Objective To investigate the short-term mortality of transcatheter arterial chemoembolization (TACE) in patients with primary liver cancer, and explore the possible causes of death and countermeasures. Methods All patients who underwent TACE at the Department of Interventional Radiology, First Affiliated Hospital of Soochow University from January 2015 to December 2020 were studied, but those with metastatic liver cancer or receiving combined treatment were excluded. The clinical and imaging data of all patients were collected before and 30 days after TACE, and the clinical characteristics of the patients with short-term postoperative death were analyzed. Death within 30 days after TACE was defined as short-term death. Results A total of 1466 TACE in 741 patients with primary liver cancer were included. Ten patients (10/741, 1.35%) died within 30 days after TACE, with a mortality rate of 0.68% for all TACE. The mortality rate of d-TACE and c-TACE was 1.62% (3/185) and 0.55 % (7/1281), respectively. The mortality rates of patients at China Liver Cancer Staging Ⅰ, Ⅱ, and Ⅲ stages were 0.45% (2/448), 0.33% (2/599), and 1.43% (6/419), respectively. The mean diameter of the largest lesion in death cases was 10.1±0.8 cm. The possible causes of death were liver failure (4 cases), rupture bleeding (3 cases), myelotoxicity (1 case), pulmonary embolism (1 case), and heart failure (1 case). Conclusion The mortality rate after TACE in patients with primary liver cancer is low, with occasional short-term postoperative deaths. The death cases are characterized by a large tumor volume, and the most common causes of short-term death are liver failure and rupture bleeding.

To address the increasing need for detecting and validating protein biomarkers in clinical specimens, mass spectrometry (MS)-based targeted proteomic techniques, including the selected reaction monitoring (SRM), parallel reaction monitoring (PRM), and massively parallel data-independent acquisition (DIA), have been developed. For optimal performance, they require the fragment ion spectra of targeted peptides as prior knowledge. In this report, we describe a MS pipe-line and spectral resource to support targeted proteomics studies for human tissue samples. To build the spectral resource, we integrated common open-source MS computational tools to assemble a freely accessible computational workflow based on Docker. We then applied the workflow to gen-erate DPHL, a comprehensive DIA pan-human library, from 1096 data-dependent acquisition (DDA) MS raw files for 16 types of cancer samples. This extensive spectral resource was then applied to a proteomic study of 17 prostate cancer (PCa) patients. Thereafter, PRM validation was applied to a larger study of 57 PCa patients and the differential expression of three proteins in prostate tumor was validated. As a second application, the DPHL spectral resource was applied to a study consisting of plasma samples from 19 diffuse large B cell lymphoma (DLBCL) patients and 18 healthy control subjects. Differentially expressed proteins between DLBCL patients and healthy control subjects were detected by DIA-MS and confirmed by PRM. These data demonstrate that the DPHL supports DIA and PRM MS pipelines for robust protein biomarker discovery. DPHL is freely accessible at https://www.iprox.org/page/project.html?id=IPX0001400000.

Objective: To summarize the effect of modified David technique on acute type A aortic dissection sinus formation. Methods: From March 2018 to September 2018, modified David technique was applied to aortic sinus remodeling in acute A-type aortic dissection in 19 patients, 13 males and 6 females. The age was 45-67(50.42±15.37) years old and the weight was 45-112(60.32±25.18) kg. Single sinus(noncoronary sinus) was repaired in 15 cases, double sinus formation(noncoronary sinus+ right coronary sinus+ coronary artery transplantation) in 2 cases, left sinus Florid sleeve technical treatment plus double sinus formation(noncoronary sinus+ right coronary sinus+ coronary artery transplantation) in 1 case, Single sinus(noncoronary sinus) repaired and aortic vavle replacement in 1 case. Frozen elephant trunk and total arch replacement in 13 cases, hemiarch replacement in 3 cases. Results: There were no deaths in this group. The cardiopulmonary bypass time was 176-245(193.27±32.46) minutes, the aortic cross clamp time was 105-187(122.36±18.57)minutes, and the operation time was 6.5-11.0(7.63±1.31) hours. The mechanical ventilation time was 18-122(48.27±34.73)hours, the intensive care unit stay time was 2-10(5.35±2.62) days, and the postoperative hospital stay was 7-22(12.63±3.25)days. There was no delayed sternal closure during operation, and there was no secondary thoracotomy after operation. One patient developed a transient advanced atrioventricular block. Transient neurological dysfunction was observed in 5 patients. All patients were followed up for more than half a year. The color Doppler echocardiography and computed tomography angiograph(CTA)showed no aortic regurgitation or residual dissection. Conclusion The application of modified David technique in the remodeling of aortic root sinus in acute type A aortic dissection is an effective technique with relatively simple process, which is worth promoting.

Objective To evaluate the clinical application of early total care (ETC) for polytrauma patients combined with thoracolumbar fractures.Methods A retrospective case control study was conducted to analyze the clinical data of 137 polytrauma patients combined with thoracolumbar fractures admitted to the First Affiliated Hospital of Soochow University and the Third People's Hospital of Zhang,jiagang from January 2012 to October 2015.There were 90 males and 47 females,aged 26-69 years,with an average age of 48.2 years.The patients were divided into ETC group (n =59) and TMC group (n =78).In the ETC group,physicians from different departments evaluated the patients and developed individualized therapeutic regimens to allow the patients to undergo surgery at early stage after injury.The TMC group preferentially stabilized the patient's condition or transferred the patients to specialist treatment,and then the surgery was performed electively after the condition of the patient was stable.The ISS of the ETC group was (22.15 ± 9.28)points,and that of the TMC group was (23.37 ± 10.74) points.All patients underwent conventional posterior pedicle screw internal fixation.For patients with burst fracture and nerve injury,posterior spinal canal decompression was performed.The thoracolumbar injury classification and severity score (TLICS),spinal load sharing classification (LSC),preoperative and postoperative Glasgow coma score (GCS),Frankel classification,hospitalization time and postoperative complications were compared between the two groups.Results The TLICS scores of ETC group were significantly lower than those of TMC group (P ＜ 0.05) while the LSC scores showed no significant differences between the two groups (P ＞ 0.05).ETC group had shorter hospitalization time [(11.8 ± 3.7)days ∶ (17.5 ±4.5)days] and lower pressure ulcer incidence [(5％ ∶ 21％)] than the TMC group (P ＜ 0.05 or 0.01),but the former had significantly higher wound infection rate [(17％ ∶ 15％)] (P ＜ 0.05).There was no significant difference in pulmonary infection and deep venous thrombosis incidence between the two groups (P ＞ 0.05).No significant differences were found in the preoperative GCS scores between the two group (P ＞ 0.05) while the postoperative GCS scores of TMC group were higher than those of ETC group (P ＜ 0.01).Postoperative GCS scores in both groups were significantly higher than their preoperative GCS (P ＜ 0.05).The results of postoperative Frankel classification in the ETC group were as follows:Grade A in one patient,Grade B in one,Grade C in three,Grade D in four and Grade E in two patients,with an improvement rate of 82％.The results of postoperative Frankel classification in the TMC group were as follows:Grade A in three patients,Grade B in three,Grade C in three,Grade D in four and Grade E in four,with an improvement rate of 65％.Conclusions For polytrauma patients combined with thoracolumbar fractures,ETC can shorten hospitalization time,reduce the pressure ulcer incidence,and better facilitate the recovery of nerve function,yet with higher wound infection risk compared with TMC.TMC was preferred subjectively for patients with unstable thoracolumbar fractures and high TLICS.

Objective:To evaluate the effect of sacral nerve stimulation (SNS) for STC by receptor tyrosine kinase c-kit.Methods:Wistar rats were fed with diphenoxylate to make slow transit constipation(STC) rat model.Sacral nerve stimulation(SNS) for the SNS Rat Group.The studied animals were allocated into three experimental groups:STC Rat Group;SNS Rat Group;Normal Rat Group;Every group included 10 rats.The c-kit of ICC in the subserosal layer of rats were analyzed by immunohistochemistry,western blot and RT-PCR.Results:The morphological characteristics of STC Rat Group were not comparable to those of the multipolar c-Kit positive ICC seen in the subserosa of colon of normal rat.In the colon of rat,c-kit protein and c-kit gene in SNS rat group and Normal rat group was significantly higher than STC rat group detecting by western blot.Statistical differences between STC Group and SNS Rat Group were found (P＜0.05);statistical differences between STC Group and Normal Rat Group were also found (P＜0.05).There was not statistical differences between SNS rat group and Normal Rat Group.Conclusion:SNS has effective treatment for the STC rat.

Objective To discuss the relativity of dyschesia with the change of puborectalismuscle.Methods 68 patients with dyschesia were compared with 68 healthy volunteers at lithotomy position undergoing 3D ultrasonography on resting,contracting and maximum exertion phase respectively.Three dimensionally reconstructed images were reconstructed and pubo-rectal angle and the thickness of puborectalis muscle at 6 o'clock position were measured.Results The pubo-rectal angle of the study group and control group had no significant differences at either resting [(86 ± 8) ° vs.(86 ± 8)°] or contracting phases [(88 ± 9) ° vs.(86 ± 7) °] (t =-0.145,t =0.434,P ＞ 0.05).While at maximum exertion the differences were significant [(80 ± 6) °vs.(95 ± 5) °,t =-5.397,P ＜ 0.05].The d-value of pubo-rectal angle between maximum and resting exertion statistically different [(6 ± 3) °,(-9 ± 7) °,t =5.551,P ＜ 0.05].The thickness of puborectalis muscle between the two groups differed statistically significant only at maximum exertion phase [(4.60 ± 0.60) mm vs.(3.97 ± 0.32) mm,t =6.872,P ＜ 0.05].The d-value of the thickness of puborectalis muscle between maximum and resting exertion were statistically different (t =-11.474,P ＜ 0.05).Conclusions The pubo-rectal angle of the study group is smaller at maximum exertion than the control group.The thickness of puborectalis muscle at six o'clock (lithotomy position) in study group is larger at maximum exertion than the control group.And the severity of constipation changed with the variation of angle.

Objective To explore the effect of multiple positioning procedure for prolapse and hemorrhoids (PPH) in treatment of connective tissue type mixed hemorrhoids,and compare the results between PPH and Milligan-Morgan surgery.Methods One hundred and sixteen patients with connective tissue type mixed hemorrhoids were divided into treatment group (62 cases) and control group (54 cases)according to random digits table method.The patients in treatment group received multiple positioning PPH,and the patients in control group received Milligan-Morgan surgery.The operative time,intraoperative blood loss,postoperative pain score,anal margin edema,wound healing time,perianal scar,anorectal stenosis,anal discharge and anorectal resting pressure were evaluated and compared between 2 groups.Results The operative time and intraoperative blood loss in treatment group were significantly lower than those in control group:(15.0 ± 2.3) min vs.(35.0 ± 3.4) min and (5.0 ± 2.1) ml vs.(15.0 ± 3.2) ml,and there were statistical differences (P ＜ 0.05).The postoperative pain score and wound healing time in treatment group were significantly lower than those in control group:(4.83 ± 0.62) scores vs.(7.82 ± 0.37) scores and (8.2 ± 2.6) d vs.(17.4 ± 3.8) d,the rates of anal margin edema,perianal scar and anorectal stenosis in treatment group were significantly lower than those in control group:8.1％ (5/62) vs.37.0％ (20/54),0 vs.29.6％ (16/54) and 1.6％(1/62) vs.16.7％ (9/54),and there were statistical differences (P ＜ 0.05 or ＜ 0.01).The postoperative anorectal resting pressure was significantly lower than preoperative in control group:(13.80 ± 4.20) kPa vs.(17.20 ± 5.87) kPa,and there was statistical difference (P＜ 0.05).One patient (1.6％,1/62) in treatment group occurred anal discharge,and 10 patients (18.5％,10/54) occurred anal discharge in control group.The rate of anal discharge in treatment group was significantly lower than that in control group,and there was statistical difference (P ＜ 0.01).Conclusions Multiple positioning PPH is effective for the treatment of connective tissue type mixed hemorrhoids.It improves the controllability of the amount of removal and the excision site.It decreases the incidence of anal margin edema,perianal scar and anal discharge scar,which provides an effective protection for the anal function.

Anorectal diseases pose significant impact on patients' physical and mental health. Specially, the living standard of the people is significantly reduced by fecal incontinence, constipation and anorectal pain. Meanwhile there is no radical treatment for these diseases. But sacral nerve stimulation (SNS) provides us with new ideas and methods to treat these diseases and achieves good curative effect. In this article, we review the current application of SNS.
Constipation ; therapy ; Electric Stimulation Therapy ; Fecal Incontinence ; therapy ; Humans ; Lumbosacral Plexus

Anorectal diseases pose significant impact on patients′ physical and mental health. Specially, the living standard of the people is significantly reduced by fecal incontinence, constipation and anorectal pain. Meanwhile there is no radical treatment for these diseases. But sacral nerve stimulation (SNS) provides us with new ideas and methods to treat these diseases and achieves good curative effect. In this article, we review the current application of SNS.

Anorectal diseases pose significant impact on patients′ physical and mental health. Specially, the living standard of the people is significantly reduced by fecal incontinence, constipation and anorectal pain. Meanwhile there is no radical treatment for these diseases. But sacral nerve stimulation (SNS) provides us with new ideas and methods to treat these diseases and achieves good curative effect. In this article, we review the current application of SNS.