Objective:To analyze the efficacy of transjugular intrahepatic portosystemic shunt (TIPS) combined with main splenic artery embolization in the treatment of patients with portal hypertension upper gastrointestinal bleeding complicated with extensive portal vein thrombosis (PVT).Methods:This study was a prospective, single-center, open-label, single-arm clinical trial. In the first phase, 81 patients with portal hypertension upper gastrointestinal bleeding who were admitted to Beijing Shijitan Hospital, Capital Medical University from January 2018 to December 2018 were consecutively enrolled, including 57 males and 24 females, with the age of (51.3±10.4) years. During TIPS surgery, the pressure of the portal vein before and after the balloon blocking the splenic artery was measured to clarify the contribution of the splenic artery to portal hypertension. In the second stage, from January 2019 to December 2022, 104 patients with portal hypertension upper gastrointestinal bleeding complicated with extensive PVT were re-enrolled, including 71 males and 33 females, with the age of (50.9±12.5) years. TIPS combined with main splenic artery embolization was performed, and portal vein pressure was measured before and after embolization. Follow up on the postoperative esophageal and gastric varices of the patients in the second stage.Results:The portal vein pressures before and after the first stage of balloon occlusion of the splenic artery were (35.2±8.4) mmHg (1 mmHg=0.133 kPa) and (24.2±6.3) mmHg, respectively. The pressure after occlusion was lower than that before occlusion, and the difference was statistically significant ( t=10.54, P<0.001). The portal vein pressures before and after the second stage embolization were (36.1±9.5) mmHg and (21.1±4.7) mmHg respectively. The pressure after embolization was lower than that before embolization, and the difference was statistically significant ( t=13.47, P<0.001). In the second stage, among the 104 patients, the proportion of those whose varicose veins disappeared or improved 6 months after the operation was 43.3%(45/104) and 51.0%(53/104), respectively. There were no patients with aggravation or rebleeding due to rupture. One year later, 8 patients (7.7%) had aggravated or ruptured esophageal and gastric varices with bleeding. Two years later, 12 patients (11.5%) had aggravated or bleeding. Conclusion:TIPS combined with main splenic artery embolization can effectively reduce the portal vein pressure in patients with portal hypertension upper gastrointestinal bleeding complicated with extensive PVT, improve the degree of esophageal and gastric varices, and reduce the risk of gastrointestinal bleeding.

Objective:To analyze the efficacy of transjugular intrahepatic portosystemic shunt (TIPS) combined with main splenic artery embolization in the treatment of patients with portal hypertension upper gastrointestinal bleeding complicated with extensive portal vein thrombosis (PVT).Methods:This study was a prospective, single-center, open-label, single-arm clinical trial. In the first phase, 81 patients with portal hypertension upper gastrointestinal bleeding who were admitted to Beijing Shijitan Hospital, Capital Medical University from January 2018 to December 2018 were consecutively enrolled, including 57 males and 24 females, with the age of (51.3±10.4) years. During TIPS surgery, the pressure of the portal vein before and after the balloon blocking the splenic artery was measured to clarify the contribution of the splenic artery to portal hypertension. In the second stage, from January 2019 to December 2022, 104 patients with portal hypertension upper gastrointestinal bleeding complicated with extensive PVT were re-enrolled, including 71 males and 33 females, with the age of (50.9±12.5) years. TIPS combined with main splenic artery embolization was performed, and portal vein pressure was measured before and after embolization. Follow up on the postoperative esophageal and gastric varices of the patients in the second stage.Results:The portal vein pressures before and after the first stage of balloon occlusion of the splenic artery were (35.2±8.4) mmHg (1 mmHg=0.133 kPa) and (24.2±6.3) mmHg, respectively. The pressure after occlusion was lower than that before occlusion, and the difference was statistically significant ( t=10.54, P<0.001). The portal vein pressures before and after the second stage embolization were (36.1±9.5) mmHg and (21.1±4.7) mmHg respectively. The pressure after embolization was lower than that before embolization, and the difference was statistically significant ( t=13.47, P<0.001). In the second stage, among the 104 patients, the proportion of those whose varicose veins disappeared or improved 6 months after the operation was 43.3%(45/104) and 51.0%(53/104), respectively. There were no patients with aggravation or rebleeding due to rupture. One year later, 8 patients (7.7%) had aggravated or ruptured esophageal and gastric varices with bleeding. Two years later, 12 patients (11.5%) had aggravated or bleeding. Conclusion:TIPS combined with main splenic artery embolization can effectively reduce the portal vein pressure in patients with portal hypertension upper gastrointestinal bleeding complicated with extensive PVT, improve the degree of esophageal and gastric varices, and reduce the risk of gastrointestinal bleeding.

Objective:To explore the effect of tenofovir disoproxil fumarate (TDF) treatment on renal function for preventing mother-to-infant transmission of hepatitis B virus (HBV) in pregnant women during the second and third trimester of pregnancy.Methods:The subjects were selected from pregnant women with HBV infection who were registered in Department of Gynecology and Obstetrics, Beijing Ditan Hospital, Capital Medical University and delivered between January and December 2021. The pregnant women who had HBV DNA ≥2.0×10 5 IU/ml and took TDF at 24-28 weeks of gestation were included in treatment group, and the pregnant women who had HBV DNA <2.0×10 5 IU/ml and did not use anti-HBV drugs during pregnancy were included in control group. The medical records data of pregnant women in the 2 groups were collected, including urine routine examination, liver function, renal function, estimated glomerular filtration rate (eGFR), blood phosphorus, serum markers of hepatitis B, HBV DNA, ect. at 24-28 weeks of gestation (baseline data), renal function, eGFR, serum phosphorus at 36-37 weeks of gestation, delivery, and 42 days postpartum, and adverse events related to renal tubular injury. Serum creatinine (Scr), blood urea nitrogen, eGFR, and blood phosphorus at baseline level, 36-37 weeks, delivery and 42 days postpartum, and changes of Scr and blood phosphorus before and after treatment between the 2 groups were compared, and adverse events related to renal tubular injury in the treatment group were recorded. Results:A total of 189 pregnant women were entered in the analysis, including 106 in the treatment group and 83 in the control group. The differences in age, proportion of primipara, baseline level of alanine aminotransferase, Scr, blood urea nitrogen, eGFR and blood phosphorus between the 2 groups were not statistically significant (all P>0.05), but the proportion of HBeAg-positive women and HBV DNA level in the treatment group were significantly higher than those in the control group (all P<0.05). The differences in Scr, blood urea nitrogen, eGFR, and blood phosphorus between the treatment group and the control group at 36-37 weeks of gestation, delivery and 42 days postpartum were not statistically significant (all P>0.05). The trends of changes in Scr, blood urea nitrogen, eGFR, and blood phosphorus from baseline level to 42 days postpartum were similar between 2 groups (all P>0.05). None of the pregnant women in the treatment group had adverse events related to renal tubular injury, such as hypophosphatemia, elevated Scr, renal hypouricemia, β2-microglobulinuria, non-diabetic glycosuria, metabolic acidosis, etc. Conclusion:TDF is safe for the kidney in the second and third trimester of pregnancy to strengthen the blocking of mother-to-infant transmission of HBV.

Objective:To explore the effect of tenofovir disoproxil fumarate (TDF) treatment on renal function for preventing mother-to-infant transmission of hepatitis B virus (HBV) in pregnant women during the second and third trimester of pregnancy.Methods:The subjects were selected from pregnant women with HBV infection who were registered in Department of Gynecology and Obstetrics, Beijing Ditan Hospital, Capital Medical University and delivered between January and December 2021. The pregnant women who had HBV DNA ≥2.0×10 5 IU/ml and took TDF at 24-28 weeks of gestation were included in treatment group, and the pregnant women who had HBV DNA <2.0×10 5 IU/ml and did not use anti-HBV drugs during pregnancy were included in control group. The medical records data of pregnant women in the 2 groups were collected, including urine routine examination, liver function, renal function, estimated glomerular filtration rate (eGFR), blood phosphorus, serum markers of hepatitis B, HBV DNA, ect. at 24-28 weeks of gestation (baseline data), renal function, eGFR, serum phosphorus at 36-37 weeks of gestation, delivery, and 42 days postpartum, and adverse events related to renal tubular injury. Serum creatinine (Scr), blood urea nitrogen, eGFR, and blood phosphorus at baseline level, 36-37 weeks, delivery and 42 days postpartum, and changes of Scr and blood phosphorus before and after treatment between the 2 groups were compared, and adverse events related to renal tubular injury in the treatment group were recorded. Results:A total of 189 pregnant women were entered in the analysis, including 106 in the treatment group and 83 in the control group. The differences in age, proportion of primipara, baseline level of alanine aminotransferase, Scr, blood urea nitrogen, eGFR and blood phosphorus between the 2 groups were not statistically significant (all P>0.05), but the proportion of HBeAg-positive women and HBV DNA level in the treatment group were significantly higher than those in the control group (all P<0.05). The differences in Scr, blood urea nitrogen, eGFR, and blood phosphorus between the treatment group and the control group at 36-37 weeks of gestation, delivery and 42 days postpartum were not statistically significant (all P>0.05). The trends of changes in Scr, blood urea nitrogen, eGFR, and blood phosphorus from baseline level to 42 days postpartum were similar between 2 groups (all P>0.05). None of the pregnant women in the treatment group had adverse events related to renal tubular injury, such as hypophosphatemia, elevated Scr, renal hypouricemia, β2-microglobulinuria, non-diabetic glycosuria, metabolic acidosis, etc. Conclusion:TDF is safe for the kidney in the second and third trimester of pregnancy to strengthen the blocking of mother-to-infant transmission of HBV.

In this paper, a biodynamic model of human upper-body in the seated posture is developed. Based on d'Alembert's principle, the non-linear biodynamic equation of the modelling is derivated. Furthermore, the function of frequency and amplitude of modelling is obtained by employing the KB method in the non-linear theory. The response of realistic human parameters and the external stimulus on the modelling is simulated by MATLAB. The results show that the modelling presents a plenty of non-linear characteristics. The parameters identified and the stable areas to keep the stabilization of upper-body in the seated posture are discussed. These data can be used to explain and estimate the mechanism for the maintenance of stable trunk posture due to the mechanical shocks transmitted through the vehicle seat.
Automobile Driving ; Biomechanical Phenomena ; Humans ; Low Back Pain ; etiology ; Models, Biological ; Nonlinear Dynamics ; Posture ; physiology ; Spine ; physiology ; Vibration