2018年 · 第52卷第08期

isolated distal deep vein thrombosis (IDDVT) is one of the common clinical types of venous reflux disorders. It is a syndrome caused by abnormal blood coagulation and obstruction of reflux in the lower leg and intermuscular veins below the popliteal vein. The incidence rate accounts for 23.0% ~59.0% of deep vein thrombosis^[1]。 Without proper treatment, 25.0%-33.3% of the thrombus spread antegrade to the proximal vein (popliteal vein or above), and expanded to obstruction of the whole lower limb vein. In severe cases, the thrombus dropped off and entered the pulmonary vessels with blood, causing pulmonary embolism (PE)^[2]。 At present, there is still a lack of strong evidence-based medical evidence to determine the best treatment for IDDVT, which is still a hot topic of debate.^[1,2]Most of them are empirical explorations. The author retrospectively analyzed the clinical data of two commonly used regimens of thrombolysis and anticoagulation in the treatment of IDDVT, in order to provide a reference for the selection of clinical treatment regimens for IDDVT.

Cholangiocarcinoma is a malignant tumor of bile duct epithelium, which is the most common primary tumor of biliary tract^[1]。 The most effective treatment for cholangiocarcinoma is radical surgical resection, but it is difficult to diagnose because of the hidden onset of cholangiocarcinoma and no obvious accompanying symptoms in the early stage. Most patients are in the advanced stage when they go to the hospital due to obstructive jaundice, weight loss and discomfort, and cannot achieve radical surgical resection^[2], making the prognosis of patients with cholangiocarcinoma overall poor. For advanced cholangiocarcinoma, the purpose of treatment is to relieve biliary obstruction, restore biliary patency, relieve jaundice, improve patients' nutritional status and quality of life, etc^[3]。 For malignant obstructive jaundice caused by cholangiocarcinoma, percutaneous transhepatic cholangial drainage (PTCD) implantation of biliary tract metal stents can effectively relieve the biliary tract obstruction and improve the quality of life of patients. Moreover, it has the advantages of less trauma, no absolute contraindication and can be used repeatedly. However, the growth of the tumor will cause restenosis of the stent to varying degrees.¹²⁵I particle can achieve the therapeutic effect by irradiating the tumor at close range and continuously at low dose for a long time, and obviously prolong the patency time of the stent^[4]。 Currently, percutaneous biliary stent implantation combined with¹²⁵I particle intracavitary irradiation in the treatment of cholangiocarcinoma is mostly about its clinical efficacy, but the related factors affecting its prognosis have not been reported at home and abroad. The authors selected the clinical data of 105 patients with cholangiocarcinoma who lost the opportunity of radical surgical resection in the Department of Hepatobiliary Surgery of our hospital from January 2012 to January 2017 to retrospectively analyze the clinical efficacy of this treatment mode and explore the related factors affecting the prognosis of patients.

Female, 19 years old. He was admitted to hospital on August 4, 2016 due to the discovery of a progressive enlarged mass in his left upper arm for more than 3 months. Physical examination: A mass about 4 cm ×2 cm in size can be palpable in the middle and lower segments of the left upper arm. It is soft in texture, poor in mobility, mild tenderness, slight numbness in the tiger's mouth area when pressed, normal dorsal extension and flexion activities of the wrist and metacarpophalangeal joints, and normal muscle strength.

Male, 29 years old. Intermittent melena for 10 years. In July 2015, there was no obvious trigger to appear intermittent stool with blood, which was bright red, the amount was not large, and no special treatment was performed. The patient's sister has multiple polyps in the colon.

Female, 28 years old, was admitted to hospital on April 15, 2017 due to recurrent right chest pain for half a year. Prior health, no history of tuberculosis, tumor, dust exposure, and hemoptysis. Physical examination showed no positive signs.