ObjectiveTo study the efficacy of transcatheter arterial chemoembolization (TACE) combined with surgical resection in the treatment of ruptured hepatocellular carcinoma (HCC).MethodsThe clinical data of 26 patients who presented with ruptured HCC to our hospital from January 2008 to December 2011 were retrospectively studied. These patients received TACE (n=19),surgical resection (n=7),and surgical resection after TACE (n=8).ResultsShock in the 19 patients who received TACE was promptly corrected and the vital signs were stabilized.On subsequent CT,the tumors shrunk in size.Salvage liver resection was carried out in 8 patients 1 month after TACE.After treatment,AFP decreased or became normalized,thus the treatment results were good. A one-stage liver resection was carried out in 7 patients. One patient died after operation and peritoneal metastases occurred in 4 patients. Conclusions TACE stopped bleeding from ruptured HCC efficaciously,reduced the need for open exploration,and improved the rate of resection of HCC.TACE combined with surgical resection significantly lowered the rate of abdominal tumor metastases.

Thyroid nodule is a common diseases of neck,which property is usually identified by ultrasound examination.Color doppler ultrasonography can reflect the distribution of blood vessels and blood flow within the nodules.And with development of new technologies,three-dimensional ultrasound increase the accuracy of identification.Three-dimension power doppler ultrasound (3D-PDUS) can reflect blood flow information within the nodule space,which is more accurate than two-dimensional ultrasound and it can be used to evaluate the blood flow in nodules qualitatively and quantitatively,provide a new reference for clinical diagnosis of thyroid nodule.

Objective To explore the effect of different delivering methods on the pelvic floor function in vaginal delivery by transvaginal three-dimensional ultrasound.Methods Eighty-four patients delivered transvaginal were classified into three groups according to the mode of delivery (perineal integrity group [n=32],episiotomy group [n=30] and forceps delivery group [n=22]).The hiatal images at resting,Valsalva,levator ani muscle maximum contraction were obtained and compared in three groups.Results There were no differences between perineal integrity group and episiotomy group in hiatal diameter and area (P＞0.05).There were significantly differences between perineal integrity group and forceps delivery group in hiatal diameter,area and change in hiatal area from rest to pelvic floor muscle contraction and from rest to Valsalva (all P＜0.05).Conclusion The injury of the pelvic floor of forceps delivery group is bigger than perineal integrity.And episiotomy is no significant difference with pelvic floor function injury.

Objective To explore the diagnostic value of comparing enhanced transvaginal ultrasound (E-TVS),none enhanced transvaginal ultrasound (TVS),and transrectal ultrasound (TRS) in preoperative detection of deep infiltrating endometriosis (DIE) in the rectosigmoid by Meta-analysis.Methods The literatures published from January 1990 to June 2016 were searched.The information of literatures were selected and evaluated.The included data was statistically analyzed by Meta-disc 1.4 software.Results Totally 25 literatures were enrolled.The pooled sensitivity,specificity,positive likelihood ratio,negative likelihood ratio,diagnostic odds ratio were 0.92,0.96,16.64,0.09,227.95 for E-TVS,0.83,0.97,16.95,0.17,112.97 for TVS,0.94,0.96,14.43,0.08,208.72 for TRS,respectively.Area under the curve were 0.980 4,0.966 3,0.979 0,respectively.Conclusion Diagnostic value of the three ultrasonography in preoperative detection of DIE in the rectosigmoid are E-TVS,TRS,TVS.E-TVS can be used as the preferred method of ultrasonic diagnosis of DIE in the rectosigmoid.

Objective To investigate the clinical therapeutic effect of radiofrequency catheter ablation in treatment of atrial fibrillation. Methods The clinical data of 30 cases of patients with atrial fibrillation that had application of ra-diofrequency catheter ablation from November 2010 to January 2013 in our hospital were analyzed. Type of atrial fib-rillation: 26 patients with paroxysmal atrial fibrillation, 4 patients with persistent atrial fibrillation. Results There were 40 times of ablation, 30 patients reached the endpoint of ablation, average power of 25 W. Atrial fibrillation ablation in 30 patients were all successful, 1 cases only annular isolated right inferior pulmonary vein, and both of right and left inferior pulmonary vein isolation ring in 12 cases. In the follow-up period, there were no cases of pulmonary vein stenosis, cardiac perforation, pneumothorax, cardiac arrest and esophageal perforation. Vagal reflex occurred in 3 cases of atrial fibrillation patients, atropine injection after the return to normal. Among the 26 cases of patients with paroxysmal atrial fibrillation ablation conversion to sinus rhythm in 16 cases, all patients after 3 months of stopping amiodarone and propafenone antiarrhythmic drugs. Conclusion Transcatheter radiofrequency ablation of atrial fibrillation can reduce heart failure and thrombosis and other complications, minimally invasive, and it has advantages of short operation time, good effect, which is worthy of promotion and application.

Objective :To compare therapeutic effect of propafenone and amiodarone on paroxysmal supraventricular tachycardia (PSVT) and their safety .Methods : A total of 90 PSVT patients ,who were treated in our hospital from Jan 2013 to May 2018 ,were selected .Patients were randomly and equally divided into propafenone group and amio—darone group ,each group received corresponding medication based on routine treatment for 24h.Blood pressure , heart rate ,cardiac function indexes :LVEDV ,LVESV and LVEF before and after treatment ,cardioversion time , successful cardioversion rate within 60 min and incidence of adverse reactions during treatment were observed and compared between two groups .Results : There was no significant difference in successful cardioversion rate (propafenone group 91.11% vs.amiodarone group 93.33%, P＝1.000) between two groups .Compared with be—fore treatment ,on 24h after treatment ,there were significant reductions in blood pressure and heart rate in two groups , P＝0. 001 all ;but there was no significant difference between two groups before and after treatment , P＞0.05 all.Cardioversion time of propafenone group was significantly shorter than that of amiodarone group [ (12. 66 ± 2.06) min vs .(22. 80 ± 2.28 ) min ] , P＝ 0. 001 .Compared with propafenone group on 24h after treatment , there was significant rise in LVEF [ (63. 24 ± 3.67)% vs.(66. 83 ± 4.01)%] ,significant reductions in LVEDV [ (96.65 ± 5.24) ml vs.(92. 09 ± 4.37) ml] and LVESV [ (38.40 ± 2.87) ml vs.(30. 13 ± 7.34) ml] in amioda—rone group , P＝ 0. 001 all.Total incidence rate of adverse reactions in amiodarone group was significantly lower than that of propafenone group (8.89% vs.24. 44%) , P＝0. 048. Conclusion : Propafenone and amiodarone possess significant therapeutic effect on PSVT .Propafenone possesses shorter cardioversion time ,while amiodarone posses— ses less adverse reactions and improve cardiac function .Therefore ,medication should be selected properly according to patient′s specific condition in clinic .

Objective:To evaluate the clinical effectiveness and safety of Jiuwei-Zhuhuang San plus amoxilcillin sodium and sulbactam sodium in the treatment of bacterial pneumonia in children. Methods:A total of 120 patients with bacterial pneumonia in children from 1 year to 14 years old were randomly divided into the study group ( n=90) and the control group ( n=30) with ratio 3 to 1, the random sequence created by SAS software. Both groups were treated with amoxilcillin sodium for basic treatment, the observation group was treated with Jiuwei-Zhuhuang San. Both groups were treated for 1 week and followed up for 1 week. The cough frequency, clinical effective rate, symptoms and signs score, Traditonal Chinese medicine (TCM) pattern scores and adverse event rate were observed. Results:Eighteen cases were dropped and eliminated in the observation group, and 4 cases were dropped and eliminated in the control group, so 72 of observation group and 26 of control group were analyzed. After treatment, the clinical effective rate of the observation group was 27.8% (20/72), and the control group was 0% (0/26), where the difference was significant ( χ2=7.445, P=0.006). The difference of TCM syndrome score before and after treatment in the observation group (-16.8 ± 8.2 vs. -11.0 ± 5.8, t=-3.858) was lower than that of the control group ( P<0.01). There was significant difference between the two groups ( Z=-2.347, P= 0.019) in the TCM syndrome. The cough frequency of the observation group was 41.7% (30/72), and the control group was 26.9% (7/26). There wasn’t any significant differences in the cough frequency between two groups ( P>0.05). There was no statistical difference in symptoms and signs score or adverse event rate between two groups ( P>0.05). Conclusion:On the basis of amoxicillin sodium and sulbactam sodium, combined use of Jiuwei-Zhuhuang San can improve the clinical effectiveness of children with bacterial pneumonia.