Objective:To analyze the characteristics of demoralization in patients with primary liver cancer undergoing transcatheter arterial chemoembolization (TACE) and the differences of death anxiety among these types using latent profile analysis.Methods:Based on the cross-sectional design, 216 patients with primary liver cancer undergoing TACE of the First Affiliated Hospital of Zhengzhou University were selected by convenient sampling method from July 2018 to May 2021, and were investigated by using the general data questionnaire, Demoralization Scale and Templer′s Death Anxiety Scale.Results:A total of 139 cases (64.4%) with high demoralization and 120 cases (55.6%) with high death anxiety were detected. The patients were divided into four subtypes: 67 cases(31.0%) in the emotional distress group, 52 cases(24.1%) in the high risk group, 72 cases (33.3%) in the sense loss group, and 25 cases (11.6%) in the low risk group. Tumor stage and working status were the main factors affecting the characteristic classification of demoralization ( β=2.615, 2.085, both P<0.05). There were significant differences in death anxiety among different subtypes of patients ( H=77.00, P<0.01). Conclusions:The level of death anxiety is higher in patients with primary liver cancer after TACE surgery, and there are differences in different subtypes of patients with demoralization. Medical staff should formulate targeted intervention measures for different subtypes of patients to reduce their symptoms of demoralization and death anxiety.

Objective To explore the relationship between the level of plasma ADAMTS4 and the vulnerability of carotid atherosclerotic plaque in patients with carotid artery stenosis and the clinical value of evaluating the vulnerability of the carotid atherosclerotic plaque.Methods 60 patients with carotid artery stenosis were divided into stable plaque group and vulnerable plaque group according to the histopathological typing after carotid endarterectomy (CEA).30 patients who had atherosclerosis but no carotid plaque formation served as control.Using ELISA to measure the level of plasma ADAMTS4.Results The level of plasma ADAMTS4 was significantly higher in the vulnerable-plaque group (112.74 ± 17.47) ng/ml compared with the stable plaque group (56.67 ± 22.14)ng/ml and the control group (56.67 ± 22.14)ng/ ml,P ＜ 0.001.Logistic analysis showed that high level of plasma ADAMTS4 was risk factor for vulnerability of carotid atherosclerotic plaque (P ＜ 0.05,OR =8.240,95 ％ CI:1.512-22.915).ROC curve showed that ADAMTS4 =100.935 ng/ml could accurately predict significant vulnerability with accuracy of 94.3％.Conclusion ADAMTS4 is an effective,sensitive and non-invasive biomarker to evaluate the vulnerability of carotid atherosclerotic plaque.

Different from the traditional health technology assessment(HTA), hospital-based health technology assessment(HB-HTA) is mainly based on the perspective of the hospital to carry out economic analysis, commonly used cost-effectiveness analysis combined with budget impact analysis methods. It pays attention to the current medical costs and effects, and supports the hospital′s internal health technology access, purchase pricing, elimination and other decisions. In the context of deepening the reform of medical insurance payment mode in China, the hospital internal medicine decision-making based on HB-HTA is particularly important. Based on the economic characteristics of health technology, the authors analyzed the differences between HB-HTA and traditional HTA in carrying out economic evaluation, introduced the steps, contents, indicators and methods of HB-HTA economic evaluation, and put forward relevant strategic suggestions.

Objective To discuss the application of the"rotating guidewire and correcting the filter recovery hook direction technique"("rotation-correction loop technique"for short),a technique invented by the authors in clinical practice,in the retrieval of complex inferior vena cava filter(IVCF),and to discuss its technical skills and advantages.Methods The clinical data of 417 patients carrying an IVCF,who were admitted to the Department of Vascular Surgery of Second Hospital of Shanxi Medical University of China to retrieve IVCF between January 2022 and December 2022,were retrospectively analyzed.Taking the time spent on the retrieval of IVCF and the intraoperative radiation dose as the evaluation indicators,the advantages and disadvantages of the standard filter retrieval technique,the"rotation-correction loop technique"and the other loop-assisted techniques were compared.Results Both the intraoperative radiation dose and the time spent on the retrieval of IVCF using"rotation-correction loop technique"were remarkably lower than those of other loop-assisted techniques(P＜0.000 1).Conclusion For the retrieval of complex IVCF,especially for the IVCF which is heavily tilted and/or its recovered hook is attached to the vascular wall,the use of"rotation-correction loop technique"can shorten the time spent on the the retrieval of IVCF and reduce the intraoperative radiation dose.This technique carries high safety and practicability,the device is simple and it can be manipulated by single physician,which is conducive to clinical application and promotion.(J Intervent Radiol,2024,33:289-294)