Objective To analyze the efficacy of CT-guided alcohol ablation of splanchnic nerve block(SNB)in the treatment of pain in patients with pancreatic cancer,and to discuss the related factors influencing the effectiveness in treating pancreatic cancer pain.Methods The clinical data of patients with pancreatic cancer pain,who was unable to receive surgery and underwent CT-guided SNB at Hai'an People's Hospital from June 2018 to September 2023,were retrospectively analyzed.According to postoperative one-month VAS pain score and the used dosage of opioids,the improvement of pain was assessed.Logistic regression analysis was used to evaluate the demographic characteristics,tumor features,and pain-related factors so as to determine the predictive factors for effective analgesia after SNB,and the survival outcomes were compared between the patients with effective SNB analgesia and the patients with ineffective SNB analgesia.Results A total of 133 patients were included in this analysis.One week after SNB,74.4％of patients achieved effective pain relief,and one month after the procedure,54.9％of patients experienced effective pain relief.One month after treatment,multivariate logistic regression analysis showed that the diabetes(OR=0.637,95％CI=0.397-0.876,P=0.034),serum CA199(OR=1.531,95％CI=1.030-2.370,P=0.042),serum MMP-1(OR=0.703,95％CI=0.457-0.983,P=0.038),preoperative ECOG score(OR=2.693,95％CI=1.234-6.609,P=0.021),and preoperative daily morphine consumption(OR=2.797,95％CI=1.148-6.695,P=0.019)were the independent predictive factors for achieving a good analgesic efficacy after SNB.Patients with poor analgesic outcomes after SNB had a significantly lower median survival time when compared to patients with good analgesic outcomes(82 days vs 149 days,P＜0.05).No serious SNB-related adverse events occurred.Conclusion For the treatment of refractory pancreatic cancer pain,CT-guided SNB is clinically safe and effective.The diabetes,ECOG score,serum MMP-1 level,CA199 level,and preoperative daily used dosage of opioids are the independent predictive factors for the efficacy of CT-guided SNB in treating pancreatic cancer pain.

ObjectiveTo investigate the quality of life in patients with severe aortic stenosis (AS) after transcatheter aortic valve replacement (TAVR) and analyze the related influencing factors. MethodsA total of 139 patients who had undergone TAVR in Department of Cardiovascular Medicine, West China Hospital, Sichuan University, were selected through the hospital electronic medical record system from April of 2012 to April of 2017. By using the General Information Questionnaire for Patients, Charlson＇s co-morbidity Index (CCI), Morisky Medication Adherence Scale, and China Cardiovascular Quality of Life Questionnaire (CQQC), their life quality were investigated and the influencing factors were analyzed. ResultsThe average score of CQQC after TAVR was (78.76±16.52), lower than the national norm. There were statistical difference in the scores of CQQC in patients with different ages, marital status, educational background, cardiac function preoperation, CCI weight, smoking status, drinking status, and regular exercise status(P＜ 0.05). Stepwise regression analysis indicated that, age,marital status, cardiac function preoperation, time of length postoperation and regular exercise could be included into the regression modal, accounting for 34.9% of variances. ConclusionsThe quality of life of patients after TAVR is low. Age, marital status, preoperative cardiac function, postoperative time and regular exercise will affect the quality of life of patients. It is suggested that medical staff should pay attention to the quality of life of TAVR patients after operation and carry out targeted nursing intervention and health education actively, as well as scientific rehabilitation exercise so as to improve the quality of life of TAVR patients after operation.

Objective: To explore the application of the 3D precise digital technology in restoring structural defects of the orbital region. Methods: Structural defects of the orbital region concerning on osseous structure and soft tissue were restored in one stage or stages using EH composite artificial bone prosthesis with complex three-dimensional structure. The fabrication of EH composite artificial bone prosthesis was based on CT scanning and 3D reconstruction of the skull with computer aided data analysis and design. The appearance, degree of satisfaction and the complications were evaluated in postoperative regular follow-up. Results: Five cases of structural defects in the orbital regions presenting bone defect and soft tissue abnormality, received treatments in the department from January 2016 to September 2017. The cases consist of one patient with dysplasia following surgical treatment, three with post-traumatic and one with Treacher-Collins syndrome. With the application of individualized EH composite artificial bone fabricated by aforementioned method, all the repair materials presented the ideal three-dimensional structure and coincided well with the defects, and soft tissue restoration of 2 cases was performed in one stage or by stages. Appearance and symmetry of the 5 cases was significantly improved, without complications of infection, rejection, exposure or graft tissue necrosis. All the patients were satisfied with the results. Conclusions In consideration of the capacity to fabricate accurate individualized repair materials, the three-dimensional digital technology plays an important role in the treatment of structural defects in the orbital region, especially the reconstruction of the bony contour. The simple orbital deformities can be treated with the repair materials and correction of soft tissue. For special orbital deformities, attention should be paid to bone structure repair, eye socket reconstruction and filling of orbital contents sequentially.