Hepatolithiasis is a common benign biliary disease in China. It is a challenge to treat hepatolithiasis. Some patients with complicated hepatolithiasis fail to achieve satisfactory outcomes after several biliary operations, and therefore, how to improve the treatment outcome of hepatolithiasis is a major problem for biliary surgeons. At present, surgery is still the main treatment method for hepatolithiasis. Percutaneous transhepatic choledochoscopic lithotripsy (PTCSL), as a minimally invasive surgical treatment for hepatolithiasis, has been accepted by many biliary surgeons and patients with hepatolithiasis and gradually gains a place in the treatment of hepatolithiasis. This article reviews the research advances in PTCSL in the treatment of hepatolithiasis.

A total of 120 patients with intermediate coronary artery disease who were admitted to Ankang Hospital of Traditional Chinese Medicine from October 2017 to October 2019 were enrolled in the study (study group), and 120 patients who had ischemic changes on ECG, but no definite angiographic stenosis served as the control group. The SUA and S1P levels were measured, and Gensini scores were evaluated. Coronary blood flow reserve fraction (FFR)≤0.8 was used as the gold standard for diagnosis of functional myocardial ischemia. Patients in the observation group with functional myocardial ischemia and no-functional myocardial ischemia were evaluated. The correlation between variables was analyzed using the Pearson method. The levels of SUA [(492.52±35.47)μmol/L], S1P [(386.42±46.19)nmol/L] and Gensini score (69.42±7.81) in the study group were significantly higher than those in the control group ( t=51.218, 35.227, 60.237; P<0.05).In the study group, patients with functional myocardial ischemia had higher SUA[(678.23±54.21)μmol/L], SIP[(483.45±34.64)nmol/L] and Gensini score[(83.22±5.34) points], and higher incidence of drinking, hypertension, diabetes, and hyperlipidemia compared with no-functional myocardial ischemia patients ( t=24.764, 18.858, 17.888, respectively; χ 2=55.883, 53.684, 27.819, 71.070, 31.111, respectively; P<0.05). Pearson analysis showed that levels of SUA and S1P in patients with coronary artery lesions were positively correlated with Gensini score ( r=0.653, 0.715; P<0.01). The levels of SUA and S1P in patients with intermediate coronary artery lesions are correlated with the severity of coronary stenosis, the combination of the two indicators has better efficacy in predicting functional myocardial ischemia.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.