AIM: To evaluate the efficacy and safety of transjugular intrahepatic portosystemic shunt (TIPS) combined with stomach and esophageal variceal embolization (SEVE) in cirrhotic patients with a large gastrorenal vessel shunt (GRVS). METHODS: Eighty-one cirrhotic patients with gastric variceal bleeding (GVB) associated with a GRVS were enrolled in the study and accepted TIPS combined with SEVE (TIPS + SEVE), by which portosystemic pressure gradient (PPG), biochemical, TIPS-related complications, shunt dysfunction, rebleeding, and death were evaluated. RESULTS: The PPGs before TIPS were greater than 12 mmHg in 81 patients. TIPS + SEVE treatment caused a significant decrease in PPG (from 37.97 +/- 6.36 mmHg to 28.15 +/- 6.52 mmHg, t = 19.22, P < 0.001). The percentage of reduction in PPG was greater than 20% from baseline. There were no significant differences in albumin, alanine aminotransferase, aspartate amino-transferase, bilirubin, prothrombin time, or Child-Pugh score before and after operation. In all patients, rebleeding rates were 3%, 6%, 12%, 18%, and 18% at 1, 3, 6, 12, and 18 mo, respectively. Five patients (6.2%) were diagnosed as having hepatic encephalopathy. The rates of shunt dysfunction were 0%, 4%, 9%, 26%, and 26%, at 1, 3, 6, 12, and 18 mo, respectively. The cumulative survival rates in 1, 3, 6, 12, and 18 mo were 100%, 100%, 95%, 90%, and 90%, respectively. CONCLUSION: Our preliminary results indicated that the efficacy and safety of TIPS + SEVE were satisfactory in cirrhotic patients with GVB associated with a GRVS (GVB + GRVS).

In this paper we complete our studies of the bonding in the ClFFn+.0.- series, characterizing the structures and energetics of the ground and low-lying excited states of CIFn- (n = 1-6) via coupled cluster calculations with large correlation consistent basis sets and interpreting the results of the calculations using concepts from generalized valence bond (GVB) theory. The chlorine anion is isoelectronic with the argon atom, possessing three 3p lone pairs. However, the electrons in Cl- are much less tightly bound than those of Ar, and it is thus possible for the fluorine atom to form recoupled pair bonds and recoupled pair bond dyads with the chlorine anion even if this is not possible with the argon atom. The calculated dissociation energies, D-0(Fn-1Cl-F), for the anions are 28.9, 72.3, 12.5, 59.9, 4.5, and 38.8 kcal/mol for n = 1-6, and the adiabatic electron affinities, EA(0)(CIFn), are 2.25, 4.78, 3.29, 5.47, 3.80, and 5.43 eV, respectively [CCSD(T)/RCCSD(T)/AVQ(+)Z]. Unlike the cation series, the ClFn- anions have competing dissociation channels, ClFn- -> ClFn-1 + F- and CIFn- -> ClFn-1- + F, because of the similar electron affinities of the fluorine atom and some of the CIFn-1 species. The CIF2- and CIF4- anions dissociate to F- and (CIF, CIF3), while the remaining members of the family dissociate to F and CIFn-1-. However, the electronic structure of the ClF2- species at its equilibrium geometry is consistent with the addition of a fluorine atom to CIF-. In addition to the ground states of ClFn-, three previously unknown excited states were found for ClF2-, ClF3-, and CIF4- with excitation energies of Delta E-0 = 2.24, 2.02 and 2.11 eV, respectively. In contrast to the ground states, which possess the maximum number of recoupled pair bond dyads, the excited state species have one fewer dyad and two additional recoupled pair bonds. (C) 2017 Elsevier B.V. All rights reserved.