Objective To evaluate the therapeutic effect of endoscopic management of plastic stents of post-liver transplantation anastomotic biliary stricture. Methods From January 2010 to October 2015, clinical data of patients with post-liver transplantation anastomotic biliary stricture and received endoscopic retrograde cholangiopancreatog﹣raphy and plastic stents management was collected. The technical success rate, ERCP-related complications, clinical remission rate and long-term complications were main outcome measurements to compare the efficacy and safety of different number of stents in managing post-liver transplantation anastomotic biliary stricture. Results Among the 18 patients (0.5 ~ 60.0 months) with post-liver transplantation ABSs, seven patients received less plastic stents treat﹣ment (< 3 stents), nine patients with persistent anastomotic or recurrent stricture received multiple plastic stents treatment (≥ 3 stents), two patients received multiple plastic stents treatment once suffered with post-liver trans﹣plantation ABSs. The endoscopic technical success rate was seventy-six over eighty (95.0 %). Among the seven pa﹣tients received less plastic stents treatment, one loss to follow-up, two were still under treatment, one died of acute hepatic failure, one died of septic stock, one combined with biliary fistula resulted in treatment failure, one achieved clinical remission, the clinical remission rate was one third (33.3 %). Among the eleven patients received multiple plastic stents treatment, two loss to follow-up, one was still under treatment, two received surgery because of failed treatment, six achieved clinical remission, the clinical remission rate was 75.0 % (6/8). The average diameters and stent durations of management of 1 stent, 2 stents, 3 stents, 4 stents, 5 stents, 7 stents were 8.5 F, 17.0 F, 24.0 F, 28.0 F, 36.0 F, 50.0 F. Among the six early postoperative complications, five cases occurred in less stent manage﹣ment and one occurred in MPSs management, the early postoperative complication rate was 7.5 %(6/80). No severe ERCP-related complications and procedure-related deaths. Conclusions Endoscopic management of plastic stents is safe and effective for post-liver transplantation ABSs. Providing larger biliary support, the multiple plastic stents treatment was superior to less plastic stents treatment in view of clinical remission rate, especially for refractory one. Multiple plastic stents did not increase the incidence of complications, it could be used as the first-line treatment of post-liver transplantation duct-to-duct biliary anastomosis for its safety and effectivity.

Objective To investigate and find a multiple treatment to reduce the mortality of sepsis patients induced by severe surgical abdominal infection.Methods While treating to severe surgical abdominal infection,inflammatory mediator bacteria,extoxin and endotoxin,immunity,dysfunction of microcirculation,nutrition and metabolism and the function of organs should be paid more attention on and considered as a whole.We also carried out 14 concrete treating measurement.Combined high dosage of anisodaminum and dexamethason were used in sbort-term.Bring forward nourishment support according to different stage of MODS and applying it in clinic could significantly reduce the companion syndrome.Oral administration of“JIE-DU-GU-BEN-TANG”which developed by our division could regulate the imbalance of immunity and inflammatory mediator.Results There were 46 patients died in 368 patients,mortality was 12.50%. Conclusion It was difficult to treat sepsis patients induced by severe abdominal infection and our new multiple treatment could significantly reduce the mortality of severe sepsis.

OBJECTIVETo discuss the relationship between the onset of peptic ulcers (PU) and meteorological factors (MF).

METHODSIn reviewing records from 17 hospitals in the city of Nanning from 1992 to 1997, we found 24, 252 cases of PU in 104, 121 samples of gastroscopic examinations. We then calculated the detectable rate of PU (DRPU) during each season every five days (FD) and made a correlated analysis with the seasonal MF during the same period in Nanning. Finally, we made a multiple regressive correlated analysis of DRPU and the 5MF for the same period of the year. A forecast model based on the MF of the previous FD was established. The real value and the forecast value was being tested and verified.

RESULTSFrom 1992 to 1997, the DRPU is: winter and spring > summer and autumn (P < 0.005). There is a close relationship between the DRPU and the average temperature (AT), the average highest temperature (AHT), the average lowest temperature (ALT), average air pressure (AAP) and the average dew point temperature (ADT) of the five days of the same period of the year (the correlated coefficients are -0.5348, -05167, -0.5384, 0.4579 and -0.4936, respectively), with P < 0.01. The AT, AHT, ALT, AAP and ADT of the previous FD are of great value in forecasting the onset of PU, with its real value and forecast value corresponding to 66.6%.

CONCLUSIONSThere exists a close relationship between DRPU and the AT, AHT, ALT, AAP and ADT of the FD for the same period. A mid-term medical meteorological forecast of the onset of PU can be made more accurately and reliably according to the close relation between the DRPU and some MF of the previous FD.

Forecasting ; Humans ; Meteorological Concepts ; Peptic Ulcer ; epidemiology ; Pressure ; Seasons ; Temperature

Objective To investigate the relationship between visceral fat related index and the severity of acute pancreatitis (AP). Methods A total of 308 patients hospitalized with AP at the First Affiliated Hospital of Guangxi Medical University from September 2014 to October 2021 were included. They were divided into mild acute pancreatitis (MAP) ( n =186), moderate severe acute pancreatitis (MSAP) ( n =60) and severe acute pancreatitis (SAP) ( n =62) for comparison in age, hospitalization cost and days, scoring systems and body mass indexes. Comparison of normally distributed continuous data with homogeneity of variance between groups was made by one-way analysis of variance, and intergroup and intragroup pairwise comparison of data with heterogeneity of variance was made by the Kruskal-Wallis H test. The receiver operating characteristic curves (ROCs) for each index were constructed and area under the curve ( AUC ) was calculated to evaluate the performance of each index. Univariable and multivariable logistic regression analyses were used to identify the independent risk factors of MSAP and SAP. Results There were significant differences among the three groups in terms of hospitalization costs and durations, TG, HDL-C, NLR, WBC, Alb, Cr, BUN, scoring systems, CMI, LAP, WTI and CVAI. Further pairwise comparisons revealed that CMI, LAP, WTI and CVAI were significantly higher in the MAP group than in MSAP and SAP groups. We also found correlation between CMI and the severity of AP ( r =0.352, P < 0.001). By comparing the AUC s, CMI was found to be the most accurate in predicting the occurrence of MSAP and SAP. Univariable logistic regression analysis showed that CMI, LAP, WTI, CVAI and WC were the risk factors of MSAP and SAP. After adjusting for confounding factors, CMI and CVAI were identified as the independent risk factors of MSAP and SAP. The risk of MSAP and SAP with CMI ≥ 0.801 was 3.740 times that with CMI < 0.801 (95% CI : 1.983~7.056, P < 0.001). Conclusions Visceral fat is related to the severity of AP. Among the four visceral fat related indexes (CMI, LAP, WTI and CVAI), cardiometabolic index is the most valuable in predicting the severity of AP and they are positively correlated. CMI, an independent risk factor for MSAP and SAP, can be used to predict and assess the severity of AP.