Objective:To examine the clinical and multimodal ultrasonic characteristics differences between carotid web（CaW）and CaW with plaque，and to investigate the potential risk factors for stroke caused by CaW.Methods:A total of 215 patients who were diagnosed with CaW and simultaneously underwent contrast-enhanced ultrasound（CEUS）and superb microvascular imaging（SMI）examinations from January 2018 to October 2023 were retrospectively enrolled. Patients were divided into CaW group（ n=67）and CaW with plaque group（ n=148），the variations in clinical and multimodal ultrasonic characteristics between CaW and CaW with plaque were collected and evaluated，and univariable and multivariable Logistic regression analysis were utilized to identify possible risk factors for stroke caused by CaW. Results:Clinical features in terms of sex，age，history of smoking，alcohol，hypertension，diabetes mellitus，hyperlipidemia，and treatment，as well as ultrasonic features including web number，length，thickness，location wall，luminal stenosis，and CEUS enhancement were different between the two groups（all P<0.05）. Triangular default on SMI was present in 98.5% of CaW and 68.2% of CaW with plaque. Multivariable Logistic regression results showed that web length（ OR=1.415，95% CI=1.001-2.001， P=0.049）and angle（ OR=1.026，95% CI=1.005-1.048， P=0.016）were independent predictors of luminal stenosis in CaW；for CaW with plaque，plaque thickness（ OR=1.906，95% CI=1.343-2.704， P<0.001）and enhancement（ OR=0.186，95% CI=0.065-0.537， P=0.002）were associated with stenosis. However，no risk factors associated with stroke caused by webs were identified. Conclusions:The clinical and multimodal ultrasonic manifestations of CaW and CaW with plaque are quite different. CaW with plaque presents two modes of extension，while a triangular filling defect observed on SMI is a typical feature of CaW. No risk factors associated with stroke caused by webs are identified.

Objective:To examine the clinical and multimodal ultrasonic characteristics differences between carotid web（CaW）and CaW with plaque，and to investigate the potential risk factors for stroke caused by CaW.Methods:A total of 215 patients who were diagnosed with CaW and simultaneously underwent contrast-enhanced ultrasound（CEUS）and superb microvascular imaging（SMI）examinations from January 2018 to October 2023 were retrospectively enrolled. Patients were divided into CaW group（ n=67）and CaW with plaque group（ n=148），the variations in clinical and multimodal ultrasonic characteristics between CaW and CaW with plaque were collected and evaluated，and univariable and multivariable Logistic regression analysis were utilized to identify possible risk factors for stroke caused by CaW. Results:Clinical features in terms of sex，age，history of smoking，alcohol，hypertension，diabetes mellitus，hyperlipidemia，and treatment，as well as ultrasonic features including web number，length，thickness，location wall，luminal stenosis，and CEUS enhancement were different between the two groups（all P<0.05）. Triangular default on SMI was present in 98.5% of CaW and 68.2% of CaW with plaque. Multivariable Logistic regression results showed that web length（ OR=1.415，95% CI=1.001-2.001， P=0.049）and angle（ OR=1.026，95% CI=1.005-1.048， P=0.016）were independent predictors of luminal stenosis in CaW；for CaW with plaque，plaque thickness（ OR=1.906，95% CI=1.343-2.704， P<0.001）and enhancement（ OR=0.186，95% CI=0.065-0.537， P=0.002）were associated with stenosis. However，no risk factors associated with stroke caused by webs were identified. Conclusions:The clinical and multimodal ultrasonic manifestations of CaW and CaW with plaque are quite different. CaW with plaque presents two modes of extension，while a triangular filling defect observed on SMI is a typical feature of CaW. No risk factors associated with stroke caused by webs are identified.

Objective To explore the difficulty and strategy of percutaneous transheptic stenting for the junction of malignant hepatic duct obstruction. Method Twenty-three patients with highly malignant biliary obstruction received percutaneous transheptic biliary drainage (PTBD) by placement of stent and/or internal-external drainage tube. All the 23 patientws were followed up to determine the successful rate of surgery, the incidence of complications, decreased serum level of bilirubin, patency time of biliary stent and survival time. Results The initial operation was sucessful in 22 cases, accounting for 95.65%. Twenty-one patients had significant decline in total bilirubin (60%) and 2 had not (10%). The levels of alanine aminotransferase (GPT) and aspartate aminotransferase (GOT) decreased markedly and returned to nomral in an average of 18 d. After operation, 2 patients had fever,1 biliary tract bleeding, 6 pain in the right upper abodminal region, 1 localized peritonitis around the puncture point, 3 GPT increase and 1 drainage tube slip. There were no serious complications such as hemorrhea and biliary fistula etc. The symptoms of all these complications disappeared in 2 to 5 days through haemostasis, anti-inflammatory therapy and liver function protection. The median survival time was 8.5 months. Conclusion Although the merging of malignant hepatic duct obstruction stenting is difficult, try to pass through the obstruction by guide wire and master the right methods of operation can significantly improve the successful rate of surgery.

Objective To explore the clinical value of endovascular embolization treatment with Guglielmi detachable coil (GDC) for the patients with ruptured intracranial aneurysm. Methods 15 cases of patients with ruptured intracranial aneurysm were undengone endovascular embolization with GDC. According to Hunt Hess classification, 8 belonged to grade Ⅰ, 6 for grade Ⅱ, and 1 in grade Ⅳ. All the patients were diagnosed with cerebral DSA and CT scan. Results 13 cases of the 15 patients (86.7%) were succeeded in embolization with GDC. Other 2 cases were failed with embolization, died of hemorrhage on the fourth day and in fourth month respectively. There were no complications and hemorrhage in the 13 cases in the follow up 3 to 25 months. Other follow up methods all showed normal appaerance and position including skull X ray films of 13 patients and carotid artery DSA of 2 patients at an interval of 6 months. Conclusion Endovascular embolization treatment with GDC is an effective method for ruptured intracranial aneurysm to avoid hemorrhage.

To investigate the relationship between autoimmune pathogenic mechanism of retinal pigmentation (RP) and syndrome patterns in traditional Chinese medicine.Erythrocytic C3b receptor rosette(RCR) and erythrocytic immunocomplex rosette(RICR), circulating immune complex (CIC) content and expression rate of human leukocyte antigen D receptor (HLA-DR) in T lymphocyte of peripheral blood were detected in 22 healthy volunteers (group A) and 52 cases of RP (group B).In group B,RCR and RICR were decreased and CIC content and expression rate of HLA-DR were increased compared with group A (P

Objective To study the effect of interventional treatment of iliac and femoral vein stenosis concomitant with deep venous thrombosis. Method Fifty-three patients were divided into 5 groups. In group A after placing into inferior vena cava a filter,11 patients adopted Amplatz Trombectomy Device for thrombolysis or ORSIS thrombolysis and persistent thrombolysis through popliteal vein. In group B thrombus was taken out through guiding catheter and then persistent thrombolysis through popliteal vein after placing into inferior vena cava filters in 9 cases. In group C 13 patients adopted persistent thrombolysis through femoral arteries. In group D 8 patients received persistent thrombolysis through popliteal vein. In group E persistent thrombolysis through foot veins was carried out in 12 patients. Seventeen patients received implanted stents and balloon-expansion in iliac and femoral veins. Results Symptoms disappeared in 26 patients(49.0%), significantly improved in 21 patients (39.6%), improved in 3 patients (5.7%), did not improve in 3 patients (5.7%), respectively. The repatency of iliac and femoral vein was achieved in more than 80% of the 17 patients. Complications developed in 3 cases in the course of thrombolysis. Conclusion The effect of mechanical removal of thrombus, persistent thrombolysis through catheter and transluminal angioplasty is safe and satisfactory.