Objective To evaluate the safety and feasibility of step-by-step balloon dilatation combined with contineous biliary drainage in treating benign biliary-enteric anastomosis stricture.Methods The clinical data and imaging materials of 49 patients with benign biliary-enteric anastomosis stricture,who were admitted to authors' hospital during the period from January 2008 to March 2014 to receive treatment,were retrospectively analyzed.Before treatment,the diagnosis of benign biliary-enteric anastomosis stricture was confirmed in all patients by color Doppler ultrasound,MRI and/or contrast-enhanced CT scan,endoscopic or DSA-guided anastomosis biopsy.Among the 49 patients,23 patients (study group) were treated with percutaneous transhepatic step-by-step balloon dilatation (the diameter of used balloon was 8 mm initially,then 10 mm balloon was used in the second month,and 12 mm balloon was used in the third month) together with contineous biliary drainage (lasting for 6 months);26 patients (control group) were treated with single percutaneous transhepatic balloon dilatation (balloon diameter of 6 mm or 8 mm) plus biliary drainage (lasting for 6 months).The improvement of clinical symptoms,the incidence of postoperative complications,and the anastomotic patency rate were compared between the two groups.Results Technical success was obtained in all patients.No procedure-related complications,such as biliary tract hemorrhage and perforation,occurred.One week after the treatment,the difference in bilirubin level between the two groups was not statistically significant (P＞0.05).Although the difference in 3-month anastomotic patency rate between the two groups was not statistically significant,the 6-month,12-month and 24-month anastomotic patency rates of the study group were significantly higher than those of the control group (P＜0.05).Three patients in the study group developed recurrent jaundice at 11.2,14.3 and 17.6 months after treatment respectively;MRI and contrast-enhanced CT scan confirmed the diagnosis of anastomotic stricture recurrence,and balloon dilatation together with drainage tube placement had to be carried out again.In the control group,16 patients developed recurrent jaundice within 3.1-17.1 months after balloon dilatation management,among them one patient died of disseminated intravascular coagulation and the remaining 15 patients received balloon dilatation together with drainage tube placement again.Conclusion For benign biliary-enteric anastomosis strictures,step-by-step balloon dilatation combined with persistent biliary drainage is a safe and effective minimally-invasive treatment.

Aim To investigate the effect of genistein on apoptosis in triple-negative breast cancer MDA-MB-231 cells and the underlying mechanisms.Methods MTT assay was used to detect the inhibition rate on breast cancer MDA-MB-231 cells of genistein.Hoechst 33258 staining was applied to determine the effect of genistein on morphology of MDA-MB-231 cells.qRT-PCR was employed to detect the mRNA expression of EGFR in MDA-MB-231 cells.Western blot was utilized to determine the expression of Bcl-2, Bax, caspase-3, EGFR, Akt, and p-Akt.The expressions of Akt and p-Akt proteins in breast cancer MDA-MB-231 cells were detected after treated with Akt activator insulin, genistein and in combination with insulin.Results Genistein inhibited the viability of breast cancer MDA-MB-231 cells in a time-dependent manner.The results of Hoechst 33258 staining showed a typical apoptotic morphological changes of MDA-MB-231 cells after treatment of genistein for 36 h.qRT-PCR showed that the mRNA expression of EGFR in MDA-MB-231 cells decreased after treated with genistein for 36 h.The expression levels of Bcl-2, EGFR, Akt, p-Akt, ERK, p-ERK were significantly down-regulated(P<0.01) compared with control.While, the expression of Bax, caspase-3 was significantly up-regulated (P<0.01).It was observed that p-Akt was significantly activated after the treatment of Akt activator insulin (P<0.01), however, significantly down-regulated (P<0.01) when treated with genistein.Conclusion Genistein could inhibit the growth of triple-negative breast cancer MDA-MB-231 cells and induce apoptosis, which probably involves regulating EGFR/PI3K/Akt signaling pathway.

Objective To study the operation method of modified Lichtenstein herniorrhaphy in patients with femoral hernia.Methods The clinical data of 37 femoral hernia patients having underwent the modified Lichtenstein herniorrhaphy from January 2010 to January 2017 were retrospectively analyzed. Results The average operation time was 50 min, and average hospitalization day was 5.6 d. During the follow-up period,the postoperative pain and foreign body sensation were mild,no recurrence of femoral hernia was found,and no complications such as postoperative infection,testicular atrophy and painful ejaculation occurred. Conclusions Modified Lichtenstein herniorrhaphy for femoral hernia is effective.

Objective To observe the difference of anoreetal dynamics between Milligan-Morgan hemorrhoidectomy plus internal sphinctemtomy and simple Milligan-Morgan bemorrhoidectomy in the treatment of annulus mixed hemorrhoids.Method Measured the anal resting pressure,maximal anal contractive pressure,rectal sensation thresholds,maximal rectal tolerable dose and maximal rectal compliance 1 day before and 3 months after Milligan-Morgan hemorrhoidectomy plus internal sphincterotomy (therapy group,50 cases)and simple Milligan-Morgan bemorrhoidectomy(control group,52 cases)by anorectal manometric device made in Sweden.Results The anal resting pressures of therapy group and eontrol group reduced signifieanfly 3 months after operation compared with that 1 day before operation(P＜ 0.01 or ＜ 0.05),but there was significant difference between the two groups in 3 months after operation(P＜0.05).The maximal anal contractive pressure,reetal sensation thresholds,maximal rectal tolerable dose and maximal rectal compliance were no significant difference between the two groups in 3 months after operation (P ＞0.05).Conclusion Anal sphineterotomy can change the high anal pressure significantly in the treatment of annulus hemorrhoids without copracrasia,it is a proper operation method.

Objective:To conduct a visual analysis of the related literature on hydrogel materials that promote wound healing, and to explore the research status, hotspots and future development trends in this field, in order to provide a reference for future research and development.Methods:The Web of Science Core Collection database was searched to obtain relevant literature on the promotion of wound healing by hydrogel materials from January 1, 2010 to October 1, 2023. Bibliometrics method were used to integrate the year, author, publication, number of national and institutional publications, cumulative citation and co-citation frequency and key words of the included literatures. VOSviewer 1.6.19 and CiteSpace 6.2.R4 were used for the literature’s visualization analysis and mapping.Results:A total of 3 863 literatures were included, involving 18 921 authors, and the number of publications in this field showed a significant increasing trend from 2010 to 2023. Zhao YJ, the researcher with the most publications, published 38 articles. There were 557 journals that had collected relevant literatures, and the International Journal of Biological Macromolecules had published the most literature, with a total of 286 publications. A total of 92 countries and 3 307 institutions had conducted research in related fields, with China publishing the most papers. Research institutions mainly come from China and the United States. The literature with the highest cumulative citation frequency was "Alginate: properties and biomedical applications", which reached 4 737 times. The highest cumulative co-citation frequency was the literature published by Qu J, et al in 2018, with a total of 404 times. Keyword co-occurrence, clustering, time line and emergence analysis showed that the early research in this field mainly focused on the process of wound healing and the cellular mechanism at the molecular level, and later gradually focused on the development of precise controlled release function of nanoparticles and antibacterial compounds in hydrogel scaffolds. Conclusion:Research on the application of hydrogel materials in wound healing is attracting increasing international attention. According to the changes of hot words, the future research trend in this field is to develop intelligent hydrogels with regulatory capabilities, wound monitoring, controlled drug delivery and diversified functions.

Objective:To conduct a visual analysis of the related literature on hydrogel materials that promote wound healing, and to explore the research status, hotspots and future development trends in this field, in order to provide a reference for future research and development.Methods:The Web of Science Core Collection database was searched to obtain relevant literature on the promotion of wound healing by hydrogel materials from January 1, 2010 to October 1, 2023. Bibliometrics method were used to integrate the year, author, publication, number of national and institutional publications, cumulative citation and co-citation frequency and key words of the included literatures. VOSviewer 1.6.19 and CiteSpace 6.2.R4 were used for the literature’s visualization analysis and mapping.Results:A total of 3 863 literatures were included, involving 18 921 authors, and the number of publications in this field showed a significant increasing trend from 2010 to 2023. Zhao YJ, the researcher with the most publications, published 38 articles. There were 557 journals that had collected relevant literatures, and the International Journal of Biological Macromolecules had published the most literature, with a total of 286 publications. A total of 92 countries and 3 307 institutions had conducted research in related fields, with China publishing the most papers. Research institutions mainly come from China and the United States. The literature with the highest cumulative citation frequency was "Alginate: properties and biomedical applications", which reached 4 737 times. The highest cumulative co-citation frequency was the literature published by Qu J, et al in 2018, with a total of 404 times. Keyword co-occurrence, clustering, time line and emergence analysis showed that the early research in this field mainly focused on the process of wound healing and the cellular mechanism at the molecular level, and later gradually focused on the development of precise controlled release function of nanoparticles and antibacterial compounds in hydrogel scaffolds. Conclusion:Research on the application of hydrogel materials in wound healing is attracting increasing international attention. According to the changes of hot words, the future research trend in this field is to develop intelligent hydrogels with regulatory capabilities, wound monitoring, controlled drug delivery and diversified functions.

Objective To determine the diagnostic value of endoscopic ultrasound-guided fine needle aspiration ( EUS-FNA ) for gastrointestinal lesions with inconclusive endoscopic biopsies. Methods A retrospective analysis was performed in 65 patients who were found to have gastrointestinal lesions with inconclusive endoscopic biopsies and underwent EUS-FNA in Drum Tower Hospital. Diagnostic value of EUS-FNA was determined by comparing with surgical histopathology and follow-up results. Results This study included 41 males ( 63％) and 24 females ( 37％) with median age of 60 years. The most common lesion was diffuse infiltrative lesions ( 37, 56. 9％) , followed by submucosal protrusion types ( 17, 26. 2％) . Fifty-four cases ( 83. 1％) were malignant lesions, and 11 cases ( 16. 9％) were benign. The overall sensitivity, specificity, and accuracy of EUS-FNA for gastrointestinal lesions with inconclusive biopsies were 76. 8％ ( 95％CI: 65. 7％-87. 8％) , 100. 0％ ( 95％CI: 66. 4％-100. 0％) , and 80. 0％( 95％CI: 70. 3％-89. 7％) , respectively. Sub-group analysis showed the sensitivity, specificity, and accuracy of EUS-FNA for diffuse infiltrative lesions were 70. 6％ ( 95％CI: 55. 3％-85. 9％, 100. 0％( 95％CI:29. 2％-100. 0％) , and 73. 0％ ( 95％CI: 58. 7％-87. 3％) , respectively. For submucosal protrusions, the sensitivity, specificity, and accuracy of EUS-FNA were 68. 8％ ( 95％CI: 46. 0％ -91. 5％) , 100. 0％ ( 95％CI: 2. 5％-100. 0％) , and 70. 6％ ( 95％CI: 44. 0％-89. 7％) , respectively. Conclusion EUS-FNA has moderate diagnostic value for endoscopic biopsy-inconclusive gastrointestinal lesions. It can be an alternative option when standard methods, such as endoscopic mucosal forceps biopsy, fail to provide a definitive diagnosis.

Mogrosides, the main sweet components isolated from Siraitia grosvenorii, are a family of cucurbitane-type tetracyclic triterpenoid saponins. Given that the high sweetness, low calorie and excellent taste, mogrosides have become the important resource for the development of natural non-nutritive sweeteners. As reported, 11α-hydroxyl group in the structural skeleton of mogrosides was closely related to sweetness and taste, but it had not been confirmed experimentally. In this work, we used mogroside IIIE as a model compound, which was 300 times sweeter than 5% sucrose and tasted better, and modified its 11α-hydroxyl group through glycosyltransferase to elucidate the relations between structure and sweetness of mogroside compounds. The glycosyltransferase HXSW-GT-2 was obtained to regio-selectively glycosylate the 11α-hydroxyl group of mogroside IIIE through the screening of glycosyltransferase library. And then, the soluble expression of HXSW-GT-02 in Escherichia coli was efficiently achieved by optimizing the induction conditions. Subsequently, the yield of glycosylated mogroside IIIE(MG-IIIE-Glu)was increased to > 85% through optimizing reaction pH, temperature, UDP-G dosage and biocatalyst loading. The product MG-IIIE-Glu was bio-prepared at a 0. 5 L scale and the final purity was 97. 8%. A “mouth feel” test showed that MG-IIIE-Glu had no sweetness and displayed obvious bitterness through the comparison with mogroside IIIE and 5% sucrose. In conclusion, the function of the 11α-hydroxyl group of mogrosides in sweetness and taste was preliminarily elucidated which would be beneficial for the structural modification and development of mogroside sweeteners.

Objective:To understand the sleep quality and mental health status of nurses in public health emergencies, and analyze the correlation between them.Methods:A total of 128 first-line nursing staff participating in public health emergencies on February 22-23, 2020 in Tianjin Beichen Hospital, Tianjin First Central Hospital, Tianjin Fourth Central Hospital were investigated by the general data questionnaire, Pittsburgh Sleep Quality Index (PSQI), and Symptom Checklist 90 (SCL-90).Results:70.3%(90/128) of nursing staff had poor sleep quality, and the total score of PSQI was (9.71±4.01) points, which was statistically significant compared with the domestic norm ( t value was 16.479, P<0.01). The total score of SCL-90 was 1.59±0.52, which was statistically significant compared with the domestic norm ratio ( t value was 4.505, P<0.01). One-way ANOVA showed that the nursing staff's age had a significant impact on sleep quality, and the difference was statistically significant ( F value was 4.092, P<0.05). Pearson correlation analysis showed that the Pittsburgh sleep quality scale index scores and symptom self-assessment scale and somatization, force, sensitive interpersonal relationship, depression, anxiety, hostile, terrorist, paranoia, and psychosis were positively correlated( r values were 0.292-0.444, P< 0.01). Conclusions:The sleep quality and mental health status of nurses in public health emergencies are poor, and the sleep quality is correlated with mental health status.

Objective To investigate the mechanism of abdominal massage for treating chronic fatigue syndrome(CFS).Methods Thirty clean-grade female Sprague-Dawley rats were randomly divided into the normal control,model control,and abdominal massage groups(n=10 rats per group).The CFS rat model was established through cold water swimming combined with the chronic restraint method in the model control and abdominal massage groups.The rats in the abdominal massage group were treated with the core techniques of Jingu zang-fu massage,namely layer press"Guanyuan"(CV4)for 8 min and Tuanmo"Zhongwan"(CV12)for 12 min as the primary intervention techniques,once a day for 14 consecutive days.The rats in the two control groups did not receive intervention;however,they were bound to the experimental bench when the experimental group was massaged.After the intervention,the indexes of the main organs of the hypothalamic-pituitary-adrenal(HPA)axis and hippocampal cell apoptosis in each group were measured.The morphology of hippocampal cells in each group was observed using Nissl staining of hippocampal tissue and transmission electron microscopy of hippocampal neurons.Results The index of each organ in the model control group was upregulated(P<0.01)compared to that of the normal control group.In contrast,the index of each organ in the abdominal massage group was downregulated(P<0.01)compared with that of the model control group.Compared to the normal control group,the index of each organ in the abdominal massage group was upregulated;however,the difference was not significant.Compared to the normal control group,the cell nuclei in the model control group were significantly consolidated,the nuclear membrane structure was ruptured,and the margins were irregular.Most of the cell morphology in the abdominal massage group was normal compared with that of the model control group,and a small number of nuclear membrane structures were unclear.Compared to the normal control group,the hippocampal neuronal cell in the other two groups was significantly damaged,and the hippocampal neuronal cell in the abdominal massage group was in good condition compared to the model control group.The degree of neuronal apoptosis in the model control group was significantly higher than that in the normal control group(P<0.01).The degree of neuronal apoptosis in the abdominal massage group decreased compared to that of the model control group(P<0.01),which was slightly higher than that in the normal control group but not significant.Conclusion Cold water swimming combined with chronic restraint can simulate CFS in rats,and abdominal massage can reduce the organ index of the hypothalamus,pituitary gland,and adrenal gland,increase hippocampal cell activity,reduce hippocampal tissue damage,inhibit hippocampal cell apoptosis,and maintain the normal physiological function of hippocampal neurons.