Objective To explore the feasibility and safety of primary suture in laparoscopic common bile duct exploration(LCBDE) for treating choledocholithiasis.Methods The clinical data in 185 cases of choledocholithiasis underwent LCBDE in Sun Yat-sen Memorial Hospital from March 2010 to October 2015 were retrospectively analyzed.The patients were divided into 1aparoscopic common bile duct exploration and primary suture(LBEPS) group(117 cases) and T tube drainage group(68 cases) according to different processing modes of common bile duct incision.The operative time,intra-operative blood loss amount and postoperative complications were observed in the two groups.Results All operations were successfully performed in both two groups without converting to laparotomy.The operative time,intra-operative blood loss amounts and postoperative complications had no statistically significant differences between the LBEPS group and T tube drainage group(P>0.05).The postoperative hospital stay of the LBEPS group was significantly shorter than that of the T tube drainage group(P<0.01).There was no bile duct stricture or stone recurrence during the follow up period in the two groups.Conclusion Under strictly grasping the operation indication,selecting correct suture material and possessing practiced operating skills,primary suture of laparoscopic choledocholithiasis is safe and feasible,can avoid the risk of T tube placing related complications,has short postoperative hospitalization duration and increases postoperative living quality.

AIM: To observe the relationship between the reversal effect of 4 alkaloids of TCM on expression of P170 being obtained multi-drug resistance to mouse S180 tumor cell induced by chemotherapy protocol of PFC and the adjustment of the cell apoptosis.And to discuss the difference among alkaloids of TCM on reversion of being obtained multi-drug resistance in clinic.To improve the curative effect thereby. METHODS: By the methods of less dosage of Chemotherapy PFC,to set up the mouse models of multi-drug resistance of S180 tumor cell.At the same time to give the mouse matrine,terandrine,oxymatrine and berberine hydrooh loride for 2 weeks and then to observe the P170,TOPOⅡ,Fas and apoposis by flow cytometry. RESULTS: Matrine and terandrine could obviously reduce the expression of P170,the activation of TOPOⅡ induced by Chemotherapy and increase the ratio of the express of Fas and the apopsis of drug resistance to tumor cell.And berberine hydrochloride could obviously reduce the expression of TOPOⅡ. CONCLUSION: The adjustment to the apoposis of tumor cell by matrine and terandrine is related to the reversion of being obtained multi-drug resistance to tumor cell' expression,besides the different degree

Objective:To explore the needs of parents of hospitalized neonates with the challenges of implementing family-centered care during the Covid-19 pandemic.Methods:Using a method of phenomenological interviewing and Colaizzi′s method of data analysis, the information of 18 parents of admitted infants of Children′s Hospital of Fudan University from January 1 to 20, 2022 were collected and analyzed.Results:In the post-epidemic era, 5 themes of needs for parents of hospitalized neonates during family-centered care were identified: closeness to babies; emotional support; training about feeding; accommodation services; financial support.Conclusions:In the post-epidemic era, experiencing worry, anxiety, uncertainty, helplessness, loss and other negative psychological experience, the parents of hospitalized neonates have many unsatisfied needs. Hospital administrators need to focus on the needs of parents for family-centered nursing care, and actively explore effective coping strategies.

Objective · To investigate the clinical characteristics of initial peritoneal dialysis (PD) patients with different peritoneal transport status, and analyze risk factors of high peritoneal transport status in PD patients. Methods · A total of 455 consecutive PD patients newly starting PD between January 2007 to October 2015 were retrospectively analyzed. According to the results of the first sPET, patients were divided into H/HA (4h D/Pcr ≥ 0.65) and L/ LA (4h D/Pcr<0.65) groups. Clinical and biochemical characteristics between the two groups were compared. Multivariate logistic regression model was established to investigate risk factors of higher peritoneal transport status of incident PD patients. Results · The study included 372 incident PD patients. The L/LA group and H/HA group had 264 cases (71.2%) and 108 cases (28.8%) respectively. The H/HA group had higher proportion of male patients (63.0% vs 50.8%, P=0.03), lower residual renal function [RRF, (4.26±2.77) mL/min vs (5.79±4.53) mL/min, P<0.01], lower serum albumin level [(29.34±6.89) g/L vs (32.08±5.86) g/L, P=0.00], and more frequent diabetic nephropathy (19.4% vs 9.5%, P=0.00), compared with L/LA group. Univariate and multivariate logistic regression analysis showed that higher peritoneal transport status was associated with lower serum albumin level (OR=0.96, 95% CI 0.28-0.99; P=0.02), male (OR=1.92, 95% CI 1.19-3.12; P=0.00), presence of diabetic nephropathy (OR=2.52, 95% CI 1.26-5.05; P=0.00) and lower residual renal function (OR=0.90,95% CI 0.83-0.96; P=0.00). The level of hsCRP in patients with hypoalbuminemia was higher than that in patients with normal albumin level (1.69 mg/L vs 0.69 mg/L, P=0.00). Conclusion · Low and low average peritoneal transport status accounted for the majority of the patients in this study. Low serum albumin levels, male, diabetic nephropathy, RRF were risk factors of initial high peritoneal solute transport status. Chronic inflammatory status might partially explain for the correlation between hypoalbuminemia and high peritoneal solute transport status in PD patients.

BACKGROUND/AIMS: Gastric hypersensitivity contributes to abdominal pain in patients with functional dyspepsia. Recent studies showed that hormones induced by stress are correlated with visceral hypersensitivity. However, the precise mechanisms underlying gastric hypersensitivity remain largely unknown. The aim of the present study was designed to investigate the roles of corticosterone (CORT) on excitability of dorsal root ganglion (DRG) neurons innervating the stomach. METHODS: DRG neurons innervating the stomach were labeled by DiI injection into the stomach wall. Patch clamp recordings were employed to examine neural excitability and voltage-gated sodium channel currents. Electromyograph technique was used to determine the responses of neck muscles to gastric distension. RESULTS: Incubation of acutely isolated DRG neurons with CORT significantly depolarized action potential threshold and enhanced the number of action potentials induced by current stimulation of the neuron. Under voltage-clamp mode, incubation of CORT enhanced voltage-gated sodium current density of the recorded neurons. Pre-incubation of GF109203X, an inhibitor of protein kinase C, blocked the CORT-induced hyperexcitability and potentiation of sodium currents. However, pre-incubation of H-89, an inhibitor of protein kinase A, did not alter the sodium current density. More importantly, intraperitoneal injection of CORT produced gastric hypersensitivity of healthy rats, which was blocked by pre-administration of GF109203X but not H-89. CONCLUSIONS: Our data strongly suggest that CORT rapidly enhanced neuronal excitability and sodium channel functions, which is most likely mediated by protein kinase C but not protein kinase A signaling pathway in DRG neurons innervating the stomach, thus underlying the gastric hypersensitivity induced by CORT injection.
Abdominal Pain ; Action Potentials ; Animals ; Corticosterone ; Cyclic AMP-Dependent Protein Kinases ; Diagnosis-Related Groups ; Dyspepsia ; Ganglia ; Ganglia, Spinal* ; Humans ; Hypersensitivity ; Injections, Intraperitoneal ; Neck Muscles ; Neurons ; Protein Kinase C* ; Protein Kinases* ; Rats* ; Sodium ; Sodium Channels ; Spinal Nerve Roots* ; Stomach* ; Visceral Pain