Advances in Doped ZnO Nanostructures for Gas Sensor.

Gas sensors based on metal oxides semiconductor (MOS) have attracted extensive attention from both academic and industry. ZnO, as a typical MOS, exhibits potential applications in toxic gas detection, owning to its wide band gap, n-type transport characteristic and excellent electrical performance. Meanwhile, doping is an effective way to improve the sensing performance of ZnO materials. In this review, the effects of different types of doping on morphology, crystal structure, band gap and depletion layer of ZnO materials are comprehensively discussed. Theoretical analysis on the strategies for enhancing the sensing properties of ZnO is also provided. This review puts forward the reasonable insight for designing efficient n-type ZnO-based semiconductor oxide sensing materials.

Thoracic Endovascular Aortic Repair for Type B Aortic Dissection Associated with Retrograde Type A Intramural Hematoma.

PURPOSE: To evaluate feasibility and efficacy of thoracic endovascular aortic repair (TEVAR) for type B aortic dissection (TBAD) associated with retrograde type A intramural hematoma (IMH). MATERIALS AND METHODS: From April 2013 to January 2017, 15 consecutive patients with TBAD associated with retrograde type A IMH who underwent TEVAR were reviewed retrospectively. There was no cardiac tamponade, aortic regurgitation, involvement of coronary artery, or sign of cerebral ischemia in these patients. Enhanced CT was used in 4 patients to diagnose malperfusion of abdominal visceral arteries or lower extremity artery and underwent emergent TEVAR. For the remaining 11 patients, repeated enhanced CT after initial medical treatment within 24 hours from onset of pain showed expansion of IMH in 8 patients or presence of periaortic hematoma in 3 patients. Delayed TEVAR was scheduled for these cases. RESULTS: Successful deployment of the stent graft was achieved in all patients. There were no severe postoperative complications, such as retrograde type A aortic dissection or aortic rupture. Sudden death occurred in 1 patient 3 months after the procedure. Thrombosis of the false lumen, shrinkage of the diameter of the aorta, and complete absorption of the IMH were observed in the remaining patients at a mean follow-up of 19.8 months ± 6.57. CONCLUSIONS: TEVAR for treatment of TBAD with retrograde type A IMH is feasible and effective. It represents a treatment option for patients with TBAD associated with type A IMH with a proximal entry tear located in the descending aorta.

Feasibility and efficacy study of microwave ablation of recurrent small HCC guided by enhanced liver-specific magnetic resonance imaging contrast agent.

OBJECTIVES: To investigate the feasibility and efficacy of liver-specific magnetic resonance imaging (MRI) with gadolinium-containing contrast agent guidance for microwave ablation (MWA) of recurrent small hepatocellular carcinoma (HCC). MATERIALS AND METHODS: The Ethics Committee of the First Affiliated Hospital of Fujian Medical University approved this study. Eighteen patients presented with 30 recurrent small HCCs, at least one lesion per patient was undetectable on unenhanced MRI, but this was clearly demonstrated in the hepatobiliary phase after liver-specific MRI contrast agent administration. Gd-BOPTA (16 cases) or Gd-EOB-DTPA (2 cases) were injected half an hour before the procedure, and MWA was performed by percutaneous puncture of the target lesion with a magnetic resonance-compatible microwave antenna under 1.5 T MRI guidance. RESULTS: The technical success rate was 100%. The mean maximum diameter of the lesions was 9.7 ± 2.8 mm (5.0-15.4 mm). The mean follow-up time was 11.6 ± 4.7 months (range, 4-19 months), and no local recurrence was observed. CONCLUSIONS: MWA of small HCCs guided by enhanced liver-specific MRI contrast agent is a safe and effective technique.

Highly enhanced photocatalytic H2 evolution of Cu2O microcube by coupling with TiO2 nanoparticles.

A Cu2O/TiO2 p-n heterojunction composite was created via a facile, controllable, one-pot hydrothermal method based on cubic Cu2O and TiO2 nanoparticles in the presence of dioctyl sulfosuccinate sodium salt (AOT) surfactant. The TiO2 nanoparticles with an average edge length of ∼10.1 nm were uniformly distributed on the crystal surface of a Cu2O cube {100}. The photocatalytic performance of the composite was effectively tuned by controlling the amount of TiO2. The Cu2O/TiO2 (60 wt%, labeled as CT-60) exhibits the highest enhanced photocatalytic activity in hydrogen production with H2 evolution of 3002.5 µmol g-1. The yield remained around 92.6% after three cycles. Hydrogen production of the CT-60 is 103 and 8.5 fold higher than the cubic Cu2O and TiO2 nanoparticles, respectively. The improvement in photocatalytic performance could be attributed to the formation of p-n heterojunction. Furthermore, the interface effect of Cu2O and TiO2 caused a broader absorbance in the visible-light region and the lower recombination of photogenerated electron-hole pairs. It is believed that the Cu2O/TiO2 p-n heterojunction composites could provide an alternative method to design highly efficient photocatalysts for solar energy.

Double-platelet Pd@ZnO microcrystals for NO2 chemical sensors: their facile synthesis and DFT investigation.

Double-platelet, single-platelet and spherical ZnO microcrystals were fabricated via a facile and controllable hydrothermal method. The morphology of the ZnO microcrystals and the exposure ratio of the (001) crystal surface were regulated by adjusting the pH of the solution. The ZnO microcrystals were modified with Pd nanoparticle loading by simple calcining, and the interaction of Pd nanoparticles (NPs) on the ZnO crystal surface increased its oxygen vacancy content. A micro-amount (0.05 wt%) of Pd NP-doped ZnO double-platelets (D-ZnO-0.05) enhanced the gas sensing of the sensor to 3.5 times that of pure double-platelet ZnO. The gas sensing results indicate that D-ZnO-0.05 exhibits a high response (71.2 for NO2 with 25 ppm), fast response/recovery (25 s/21 s), and superior long-term stability (remained at around 95.5% after 35 days). The enhancement in the gas sensing could be attributed to the catalysis of Pd NPs and the increase in the number of oxygen vacancies as a result of Pd loading. The band structure of D-ZnO-0.05 could be effectively tuned by introducing Pd nanoparticles, as shown in density functional theory (DFT) calculations. The Pd dopant and oxygen vacancies reduce the band gap of the ZnO(001) crystal materials, resulting in excellent sensor performance. It is believed that the D-ZnO-0.05 microcrystals could provide inspiration for crystal growth studies and high NO2 gas sensing.

Irradiation stents vs. conventional metal stents for unresectable malignant biliary obstruction: A multicenter trial.

BACKGROUND & AIMS: Placement of an irradiation stent has been demonstrated to offer longer patency and survival than an uncovered self-expandable metallic stent (SEMS) in patients with unresectable malignant biliary obstruction (MBO). We aim to further assess the efficacy of an irradiation stent compared to an uncovered SEMS in those patients. METHODS: We performed a randomized, open-label trial of participants with unresectable MBO at 20 centers in China. A total of 328 participants were allocated in parallel to the irradiation stent group (ISG) or the uncovered SEMS group (USG). Endpoints included stent patency (primary), technical success, relief of jaundice, overall survival, and complications. RESULTS: The first quartile stent patency time (when 25% of the patients experienced stent restenosis) was 212 days for the ISG and 104 days for the USG. Irradiation stents were significantly associated with a decrease in the rate of stent restenosis (9% vs. 15% at 90 days; 16% vs. 27% at 180 days; 21% vs. 33% at 360 days; p = 0.010). Patients in the ISG obtained longer survival time (median 202 days vs. 140 days; p = 0.020). No significant results were observed in technical success rate (93% vs. 95%; p = 0.499), relief of jaundice (85% vs. 80%; p = 0.308), and the incidence of grade 3 and 4 complications (8.5% vs. 7.9%; p = 0.841). CONCLUSIONS: Insertion of irradiation stents instead of uncovered SEMS could improve patency and overall survival in patients with unresectable MBO. LAY SUMMARY: For patients with unresectable malignant biliary obstruction (MBO), placement of a self-expandable metallic stent (SEMS) is a recommended palliative modality to relieve pruritus, cholangitis, pain, and jaundice. However, restenosis is a main pitfall after stent placement. Data from this first multicenter randomized controlled trial showed that insertion of an irradiation stent provided longer patency and better survival than a conventional metal stent. ClinicalTrials.gov ID: NCT02001779.

Superlyophilicity-Facilitated Synthesis Reaction at the Microscale: Ordered Graphdiyne Stripe Arrays.

As a new member of carbon allotropes, graphdiyne is a promising material with excellent electronic performance and high elasticity, indicating the possibility of graphdiyne to serve as the building blocks in flexible electronics. However, precise positioning/patterning of graphdiyne is still a challenge for the realization of large-area and flexible organic electronic devices and circuits. Here, the direct in situ synthesis of patterning graphdiyne stripe arrays dominated by the superlyophilic grooved templates is reported, whereas the superlyophilicity of grooved templates plays a key role in allowing continuous mass transport of raw reactants into the microscale spacing. After the completion of cross-coupling reaction procedure, precisely patterned graphdiyne stripes can be generated accordingly. The size of graphdiyne stripe arrays is depending on the silicon substrate size (1 cm × 1.5 cm), and the layer thickness can be manipulated from just several nanometers to hundreds of nanometers by varying the primary concentration of hexaethynylbenzene monomers. As a proof-of-principle demonstration, a stretchable sensor based on the graphdiyne stripe arrays is performed to monitor the human finger motion. It is expected that this wettability-facilitated strategy will provide new insights into the controlled synthesis of graphdiyne toward promising flexible electronics and other optoelectronic applications.

Radiation-Emitting metallic stent for unresectable bismuth type III or IV perihilar cholangiocarcinoma: a multicenter randomized trial.

BACKGROUND AIMS: Self-expandable metallic stents (SEMSs) have been recommended for patients with unresectable malignant biliary obstruction while radiation-emitting metallic stents (REMSs) loaded with 125I seeds have recently been approved to provide longer patency and overall survival in malignant biliary tract obstruction. This trial is to evaluate the efficacy and safety of REMS plus hepatic arterial infusion chemotherapy (REMS-HAIC) versus SEMS plus HAIC (SEMS-HAIC) for unresectable perihilar cholangiocarcinoma (pCCA). METHODS: This multicenter randomized controlled trial recruited patients with unresectable Bismuth type III or IV pCCA between March 2021 and January 2023. Patients were randomly assigned (1:1 ratio) to receive either REMS-HAIC or SEMS-HAIC using permuted block randomization, with a block size of six. The primary endpoint was overall survival (OS). The secondary endpoints were time to symptomatic progression (TTSP), stent patency, relief of jaundice, quality of life, and safety. RESULTS: A total of 126 patients were included in the intent-to-treat population, with 63 in each group. The median OS was 10.2 months versus 6.7 months (P=0.002). The median TTSP was 8.6 months versus 5.4 months (P=0.003). The median stent patency was longer in the REMS-HAIC group than in the SEMS-HAIC group (P=0.001). The REMS-HAIC group showed better improvement in physical functioning scale (P<0.05) and fatigue symptoms (P<0.05) when compared to the SEMS-HAIC group. No significant differences were observed in relief of jaundice (85.7% vs. 84.1%; P=0.803) or the incidence of grade 3 or 4 adverse events (9.8% vs. 11.9%; P=0.721). CONCLUSION: REMS plus HAIC showed better OS, TTSP, and stent patency compared with SEMS plus HAIC in patients with unresectable Bismuth type III or IV pCCA with an acceptable safety profile.

Structure and structural transition of chiral domains in oligo(p-phenylenevinylene) assembly investigated by scanning tunneling microscopy.

OPV3-CHO molecules are employed to prepare assembly on highly oriented pyrolytic graphite, and the so-prepared assembly is investigated by scanning tunneling microscopy. In the assembly chiral domains are observed with various structures such as linear and windmill. The chiral structural formation, stability, transition, and possible unification are intensively studied. After thermal annealing, linear structure was the only structure. To achieve a unified assembly with a single structure, an efficient method is proposed by coadsorption of OPV3-CHO with selected molecules. For example, an assembly with side-by-side helix structure is formed by a simple coadsorption of OPV3-CHO with alkyl bromide (C(n)H(2n+1)Br, n = 15-18). The experiments by cocrystallization of OPV3-CHO/C(n)H(2n+1)X (X = Cl, Br, and I) show the important role of halogen bonding in formation of the uniform structure. The results are significant in understanding the intermolecular noncovalent interactions that dominate the surface structure and chirality.

[Clinical study of percutaneous transhepatic balloon dilation:a novel procedure for common bile duct stone].

OBJECTIVE: To investigate the safety and efficacy of percutaneous transhepatic balloon dilation for the removal of common bile duct stone. METHODS: Sixty-eight cases with common bile duct stone treated with percutaneous transhepatic balloon dilation in our department from July 2008 to April 2011 were analyzed retrospectively.Record CA19-9, total bilirubin, indirect bilirubin and albumin before the procedure, 1 week and 1 month later. Check if immediate complications occurs, including hemorrhage, perforation, pancreatitis and cholangitis. During the following up for 2 years, stone recurrence, reflux cholangitis and other long-term complications were observed. Analyze the changes of indicators between preoperative and postoperative and the correlation. RESULTS: All of the 68 patients were treated successfully.53 patients underwent one procedure, and 15 patients received twice or more times of procedures. CA19-9, TBIL and IBIL decreased significantly 1 week later and 1 month later compared with those before the procedure, while ALB was opposite.Incidences of biliary tract infection, hemorrhage, and pancreatitis were 4.4% (3/68), 2.9% (2/68) and 1.5% (1/68) respectively.No severe complications occurred, including perforation of gastrointestinal or biliary tract.Incidences of recurrent stone and reflux cholangitis were 14.7% (10/68) and 5.9% (4/68) in two years after the procedure. CONCLUSION: Percutaneous transhepatic balloon dilation is a safe and effective procedure for patients with common bile duct stone. For the cases which could not be handled with endoscopic procedures, it provides a new therapeutic approach.

Irradiation stent with 125 I plus TACE versus sorafenib plus TACE for hepatocellular carcinoma with major portal vein tumor thrombosis: a multicenter randomized trial.

BACKGROUND AND AIM: Treatment strategy for hepatocellular carcinoma (HCC) and Vp4 [main trunk] portal vein tumor thrombosis (PVTT) remains limited due to posttreatment liver failure. We aimed to assess the efficacy of irradiation stent placement with 125 I plus transcatheter arterial chemoembolization (TACE) (ISP-TACE) compared to sorafenib plus TACE (Sora-TACE) in these patients. METHODS: In this multicenter randomized controlled trial, participants with HCC and Vp4 PVTT without extrahepatic metastases were enrolled from November 2018 to July 2021 at 16 medical centers. The primary endpoint was overall survival (OS). The secondary endpoints were hepatic function, time to symptomatic progression, patency of portal vein, disease control rate, and treatment safety. RESULTS: Of 105 randomized participants, 51 were assigned to the ISP-TACE group, and 54 were assigned to the Sora-TACE group. The median OS was 9.9 months versus 6.3 months (95% CI: 0.27-0.82; P =0.01). Incidence of acute hepatic decompensation was 16% (8 of 51) versus 33% (18 of 54) ( P =0.036). The time to symptomatic progression was 6.6 months versus 4.2 months (95% CI: 0.38-0.93; P =0.037). The median stent patency was 7.2 months (interquartile range, 4.7-9.3) in the ISP-TACE group. The disease control rate was 86% (44 of 51) versus 67% (36 of 54) ( P =0.018). Incidences of adverse events at least grade 3 were comparable between the safety populations of the two groups: 16 of 49 (33%) versus 18 of 50 (36%) ( P =0.73). CONCLUSION: Irradiation stent placement plus TACE showed superior results compared with sorafenib plus TACE in prolonging OS in patients with HCC and Vp4 PVTT.

Amidetriazole: a versatile building block for construction of oxyanion anion receptors.

The design and synthesis of efficient receptors for tetrahedral oxyanions is an emerging field in supramolecular chemistry. Herein, we have developed a urea-like anion-recognizing motif, amidetriazole, which can be easily synthesized and derived and shows good solubility. A series of simple acyclic receptors were designed and synthesized to confirm the potential of amidetriazole for the construction of tetrahedral oxyanion receptors. This molecular platform can be used extensively for the construction of numerous receptor systems appended with functional groups, which opens the way to many applications in the field of supramolecular chemistry.

The role of bile acid subtypes in the diagnosis of cholangiocarcinoma.

OBJECTIVES: To find the potential biomarkers of cholangiocarcinoma, form a biomarker package, evaluate its efficiency, and validate it. METHODS: R software was used to analyze the differential expression of mRNAs between cholangiocarcinoma and adjacent nontumorous tissues, obtained from The Cancer Genome Atlas (TCGA), and enrich the KEGG pathway. Metabo-Profile Inc. performed the comprehensive bile acid profiling and quantitation. The training set concluded 20 cholangiocarcinoma and 20 nontumorous volunteers. Receiver operating characteristic (ROC) curve and accompanying area under the curve (AUC) was calculated. The top four bile acids formed a new biomarker package. The validation set included 15 cholangiocarcinoma and 15 nontumorous, and the sensitivity and specificity of the new biomarker package were tested. RESULTS: Gene expression of 36 cholangiocarcinoma and nine adjacent nontumorous tissues was obtained in January 2020. Totally 9887 differential genes were eligible (logFC ≥ 1 or ≤ -1, P < 0.05, and adjust P < 0.01). GO analysis showed that 20 KEGG pathways were enriched, including primary bile acid biosynthesis and bile secretion. Comprehensive bile acid profiling and quantitation showed 15 differential bile acid types, and the ROC-AUC was between 0.953 and 0.750. HDCA, isoLCA, bCDCA, and DCA were selected to form a biomarker package. The Logit (p = cholangiocarcinoma) = 7.898 - 3.70*(1isoLCA) - 0.444*(bCDCA) + 0.415*(HDCA) + 0.041*DCA. Its ROC-AUC was 0.944. In the validation set, the sensitivity was 0.933 and the specificity was 0.867. CONCLUSION: Bile acid types package was efficient to distinguish nontumorous population and cholangiocarcinoma. The difference might be associated to the downregulation of primary bile acid biosynthesis and bile secretion pathway of cholangiocarcinoma.

Nanometer-sized reactor--a porphyrin-based model system for anion species.

Although many cagelike molecules can create a catalytic environment for promoting chemical reactions, the construction of receptors that can host anionic species and sensitize their reaction is novel. Here we report the photochemically induced dimerization of the anion radicals of TCNQ (7,7,8,8-tetracyano-para-quinodimethane) in organic solvent under aerobic conditions when they are encapsulated inside a cationic photoactive receptor. There is clear evidence for a rate increase of over two orders of magnitude, photosensitization of the host, and demonstrated turnover of the catalyst.

Antidiabetic effect of oleanolic acid: a promising use of a traditional pharmacological agent.

Diabetes mellitus (DM) is a metabolic disorder characterized by chronic hyperglycemia. Although the clear mechanisms of DM and insulin resistance are still to be cleared, it has been well documented that reactive oxygen species (ROS) play a pivotal role in DM and multiple types of insulin resistance. For the past few years, natural substances have been shown to have the potential to treatment DM. Attention has been especially focused on plants rich in triterpenoids, which generally show antioxidant and antiglycation effect. In our previous studies, it was shown that oleanolic acid (OA), a natural triterpenoid and an aglycone of many saponins, is a potent antioxidant acting as not only a free radical-scavenger through direct chemical reactions but also as a biological molecule, which may enhance the antioxidant defenses. The present study aimed to investigate the potential antidiabetic effect of OA. Oleanolic acid showed a significant blood glucose-lowering and weight-losing effect in diabetic animals induced by streptozotocin (STZ). In the insulin resistant model, it was also shown that OA may promote insulin signal transduction and inhibit oxidative stress-induced hepatic insulin resistance and gluconeogenesis, in which process the phosphorylation of ERK and the protective effect on mitochondrial function may be involved. These findings may significantly better the understanding of the pharmacological actions of OA and advance therapeutic approaches to DM.

Lobaplatin Enhances Radioactive 125I Seed-Induced Apoptosis and Anti-Proliferative Effect in Non-Small Cell Lung Cancer by Suppressing the AKT/mTOR Pathway.

INTRODUCTION: In recent years, radioactive 125I seed implantation combined with chemotherapy has been regarded as a safe and effective treatment for advanced non-small cell lung cancer (NSCLC). However, the mechanism underlying this success is still unclear. METHODS: In this study, we investigated the apoptosis and anti-proliferative effect induced by 125I in A549, H1975, and H157 cells and determined whether a sensitizing concentration of lobaplatin (LBP) could enhance these effects. We performed in vitro experiments on A549, H1975, and H157 cells; we investigated the effects of 125I or lobaplatin (LBP) alone, or in combination, on cellular apoptosis and proliferation by performing flow cytometry, Bax/Bcl2 ratio, TUNEL, cell viability assay, cell cycle, and EdU. To further verify our findings, a subcutaneous tumor mouse model was established. Moreover, AKT/mTOR pathway was detected to determine whether this pathway was involved in the anti-cancer effect of 125I and LBP by up-regulating or down-regulating the expression of mTOR. RESULTS: Based on our results, the sensitizing concentration of LBP could enhance the 125I-induced apoptosis and anti-proliferation effect. Furthermore, the subcutaneous tumor mouse model obtained the consistent results. More importantly, the AKT/mTOR pathway was down-regulated after the treatment of 125I and LBP, and the anti-cancer effect of 125I and LBP could be compromised by up-regulating the mTOR expression. CONCLUSION: Our study proved that LBP promotes the apoptotic and anti-proliferative effects of 125I in NSCLC cells by inhibiting the AKT/mTOR pathway and provides a foundation for future studies and enhanced combinatorial approaches for NSCLC in the clinical setting.

Endovascular stenting and coil embolization for management of radiation-induced pseudoaneurysms of the peripheral arteries.

OBJECTIVE: This study was performed to evaluate the safety and efficacy of endovascular stenting and embolization for the management of radiation-induced peripheral arterial pseudoaneurysms. METHODS: Twelve consecutive patients with radiation-induced peripheral arterial pseudoaneurysms (diameter of 10-30 mm and mean size of 20.42 mm) were admitted to our hospital from 1 January 2015 to 31 October 2019. The patients' baseline characteristics, perioperative parameters, device characteristics, and curative effects were systematically recorded and analyzed. RESULTS: The 12 patients comprised 3 men and 9 women with a mean age of 62.90 ± 13.97 years. The iliac artery was the most commonly involved artery, followed by the subclavian artery. In all patients, the pseudoaneurysms were detected by enhanced computed tomography. Twelve covered stents were deployed (7 or 8 mm in diameter and 50 mm in length). Additional coil embolization was performed in three patients (Patients 8, 9, and 10). The primary and secondary technical success rate was 91.7% and 100%, respectively. Apart from one death caused by rebleeding, no patients developed rebleeding during follow-up. CONCLUSION: Endovascular stenting and coil embolization are feasible and effective for the management of radiation-induced peripheral arterial pseudoaneurysms in highly selected patients.

Scutellarin improves the radiosensitivity of non-small cell lung cancer cells to iodine-125 seeds via downregulating the AKT/mTOR pathway.

BACKGROUND: In our previous study, we indicated that scutellarin (SCU) induced an anticancer effect in A549 cells. However, whether SCU regulates the radiosensitivity of non-small cell lung cancer (NSCLC) and its related mechanism is still unclear. METHODS: In this study, we explored the anticancer effect induced by iodine-125 (125 I) and SCU at a sensitizing concentration in A549 and H1975 cells. Cellular apoptosis and proliferation were detected by flow cytometry, Bcl-2/Bax expression level, cell cycle, CCK-8, and EdU staining. A tumor model using nude mice was also carried out to investigate the combined effect of 125 I and SCU in vivo. In addition, the expression level of AKT/mTOR pathway was detected to investigate whether it is linked to the anticancer effect of 125 I and SCU. RESULTS: SCU at a sensitizing concentration promoted the 125 I-induced apoptosis and antiproliferative effect in A549 and H1975 cells. Moreover, the same results were obtained in vivo. Based on our findings, the AKT/mTOR pathway was significantly downregulated after combined treatment with 125 I and SCU. CONCLUSIONS: The results of our study suggested that SCU promotes the anticancer effects induced by 125 I in NSCLC cells by downregulating the AKT/mTOR pathway and lays a foundation for future application of this combined treatment.

Modified percutaneous transhepatic papillary balloon dilation for patients with refractory hepatolithiasis.

BACKGROUND: Some patients with hepatolithiasis cannot tolerate surgery due to severe cardiac or pulmonary comorbidities, or cannot be endoscopically treated because of altered gastrointestinal anatomies. AIM: To propose a modified percutaneous transhepatic papillary balloon dilation procedure, and evaluate the clinical efficacy and safety of this modality. METHODS: Data from 21 consecutive patients who underwent modified percutaneous transhepatic papillary balloon dilation with hepatolithiasis were retrospectively analyzed. Using auxiliary devices, intrahepatic bile duct stones were pushed into the common bile duct and expelled into the duodenum with an inflated balloon catheter. The outcomes recorded included success rate, procedure time, hospital stay, causes of failure, and procedure-related complications. Patients with possible long-term complications were followed up for 2 years. RESULTS: Intrahepatic bile duct stones were successfully removed in 20 (95.23%) patients. Mean procedure time was 65.8 ± 5.3 min. Mean hospital stay was 10.7 ± 1.5 d. No pancreatitis, gastrointestinal, or biliary duct perforation was observed. All patients were followed up for 2 years, and there was no evidence of reflux cholangitis or calculi recurrence. CONCLUSION: Modified percutaneous transhepatic papillary balloon dilation was feasible and safe with a small number of patients with hepatolithiasis, and may be a treatment option in patients with severe comorbidities or in patients in whom endoscopic procedure was not successful.

Percutaneous transhepatic cholangiography versus endoscopic retrograde cholangiography for the pathological diagnosis of suspected malignant bile duct strictures.

To compare the diagnostic performance of percutaneous transhepatic cholangiography and endoscopic retrograde cholangiography for the pathological assessment of suspected malignant bile duct stricture, using brush cytology and forceps biopsy.The study group comprised 79 consecutive patients who underwent pathological assessment for suspected malignant biliary stricture, 38 of whom underwent percutaneous transhepatic cholangiography (group A) and the other 41 underwent endoscopic retrograde cholangiography (group B). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated. A subset analysis was performed to determine the effect of location and pathological type of the stricture on diagnostic performance, and complications were analyzed.The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 86.7%, 100%, 100%, 66.7%, and 89.5%, respectively, in group A, and 77.1%, 100%, 100%, 42.9%, and 80.4%, respectively, in group B. For hilar biliary strictures, the sensitivity and accuracy were superior in group A than in group B. Mild complications (transient c and bile leakage) were identified in 7 cases in each group, all resolved spontaneously within 3 to 5 days.Both brush cytology and forceps biopsy performed during percutaneous transhepatic cholangiography and endoscopic retrograde cholangiography provided good diagnostic sensitivity and accuracy. Therefore, both diagnostic approaches can play an important role in planning therapeutic strategy. However, for strictures located at the hilum, pathology sampling via percutaneous transhepatic cholangiography is preferable to endoscopic retrograde cholangiography, as it provides higher sensitivity and accuracy.