[The ventilation efficacy and safety of new nasopharyngeal airway applied in left atrial appendage occlusion].

Objective: The present retrospective study aimed to analyses the ventilation efficacy and safety of new nasopharyngeal airway applied in left atrial appendage occlusion. Methods: A total of 37 advanced aged patients diagnosed with atrial fibrillation(>65 years)who underwent left atrial appendage occlusion (LAAO) in Xuanwu Hospital of Capital Medical University from March 2021 to March 2022 were enrolled in this study. All patients received supplemental oxygen by a new nasopharyngeal airway to ensure intraoperative ventilation. The primary outcome was the occurrence of hypoxemia. The secondary outcomes included the incidence of hypotension after anesthesia, the incidence of body movement during surgery, significant fluctuations of the vital signs such as mean arterial pressure (MAP), heart rate (HR), saturation of pulse oxygen (SpO2) and respiratory rate (RR) at different time points (T1: pre-operation; T2: at the time of placing nasopharyngeal airway; T3: at the time of placing transesophageal echocardiography(TEE); T4: at the time of TEE intraoperative exploration; T5: end of the surgery; T6: at the time of patient woke up), and the incidence of postoperative adverse events. Results: There were 24 males and 13 females with a mean age of (73.8±7.7) years. The incidence of hypoxemia was 16.2% (6/37), which could return to normal after simple treatment. The incidence of hypotension was 27.0% (10/37), occurred after anesthesia induction mainly.32.4% (12/37) of the patients experienced movements, but no adverse events led to surgical termination. MAP at different time points was significantly different (P=0.001), but other vital signs of HR, SpO2 and RR were not significantly different(all P>0.05), without serious hemodynamic fluctuations. The incidence of postoperative adverse cardiovascular events was 10.8% (4/37), and delirium was 2.7% (1/37). All patients successfully completed the surgery and were safely discharged from the hospital. Conclusion: The new nasopharyngeal airway can meet the requirements of airway management during left atrial appendage occlusion under intravenous anesthesia without serious adverse events.

[Research progress on the regulatory mechanism of non-coding RNA in arsenic toxicity].

Arsenic is a non-metallic element, and the International Agency for Research on Cancer has identified arsenic and its compounds as carcinogens. Arsenic and its compounds can be absorbed through the respiratory tract, skin and digestive tract, distributed in the liver, kidney, lung and skin, and cause damage. Non-coding RNAs are closely related to arsenic-induced nervous system disorders, cell necrosis, reproductive toxicity, and carcinogenesis. In recent years, the network regulation of microRNAs (miRNAs) , long non-coding RNAs (lncRNAs) , and circular RNAs (circRNAs) among non-coding RNAs in various diseases induced by arsenic has become a new research field. This paper summarizes the existing scientific research results, and expounds the mechanism of miRNAs, lncRNAs and circRNAs in arsenic toxicity, and provides basic data and theoretical basis for the prevention and treatment of arsenic poisoning.

[Effects of Nd(2)O(3) exposure of rare earth particles on C57 BL/6J male mice sex hormone secretion and CYP11A1/PLZF/STRA8 protein expression].

Objective: To explore the effects of Nd(2)O(3) exposure to rare earth particles on the secretion of sex hormones, cytochrome P450 family member 11A1 (CYP11A1) , spermatogenesis markers promyelocytic leukemia zinc finger protein (PLZF) and retinoic acid stimulating gene 8 (STRA8) protein in C57 BL/6J male mice. Methods: In March 2021, Forty-eight male C57 BL/6J mice aged 6-8 weeks divided into control group and Nd(2)O(3) exposure low, medium and high dose groups (exposing doses of 62.5, 125.0, 250.0 mg/ml Nd(2)O(3)) , 12 per group. The mice in the Nd(2)O(3) groups were perfused with different doses of Nd(2)O(3) suspension by a one-time non-exposing tracheal instillation method, and the control group was perfused with an equal volume of normal saline, with a volume of 0.1 ml, to establish a mouse reproductive function injury model. After 28 days of exposure, the mice's body weight, testes and epididymis were weighed, and the organ coefficients were calculated; the two epididymis were taken to make a sperm suspension to determine the sperm count, survival rate, and deformity rate; inductively coupled plasma mass spectrometry (ICP-MS) method was used to detect the content of Nd in mouse testis tissue; HE staining was used to detect testicular tissue pathological changes and quantitative analysis; enzyme-linked immunosorbent assay (ELISA) method was used to detect serum luteinizing hormone (LH) and follicle stimulating hormone (FSH) and testosterone (T) content; western blot was used to detect the protein levels of CYP11A1, PLZF and STRA8 in testicular tissues. Results: Compared with the control group, with the increase of the exposure dose, the Nd content in the testis of the mice showed an increasing trend, the sperm survival rate and LH showed a decreasing trend, and the sperm deformity rate showed an increasing trend (P<0.05) ; Pathological showed that the number of sperm in the seminiferous tubules of the testicular tissue in the Nd(2)O(3) medium and high dose groups was significantly reduced, and the germinal epithelial disintegration, intraepithelial vacuolization, and exfoliation of spermatogenic cells and supporting cells occurred; The height of germinal epithelium was significantly reduced, and the percentage of damaged seminiferous tubules showed an increasing trend (P<0.05) ; FSH and T levels in serum in the middle and high dose groups of Nd(2)O(3), and CYP11A1, PLZF and STRA8 proteins in testicular tissues showed a downward trend with increasing dose (P<0.05) . Conclusion: The rare earth particulate Nd(2)O(3) may interfere with the expression of CYP11A1, PLZF and STRA8 protein, thereby causing the disorder of sex hormone secretion in the body, the maintenance of spermatogonia and the obstruction of the process of meiosis, causing reproductive function damage.

[The effects of long-term exposure to silica dust on serum CC16 and KL-6 levels].

Objective: To investigate the effects of long-term exposure to silica dust on serum CC16 and KL-6 levels. Methods: The patients with stage I silicosis who were hospitalized in our hospital from April 2016 to April 2017 were treated as silicosis group. The silica dust exposed workers without silicosis who were taken the physical examination in our hospital were taken as a dust-exposed group. The healthy control group comes from in the same period of community physical examination did not touch the dust. The levels of CC16 and KL-6 in serum of all subjects were determined by enzyme-linked immunosorbent assay (ELISA) , and the levels of CC16 and KL-6 in serum were compared in three groups. Results: Compared with the control group, the serum levels of CC16 in the silicosis group (P<0.01) and the dust-exposed group (P<0.01) were significantly lower. Compared with the control group, the level of serum KL-6 in the silicosis group was significantly decreased (P<0.01) compared with the control group, while the level of KL-6 in the serum of the dust-exposed group was significantly increased (P<0.01) . The ROC area of CC16 for diagnosis of silicosis was 0.92 (P<0.01) , with a sensitivity of 81.37%, specificity of 92.63% and Kappa value of 0.74. Conclusion: Long-term exposure to silica dust may lead to a decrease in serum CC16 levels. Reduced serum CC16 levels may be useful in identifying the diagnosis of silicosis.

[Analysis of annual hospitalization rate of pneumoconiosis patients and related influencing factors of social security].

Objective: To study the main factors that influencing Pneumoconiosis patients' healthcare seeking behaviors. Methods: Conducting a descriptive analysis to analyze the relationship between the annual hospitalization rate and social security status (medical insurance, location of medical insurance, proportion of insurance used for reimbursement of pneumoconiosis, whether there is employment injury insurance at work, whether to apply for compensation after diagnosing pneumoconiosis, whether they receive social assistance and a minimum allowance) , social relationship status of patients (whether there is pneumoconiosis in the family or relatives, whether there is a pneumoconiosis in a friend or a colleague, and whether or not he/she has received financial assistance) , life quality of patients (subjective feelings) and living standard of patients (dietary level) based on data acquired from 120 pneumoconiosis patients. Results: The results of single factor analysis reveal that the location of medical insurance, the proportion of insurance for reimbursement of pneumoconiosis, whether there is employment injury insurance at work, whether to apply for compensation after diagnosing pneumoconiosis are statistically significant in pneumoconiosis patients' hospital utilization ratio (P<0.05) . The place where medical insurance is located is the current place of residence, the reimbursement ratio of medical insurance for pneumoconiosis is listed as 50%-70%, the work unit has medical insurance, those who have not applied for compensation for pneumoconiosis have a higher utilization rate of hospitalization services. The annual hospitalization rate was 73.3%, 80.0%, 60.6%, 63.0%, respectively. Conclusion: The location of patient medical insurance, the proportion of insurance used for reimbursement of pneumoconiosis, whether there is employment injury insurance at work, and whether to apply for compensation after pneumoconiosis are the influencing factors of the patients' annual hospitalization rate.

[Analysis of outpatient utilization of pneumoconiosis patients in Jiangsu province].

Objective: To understand the situation and characteristics of out-patient utilization of urban and rural pneumoconiosis patients in Jiangsu province, and to provide a reference for the formulation of relevant policies. Methods: Using a questionnaire on patients with pneumoconiosis and their influencing factors, 120 patients with pneumoconiosis were randomly selected in Nanjing, Wuxi, Suzhou, Yancheng Vocational Defense Institute or CDC. The rate of outpatients with pneumoconiosis in urban and rural areas and the choice of out-patient hospitals were analyzed. Results: Of the 75 patients with severe pneumoconi-related symptoms such as chest tightness and dyspnea in the first two weeks of the survey, 36 (48.0%) lived in cities and 39 (52.0%) lived in rural areas. Patients with pneumoconiosis who live in urban and rural areas have different aggravating conditions within two weeks. Two weeks of aggravated symptoms in outpatient consultations accounted for36 (48.0%) . Of the 36 patients who used outpatient treatment, rural residents mainly chose 8 people from a hospital and a township health hospital, accounting for 34.8%, while 10 people from urban residents chose a nursing home or nursing home, accounting for 40.0%. The main reason why urban and rural pneumoconiosis patients did not go to the doctor is "conscious symptoms are lighter" and "feel that the doctor is useless." Conclusion: The rate of outpatients with pneumoconiosis in Jiangsu province within two weeks is lower than that of ordinary elderly residents. There may be differences in treatment behavior patterns of urban and rural pneumoconiosis patients.Economic factors have a certain influence on the outpatient treatment behavior of pneumoconiosis patients. The recognition of outpatient service is the main factor affecting the outpatient treatment of pneumoconiosis patients. It is very important to popularize the knowledge of pneumoconiosis and do a good job in propaganda of occupational diseases and health education for pneumoconiosis patients. Focusing on the outpatient treatment of pneumoconiosis patients and making targeted medical policies is very important to standardize and improve the rehabilitation of pneumoconiosis patients.

[The health status of radiation workers and the analysis of crystalline lens results].

Objective: To understand the healthy status of radiation workers on the staff in Nanjing, and to analysis the relationship between abnormal crystalline lens and its influencing factors. Methods: We described physical indicators including blood pressure (BP) 、blood sugar (BG) 、thyroid B ultrasound、crystalline lens、chromosome and so on among 3 349 radiation workers on the staff in the year 2016 from Jan 1 to Dec 31, and the abnormal results of crystalline lens were analyzed statistically. Results: The rate of abnormal BP、BG、WBC、Thyroid B ultrasound、crystalline lens was 19.0%、2.2%、5.8%、30.0%、3.6% respectively; The rate of chromosome aberration was 0.1%, and the chromosomal micronuclei are all within normal range. With the rate of abnormal crystalline lens increasing in age and working years, statistical significance both existed in the trend; Compared to the lowest group, the risk of abnormal crystalline lens increased 3.86 times in ≥60 year old group and 3.16 times in ≥30 years working group; The risk of abnormal crystalline lens in nosocomial radation group was higher than non-medical group; There's no found in smoking and drinking alcohol increasing the risk. Morphologically, dot abnormal focused on 30~39 years old and 0~9 working years group, while lamellar abnormal concentrated upon ≥60 year old、≥30 working years group; Age and working-year were both the risk factors of lamellar abnormal; The risk of lamellar abnormal in nosocomial radiation group was significantly higher than non-medical group. Conclusion: Existing nisk foctions in the radiation work has a serious impact on several healthy physiology indicators, the more prominent was crystalline lens. Attention should be paid to eye protection and comprehensive health management.

[Analysis of occupational chronic carbon disulfide poisoning: a study of 372 cases].

Objective: To investigate the clinical features of occupational chronic carbon disulfide(CS(2)) poisoning. Methods: A total of 372 patients with occupational chronic CS(2) poisoning were selected from a chemical fiber factory, and their clinical features were summarized and analyzed. Results: Major clinical manifestations of the 372 patients with occupational chronic CS(2) poisoning included sleep disorders, dizziness, headache, and numbness of limbs, and the detection rates of these manifestations were 84.7%, 84.4%, 79.8%, and 72.8%, respectively. Electroneuromyography showed peripheral nerve injuries. Conclusion: Occupational chronic CS(2) poisoning can affect the central and peripheral nervous system.

[Effect of low-dose ionizing radiation exposure on thyroid function in a medical occupational population].

Objective: We evaluated the effect of low-dose of ionizing radiation on thyroid function of medical occupational group with long-term exposure; furthermore; we analyzed the relationship between the thyroid hormones and the risk factors; such as exposure length; department. Ultimately; providing the scientific basis for setting the ionizing radiation protection standards. Methods: The population who engaged radiodiagnosis and radiotherapy in a tertiary-A hospital were set up as occupational exposure; 724 medical professionals as the research object. We figured out the basic information and general condition of the groups by face-to-face questionnaire survey; By means of the thyroid hormone testing; we analyzed the thyroid hormone levels with different population; occupational exposure factors. Then; obtained the prevalence of thyroid nodules by the thyroid ultrasound. Besides; we used the logistic regression model to analyze the risk factors related to thyroid nodule. Applying Epidata、Excel in data management. All the data was analyzed by statistical software package Stata12.0. Descriptive statistics; single factor analysis of variance and other statistical methods were used for data analysis. Test standard: α=0.05、P<0.05 statistical significant. Results: 1. Based on the work experience; we divided the study population into four groups; such as 1-9; 10-19; 20-29; and>30 years. The difference of the TSH level among the four groups was statistically significant (P<0.05) . 2. The multiple logistic regression showed that sex and seniority were the independent risk factors for the abnormal rate of thyroid nodules. Conclusion: Long-term exposure to low-dose ionizing radiatiom could induce the thyroid damage of medical occupational population; which should be broader concerned.

[Effects of Workload on Reproductive Health Status of Female Workers in Mechanical Manufacturing Industry].

Objective: To investigate the reproductive health status of female workers in the machinery industry and to analysis the effect of workload on their reproductive health. Methods: 5 732 female mechanical workers were selected and investigated by the Female Workers' Reproductive Health Questionnaire, which was printed by the occupational health and poisoning control institute of China CDC to collect the information about the reproductive health status of from March to December in 2016. Results: The rate of abnormal menstruation was 27.15%, and the rate of gynecological diseases of female workers was 34.39%. The menstruation abnormality and gynecological diseases rate of female workers with high workload was higher than that female workers with low workload (both P<0.01) . High workload was the independent the risk factor associated with the menstruation abnormality (OR=1.88, 95%CI: 1.54~2.31, P<0.01) and gynecological diseases (OR=1.97, 95% CI: 1.61~2.40, P<0.01) . Conclusion: The workload has a large impact on the reproductive health status of female workers.

Morphological features of an endangered Japanese strain of Cyprinus carpio: reconstruction based on seven SNP markers.

Morphological analyses of 183 specimens of Japanese common carp Cyprinus carpio (171 from Lake Biwa and 12 from nursery ponds) using genetic hybrid indices demonstrated that the typical native Japanese strain of C. carpio has a more elongate body, more branched dorsal-fin rays, fewer and shorter gill rakers, more developed pneumatic bulb, more coiled pneumatic duct, longer posterior swimbladder and shorter intestine than the typical introduced C. carpio. These results provide a basis for a better understanding of the ecological characteristics and taxonomic status of the endangered Japanese strain of C. carpio.

[Impact of symptom onset to first medical contact time on the prognosis of patients with acute ST-segment elevation myocardial infarction].

Objective: To investigate the impact of symptom onset to first medical contact (SO-to-FMC)time on the prognosis of patients with acute ST-segment elevation myocardial infarction(STEMI). Methods: The clinical data of 341 consecutive STEMI patients, who were hospitalized to our hospital and received primary percutaneous coronary intervention(PCI) from August 2011 to April 2016, were retrospectively analyzed. The patients were divided into ≤90 min group (201 cases) and >90 min group (140 cases) according to the SO-to-FMC time. The treatment time, mortality and incidence of major adverse cardiac and cerebro-vascular events(MACCE) were analyzed. The risk factor of 1-year mortality after PCI and 1-year incidence of MACCE during the post-discharge follow-up period were analyzed by binary logistic regression analysis. The predictor of 4.5-year mortality after PCI was analyzed by multivariate Cox regression analysis. Methods The door to balloon time (104(88, 125) min vs. 111(92, 144)min, P=0.023), first medical contact to balloon time(146(119, 197) min vs. 177(125, 237)min, P=0.005), and symptom onset-to-balloon time(200(170, 257) min vs. 338(270, 474)min, P<0.001)were all significantly shorter in the ≤90 min group than in>90 min group. The 30-day mortality (2.99% (6/201) vs. 7.86%(11/140), P=0.042), 1-year mortality (2.89 (5/173) vs. 9.57(11/115), P=0.015), 1-year incidence of MACCE during the post-discharge follow-up period(1.16%(2/173) vs. 6.96%(8/115), P=0.021), and 4.5-year cumulative mortality(3.00% vs. 11.20%, P=0.007) after PCI were significantly lower in the ≤90 min group than in the >90 min group. Moreover, the 4.5-year incidence with free of MACCE (97.20% vs. 88.80%, P=0.025) during the post-discharge follow-up period was significantly higher in the ≤90 min group than in the >90 min group. In-hospital mortality was similar between the two groups (2.49%(5/201) vs. 6.43%(9/140), P=0.071). Results: The door to balloon time (104(88, 125) min vs. 111(92, 144)min, P=0.023) , first medical contact to balloon time(146(119, 197) min vs. 177(125, 237)min, P=0.005), and symptom onset-to-balloon time(200(170, 257) min vs. 338(270, 474)min, P<0.001) were all significantly shorter in the ≤90 min group than in >90 min group. The 30-day mortality(2.99% (6/201) vs. 7.86%(11/140), P=0.042), 1-year mortality (2.89(5/173) vs. 9.57(11/115), P=0.015), 1-year incidence of MACCE during the post-discharge follow-up period (1.16%(2/173) vs. 6.96%(8/115), P=0.021), and 4.5-year cumulative mortality (3.00% vs. 11.20%, P=0.007) after PCI were significantly lower in the ≤90 min group than in the >90 min group. Moreover, the 4.5-year incidence with free of MACCE (97.20% vs. 88.80%, P=0.025) during the post-discharge follow-up period was significantly higher in the ≤90 min group than in the >90 min group. In-hospital mortality was similar between the two groups (2.49%(5/201) vs. 6.43%(9/140), P=0.071). Results of binary logistic regression analysis showed that the SO-to-FMC time >90 min was the risk factor of 1-year mortality(OR=2.90, 95%CI 1.22-6.92, P=0.016) and 1-year incidence of MACCE (OR=5.19, 95%CI 1.21-22.20, P=0.026) during the post-discharge follow-up period. Multivariate Cox regression analysis demonstrated that the SO-to-FMC time >90 min was the risk factor of 4.5-year mortality after PCI in patients with STEMI (HR=2.88, 95%CI 1.10-7.53, P=0.031). Conclusion: Shorting the SO-to-FMC time can significantly reduce the treatment time of STEMI patients, short and long-term mortalities and the incidence of MACCE, and improve the prognosis of patients with STEMI.

Covered airway stent placement for malignant tracheobronchial strictures in patients with an endotracheal tube.

AIM: To evaluate the technical feasibility and safety of covered airway stent placement for malignant tracheobronchial strictures in patients with an endotracheal tube. MATERIALS AND METHODS: Data regarding retrievable, expandable, metal stent placement under fluoroscopic guidance in 20 patients with an endotracheal tube inserted for malignant tracheobronchial strictures were retrospectively analysed. The clinical effectiveness was assessed using the following variables: technical and clinical success; procedure and stent-related complications; and duration of intubation following stent placement. RESULTS: Stent placement was technically successful in all 20 patients (100%), and with 19 of the 20 patients (95%) showing symptomatic improvement within 5 days. The endotracheal tube could be removed during (n=7) or after (n=12) stent placement, and the mean duration of intubation following stent placement was 1.4 days (range 0-3 days). One patient could not have his endotracheal tube removed and he died 9 days following stent placement in an intubated state. There were no procedure-related complications. Stent-related complications in three patients included partial (n=2) and complete (n=1) stent migration, all of which were managed with placement of a second stent (n=2) or stent removal and placement of a second stent (n=1). CONCLUSION: Covered airway stent placement under fluoroscopic guidance in patients with an endotracheal tube inserted for malignant tracheobronchial strictures, is both technically feasible and safe.

[Effect of umbilical cord mesenchymal stem cell transplantation on immune function and prognosis of patients with decompensated hepatitis B cirrhosis].

Objective: To investigate the effect of human umbilical cord mesenchymal stem cells (hUCMSCs) on the immune function and prognosis of patients with decompensated hepatitis B cirrhosis. Methods: A total of 65 patients with decompensated hepatitis B cirrhosis were divided into observation group and control group. The patients in the observation group were given intervention (via the proper hepatic artery or the portal vein) and intravenous infusion of 4×108 hUCMSCs in two doses, as well as the same basic treatment as in the control group. The patients in the control group were given conventional medical treatment. ELISA as used to measure the serum levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNFα), interleukin-10 (IL-10), and transforming growth factor-ß (TGFß) in the observation group before surgery and at 1 week after surgery, as well as the serum levels of IL-6, TNFα, IL-10, and TGFß in the control group on admission and at 1 week after admission. Flow cytometry was used to measure the percentage of lymphocyte subsets in the observation group before surgery and at 1 week after surgery, as well as that in the control group on admission and at 1 week after admission. In addition, the patients' prognosis and major complications during hospitalization were observed in both groups, and the patients were followed up for 24 weeks to record the number of deaths. The t-test was used for comparison of continuous data, and the chi-square test was used for comparison of categorical data which were expressed as percentages. Results: At 1 week after the transplantation of hUCMSCs, compared with the control group, the observation group had significant reductions in the serum levels of IL-6 and TNFα and significant increases in the serum levels of IL-10 and TGFß (all P < 0.001), as well as significant increases in the percentages of T4 cells and Treg cells and significant reductions in the percentages of T8 cells and B cells (all P < 0.05). There were no significant differences in the changes in T3 cells and natural killer cells between the two groups (P > 0.05). Compared with the control group, the observation group had a significantly lower probability of progression to liver failure (6.45% vs 14.71%, P = 0.017). Conclusion: In the treatment of patients with decompensated hepatitis B cirrhosis, transplantation of UCMSCs can inhibit the proliferation of T cells and B cells and the differentiation of T8 cells, upregulate Treg cells, promote the secretion of immunosuppressive cytokines, and reduce the production of inflammatory cytokines. Therefore, it can alleviate liver inflammatory response and liver cell damage and reduce the probability of hepatic failure.

Local non-viral gene delivery of apoptin delays the onset of paresis in an experimental model of intramedullary spinal cord tumor.

OBJECTIVE: The objective of this study is to evaluate the safety and efficacy of a tumor-specific apoptosis-inducing gene, apoptin, as delivered by the non-viral carrier, PAM-RG4, in an animal model of spinal cord tumor. METHODS: Male Sprague-Dawley rats were given a 2.5-µl intramedullary injection of C6 glioma (100,000) cells and randomized into three groups (day 0). On day 5, animals received a 7.5-µl intramedullary injection of Dulbecco's modified Eagle's medium (Group 1; n=7), PAM-RG4/control gene polyplex (Group 2; n=7), or PAM-RG4/apoptin gene polyplex (Group 3; n=8). Hindlimb functional strength was assessed every other day for the duration of the study. The spinal cords of killed animals were collected and hematoxylin-eosin stained. RESULTS: Following treatment, animals that received apoptin had significantly higher mean functional hindlimb scores than those of sham control animals, showing a level of preserved hindlimb function throughout the study. In addition, Group 1 (sham control) and Group 2 (control gene) animals had median survival scores lower than those of animals receiving apoptin. Histopathological analysis showed marked retardation of tumor progression in apoptin-treated animals compared with sham controls. CONCLUSION: Our study suggests that apoptin is safe for use in the mammalian spinal cord as well as effective in slowing the progression of tumor growth in the spinal cord. The significant slowing of tumor progression, as manifested by the preserved hindlimb function, coupled with the reduction in tumor volume, shows local non-viral delivery of apoptin could serve as an emerging therapy for the treatment of intramedullary spinal cord tumors.

[A review on critics of Wenre Jingwei].

Wenre Jingwei(,Warp and Weft of Warm and Hot Disorders) is believed the masterpiece written by Wang Mengying, who was a famous physician in the Qing Dynasty. It represents the essence of Wang's theory in terms of Epidemic Febrile Diseases. It has been interpreted and analyzed by seven critics. However, these seven critics have not been widely known up to now. This paper introduces the life history of the critics and their medical achievements, in order to clarify their contributions to this book and enrich the content of medical history.

Transcatheter arterial chemo-lipiodol infusion for unresectable hepatocellular carcinoma in 96 high-risk patients.

AIM: To evaluate the safety and efficacy of transcatheter arterial chemo-lipiodol infusion (TACL) in high-risk patients with unresectable hepatocellular carcinoma (HCC). MATERIALS AND METHODS: From January 2005 to April 2009, 96 patients underwent TACL. All patients had diffuse, infiltrative or multifocal tumours. Twenty-nine (30%) patients had an increased serum bilirubin level (>or=2mg/dl), and 75 patients (78%) had a low serum albumin level (<3.5mg/dl). The Child-Pugh (CP) score was 9 or more in 13 (14%) patients. Sixty-five patients (68%) had major portal vein occlusion. Sixteen patients (17%) had biliary dilatation. RESULTS: TACL was technically successful in all patients. After TACL, 18 (19%) of the 96 patients showed tumour response using computed tomography (CT) criteria. The 30 day mortality and morbidity rates were 1 and 2%, respectively. The median survival period was 8.6 months, and the overall 6 month, 1, 2, and 3 year survival rates were 59, 44, 26, and 15%, respectively. Portal vein occlusion (p<0.001) was the only significant risk factor associated with the length of the survival period after TACL, whereas the CP score (p=0.498), serum bilirubin level (p=0.153), serum albumin level (p=0.399), and biliary obstruction (p=0.636) had no significant effect. CONCLUSIONS: TACL can be performed safely in high risk HCC patients resulting in a median survival rate of 8.6 months in the present series.