Objective To study the effect of minimally invasive surgery for treatment of cholecystolithiasis together with common bile duet stones.Methods 245 patients suffered from common bile duct stones were admitted and received the therapeutical procedures.All patients were randomly divided into two groups.138 patients in the treatment group treated with minimally invasive surgery;107 patients in the control group treated with the traditional way of laparotomy.Results Compared with the control group,the treatment group showed high cure rate of 97.83%(P＞0.05),low complication rate of 5.19%,short hospital stays of(7.5±2.1)d,less cost of(8 134±1 676)CNY (x2=18.34,t=8.75,6.93,all P＜0.01).Conclusion Minimally invasive surgery had more advantages and wide application for both doctors and patients.

Background and purpose:Lung cancer is the leading cause of morbidity and cancer-related mortality worldwide. A variety of driver genes were detected in lung cancer. Studies have shown that different gene mutations of lung cancer were found between different races. Most of Uyghurs live in Xinjiang, accompanied by a high morbidity of lung cancer. This study aimed to investigate the expression of driver genes in Uyghur patients with lung cancer in Xinjiang, China.Methods:This study collected the tissue specimens of 43 Uyghur patients with lung cancer, with a very different method to detectEGFR gene expression. real-time fluorescent quantitative polymerase chain reaction(RTFQ-PCR) was used to detectK-ras,ALK,ROS1, mutatedBRAF andPIK3CA gene expression. Analysis of the correlation between lung cancer gene mutations in Uyghur and clinical features of patients with lung cancer were performed.Results:Among 43 cases of specimens,EGFR mutation rate was 11.63%, while theEGFR gene mutation rates in adenocarcinoma and squamous cell carcinoma were 26.67% and 4.76%, respectively.EGFR gene mutation was not detected in large cell carcinoma, adenosquamous carcinoma and small cell lung cancer.EGFR gene mutation rate in patients with adenocarcinoma (26.67%) was signiifcantly higher than that in other types of lung cancer (3.57%). The difference was statistically signiifcant (P=0.024). There were 6 patients withK-ras12/13 heterozygous mutation, and the mutation detection rate was 16.28% (6/43). There were 2 patients withPIK3CA heterozygous mutation, and the mu-tation detection rate was 4.65% (2/43).EGFR andK-ras mutations occurred simultaneously in 1 case. No relationship was found betweenEGFR mutations and age, gender, smoking status, TNM staging, ECOG score among Uyghur lung cancer patients. This study did not ifnd mutation inALK,ROS1 fusion gene andBRAF gene among the 43 specimens. Conclusion:Compared with Asian populations, Xinjiang Uyghur patients with lung cancer have a lower rate ofEGFR mutations and a higher rate ofK-ras mutations, which is similar to the characteristics of European Caucasians.

Objective To analyze the image characteristics of chest schwannoma in coincidence 18FFDG SPECT studies,and to evaluate its prospective diagnostic function on chest schwannoma.Methods Four cases confirmed as schwannoma by surgery and pathology were enrolled in this retrospective study.Enhanced CT and coincidence 18F-FDG SPECT studies were performed before surgery.Imaging characteristics for the diagnosis of chest schwannoma were summarized.Results Tumors were totally removed by surgery.The histological diagnosis of schwannoma was confirmed by pathological,HE and immunohistological staining examination (positivity for the S-100 protein and vimentin),including 1 case of malignant schwannoma and 3 cases of benign.Four cases all showed high uptake of 18F-FDG.The uptake in malignant schwannoma was much higher than that in benign schwannoma.Benign schwannomas were noninvasive masses and mainly showed compression symptoms,with obvious lobulation and distinct borders.Malignant schwannoma was invasive masses.Conclusions 18 F-FDG coincidence SPECT is of limited value as a prospective diagnostic imaging technique for the identification of benign schwannoma from malignant schwannoma.But it could play an important role in the staging,restaging,and post-therapy follow-up of schwannoma.

Objective To evaluate the diagnostic value of dobutamine?stressed cardiac morphing ( CM) MPI ( CMMPI) for coronary artery disease ( CAD) in middle?aged patients. Methods A total of 97 middle?aged patients (52 males, 45 females, age 40-65 (52.98±7.74) years) from March 2011 to Febru?ary 2015 with chest distress, cardiopalmus and chest pain symptoms ( suspected CAD) were retrospectively studied. Informed consents were signed by patients before examination. All patients underwent one?day dobu?tamine?stressed/rest CMMPI and CAG within one month. The diagnostic value of CMMPI was assessed and compared with CAG. Results CMMPI revealed 42 abnormal cases and 9 normal cases in 51 cases with cor?onary artery stenosis by CAG. CMMPI found 11 abnormal cases and 35 normal cases in 46 cases with normal coronary artery by CAG. In comparison with CAG, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of CMMPI were 82.35%(42/51), 76.09%(35/46), 79.38%(77/97), 79.25%(42/53)and 79.55%(35/44) respectively. The side effect was slight and transient with an inci?dence of 82.47%(80/97). Conclusion The dobutamine?stressed CMMPI has an important value for the diagnosis of CAD and the assessment of myocardial damage in middle?aged patients.

Objective To investigate the change in the proportion of NK or NKT cells in the peripheral blood of patients with HBV associated acute-on-chronic liver failure(HBV-ACLF) .Methods the frequency of NK or NKT cells in the blood of 25 healthy controls(HC) ,40 patients with chronic hepatitis B(CHB) and 26 HBV-ACLF patients was detected by flow cytometry .The differ-ences in the proportion of NK and NKT cells among the three groups were analyzed by SPSS software and the correlation was ana-lyzed between the frequence of NK or NKT cells and HBV markers and the level of liver function .Results the proportion of NK cells in HC ,CHB ,or HBV-ACLF group was (15 .0 ± 6 .0)% ,(11 .4 ± 6 .8)% ,(8 .9 ± 6 .7)% respectively ,and the difference be-tween the HBV-ACLF group and HC or CHB group was statistically significant (P<0 .05) .And for the NKT cells ,its frequence in the HC ,CHB ,or HBV-ACLF group was (1 .9 ± 1 .3)% ,(4 .3 ± 3 .7)% ,(5 .4 ± 8 .6)% respectively ,and there was significant difference between the HBV-ACLF group and HC group(P<0 .05) .Conclusion The proportion of NK cells in HBV-ACLF has a significant decline ,while NKT cells has a significant increases .it indicate that NK or NKT cells might be play a certain role in the HBV-ACLF development process .

Objective To explore the prevalence and influencing factors of coronary atherosclerotic heart disease (CHD) in rheumatoid arthritis (RA) patients during past 10 years. Methods A total of 5 426 RA patients were selected from Jan. 1, 2009 to Mar. 20, 2019 in the Tianjin First Central Hospital, and 1 483 osteoarthritis (OA) patients were selected as controls. Basic information, laboratory indicators, prevalence of CHD and related complications, and drug use of RA and OA patients were collected and compared. The influencing factors of CHD prevalence in RA patients were analyzed by logistic regression. Results There was no significant difference in the prevalence of CHD between male and female RA patients (32.1%, 321/1 000 vs 32.3%, 323/1 000; χ2＝0.02, P＝0.90). The prevalence rates of CHD, hyperlipidemia and hypertension in RA patients were significantly increased in the past 10 years (χ2＝115.67, 129.41, 193.81, all P＜0.01), while the prevalence of diabetes mellitus was significantly decreased after 2014 (χ2＝29.99, P＜0.01). After propensity score matching of 1∶1 by age and gender, there was no significant difference in CHD prevalence between the RA and OA patients (P＝0.74). The levels of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), interleukin 2 receptor (IL-2R), interleukin 6 (IL-6), high density lipoprotein-cholesterol (HDL-C), rheumatoid factor (RF), anti-cyclic citrullinated peptide (ACCP), D-dimer, fibrinogen (FiB) and creatine kinase-myocardial band (CK-MB), and positive rate of anti-keratin antibody (AKA) were significantly higher in the RA patients than those in the OA patients, while the levels of creatine kinase (CK) and blood glucose were significantly lower than those in the OA patients (all P＜0.05). The levels of ESR, CRP, total cholesterol, low density lipoprotein-cholesterol (LDL-C), triglyceride, immunoglobulin G-rheumatoid factor (IgG-RF), ACCP, FiB, blood glucose and uric acid, and the positive rate of AKA were all significantly higher in the RA patients with CHD than those in the RA patients without CHD, while the levels of HDL-C, immunoglobulin G (IgG), immunoglobulin M (IgM) and 25-hydroxyvitamin D were significantly lower than those in the RA patients without CHD (all P＜0.05). Logistic regression analysis showed that the prevalence of CHD was negatively correlated with the levels of total cholesterol, ACCP, IgG and 25-hydroxyvitamin D, but positively correlated with the levels of IgG-RF and uric acid in PA patients (all P＜0.05). Conclusion In clinical treatment, we should pay more attention to the risk factors of CHD in RA patients so as to select more targeted and effective RA treatment, reducing the risk of CHD and improving the quality of life of patients.

Objective To estimate the relative risk for lung cancer associated with genetic polymorphism of T6235C mutation in 3' non-coding region (Msp Ⅰ) of cytochrome P450 1A1 (CYP1A1) and glntathione S-transferase M1 (GSTM1) in the Mongolian population in Inner Mongolian Region of China. Methods Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and multiplex PCR methods were used to analyze blood samples obtained from 263 case subjects and 263 control subjects to determine their genotypes for CYP1A1 and GSTM1.Control subjects were matched with case subjects by ethnic background, age and gender. Results The frequencies of the variant CYP1A1 genotypes (CYP1A1C) and GSTM1-null in lung cancer groups were higher than those in control groups (38.4% vs. 28. 5% and 57.8% vs. 48.0%). The individuals who corried with CYP1A1C genotype had a significantly higher risk of lung cancer (OR=1.56, 95% CI=1.08 to 2.25, P=0.016) than those who carried with non-variation CYP1A1 genotype. The ones who carried with GSTM1-null genotype also had a significantly higher risk of lung cancer (OR=1.49, 95% CI=1.06 to 2.10, P=0.023) than these who carried with GSTM1-present genotype.When combination of polymorphisms of CYP1A1 and GSTM1 genotypes was analyzed, the risk of lung cancer for combination of CYP1A1C and GSTM1-null genotypes was increased significantly (OR=2.084, 95e CI=1.27 to 3.42, P=0.003). Susceptibility to lung cancer was related to smoking (OR=2.10, 95% CI=1.48 to 2.98, P=0.000). Considering smoking status, the risk of lung cancer for combination of smoking and CYP1A1C genotype was remarkably increased (OR=2.76, 950/0 CI=1.74 to 4. 37, P=0.000). It was the same case with combination of smoking and GSTM1-null genotype (OR=4. 38, 95% CI=2.35 to 8.15, P=0.000). Conclusion The polymorphisms of CYP1A1C genotype and GSTM1-null are the risk factors of lung cancer in the Mongolian population in Inner Mongolia Region of China. Smoking is also related to susceptibility to lung cancer. There may be a synergetic interaction between CYP1A1C and GSTM1-null in the elevated susceptibility of lung cancer. Smoking may have a synergetic interaction with CYP1A1C and GSTM1-null in the elevated susceptibility of lung cancer.

Objective To explore the outcome of monoclonal gammopathy of undetermined significance (MGUS). Methods The data from 14 MGUS patients in our hospital including clinical features, outcome and change of M protein concentration were analyzed retrospectively. Results The MGUS didn't have the clinical manifestations of multiple myeloma (MM), the time of outcome from MGUS to MM was about 4-20 years (mean time, 10 years). The most types of MM were IgA and IgG, 6 cases were IgA type, 6 cases were IgG type and 2 cases were light chain type. The concentration of immune globulin in general showed an upward trend year by year. A few showed fold lines ascend. Conclusions The elevated monoclonal immunoglobulin may develop into MM after many years. We must follow up frequently to avoid error diagnosis and missed diagnosis.

OBJECTIVE: To explore the effects of Tanreqing injection, a traditional Chinese herbal preparation for clearing heat and resolving phlegm, in treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) by improving airway inflammation and airway mucus hypersecretion. METHODS: A randomized controlled trial (RCT) was designed. Ninety AECOPD patients were randomly divided into Tanreqing group, ambroxol hydrochloride group and control group. The patients in the three groups were all treated with conventional therapy. Furthermore, intravenous drip infusion of 20 ml Tanreqing injection (once daily) and 15 mg ambroxol hydrochloride injection (twice daily) were administered respectively to the patients in the Tanreqing group and ambroxol hydrochloride group. They were all treated for 10 days. Symptom score of traditional Chinese medicine (TCM), plasma concentrations of interleukin-8 (IL-8), IL-10 and neutrophil elastase (NE) were detected before and after treatment. RESULTS: Cough, sputum amount, expectoration, dyspnea, fever, coated tongue and pulse tracings were improved obviously in Tanreqing group (P<0.05), and the effects of Tanreqing on improving cough, sputum amount and expectoration were better than the conventional therapy (P<0.05), while there was no significant difference between Tanreqing group and ambroxol hydrochloride group (P>0.05). Compared with ambroxol hydrochloride group and the control group, the coated tongue was improved obviously in Tanreqing group (P>0.05). After treatment, plasma concentrations of IL-8, IL-10 and NE were decreased in Tanreqing group and ambroxol hydrochloride group (P<0.05), and the levels of IL-8 and IL-10 in the control group were decreased (P<0.05). The change of IL-8 level before and after treatment in Tanreqing group was greater than that in ambroxol hydrochloride group and the control group. The changes of IL-10 and NE levels in ambroxol hydrochloride group were greater than those in Tanreqing group and the control group, while there was no significant difference in the changes of serum levels of IL-8, IL-10 and NE among the three groups (P>0.05). Total response rates in Tanreqing group and ambroxol hydrochloride group were higher than that in the control group (P<0.05), while there was no significant difference in total response rate between Tanreqing group and ambroxol hydrochloride group (P>0.05). There was no significant difference in total response rate among the three groups (P>0.05). CONCLUSION: Tanreqing injection can improve TCM signs and symptoms in AECOPD patients, and the mechanism maybe due to the decrease of serum levels of IL-8 and NE and improvement of IL-10 level.