2016年 · 第96卷第10期

Hepatectomy is still the gold standard in the treatment of liver malignancies, and complete resection of the lesion can provide a chance of cure. Liver metastasis from colorectal cancer is also the most common indication for hepatectomy. Patients with complete resection of these lesions can have a 5-year survival rate of 30% to 40%. However, in practice, most patients with primary or secondary liver malignant tumors are not suitable for hepatectomy, and the efficacy of traditional systemic chemotherapy for these patients is limited. Therefore, the emergence of tumor ablation methods fills the therapeutic gap in patients who are not suitable for hepatectomy^[1,2,3]。 At present, the most commonly used tumor ablation methods in clinical practice should be mainly divided into two categories: chemical ablation and thermal ablation. The application of radiofrequency ablation (RFA), one of thermal ablation, in liver surgery is discussed.

The "13th Five-Year Plan" is a critical period for China to build a moderately prosperous society in an all-round way and a sprint stage for building an innovative country. Carrying out in-depth strategic research and scientifically planning the development of science funds during the 13th Five-Year Plan are of great significance for the prosperity of basic research, the enhancement of China's original innovation ability and the service of innovation-driven development.

Aortic dissection is the most dangerous lesion in aortic diseases, with acute onset, rapid progression and serious consequences^[1]。 With the development of surgical and interventional techniques, the efficacy of aortic dissection has improved year by year. However, when Stanford Type B aortic dissection extends to the left subclavian artery or even the distal aortic arch, the treatment plan is more complicated^[2]。 Interventional therapy alone lacks sufficient anchoring area, and traditional surgical procedure is invasive. Hybrid surgery, that is, partial aortic arch artificial blood vessel bypass surgery combined with endovascular aortic isolation, on the one hand, avoids deep hypothermic circulatory arrest, reduces trauma, and simplifies the surgical method; On the other hand, it expands the adaptation range of descending aorta endovascular isolation. In this study, 50 cases of complex Stanford type B aortic dissection were treated by hybrid surgery, and the curative effect was good. The experience is summarized below.

A 58-year-old female was admitted to the Fourth Hospital of Hebei Medical University on June 2, 2015 due to "double lung cancer with multiple bone metastases for 3 years and 10 months and left lower limb pain for 8 months". The patient was admitted to the hospital on 25-Aug-2011 mainly for "left chest pain for 7 d". Cytopathological diagnosis of PET/CT and lung biopsy was that lung cancer of both lungs with multiple bone metastases, which was not suitable for surgical treatment. Multiple cycles of chemotherapy were given, and bone metastasis of thoracic vertebra appeared on October 31, 2012. When the disease progressed, targeted therapy with icotinib hydrochloride was given. On December 18, 2014, the main cause of "double lung cancer with multiple bone metastases for 3 years and pain in the left lower limb for 3 months" was readmitted to hospital. The pain control of oral irecoxib tablets was not satisfactory, so it was changed to morphine sulfate sustained-release tablets 10 mg, orally taken twice a day. The patient was intolerable due to dizziness, nausea and vomiting, so it was changed to diclofenac sodium sustained-release tablets 75 mg, orally taken once a day, but the pain control was still not satisfactory; Fentanyl patch was given 1.4 mg/72 h for external use, and dizziness, nausea, sweating, and palpitation occurred. The symptoms of patients given metoclopramide, ondansetron and other drugs did not improve. Continue to use diclofenac sodium sustained-release tablets to control pain, but the effect is not good. On 7 March 2015, the patient was admitted to the hospital mainly for "left back pain aggravated for 1 d", complaining of pain in the left shoulder and left upper limb. The nature of the pain was described as traction pain and cold pain, which aggravated after activity, affecting sleep, and the pain numerical score (NRS) was>5 points. On 12 Mar 2015, MRI of thoracolumbar spine showed: compression fracture of thoracic 11 vertebral body; Uneven bone signals in thoracic 6, 7 and lumbar 2 vertebrae.

With the deepening of people's understanding, the definition and classification of pulmonary hypertension are constantly being updated. This article is about the 2015 European Society of Cardiology/European Respiratory Society (ESC/ERS) Guidelines for the Diagnosis and Treatment of Pulmonary Hypertension^[1]The relevant definitions and classification updates are interpreted, and the changes in the guidelines are explained in combination with clinical practice.

Cholangiocarcinoma is a malignant tumor that mainly originates from bile duct epithelial cells. Bile, as the microenvironment of bile duct epithelium, mainly participates in lipid digestion and absorption of fat-soluble vitamins. Bile acids are one of the main components in bile. In recent years, it has been found that bile acids can also be used as signal transduction molecules, participate in oxidative stress in the body, and participate in the development of cholangiocarcinoma through bile acid receptors such as FXR, TGR5 and S1PR2. This paper mainly introduces the relationship between metabolic regulation of bile acids and the development of cholangiocarcinoma at the molecular level.