Objective:To investigate the curative effect and prognostic factors of primary liver cancer(PHC) treated with radical resection combined with transcatheter arterial chemoembolization (TACE).Methods:A retrospective analysis was used to analyze the clinical data of 136 cases of PHC patients treated in Qianjiang Central Hospital of Hubei Province from January 2008 to January 2012,the 86 cases received radical resection and postoperative adjuvant TACE treatment of patients as the observation group,and the remaining 50 cases only with radical resection in the treatment of patients were selected as control group.After 6 months of treatment,the level of tumor markers Carcinoembryonic antigen(CEA),alpha fetoprotein(AFP),CA199 and alanine aminotransferase(ALT) in two groups were observed and compared.The survival status and prognostic factors of the two groups were compared.Results:After 6 months of treatment,the leve of tumor markers CEA,AFP,CA199 and ALT in the observation group were significantly lower than those in the control group(P＜0.05);The 1-year,2-year,and 3-year survival rate of the observation group were significantly higher than those in the control group;Univariate analysis showed that the differentiation degree,tumor size,lymph node metastasis,vascular tumor thrombus,CA199 concentration factors and the observation group patients (radical resection and postoperative adjuvant TACE) postoperative survival period (P＜0.05);Further multivariate analysis showed that the degree of differentiation,lymph node metastasis and CA199 concentration were the important factors influencing the prognosis of patients with TACE after radical resection (P＜0.05).Conclusion:Radical resection combined with TACE in the treatment of PHC has well clinical curative effect,which can effectively improve the postoperative long-term survival rate.Degree of differentiation,lymph node metastasis,and CA199 concentration are important factors impacting the radical resection operation adjuvant TACE prognosis.

Objective To evaluate the influence of hyperthermia on T helper subgroup (T help type1/T help type2,Th1/Th2) for patients with esophageal carcinoma. Methods 22 patients of esophageal carcinoma were randomly divided into two groups. Both group patients were treated by external radiation, the total dose was 64-66 Gy/30-33 fractions. Radiotherapy was the only therapy method in group A. Hypertbermia was used twice every week, with 8-10 fractions except for radiotherapy in group B. All patients were phlebetomized at the beginning and the end of radiotherapy for examining Th1/Th2 by flow cytometry. Results Th1 was significantly decreased in group A(t = 5.33, P < 0.01). All indexes in group B had no difference (t = - 1.41, P > 0.05). TheThl in group A was decreased much more than that in group B(t = 4.28, P < 0.05). Conclusion Hyperthermia could rectify the balance of Th1/Tb2.

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OBJECTIVE: To determine the value of contrast-enhanced ultrasound in the diagnosis of benign and malignant hepatic tumors. METHODS: A total of 83 patients with 123 focal liver lesions (FLLs) underwent contrast enhanced ultrasound (CEUS) examination. The contrast enhanced characterization of FLLs were compared. RESULTS: All the 103 lesions in hepatocallular carcinoma improved quickly in the arterial phase or portal phase. Altogether 98 lesions (95%) washed out during the late phase but the rest 5 lesions (5%) did not. Of the 69 lesions of hepatocellular carcinoma, 53(77%) enhanced global in the arterial phase or portal phase, and the rest 16 (23%) showed inhomogeneous enhancement but no enhancement in the central area during arterial phase or portal phase. A total of 66(96%) presented wash-out during the late phase, and 3(4%) had no wash-out. Of the 34 lesions of metastatic hepatic carcinoma, 24(71%)presented inhomogeneous enhancement in the arterial phase or portal phase, 10(29%) enhanced globally in the arterial phase or portal phase, 32 (94%) presented wash-out during the late phase, and 2(6%) had no wash-out in the late phase. Of the 20 lesions of benign hepatic tumor, 18(90%) presented inhomogeneous enhancement slowly in the arterial phase or portal phase, 14 (70%) slightly enhanced, and 20 (100%) presented no wash-out in the the late phase. CONCLUSION CEUS can improve the accuracy of diagnosis of benign and malignant hepatic tumors.
Adult ; Aged ; Aged, 80 and over ; Carcinoma, Hepatocellular ; diagnostic imaging ; pathology ; Contrast Media ; Diagnosis, Differential ; Female ; Hemangioma ; diagnostic imaging ; pathology ; Humans ; Image Enhancement ; Liver Neoplasms ; diagnostic imaging ; pathology ; secondary ; Male ; Middle Aged ; Ultrasonography

Objective To explore the method and points for attention in laparoscopic cholecystectomy(LC) of porcelain gallbladder.Methods Twenty-eight cases of porcelain gallbladder, especially 17 LC cases, from January 1980 to January 2005 were analyzed retrospectively.Results Of 28 cases(0.44%) of porcelain gallbladder in 6328 cholecystectomy patients,calcification of gallbladder occurred in 92.86% patients diagnosed by B ultrasonography 17 LC patients were cured. Two cases with gallbladder carcinoma no implantion or metastases happened.Conclusion B ultrasonography before operation and improving of the operative mode and skill in LC are the keys to get the successful results.

Objective:To investigate the variations in ocular biometry and its influencing factors in adult Tibetans of Lhasa.Methods:A cross-sectional study was adopted.A total of 100 consecutive adult Tibetans (100 eyes) with cataract, who were treated in Tibet Autonomous Region People's Hospital from March 2017 to July 2017 were enrolled, including 51 males and 49 females, with an average age of (63.38±12.80) years.The subjects were divided into two groups, with 57 subjects (57 eyes) older than 60 years in the elder group and 43 subjects (43 eyes) younger than 60 years in the youth group.Corneal curvature, corneal astigmatism, anterior chamber depth and axial length of subjects were measured and compared with those of Beijing population which were used as standardized data of Han Chinese.The differences in ocular parameters associated with age and gender were analyzed.This study adhered to the Declaration of Helsinki.The study protocol was approved by an Ethics Committee of Tibet Autonomous Region People's Hospital (No.ME-TBHP-21-KJ-005).Written informed consent was obtained from each subject prior to any examination.Results:The mean corneal curvature, corneal astigmatism, anterior chamber depth and axial length of the 100 Tibetans were (43.68±1.62)D, 0.750 (0.375, 1.000)D, (3.05±0.41)mm, (23.07±0.86)mm, respectively.The axial length of Tibetan was shorter than that of Beijing Han people and the difference was significant ( t=2.65, P<0.01).Corneal astigmatism of the elder group was higher than that of youth group and the difference was significant ( t=2.11, P<0.05).There were no significant differences in corneal curvature, anterior chamber depth and axial length between the elder group and youth group (all at P>0.05).The anterior chamber depth and axial length of males were much longer than those of females, and the differences were significant ( t=2.71, 2.25; both at P<0.05). Conclusions:In adult Tibetan population, the axial length is short, and the anterior chamber is deep.The corneal astigmatism increases with age and there is a gender difference in axial length and anterior chamber depth.

OBJECTIVE: To assess the left ventricular (LV) longitudinal systolic and diastolic function in patients treated by epirubicin by velocity vector imaging (VVI) and to discuss the important clinical value of VVI in quantitatively evaluating the regional longitudinal function. METHODS: Thirty patients with breast cancer treated with epirubicin chemotherapy and 30 normal controls were included in the study. Dynamic images of apical long axis, four-chamber and two chamber view were obtained in all subjects, and the longitudinal systolic and diatolic parameters were measured in all subjects, including systolic maximum velocity (Vs), systolic maximum strain (SS), systolic maximum strain rate (SSR), diastolic maximum velocity (Vd), and diastolic maximum strain rate (DSR). The parameters were compared between the 2 groups. The conventional echcardiographic parameters were also obtained. RESULTS: There was no significant change in all baseline parameters before the chemotherapy in 30 breast cancer patients compared with the normal controls (P>0.05). After the second chemotherapy cycle, DSR was lower in every segment, Vd was lower in the free wall, mainly the lateral, anterior and inferior wall (P<0.05), while Vd didn't change significantly in the septum wall (P>0.05). After the third chemotherapy cycle, Vd, DSR and SSR decreased significantly in all segments (P<0.05). Vs and SS didn't change significantly (P>0.05). CONCLUSION VVI can monitor the epirubicin cardiotoxicity early and is more sensitive than echocardiograph.
Adult ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Blood Flow Velocity ; Breast Neoplasms ; drug therapy ; Carcinoma, Ductal, Breast ; drug therapy ; Cardiac Volume ; Case-Control Studies ; Echocardiography ; Elasticity Imaging Techniques ; Epirubicin ; administration & dosage ; adverse effects ; Female ; Humans ; Middle Aged ; Ventricular Dysfunction, Left ; chemically induced ; diagnostic imaging

Objective To investigate positive picobirnaviruses(PVBs)infection and its association with unex-plained diarrhea in children. Methods From January to December 2015,the Clinical Microbiology Testing Center of Xuzhou Central Hospital as the sampling location,7 PVB reverse transcription - polymerase chain reaction(RT - PCR)- positive fecal samples with diarrhea were collected from children under 6 years old and 4 samples from healthy chil-dren were obtained and all the samples were analyzed by viral metagenomics to investigate the relationship between PVBs and diarrhea in children. Phylogenetic analysis of RdRp in the isolated PVB sequences was carried out to clarify the relationship between PVB classification and diarrhea. Results All the 7 diarrhea feces contained high titers of PVB sequences,while 3 of the controls were negative,and 1 with low titers of PVB. RdRp analysis was carried out on the iso-lated PVB sequences,which displayed that 7 RdRp sequences caming from 7 fecal samples separately,so named ChXz- 1 to ChXz - 7 respectively. Phylogenetic analysis based on the predicted amino acid sequences of RdRp from this study and whole RdRp sequences available in the GenBank database indicated that the 7 RdRp sequences belonged to 3 genogroups,in which ChXz - 1,ChXz - 2,ChXz - 3 belonging to genogroup Ⅰ,ChXz - 4,ChXz - 5,ChXz - 7 belong-ing to genogroup Ⅱ,and ChXz - 6 belonging to genogroup Ⅲ. Conclusions PVBs might be the cause of diarrhea in children in this study,and all the 3 different PVBs may lead to diarrhea.

Objective To investigate the correlation between the progression of cerebral microbleed (CMB) and their distribution patterns in patients with lacunar infarction (LI) and the worsening of chronic kidney disease (CKD).Methods A prospective cohort study was used.Two hundred and fourteen patients with LI from June 2014 to June 2016 in Siyang People's Hospital of Jiangsu Province were consecutively selected.The clinical,laboratory and imaging-related data of patients were recorded in detail.The chronic kidney disease epidemiology collaboration (CKD-EPI) formula was used to estimate the estimation glomerular filtration rate (eGFR).After admission and 1-year'follow-up,head MRI (including gradient echo sequences) was performed,and the CMB distribution pattern was evaluated using the microbleed anatomical rating scale (MARS).Results Among the 214 patients with LI,90 patients were in CMB-positive group,of which simple lobe of brain CMB was in 16 cases,and deep/subtentorial CMB was in 74 cases,and 124 patients were in CMB-negative group.The baseline eGFR and eGFR classifications in CMB-negative group were significantly better than those in CMB-positive group,and there were statistical differences (P＜0.01 or ＜0.05).After 1 year'follow-up,worsening of CMB was in 45 cases,and worsening of CKD was in 22 cases.Multivariate Logistic regression analysis result showed that age and stroke history were independent risk factors for worsening of CMB in LI patients with simple lobe of brain CMB (OR =1.14 and 2.91,95％ CI 1.06 to 1.23 and 1.14 to 7.42,P＜0.01 or ＜0.05),and baseline eGFR and worsening of CKD were independent risk factors for worsening of CMB in LI patients with deep/subtentorial CMB (OR =0.90 and 4.11,95％ CI 0.87 to 0.94 and 1.04 to 16.21,P＜0.01 or ＜0.05).Conclusions Renal function in LI patients with CMB negative is significantly better than that in LI patients with CMB positive.In LI patients with deep/subtentorial CMB,the worsening of CMB is associated with worsening of CKD;in LI patients with simple lobe of brain CMB,the worsening of CMB is not associated with worsening of CKD.

Objective:To observe the therapeutic effect of intraocular lens (IOL) protected phacoemulsification (PHACO) in patients with hard nucleus cataract.Methods:A randomized controlled clinical study was conducted.A total of consecutive 120 patients (120 eyes) with hard nucleus cataract of Emery grade Ⅳ or Ⅴ were enrolled from January 2019 to May 2022.The patients were randomly divided into PHACO group receiving routine PHACO, IOL protected PHACO group receiving PHACO under IOL protection, and extracapsular cataract extraction (ECCE) group receiving ECCE, with 40 cases (40 eyes) in each group.Finally, 99 patients completed the follow-up, including 30 cases (30 eyes) in PHACO group, 35 cases (35 eyes) in IOL protected PHACO group, and 34 cases (34 eyes) in ECCE group.The total operation time, intraoperative PHACO time and cumulative energy release of each patient were recorded.The corneal endothelial cell density (ECD), coefficient of variation in endothelial cell area (CV), hexagonal endothelial cell ratio (6A), corneal astigmatism and the number of eyes with different grades of uncorrected visual acuity were measured and compared after 3-month follow-up.The intraoperative and postoperative complications were recorded.This study adhered to the Declaration of Helsinki and was approved by the Ethics Committee of Yanbian University Hospital (NO.2023002).Patients were informed of study content and purpose and signed a consent form before treatment.Results:There was no significant difference in ultrasonic energy and time between PHACO group and IOL protected PHACO group ( P=0.691, 0.982).The total operation time was (38.81±2.73) and (36.45±3.45) minutes in PHACO group and IOL protected PHACO group, significantly shorter than (69.60±4.35) minutes in ECCE group (both at P<0.001).There was no significant difference in age, sex, lens nucleus hardness and other baseline data among the three groups before operation (all at P>0.05).Three months after operation, the number of patients with higher uncorrected visual acuity in PHACO group and IOL protected PHACO group was larger than that in ECCE group ( P=0.006, 0.007).The ECD and 6A in IOL protected PHACO group were (2 155.57±177.88)/mm 2 and (41.31±5.18)%, respectively, which were significantly higher than (1 912.64±224.11)/mm 2 and (36.18±3.27)% in PHACO group, and the CV in IOL protected PHACO group was (50.34±5.90)%, which was lower than (55.67±3.30)% in PHACO group, showing statistically significant differences ( P=0.007, 0.003, 0.005).At 1 week and 3 months after the operation, the corneal astigmatism was significantly lower in IOL-protected PHACO group than in ECCE group, but higher than in PHACO group, and the difference were statistically significant (all at P<0.05). Conclusions:Compared with conventional PHACO, IOL-protected PHACO can effectively reduce the damage of corneal endothelium caused by ultrasonic energy, shorten the operation time and reduce postoperative inflammatory reaction compared with ECCE, and does not significantly increase postoperative corneal astigmatism.IOL-protected PHACO is an effective improved surgical method for patients with hard nucleus cataract.