This paper reported twenty-two cases of residual biliary duct stones.Because of biliary duct stenosis of stone impaction,the intrahepatic duct could not show by routine cholangiography through T-tube. We inserted a nylon cathetr lmm in diamenter into the selective biliary duct,and per- formed cholangiography through the catheter.The results were satisfactory in 20 of the 22 pa- tients. In the patients with large stones in the intrahepatic duct,the stone-dissolving liquid was instilled through a catheter which was kept in the selective duct.Finally,the stones fragmentated and were removed out successfully.

[Objective] To explore the effective method for functional indigestion.[Method] 99 cases were divided into 2 groups,the treatment group 66 cases were treated with self-made formula,the control with cisapridecap.[Result] In treatment group,35 cases were cured,15 had marked effect,11 were effective,5 had no effect,the total effective rate was 92.4%;for control one,they were 11,9,7,6 and 81.1% respectively.[Conclusion] TCM Sanhua Zhuyun Decoction has good effect on functional indigestion.

It is reported here that removal of residual stones and choledochofiberscopy through T-tube fistula were peformed on 512 patients. The removal procdeure followed by complica- tions, including fever (19 cases), hemorrhage (11 cases), fistulation between T-tube fistula and duodenum (6 cases), false passage formed by damage to the fistula (4 cases) and gallstones falling into false passage and being difficult to remove (2 cases) . The compli- cations with exception of the gallstones falling into false passage were adjusted after antibiotic treatment, coagulant drip by inserting a catheter and false passage drainge, respectively. The opening of T-tube fistula did not heal following remval of residual stones after Roux-en-y in two patients whose wounds only healed after suturing the intestinal wall and abdominal wall by reoperation. The causes, prevention and treatment of complications Were discussed in this papar.

The Coronavirus Disease 2019(COVID-19) pandemic is having a dramatic impact on human health,lives,and the global economy. The development of a safe and efficacious vaccine is the most effective intervention to protect the population from the disease and limit the spread of the virus. Based on the current guidelines and research progress of severe acute respiratory symptom coronavirus 2(SARS-CoV-2) vaccines in various countries,this review summarized the research progress on non-clinical safety evaluation of SARS-CoV-2 vaccines by referring to the guidelines and relevant literatures over the world,in order to provide a reference for non-clinical research of SARS-CoV-2 vaccines.

BACKGROUND:Because of the deficiency of researches on connective tissue growth factor associated with orthopedic diseases, very little attention has been paid to the studies on connective tissue growth factor in the intervertebral disc.
OBJECTIVE:Through exploring the role and mechanism of connective tissue growth factor in disc degeneration, to provide new evidence for biotherapy of disc degeneration.
METHODS: A computer-based search of PubMed and CNKI was performed by the first author to retrieve articles relevant to the effect and mechanism of connective tissue growth factor on degenerative disc and its related tissues published from January 1997 to October 2014. The keywords were “intervertebral disc; CTGF; TGF-β;hypoxia; disc degeneration” in Chinese and English, respectively, which appeared in the title, abstract or keywords. Articles published recently or in authoritative journals were preferred, and finaly 34 articles were included in result analysis.
RESULTS AND CONCLUSION:Recentlyin vivo and in vitro studies on the intervertebral disc have clearly demonstrated the anabolic role of connective tissue growth factor in stimulating matrix production from nucleus pulposus cels and revealed that the transforming growth factorβ-connective tissue growth factor axis was of great importance to celular matrix productionviaregulations and stimulations to transforming growth factor β and hypoxia, while the regulation of hypoxia for connective tissue growth factor was another in a specific cel and tissue manner.

Objective To investigate the prevalence of anxiety and depression one month before idiopathic benign paroxysmal positional vertigo (BPPV) episode. Methods Patients from Vertigo Clinic of Department of Neurology, West Campus, Chaoyang Hospital, were enrolled from January 2014 to June 2016. For patients with first visiting idiopathic BPPV, Hamilton Anxiety Scale and Hamilton Depression Scale were used at the consulting room by an experienced neurologist to reflect the emotional state one month before idiopathic BPPV episode. The occurrence rate of mood disorders was compared with usual model. Results One hundred and eighty five patients with idiopathic BPPV, aged 28 to 82 (57.6±12.0) years, 19.5% (36/185) being male, 80.5% (149/185) being female, were enrolled into this research. No anxiety, probable anxiety, definite anxiety and severe anxiety accounted for 15.1% (28/185), 33.0% (61/185), 47.6% (88/185) and 4.3% (8/185), respectively;no depression, probable depression, definite depression and severe depression accounted for 18.4% (34/185), 48.6% (90/185), 29.2% (54/185) and 3.8% (7/185), respectively;no mood disorders, probable mood disorders, definite mood disorders and severe mood disorders accounted for 11.4% (21/185), 33.5% (62/185), 49.2% (91/185) and 5.9% (11/185), respectively;total definite mood disorders and severe mood disorders accounted for 55.1% (102/185), higher than usual model (14.4%)Conclusion Anxiety and depression is common before idiopathic BPPV episode.

[Objective] To discuss the clinical effect of Jianpi Qingwei Decoction on chronic erosive gastritis(CEG). [Method] Choose the said patients 68 cas-es, randomly divide them into treatment group(n=38) and control one(n=30).The treatment group take the self-made Jianpi Qingwei Decoction for treat-ment;the control one, lansoprazole and col oid pectinBi. Both take 4w as a course;after 1 course, compare their cure effect and side effects;fol ow up the re-currence. [Result] In the treatment group, 22 cases were cured, 13 better, 3 uncured, the total effective rate 92.10%;for the control one, they were respective-ly 13,11,6 and 80.00%;by comparison, their difference had statistical meaning;there ’s no recurrence fol owing up for half year. [Conclusion] Jianpi Qingwei Decoction has marked cure effect and little side effects on CEG, without easy recurrence, worth promotion.

Objective To describe the anxiety status of new nurses in emergency department so as to put forward strategies for nursing management. Methods Thirty-two new nurses (working time less than 2 years) from emergency department of two class Ⅲ- A general hospitals in Xiamen were surveyed by using Zung self-rating anxiety scale (SAS). Results The average of SAS total score showed significant difference from that of the Chinese norm, but no significant difference could be seen in the score of SAS be-tween college and baccalaureate nurses.Nurses with different working length showed significant difference in SAS score. Conclusions Anxiety status of new nurses in emergency department is serious, nursing man-agers should make more efforts to conduct mental health education and improve psychological quality of new nurses in emergency department to relieve their anxiety.

Objective To investigate the usage of antiplatelet drugs(APD)therapy in ischemic stroke with a history of intracranial hemorrhage(ICH)and impact of APD therapy in recurrences of the ICH and the ischemic stroke. Methods In a retrospective study, all survivors of ischemic stroke with ICH who visited our hospital previous to this study were followed by clinic visit or by telephone interview and recurrent ICH, ischemic stroke, and APD use were recorded. Kaplan-Meier plot and Logistic regression were used to assess the effect of APD on recurrent ICH and isclemic stroke. Results Recurrent ICH was more common in patients with lobar hemorrhage compared than patients with deep hemorrhage. APD use was more common for prevention of myocardial infarction and atrial fibrillation. APD use did not increase ICH recurrence (OR = 1. 149, 95% CI 0. 376-3.513, P=0.808)and did not shorten duration of ICH recurrence(X2=1.257, P=0.262); however, it did reduce ischemic stroke recurrence(OR=0.410, 95% CI0. 203-0.826, P=0.013)and prolonged duration(X2 =14.315, P=0.001). Conclusion APD use was not associated with ICH recurrence and was beneficial to recurrence ischemic stroke in this observation study.

Objectives To explore the ultrasonic features in the differential diagnosis of thyroid multiple nodules with thyroid carcinoma and summarize the causes of misdiagnosis,and to improve the accuracy of ultrasonic diagnosis of thyroid carcinoma.Methods The ultrasound images from the 40 patients with thyroid carcinoma were selected,whose diagnosis of thyroid carcinoma was confirmed by the pathological examinations after surgery but misdiagnosed or not identified by ultrasound examination.These ultrasound images were retrospectively analyzed through observing the carcinomatous nodules in size,aspect ratio,shape,border,envelope,internal echo,calcification characteristics,posterior echo,acoustic halo,the distribution of blood flow,and the relationship with thyroid capsule and anterior organization,whether to transfer to neck or spraclavicular lymph nodes,and the performance of elasticity imaging,and then these features were compared with the ultrasonic features of the benign thyroid nodules.Results The ultrasonic features of thyroid multiple nodules with thyroid carcinoma were complicated and each nodule should be observed and analyzed individually.The ultrasonic features of carcinomatous nodules were:(1) irregnlar shape,(2)aspect ratio ≥ 1,(3)unclear border,(4)no capsule,(5)heterogeneous hypo echo inside of the carcinomatous nodules,(6)scattered distribution of clustered microcalcifications,(7)incomplete acoustic halo or absent,(8)blood supply to the centrality inside of the carcinomatous nodules,(9)invaded thyroid capsule and anterior organizations,(10)transformation to neck or supraclavicular lymph nodes in the minority of patients,(11) elasticity imaging score of 3 ～ 5.Conclusions It is quite difficult to identify the ultrasonic features of thyroid multiple nodules with thyroid carcinoma and it is with high misdiagnosis rate.A comprehensive analysis of sonographic features is essential in clinical practices,and it will contribute to improving the accuracy of the ultrasonic diagnosis of thyroid multiple nodules with thyroid carcinoma.