Objective To compare the effects between percutaneous transhepatic gallbladder drainage (PTGD) plus delayed laparoscopic cholecystectomy (LC) in comparison with emergency LC for elderly patients with acute cholecystitis.Methods From June 2011 to December 2014,the clinical data of elderly patients with acute cholecystitis receiving PTGD plus LC and emergency LC were retrospectively studied.Results In this study 38 patients received PTGD plus LC,59 patients received emergency LC.Patients in PTGD + LC group had longer operative time (67 ± 14) min and higher conversion rate (5 cases)than those in LC group (51 ± 13) min,1 case (t =5.741,x2 =5.057,P ＜ 0.05),but had quicker bowel function recovery time (24.5 ±6.4) h,shorter hospital stay (4.2 ± 1.8) d,less complications (3 cases)than those inLC group (27±5.2) h,(6.2±1.9) d,17 cases (t =2.11,t=5.165,x2 =6.18,P＜0.05).Conclusions Percutaneous transhepatic gallbladder drainage plus delayed cholecystectomy is safe for elderly patients with acute cholecystitis.

Objective To evaluate the effect of ixeris sonchifolia on mitochondrial transcription factor A (mtTFA) expression following myocardial injury induced by exhausting exercise in rats.Methods Forty male Wistar rats,weighing 200-220 g,were randomly divided into 3 groups using a random number table:control group (group C,n =8),exhausting exercise group (group ES,n =16) and ixeris sonchifolia group (group IS,n =16).The model of myocardial injury was established by exhausting swimming.In IS group,the rats were subjected to exhausting swimming after intraperitoneal ixeris sonchifolia 20 g/kg.In ES and IS groups,8 rats were chosen at 6 and 24 h after exhaustion,and blood samples were taken from the inferior vena cava for determination of serum cardiac troponin I (cTnI) concentrations by ELISA.The animals were sacrificed after blood sampling and myocardial specimens were obtained for microscopic examination and for determination of mtTFA expression by Western blot.Results Compared with group C,the concentration of serum cTnI was significantly increased,and the expression of mtTFA in myocardial tissues was down-regulated at 6 and 24 h after exhaustion in ES and IS groups.Compared with group ES,the concentration of serum cTnI was significantly decreased,and the expression of mtTFA in myocardial tissues was up-regulated at 6 and 24 h after exhaustion in group IS.Conclusion Ixeris sonchifolia can reduce exhausting exercise-induced myocardial injury through up-regulating myocardial mtTFA expression in rats.

Objective To explore the management strategy of hepatic trauma. Methods From January 1997 to January 2008, a retrospective study was performed on 112 cases of hepatic trauma. Base on the classification of AAST,non-operative treatment was used in 40 hemodynamic steady patients (grade Ⅰto Ⅱ), hepatic repair was therapeutic method to grade Ⅱ to Ⅳ (48 cases), while hepatectomy or plus selective ligation of hepatic artery were chosen for grade Ⅳ to Ⅴ (13 cases). Peripheral hepatic tamping or plus selective ligation of hepatic artery were effective therapeutic approaches to grade Ⅳ to Ⅴ (11 cases) according to damage control surgery. Results In the operative case.s, 60 cases were cured, 12 died. All non-operative cases were cured. Conclusions Non-operative management is widely becoming one of the most important strategies in the treatment of hepatic trauma with stable hemodynamics. Surgical intervention is still the principal measure of treatment for severe hepatic trauma. According to specific condition, appropriate operative procedures, damage control surgery and prompt management of associated injury will earn a higher success rate.

ObjectiveTo investigate the effects and molecular mechanism of simvastatin in liver fibrosis model of non-alcoholic fatty liver disease (NAFLD) in vivo and hepatic stellate cell in vitro.MethodsFirstly,the rat liver fibrosis model of NAFLD was established by high-fat diet administration and intervened with simvastatin.The expression of endothelial nitric oxide synthase (eNOS),inducible nitric oxide synthase (iNOS) and Collagen Ⅰ at mRNA and protein level were detected by reverse transcription-polymerase chain reaction (RT-PCR) and Western blot.Secondly,quiescent phenotype of LX-2 cell line was induced by promoting adipocyte differentiation medium in vitro,and then the quiescent phenotype of LX-2 cell were treated with transforming growth factor β1(TGF-β1),Nitroso-L-arginine methyl ester (L-NAME) which was NOS inhibitor,simvastatin,TGFβ1 with simvastatin,and L-NAME with simvastatin separately.The changes of eNOS,iNOS,αsmooth muscle actin (α-SMA) and Collagen Ⅰexpressions at mRNA and protein level were determined by RT-PCR and Western blot.ResultsAs modeling time extended,the expressions of eNOS in rat's liver tissue of model group at mRNA and protein level decreased gradually,however the expression of iNOS and Collagen Ⅰ at mRNA and protein level increased gradually,compared with normal control group and the differences were statistically significant (P ＜0.05 and 0.01).By 24weeks,the expressions of eNOS in rat's liver tissue of simvastatin group at mRNA and protein level were increased,the expression of iNOS at mRNA and protein level were decreased and the expression of Collagen Ⅰ at mRNA and protein level were decreased (all P ＜0.05).The expression of eNOS in rat's liver tissue of model group negatively correlated with the expression of Collagen Ⅰ at mRNA and protein level (all P ＜0.01).The expression of iNOS positively correlated with that of Collagen Ⅰ at mRNA and protein level (all P ＜0.01).In LX-2 cell culture,L-NAME inhibited the activation of LX-2,reduced eNOS and iNOS expression and increased α-SMA and CollagenⅠexpression,consistent with the role of TGF-β1.Simvastatin could directly increase the eNOS expression both in quiescent and activated LX-2 cells,decrease iNOS expression,maintain quiescent phenotype and inhibit its activation.ConclusionsSimvastatin ameliorated the genesis and progression of liver fibrosis by increasing eNOS expression in LX-2 cells and reducing iNOS,α-SMA and Collagen Ⅰ expression.

Objective To evaluate the life quality in patients who underwent laparoscopic appendectomy resection and open appendectomy resection for choledocholithiasis.Methods A survey was made on 30 patients who underwent laparoscopic appendectomy resection and 30 patients who underwent open appendectomy resection.The quality of life was measured with the Gastrointestinal quality of life index (GIQLI) preoperation and 2,5,10,16 weeks after the operation.Results There were no significant difference in the GIQLI scores.The GIQLI scores were 121,115,126,131,and 133 respectively in preoperation and 2,5,10,and 16 weeks after laparoscopic appendectomy resection.The scores of GIQLI were 122,109,120,127,and 129 respectively in preoperation and 2,5,10,and 16 weeks after open appendectomy resection.Conclusion The GIQLI scores from laparoscopic appendectomy resection group is better than that from the open appendectomy resection group.

AIM:To investigate the expression and function of store-operated calcium channels ( SOCC) in human circulating fibrocytes.METHODS:Peripheral blood mononuclear cells ( PBMCs) were isolated and cultured in ser-um-free media.After 7 d, the PBMCs differentiated into fibrocytes.RT-PCR and real-time PCR were performed to deter-mine the mRNA expression of ORAI1-3 and STIM1-2 in the fibrocytes.SOCC inhibitor SKF-96365 was used to elucidate the role of SOCC in the differentiation of fibrocytes.RESULTS:The results of real-time PCR showed that the mRNA ex-pression of ORAI1-3 and STIM1-2 was positive in cultured fibrocytes.SKF-96365 (10μmol/L) significantly inhibited the differentiation of fibrocytes.CONCLUSION:SOCC-related proteins ORAI1-3 and STIM1-2 are abundantly expressed in the fibrocytes, and may play an important role in the differentiation of these cells.

Objective To develop a Jingcen DY?1 type spraying tanker for Oncomelania hupensis snail control and evaluate its effect of field application as well as the cost. Methods The currently available tractor was used as a vector,and the mechan?ical and electrical equipments and containers were integrated with shafts,pipelines and electric lines to produce a spraying tank?er for snail control,with the functions of carrying people and molluscicides,generating electric power and getting water,mixing stocking solutions,adjusting molluscicide solutions evenly,and spraying drugs. The volume of the molluscicide solution,flow rate of water injection,and the flow rate,range and advance speed of the spray gun were tested,and the solution concentrations of molluscicide in the tanker and at the muzzle of the spray gun at different time were detected. Meanwhile,the molluscicidal ef?fect and cost of the spraying tanker were analyzed by the field test. Results The volume of the liquid storage pot of the Jingcen DY?1 type spraying tanker was 1 800 L,the flow rate of water injection was 400 L/min,the flow rate and the spray range of the standard spray gun were 110-200 L/min and 19.70-23.50 m,respectively,the efficiency of drug spraying of the spraying tanker was 6 000 m2/h,and the ratio of spray width(m)to march speed(m/min)was 1∶200. When 5 min post mother liquid recirculat?ing ,the average concentration of the molluscicide at the upper? ,middle? and lower?layers of the liquid storage pot was (1 030.39 ± 43.00)mg/L,with a variation coefficient of 4.17%. The average concentration of the molluscicide in the spraying process(spraying for 2,4,6,8,9 min)was(953.00 ± 68.87)mg/L,with a variation coefficient of 7.22%. The concentration of the residual drug in the liquid storage pot post spraying was 1 000.43 mg/L,which reached the effect concentration for snail con?trol. After spraying for 7 days in the field,the average density of living snails reduced by 88.20% as compared to that before spraying,and the adjusted mortality of snails was 87.65%. The unit cost of Jingcen DY?1 spraying tanker was 0.086 7 Yuan/m2, which reduced by 58.20% as compared to that of the conventional spraying tanker. Conclusions Jingcen DY?1 type spraying tanker for snail control which integrates various equipments together can effectively control the concentration and dose of the mol?luscicide,and the machine is labor?saving,efficient,economic and well adapted,and is worthy to be widely applied.

Objective To evaluate the effects of laparoscopic splenectomy and esophagogastric devascularization(LSPD) vs.open procedure(OSPD) on stress and immune function in patients with portal hypertension due to cirrhosis.Methods From June 2015 to June 2017 a total of 66 patients underwent LSPD or OSPD procedures.Results Plasma cortisol concentration in the LSPD group was lower than that in the OSPD group (Fgroup =18.85,P =0.020).Cortisol concentration in the two groups increased firstly and then decreased with time extension (Ftime =532.08,P =0.000).The level of CD3 +,CD4 +,CD4 +/CD8 + in LSPD group was higher than that in OSPD group,and the level of CD8 + was lower than that in OSPD group (Fgroup =3.55,21.47,154.84,64.29,P ＜ 0.05),the levels of CD3 +,CD4 + and CD4 +/CD8 + in the two groups first decreased and then increased with the extension of time,and the levels of CD8 + increased firstly and then decreased (Ftime =199.22,298.48,864.33,510.23,P ＜ 0.05),the increase range of CD3 +,CD4 +,and CD4 +/CD8 + in LSED group was higher than that in OSPD group (Finteraction =19.27,18.21,79.55,35.21,P ＜ 0.05);there was no statistical significance in the complications such as:rebleeding,thrombosis and splenic fever in the two groups (x2 =0.05,0.67,0.07,0.16,P=0.829,0.413,0.789,0.693).But the postoperative chest/cavity effusion and fever (＞ 38.0 ℃,and ＞ 3 days) is OSPD group is higher than in the LSPD group(x2 =5.49,6.68,P =0.019,0.010).Conclusion LSPD effectively reduces postoperative stress,protects immune function,decreases postoperative pleural and abdominal effusion and fever.

Objective To analyze the four types of laparoscopic operation in the treatment of upper ureteral calculi with diameter more than 1 cm.Methods From July 2012 to September 2015,150 cases of patients with upper ureteral calculi diameter more than 1cm were analyzed.According to the different surgical methods,patients were divided into four groups.There are 39 cases in URL group,32 cases in RLU group,36 cases in PCNL group and 43 cases in FURL group.The diameter of calculi in RLU group and PCNL group was much larger than those in URL group and FURL group(P ＜ 0.05).There was no difference in terms of sex,age,stone location,stone composition,and the ESWL treatment failure rate among the four groups(P ＞ 0.05).The operation time,postoperative hospitalization days,postoperative bowel recovery,postoperative ESWL rate,complications and postoperative calculi clearance rate were compared among the four groups.Results In RLU,PCNL,URL and FURL group,the operation time were (38.5 ± 13.0) min,(83.4 ± 6.1) min,(69.6 ± 13.0) min and (50.1 ± 6.3) min,respectively,and there were significant differences among the four groups (RLU group ＞ PCNL group ＞ FURL group ＞ URL group,P ＜ 0.05).Postoperative hospitalization days of RLU group,PCNL group,URL group and FURL group were (6.5 ± 0.6) d,(9.5 ± 0.7) d,(8.4 ± 0.7) d and (7.7 ± 0.7) d respectively,and there were significant differences in terms of hospitalization days (RLU group ＞ PCNL group ＞ FURL group ＞ URL group,P ＜ 0.05).The calculi clearance rates of RLU group,PCNL group,URL group and FURL group were 79.5％,100.0％,94.4％ and 88.4％ at 3 days after operation,and 82.1％,100.0％,97.2％ and 95.3％ at 1 month after operation.The postoperative calculi clearance rates at 3 days and 1 month in RLU group were higher than those in URL group(P ＜ 0.05),but there was no difference between PCNL group and RLU group (P ＞ 0.05).Postoperative ESWL rates of RLU group,PCNL group,URL group and FURL group were 12.8％,0,2.8％ and 4.7％,and there was no difference among the four groups.The decreased value of RBC in PCNL group and FURL group was higher than that of URL group and RLU group(P ＜ 0.05).One patient in PCNL group suffered from massive hemorrhage,and required blood transfusion.The complication rates in the four groups were 23.1％ (9/39),9.4％ (3/32),13.9％ (5/36) and 9.3％ (4/43) respectively,and there was no difference of complication among them(P ＞ 0.05).Conclusions Four types of endoscopes have the advantages of safety,small wound and quick recovery for ureter calculi larger than 1 cm.The URL operation is simple,with less injury,quick recovery,but low stone clearance rate.FURL requires high level of skill for the operator,and is an effective treatment for ureteric,renal pelvic,and kidney stones which are smaller than 2 cm.FURL avoids the extra ESWL treatment,but costs much.PCNL has more injury and requires high-level surgical skills with a high stone clearance rate.RLU has a high stone clearance rate but is much difficult,which can be used as a remedy for the failure of FURL or PCNL.

Objective:To analyze and predict the transmission risk of visceral leishmaniasis in Gansu Province based on an ecological niche model, providing a basis for the development of precise prevention and control measures and epidemic surveillance.Methods:The information of reported cases of visceral leishmaniasis in Gansu Province from 2015 to 2021 were collected from the National Infectious Disease Reporting Information Management System, and the longitude and latitude coordinates of the distribution points of cases and the data of 19 climate variables, 5 geographical variables and 2 socio-economic variables within the region were obtained. Based on an ecological niche model, a model for predicting the transmission risk of visceral leishmaniasis was constructed using the maximum entropy algorithm (MaxEnt), and its performance was evaluated by the area under the receiver operating characteristic curve (AUC). Then the importance of each environmental variable of the model was evaluated, and the distribution area of visceral leishmaniasis transmission risk in Gansu Province was predicted.Results:A total of 368 cases of visceral leishmaniasis were reported in Gansu Province from 2015 to 2021, of which 89.13% (328/368) were from Longnan City and Gannan Tibetan Autonomous Prefecture (Gannan Prefecture). The number of cases peaked in 2017 (79 cases, 21.47%). The model had high prediction accuracy (AUC = 0.985). The results of model analysis showed that the important climate variable affecting the distribution of visceral leishmaniasis was the average temperature in the coldest quarter (contribution value of 3.1), the geographical variables were land use type (contribution value of 52.6) and vegetation cover type (contribution value of 8.5), and the socio-economic variable was population size (contribution value of 14.3). The distribution results of transmission risk showed that high, medium and low risk areas exhibited a gradual transition from the southern part to the northwest part of Gansu Province. The high risk areas were mainly located in the central and southern parts of Longnan City and the southern part of Gannan Prefecture, accounting for 0.18% of the total area of the province. Medium and low risk areas accounted for 0.48% and 2.47% of the total area of the province, respectively; and areas with no risk accounted for 96.87%.Conclusions:The ecological niche model predicts that the spread of visceral leishmaniasis in Gansu Province is characterized by point like dispersion and local high aggregation distribution. It is necessary to strengthen monitoring and prevention and control of high-risk areas such as Longnan City and Gannan Prefecture.