Objective To investigate the timing of cholecystectomy in patients with mild biliary acute pancreatitis.Methods 80 patients with mild acute biliary pancreatitis were prospectively collected.According to the principle of random digital table, the patients were randomly divided into the study group and control group,40 cases in each group.The study group underwent early cholecystectomy, while the control group received delayed cholecystectomy.Main indicators included biliary tract complications, perioperative complications, conversion to open surgery, operation time and total hospital stay were observed.Results Compared with the control group, the total hospitalization time of the study group was significantly shorter[(9.39±2.48)d vs.(11.48±3.28)d,t=3.582,P=0.000].There were no statistically significant differences in the rate of conversion to open surgery, operation time, perioperative complications and mortality between the two groups (P>0.05).The incidence rates of acute cholecystitis, biliary colic and total biliary complications of the study group were 0.00%,0.00% and 0.00%, which were significantly lower than those in the control group (15.00%,22.50% and 47.50%) (x2=4.505,8.013 and 22.364,P=0.034,0.005 and 0.000).Conclusion Early laparoscopic cholecystectomy is helpful to reduce the incidence of adverse events in the biliary system.

ObjectiveTo explore the clinical effects of laparoscopic common bile duct exploration and primary suture combined with choledochoscopy (LBEPS) and laparoscopic common bile and duct exploration T-tube drainage(LCHTD) on cholelithiasis.Methods101 cholelithiasis patients were selected and,grouped by the operation methods.56 cases were treated with LCHTD,while 45 cases were treated with LBEPS.The operation time,blood lose,and postoperative digest function recovery time were ampared betreen two groups.ResultsThe operation time betreen the two groups has no significant difference(P ＞ 0.05 ),while the blood lose,postoperative digest function recovery time in LBEPS group were better than the LCHTD group( all P ＜ 0.05 ),the differences were statistically significant.Meanwhile the LBEPS group had a less complication and re-treatment rate than those of the LCHTD group ( P＜0.05).ConclusionCompared with LCHTD,LBEPS had smaller trauma,less operation complications and faster postoperative digest recovery time,worthy of clinical promotion.

Objective:To discuss the curative effect of bifid triple viable capsules in the patients after laparoscopic cholecystecto-my ( LC) . Methods:Totally 100 cases of patients with LC were selected and divided into the observation group and the control group at random. The patients in the two groups underwent LC under the general anesthesia, and were given routine medical treatment after the operation. The patients in the observation group were additionally given bifid triple viable capsules, 630mg per time, twice a day for 1 week as the treatment course. The changes in the occurrence of diarrhea, alteration of intestinal flora and plasma D-lactic acid of the patients and drug adverse reactions in the two groups were observed and compared after the medical treatment. Results:One week after the operation, the occurrence of diarrhea and alteration of intestinal flora of the patients in the observation group were lower than those in the control group (P<0. 05), and compared with those before the treatment, the plasma D-lactic acid levels of the patients in the two groups were declined (P<0. 05 or P<0. 01), and the declining rate in the observation group was much higher than that in the control group (P<0. 05). Totally 3 and 5 cases of drug adverse reactions were appeared in the observation group and the control group, respectively with no significant difference (P>0. 05). Conclusion: The application of bifid triple viable capsules in the pa-tients after LC can effectively reduce the plasma D-lactic acid levels, occurrence of diarrhea and alteration of intestinal flora with prom-ising security, which is good for the postoperative recovery of the patients.

Objective To evaluate the clinical value of medical thoracoscopy in the diagnosis of exudative pleural effusions with unknown etiology.Methods We analyzed retrospectively the clinical data of 180 patients with undiagnosed pleural effusions who underwent medical thoracoscopy and appraised clinical value regarding validity,effectivity and applicability of thoracoscopy.Result In 180 cases of pleural effusion,there were 178 cases of patients with a clear diagnosis,including 87 cases of tuberculous pleurisy,28 cases of malignant tumor,malignant breast bildes mesothelioma in 2,lung cancer in 24,bile duct carcinoma in 1,cercival cancer in 1),pneumonia 58 case fo pyothorax,5 caseso of pyothorax,and 2 cases withou clear diagnosis.No check failure and terminate,the 95％CI was 5 cases of 97.78％-99.98％.Conclusions Medical thoracoscopy is a safe and effective method in the diagnosis of exudative pleural effusions with unknown aetiology.The early application of this method is very helpful for the management of the pleural diseases in suitable patients.

Objective To evaluate ultrasonography combined with magnetic resonance imaging(MRI) diagnosis value for fetal brain deformities.Methods The results of ultrasonography and MRI was analysied in 12 fetuses with deformities,which were compared to postnatal,autopsy or other hospital inspection results and evaluated the accuracy.Results In 8 cases,the diagnoses established by ultrasonography were correct.3 cases were misdiagnosed by ultrasonography,1 case was missed the diagnosis.In 11 cases,the diagnoses established by MRI were correct and 1 case was missed the diagnosis.Conclusion Ultrasonography must be choosed in diagnosising fetal skull brain deformities,MRI was supplement to ultrasonography in complicated pregnancies.The combination of ultrasonography and MRI have an important value in guiding pregnant women to determine whether or not to continue the pregnancy.

AIM: To construct a recombinant lentivirus RNAi vector carrying cytochrome C oxidase gene to obtain the titer of the lentiviral stock for investigation of the expression in the eukaryotic cell and the affection of the COX gene silencing in the eukaryotic cells. METHODS: According to the DNA of the cytochrome C oxidase gene, we designed and synthesized complementary single-strand DNA oligos, annealed the single-stranded oligos to generate a ds oligo, cloned the ds oligo into pENTR/U6 to obtain an entry clone; An LR recombination reaction was performed between the pENTR/U6 entry construct and pLenti6/BLOCK-iT-Dest to generate expression construct, the 293FT cell line was cotransfected with pLenti6/BLOCK-iT expression construct, and the viral packaging mix, viral supernatant was harvested to determine the titer. RESULTS: The DNA sequence of interest clone to the vector was constructd to generate an entry clone and an expression clone successfully, which were proved by sequence determination. A vector producing cell line 293FT was established, and the titer for transfection was obtained. Western blotting analysis demonstrated that COX shRNA expression construction could suppress the expression of MTCOX-I. CONCLUSION: A lentivirus RNAi vector containing cytochrome C oxidase gene was successfully constructed.

Objective To discuss curative effect of Octreotide on early inflammatory intestinal obstruction after abdomi-nal operation and its influence on serum LPS and High sensitive C-reactive protein (hs-CRP) levels. Methods All 64 cases of patients with early inflammatory intestinal obstruction after abdominal operation were selected and divided into observation group (n=32) and control group (n=32) at random. The patients in two groups were given routine medical treatment, such like fasting, instant gastrointestinal decompression, anti-infection, intravenous nutrition,maintenance of water-electrolyte and acid-base balance and etc. The patients in observation group were additionally given 0.1mg Octreotide by hypodermic injection,q8h,while the patients in control group were given the same medical treatment as that in observation group except for Octreotide. The changes of serum LPS and hs-CRP levels of patients in two groups before and 6 days after the medical treatment,and the curative effect and untoward effect was compared as well. Results After 6 days' medical treatment, serum LPS and hs-CRP levels of patients in two groups were obvi-ously declined than before(P<0.05 or P<0.01),and the declining rate of patients in observation group was much higher than that in control group (P<0.05), and the total clinical efficiency in observation group (93.75%) was much higher than that in control group (75.00%)(χ2=4.27,P<0.05). 1 and 3 cases of untoward effect were appeared on patients in control group and observation group during treatment with light symptom, and after comparing the occurrence rates of untoward effect of patients in two groups,no differences were appeared(χ2=0.27,P>0.05). Conclusion Octreotide has reliable curative effect on early inflammatory intestinal obstruction after abdominal operation with high security, whose mechanism of action has close effect on obvious reducing serum LPS and hs-CRP levels of patients.

Objective To analyze the biological characteristics of clinical isolates of coxsackievir-us A6 (CVA6), a pathogen of hand,foot and mouth disease (HFMD), and to provide reference for vaccine development. Methods CVA6 strains were isolated from 21 stool and throat swab specimens of patients with HFMD in Yunnan Province and then identified. Their growth characteristics, plaque morphology and virulence to suckling mice were analyzed. Results Five CVA6 strains, named CVA6-129, CVA6-113, CVA6-57, CVA6-94 and CVA6-162, were isolated and all belonged to D3 subtype. Only the CVA6-129 strain could proliferate rapidly in Vero and KMB17 cells and the proliferation peaked 30 h after inoculation. The infectious titer of the CVA6-129 strain was 7. 54 lgCCID50 (50％ cell culture infective dose) / ml in KMB17 cells. Different morphologies of plaques were formed by the CVA6-129 strain in Vero and KMB17 cells at the same time points, which were small and round with clear edges in Vero cells, and large and irregular with blurry edges in KMB17 cells. Suckling mice were susceptible to CVA6 via intramuscular and intraperito-neal injection. The most common symptoms in infected suckling mice were reduced mobility, hind limb pa-ralysis and quadriplegia. CVA6 infection could result in death in severe cases. Conclusions This study isolated five CVA6 strains from a number of clinical samples of suspected HFMD cases, of which the CVA6-129 strain showed potential as a vaccine candidate.

Triptolide (TP), a major active component of Tripterygium wilfordii Hook.F. (TWHF), is used to treat rheumatoid arthritis (RA). However, it has a narrow therapeutic window due to its serious toxicities. To increase the therapeutic index, a new triptolide-loaded transdermal delivery system, named triptolide-loaded liposome hydrogel patch (TP-LHP), has been developed. In this paper, we used a micro-needle array to deliver TP-LHP to promote transdermal absorption and evaluated this treatment on the pharmacokinetics and pharmacodynamics of TP-LHP in a rat model of collagen-induced arthritis (CIA). The pharmacokinetic results showed that transdermal delivery of microneedle TP-LHP yielded plasma drug levels which fit a one-compartment open model. The relationship equation between plasma concentration and time was C=303.59×(e(-0.064t) -e(-0.287t) ). The results of pharmacodynamic study demonstrated that TP-LHP treatment mitigated the degree of joint swelling and suppressed the expressions of fetal liver kinase-1, fetal liver tyrosine kinase-4 and hypoxia-inducible factor-1α in synovium. Other indicators were also reduced by TP-LHP, including hyperfunction of immune, interleukin-1β and interleukin-6 levels in serum. The therapeutic mechanism of TP-LHP might be regulation of the balance between Th1 and Th2, as well as inhibition of the expression and biological effects of vascular endothelial growth factor.

【Objective】 To explore the correlation between serological screening of human T-lymphotropic virus antibodies (anti HTLV) and Western blot(WB) confirmatory tests among blood donors, so as to explore the infection status of HTLV Ⅰ/Ⅱ in Guangzhou. 【Methods】 The anti HTLV Ⅰ/Ⅱ enzyme-linked immunosorbent assay(ELISA) kit was used to screen voluntary blood donors from Guangzhou Blood Center from July 2016 to August 2022. WB was used to confirm 395 reactive blood samples by ELISA. The correlation between the S/CO values of anti HTLV Ⅰ/Ⅱ ELISA reagents and the confirmatory test was analyzed using ROC curves. 【Results】 The results showed that 25 out of 395 initially screened reactive blood donor samples were confirmed as HTLV positive by WB, while 16 were uncertain. ROC curve analysis showed a correlation between the S/CO values by ELISA and the confirmatory test results: the S/CO value at the highest Youden index was 3.789, which was the optimal threshold. The S/CO value had a certain correlation with the predicted positive rate of confirmatory results (P<0.05): the larger the S/CO value, the higher the predicted positive value. The overall prevalence of HTLV in Guangzhou is relatively low. 【Conclusion】 The prevalence of HTLV among blood donors in Guangzhou is low.Since the false positive rate of HTLV Ⅰ/Ⅱ antibody by ELISA serological screening is high, the confirmatory testing is particularly important.