Objective To retrospective analysis summarized the effectiveness and safety of the"triple"conversion therapy regimen combining immune,targeted and local therapy.Methods From February 2019 to June 2023,52 patients with advanced liver cancer from February 2019 to June 2023 in XI,an Jiao Tong university medicine college affiliated 3201 hospital were admitted and received conversion treatment regimens combining sintilimab with bevacizumab and combined with local treatment,analyzed the surgical resection rate and pathological complete response rate(pCR),complete response rate(CR),partial response rate(PR),progression of disease(PD),stable disease(SD),objective response rate(ORR)and disease control rate(DCR).To evaluated the effect of conversion therapy and adverse reactions.Results 21 cases had recived operative resection in the 52 patients with primary liver cancer receiving sintilimab and bevacizumab.The postoperative resection rate was 40.4％(21/52),pCR 42.9％(9/21).The other 31 cases have complete response 5.8％(3/52),PR 25.0％(13/52),PD 11.5％(6/52),SD 17.3％(9/52).The overall objective response rate(ORR)was71.2％(37/52),and the disease control rate(DCR)was 88.5％(46/52).Adverse reactions manifest as Grade 1-2 skin-related damage primarily affecting the epidermis.Conclusions For patients with potentially resectable primary liver cancer in middle and advanced stage,the"triple"conversion therapy with sintilimab combined with bevacizumab as systematic treatment and combined with local therapy can achieve good conversion treatment effect with controllable safety.

Objective:To explore the clinical efficacy of endoscopic retrograde cholangiopancreatography (ERCP) combined with endoscopic nasobiliary drainage (ENBD) in the treatment of acute obstructive suppurative cholangitis (AOSC).Methods:A total of 72 patients with AOSC admitted to Anqing Municipal Hospital from September 2021 to July 2023 were selected prospectively, and they were divided into two groups according to random number table method, each with 36 patients. The endoscopic group underwent ERCP+ENBD, while the surgical group underwent laparoscopic common bile duct exploration (LCBDE). The treatment effectiveness, clinical symptom improvement time, liver function indicators, inflammatory factors and complications between the two groups were compared.Results:The total effective rate in the endoscopic group was higher than that in the surgical group: 97.22% (35/36) vs. 77.78% (28/36), there was statistical difference ( χ2 = 4.57, P<0.05). The disappearance time of abdominal pain, recovery time of gastrointestinal function, and hospitalization time in the endoscopic group were shorter than those in the surgical group: (2.76 ± 0.65) d vs. (3.35 ± 0.72) d, (3.08 ± 0.83) d vs. (5.13 ± 1.07) d, (8.45 ± 1.26) d vs. (10.69 ± 1.48) d, there were statistical differences ( P<0.05). The levels of serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), glutamyltranspeptidase (GGT), procalcitonin (PCT), C-reactive protein (CRP) in the two groups befor surgery had no statistical differences ( P>0.05). The levels of ALT, AST, GGT, PCT and CRP were decreased at 24 and 48 h after surgery in both groups, and the above indexes in the endoscopic group were lower than those in the surgical group: at 24 h after surgery: (42.18 ± 5.12) U/L vs. (48.53 ± 6.06) U/L, (60.25 ± 8.57) U/L vs. (69.13 ± 10.13) U/L, (155.74 ± 24.61) U/L vs. (171.45 ± 20.85) U/L, (2.67 ± 0.40) μg/L vs. (3.09 ± 0.52) μg/L, (38.72 ± 5.21) mg/L vs. (44.16 ± 7.83) mg/L; at 48 h after surgery: (34.22 ± 4.74) U/L vs. (39.17 ± 5.83) U/L, (34.10 ± 5.18) U/L vs. (38.52 ± 6.06) U/L, (124.57 ± 20.53) U/L vs. (147.82 ± 16.81) U/L, (1.13 ± 0.27) μg/L vs. (1.46 ± 0.33) μg/L, (20.14 ± 3.75) mg/L vs. (27.39 ± 5.28) mg/L, there were statistical differences ( P<0.05). The complications between the two groups had no statistical difference ( P>0.05). Conclusions:ERCP + ENBD in the treatment of AOSC patients can significantly improve the clinical efficacy, alleviate inflammatory reactions, improve liver function, promote disease recovery, and have high safety.

Objective:To explore the clinical efficacy of endoscopic retrograde cholangiopancreatography (ERCP) combined with endoscopic nasobiliary drainage (ENBD) in the treatment of acute obstructive suppurative cholangitis (AOSC).Methods:A total of 72 patients with AOSC admitted to Anqing Municipal Hospital from September 2021 to July 2023 were selected prospectively, and they were divided into two groups according to random number table method, each with 36 patients. The endoscopic group underwent ERCP+ENBD, while the surgical group underwent laparoscopic common bile duct exploration (LCBDE). The treatment effectiveness, clinical symptom improvement time, liver function indicators, inflammatory factors and complications between the two groups were compared.Results:The total effective rate in the endoscopic group was higher than that in the surgical group: 97.22% (35/36) vs. 77.78% (28/36), there was statistical difference ( χ2 = 4.57, P<0.05). The disappearance time of abdominal pain, recovery time of gastrointestinal function, and hospitalization time in the endoscopic group were shorter than those in the surgical group: (2.76 ± 0.65) d vs. (3.35 ± 0.72) d, (3.08 ± 0.83) d vs. (5.13 ± 1.07) d, (8.45 ± 1.26) d vs. (10.69 ± 1.48) d, there were statistical differences ( P<0.05). The levels of serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), glutamyltranspeptidase (GGT), procalcitonin (PCT), C-reactive protein (CRP) in the two groups befor surgery had no statistical differences ( P>0.05). The levels of ALT, AST, GGT, PCT and CRP were decreased at 24 and 48 h after surgery in both groups, and the above indexes in the endoscopic group were lower than those in the surgical group: at 24 h after surgery: (42.18 ± 5.12) U/L vs. (48.53 ± 6.06) U/L, (60.25 ± 8.57) U/L vs. (69.13 ± 10.13) U/L, (155.74 ± 24.61) U/L vs. (171.45 ± 20.85) U/L, (2.67 ± 0.40) μg/L vs. (3.09 ± 0.52) μg/L, (38.72 ± 5.21) mg/L vs. (44.16 ± 7.83) mg/L; at 48 h after surgery: (34.22 ± 4.74) U/L vs. (39.17 ± 5.83) U/L, (34.10 ± 5.18) U/L vs. (38.52 ± 6.06) U/L, (124.57 ± 20.53) U/L vs. (147.82 ± 16.81) U/L, (1.13 ± 0.27) μg/L vs. (1.46 ± 0.33) μg/L, (20.14 ± 3.75) mg/L vs. (27.39 ± 5.28) mg/L, there were statistical differences ( P<0.05). The complications between the two groups had no statistical difference ( P>0.05). Conclusions:ERCP + ENBD in the treatment of AOSC patients can significantly improve the clinical efficacy, alleviate inflammatory reactions, improve liver function, promote disease recovery, and have high safety.

Objective To retrospective analysis summarized the effectiveness and safety of the"triple"conversion therapy regimen combining immune,targeted and local therapy.Methods From February 2019 to June 2023,52 patients with advanced liver cancer from February 2019 to June 2023 in XI,an Jiao Tong university medicine college affiliated 3201 hospital were admitted and received conversion treatment regimens combining sintilimab with bevacizumab and combined with local treatment,analyzed the surgical resection rate and pathological complete response rate(pCR),complete response rate(CR),partial response rate(PR),progression of disease(PD),stable disease(SD),objective response rate(ORR)and disease control rate(DCR).To evaluated the effect of conversion therapy and adverse reactions.Results 21 cases had recived operative resection in the 52 patients with primary liver cancer receiving sintilimab and bevacizumab.The postoperative resection rate was 40.4％(21/52),pCR 42.9％(9/21).The other 31 cases have complete response 5.8％(3/52),PR 25.0％(13/52),PD 11.5％(6/52),SD 17.3％(9/52).The overall objective response rate(ORR)was71.2％(37/52),and the disease control rate(DCR)was 88.5％(46/52).Adverse reactions manifest as Grade 1-2 skin-related damage primarily affecting the epidermis.Conclusions For patients with potentially resectable primary liver cancer in middle and advanced stage,the"triple"conversion therapy with sintilimab combined with bevacizumab as systematic treatment and combined with local therapy can achieve good conversion treatment effect with controllable safety.

Objective To investigate whether fenoldopam(FNDP)(an agonist of type 1 dopamine receptor)has a protective effect on thoracic aortic aneurysm(TAA)in mice.Methods Three-week-old male C57BL/6J mice were treated with β-aminopropionitrile(BAPN)to induce TAA.The mice were divided into three groups:the con-trol group,the BAPN group,and the BAPN+FNDP group(FNDP injected intraperitoneally).The incidence and survival rate of TAA were recorded.Gross anatomy of the whole aortae was observed.Elastin staining was per-formed to assess morphological change,while immunohistochemistry was employed to evaluate the expressions of matrix metalloproteinase 2(MMP2),matrix metalloproteinase 9(MMP9)and cluster of differentiation 68(CD68)respectively.Gelatin zymography was conducted to assess MMP2 and MMP9 activity.Reverse transcription-poly-merase chain reaction(RT-PCR)was performed to measure the mRNA expression levels of dopamine receptor D1(D1DR),dopamine receptor d2(D2DR),dopamine receptor d3(D3DR),dopamine receptor d5(D5DR),in-terleukin-1β(IL-1β),interleukin-6(IL-6),tumour necrosis factor-α(TNF-α),monocyte chemoattractant pro-tein-1(MCP-1),alpha-smooth muscle actin(α-SMA)and smooth muscle protein 22-alpha(SM22α).Results Compared to the control group,the BAPN group exhibited significant formation of TAA.Elastic fiber disruption was also observed in the thoracic aortic wall,along with a significant decrease in the mRNA levels of D1DR and D5DR.The BAPN+FNDP group showed a significant reduction in the incidence of TAA formation and the rate of aneu-rysm rupture compared to the BAPN group.The disruption and rupture of elastic fibers in the thoracic aortic wall were significantly improved in the BAPN+FNDP group.The levels of MMP2 and MMP9 in the thoracic aortic wall significantly decreased,and the enzymatic activity of MMP2 in the serum was significantly reduced.Moreover,macrophage infiltration in the thoracic aortic wall was significantly reduced and the mRNA levels of IL-1β,IL-6,TNF-α and MCP-1 also significantly decreased after FNDP treatment.There was no statistically significant differ-ence in the mRNA levels of α-SMA and SM22α.Conclusion FNDP shows an inhibitory effect on TAA progres-sion in mice,suggesting a potential of FNDP as a therapeutic agent for TAA.

Objective To investigate the expression of 8-hydroxy deoxy guanosine(8-OHdG)and nectin-4 in the serum of primary liver cancer(PLC),and to evaluate the efficacy of transcatheter chemoembolization(TACE)for PLC.Methods From January 2021 to June 2022,180 patients with primary liver cancer with TACE were studied.According to the efficacy of TACE patients,they were separated into a good group(n=137)and an adverse group(n=43).The general clinical data and the serum expression levels of 8-OHdG and nectin-4 were compared between the two groups;multivariate Logistic regression was applied to analyze the influencing factors of postoperative efficacy in TACE for primary liver cancer;receiver operating characteristic was applied to analyze the value of serum 8-OHdG and nectin-4 levels in evaluating the efficacy of TACE for primary liver cancer.Results There were no significant differences in age,sex,BMI,Child-Pugh grade,tumor location,tumor number,tumor diameter,tumor contour,degree of differentiation,tumor envelope,vascular cancer thrombus,bile duct cancer thrombus and lymph node metastasis between the poor postoperative efficacy group and the good efficacy group after TACE for primary liver cancer(P＞0.05).The expression levels of serum 8-OHdG and nectin-4 in the poor postoperative efficacy group after TACE for primary liver cancer were obviously higher than those in the good efficacy group(P＜0.05).Multivariate Logistic regression analysis showed that serum 8-OHdG,nectin-4,tumor diameter,TNM staging and Lymph node metastasis were all independent influencing factors for the postoperative efficacy of TACE in primary liver cancer(P＜0.05).The AUC of the combined evaluation of serum 8-OHdG and nectin-4 for the postoperative efficacy of TACE in primary liver cancer was 0.930,with a sensitivity of 86.05％and a specificity of 94.16％,which was superior to their respective individual evaluations(Zcombination-8-OHdG=2.033,Zcombination-nectin-4=3.221,P=0.042,0.001).Conclusion The serum levels of 8-OHdG and nectin-4 are obviously increased in the poor postoperative efficacy group after TACE for primary liver cancer.The combination of the two has a good evaluation effect on the postoperative efficacy of TACE for primary liver cancer.

Objective:To focus on the publicity of medical research in medical colleges and universities in the new era, analyze the current practices and problems, and think how to promote scientific and technological innovation in medical colleges and universities.Methods:Through case analysis and data statistics, suggestions were put forward for medical colleges and universities to further promote medical research publicity by using the example of Peking University Health Science Center.Results:Strengthening medical scientific research publicity is part of the national development strategy as well as the high-quality development of medical colleges and universities.Peking University Health Science Center does well in meeting the new development requirements and makes solid progress from the perspective of the content, topics, characters and platforms of scientific research publicity, but there is still room for improving management, popularizing fundamental research achievements and raising social impact.Conclusions:Scientific research publicity is an important aspect of scientific research management. It is suggested to promote the role of scientific research publicity in scientific research management of medical colleges and universities from the aspects of improving management mode, strengthening correct orientation, improving content quality, establishing brand thinking, and making good use of integrated communication, so as to promote the innovative and high-quality development of medical research, and better serve the national scientific and technological development and construction of Healthy China.

Objective To investigate the clinical effect of percutaneous transhepatic drainage combined with sequential percutaneous nephroscopy for necrosectomy and drainage in the treatment of refractory liver abscess after transcatheter arterial embolization (TACE). Methods A retrospective analysis was performed for three patients with refractory liver abscess after TACE in The Affiliated 3201 Hospital of Xi'an Jiaotong University School of Medicine from January 2018 to December 2020, and among the three patients, one had the formation of liver abscess after TACE for hepatic metastases after pancreaticoduodenectomy, one had liver abscess after repeated TACE for massive hepatocellular carcinoma, and one had secondary liver abscess after TACE for traumatic hepatic rupture. All three patients received percutaneous transhepatic drainage and sequential percutaneous nephroscopy for the treatment of refractory liver abscess, and their specific treatment process was summarized. Results All three patients were diagnosed with refractory liver abscess based on CT, routine blood test, procalcitonin, blood culture, and clinical manifestation. Percutaneous transhepatic catheterization under the guidance of conventional ultrasonography or CT and effective antibiotics had an unsatisfactory therapeutic effect, and after sequential percutaneous nephroscopy was performed for necrosectomy and drainage, liver abscess was cured and the patients had good prognosis. Conclusion For refractory liver abscess after TACE, when routine puncture treatment has an unsatisfactory therapeutic effect or a patient cannot tolerate surgical operation, percutaneous transhepatic drainage combined with sequential percutaneous nephroscopy is safe and effective in the treatment of refractory liver abscess.

Objective To investigate the clinical effect of two-step percutaneous transhepatic choledochoscopic lithotomy (PTCSL) in the treatment of complex hepatolithiasis. Methods A retrospective analysis was performed for the clinical data of 118 patients with complex hepatolithiasis who were admitted to 3201 Hospital of Xi'an Jiaotong University Health Science Center from January 2018 to June 2020, and according to the surgical procedure, they were divided into PTCSL group with 60 patients and surgery group with 58 patients. All patients were followed up for half a year to 3 years via telephone and outpatient service. The two groups were compared in terms of general information, perioperative indicators (including time of operation, intraoperative blood loss, incision length, time to first flatus and time to first defecation after surgery, time to extraction of abdominal drainage tube, and length of hospital stay), changes in liver function and inflammatory indicators, postoperative complications (bile leakage, acute cholangitis, wound infection, and venous thrombosis of lower extremities), stone clearance rate and recurrence rate, and quality of life. The two-independent-samples t -test was used for comparison of continuous data between two groups; the paired t -test was used for comparison between different periods of time within group; the chi-square test was used for comparison of categorical data between two groups. Results Compared with the surgery group, the PTCSL group had significantly shorter time of operation, time to first flatus and time to first defecation after surgery, and time to extraction of abdominal drainage tube, a significantly lower intraoperative blood loss, and a significantly shorter incision length (all P < 0.05). On day 1 after surgery, both groups had significant reductions in alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ( P < 0.05) and a significant increase in white blood cell count (WBC) ( P < 0.05), and the PTCSL group had significantly lower levels of ALT, AST, and WBC than the surgery group (all P < 0.05). Compared with the surgery group, the PTCSL group had significantly lower incidence rates of postoperative bile leakage (5.0% vs 17.2%, P < 0.05), acute cholangitis (3.3% vs 13.8%, P < 0.05), wound infection (1.7% vs 10.3%, P < 0.05), and venous thrombosis of lower extremities (1.7% vs 12.1%, P < 0.05). Compared with the surgery group, the PTCSL group had a significantly higher stone clearance rate (58.3% vs 37.9%, P < 0.05) and a significantly lower long-term stone recurrence rate (10.0% vs 20.7%, P < 0.05). The PTCSL group had significantly higher quality of life scores than the surgery group (all P < 0.05). Conclusion For the treatment of complex hepatolithiasis, two-step PTCSL can effectively remove stones, with the advantages of fast postoperative recovery, low recurrence rate and incidence rate of complications, and high quality of life, and therefore, it is an effective alternative surgical procedure.

Objective To observe the clinical features and evaluate the risk factors affecting prognosis in patients with secondary sepsis of gastrointestinal perforation (GIP). Methods A retrospective cohort study was conducted, and the patients with GIP admitted to the Department of General Surgery of Affiliated Shuyang People's Hospital of Xuzhou Medical University from January 1, 2014 to April 30, 2017 were enrolled, according to the presence or absence of sepsis occurrence, they were divided into GIP with and GIP without sepsis groups. The difference of gender, age, the time between the onset of GIP and the occurrence of sepsis, infection situation, body temperature, heart rate, respiratory frequency, white blood cell count (WBC), systemic inflammatory response syndrome (SIRS) in accord with standard, C-reactive protein (CRP), blood sugar, mean arterial pressure (MAP), lactic acid, number of cases having undergone laparoscopic surgery, sequential organ failure score (SOFA) and quick sequential organ failure score (qSOFA), Glasgow coma score(GCS), length of stay in intensive care unit (ICU), the total length of stay in hospital were compared;the status of survival and prognosis was assessed on day 30 by the Glasgow Outcome Scale (GOS). The indicators with statistical significance in the two groups were brought into the Cox regression model to analyze the independent risk factors affecting the prognosis of the patients. Results Fifty-eight patients with GIP were enrolled in this study. Among them, 22 cases developed secondary sepsis (GIP with sepsis group, there were 50.0% cases with single organ failure and 50.0% cases with multiple-organ failure, cases only in accord with 0-1 SIRS criteria accounting for 81.8%, and the mortality of secondary sepsis being 31.8%). No sepsis occurred in 36 patients (GIP without sepsis group). In GIP with sepsis group, the age, blood glucose, lactic acid, SOFA score, qSOFA, and the length of stay in ICU were significantly higher than those of GIP without sepsis group [age (years): 68.7±15.9 vs. 56.1±17.2, blood glucose (mmol/L): 6.9±2.3 vs. 5.9±1.2, lactic acid (mmol/L): 2.9±1.3 vs. 1.2±0.7, SOFA score: 5.6±3.2 vs. 0.5±0.4, qSOFA score: 1.0±0.9 vs. 0.3±0.1, the length of stay in ICU (days): 1.0 (0-4.0) vs. 0.1 (0-2.0), all P < 0.05], while MAP, GCS, and GOS scores in GIP with sepsis group were significantly lower than those in GIP without sepsis group [MAP (mmHg, 1 mmHg =0.133 kPa): 83.6±18.7 vs. 100.0±14.3, GCS score: 12.8±3.5 vs. 14.5±0.5, GOS score: 3.5±1.9 vs. 4.9±0.2, all P < 0.01]. Cox multivariable regression analysis showed: only low MAP and low GCS score were the independent risk predictors of death outcome for GIP with sepsis, the relative risk (RR) was 0.896 [95% confidence interval (CI) = 0.815-0.984, P = 0.022] and 0.585 (95%CI = 0.395-0.866, P = 0.007) respectively. Conclusion Patients with secondary sepsis following GIP have relatively high morbidity and much more risk factors, but only low MAP and low GCS score are closely associated with its high risk of death.