Objective To evaluate the effectiveness and safety of percutaneous transhepatic balloon dilation for the removal of common bile duct stones.Methods 60 patients of common bile duct stone were divided into two groups:PTBD group (30 cases) and endoscopic sphicterotomy (EST) group (30 cases).Postoperatively biliary tract was drained for three days.Results All stones were removed in 28 patients (93％) in PTBD group and 29 cases (97％) in EST group.Early complications occurred in 13％ in PTBD patients and in 17％ in EST patients(x2 =0.35,x2 =0.13,P ＞0.05).There was no mortality in neither group.Long-term complications such as gallstone recurrence and cholangitis in PTBD group was significantly less than that in EST group (x2 =6.41,P ＜ 0.05).Conclusions The success rate of PTBD was similar to that of EST and while in PTBD the function of Oddi's sphincter was well reserved.PTBD procedure is a valuable alternative to EST in patients with bile duct stones,especially in patients who are not suitable for EST.

BACKGROUND:Restenosis after angioplasty severely limited the application and long-period therapeutic effects of percutaneous coronary intervention. Changes in smooth muscle cel phenotype and their proliferation are important mechanisms of restenosis after angioplasty.
OBJECTIVE:To use bal oon in vivo transduction of osteopontin short hairpin RNA (OPN-shRNA), to inhibit osteopontin expression at the injured blood vessels of a rabbit model of experimental atherosclerosis, and to prevent restenosis after angioplasty.
METHODS:A total of 20 rabbit models of atherosclerosis were established and randomly equal y assigned to empty plasmid group and OPN-shRNA plasmid group. The plasmid recombinant OPN-shRNA and empty plasmid were transferred to the ventral aorta by bal oon.
RESULTS AND CONCLUSION:After bal oon dilatation, specific green fluorescence was detected in the layer of vascular smooth muscle in the two groups. Moreover, with prolonged time of transfection, fluorescence intensity gradual y decreased. Compared with the empty plasmid group, the expanded artery lumen area obviously increased in the OPN-shRNA plasmid group, and plaque burden evidently reduced. Results indicated that bal oon catheter used in regional blood vessels in rabbit models of atherosclerosis could successful y transduce OPN-shRNA plasmid. The restenosis of the expanded blood vessels lessened, and thrombus burden relieved. It is of great importance to prevent the occurrence of restenosis after angioplasty in rabbit models.

Objective To compare the diagnostic value of DSA with that of Gd-EOB-DTPA-enhanced MRI for postoperative recurrent tiny hepatocellular carcinoma (HCC) lesions.Methods The clinical data of a total of 38 patients,who were admitted to authors' hospital during the period from September 2011 to March 2016 as clinically they were suspected to have postoperative recurrent tiny HCC lesions,were retrospectively analyzed.DSA,DSA plus lipiodol CT scan and Gd-EOB-DTPA-enhanced MRI were performed in all patients.The positive and negative diagnosis rates were compared among different examination methods,the diagnostic sensitivity and specificity were calculated.The imaging diagnosis of each patient was made by two associationchief radiologists independently,both the pathological findings from surgery or puncture biopsy and the 6-month follow-up results were taken as the final diagnosis basis.Results A total of 47 lesions were detected in the 38 patients.The diameter of the lesions was 0.5-2.0 cm,with an average of (1.2+0.8) cm.Of the 47 lesions,41 were proved to be recurrent tiny HCC lesions.Among the 41 lesions,22 had pathological evidence,and the remaining 19 lesions were confirmed through clinical follow-up.Six lesions were non-HCC focus,which were proved by clinical follow-up.For all lesions,the diagnostic sensitivity and specificity were 72.2％ and 80.0％ respectively by conventional DSA,which were 90.2％ and 100％ respectively by DSA plus lipiodol CT scan,and were 95.1％ and 100％ respectively by Gd-EOB-DTPA-enhanced MRI.Statistical analysis indicated that significant differences in diagnostic sensitivity and specificity existed between conventional DSA and DSA plus lipiodol CT scan as well as between conventional DSA and Gd-EOB-DTPA-enhanced MRI (P＜0.05),while the differences in diagnostic sensitivity and specificity between DSA plus lipiodol CT scan and Gd-EOB-DTPA-enhanced MRI were not statistically significant (P＞0.05).Conclusion For the detection of postoperative recurrent tiny HCC lesions,DSA plus lipiodol CT scan has quite the same diagnostic value as Gd-EOB-DTPA-enhanced MRI does.For patients who are not suitable to receive MRI examination,the use of DSA plus lipiodol CT scan,as an alternative means of inspection,should be taken into consideration.

ObjectiveTo evaluate radio-frequency hemostasis in hepatectomy.MethodsFrom January 2009 to February 2011,the clinical data of 60 patients undergoing curative liver resection were divided into two groups using radio-frequency hemostasis (RFH) and clamp crushing method (CCM) respectively,RFH group (30 cases) and CCM group (30 cases).There was no difference between the 2 groups regarding the age,sex.hepatic function and tumor size.Data regarding the intra-operative and postoperative courses of the patients were analyzed.ResultsNo damage of hepatic vein occured in RFH group.Hepatic veins rupture occurred in 5 cases and massive bleeding occurred in 3 cases in CCM group.lntra-operative blood loss was significantly less in FRH group [ (219 ±62) ml] than in CCM group [ (416 ±96) ml ] (P ＜ 0.05 ).The postoperative drainage volume in RFH group was significantly less than that in CCM group on the third postoperative day.The serum ALT and T-BIL in RFH group was significantly lower than that in CCM group on postoperative day 1 and day 7 ( separately t =5.987,16.803,22.264,8.386,8.255,all P ＜0.05 ).Postoperative hepatic function in RFH group was significantly better than that in CCM group.ConclusionsThe use of radio-frequency hemostasis in hepatectomy is less traumatic,of less bleeding,faster recovery than clamp crashing method.

ObjectiveTo observe the effect of equilibrium therapy of decontamination living creature of blood dilution (ETBD) on acute cerebral infarction.Methods124 inpatients were divided randomly into the treatment group and control group with 62 cases in each group. The patients of the treatment group were treated with routine medicine and ETBD. The patients of the control group were treated only with routine medicine. The blood-lipid and blood viscosity were tested and nerve function evaluation was performed before and on the 15th day after the treatment in two groups.ResultsAfter treatment, the levels of blood-lipid, blood viscosity and nerve functions of all patients in two groups were better than that before the treatment, but the effect of the treatment group was better than that of the control group ( P<0.05), and no obvious adverse reaction was found.ConclusionETBD is a safe, effect, simply and convenient therapeutic method for acute cerebral infarction and it is suitable for primarily medical units.

OBJECTIVE: To assess the association of polymorphisms of receptor of advanced glycation end products (RAGE) gene, monocyte to high-density lipoprotein cholesterol ratio (MHR) and variability of heart rate among patients with coronary heart disease (CHD). METHODS: 120 patients with CHD and 120 healthy individuals were respectively selected as the observation group and the control group. Allelic and genotypic differences of -429T>C, 1704G>T, 82G>S, MHR ratio and heart rate variability between the two groups and patients with different severity were analyzed. The correlation between their genotypes and MHR ratio and heart rate variability was analyzed. RESULTS: The 82G>S polymorphism of the RAGE gene and the allelic difference between the two groups and patients with different severity were statistically significant (P< 0.05). Compared with the control group and patients with mild to moderate phenotype, monocyte, total cholesterol, triglyceride, low density lipoprotein, MHR, low frequency in the observation group and patients with severe symptoms were significantly higher, while their high density lipoprotein, standard deviation of NN intervals (SDNN), standard deviation average of NN intervals (SDANN), root mean square successive differences, percentage of differences exceeding 50ms between adjacent normal number of intervals (PMN50), high frequency (HF) were significantly lower. The gene frequencies of G-Gly-T, T-Gly-T, G-Ser-T and G-Gly-C were correlated with SDNN, SDANN, rMSSD, PMN50, HF and MHR, but negatively correlated with low frequency. CONCLUSION Polymorphisms of the RAGE gene in patients with coronary heart disease are associated with the MHR ratio and heart rate variability, which can be used as markers for the diagnosis and efficacy evaluation.
Antigens, Neoplasm ; Coronary Disease/genetics* ; Gene Frequency ; Glycation End Products, Advanced ; Heart Rate ; Humans ; Mitogen-Activated Protein Kinases ; Polymorphism, Genetic

Objective:To retrospectively analyze the impact of adjuvant iodine-125( 125I)brachytherapy on postoperative recurrence and survival for patients with hepatocellular carcinoma (HCC) treated with partial hepatectomy with narrow resection margins. Methods:The data of 72 HCC patients who underwent partial hepatectomy with narrow resection margins from January 2011 to June 2015 at Weihai Municipal Hospital were analyzed retrospectively. The patients were divided into the adjuvant 125I brachytherapy group ( 125I group) ( n=36) and the control group ( n=36). The data of the two groups of patients were compared to study the factors influencing long-term survival outcomes and recurrence. Results:The follow-up time was (45.0±18.4) months. There were no deaths relating to 125I brachytherapy. The median recurrent free survival (RFS) was significantly longer in the 125I group than the control group (41.0 months vs 21.5 months, P<0.05). The 1-, 3- and 5-year RFS rates of the 125I group and the control group were 94.4%, 58.3%, 41.6% versus 86.1%, 33.3%, 25.0%, respectively ( P<0.05). The 1-, 3- and 5-year overall survival (OS) rates of the 125I group versus the control group were 97.2%, 69.4%, 52.8% versus 94.4%, 52.8%, 27.8%, respectively ( P<0.05). On multivariate analysis, 125I implantation was an independent factor affecting RFS and OS ( HR=2.112, 95% CI: 1.155-3.860, P<0.05; HR=2.492, 95% CI: 1.272-4.693, P<0.05). Conclusion:Adjuvant 125I brachytherapy was safe and effective for HCC patients with narrow resection margins after hepatectomy. It obviously reduced the tumor recurrence rate and prolonged the long-term RFS and OS.

Circular RNA (circRNA) is involved in tumor progression. CircPVT1 is an oncogene that is abnormally expressed and correlated with a variety of tumors. It can regulate tumors' malignant behavior and affect the survival and prognosis of patients. This article reviews research on the regulatory roles of circPVT1 in tumors to provide references for accurate treatment.

Objective:To investigate the trend of radiological diagnostic examination frequency and the related influencing factors in a general hospital in recent four years.Methods:The hospital information system and the radiology information system were used to collect the information on the numbers of the outpatients, the emergency patients, and the inpatients and the radiology examination information from 2019 to 2022. The examination frequency and proportion of various imaging equipment were counted by using the perspective table of data, and the examination items and the proportion of the radiological diagnostic examinations were calculated. The positive rates of the radiological examinations were measured from 2019 to 2022. The gender and age distribution of the patients were analyzed. Spearman correlation analysis was used to analyze the relationships between the numbers of the patients undergoing radiological examinations and the numbers of the outpatients, emergency patients and the inpatients.Results:The annual frequency of radiological diagnostic examinations from 2019 to 2022 were 307 306, 245 418, 317 250 and 325 625, respectively, with a total of 1 195 599. Among them, the proportions of CT, X-rays, bedside X-rays, bone density, gastrointestinal imaging and mammography were 59.74%, 38.04%, 1.39%, 0.42%, 0.21% and 0.19%, respectively. In each year, the proportion of CT in all radiological diagnostic examinations was 49.58%, 63.40%, 60.40% and 65.20%, respectively. The frequency of emergency CT and emergency chest CT was correlated with the number of emergency patients( r =0.63, 0.61, P<0.05), and the frequency of non-emergency CT was correlated with the number of outpatients and inpatients ( r =0.61, 0.66, P<0.05). The positive rates of the CT examinations were higher than 80% except the lowest of 79.95% in 2021. Conclusions:Radiological examinations especially CT examinations have increased significantly, and played an important role in the diagnosis of diseases. However, attention should be paid to the Justification of the CT examinations. Timely statistical analysis of radiological examination information can provide data supports and references for scientific management of radiological examinations.

Alpinia katsumadai is recorded in Chinese herbal classics of previous dynasties，with a long history of medicinal use and significantly efficacy. This paper made a comprehensive textual research and summarization of the name，origin，distribution of producing areas，genuine producing area，harvesting time，processing method，property and flavor，and treatment functions of A. katsumadai by reviewing the ancient and modern literatures systematically. A. katsumadai has many alias names， such as Doukou，Loukou，Caokou in Chinese. Through the analysis of ancient herbal researches and drawings，it is concluded that there was some disordered uses of A. katsumadai with A. zerumbet and Amomum tsaoko. And the varieties of A. katsumadai have changed in some areas from ancient to present. The original plants of A. katsumadai is Alpinia katsumadai， which belongs to Alpinia of Zingiberaceae in modern textual research. A. katsumadai mainly grows in Lingnan and some other tropical areas； especially， those produced in Hainan have a better quality. The harvest time is usually in summer and autumn when fruits are all ripe. The processing methods of A. katsumadai are various， including heating and bending wrapped with flour， processing slowly with Euodiae Fructus，stir-frying in ancient times，while purifying processing （peeling） is generally used in modern times. A. katsumadai has the effect in invigorating spleen and warming stomach，lower Qi and relieving stagnation-syndrome，drying dampness and driving cold. In modern studies， efforts shall be made to strengthen basic research，establish quantitative standards for processing and digital standard for genuine medicinal materials of A. katsumadai， and deeply explore the compatibility regularity and application of A. katsumadai in ancient prescriptions， in order to ensure the quality and maximize its medicinal value in modern studies.