前瞻性分析蚌埠医学院第一附属医院收治的108例非血栓性髂静脉压迫综合征患者的多平面静脉造影资料，测量其下腔静脉（IVC）直径、左髂总静脉（LCIV）开口0、20、40、60、80 mm处髂静脉直径、IVC与LCIV所成角度、LCIV长度。最终解除压迫后LCIV直径为（15.6±1.9）mm，髂外静脉（LEIV）为（11.2±1.8）mm，IVC为（19.6±3.2）mm，LCIV长度为（61.3±11.0）mm，IVC与LCIV夹角为36.4°±15.8°。本研究显示下腔静脉与髂总静脉、髂外静脉变化存在一致性；髂总静脉长度与髂外静脉直径、下腔静脉与髂静脉所成角度呈负相关。

Objective:To identify the influencing factors of pathological progression in patients with Budd-Chiari syndrome (BCS) after endovascular treatment.Methods:Clinical data of 55 patients with BCS admitted the First Affiliated Hospital of Bengbu Medical College from January 2014 to December 2020 were retrospectively analyzed. Among them, 24 patients were male and 31 female, aged (48±11) years on average. The informed consents of all patients were obtained and the local ethical committee approval was received. After the first endovascular treatment, 31 patients were diagnosed with simple diaphragm type BCS, 18 cases with short-segment lesion type BCS and 6 cases with long-segment lesion type BCS. All enrolled patients received multiple endovascular treatments for consecutive 3 years or longer. The pathological progression of lesion was observed. The effects on the changes of lesions by age upon first admission, sex, frequency of surgeries, average patency time, type of lesion upon first admission and duration of taking anticoagulants were evaluated by multivariate Logistic regression analysis.Results:55 patients received 288 times of endovascular treatment which was balloon dilatation. The success rate of surgery was 100%. The vascular recanalization rate was 100%. The median time of the first patency was 9 months, 8 months for the second patency, 8 months for the third patency and 8 months for the last patency. During the treating period, the lesion type changed in 22 patients. Among them, simple diaphragm type progressed to short-segment lesion type in 13 cases, short-segment lesion type evolved to long-segment lesion type in 5, short-segment lesion type complicated with thrombosis in 3, and long-segment lesion type progressed to mixed lesion type in 1. Multivariate Logistic regression analysis demonstrated that the time of use of anticoagulants was an independent factor affecting the progression of BCS (OR=0.124, 95%CI: 0.032-0.479, P=0.002).Conclusions:Patients with BCS have the tendency of progression after endovascular treatment. Thrombosis is a critical factor for disease progression. Regular use of anticoagulants might retard the progression of lesions.

颈动脉狭窄(carotid artery stenosis,CS)是指多种原因造成颈动脉的狭窄,导致脑供血不足,甚至出现缺血性脑卒中的临床症候群.动脉粥样硬化是颈动脉狭窄的主要病因.随着影像技术不断进步,CS的诊断及评估更加精准.腔内技术的进展,也为CS的诊治提供新思路.本文结合国内外相关文献,就颅外颈动脉粥样硬化性狭窄的诊疗进展作一综述.

回顾性分析32例主动脉分叉覆膜支架腔内重建治疗TASCⅡD型主髂动脉闭塞症患者的近中期疗效。治疗技术成功率为100％，术后并发症率为6.25％，均无围手术期死亡，5例发生了支架内再闭塞（15.6％）。全因死亡率为0，12个月和24个月的一期通畅率分别为87.5％、84.38％，二期通畅率均为100％。本研究显示主动脉分叉覆膜支架腔内重建技术治疗 TASCⅡD型主髂动脉闭塞性疾病是安全、有效的，并可获得满意的近中期通畅率。

髂静脉压迫综合征(IVCS)是髂静脉受压导致的下肢和盆腔静脉回流障碍性疾病,常合并下肢的慢性静脉功能不全、静脉曲张、深静脉血栓形成等.临床上则表现为下肢水肿、浅表静脉曲张、足靴区色素沉着、静脉性溃疡等.现血管的腔内技术已替代传统的手术,如球囊扩张术和支架植入术,并取得良好的远期临床疗效,且通畅率高.本文结合国内外相关文献,就IVCS的诊疗进展作一综述.

Objective:To evaluate the effect of carbohydrate antigen 19-9 (CA19-9)/total tumor volume (TTV), the ratio of CA19-9 to TTV, as a prognostic marker on tumor recurrence and long-term survival in patients with pancreatic ductal adenocarcinoma (PDAC) following pancreaticoduodenectomy (PD).Methods:The data of 203 patients who underwent PD for PDAC in Beijing Chaoyang Hospital Affiliated to Capital Medical University from January 2011 to December 2019 were analyzed. Univariate and multivariate analyses were performed of the clinicopathological data to screen out the risk factors affecting long-term prognosis of PDAC. CA19-9/TTV was calculated according to preoperative CA19-9 and TTV, and the ROC curve was drawn based on CA19-9/TTV and 1-year survival, so as to determine the optimal cut-off value of CA19-9/TTV and group criterion. The differences of clinicopathological data and postoperative complications between the two groups were compared to explore their relationship with long-term prognosis in patients with PDAC undergoing PD.Results:The median overall survival (OS) was 18 months, and the 1-, 3-, and 5-year OS rates were 64.1%, 25.6% and 15.2%, respectively. Tumor differentiation and CA19-9/TTV were independent risk factors for long-term prognosis of PDAC (P=0.002, 0.005). The best cut-off value of ROC curve was 5.62 (area under curve, 0.633; 95% CI: 0.548-0.718). Patients with CA19-9/TTV≤5.62 were labeled as Group 1, and others were Group 2. There was no significant difference in clinicopathological data between the two groups. The median OS in Group 1 and Group 2 was 26 and 15 months respectively, and the 1-, 3- and 5-year OS rates were 82.7%, 40.8%, 24.8% and 57.5%, 19.0%, 11.2%, respectively (P=0.002).Conclusion:CA19-9/TTV is an independent risk factor for the prognosis of PDAC after PD, which may be a new marker for lower survival benefits.

患者男,82岁.2月前无意发现左大腿前方中下段鹅蛋大小的包块,无痛感,肿物表面皮肤无红肿,近2月来肿物生长迅速,前来就诊.既往有吸烟史40余年.查体:体温37.9℃,脉搏82次/min,呼吸18次/min,血压170/80 mm Hg(1 mm Hg=0.133 kPa),血常规、尿常规及胸透检查均未见异常.

附睾炎是阴囊内常见的疾病,近几年来屡有报道.本文应用彩色多普勒超声技术对临床已确诊的33例附睾炎患者治疗前后的声像图表现进行追踪观察,现将结果报道如下.

应用介入超声治疗肝脓肿,因疗效显著深受临床医师重视,并作为首选治疗方法.我院自2003年6月以来,对21例肝脓肿患者进行超声引导介入性治疗,取得了满意的临床效果,现报道如下.

Objective: To investigate the clinical value of per rectum ultrasound-guided biopsy in prostate diseases. Methods: 21 cases with doubtful prostatic carcinomas performed per rectum ultrasound-guided biopsy. Results: 6 of 21 cases were prostatic carcinoma,11 hyperplasia of prostate including 2 complicated with inflammation,1 prostatic endothelioma and 1 prostatic tuberculosis.20 of 21 cases were coincident with surgical outcome.There was no serious complication. Conclusion: Per rectum ultrasound-guided biopsy is effective technique for preoperative diagnosis of prostatic carcinomas.It is useful in differential diagnosis in prostate diseases.The technique is simple,accurate and without serious complication and should be recommended.