Objective To explore the feasibility of transauricular arterial access for hepatic artery catheterization in rabbits.Methods Thirty healthy New Zealand White rabbits were randomly divided into 5 groups ( n =6 in each group):transauricular vein injection group , transarterial infusion group , transarterial lipiodol group , transarterial gelfoam group and transhepatic puncture group .Every rabbit was prescribed elemene (20 mg/kg) via different access in 6 minutes. All the rabbits of hepatic artery catheterization were divided into two groups according to their serial number :transauricular arterial access group (odd, n=9) and transfemoral arterial access group (even, n=9).The arterial access could be changed each other due to the failure of one technique .The catheterization time , success rate and survival rate were compared between the two groups .Venous blood collection via auricular vein or jugular vein for pharmacokinetics was performed in each rabbit .Results Technical success rates of hepatic artery catheterization were 0% ( 0/9 ) and 88.9%( 16/18 ) for transauricular and transfemoral arterial access , respectively . The time duration of transauricular and transfemoral access groups was 28.4 ±13.6 and 33.9 ±19.6 minutes, respectively (P>0.05).The survival rates of the transauricular and transfemoral access groups were 100%(9/9) and 88.9%(16/18), respectively.Blood samples were collected via auricular vein in 4 and jugular vein in 23 rabbits.Conclusions Hepatic artery catheterization via transauricular arterial access is technically not feasible , while transfemoral access is simple and suitable in rabbits .Blood collection via the jugular vein may be a more reliable and valuable method for pharmacokinetic studies in rabbits .

Objective To evaluate the value of covered self-expending metallic stent in the management of malignant esophageal and duodenal strictures or fistulas and explore the treatment for the associated common complications.Methods With interventional procedure under fluoroscopic guidance,95 self-expending mesh stents were implanted in 87 patients,including esophageal carcinoma(50 cases),esophagogastric anastomotic stenosis(23 cases),gastroduodenal malignant stenosis(5 cases),esophagobronchial fistula(3 cases),esophagogastric anastomotic fistula(6 cases).Results Stent placement was successful in all patients at the first trial,having no instant complication except one acute bleeding during the procedure and all of them with relief of stenostic complaint,restoration of clictelic function and closure of fistulas.The long-term curative effect showed something to do with different kind of disease,and the related treatment.Conclusion Self-expending metallic covered mesh stent is safe,effective and less complication;and could be further promoted with addition of radiotherapy and(or)chemotherapy.

The relatively high abundance of geochemical elements such as Nb, Zr, Y and other elements shows serious interferences in the determination of trace silver in geochemical samples by inductively coupled plasma-mass spectrometry ( ICP-MS) . Thus it will lead to large deviation in the determination of geochemical samples without separation and enrichment. The traditional emission spectrum or graphite furnace atomic absorption method is only single-element analysis to the silver and with bad sample representativeness. In this study, load diphenylthiourea ( DPTU) foam selective enrichment was used for the separation of Au and Ag from other interfering elements in geological samples, and thiourea liberation-ICP-MS method was developed for the simultaneous determination of Au and Ag. The samples were first decomposed by 1:1 aqua regia. After addition of 50 mL of water, the samples were adsorbed under oscillation for 30 min at 20℃. The detection limits of the Au and Ag were 0. 02 ng/g and 0. 007μg/g, respectively. The proposed method was successfully applied to the determination of Au and Ag in eight national standard materials.

Objective To investigate the effect of vitamin D (VD) on gastric cancer and its underlying mechanisms by detecting serum VD levels in gastric cancer patients and the expression of vitamin D receptor (VDR) in gastric tumor.Methods Serum VD levels was detected by enzyme linked immunosorbent assay,VRD expression of tumor tissue and normal mucosa were detected by immunohistochemistry.At the same time,relationships of VDR expression and the prognosis of the patients were analyzed.Results The serum levels of VD of gastric cancer patients were lower than that of healthy people (P＜0.05),and they were negatively related to the degree of cell differentiation significantly (P＜0.001).VDR expression in gastric tumor tissue significantly decreased compared to that of the normal mucosa (P＜0.05).A significant correlation was found between the VDR expression and the differentiation grade of the carcinoma,with well differentiated carcinoma having the highest level of VDR expression (P＜0.05).For patients with gastric cancer,those with positive VDR expression had significant longer progression-free survival (PFS) and overall survival (OS) than the patients with negative VDR expression (P＜0.05).Conclusions VD may be a protecting factor of gastric cancer.VDR can be regarded as a marker of differentiation of gastric cancer and served as an effective prognostic factor in patients with postoperative gastric cancer.

Objective To evaluate the diagnostic and therapeutic value and safety of transcatheter arterial angiography and embolization in patients with endoscopic refractory gastrointestinal bleeding.Methods Thirty-one cases of endoscopic refractory gastrointestinal bleeding were performed DSA and treated with transcatheter arterial angiography and embolization.The safty and efficacy was evaluated.Results Angiographic positive rate of bleeding was 80.65％ (25/31);28 cases was treated with embolization.The success rate of first embolization was 75.00％ (21/28),and the total success rate was 82.14 ％ (23/28) by the second embolization.Seven patients received surgical resection after interventional therapy,including 2 cases of jejunal stromal tumors and 5 cases of gastric malignant tumors.Four cases of gastric cancer patients underwent rebleeding within 30 days after interventional therapy,of which 2 died of heart or lung function failure due to basic diseases.Except for 1 patient of anastomotic bleeding after gastrointestinal anastomosis occurred anastomotic fistula after embolization,who recovery with the support treatment,no other cases occurred serious gastrointestinal ischemic necrosis.Conclusion Interventional diagnosis and treatment for gastrointestinal bleeding hemostasis is effective and safety,and also can achieve good results especially for malignant gastric tumor hemorrhage,which can be used for endoscopic refractory gastrointestinal bleeding patients.

Objective:To explore the application effect of checklist teaching in clinical nursing internship teaching in nephrology.Methods:A total of 49 full-time undergraduate nursing students who interned between July and December 2023 were selected as the observation group, while 49 full-time undergraduate nursing students who interned between July and December 2022 were selected as the control group. During the internship teaching process, the observation group received a checklist teaching, while the control group received traditional teaching. The effectiveness of the checklist teaching method was evaluated by comparing the internship performance, sense of belonging, and satisfaction of both students and teachers between two groups of nursing students. SPSS 26.0 was used for chi-square test and t test. Results:After teaching, the theoretical scores [(97.45±1.63) vs. (93.26±2.38)] and operational skills scores [(96.15±1.90) vs. (93.25±2.46)] were significantly higher in the observation group than in the control group ( P<0.05). After teaching, the observation group had significantly higher scores for the sense of belonging and satisfaction scores in all dimensions during the internship compared to the control group ( P<0.05). After teaching, the teaching staff showed significantly higher satisfaction scores in all dimensions in the observation group than in the control group ( P<0.05). Conclusions:Applying checklist teaching to clinical teaching of nephrology nursing can significantly improve the internship assessment scores of students, promote the teaching performance of teaching staff, and enhance the satisfaction of both teachers and students.

Objective:To investigate the relationship between serum matrix metalloproteinase-9 (MMP-9) level and the location and severity of bleeding in patients with cerebral microbleeds(CMBs).Methods:A total of 60 CMBs patients admitted to the Department of Neurology of the First Affiliated Hospital of the Xinxiang Medical University from January 2019 to August 2020 were selected as subjects as the CMBs group, and 60 healthy controls without nervous system diseases in outpatient physical examination during the same period were selected as the control group. The clinical data and biochemical indicators of the two groups were collected. Serum MMP-9 levels were measured by enzyme linked immunosorbent assay (ELISA). According to susceptibility weighted imaging (SWI), CMBs patients were divided into grade 1 group ( n=24), grade 2 group ( n=19) and grade 3 group ( n=17), and according to the micro analytical rating scale (MARS), the CMBs patients were divided into the lobar group ( n=19), the deep or infratentorial group ( n=17) and the mixed group ( n=24).The relationship between serum MMP-9 level and the location and severity of CMBs was analyzed. SPSS 19.0 software was used for data statistical analysis.One-way ANOVA, t-test and rank sum test were used for comparison. Logistic regression analysis was used to analyze the influencing factors. Pearson correlation analysis and Spearman correlation analysis were used for correlation analysis. Results:The level of MMP-9 in CMBs group was significantly higher than that in control group (208.13(142.25, 285.88) μg/L, 149.50(93.40, 186.51)μg/L), and the difference was statistically significant ( P<0.05). Serum MMP-9 level was a risk factor of CMBs ( β=1.322, OR=3.750, 95% CI=2.038-7.997, P=0.002). The difference of level of MMP-9 in different severity of CMBs was statistically significant (147.55(109.25, 266.47)μg/L, 242.12(147.55, 288.80)μg/L, 270.42(203.43, 364.27)μg/L, P=0.017). Serum MMP-9 level was positively correlated with the number of CMBs ( r=0.371, P=0.003). The difference of MMP-9 level of CMBs in different locations were statistically significant (249.77(158.43, 338.46)μg/L, 188.83(138.52, 243.15)μg/L, 210.65(144.25, 255.78)μg/L, P=0.013). The increased serum MMP-9 level was a risk factor for CMBs( β=0.401, OR=1.122, 95% CI=1.004-1.204, P=0.036). Conclusion:The increased level of serum MMP-9 may be a risk factor of CMBs, especially for CMBs in cerebral lobesand, and the level of MMP-9 is positively correlated with the severity of CMBs.

Objective To assess the influence of different interventional injection routes of raltitrexed on the liver function, histology and pharmacokinetics in experimental rabbits, and to discuss the feasibility, safety and advantages of local application of raltitrexed. Methods A total of 25 New Zealand white rabbits were randomly and equally divided into 5 groups with 5 rabbits in each group: group A (using peripheral intravenous injection), group B (employing hepatic arterial infusion), group C (adopting hepatic artery embolization with Lipiodol), group D (hepatic artery embolization with gelfoam particles), and group E (direct puncture of liver and injection). Clinical equivalent dose (0. 17 mg/kg) raltitrexed injection was given to each experimental rabbit. At 5, 15, 30, 60, 120 and 180 min after the treatment, venous blood sample was collected for pharmacokinetic analysis. At 6 h and one week after administration of drug, liver functions were tested, and histological specimens of liver tissues were made at the same time. Results The peripheral blood drug concentrations at 5 and 60 min in group A were 0. 91 μg/mL and 0 μg/mL respectively, at 5 and 180 min in group B were 1. 73 μg/mL and 0. 37 μg/mL respectively, at 5 and 180 min in group C were 0. 82 μg/mL and 0. 08 μg/mL respectively, at 5 and 180 min in group D were 0. 94 μg/mL and 0. 08 μg/mL, and at 5 and 60 min in group E were 0. 39 μg/mL and 0. 13 μg/mL respectively. Six hours after administration of drug, the serum levels of AST, ALT in group C, group D and group E were significantly increased (P＜0. 0l), which returned to normal levels in one week after the treatment. The severity of liver tissue degeneration and necrosis detected in each group varied, in a severity - decreasing order, from group E, group C, group D, group B and group A. In group E, the surrounding normal liver tissue had no obvious necrosis. Conclusion The rabbit' s liver has no significant first pass elimination effect to raltitrexed. The equivalent dose of raltitrexed administered through the hepatic artery can cause obvious hepatocellular injury. Direct puncture and injection produce limited liver injury. Clinically, the dose of raltitrexed can be adjusted based on the degree of super selective catheterization condition and tumor size. (J Intervent Radiol, 2018, 27:247-251)

Objective:To investigate and compare the effectiveness and safety of infrared bipolar radiofrequency (IR-RF) and nonablative fractional laser (NAFL) including 1 540 nm Er: glass and 1 927 nm thulium-doped laser, so as to choose a better pathway for clinical treatments on periorbital wrinkles.Methods:A prospective randomized self-controlled study was conducted in the Department of Laser and Aesthetic Medicine, Shanghai Ninth People’s Hospital. A total of 27 patients divided into 3 groups by random number table underwent split-face treatments between December 2019 and January 2021. Two of the three treatments were selected randomly for patients in each group: Group A, left side IR-RF vs. right side 1 540 nm NAFL; Group B, left side IR-RF vs. right side 1 927 nm NAFL; Group C, left side 1 540 nm NAFL vs. right side 1 927 nm NAFL. In total 3 sessions were given at 2 months interval. Therapeutic outcomes were evaluated by subjective (GAIS and Fitzpatrick wrinkle score) and objective (VISIA-CR) assessments. Side effects and pain visual evaluation (VAS) were also recorded. Wilcoxon signed-rank tests were used to evaluate the differences among the three therapeutic method , and relationships with VAS and patients’ age.Results:In total 30 patients (10 in each group) were recruited and finally 27 cases completed all treatments and follow-ups: Group A, 9 patients (male 3, female 6); Group B, 8 patients (male 3, female 5); Group C, 10 patients (male 4, female 6). The age distributions: Group A, 33-65 years, mean 36.9 years; Group B, 28-67 years, mean 38.6 years; Group C, 25-58 years, mean 37.8 years. GAIS comparisons: no statistical differences were found in each group between baseline and post-treatment ( P>0.05). Fitzpatrick wrinkle score: the overall analysis showed significant improvements were not found in IR-RF treated-side but were observed in 1 540 nm and 1 927 nm NAFL treated sides ( P<0.05). Furthermore, the 1 927 nm NAFL treated side showed more decreased scores than 1 540 nm NAFL treated side ( P<0.05). The VISIA analysis of feature counts of skin texture showed similar result. Besides, the patients over 50 years old showed significantly improvements compared with the ones under this age threshold in IR-RF treated sides ( P<0.05). The pain VAS in IR-RF treated side was significant lower than NAFL-treated side (2.2 vs. 5.8, P<0.05). Only one patient reported post-inflammatory hyperpigmentation (PIH) in 1540 nm NAFL treated side, which disappeared progressively in 4 months after last treatment. Conclusion:Nonablative fractional laser is effective and safe in improving periorbital wrinkles. Infrared bipolar radiofrequency might be more suitable for elderly patients especially with low pain level.

Objective:To investigate and compare the effectiveness and safety of infrared bipolar radiofrequency (IR-RF) and nonablative fractional laser (NAFL) including 1 540 nm Er: glass and 1 927 nm thulium-doped laser, so as to choose a better pathway for clinical treatments on periorbital wrinkles.Methods:A prospective randomized self-controlled study was conducted in the Department of Laser and Aesthetic Medicine, Shanghai Ninth People’s Hospital. A total of 27 patients divided into 3 groups by random number table underwent split-face treatments between December 2019 and January 2021. Two of the three treatments were selected randomly for patients in each group: Group A, left side IR-RF vs. right side 1 540 nm NAFL; Group B, left side IR-RF vs. right side 1 927 nm NAFL; Group C, left side 1 540 nm NAFL vs. right side 1 927 nm NAFL. In total 3 sessions were given at 2 months interval. Therapeutic outcomes were evaluated by subjective (GAIS and Fitzpatrick wrinkle score) and objective (VISIA-CR) assessments. Side effects and pain visual evaluation (VAS) were also recorded. Wilcoxon signed-rank tests were used to evaluate the differences among the three therapeutic method , and relationships with VAS and patients’ age.Results:In total 30 patients (10 in each group) were recruited and finally 27 cases completed all treatments and follow-ups: Group A, 9 patients (male 3, female 6); Group B, 8 patients (male 3, female 5); Group C, 10 patients (male 4, female 6). The age distributions: Group A, 33-65 years, mean 36.9 years; Group B, 28-67 years, mean 38.6 years; Group C, 25-58 years, mean 37.8 years. GAIS comparisons: no statistical differences were found in each group between baseline and post-treatment ( P>0.05). Fitzpatrick wrinkle score: the overall analysis showed significant improvements were not found in IR-RF treated-side but were observed in 1 540 nm and 1 927 nm NAFL treated sides ( P<0.05). Furthermore, the 1 927 nm NAFL treated side showed more decreased scores than 1 540 nm NAFL treated side ( P<0.05). The VISIA analysis of feature counts of skin texture showed similar result. Besides, the patients over 50 years old showed significantly improvements compared with the ones under this age threshold in IR-RF treated sides ( P<0.05). The pain VAS in IR-RF treated side was significant lower than NAFL-treated side (2.2 vs. 5.8, P<0.05). Only one patient reported post-inflammatory hyperpigmentation (PIH) in 1540 nm NAFL treated side, which disappeared progressively in 4 months after last treatment. Conclusion:Nonablative fractional laser is effective and safe in improving periorbital wrinkles. Infrared bipolar radiofrequency might be more suitable for elderly patients especially with low pain level.