Objective To discuss the technical advantages of MRI image fusion technology in guiding percutaneous balloon compression(PBC)for trigeminal neuralgia(TN).Methods The clinical data of 13 patients with TN,who received MRI image fusion technology-guided PBC from November 2022 to July 2023,were retrospectively analyzed.The MRI images of the trigeminal nerve obtained one week before surgery were fused with the intraoperative DynaCT images of the skull base so as to simultaneously display the Meckel s cave and foramen ovale,and under the 3-D view the optimal puncture path was determined.The needle was positioned at the entry point of the skin,than the skin was cut open with a sharp surgical blade and the needle was inserted to the foramen ovale area to a predetermined depth.Lateral skull base fluoroscopy and DynaCT scan were used to check that the puncture needle tip was placed into the foramen ovale.Than the puncture needle was replaced by a fine guiding-needle and it was pushed into the Meckel's cave.Under the dual guidance of lateral fluoroscopy and fusion image,the balloon was push forward and was filled with iodine contrast media to compress the trigeminal ganglion within the Meckel's cave.After completion of the treatment,the balloon and puncture needle were removed and manual oppression was applied on the face to achieve hemostasis.Results Immediately after PBC,the pain was relieved in all patients.No permanent or serious complications occurred.One patient had a relapse 3 months after PBC and a second PBC procedure had to be carried out.No obvious pain recurrence was observed in the remaining patients during follow-up period.During the surgery,the mean number of foramen ovale puncturing was(1.31±0.46)times,the mean X-ray exposure time was(8.64±5.66)min,and the mean cumulative dose of X-ray was(570.29±257.15)mGy.After PBC,12 patients(92.31％)developed facial numbness and one patient(7.69％)developed facial pain,all of which were healed after treatment.Conclusion MRI image fusion technology can improve the visualization and accuracy of PBC procedure.It can also reduce the number of puncturing,decrease the radiation exposure dose,and improve the surgical ability of young doctors.Therefore,MRI image fusion technology should be further developed and applied in clinical practice.

ObjectiveTo investigate the prevalence of nonalcoholic fatty liver disease (NAFLD) in Haikou, China and the association of NAFLD with metabolic syndrome (MS) and its components. MethodsA total of 18771 persons who underwent physical examination in Haikou People’s Hospital from September 2016 to August 2017 were enrolled. Body height, body weight, blood pressure, fasting plasma glucose, blood lipids, and liver function parameters were measured, and ultrasound examination was performed for the liver. The prevalence rate of NAFLD was calculated, and the association of NAFLD with MS and its components was analyzed. The t-test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. ResultsOf all 18771 persons, 5715 had NAFLD, resulting in a prevalence rate of 30.45%; the prevalence rate of NAFLD was 41.74% in men and 1722% in women. Men aged 45-59 years had the highest prevalence rate of NAFLD, and women aged ≥45 years had the highest prevalence rate. Men had a significantly higher prevalence rate of moderate NAFLD than women (8.10% vs 1.19%, χ2=476.1, P＜0.001). Men with obesity and overweight had a higher prevalence rate of NAFLD, and women with obesity had a higher prevalence rate; in both men and women, there was a significant difference in the prevalence rate of NAFLD between groups with different levels of body mass index (BMI) (χ2=2111，1917，all P＜0.001). NAFLD patients had significantly higher BMI, blood pressure, fasting plasma glucose, triglyceride, alanine aminotransferase, aspartate aminotransferase, and gamma-glutamyl transpeptidase than non-NAFLD patients (t=41.276, 32.339, 31.487, 12.185, 9.716, 38.382, 26.350, 25.291, and 15.008, all P＜0.001). ConclusionThere is a high prevalence rate of NAFLD in people undergoing physical examination in Haikou, and men tend to have a higher prevalence rate than women. NAFLD is closely associated with MS and its components.

Objective To investigate the clinical value of vacuum pad and body film fixation in radiotherapy for thoracic and abdominal tumors. Methods A total of 240 patients with thoracic and abdominal tumors who were treated with radiotherapy were randomly selected and divided into group A (simple vacuum pad fixation,60 patients),group B(simple body film fixation with unimproved solid plate, 60 patients),and group C(vacuum pad and body film fixation with improved solid plate,120 patients).The difference between groups were analyzed with single variance analysis method. Results The setup error was small in group C and large in groups A and B. There were significant differences in the setup error between the three fixation methods(P=0.000). Conclusions A combination of vacuum pad and body film fixation is better than vacuum pad or body film fixation in radiotherapy for thoracic and abdominal tumors. The combination method has many benefits, including simple and convenient operation, comfortable and repeatable body fixation,reduced artificial errors,and improved positioning precision.

ObjectiveTo investigate the clinical features of patients with acute exacerbation of chronic hepatitis B, and to provide a basis of evidence-based medicine for the diagnosis and treatment of acute exacerbation of chronic hepatitis B. MethodsA retrospective analysis was performed for the clinical data of 74 patients with acute exacerbation of chronic hepatitis B who were diagnosed in The People′s Hospital of Haikou from January 2011 to October 2015. These patients were divided into HBeAg positive group (51 patients) and HBeAg negative group (23 patients). The t-test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. ResultsThe patients with acute onset of chronic hepatitis B had a level of alanine aminotransferase (ALT) of 523-2940 U/L and were manifested as icteric hepatitis (64 patients, 86.49%), and 65 patients (87.84%) were cured within 4 weeks. There were no significant differences in baseline ALT, aspartate aminotransferase, and HBV DNA levels between the HBeAg positive group and the HBeAg negative group (all P＞0.05), and the HBeAg negative group had a significantly higher level of total bilirubin (TBil) than the HBeAg positive group (141.1±132.9 μmol/L vs 80.1±68.8μmol/L, t=2.745, P=0.007). ConclusionThe acute exacerbation of chronic hepatitis B is similar to acute hepatitis B, and the patients with negative HBeAg have a high level of TBil and severe hepatocyte injury.