This case report describes a 68-year-old male patient diagnosed with primary hepatocellular carcinoma (HCC). After receiving Yttrium-90 microsphere selective internal radiation therapy (⁹⁰Y-SIRT), the tumor significantly reduced in size, and tumor markers alpha fetoprotein (AFP) and abnormal prothrombin (PIVKA-Ⅱ) decreased. Postoperative pathological results showed minimal residual tumor cells, indicating that ⁹⁰Y-SIRT has good efficacy and safety in downstaging and conversion of HCC, thereby facilitating subsequent surgical resection.

Objective:We aimed to build a novel model with metastasis-related genes (MTGs) signature for predicting progression-free interval (PFI) of papillary thyroid carcinoma (PTC) .Methods:We integrated PTC datasets with the MTGs to identify differentially expressed MTGs (DE-MTGs), then we established a novel MTGs based signature and validated it in external datasets and cell lines. Finally, we established a signature and clinical parameters-based nomogram for predicting the PFI of PTC.Results:We identified 155 DE-MTGs related to PFI in PTC. The functional enrichment analysis showed that the DE-MTGs were associated with essential oncogenic processes. Consequently, we established and optimized a novel 10-gene signature. The novel signature had a C-index of 0.76 and the relevant nomogram had a C-index of 0.80. Also, it was closely related to pivotal clinical characters of multiple datasets and invasiveness of PTC cell lines. And the signature was an independent prognostic factor in PTC. Finally, we built a nomogram including the signature and relevant clinical factors. The efficacy was satisfying in predicting PTC’s PFI.Conclusions:The MTG signature and nomogram were closely associated with PTC prognosis and may help clinicians improve the individualized prediction of PFI.

Objective:To compare the perioperative complications of carotid endarterectomy with patch angioplasty or primary closure.Methods:The clinical data of 492 carotid endarterectomy patients at the Vascular Surgery Department of Anzhen Hospital from Mar 2003 to Dec 2016 was analyzed retrospectively.Results:There were 364 cases (74%) in the patch angioplasty group and 128 cases (26%) in the primary closure group. The incidence of perioperative ischemic stroke was significantly lower in the patch angioplasty group than that in the primary closure group (0.8% vs. 3.9%, P=0.031), and there was no difference in the incidence of the remaining perioperative complications. By subgroup analysis, the incidence of perioperative ischemic stroke was significantly lower in the patch angioplasty group than in the primary closure group when the diameter of the internal carotid artery was <5 mm (0.7% vs. 6.0%, P=0.001), whereas there was no difference between the two groups when the diameter of the internal carotid artery was ≥5 mm. Conclusions:Carotid endarterectomy with patch angioplasty can reduce the incidence of perioperative cerebral infarction, especially in cases with an internal carotid artery diameter <5 mm.

Objective To evaluate retrograde transpopliteal access for femoral-popliteal artery total occlusion with blind puncture.Methods Clinical data of 22 cases admitted from Sep 2014 to June 2016 undergoing endovascular treatment of the femoral-politeal artery occlusion with transpopliteal artery retrograde access by blind puncture were analyzed.Results A total of 22 patients underwent retrograde popliteal access with blind puncture after antegrade attempts failed.Puncture above the knee was performed in 18 cases and below the knee in 4 cases.The average increase of ABI was 0.57.Hematoma of puncture site was observed in 2 patients,other complications included pneumonia in 1 case and renal insufficiency in 2 cases.The mean follow-up time was (13 ± 5)months.Restenosis occurred in 8 patiens(36.4％)during the follow-up time.The primary patency was (86.4 ± 0.07) ％ at 6 months and (70.7-± 0.12) ％ at 12 months.There was no major amputation rate and mortality during the follow-up.Conclusions Retrograde transpopliteal access for femoral-popliteal artery occlusion with blind puncture is safe and effective.

Under the concept of Internet+, this paper proposed modern medical equipment management system, which could satisfy our hospital and also agree with the evaluation of 3A hospital. The system can monitor, analyze and effectively manage the whole life of the equipment that included assembly, use, maintenance, update and rejection. The system mainly includes eleven modules that are equipment management, repair management, online-repair management, PM management, metering management, benefit analysis, guarantee management, supporter management, barcode management, inventory management and inspection management. The system could help to manage medical equipment effectively and optimize resource al ocation.

Objective To explore the means of haemostasis in gallbladder preserving cholecystolithotomy. Methods The clinical data of 31 cases were retrospectively analyzed, summarizes the successful experiences. Results There appeared 31 cases the gallbladder internal bleeding in 512 cases gallbladder preserving cholecystolithotomy. In all the cases, 31 operations were stopped bleeding satisfactorily and performed successfully without conversion to conventional laparoscopic surgery, without perforation of gallbladder. pressure and lavage hemostasis had common effect, the control coagulation hemostasis had satisfaction rate 96.6%. Except one patient used gallbladder whole layers suture method. Conclusion The control coagulation hemostasis with the high-frequency electric knife is the optimal way, pressure and lavage hemostasis is basal, and gallbladder whole layers suture method is supplement.

Aim To investigate the preventive effect of Polygonum Multiflorum (PM)on the deteriorated mi-cro-structure and biomechanical properties induced by prednisone.Methods Ninety 6-month-old male Sprague-Dawley rats were randomly divided into nine groups,which were control,prednisone,CAL,30%ethanol eluent of the PM(H,M,L),PM(H,M,L). Prednisone was gavaged to rat for 21 weeks as model group of osteoporosis.Meanwhile,tested herbal ab-stract were orally administrated to the modeled rats in-duced by prednisone.At the end of the experiment, the right femur was collected for micro-CT scanning, three-dimensional reconstruction and biomechanical test.Results Compared with the control group,mod-el group showed destruction of bone microarchitecture, BV /TV fell 28.6%(P <0.05),bone biomechanical parameters decreases,and stiffness fell 29.7%(P <0.01 ). Compared with the model group, positive group had significantly improved effect on bone micro-architecture,and biomechanical parameters,BV /TV increased 46.7%(P <0.01 ),and stiffness increased 25.9%(P <0.01 ).30% ethanol eluent of the PM (M,L)dose may improve bone microstructure by in-creasing BV /TV 46.7% (P <0.01 ),40.0% (P <0.05)respectively,PM(H)may improve the biome-chanical parameters by increasing stiffness 24.7%(P<0.05),and 30% ethanol eluent of the PM(H)and PMhigh-dose may improve the biomechanical parame-ters,but not as positive group.Conclusions Predni-sone reduces biomechanical properties of rat femur and deteriorates femoral microstructure.30% ethanol eluent of the PM(M,L)and PM(H)plays a preventive role in the changes of micro-structural and biomechanical properties by prednisone,and increases BMD,whereas other groups have no significant preventive effect.

Objective To study the efficacy and safety of Solifenacin on female overactive bladder (OAB) symptoms secondary to uncomplicated lower urinary tract infection. Methods Seventy-three adult female patients who had clinically diagnosed as OAB symptoms secondary to uncomplicated lower urinary tract infection were randomly divided into treatment group (41 cases) and control group (32 cases). Treatment group received Solifenacin , 5 mg orally qd , as well as OAB behavioral therapy , but control group was given only OAB behavioral therapy. The overactive bladder syndrome score (OABSS) was evaluated before and after antibiotic treatment in all the patients , and the treatment or observation time lasted four weeks after the antibiotic treatment were deactivated. Then OABSS scoring and the cure rate between two groups were compared. Results OABSS score of treatment group decreased significantly after receiving Solifenacin treatment one week , and the cure rate reached 56.10%, and two weeks later, the cure rate reached 92.68%. OABSS score of control group had no significant change one week after treatment and the cure rate was only 6.25%, but at the fourth week OABSS had decreased significantly and the cure rate reached 37.50%, which was still significantly lower than that of treatment group. There were no drug adverse events during treatment in both groups. Conclusions There is obvious clinical effect of solifenacin on female OAB symptoms secondary to uncomplicated lower urinary tract infection, which is safe and could significantly shorten the course of treatment.

Objective:To observe the effects of sonicated extract of Porphyromonas endodontalis(P.endodontalis)on the cell cy-cle and apoptosis of human osteoblastic hFOB 1 .1 9 cells.Methods:hFOB 1 .1 9 cells were treated with sonicated extract of P.end-odontalis at 0 (the control),1 ,1 0 and 1 00 μg/ml for 1 2,24 and 48 h respectively.MTT assay was used to examine cell prolifera-tion.The cell cycle distribution and apoptosis were examined by flow cytometry.Results:The sonicated exact of P.endodontalis in-hibited the proliferation of hFOB 1 .1 9 cells in a time-and dose-dependent manner.24 h treatment of 1 0 μg/ml and 1 00 μg/ml ex-act arrested the cell cycle of the cells in G1 phase,48 h treatment induced apoptosis in a dose-dependent manner.Conclusion:Sonicated exact of P.endodontalis may arrest hFOB 1 .1 9 cells in G1 phase and induce cell apoptosis,leading to inhibition of the cell proliferation.

Objective To evaluate the clinical characteristics,diagnosis and treatment method of pancreatic sinistral portal hypertension caused by tumors in the body and tail of the pancreas.Methods A retrospective review of 40 patients diagnosed with pancreatic sinistral portal hypertension at Peking Union Medical College Hospital from January 2007 to December 2012 was performed.Results The Initial symptoms were epigastric pain and discomfort (n =12),emaciation (n =5),low-back pain (n =4),splenomegaly (n =2),hematemesis and melena (n =4),hypoglycemic coma (n =1).All 40 patients had splenomegaly and varices in the gastric fundus with normal liver function.8 had combined esophageal varices.24 had hypersplenism and 26 had elevated serum CA19-9 level.25 patients received surgical intervention and 15 were treated conservatively.Pathology confirmed malignancy in 29 patients and benign lesions in 11.Thirty-five patients (35/40,88％) were followed up for 12 to 72 months.For patients undergoing surgery,hypersplenism and varices in the gastric fundus were all relieved.There was no upper gastrointestinal bleeding occurred during follow-up.For patients treated conservatively,hypersplenism remained stable and among them 4 patients had upper gastrointestinal bleeding,and successfully treated by medication,therapeutic endoscopy and interventional therapy.Conclusions Patients with pancreatic sinistral portal hypertension caused by tumor in the body and tail of the pancreas can be cured successfully by surgery.In those patients portal hypertension can present as initial clinical manifestation.