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pancreatic cancer is a common malignant tumor of digestive system, with poor prognosis. About 80% of patients have lost the opportunity of surgical resection when diagnosed. In different treatment schemes, radioactive seed 125I implantation can improve the quality of life of patients with unresectable pancreatic cancer and is expected to improve their survival rate. This article reviews the clinical applications of 125I particle implantation therapy combined with chemotherapy, cryotherapy, intracavitary irradiation, stent placement, radiofrequency ablation, nanoknife, and bypass surgery, in order to better promote its clinical application. However, it is necessary to establish unified dosage standards and regulatory guidelines to make them safer and more widely serve clinical practice.
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Objective:To evaluate the safety and effectiveness of transjugular intrahepatic portosystemic shunt (TIPS) in hepatocellular carcinoma (HCC) patients with Vp4 portal vein tumor thrombus (PVTT).Methods:Data of 15 patients undergoing TIPS for HCC with Vp4 PVTT and portal hypertension (PTN) in Peking University First Hospital from July 2018 to February 2023 were retrospectively analyzed, including 14 males and 1 female, aged (61.5±11.1) years old, ranging from 40 to 78 years old. The success rate of TIPS, portal pressure gradient (PPG) before and after procedure, perioperative adverse effects and complications were recorded. The survival status of patients was followed up by telephone review after surgery. Kaplan-Meier method was used for survival analysis.Results:The procedure of TIPS was performed uneventfully in all patients, with a technical success rate of 100% (15/15). PPG before and after TIPS were (31.73±5.48) mmHg (1 mmHg=0.133 kPa) and (17.60±3.66) mmHg, respectively, and the difference was statistically significant ( P<0.001). No perioperative death, hepatic artery or bile duct injury, acute liver failure or other major complications occurred. Compared with the preoperative status, the performance status scores [0(0, 0) vs. 3(3, 3)] and Child-Pugh scores [6(5, 8) vs. 9(8, 10)] were lower in patients one month after TIPS (all P<0.05). The median survival time was 228 d. Kaplan-Meier curves showed that the cumulative survival rates at 3, 6, 12 and 24 months after TIPS were 100%, 64.3%, 32.7% and 8.2%, respectively. Conclusion:TIPS could be safe and effective for HCC with Vp4 PVTT and severe PTN.
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Objective To investigate the species, antimicrobial resistance, and fluoroquinolone resistance gene profiles of Nocardia in the General Hospital of Ningxia Medical University. Methods Nocardia isolates were collected in the General Hospital of Ningxia Medical University during the period from January 2013 to June 2017. Broth dilution method was used to determine the susceptibility of the Nocardia strains to 15 antibiotics. Fluoroquinolone resistance genes gyrA, parC, qnrA, qnrB and qnrS were detected by polymerase chain reaction. Results A total of 16 isolates of Nocardia were collected, including Nocardia cyriacigeorgica (62.6％, 10/16), Nocardia farcinica (18.7％, 3/16), and Nocardia otitidiscaviarum (18.7％, 3/16). Most Nocardia isolates (81.2％, 13/16) were resistant to ciprofloxacin. About 12.5％, 12.5％, 25.0％ and 18.7％ of the strains were resistant to ceftriaxone, tobramycin, gentamicin and cefepime. Overall, gyrA, parC, qnrA and qnrB were identified in 18.8％, 37.5％, 25.0％ and 18.7％ of the Nocardia strains. The qnrS gene was not found in any strain. Conclusions The most frequently Nocardia species in the hospital was Nocardia cyriacigeorgica. Fluoroquinolone resistance is serious in the Nocardia isolates.Fluoroquinolone resistance of Nocardia is likely associated with gyrA, parC, qnrA, and qnrB genes. We should pay close attention to the emergence and antimicrobial susceptibility of Nocardia infection.