Ursodeoxycholic acid combined with percutaneous transhepatic balloon dilation for management of gallstones after elimination of common bile duct stones

AIM To evaluate the effectiveness and safety of combined ursodeoxycholic acid and percutaneous transhepatic balloon dilation for management of gallstones after expulsion of common bile duct(CBD) stones.METHODS From April 2014 to May 2016, 15 consecutive patients(6 men and 9 women) aged 45-86(mean, 69.07 ± 9.91) years suffering from CBD stones associated with gallstones were evaluated. Good gallbladder contraction function was confirmed by type B ultrasonography. Dilation of the CBD and cystic duct was detected. Percutaneous transhepatic balloon dilation of the papilla was performed, ursodeoxycholic acid was administered, and all patients had a high-fat diet. All subjects underwent repeated cholangiography, and percutaneous transhepatic removal was carried out in patients with secondary CBD stones originating from the gallbladder. RESULTS All patients underwent percutaneous transhepatic balloon dilation with a primary success rate of 100%. The combined therapy was successful in 86.7% of patients with concomitant CBD stones and gallstones. No remaining stones were detected in the gallbladder. Transient adverse events include abdominal pain(n = 1), abdominal distension(n = 1), and fever(n = 1). Complications were treated successfully via nonsurgical management without long-term complications. No procedure-related mortality occurred. CONCLUSION For patients with concomitant CBD stones and gallstones, after percutaneous transhepatic removal of primary CBD stones, oral ursodeoxycholic acid and a high-fat diet followed by percutaneous transhepatic removal of secondary CBD stones appear to be a feasible and effective option for management of gallstones.

Successful recovery of COVID-19-associated recurrent diarrhea and gastrointestinal hemorrhage using convalescent plasma

Background: Gastrointestinal symptoms are not rare among coronavirus disease 2019(COVID-19) patients, but there have been no reports regarding convalescent plasma therapy for the recovery of gastrointestinal problems in COVID-19 patients.Case presentation: We present two cases of patients with COVID-19-associated recurrent diarrhea and positive fecal occult blood who successfully recovered after a one-time convalescent plasma administration.Conclusion: When COVID-19 patients develop recurrent or refractory gastrointestinal symptoms and fail to respond to the available treatment, alternative therapy with convalescent plasma administration may be considered.

Clinicopathologic features and prognostic factors of malignant eyelid tumors

AIM:To investigate the clinical characteristics and prognosis of patients with malignant eyelid tumors.·METHODS:This was a retrospective,non-randomized,clinical reviews.Between January,2002 and December,2011,75 cases with histologically confirmed malignant eyelid tumors were evaluated.Patients’ charts were reviewed for clinical information,treatment procedure,and disease course.Survival analysis in terms of recurrence-free survival was performed using age,sex,location of tumor and histopathological type.The followup ranged from 1 to 78 months(mean=21 months).·RESULTS:The 75 eyelid tumors included 35 basal cell carcinoma(BCC,46.7%),22 sebaceous gland carcinoma(SGC,29.3%),7 squamous cell carcinoma(SCC,9.3%),10 malignant melanoma(MM,13.3%),and 1 Merkel cell carcinoma(MCC,1.3%).Recurrence developed in 17cases(22.7%).The recurrence rate of BCC(4/35,11.4%)was significant lower than MM(6/10,60.0%,P 【0.001).The mean interval of recurrence was 21 months(range 3-62) for all eyelid tumors.Tumor located at canthus had higher recurrence rate(50%) compared with those located at eyelid(19%,P 【0.05).Histological type was independent variable for recurrence by Cox regression analysis.·CONCLUSION:It is important to achieve a negative tumor margin in canthus located malignant eyelid tumor.Clinicians should have a high level of suspicion for recurrence according to histological type when treating patients with eyelid tumor.

Effect of heat treatment on microstructure and mechanical properties of selective laser-melted PH13-8Mo stainless steel

PH13-8Mo stainless steel powder with high sphericity and well fluidity was prepared by the plasma rotating electrode process.The formed parts with ultra-high purity were manufactured by selective laser melting.The tensile and impact mechanical properties of the printed parts under three heat treatment regimes were compared to those without heat treatment.The microstructure,grain orientation and phase composition were characterized by electron-backscatter diffraction,X-ray diffraction and transmission electron microscopy.The characterization results reveal that the addition of heat treatment makes the grains enlarge,and after different heat treatments,the average grain size from 1.51μm in the printed state increases to 2.78,3.09 and 2.06μm,respectively.The formed parts are mainly composed of martensite and retained austenite.Moreover,the NiAl and M23C precipitates form,which are the major strengthening phases of PH13-8Mo stainless steel.The optimal heat treatment process is 925℃×1 h water cooling(WC)+0℃×2 h air cooling(AC)+540℃×4 h AC.Using this heat treatment process,PH13-8Mo formed parts have the optimal comprehensive mechanical properties:the tensile strength,yield strength and impact energy KU2 are 1492 MPa,1432 MPa and 63 J,respectively.The strengthening and toughening via heat treatment are mainly attributed to dislocation strengthening,the formation of NiAl and M23Co precipitates and the change of volume fraction of the retained austenite.

Carbide dissolution and austenite grain growth behavior of a new ultrahigh-strength stainless steel

The isothermal grain growth behavior for a new ultrahigh-strength stainless steel (UHSSS) is investigated in temperature range from 900 to 1150 ℃ and holding time range from 0 to 20 min. In the temperature range from 1000 to 1050 ℃, a bimodal grain size distribution was induced by different austenite grain growth rates which resulted from the weakened pin-ning effect by the partial dissolution of M6C particles along austenite grain boundaries. Further raising heating temperatures, M6C particles almost dissolved and the bimodal grain size distribution phenomenon became weakened, indicating that the austenite grain coarsening temperature of the new UHSSS was close to 1050 ℃. According to the present experimental results, a pragmatic mathematical model based on the Arrhenius equations was developed to predict the austenite grain growth process, which elaborated the influence of heating temperature, holding time and initial grain size on the austenite grain growth. Predictions for the new UHSSS presented a good agreement with experimental results.

Neoadjuvant chemotherapy:practice and thinking for Chinese patients with early breast cancer

Although some researchers hypothesized that neoadjuvant chemotherapy may improve prognosis of patients with breast cancer because it allows them to receive earlier systemic treatment,no large randomized controlled trials have confirmed this hypothesis.Thus,it is generally accepted that there is no difference in disease-free survival(DFS)or overall survival(OS)for patients receiving neoadjuvant or adjuvant chemotherapy for breast cancer.[1,2]Karagiannis et al[3]published an article in 2017 that incited some controversy because it reported that neoadjuvant chemotherapy promoted breast cancer micrometastasis to the blood vessels and lungs,based on the study of a polyomavirus middle T antigen mouse model and human xenograft in vivo and in fixed tissue.

Effect of solution pH,Cl- concentration and temperature on electrochemical behavior of PH13-8Mo steel in acidic environments

The effect of solution pH,Cl;concentration and temperature on the electrochemical corrosion behavior of PH13-8Mo steel in acidic solution was investigated by using the electrochemical tests,scanning electron microscopy and X-ray photoelectron spectroscopy.The PH13-8Mo martensitic precipitation hardened stainless steel is in the passivity state when the pH value is above 3.0,below which the anodic polarization curves of the steel are actively dissolved.The corrosion current density gradually decreases with increasing the solution pH and decreasing Cl;concentration and solution temperature.Pits are initiated on the sample surface in the presence of the Cl;and gradually developed into uniform corrosion with increasing the Cl;concentrations.Moreover,the corrosion is more serious with an increase in solution temperature.