ObjectiveTo study the relationship between carotid sclerosis and lipoprotein (LP) (a) in patients with coronary artery disease. MethodsOne hundred and fifty-nine coronary artery disease patients with coronary arteriongraphy (CAG) positive were selected as the study group, and Gensini points were taken in these patients. Forty CAG normal patients was in control group, and all of them were examined with ultrasound, and serum levels of LP (a) were tested. According to ultrasound, study group were divided into 4 subgroups: normal intima group(24 cases), mild stenosis group(41 cases), moderate stenosis group (82 cases) and severe stenosis group ( 12 cases). ResultsThe rate of carotid sclerosis in study group [84.9％ (135/159)] was significantly higher than that in control group [42.5％ ( 17/40 )] (P ＜ 0.01 ). Gensini points in moderate and severe stenosis group were significantly higher than those in normal intima and mild stenosis group (P ＜ 0.05 or ＜ 0.01 ), Gensini points in severe stenosis group were significantly higher than those in moderately group(P ＜ 0.01 ), but there was no significant difference between mild stenosis group and normal intima group(P ＞ 0.05 ). The level of LP(a) in study group[(35.27 + 23.38) mg/L] was significantly higher than that in control group[(23.13 ± 16.56) mg/L](P＜ 0.01 ). The level of LP(a) in mild stenosis group was significantly lower than that in moderate and severe stenosis group(P＜ 0.05 or ＜ 0.01 ), and there was no significantly difference compared with that in normal intima group(P＞ 0.05 ). ConclusionsCarotid sclerosis ultrasonic testing helps to predict the risk degree of coronary artery disease. The level of LP(a ) is closely related with carotid sclerosis and has important value in judging the condition of patients with coronary artery disease.

Objective:To investigate the efficacy, safety and prognostic factors of percutaneous biliary stent combined with iodine-125 seed chain brachytherapy (radiotherapy) in the treatment of malignant obstructive jaundice.Methods:Data of 107 cases with malignant obstructive jaundice treated with percutaneous biliary stent implantation from January 2017 to December 2020 were retrospectively analyzed. Among them, 58 cases received biliary stent combined with iodne-125 seed chain brachytherapy (study group), and 49 cases received biliary stent implantation (control group). The changes of bilirubin, stent patency time, complications, overall survival (OS) and prognostic factors were analyzed in both groups.Results:The incidence of complications in the study group and the control group were 17.2% and 18.3% respectively, and the difference was not statistically significant ( P=0.974). Serum total bilirubin levels were decreased significantly in both groups at one month after surgery ( P<0.001). Postoperative stent patency time was significantly better in the study group (10.0±1.6 months) (95% CI: 8.2～12.5) than that in the control group (5.2±0.4 months) (95% CI: 4.1～6.0, P<0.001). The median OS was longer in the study group (11.2±1.8 months) (95% CI: 9.2～12.8) than that in the control group (8.0±1.1 months) (95% CI: 8.0～12.8, P<0.001). Multivariate analysis result showed that stent combined with brachytherapy ( HR=0.08, 95% CI:0.04～0.15, P<0.001) and receiving further anti-tumor therapy after surgery ( HR=0.27, 95% CI:0.15~0.49, P<0.001) were independent risk factors affecting the patency of biliary stents. Preoperative percutaneous transhepatic biliary drainage ( HR=0.46, 95% CI:0.28～0.74, P=0.002), stent combined with brachytherapy ( HR=0.23, 95% CI:0.14～0.39, P<0.001) and receiving further anti-tumor therapy after surgery ( HR=0.37, 95% CI:0.22～0.61, P<0.001) were independent risk factors affecting OS. Conclusion:Percutaneous biliary stent combined with brachytherapy is safe and effective in the treatment of malignant obstructive jaundice, which can significantly prolong the patency time of biliary stent and the survival time of patients.