Effect of Preexisting Sarcopenia on Acute and Late Postoperative Pneumonia Among Patients With Oral Cavity Squamous Cell Carcinoma.

BACKGROUND: Whether preexisting sarcopenia is an independent risk factor for postoperative pneumonia (POP) for patients with oral cavity squamous cell carcinoma (OCSCC) remains unclear. Therefore, we conducted a propensity score-matched population-based cohort study to compare the risk of acute and late POP for patients with sarcopenic and nonsarcopenic OCSCC who underwent curative surgery. PATIENTS AND METHODS: We included patients with OCSCC who underwent curative surgery and categorized them into 2 groups depending on whether they had preexisting sarcopenia. The patients in the sarcopenic and nonsarcopenic groups were matched at a ratio of 2:1. RESULTS: The matching process yielded 16,257 patients (10,822 without sarcopenia and 5,435 with sarcopenia). In multivariate Cox regression analyses, the adjusted hazard ratio of POP for the group with OCSCC with preexisting sarcopenia was 1.20 (95% CI, 1.14-1.26; P<.0001) compared with the nonsarcopenic group. Among the patients with OCSCC who received curative surgery, those in the sarcopenic group exhibited a higher POP risk than those in the nonsarcopenic group for the following postoperative time periods: 31st to 90th day, 91st day to first year, first to second year, second to third year, third to fourth year, and fourth to fifth year. CONCLUSIONS: The high incidence of pneumonia persists for a long time in patients with OCSCC who receive curative surgery; this high incidence may even persist for 5 years after surgery, especially in patients with sarcopenia. For susceptible patients who are at risk for OCSCC, sarcopenia prevention measures (eg, exercise and early nutrition intervention) should be implemented.

An alternative surgical technique for advanced tongue/tongue base cancer without free flap reconstruction.

BACKGROUND/PURPOSE: Locally advanced tongue or tongue base cancer is recommended to be treated by radical resection that is usually detrimental to physiological functions. This study reports the efficacy and treatment outcome of the patients who had received total glossectomy and laryngeal suspension without lip-split mandibulotomy and free flap reconstruction to preserve laryngopharyngeal function. METHODS: From 2010 to 2018, 37 consecutive patients who had received the surgery were retrospectively recruited. RESULTS: The overall five-year survival is 72%. The postoperative dependent rate of feeding tube and tracheostomy largely decreases within 1-year follow-up. Treated by this surgical method, these patients are free from facial disfiguration, donor site morbidity, and destructive mastication and occlusion. It is also feasible to perform this surgical technique in the recurrent cases previously treated by chemoradiation. CONCLUSION: Total glossectomy with laryngeal suspension can be successfully applied to locally advanced tongue or tongue base cancer, and benefits the patients with improved survival and preserved physiological function. Especially surgeons for free flap reconstruction are understaffed at some regional or district hospitals.

[Helping a Preterm Infant Through the Transitional Feeding Period Using a Cue-Based Feeding Approach of Developmental Care].

The aim of this case report was to identify the optimal point to start oral feeding in order to help a preterm infant successfully pass through the transitional feeding period. Because all preterm infants must go through a transitional feeding period, going through this period successfully is very important. This case report described a nursing experience related to caring for a low-birth-weight preterm infant who showed hunger cues before feeding at around 31gestational weeks during the tube-feeding period. An assessment revealed that the preterm infant did not exhibit good sucking, breathing, and swallowing coordination. Therefore, we decided to design a nursing care plan to help the preterm infant transition smoothly from tube feeding to oral feeding. The nursing care period was from September 21st to November 2th, 2017. The care processes included: 1) the oral stimulation phase: provision of oral stimulation to increase oral motor function, 2) the oral feeding training phase: use of the Preterm Oral Feeding Readiness Scale (POFRAS) assessment tool to assess feeding readiness before oral feeding, 3) use of a cue-based approach to decide the starting and stopping points, and, finally, 4) the transition to the demand feeding phase. As the preterm infant grew, the body weight and feeding amount both increased positively and without complications. This experience may serve as a model for developing clinical guidelines for a cue-based feeding approach for preterm infants during the transitional feeding period.

Investigation of time-dependent risk of mental disorders after infertility diagnosis, through survival analysis and data mining: a nationwide cohort study.

OBJECTIVES: Infertile patients are vulnerable to mental disorders. However, a time-dependent model predicting the onset of mental disorders specific to infertile patients is lacking. This study examined the risk factors for the development of mental disorders in infertile patients and measured the duration until the occurrence of mental disorders after a diagnosis of infertility. METHODS: A total of 13,317 infertile patients in the 2002-2013 Taiwan National Health Insurance Research Database were observed. The 11 independent variables included in the hypothesised model, together with the dates of infertility and mental disorder diagnoses, were analysed using Cox proportional hazards. Data-mining methods using C5.0 and Apriori supplemented the statistical analyses. RESULTS: The total prevalence rate of mental disorders among infertile patients in Taiwan was 12.41%, including anxiety (4.66%), depression (1.81%) and other mental disorders (5.94%). The average time interval for onset of mental illness identified using survival analysis was 1.67 years. Income, occupation, treatment method, co-morbidity, region and hospital level and ownership were significant predictors of development of mental illness (all p < .05). CONCLUSIONS: The four categories of factors associated with time-dependent onset were demographics, health, health care provider and geographical characteristics. Certain patient characteristics may predict a higher likelihood of onset of a specific mental disorder. Clinical practitioners may use the findings to identify high-risk patients and make timely health interventions.

IL-28 and IL-29 as protective markers in subject with dengue fever.

About 400 million people every year are estimated to contract dengue virus infection, which causes prolonged morbidity and sometimes mortality. Interleukin (IL)-28 and IL-29 are relatively newly discovered cytokines and play an important role in our immune defense against pathogens, especially for viral infection. In the present study, we investigated serum IL-28 and IL-29 expression and the relationship to clinical and laboratory parameters in patients with dengue virus infection. Adult patients with dengue (n = 45) and control group (n = 24) were included prospectively. Clinical symptoms and laboratory data were collected from every patient. We investigated IL-28 and IL-29 levels in serum by ELISA. The concentrations of serum IL-28 and IL-29 were significantly higher in subjects with dengue when compared to those of control group. The patients with higher serum IL-28 and IL-29 levels had significantly lower ALAT and peripheral blood neutrophil percentage, but higher peripheral platelet, total white blood cell (WBC), monocyte, and lymphocyte counts. Patients with higher serum IL-28 and IL-29 levels also had more flu-like symptoms, but less vomiting. Increased level of IL-28 and IL-29 was associated with better liver function, platelet and WBC numbers and clinical symptom in subjects with dengue and could potentially serve as a protective marker.

Genotoxicity assessment of multispecies probiotics using reverse mutation, mammalian chromosomal aberration, and rodent micronucleus tests.

Genotoxicity assessment is carried out on freeze dried powder of cultured probiotics containing Lactobacillus rhamnosus LCR177, Bifidobacterium adolescentis BA286, and Pediococcus acidilactici PA318. Ames tests, in vitro mammalian chromosome aberration assay, and micronucleus tests in mouse peripheral blood are performed. For 5 strains of Salmonella Typhimurium, the Ames tests show no increased reverse mutation upon exposure to the test substance. In CHO cells, the frequency of chromosome aberration does not increase in responding to the treatment of probiotics. Likewise, the frequency of micronucleated reticulocytes in probiotics-fed mice is indistinguishable from that in the negative control group. Taken together, the toxicity assessment studies suggest that the multispecies probiotic mixture does not have mutagenic effects on various organisms.

The effect of statin medication on the incidence of oral squamous cell carcinoma among betel-nut chewers.

BACKGROUND: This study examines the relationship between statin use and oral cancer squamous cell carcinoma (OCSCC) risk in a cohort of 47 942 betel nut chewers. METHODS: The study used individual 1:1 matching and propensity score matching to compare statin users and nonusers. RESULTS: The incidence rate of OCSCC was significantly lower in statin users compared to nonusers (17.12 vs. 26.75 per 10 000 person-years), yielding an incidence rate ratio of 0.64. After adjusting for confounders, statin use was associated with a reduced risk of OCSCC (adjusted hazard ratio: 0.61; 95% confidence interval: 0.52-0.71). A dose-response relationship was observed, with a significant reduction in OCSCC incidence when the cumulative defined daily dose of statin use was equal to or greater than Q3. The risk of OCSCC was lower among users of both hydrophilic and lipophilic statins. CONCLUSION: This study provides evidence that statin use is associated with a reduced risk of OCSCC in betel nut chewers.

Thiols screened by the neocarzinostatin protein for preserving or detoxifying its bound enediyne antibiotic.

Neocarzinostatin is an antibiotic chromoprotein produced by Streptomyces carzinostaticus. Its enediyne-containing chromophore exhibits high DNA cleavage activity and belongs to one of the most potent categories of antitumor agents. The labile chromophore is readily inactivated by environmental thiols including the most abundant glutathione. How the microorganism preserves the secreted antibiotic and at the same time is immune to its toxicity are of interest. Site-directed mutagenesis studies of the neocarzinostatin protein have shown that residues D33 and D99 play primary and secondary roles, respectively, in preserving neocarzinostatin from acidic glutathione whereas D79 and other residues around the opening of the binding cleft have an insignificant effect. Biothiol analyses revealed that cells of S. carzinostaticus produced no glutathione, but instead neutral mycothiol, which is known to serve functions analogous to glutathione. Mycothiol was the only neutral-charged thiol produced by the organism; all other identified biothiols carried at least partial negative charges. When the bacteria were cultured under conditions that stimulated the biosynthesis of neocarzinostatin, the yield of mycothiol increased significantly, which suggests mycothiol-dependent cellular detoxification. Treating neocarzinostatin samples with the cell extract that retained active sulfhydryls led to efficient drug inactivation, which indicates that mycothiol is allowed to approach the protein-bound chromophore. The anionic side-chains of D33 and D99 in the neocarzinostatin protein played two critical roles in a single thiol-screening operation: Preserving the antibiotic for defense and survival by rejecting the ubiquitous glutathione through charge-charge repulsion in the outer-cell environment and detoxifying the toxin in the inner-cell body for self-resistance by accepting the cell-produced neutral mycothiol.

Effect of Pre-Existing Sarcopenia on Oncological Outcomes for Oral Cavity Squamous Cell Carcinoma Undergoing Curative Surgery: A Propensity Score-Matched, Nationwide, Population-Based Cohort Study.

Purpose: The effect of pre-existing sarcopenia on patients with oral cavity squamous cell carcinoma (OCSCC) remains unknown. Therefore, we designed a propensity score-matched population-based cohort study to compare the oncological outcomes of patients with OCSCC undergoing curative surgery with and without sarcopenia. Patients and Methods: We included patients with OCSCC undergoing curative surgery and categorized them into two groups according to the presence or absence of pre-existing sarcopenia. Patients in both the groups were matched at a ratio of 2:1. Results: The matching process yielded 16,294 patients (10,855 and 5439 without and with pre-existing sarcopenia, respectively). In multivariate Cox regression analyses, the adjusted hazard ratio (aHR, 95% confidence interval [CI]) of all-cause mortality for OCSCC with and without pre-existing sarcopenia was 1.15 (1.11−1.21, p < 0.0001). Furthermore, the aHRs (95% CIs) of locoregional recurrence and distant metastasis for OCSCC with and without pre-existing sarcopenia were 1.07 (1.03−1.18, p = 0.0020) and 1.07 (1.03−1.20, p = 0.0148), respectively. Conclusions: Pre-existing sarcopenia might be a significant poor prognostic factor for overall survival, locoregional recurrence, and distant metastasis for patients with OCSCC undergoing curative surgery. In susceptible patients at a risk of OCSCC, sarcopenia prevention measures should be encouraged, such as exercise and early nutrition intervention.

Plasma decorin predicts the presence of esophageal squamous cell carcinoma.

Using a microarray technique, we found decorin to be underexpressed, but osteopontin (OPN) to be overexpressed, in esophageal squamous cell carcinoma (ESCC). This study aims to examine whether plasma decorin and OPN plus personal substances use (tobacco, alcohol and areca) can serve as suitable clinical markers to predict the presence of ESCC. In total, 570 archived plasma specimens (275 patients and 295 controls) were collected from 2 medical centers in Taiwan between 2000 and 2008. Decorin and OPN protein levels were measured by ELISA. Means and standard deviation of plasma decorin were 5.6 + or - 3.6 ng/ml in case patients, which were significantly lower than those in controls (7.8 + or - 3.1, p < 0.0001). Plasma OPN levels in case patients were not significantly different from controls (p = 0.33). When compared to subjects with the lowest quartile of plasma decorin, those with the highest quartile one had a significantly lower risk to have ESCC (Adjusted OR = 0.03, p < 0.001). Receiver operator characteristic (ROC) analysis was performed for the combination of plasma decorin and 3 substances use (smoke, alcohol and areca) for the patients compared with the controls. The area under the curve was 88.6% and the optimal cut-point of ROC curve (any 3 factors) had 73.5% sensitivity and 90.2% specificity with approximately 82% of corrected classification. Plasma decorin, but not OPN, is a potential clinical marker for the detection of ESCC. When plasma decorin plus the use of the 3 substances are combined, this factor cluster could be used to detect the presence of ESCC.

Redesigning ambulatory care management for uncontrolled type 2 diabetes: a prospective cohort study of the impact of a Boot Camp model on outcomes.

Objective: Type 2 diabetes care management (DCM) is challenging. Few studies report meaningful improvements in clinical care settings, warranting DCM redesign. We developed a Boot Camp to provide timely, patient-centered, technology-enabled DCM. Impact on hemoglobin A1c (HbA1c), emergency department (ED) visits and hospitalizations among adults with uncontrolled type 2 diabetes were examined. Research design and methods: The intervention was designed using the Practical Robust Implementation and Sustainability Model to embed elements of the chronic care model. Adults with HbA1c>9% (75 mmol/mol) enrolled between November 2014 and November 2017 received diabetes education and medication management by diabetes educators and nurse practitioners via initial clinic and subsequent weekly virtual visits, facilitated by near-real-time blood glucose transmission for 90 days. HbA1c and risk for ED visits and hospitalizations at 90 days, and potential savings from reducing avoidable medical utilizations were examined. Boot Camp completers were compared with concurrent, propensity-matched chart controls receiving usual DCM in primary care practices. Results: A cohort of 366 Boot Camp participants plus 366 controls was analyzed. Participants were 79% African-American, 63% female and 59% Medicare-insured or Medicaid-insured and mean age 56 years. Baseline mean HbA1c for cases and controls was 11.2% (99 mmol/mol) and 11.3% (100 mmol/mol), respectively. At 90 days, HbA1c was 8.1% (65 mmol/mol) and 9.9% (85 mmol/mol), p<0.001, respectively. Risk for 90-day all-cause hospitalizations decreased 77% for participants and increased 58% for controls, p=0.036. Mean potential for monetization of US$3086 annually per participant for averted hospitalizations were calculated. Conclusions: Redesigning diabetes care management using a pragmatic technology-enabled approach supported translation of evidence-based best practices across a mixed-payer regional healthcare system. Diabetes educators successfully participated in medication initiation and titration. Improvement in glycemic control, reduction in hospitalizations and potential for monetization was demonstrated in a high-risk cohort of adults with uncontrolled type 2 diabetes. Trial registration number: NCT02925312.

Prognostic factors of unknown primary head and neck squamous cell carcinoma.

OBJECTIVE: To evaluate the prognostic factors of unknown primary head and neck squamous cell carcinoma (HNSCC). STUDY DESIGN: Retrospective study. SUBJECTS: Patients with unknown primary HNSCC from 1980 to 2000 were included. RESULTS: Forty-eight patients, predominantly male and with a mean age of 63.3+/-11.6 years, were recruited. The median survival time (MST) was 44 months. The overall survival rate was 60.4 percent at three years and 39.6 percent at five years. Forty-two patients receiving intervention regimens had a MST of 45 months, while six patients receiving palliative therapy had a MST of 8.5 months (log rank test, P=0.016). With multivariate Cox regression analysis, age (per year), higher nodal stage (N3 vs N1 or N2), and treatment (operation vs nonoperation) had a hazard ratio of 1.081 (P<0.0001), 5.852 (P=0.010), and 0.4 (P=0.042), respectively. CONCLUSION: Older age, higher nodal stage, and palliative treatment indicated poor prognosis. Survival time might be prolonged if surgical treatment is tolerable.

Malignant parotid tumor and facial palsy.

OBJECTIVE: To evaluate risk factors for postoperative facial palsy in patients with parotid carcinoma. STUDY DESIGN AND SETTING: We conducted a retrospective chart review of patients with parotid carcinoma who underwent parotidectomy at National Taiwan University Hospital from 1980 to 2000. RESULTS: Eighty-eight patients with a mean age of 53 +/- 17 y were recruited. Sixty patients (68.2%) experienced postoperative facial palsy. Tumor size of larger than 4 cm was associated with an increased incidence of facial palsy (P = 0.0422). Facial palsy was noted in 95.5 percent of patients with facial nerve involvement and 51.3 percent of patients without facial nerve involvement (P = 0.0004). Of 42 patients with tumor over the deep lobe, 37 (88.1%) had facial palsy but only 50 percent (23 of 46) of those with tumor over the superficial lobe had facial palsy (P = 0.0001). CONCLUSION: There were no significant associations between histopathology and facial palsy. Increasing tumor size, deep lobe tumor location, and tumor invasion of facial nerve increased the incidence of postparotidectomy facial palsy. SIGNIFICANCE: By paying attention to these risk factors a reduction of postoperative facial nerve palsy my be achieved.

Differences in Mortality and Clinical Manifestations of Dengue Hemorrhagic Fever in Taiwan in Different Years: A Comparison for Cases in 2014 and 2015 Epidemics.

People in southern Taiwan experienced two major dengue outbreaks in 2014 and 2015. The mortality and clinical features were very different between these 2 years. Dengue virus serotype 1 (DENV-1) caused epidemic outbreak in 2014 and DENV-2 was predominant in 2015. The characteristics of dengue hemorrhagic fever (DHF) cases in the 2 years was analyzed. We conducted a retrospective chart review to analyze the clinical and laboratory features of 206 adult patients with DHF in southern Taiwan in 2014 and 2015. The mortality rate of DHF cases in 2015 was higher than that of cases in 2014 (38.7% versus 12.4%, P < 0.0001). Compared with cases in 2014, DHF cases in 2015 had more complications, such as gastrointestinal bleeding (78.5% versus 61.9%, P = 0.01), severe hepatitis (30.1% versus 8%, P < 0.0001), and myocarditis (14% versus 0.9%, P < 0.0001). Among the mortality cases, diabetes, chronic renal failure, proton-pump inhibitors using, platelet transfusion, and Charlson comorbidity index score (Charlson score) were also higher in 2015. Multivariate analysis for the mortality cases revealed that the risk factors were Charlson score ≥ 5 (P = 0.02, odds ratio [OR] = 4.07, 95% confidence interval [CI] = 1.244-13.307), severe hepatitis (P < 0.0001, OR = 11.97, 95% CI = 3.831-37.396), and acute renal failure (P < 0.0001, OR = 98.76, 95% CI = 10.847-899.22). DHF cases in 2015 had higher mortality and more complications, such as gastrointestinal bleeding, severe hepatitis, and myocarditis, than in 2014 in southern Taiwan. In the 2-year DHF case series, Charlson score ≥ 5, severe hepatitis, and acute renal failure were independent significant variables for mortality.

Time-Lagging Interplay Effect and Excess Risk of Meteorological/Mosquito Parameters and Petrochemical Gas Explosion on Dengue Incidence.

In Kaohsiung, a metropolitan city in Taiwan at high risk of dengue epidemic, weather factors combined with an accidental petrochemical gas explosion (PGE) may affect mosquito‒human dynamics in 2014. Generalized estimating equations with lagged-time Poisson regression analyses were used to evaluate the effect of meteorological/mosquito parameters and PGE on dengue incidences (2000-2014) in Kaohsiung. Increased minimum temperatures rendered a 2- and 3-month lagging interactive effect on higher dengue risks, and higher rainfall exhibited a 1- and 2-month lagging interplay effect on lower risks (interaction, P ≤ 0.001). The dengue risk was significantly higher than that in a large-scale outbreak year (2002) from week 5 after PGE accident in 2014 (2.9‒8.3-fold for weeks 5‒22). The greatest cross-correlation of dengue incidences in the PGE-affected and PGE-neighboring districts was identified at weeks 1 after the PGE (rs = 0.956, P < 0.001). Compared with the reference years, the combined effect of minimum temperature, rainfall, and PGE accounted for 75.1% of excess dengue risk in 2014. In conclusion, time-lagging interplay effects from minimum temperature and rainfall may be respectively associated with early and near environments facilitating dengue transmission. Events that interact with weather and influence mosquito‒human dynamics, such as PGEs, should not be ignored in dengue prevention and control.

Consumption of sugar-sweetened beverages is associated with components of the metabolic syndrome in adolescents.

Sugar-sweetened beverages (SSBs) are the principle source of added sugar in diets. Cardiometabolic disturbances can occur from early childhood to adulthood. The aim of this cross-sectional study was to examine the gender-specific association of SSB intake with metabolic syndrome (MetS) and its components among adolescents in Taiwan. A total of 2727 adolescents aged 12 to 16 years randomly selected from three diverse economic areas in Southern Taiwan by using a multistage-sampling strategy participated in this study. Demographic, dietary, physical and anthropometric parameters were measured, and serum lipid profiles and glucose levels were determined. The International Diabetes Federation (IDF) specifies that MetS requires abdominal obesity and ≥2 abnormal components, and Cook criteria for MetS require ≥3 abnormal components. We applied survey-data modules to data analyses, and used multiple regression and logistic models to adjust for covariates. An increased SSB intake was linked to a greater waist circumference in both sexes and to systolic blood pressure in boys (P for trend: ≤0.043). Male moderate and high consuming SSB drinkers exhibited triglyceride levels that were 8.0 and 8.2 mg/dL significantly higher, respectively, than those of nondrinkers. Compared with nondrinkers, boys who consumed >500 mL/day (high quantity) of SSBs exhibited 10.3-fold (95% confidence intervals (CIs): 1.2-90.2) and 5.1-fold (95% CIs: 1.01-25.5) risks of contracting MetS, as defined by the IDF and Cook criteria for MetS, respectively. In girls, the risk estimates for the same comparison were not significant by the IDF criteria (6.5-fold risk, 95% CIs: 0.9-∞) or Cook criteria (5.9-fold risk, 95% CIs: 0.8-43.8) for MetS. High SSB consumption was also linked to 1.9-fold (95% CIs: 1.1-3.1) and 2.7-fold (95% CIs: 1.3-5.7) higher risks of being at a greater overall metabolic risk in girls and boys, respectively. In conclusion, a high SSB intake is associated with adolescent MetS among boys but not girls in Taiwan.

Elevated serum triglyceride and retinol-binding protein 4 levels associated with fructose-sweetened beverages in adolescents.

BACKGROUND: The metabolic effect of fructose in sugar-sweetened beverages (SSB) has been linked to de novo lipogenesis and uric acid (UA) production. OBJECTIVES: This study investigated the biological effects of SSB consumption on serum lipid profiles and retinol-binding protein 4 (RBP4) among Taiwanese adolescents. METHODS: We evaluated the anthropometric parameters and biochemical outcomes of 200 representative adolescents (98 boys and 102 girls) who were randomly selected from a large-scale cross-sectional study. Data were analyzed using multiple regression models adjusted for covariates. RESULTS: Increased SSB consumption was associated with increased waist and hip circumferences, body mass index (BMI) values and serum UA, triglyceride (TG) and RBP4 levels. Adolescents who consumed >500 ml/day of beverages half-to-heavily sweetened with high-fructose corn syrup (HFCS) exhibited TG and RBP4 levels 22.7 mg/dl and 13.92 ng/ml higher than non-drinkers, respectively. HFCS drinkers with hyperuricemia had higher TG levels than HFCS drinkers with normal UA levels (98.6 vs. 81.6 mg/dl). The intake of HFCS-rich SSBs and high value of BMI (≥24) interactively reinforced RBP4 levels among overweight/obese adolescents. Circulating RBP4 levels were significantly correlated with weight-related outcomes and TG and UA concentration among HFCS drinkers (r = 0.253 to 0.404), but not among non-drinkers. CONCLUSIONS: High-quantity HFCS-rich beverage consumption is associated with higher TG and RBP4 levels. Hyperuricemia is likely to intensify the influence of HFCS-rich SSB intake on elevated TG levels, and in overweight and obese adolescents, high BMI may modify the action of fructose on higher circulating levels of RBP4.

[Effect of partial splenic embolization in prevention of gastroesophageal variceal rebleeding].

OBJECTIVE: To evaluate the effect of partial splenic embolization (PSE) in prevention of gastroesophageal variceal rebleeding. METHODS: Sixty-two patients with recent gastroesophageal variceal bleeding were treated by PSE with Seldinger technique. All the patients were followed-up for 12 months. The data including peripheral blood cell count, liver function, plasma prothrombin time (PT), portal vein diameter, and appearance of gastroesophageal varices under gastroscopy were collected before and after embolization for statistical analysis. RESULTS: Five days after the operation, the numbers of leucocytes and platelets were significantly increased (P<0.05), and PT was significantly shortened (P<0.05). All the patients showed a good response after PSE with reduced internal diameter of the portal vein and blood flow (P<0.05). Gastroesophageal varices were relieved in all the patients. Rebleeding occurred in 11 patients during the follow-up. CONCLUSION: PSE can be effective in preventing gastroesophageal variceal rebleeding.