OBJECTIVE: To study the role of estrogen receptor (ER) and progesterone receptor (PR) in the formation of cholesterol calculus and investigate the effects of Shengqing Capsule (SQC), a Chinese patent herbal medicine with the function of soothing liver and draining gallbladder, on ER and PR expressions. METHODS: A total of 80 female guinea pigs were divided into normal control group, untreated group, ursodeoxycholic acid group (UDCA group) and SQC group. The cholesterol gallstone was induced by feeding the guinea pigs with high-fat lithogenic diet. SQC and UDCA were separately administered to the guinea pigs in the SQC group and UDCA group. After 7-week administration, all the animals were sacrificed to calculate the incidence of calculus formation and detect the expressions the ER and PR in the epithelial tissue of gallbladder by immunohistochemical method. RESULTS: Gallstone was cholesterol calculus detected by infrared spectrum. The incidence of calculus formation in the SQC group (27.78%) was significantly lower than that in the untreated group (81.25%) (X(2)=9.721 5, P=0.001 8). On the basis of Reiner standard, the expression distribution of ER and PR increased gradually from the normal control group through the SQC group and UDCA group to the untreated group. Except for the former two groups and the latter two groups, the differences between the other groups and UDCA group were statistically significant (P<0.05). Besides, the differences of positive expression rates between groups were statistically significant (P<0.05). CONCLUSION: Increased expressions of ER and PR are closely related to the formation of cholesterol stone. And Shengqing Capsule can down-regulate the expressions of ER and PR.

Objective To explore the feasibility of radical cholecystectomy for early gallbladder car cinoma found during or after laparoscopic cholecystectomy.Methods A retrospective study was conducted on patients who received laparoscopic cholecystectomy between January 2007 to August 2013 and were diagnosed to have gallbladder cancer during or after the operation.There were 34 patients.In 29 patients intraoperative frozen section diagnosed gallbladder carcinoma.In 5 patients postoperative histopathological study diagnosed stage Ⅰ or Ⅱ gallbladder carcinoma.Results Surgery was conducted successfully on these 34 patients.In 20 patients with stage Ⅰ,Ⅱ and Ⅲ,the tumor had invaded the serosa,or into the liver with a depth of less than 2 cm,laparoscopic cholecystectomy alone or radical/extended radical cholecystectomy were carried out.In 9 patients,the laparoscopic surgery was converted to open surgery and these patients underwent cholecystectomy with resection of the adjacent liver segments/sections.In 5 patients who were diagnosed to have gallbladder carcinoma after laparoscopic cholecystectomy,they were re-operated with laparoscopic radical cholecystectomy.Conclusions Stage Ⅰ,Ⅱ and Ⅲ gallbladder carcinoma with tumor invasion into serosa,or patients with tumor invasion into the liver with a depth of less than 2 cm should undergo radical or extended radical cholecystectomy.Laparoscopic assisted radical or extended radical cholecystectomy could achieve the same operation as with open surgery but with better short-term results.There were less pain,smaller incisions,better scars and shorter hospitalization stay.

An analytical method based on ultra performance liquid chromatography-tandem mass spectrometry was developed for the determination of cyantraniliprole and its main metabolite J9 Z38 residues in pepper and soil. The fate of cyantraniliprole and J9Z38 in pepper and soil was also evaluated. The target compounds were extracted with acetonitrile, cleaned up by C18 cartridge, and further analyzed by gradient ultra performance liquid chromatography-tandem mass spectrometry with electrospray ionization in positive mode ( ESI﹢) using a UPLC BEH C18 Column. The method was validated using fortified pepper and soil. Intra-day mean recoveries of cyantraniliprole and J9Z38 at three spiked levels (0. 01, 0. 10 and 1. 00 mg/kg) ranged from 88. 6% to 105 . 7% with relative standard deviations of 3 . 8%-15 . 1%. Inter-day mean recoveries of cyantraniliprole and J9 Z38 were found between 91 . 4% and 105 . 3% with relative standard deviations of 4 . 9%-12 . 3% at three spiked levels. Limits of quantification ( LOQs) of cyantraniliprole and J9Z38 were 0. 1 and 0. 2 μg/kg, respectively. Linear calibration functions with correlation coefficients of r>0. 9992 were obtained in the concentration range of 2. 0-128. 0 μg/L. This method was applied to the analysis of cyantraniliprole and J9Z38 residues in real pepper and soil samples selected from field. The results of the residue dynamic experiment showed that the half-life of cyantraniliprole ranged from 9 . 2 to 11 . 2 days in pepper and from 9 . 2 to 20. 8 days in soil. While, the residues of J9Z38 in pepper were below LOQ, and the half-life of J9Z38 in soil was 9. 4 days. The degradation speed of cyantraniliprole increased with the increase of the precipitation.

Objective:To explore the epidemiological characteristics and the antibiotic resistance of Streptococcus pneumoniae isolates, and to provide the evidence for the rational use of antimicrobial agents to treat Streptococcus pneumoniae infection. Methods:The positive microbiological laboratory identification and antimicrobial susceptibility testing of Streptococcus pneumoniae from sputum of children with respiratory infections during January 2010 to December 2017 in Children′s Hospital of Soochow University were retrospectively analyzed. The positive rates of Streptococcus pneumoniae of different genders, ages, years and seasons were compared. The annual detection rates and trends of drug resistance of Streptococcus pneumoniae to penicillin, amoxicillin and cefotaxime were analyzed by Mann-Kendall trend test. The seasonal decomposition of time series was conducted to assess the association between Streptococcus pneumoniae detection rate and season. Enumeration data was compared using χ2 test. Results:Of the 88 480 sputum specimens, the total positive rate of Streptococcus pneumoniae was 10.3%(9 081/88 480). The detection rates of Streptococcus pneumoniae in children aged 0 to <0.5 years old, 0.5 to <2 years old, 2 to <3 years old, 3 to <5 years old, and 5 to <15 years old were 4.2%(1 407/33 224), 13.1%(3 191/24 390), 14.9%(2 417/16 252), 17.9%(1 474/8 246) and 9.3%(592/6 368), respectively. The difference was statistically significant ( χ2=2 421.6, P<0.01). The detection rates were 8.1%(1 321/16 306) from January to March, 10.9%(2 194/20 207) from April to June, 8.5%(2 141/25 058) from July to September, and 12.7%(3 425/26 909) from October to December. The discrepancy of positive rates in different seasons showed statistical significance ( χ2=311.5, P<0.01). During 2010 to 2017, significant decreases in antibiotic resistant rates of Streptococcus pneumoniae to penicillin, amoxicillin and cefotaxime were detected (tau=-0.93, -0.93 and -0.71, respectively, all P<0.05). Conclusions:The detection rate of Streptococcus pneumoniae in sputum of children with respiratory infections may present seasonal pattern and vary between different ages of children. The resistance to β-lactam antibiotics has declined.

For patients with partial jaw defects, cysts and dental implants, doctors need to take panoramic X-ray films or manually draw dental arch lines to generate Panorama images in order to observe their complete dentition information during oral diagnosis. In order to solve the problems of additional burden for patients to take panoramic X-ray films and time-consuming issue for doctors to manually segment dental arch lines, this paper proposes an automatic panorama reconstruction method based on cone beam computerized tomography (CBCT). The V-network (VNet) is used to pre-segment the teeth and the background to generate the corresponding binary image, and then the Bezier curve is used to define the best dental arch curve to generate the oral panorama. In addition, this research also addressed the issues of mistakenly recognizing the teeth and jaws as dental arches, incomplete coverage of the dental arch area by the generated dental arch lines, and low robustness, providing intelligent methods for dental diagnosis and improve the work efficiency of doctors.
Humans ; Radiography, Panoramic/methods* ; Cone-Beam Computed Tomography/methods* ; Head ; Image Processing, Computer-Assisted/methods*

OBJECTIVE To optimize th e p rocessing technology of Portulaca oleracea charcoal，and to investigate its improvement effect on the symptom of hemorrhoid model rats. METHODS The effects of roasting temperature ，dosage and roasting time on the processing technology of P. oleracea charcoal were investigated with Box-Behnken response surface methodology using comprehensive score of tannin content ，water-soluble extract content and appearance properties as the index. The optimal process parameters are selected and verified. The hemorrhoid model rats were treated with P. oleracea charcoal（0.8 g/mL）prepared by the optimal processing technology ，once a day ，for 11 days. After last medication ，the perianal pathological score of hemorrhoid model rats were performed ；serum levels of tumor necrosis factor α（TNF-α），interleukin 6（IL-6）and IL- 1β were detected. RESULTS The optimal processing technology of P. oleracea charcoal included roasting temperature of 200 ℃， dosage of 150 g and roasting time of 14 min. Results of validation test showed that the comprehensive score of P. oleracea charcoal was 92.57，and relative error of it with predicted value （96.59）was －4.13％. External use of P. oleracea charcoal 0.8 g/mL prepared by the optimal processing technology could significantly promote the wound healing of hemorrhoid model rats ，reduced the amount of exudate ，and decreased the levels of TNF-α，IL-6 and IL-β in serum. CONCLUSIONS The optimized processing technology of P. oleracea charcoal is feasible. P. oleracea charcoal prepared by the optimized processing technology has good curative effect on the symptom of hemorrhoid model rats.

ObjectiveTo investigate the efficacy and safety of cryoablation combined with Camrelizumab monoclonal antibody in the treatment of hepatocellular carcinoma （HCC）. MethodsA total of 103 HCC patients who were admitted to our hospital from June 2020 to June 2023 were enrolled and randomly divided into combined treatment group with 53 patients and control group with 50 patients. The patients in the control group received percutaneous argon-helium cryoablation， and those in the combined treatment group received percutaneous argon-helium cryoablation combined with Camrelizumab monoclonal antibody. The two groups were compared in terms of short-term response， changes in T lymphocyte subsets after treatment， changes in liver function and alpha-fetoprotein （AFP） after treatment， and progression-free survival and overall survival during follow-up. The t-test was used for comparison of normally distributed continuous data between groups， and the chi-square test was used for comparison of categorical data between groups. The Kaplan-Meier method was used to plot survival curves， and the log-rank test was used for comparison of survival time between the two groups. ResultsThe combined treatment group had significantly higher overall response rate and disease control rate than the control group （χ²=4.156 and 4.348， P=0.042 and 0.037）. After treatment， the combined treatment group had significant increases in the percentages of CD3⁺ and CD4⁺ T lymphocytes and CD4⁺/CD8⁺ ratio （P<0.05） and a significant reduction in the percentage of CD8⁺ T lymphocytes （P<0.05）， while the control group had no significant changes in T lymphocyte subsets after treatment （P>0.05）， and compared with the control group after treatment， the combined treatment group had significantly higher percentages of CD3⁺ and CD4⁺ T lymphocytes and CD4⁺/CD8⁺ ratio （all P<0.05） and a significantly lower percentage of CD8⁺ T lymphocytes （P<0.05）. After treatment， both groups had significant reductions in the levels of alanine aminotransferase （ALT）， aspartate aminotransferase （AST）， and AFP （all P<0.05） and a significant increase in the level of albumin （Alb） （P>0.05）， and compared with the control group after treatment， the combined treatment group had significantly lower levels of ALT， AST， and AFP （all P<0.05） and a significantly higher level of Alb （P<0.05）. There were no significant differences in the incidence rates of grade Ⅲ‍—‍Ⅳ （moderate to severe） adverse reactions between the two groups （P>0.05）. Compared with the control group， the combined treatment group had significantly better median progression-free survival （21.32 months vs 15.31 months， χ²=4.689， P=0.030） and median overall survival （28.36 months vs 20.75 months， χ²=5.030， P=0.025）. ConclusionArgon-helium cryoablation combined with Camrelizumab monoclonal antibody can effectively improve short-term response， enhance immune function， and prolong survival time， with a favorable safety profile.