Objective To study the effects of different operation time of laparoscopic cholecystectomy(LC) on systemic stress response.Methods A total of 40 patients conducted by LC were divided into the Group A(

Objective To evaluate the effects of sirolimus on scopolamine-induced cognitive dysfunction in rats.Methods Thirty male Wistar rats,aged 3 months,weighing 200-250 g,were equally randomized into 3 groups:normal saline group (NS group),scopolamine group (SC group) and scopolamine + sirolimus group (SS group).Normal saline,scopolamine 0.8 mg/kg and sirolimus 3.5 mg/kg + scopolamine 0.8 mg/kg were injected intraperitoneally in groups NS,SC and SS,respectively,and the injection was continued for 14 consecutive days.The cognitive function was assessed by Morris water maze test on 15th day.After behavior test,the rats were sacrificed and the prefrontal cortex and hippocampus were harvested for determination of amyloid β protein (Aβ) and Tau protein expression.Results Compared with NS group,the escape latency was significantly prolonged,the ratio of time spent in the target quadrant was decreased,Aβ expression in prefrontal cortex and hippocampus was upregulated and Tau protein expression in prefrontal cortex and hippocampus was down-regulated in group SC (P ＜0.05 or 0.01).Compared with SC group,the escape latency was significantly shortened,the ratio of time spent in the target quadrant was increased,Aβ expression in prefrontal cortex and hippocampus was down-regulated and Tau protein expression in prefrontal cortex and hippocampus was up-regulated in group SS (P ＜ 0.05 or 0.01).Conclusion Sirolimus can significantly improve scopolamine-induced cognitive dysfunction in rats and the changes in the expression of Aβ and Tau protein in prefrontal cortex and hippocampus may be involved in the mechanism.

Bronchopulmonary dysplasia (BPD) is a common respiratory complication after preterm birth that severely affects the prognosis and quality of life in preterm infants. In recent years, significant progress has been made in neonatal care, but the incidence of BPD remains high. After long-term exploration and application, some medications such as exogenous pulmonary surfactants, glucocorticoids and caffeine have been widely used for the prevention and treatment of BPD. However, some medications including diuretics, inhaled nitric oxide and bronchodilators have not been proved to be effective and safe. This review summarizes the present drugs for the prevention of BPD in publications.

Objective:To explore the current status of surgery for portal hypertension to grasp current status and future development of surgery in China.Methods:This study is jointly sponsored by China Hepatobiliary & Pancreatic Specialist Alliance & Portal Hypertension Alliance in China (CHESS).Comprehensive surveying is conducted for basic domestic situations of surgery for portal hypertension, including case load, surgical approaches, management of postoperative complications, primary effects, existing confusion and obstacles, liver transplantation(LT), laparoscopic procedures and transjugular intrahepatic portosystemic shunt(TIPS), etc.Results:A total of 8 512 cases of portal hypertension surgery are performed at 378 hospitals nationwide in 2021.Splenectomy plus devascularization predominated(53.0%)and laparoscopy accounted for 76.1%.Primary goal is preventing rebleeding(67.0%) and 72.8% of hospitals used preventive anticoagulants after conventional surgery.And 80.7% of teams believe that the formation of postoperative portal vein thrombosis is a surgical dilemma and 65.3% of hospitals practiced both laparoscopy and TIPS.The major reasons for patients with portal hypertension not receiving LT are due to a lack of qualifications for LT(69.3%)and economic factors(69.0%).Conclusions:Surgery is an integral part of management of portal hypertension in China.However, it is imperative to further standardize the grasp of surgical indications, the handling of surgical operation and the management of postoperative complications.Moreover, prospective, multi-center randomized controlled clinical studies should be performed.

Objective:To investigate the safety and feasibility of the CHESS endoscpic ruler (CHESS ruler), and the consistency between the measured values and the interpretation values by endoscopic physician experience.Methods:From January 2021 to January 2022, a total of 105 liver cirrhosis patients with portal hypertension were prospectively enrolled from General Hospital, Xixia Branch Hospital, Ningnan Hospital of People′s Hospital of Ningxia Hui Autonomous Region (29 cases), and the First People′s Hospital of Yinchuan (25 cases), General Hospital of Ningxia Medical University (18 cases), Wuzhong People′s Hospital (10 cases), the Fifth People′s Hospital of Ningxia Hui Autonomous Region (10 cases), Shizuishan Second People′s Hospital (6 cases), Yinchuan Second People′s Hospital (5 cases), and Zhongwei People′s Hospital (2 cases) 8 hospitals. The clinical characteristics of all the patients, including gender, age, nationality, etiolog of liver cirrhosis, and Child-Pugh classification of liver function were recorded. A big gastroesophageal varices was defined as diameter of varices ≥5 mm. Endoscopist (associated chief physician) performed gastroscopy according to the routine gastroscopy procedures, and the diameter of the biggest esophageal varices was measured by experience and images were collected, and then objective measurement was with the CHESS ruler and images were collected. The diameter of esophageal varices of 10 randomly selected patients (random number table method) was determined by 6 endoscopists (attending physician or associated chief physician) with experience or measured by CHESS ruler. Kappa test was used to test the consistency in the diameter of esophageal varices between measured values by CHESS ruler and the interpretation values by endoscopic physician experience.Results:Among 105 liver cirrhosis patients with portal hypertension, male 65 cases and female 40 cases, aged (54.8±12.2) years old, Han nationality 82 cases, Hui nationality 21 cases and Mongolian nationality 2 cases. The etiology of liver cirrhosis included chronic hepatitis B (79 cases), alcoholic liver disease (7 cases), autoimmune hepatitis (7 cases), chronic hepatitis C (2 cases), and other etiology (10 cases). Liver function of 32 cases was Child-Pugh A, Child-Pugh B 57 cases, and Child-Pugh C 16 cases. All 105 liver cirrhosis patients with cirrhotic portal hypertension were successfully measured the diameter of gastroesophageal varices by CHESS ruler, and the success rate of application of CHESS ruler was 100.0% (105/105). The procedure time from the CHESS ruler into the body to the exit of the body after measurement was (3.50±2.55) min. No complications happened in all the patients during measurement. Among 105 liver cirrhosis patients with cirrhotic portal hypertension, 96 cases (91.4%) were recognized as big gastroesophageal varices by the endoscopists. Totally 93 cases (88.6%) were considered as big gastroesophageal varices by CHESS ruler. Eight cases were recognized as big gastroesophageal varices by the endoscopist, however not by the CHESS ruler; 5 cases were recognized as big gastroesophageal varices by the CHESS ruler, but not by the endoscopists; 4 cases were not recognized as big gastroesophageal varices both by the endoscopists and CHESS ruler; 88 cases were recognized as big gastroesophageal varices both by the endoscopists and CHESS ruler. The missed diagnostic rate of big gastroesophageal varices by the endoscopists experience was 5.4% (5/93), and the Kappa value of consistency coefficient between the measurement by the CHESS ruler and the interpretation by endoscopists experience was 0.31 (95% confidence interval 0.03 to 0.60). The overall Kappa value of consistency coefficient by 6 endoscopists measured by CHESS ruler in big gastroesophageal varices diagnosis was 0.77 (95% confidence interval 0.61 to 0.93).Conclusion:As an objective measurement tool, CHESS ruler can make up for the deficiency of subjective judgment by endoscopists, accurately measure the diameter of gastroesophageal varices, and is highly feasible and safe.