Objective To study the diagnosis and treatm ent of choledochoduodenal Fistula (CDF).Methods To analysis preoperative and operative examination and postoperative situation of CDF.Results The operation confirmed the preoperative ERCP diagnosis of 19 cases with CDF.9 cases have been taken the choledochojejunostomy with tran sverse cutting the common bile duct and this method has been proved very effecti ve. Conclusions ERCP is an important method for the preoper ative diagnosis of CDF. The choledochojejunostomy with the common bile transvers ed cat duct is a recommended procedure to CDF.

Objective To investigate the influence of somatostatin (SS) and protein tyrosine enzyme 1 B (PTP1B) on the proliferation and the matrix protein secretion and phosphorylation of JAK2/STAT3 of hepatic stellate cells (HSC) induced by leptin. Methods The effect of different concentrations of SS on the proliferation of activatied HSCs induced by leptin was detected with MTT assay. HSCs were divided into control group, leptin group, leptin+10-7 mol/LSS group, leptin+10-6 mol/LSS group, TIMP-1, type I collagen and PTP1B protein and mRNA. Phosphorylation of JAK2/STAT3 were detected by RT-PCR, Western bolt and ELISA assay. Results SS could promote leptin-induced proliferation of HSCs in a dose-adependent manner. SS can improve PTP1B protein and mRNA, and higher does of SS could render more increase compared with the lower does. SS could reduce TIMP-1 mRNA, type I collagen mRNA and protein expression, and make the JAK2/STAT3 dephosphorylated, and the higher SS group reduce these factors more obviously than the lower group. Conclusion SS up-regulates PTP1B expression, inhibits JAK2/STAT3 signal transduction, proliferation, and reduces TIMP-1, I collagen expression in actived HSCs induced by leptin.

Objective To observe the influence of octreotide(OCT)on plasma ALT and AST and hepatic tissue protein expression of Bcl-2,Bax,GRP78 and CHOP in rats liver with fibrosis,to explore whether it relieves liver injury in rats with hepatic fibrosis by relieving endoplasmic reticulum stress(ERS)reaction. Methods For-ty Sprague-Dawley rats were randomly divided into Con group ,Mod group and OCT-treatment groups at high and low doses(1,10 mg/kg/12 h respectively). Except for rats in Con group,all rats were injected with 40%CCl4 sub-cutaneously twice a week for 8 weeks to establish hepatic fibrosis ,and those in OCT-treatment groups were injected at different doses of OCT twice a day at the same time. Plasma ALT and AST was assayed;the isolated livers were evaluated for histopathological changes by HE staining and Masson staining;hepatic histological grading and stag-ing were assessed by Ishak scoring system;Bcl-2,Bax,GRP78 and CHOP protein expression levels were deter-mined by Western blot. Results Compared with those in Con group ,the degrees of inflammatory cell infiltration and fibers,hepatic histological grading and staging,plasma ALT,AST activities and Bax,GRP78,CHOP protein levels were significantly increased in Mod and OCT-treatment groups ,but Bcl-2 protein level was significantly de-creased at the same time(P<0.01). Compared with those in Mod group ,the degrees of inflammatory cell infiltra-tion and fibers,hepatic histological grading and staging,plasma ALT,AST activities and Bax,GRP78,CHOP protein levels were significantly decreased in OCT-treatment groups ,but Bcl-2 protein level was significantly in-creased at the same time(P < 0.05). There was no significant difference between 2 OCT-treatment groups(P >0.05). Conclusions OCT can reduce the level of liver injury in rats with hepatic fibrosis ,thus the mechanism may be related to relieving the ERS reaction in liver.

Objective:To investigate the application of cardiac magnetic resonance (CMR) quantitative techniques in evaluating myocardial involvement differences between new onset and longstanding systemic lupus erythematosus (SLE) patients.Methods:From August 2020 to April 2023, 14 new onset and 15 longstanding SLE patients treated at the First Affiliated Hospital of Anhui Medical University were prospectively included as the study group. Additionally, 18 age-, gender-, body surface area-, and body mass index-matched healthy volunteers were included as the control group. Clinical baseline data, electrocardiograms, and CMR results including left ventricular ejection fraction (LVEF), left ventricular end-systolic volume index (LVESVI), left ventricular end-diastolic volume index (LVEDVI), cardiac index (CI), left ventricular stroke volume index (LVSVI), left ventricular mass index (LVMI), myocardial strain, native T 1 values, and T 2 values were collected. One-way analysis of variance (ANOVA) or Kruskal-Wallis H test was used to compare the quantitative parameters among the three groups. Bonferroni correction was applied for pairwise group comparisons. Results:The native T 1 values [1 114.50 (1 089.33, 1 150.39) ms, 1 085.32 (1 051.31, 1 129.75) ms] and T 2 values [(55.9±3.4) ms, (53.3±1.5) ms] of new onset and longstanding SLE patients were higher than those of the healthy control group [native T 1 values 1052.62 (1024.75, 1077.59) ms, H=17.72, P<0.001; T 2 values (51.2±1.3) ms, F=18.70, P<0.001]. The T 2 values of the new onset SLE group was higher than that of the longstanding SLE group ( P<0.05). The LVEDVI[86.87 (80.80, 93.55) ml/m 2], LVSVI [54.63 (50.42, 59.03) ml/m 2], and LVMI [48.39 (41.65, 53.26) g/m 2] of the new onset SLE group were higher than those of the control group [LVEDVI: 71.11 (65.80, 81.28) ml/m 2, Z=3.02, P=0.003; LVSVI: 42.17 (40.36, 51.33) ml/m 2, Z=2.76, P=0.006; LVMI: 38.48 (35.22, 43.83) g/m 2, Z=3.10, P=0.002]. The LVEDVI and LVSVI of the new onset SLE group were also higher than those of the longstanding SLE group [LVEDVI: 73.30 (69.87, 84.71) ml/m 2, Z=1.97, P=0.048; LVSVI: 45.53 (42.28, 50.98) ml/m 2, Z=2.34, P=0.020]. Conclusion:Myocardial involvement is more severe in new onset SLE patients, whereas acute myocardial injury is alleviated in longstanding SLE patients. Therefore, early detection of cardiac involvement in SLE patients is crucial for improving prognosis.