis showed that PLR was positively correlated with TIMI score ( r=0.563, P=0.024) . Logistic regression analysis showed that Killip grade, serum creatinine and PLR were independent risk factors of AMI ( OR=7.532,60.14,8.234; P<0.05). PLR may effectively evaluate the prognosis of acute myocardial infarction, suggesting that its clinical value should be condidered.

Objective:To investigate the current status of anticoagulant therapy and the incidence of ischemic and bleeding events in hospitalized patients aged 90 years and over with non-valvular atrial fibrillation(NVAF).Methods:We retrospectively collected clinical data, antithrombotic treatment strategies, in-hospital ischemic stroke and bleeding events from NVAF patients(≥90 years)who were admitted to our hospital from June 2014 to August 2018.Based on the CHA 2DS 2-VASc score(2, 3, and ≥4 respectively), patients were divided into three ischemic risk groups, and antithrombotic treatment strategies and in-hospital ischemic stroke events were compared between the three groups.Alternatively, patients were divided into the high bleeding risk group(HAS-BLED score ≥3, )and the non-high bleeding risk group(HAS-BLED score ≤2), and antithrombic treatment strategies and the major bleeding events were compared between the two groups. Results:Among the 223 hospitalized NVAF patients aged 90 years and over, 42.6% of them received anticoagulant treatment, 25.6% received antiplatelet drugs, and 31.8% received non-antithrombotic treatment.With the increase of the CHA 2DS 2-VASc score, there was a trend of declined rates of non-antithrombotic treatment among the three ischemic risk groups(47.4%, 42.9%, 26.4%, P=0.06), and the rates of in-hospital ischemic stroke were similar among groups(10.5%, 12.2%, 15.5%, P=0.75). Moreover, compared with the non-high bleeding risk group, patients in the high bleeding risk group more frequently received anticoagulant treatment(47.2% vs.38.3%)and less frequently received non-antithrombotic therapy(28.7% vs.34.7%). There was no significant difference in antithrombotic treatment strategies( P=0.39)or rate of in-hospital major bleeding events(13.0% vs.10.2%, P=0.51). However, the rate of in-hospital major bleeding events was significantly higher in those with concurrent infections(16.8% vs.6.4%, P=0.02)or respiratory failure(21.3% vs.8.0%, P=0.01). Conclusions:The rate of anticoagulant use in NVAF patients aged 90 years and over is too low during hospitalization, and anticoagulant therapy should be standardized.In addition to the HAS-BLED score, we should consider the complications that increase the bleeding risk, such as infections and respiratory failure, when evaluating the bleeding risk.

Objective:To investigate clinical features and risk factors for pulmonary embolism in elderly patients with tumor-associated venous thromboembolism(VTE).Methods:Patients aged ≥65 years with malignant tumors combined with deep venous thromboembolism(DVT)in our hospital from June 2014 to November 2018 were enrolled retrospectively.General information such as age, sex, date of hospitalization, primary tumor location, tumor metastasis, concomitant disease, thrombosis type and site were collected.The Charlson comorbidity index was calculated.According to the site of deep vein thrombosis, patients were divided into the DVT group and the pulmonary embolism(PTE)group.Risk factors for PE were analyzed statistically on the indicators in the two groups.Results:Of the 318 patients, 281(88.4%)were in the DVT group and 37(11.6%)were in the PE group.There were no statistically significant differences in age, sex, smoking history, length of hospital stay, primary tumor type or tumor metastasis between the two groups( P>0.05). The main comorbidities included hypertension, diabetes mellitus, atherosclerotic coronary disease, chronic obstructive pulmonary disease, heart failure, cerebrovascular disease, chronic kidney disease and chronic liver disease, and there was no statistically significant difference in the number of patients with the above diseases between the two groups( P>0.05). Charlson comorbidity index scores were higher in the PE group than in the DVT group(7.22±3.95 vs.5.69±2.89, P=0.028). Logistic regression analysis showed that age( OR=0.9, 95% CI: 0.846-0.985, P=0.001), tumor metastasis( OR=0.006, 95% CI: 0.001-0.032, P=0.000), and Charlson comorbidity index score( OR=2.278, 95% CI: 1.772-2.929, P=0.000)were all independent risk factors for PTE. Conclusions:Age, tumor metastasis and Charlson comorbidity index score are independent risk factors for PE in elderly tumor patients.