Objective:To investigate the prevalence of Kashin-Beck disease (KBD) in Liaoning Province, analyze its disease progression, and provide a scientific basis for timely adjustment in prevention and control strategies and work priorities.Methods:From March 2019 to October 2024, a cross-sectional study was conducted in five KBD endemic townships in Liaoning Province. The monitoring was conducted on a village by village basis, including the name of the administrative village, the name of the natural village (township), the number of permanent households (residing for ≥6 months), the number of permanent residents, the number of permanent residents aged 7 to 12, the management and treatment of adult patients, the implementation of prevention and control measures, and the implementation of child nutrition improvement programs (grain replacement). Anteroposterior X-rays of both hands were taken for children with abnormal signs or suspected KBD. Cases were confirmed as KBD if both clinical examination and X-ray review were positive. Five-year KBD surveillance data were analyzed, including the numbers of clinically positive and X-ray positive cases at each monitoring site, with positive detection rates calculated to macroscopically analyze the dynamic changes in KBD status.Results:From 2019 to 2024, a total of 180 103 children aged 7 - 12 years old were monitored in KBD endemic villages in Liaoning Province. Among them, 321 children showed abnormal clinical signs, but hand X-rays revealed no positive changes indicative of KBD. The annual positive detection rate for KBD was 0 throughout the study period. In 2024, in 1 500 endemic natural villages (hamlets) in Liaoning Province, 39 205 acres of farmland were converted to economic crops (1.96% of original farmland), and 16 520 acres were returned to forest or grassland (1.74% of original farmland). There were 534 KBD patients, with a prevalence rate of 6.7/10 000. All patients had completed patient information management, follow-up evaluation, achieving a 100% management rate. Four hundred thirty-five patients with Kashin Beck disease were planned for treatment, but, 476 patients were actually treated with medication, resulting in a planned treatment completion rate of 109.43% and a patient treatment rate of 89.14%.Conclusion:From 2019 to 2024, Liaoning Province has achieved the goal of eliminating KBD and maintained sustained elimination status.

Objective:To investigate the prevalence of Kashin-Beck disease (KBD) in Liaoning Province, analyze its disease progression, and provide a scientific basis for timely adjustment in prevention and control strategies and work priorities.Methods:From March 2019 to October 2024, a cross-sectional study was conducted in five KBD endemic townships in Liaoning Province. The monitoring was conducted on a village by village basis, including the name of the administrative village, the name of the natural village (township), the number of permanent households (residing for ≥6 months), the number of permanent residents, the number of permanent residents aged 7 to 12, the management and treatment of adult patients, the implementation of prevention and control measures, and the implementation of child nutrition improvement programs (grain replacement). Anteroposterior X-rays of both hands were taken for children with abnormal signs or suspected KBD. Cases were confirmed as KBD if both clinical examination and X-ray review were positive. Five-year KBD surveillance data were analyzed, including the numbers of clinically positive and X-ray positive cases at each monitoring site, with positive detection rates calculated to macroscopically analyze the dynamic changes in KBD status.Results:From 2019 to 2024, a total of 180 103 children aged 7 - 12 years old were monitored in KBD endemic villages in Liaoning Province. Among them, 321 children showed abnormal clinical signs, but hand X-rays revealed no positive changes indicative of KBD. The annual positive detection rate for KBD was 0 throughout the study period. In 2024, in 1 500 endemic natural villages (hamlets) in Liaoning Province, 39 205 acres of farmland were converted to economic crops (1.96% of original farmland), and 16 520 acres were returned to forest or grassland (1.74% of original farmland). There were 534 KBD patients, with a prevalence rate of 6.7/10 000. All patients had completed patient information management, follow-up evaluation, achieving a 100% management rate. Four hundred thirty-five patients with Kashin Beck disease were planned for treatment, but, 476 patients were actually treated with medication, resulting in a planned treatment completion rate of 109.43% and a patient treatment rate of 89.14%.Conclusion:From 2019 to 2024, Liaoning Province has achieved the goal of eliminating KBD and maintained sustained elimination status.

Objective: To explore the safety and feasibility of associating diaphragm resection and liver-diaphragmatic metastasis lesions resection for patients with advanced ovarian cancer. Methods: Retrospectively analysis 83 cases(98 times) of advanced ovarian cancer with liver-diaphragmatic metastasis between January 2012 and December 2016 at Department of Liver Surgery, Peking Union Medical College Hospital.The patients were aged from 19 to 75 years.Surgical procedure included metastatic lesions resection(43 times) and stripping(55 times). Operation status, post-operative complications, pathology results and follow-up of the patients were analyzed. Results: Fifteen patients received twice surgical treatment and 68 patients received one time surgical treatment. Postoperative hemorrhage in chest and between liver and diaphragm was not occurred in all cases.Dyspnea and low oxygen saturation were occurred in two cases of stripping patients and 1 case of metastatic lesions resection patients.Results of CT examination indicated that there was medium to large amount of ascites in right chests.The symptoms were relieved after placing thoracic closed drainage.Other patients were recovered smoothly.All patients were diagnosed as ovarian cancer by pathological examination. Conclusion Associating diaphragm resection is safe and feasible for liver-diaphragmatic metastasis lesions from ovarian cancer.

Objective To summarize the clinical diagnosis and treatment of nodular regenerative hyperplasia of the liver. Methods Retrospective analysis was made on the clinical manifestations,imagings, laboratory tests, diagnosis, treatment and prognosis of 18 consecutive cases finally established as NRH during the past 26 years. Results 15 of the 18 cases showed portal hypertension, 4 cases showed mono or multiple occupations of the liver, 8 cases suffered from concurrent autoimmune diseases, 3 cases were suspected of blood diseases. Preoperatively, 13 cases were diagnosed as cirrhosis, 2 cases were diagnosed as liver cancer or focal nodular hyperplasia ( FNH). All cases were diagnosed by operative wedging biopsy. 3 cases received splenectomy, 4 cases received disconnection /Phemister surgery, 3 cases received liver occupation/liver lobe resection, 1 case received partial small bowel resection, and 1 case received spleen artery restrictive surgery. Postoperatively, symptoms of portal hypertension relieved obviously. Follow-up study showed most of the patients were stable and prognosis of the NRH was good.Conclusions NRH may relate to the disturbance of liver blood supply, and most common clinical manifestation is portal hypertension, and can combine with immune diseases, hematopathy also can present single or multiple liver occupations. Differential diagnoses include liver cirrhosis, FNH, idiopathic portal hypertension. Diagnosis of NRH relies on liver wedging biopsy. Surgery can relive concurrent portal hypertension.

Objective To investigate the effect and long-term prognosis of patients who underwent hepatectomy for hepatolithiasis. Methods We retrospectively analyzed the medical records of 98 patients with hepatolithiasis who were treated by hepatectomy in Peking Union Medical College Hospital.Results Male/femah:1/1.7;median age:55 years old.58 cases(59.2%)had been treated before;among them.50 by surgery.In 88 cages(89.8%)hepatolithiasis involved the left lobe only,in 2(2.0%) only the right lobe involved.and in 8(8.2%)both left and right lobe were involved.51(52.0%)had extrahepatic biliary stones,30(30.6%)had biliary duct strictures,28(28.6%)had a history of biliary ascariasis.and 5(5.1%)had a concurrent biliary tract malignancy.All received partial hepatectomy according to the stone location;for the 8 bilaterally involved patients,left hepatectomy and right lithotomy were performed.Postoperative complications occurredin 14 cases(14.3%),and there were2perioperative deaths(2.0%).Seventy-eight patients(79.6%)have beenfollowedupfor over1 yearwith no tumors;the results were excellent or good in 91.0%;the stone residue and recurrence rate were both 2.0%.Conclusions Hepatectomy not only eliminates calcuci,but also removes diseased biliary tracts,with advantages of low residue stone and recurrence rate.

Objective To investigate the impact of vascular inflow occlusion of the liver on arterial lactate level and pH value. Methods In this study, 68 patients who underwent hepatectomy from January 2006 to December 2008 were retrospectively studied. The patients were assigned to one of the three study groups according the vascular inflow status: clamping of portal vein and hepatic artery in the hepatic pedicle (n = 20), hemihepatectomy under total hemihepatic vascular exclusion (THVE, n = 22), and non-vascular occlusion (n = 26). Postoperative arterial blood gas analysis including systemic arterial lactate concentration, and liver and renal function tests were performed. Results Systemic arterial blood lactate levels significantly elevated in the portal clamping and THVE groups (5.53 ±2. 31 mmol/L and 5.62 ±2.52mmol/L, respectively), compared to the non-occlusion group (3. 37 ± 1.56 mmol/L, P < 0. 05) ;significant increase in arterial HCO3- level was observed in the THVE group in comparison to the nonocclusion group (19. 68 ± 3. 82) mmol/L vs. (21.65 ± 2. 48) mmol/L, (P < 0. 05). There were no significant differences as to the changes of pH values, liver and renal function tests between the three groups. Conclusions Vascular inflow deprivation may result in significantly increased arterial lactate level. Thus, intense surveillance of blood lactate level with prompt treatment is necessary to prevent postoperative hyperlactatemia and metabolic acidosis.