Objective Study of the feasibility that the former changing trend of tumour after the first BAI can forecast the later curative effect on tumour.Methods Bronchus artery and relational body arteries opacification and BAI have been introduced in 82 primary pulmonary carcinoma cases.In the statistic analysis,SPSS 13.0 for Windows Stat.Software Package has been used.At the meanwhile chi square test,one-sample t-test,GLM-univariate analysis have been adopted as well to study the relationship between the former changing trend of tumour and Later Curative Effect after BAI in mid-advanced stage pulmonary carcinoma.Result There are significance statistical significances between the former changing trend of tumour and the later curative effect after the first BAI in mid-advanced stage pulmonary carcinoma.Conclusion The former changing trend of tumour after the first BAI is the factor influencing the later curative effect.

Objective To study later eurative effects after BAI with single factor analysis.MethodsBronchus artery and relational body arteries opacification and BAI had been introduced in 82 primary pulmonary carcinoma cases.In the statistic analysis,SPSS 13.0 had been used.ResultsThe tumour blood supply types and the times of effective BAI treatment were the factors influencing the later treatment period.Tumour pathologic types,the branches of tumour blood supply,tumour clinic cTNM stages,chems project influenced faintly later curative effect.ConclusionThe blood supply types of primary pulmonary carcinoma and the times of effective BAI treatment are the factors influencing the later treatment period.

Objective To research the angiographic manifestations of rabbit implanted VX_2 liver carcinoma.Methods 34 New Zealand big white rabbit were implanted VX_2 tumor pieces under orthophoria into liver left middle segment.Angiography of coeliac artery-hepatic artery catheterization via right femoral artery was performed at the third week after inoculation.Results The tumor blood vessel and tumor stain in 6 rabbit could be not showed clearly by digital cinematography mode but which could be showed in 28 rabbit by digital subtraction mode.The tumor angiographic signs included:dilating growth of tumor,the feeding arteria surrounding the tumor surface were resemblance to the clenched fist,embraced globosity and wreath in form;many slender vessels from feeding arteria appeared as small bud form,root form and filose form pushed forward to the center from the surface of tumor.The tumor vascular density in periphery was higher than that in center and formed circular or oval tumor stain which more denser at periphery than center.The tumor node stain was complete with definite margin when tumor size was large or equal to 1 cm in diameter,and the tumor stain appeared as clump with indefinit margin.Conclusion There are abundant vascularity for rabbit implanted liver VX_2 tumor,and more abundant at periphery part than center part, coeliac artery catheterization angiography can show the typical manifestations of tumor clearly.

Objective To investigate the relationship between Pin1 and CyclinD1 expression and the development of gastrointestinal stromal tu?mor(GIST). Methods The protein and mRNA expression of Pin1 and CyclinD1 in 85 samples of GIST and adjacent non?cancerous tissues were detected by immunohistochemistry and real?time quantitative polymerase chain reaction. Results The expression rate of Pin1 protein in GIST tis?sues(64.7%;55/85)was higher than that in adjacent non?cancerous tissues(26.7%;4/15). Similarly,the expression rate of CyclinD1 protein in GIST tissues(42.3%;36/85)was higher than that in adjacent non?cancerous tissues(6.7%;1/15). The expression of Pin1 and CyclinD1 mRNA in GIST tissues was 7.03 and 5.53 times that in adjacent non?cancerous tissues ,respectively. There was no obvious correlation between the expres?sion of Pin1 and clinicopathological parameters. The expression of CyclinD1 was positively correlated with the grade of NIH and tumor diameter (P<0.05). There was a significant correlation between the expression of Pin1 and CyclinD1 in GIST tissues. Conclusion The expression of both Pin1 and CyclinD1 was up?regulated in GIST tissues. The significant correlation between the expression of Pin1 and CyclinD1 in GIST tissues sug?gests that their synergistic effect promotes carcinogenesis and the development of GIST.

ObjectiveTo investigate the risk factors and insulin resistance (IR) of nonalcoholic fatty liver disease (NAFLD) with a normal visceral adipose tissue (VAT) area. MethodsA total of 45 NAFLD persons with a normal VAT area who were admitted to Quanzhou First Hospital Affiliated to Fujian Medical University from June 2017 to May 2018 were enrolled as observation group, and 27 non-NAFLD patients with a normal VAT area were enrolled as control group. VAT area, waist circumference, fasting blood glucose (FBG), and fasting insulin (FINS) were measured for both groups, homeostasis model assessment of insulin resistance (HOMA-IR) was calculated, and the correlation of IR with the indices including waist circumference was analyzed. The independent samples t-test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between groups. Pearson correlation analysis and Spearman correlation analysis were used to investigate the correlation of normally and non-normally distributed continuous data. A forward logistic regression analysis was used to identify related risk factors. ResultsThe NAFLD group had a significantly higher level of IR than the control group, and there was a significant difference in HOMA-IR between the two groups (2.66(1.59-4.06) vs 1.84(125-2.47), Z=364.000, P=0005). IR was positively correlated with FBG (r=0.412, P=0.005), FINS (r=0.789, P＜0001), and TG (r=0.306, P=0041). IR was negatively correlated with HDL(r=-9398,P=0007). The multivariate regression analysis showed that waist circumference was an independent risk factor for NAFLD with a normal VAT area (regression coefficient = 0.181, odds ratio = 1.198, 95% confidence interval: 1.099-1.306, P＜0.001). ConclusionThere is a certain degree of IR in NAFLD patients with a normal VAT, and waist circumference is an independent risk for NAFLD with a normal VAT.

Objective To analyze the clinical and dosimetric risk factors for computed tomography (CT) grade of radiation-induced lung injury in lung cancer treated with three-dimensional conformal radiotherapy (3DCRT).Methods Eighty-nine lung cancer patients treated with 3DCRT were enrolled and CT scan images in more than 6 months were retrospectively analyzed.Clinical and dosimetric parameters were reviewed.Radiation-induced lung injuries were classified into 5 grades on CT images.Grade 3 or worse were considered clinically significant.Statistical software SPSS IS.0 was used to analyze the clinical and dosimetric risk factors that influenced the CT grade of radiation-induced lung injury.Results Eight of 89 patients (9.0%) developed grade 0 of radiation-induced lung injury,13 developed grade 1 (14.6%) ,24 developed grade 2 (27.0%) ,23 developed grade 3 (25.8%) and 21 developed grade 4 (23.6%).Univariable analysis showed that concurrent chemotherapy (CCT),GTV margin,involved ipsilateral lung mean lung dose(IMLD) ,the percent of involved ipsilateral lung receiving over IS,20,25 ,30,35 ,40 and 45 Gy (V_(15),V_(20) ,V_(25),V_(30) ,V_(35),V_(40) ,V_(45) were significantly associated with over grade 3 of radiation-induced lung injury .On multivariate logistic regression analysis,CCT,GTV margin and V_(20) of ipsilateral lung emerged as statistically significant risk factors of over grade 3 radiation-induced lung injuries CT images.Conclusions CCT,GTV margin and V_(20) of ipsilateral lung might be clinical and dosimetric risk factors associated with the severe CT grade of radiation-induced lung injury for lung cancer treated with 3DCRT.

Objective To explore the influence factors on hepatitis B virus (HBV) relapse after nucleos(t)ide analogues (NA) withdrawal in the chronic hepatitis B (CHB) patients who met NA cessation criteria. Methods Eighty-one consecutive CHB patients were treated with NA, 38 with lamivudine (LAM), 25 with adefovir dipivoxil (ADV), 12 with entecavir (ETV), 6 with LAM +ADV. Among recruited patients, 40 were hepatitis B virus e antigen (HBeAg) positive, 41 were HBeAg negative, 67 of them were initial treatment, 14 were retreatment due to resistance to NA at baseline. The treatment was discontinued after meeting China therapeutic end-point criteria. HBV DNA, HBV serological markers, alanine aminotransferase (ALT) were measured respectively at baseline, every month before virological response, every 3 months after virological response, every month within first 6 months and every 2 months over 6 months after drugs withdrawal. Twelve probable influence factors on relapse which were sex, age, HBV family history, baseline HBV DNA,baseline HBeAg status, baseline ALT, virological response time, total duration of treatment, duration of additional treatment, the level of hepatitis B virus surface antigen (HBsAg) at cessation therapy,initial treatment or retreatment, drug category were analyzed with univariate, multivariate Cox regression modle and stratified analysis. The cumulative relapse was calculated by the Kaplan-Meier method. Results A total of 36 patients (44. 4%) relapsed within 1 year. Initial treatment or retreatment, HBV family history, virological response time, the level of HBsAg at cessation therapy were independent risk factors. The relapse rate of retreatment was higher than that of initial treatment (78.6% vs 37. 3% , χ2 = 7. 983, P = 0. 005) , those of patients with HBV family history higher than without family history (64. 5% vs 15.0%, χ2 =12. 096,P = 0.002), those of patients obtained virological response within 3 months lower than after 3 months(34. 0% vs 64. 3% , χ2 =6. 823,P=0. 009) , those of patients with HBsAg≤150 μg/L at cessation therapy lower than >150 μg/L(27. 6% vs 53. 8%, χ2=5. 199,P=0. 023). Conclusions Retreatment, HBV family history, later virological response and higher HBsAg level at cessation therapy are risk factors of relapse after NA withdrawal. Such patients should be treated with prolonged duration after meeting end-point criteria to strengthen the efficacy.

Background/Aims: Data on the natural course of Chinese patients with ulcerative colitis (UC) was lacking. This study aimed to evaluate the natural history and prognosis of patients with UC in the past 15 years in China. Methods: This cohort study included patients with UC in a tertiary hospital in southern China from 2007 to 2021 (cohort I: 2007–2011, cohort II: 2012–2016, cohort III: 2017–2021). Patients’ clinical characteristics and natural history were analyzed retrospectively. Results: Of 1,139 included patients, 683 patients presented with proctitis or left-sided colitis at diagnosis and 38.5% of them (263/683) developed proximal disease extension. Fifty-eight percent of patients experienced relapse, chronic continuous and intermittent active course. Five patients (0.4%) developed colorectal tumors/dysplasia. The overall surgery rate was 8.6%, and the rates were 14.2%, 7.8%, and 8.0% in the 3 cohorts, respectively (P= 0.059). Average time from diagnosis to surgery decreased from cohorts I to III (144 months vs. 36 months, P< 0.001), so did the use of glucocorticoids (58.2% vs. 43.5%, P< 0.001) and immunosuppressants (14.1% vs. 13.4%, P= 0.016), and days of hospitalization (13 days vs. 9 days, P< 0.001). Biologics were used more frequently during the first year (0.8%, 2.1%, and 13.7% for cohorts I to III, respectively; P< 0.001). The rate of mucosal healing increased over time. Conclusions In Chinese UC patients, one-third of patients experienced proximal disease extension. The rates of malignancy and mortality were low. More biologics were used, while use of immunosuppressants and glucocorticoids were reduced over time. Early biologics use seemed to promote mucosal healing, but the rate of colectomy has not dramatically decreased.

Objective To compare the effectiveness and safety of endoscopic submucosal dissection ( ESD) with endoscopic piecemeal mucosal resection ( EPMR) for early esophageal cancer and precancerous lesions with length more than 5 cm. Methods A retrospective analysis was performed on data of 85 patients diagnosed as early esophageal cancer and precancerous lesions with length more than 5 cm in Fujian Medical Association of Early Esophageal Carcinoma from January 2012 to July 2017. The patients were divided into ESD group (52 cases) and EPMR group (33 cases), and the effectiveness and safety between the two groups were compared. Results There was no significant difference on the complete resection rate between the two groups[86. 5％ (45/52) VS 87. 9％ (29/33), P>0. 05]. The operative time (58. 53±30. 50 min VS 32. 06±9. 12 min), postoperative fasting time (4. 18±1. 30 d VS 3. 67±0. 96 d), postoperative hospital-stay time (7. 45±2. 44 d VS 6. 54±1. 73 d), and postoperative antibiotics using time (3. 48±2. 33 d VS 1. 96±2. 20 d) in ESD group were higher than those in EPMR group (all P<0. 05). There were no significant difference in the rate of intraoperative complication and short-term postoperative complication, such as fever, chest pain, and postoperative bleeding, between the two groups ( all P>0. 05 ) . But the postoperative stricture rate of ESD group was higher than that of EPMR group[23. 1％ (12/52) VS 6. 1％(2/33), P<0. 05]. During the follow-up of 3-63 months, 5 cases recurred in ESD group and 1 case in EPMR group, with no significant difference ( P>0. 05). Conclusion ESD and EPMR have equivalent efficacy and safety on the treatment of early esophageal cancer and precancerous lesion. EPMR has a shorter operative time, lower rate of post-operative stricture, and is easier to master.

Objective:To investigate the application value of obliquus externus abdominis pedicle flap graft technique in repair of giant abdominal incisional hernia.Methods:The retrospective and descriptive study was conducted. The clinical data of 14 patients with giant abdominal incisional hernia who were admitted to Affiliated Hangzhou First People′s Hospital of Zhejiang University School of Medicine from June 2015 to June 2018 were collected. There were 5 males and 9 females, aged (67±10)years, with a range from 45 to 80 years. All the 14 patients underwent repair of abdominal wall defect and functional reconstruction with obliquus externus abdominis pedicle flap graft technique. Observation indicators: (1) surgical situations; (2) postoperative situations; (3) hernia-related quality of life; (4) follow-up. Follow-up using outpatient examination was performed at postoperative 1 and 12 months, and once a year thereafter to detect the recurrence of incisional hernia or abdominal bulging up to June 2019. Measurement data with normal distribution were represented as Mean± SD, and comparison within groups was analyzed using the paired sample t test. Measurement data with skewed distribution were described as M (range). Count data were described as absolute numbers or percentages. Results:(1) Surgical situations: all the 14 patients underwent repair of abdominal wall defect and functional reconstruction with unilateral obliquus externus abdominis pedicle flap graft technique successfully, and reinforced repair with mesh. All the meshes were standard polypropylene meshes which were placed in the retro muscular or preperitoneal space. The operation time, volume of intraoperative bleeding, mesh size of the 14 patients were (153±34)minutes, (119±59)mL, (450±156)cm 2, respectively. (2) Postoperative situations: the duration of hospital stay of the 14 patients were (14±3)days. Of the 14 patients, 1 had type Ⅲ seroma and was cured after conservative treatment. There were no complications such as ischaemia and necrosis of external oblique muscle flap, incision dehiscence, infection of operation site, intestinal obstruction or intestinal fistula observed in the 14 patients. (3) Hernia-related quality of life: the score of hernia-related quality of life of the 14 patients before operation and at postoperative 12 months were 38±8 and 77±15 respectively, showing a significant difference ( t=12.729, P<0.05). (4) Follow-up: 14 patients were followed up for 12-48 months, with a median follow-up of 16 month. During the follow-up, none of the 14 patients had recurrence of incisional hernia or abdominal wall bulging. Conclusion:Obliquus externus abdominis pedicle flap graft technique can be used for repair of giant abdominal incisional hernia, which will lead to less surgical complications and improve hernia-related quality of life of patients.