Post-ERCP pancreatitis(PEP) is the most common and serious complications about endoscopic retrograde cholangiopancreatography(ERCP).A number of studies have been confirmed that PEP can be prevented by pancreatic stents.We summarized earlier results in this field to expand the clinical use for this high-tech.

Objective To investigate the clinical value of contrast-enhanced ultrasonography(CEUS) in evaluating treatment response of hepatocellular carcinoma after interventional therapy. Methods One hundred and three patients with 136 lesions of hepatocellular carcinoma confirmed by pathology were examined by common color ultrasound (US), contrast-enhanced CT, CEUS and DSA pre- and post-interventional treatment respectively. Results The sensitivity,specificity and accuracy of CEUS for focus judgment after interventional therapy were 95.8%, 95.6% and 98. 5% respectively. The sensitivity, specificity and accuracy of US in detecting tumor deactivation and residue were 92.3% ,77.4% and 83.1% respectively. CEUS were highly consistent with the results of enhanced CT/DSA (Kappa = 0.93) and significantly higher than those of US (Kappa = 0.66). Conclusions CEUS is useful to monitor the efficacy and guide treatment after interventional therapy.

OBJECTIVE:To study the effect of Yi medicine Acanthopanax trifo-liatus alcohol extract on the contents of IL-1β, IL-6,IL-10,NO,TNF-αand PGE2 in serum of adjuvant-induced arthritis(AA)rats. METHODS:60 SD rats were randomly divid-ed into normal control group (distilled water),model group (distilled water),positive control group (nimesulide,0.03 g/kg), A. trifo-liatus high-dose,medium-dose and low-dose groups [7,3.5,1.75 g(medicinal material)/kg]. Except for normal control group,other groups were given 0.1 ml Freund’s complete adjuvant on posterior right toe to induce AA model. After modeling, those groups were given relevant medicine intragastrically,once a day. The contents of IL-1β,IL-6,IL-10,TNF-α,NO,PGE2 in rat serum were measured 30 days later. The pathological morphology of the rat ankle was also observed. RESULTS:Compared with normal control group,the contents of IL-1β,IL-6,TNF-α,NO and PGE2 in serum increased in model group while the content of IL-10 decreased,with statistical significance (P<0.01);compared with model group,the contents of IL-1β,IL-6,TNF-α,NO and PGE2 in serum decreased in A. trifo-liatus high-dose groups while the content of IL-10 decreased,with statistical significance (P<0.05). The pathology results showed that part of the slice synoviocytes mild thickening,fibrous tissue mild hyperplasia,in-flammatory cells infiltration at varying degrees,macrophages mild hyperplasia in A. trifo-liatus groups. Those changes were not found in normal control group. CONCLUSIONS:A. trifo-liatus alcohol extract has an obvious anti-inflammatory action to AA mod-el rat,by a mechanism of decreasing the contents of IL-1β,IL-6,TNF-α,NO and PGE2,and increasing the content of IL-10.

Objective To discuss the reasons,surgical procedures and prognosis of multiple-operations for intra-and extrahepatic cholangiolithiasis.Methods The retrospective cohort study was adopted.The clinical data of 85 patients with intra-and extrahepatic cholangiolithiasis who underwent multiple-operations at the Second Affiliated Hospital of Anhui Medical University from January 2006 to January 2015 were collected.Individualized operations were determined according to the distribution of stones and liver functional reserve,including stones removal by incising bile duct and external biliary drainage,Roux-en-Y hepaticojejunostomy and hepatolobectomy or segmental hepatectomy.The treatment followed the principles as complete removal of stones,complete resection of lesions,correction of stenosis and adequate drainage.Bile was extracted during operation for bacilli culture.Patients received the postoperative symptomatic treatments,including anti-inflammation,hemostasis,liver protection,acid inhibition and nutritional support.The observation indicators included reoperation reasons,operation method,operation time,volume of intraoperative blood loss and transfusion,hepatic inflow occlusion,stone clearance rate,postoperative complications and treatments,bacilli culture of bile,results of pathological examination and duration of hospital stay,results of follow-up.The follow-up using outpatient examination and telephone interview was performed to detect postoperative living conditions and results of abdominal ultrasound once every 3 or 6 months in patients without stone residue and once every 1 month in patients with stone residue from postoperative week 6 to December 2015.Measurement data with normal distribution and with skewed distribution were represented as x ± s and M (range),respectively.Results (1) Reasons of reoperation:85 patients had stone residue or recurrence,including 7 combined with stenosis of bilioenteric anastomosis,5 with secondary malignant biliary tumors and 2 with gastrointestinal stromal tumor invading intrahepatic bile duct.(2) Intraoperative status of reoperation:of 85 patients,25 received partial hepatectomy + stones removal by incising common bile duct + choledochoscopy exploration + T-tube drainage,21 received partial hepatectomy + stones removal by incising common bile duct + choledochoscopy exploration + Roux-en-Y hepaticojejunostomy,13 received stones removal by incising common bile duct + choledochoscopy exploration + T-tube drainage,8 received stones removal by incising common bile duct + choledochoscopy exploration + Roux-en-Y hepaticojejunostomy,5 received partial hepatectomy + removal of former bilioenteric anastomosis + choledochoscopy exploration + T-tube drainage,4 received former intestinal Y-loop resection + stones removal by choledochoscopy + Roux-en-Y hepaticojejunostomy,3 received stones removal by incising intrahepatic bile duct + choledochoscopy exploration + T-tube drainage,3 received partial hepatectomy + residual gallbladder resection + stones removal by incising common bile duct + choledochoscopy exploration + Roux-en-Y hepaticojejunostomy,2 received partial hepatectomy + residual gallbladder resection + stones removal by incising common bile duct + choledochoscopy exploration + T-tube drainage and 1 received residual gallbladder resection + removal of former bilioenteric anastomosis + choledochoscopy exploration + Roux-en-Y hepaticojejunostomy.Operation time and volume of intraoperative blood loss of the 85 patients were (259 ± 66) minutes and (180 ± 142) mL,respectively.Seven patients underwent intraoperative blood transfusion and 17 underwent first hepatic hilum occlusion.ALl the 85 patients received intraoperative choledochoscopy exploration.The immediate and final stone clearance rates were 62.4％ (53/85) and 87.0％ (67/77).(3) Postoperative status of reoperations:of 85 patients,45 had postoperative complications.Sixteen patients with incision infection were improved by wound drainage and dressing,anti-infection and supporting treatments without other treatments.Ten patients with pleural effusion were out of hospital after effective anti-infection and nutritional support treatments.Eight patients with biliary fistula were discharged from hospital after abdominal drainage.Six patients with incision infection combined with pleural effusion were discharged from hospital after wound drainage and dressing,anti-infection and nutritional support treatments.Among 5 patients with bile duct bleeding,1 was self-healing,1 underwent reoperation and 3 were improved by conservative treatment.The bacilli culture of bile in 68 patients was positive,and bacteria mainly consisted of Escherichia coli,Enterobacter cloacae,Pseudomonas aeruginosa and Klebsiella pneumoniae.Of 85 patients,78,5 and 2 patients were respectively confirmed with hepatolithiasis,bile duct cell adenocarcinoma combined with stone recurrence and choledocholithiasis combined with interstitialoma by pathological examination.Duration of hospital stay was (21 ±8)days.(4) Results of follow-up:77 patients were followed up for a median time of 32 months (range,6-108 months) with an overall follow-up rate of 90.6％ (77/85).During follow-up,50 patients had good survival,27 had poor survival including 11 with stone residue,9 with stone recurrence and 7 with bile duct canceration,and 7 died of no operation of secondary tumors.Conclusions Stone residue and recurrence are the main reasons for reoperation.The individualized surgical methods are determined according to preoperative stone distribution,with or without atrophy of liver lobe,with or without canceration and condition of liver function,which can increase the stone clerance rate,reduce the stone residue and recurrence rates and avoid reoperation.

Quantitative specific detection of Staphylococcus aureus is based on recombinant lysostaphin and ATP bioluminescence. To produce recombinant lysostaphin, the lysostaphin gene was chemically synthesized and inserted it into prokaryotic expression vector pQE30, and the resulting expression plasmid pQE30-Lys was transformed into E. coli M15 for expressing lysostaphin with IPTG induction. The recombinant protein was purified by Ni(2+)-NTA affinity chromatography. Staphylococcus aureus was detected by the recombinant lysostaphin with ATP bioluminescence, and plate count method. The results of the two methods were compared. The recombinant lysostaphin was successfully expressed, and a method of quantitative specific detection of S. aureus has been established, which showed a significant linear correlation with the colony counting. The detection method developed has good perspective to quantify S. aureus.
Adenosine Triphosphate ; chemistry ; Chromatography, Affinity ; Escherichia coli ; Luminescent Measurements ; methods ; Lysostaphin ; chemistry ; Recombinant Proteins ; chemistry ; Staphylococcus aureus ; isolation & purification

Objective To evaluate the intraoperative complication and postoperative visual acuity effect of phacoemulsification in patients with pseudoexfoliation syndrome. Methods Phacoemulsification and intraocular lens(IOL) implantation was performed on 21 eyes of 19 pseudoexfoliation patients, aged 67-92 years old and (80.24?7.46) years old on average with the history of the disease being (7?4.3) years. Five eyes in Group 1 were complicated with glaucoma. In Group 2, phacoemulsification and IOL implantation was performed on 50 eyes in 42 patients with non-pseudoexfoliation syndrome, 〔aged 61-91 years, mean age (79.52?8.53) years〕. All operations were completed by one surgeon, and followed up for 1 year. Results In both Group 1 and Group 2, the occurrence of posterior capsular tear and vitreous body loss were 9.5% and 2.0%, respectively(P

Objective To observe the therapeutic effect of acupoint injection with nucleotide plus conventional western medicine treatment for moderate and severe chronic obstructive pulmonary disease (COPD).Methods Sixty patients confirmed as moderate and severe COPD were evenly randomized into treatment group and control group.The treatment group was given conventional western medicine treatment and injection with nucleotide on bilateral Dingchuan points,and the control group was given conventional western medicine treatment alone.The treatment lasted for one year.The frequency of COPD acute onset and hospitalization times within one year were recorded.Meanwhile,the severity of dyspnea was evaluated with Medical Research Council (MRC) dyspnea scale scoring.Results (1)The frequency of COPD acute onset and hospitalization times within one year in the treatment group were lowered,and the differences were significant compared with those in the control group (P ＜ 0.05 or P ＜ 0.01).(2) After treatment,MRC dyspnea scale scores in the treatment group were improved (P ＜ 0.05 compared with those before treatment),but the improvement of the scores was insignificant in the control group(P ＞ 0.05).The intergroup comparison showed that the effect on improving MRC dyspnea scale scores in the treatment group was superior to that in the control group (P ＜ 0.05),indicating that the severity of dyspnea was much improved in the treatment group as compared with the control group.Conclusion Acupoint injection with nucleotide is effective on enhancing the therapeutic effect of conventional western medicine treatment for moderate and severe COPD.

Objective To develop a technique of aesthetic repair procedures for the skin and soft tissue defect after injury.Methods Nineteen cases of patients with skin and soft tissue defects after injury were chosen in this study,in which there were 19 wounds involved.Thirty-seven expanders were inserted into the subcutaneous pockets beside the wounds in the right time and were inflated by a fast expansion model (one time every two days). After completion of inflation,the expanded skin flaps were made and transferred to repair the wounds.Results All the 37 expanders were inflated successfully in duration of 46-63 days.Five expansion areas presented complications that were correctly controlled.All of the wounds were covered and healed well after the expanded skin flap transplantation.Twelve patients were followed up for 6 months after operation.The long-term results showed that the color and texture of the flaps matched the recipient sites well without swelling.The aesthetic appearance of the repaired sites looked satisfactory.Conclusions The rapid tissue expansion is a better option for repairs of some skin and soft tissue defects after injury in certain areas.

Objective To investigate the osteogenie and adipogenic difference of bone marrowdeftved mesenchymal stem cells(MSCs)between patients with aplastic anemia(AA)and healthy volunteers and to explore the role of MSCs adipo-differentiation in the pathogenetic mechanism of AA.Methods MSCs were isolated from bone marrow of patients with AA and healthy donors and expanded in vitro.MSCs derived from the AA patients and healthy volunteers were compared with respect to morphology,in vitro proliteration capacity,phenotype,differentiation ability and gene expression during differentiation.Results The MSCs clones in the AA patients were(19.30±4.77)/(5×105 MNCs)7 days after culture,being significantly lower than those in the healthy volunteers,which was(47.72±3.46)/(5×105 MSCs)(P＜0.05).Compared with those the healthy donors,MSCs from the AA patients had similar proliferative capacity in the first 8 passages and then decreased in the following passages.MSCs from different sources had the same Dhenotype.MSCs from the AA patients could differentiate more easily into adipocytes but less easily and slower into osteoblasts than those from the healthy volunteers.Conclusion The increased adipogenic capacity and decreased osteogenic capacity of MSCs in AA patients may contribute to the development and progress of AA.

Objective:To evaluate the effect of different reconstruction images on cardiac dose evaluation by comparing the differences between 4D-CT series and special reconstruction images in evaluating the dose-volume index of cardiac structures.Methods:ECG 4D-CT series were scanned in 15 female patients with left breast cancer. The images of 0-95% 20 phases were reconstructed at an interval of 5% cardiac cycle. The maximum intensity projection (MIP), minimum intensity projection (MinIP), average intensity projection (AIP) and sum intensity projection (SIP) images were obtained by special reconstruction of 4D-CT series. Left ventricle (LV) and left anterior descending coronary artery (LADCA) were delineated on 4D-CT and special reconstruction series, respectively. The intensity-modulated radiation therapy plan of the left breast cancer was designed on the basis of 0% phase, and the cumulative dose (Dose-cumulate) of 20 phases was obtained by deformation registration. The doses of 0% phase were deformed and registered to MIP, MinIP, AIP and SIP images to obtain the corresponding dose distribution. The dose-volume indexes of LV and LADCA based on different CT images were compared.Results:In the evaluation of dose-volume index of LV, compared with 4D-CT series, the change rates of V 5Gy, V 30Gy, V 40Gy, D max and D mean on MIP images were 3.8%, 2.0%, 0.9%, 3.8% and 1.7%, respectively. There was significant difference in V 5 and D max between MIP and 4D-CT (both P<0.05). Compared with 4D-CT, the change rates of D max on MinIP, SIP and AIP images were 2.5%, 3.1% and 1.5%, respectively (all P<0.05). In the evaluation of dose-volume index of LADCA, only the change rate of D max on four special reconstructed images was<5%( P<0.05). Conclusions:In the dose-volume evaluation of LV, the V 30Gy, V 40Gy and D mean obtained by MIP are basically equivalent to those obtained by 4D-CT series, which can be used to substitute 4D-CT series to evaluate the dose-volume. The special reconstruction image of LADCA can not replace 4D-CT series.