Objective To improve the cure rate of hepatobiliary lithiasis.Methods Two hundred and seventy-five patients with retained gallstones in the hepatic bile ducts after choledochostomy were treated with choledochofiberscope from August 1989 to August 2001 in this hospital.Results In 252 cases(91.6%), the residual gallstones were thoroughly removed with choledochoscope and in remaining 23 cases(8.4%), the stones were not completely removed. The factors affecting the results of the procedures include improper locating of T-tube, the exfoliation of T-tube and closure of fistula, the size and the incarceration of retained gallstones, the narrowed bile ducts, the performance of intraoperative choledochoscope, the method of operation.Conclusions Choledochofiberscope is of great value in surgical treatment of hepatobiliary lithiasis. However it can't completely replace to remove the damaged liver caused by the gallstones.

The B Phycoerythrin(B PE) could both be separated after crude phycobiliproteins from Porphyridium cruentum were precipitated in ammonium sulphate and dialyzed,then chromatographed on a hydroxylapatite (HA) Column and a Sephadex G 100 column respectively.The purity of B PE separated by two methods was 4.92 and 3.78 (A 545 nm/A 280 nm) respectively.When the purified B PE was electrophoresed under polyacryiamide gradient gel electrophoresis condition,only one band was observed.The B PE possessed an absorption maximum at 545nm and a room fluoresence emission at 574.5nm.

The interaction between the antibody and the corresponding target molecule determines the characteristics of immunoassay. In this study, a single chain variable fragment antibody (scFv4C7) derived from the hybridoma strain 4C7 were prepared via genetic engineering technique. The recognition properties of scFv4 C7 was determined and compared to those of the parent monoclonal antibody by indirect competitive enzyme-linked immunosorbent assay(ic-ELISA). Three dimensional structure of the scFv4C7 was presented by Swiss-Model, and sulfathiazole ( STZ) was docked to the scFv4C7 model to obtain the structure of the binding complex. The results from the ic-ELISA showed that the binding properties of scFv4C7 were comparable with the parent monoclonal antibody and STZ was almost completely buried in a deep binding pocket formed by the heavy chain and light chain of the antibody. The interaction between STZ and scFv4C7 was more closely related to the heavy chain and the complementarity-determining region ( CDR ) H3 loop played more important role than other CDR loops. The study preliminary provided the necessary structural information for the preparation of antibody with broader specificity and higher affinity.

Objective To assess the value of arterial spin labeling(ASL) MRI in the staging of early renal allograft function. Methods Sixty two renal allograft recipients (2 to 4 weeks after kidney transplantation) and 20 age match volunteers were included in this study. All subjects underwent conventional MRI and ASL MRI which was performed in the oblique-sagittal plane. Recipients were divided into two groups according to the estimated glomerular filtration rate (eGFR), recipients with good allograft function (eGFR≥60 ml · min-1 · 1.73 m-2,n=37) and recipients with impaired allograft function (eGFR<60 ml · min - 1 · 1.73 m - 2,n=25). Renal blood flow (RBF) was measured and an intra-class correlation coefficient (ICC) was calculated to confirm the reproducibility of the measured results from two doctors. One-way analysis of variance (ANOVA) and Bonferroni were used to compare the different cortical RBF among three groups. Correlation of RBF with eGFR was evaluated using Pearson correlation coefficients. The receiver operating characteristic (ROC) curve was performed to assess the diagnostic efficacy of using cortical RBF to discriminate allografts with impaired function from good function. Results RBF values showed good reproducibility between doctors with an ICC larger than 0.90 in different group. Mean cortical RBF were (390 ± 61),(290 ± 69),(201 ± 86) ml · 100 g-1 · min-1 for healthy controls, recipients with good and impaired allograft function, respectively(F=37.313,P<0.01). RBF exhibited a significant correlation with renal function as determined by eGFR for recipients (r=0.60,P<0.01). Mean cortical RBF showed a high area under the ROC curve (0.773) to discriminate renal allografts with different function, with a sensitivity of 56.0% (14/25) and a specificity of 89.2% (33/37). Conclusion ASL MRI can assess the early renal allografts perfusion, and provide valuable information in the staging of renal function. It could be a useful method for evaluating renal function noninvasively.

Purpose To investigate the value of arterial spin labeling (ASL) in evaluating renal function in patients with renal cell carcinoma (RCC) after laparoscopic partial nephrectomy.Materials and Methods Fifteen patients with RCC undergoing laparoscopic partial nephrectomy were studied prospectively.The patients were performed ASL scan one week before and three months after operation.The correlation between renal blood flow (RBF) value measured by ASL and the glomerular filtration rate (GFR) measured by radionuclide method in the renal cortex of healthy side was analyzed.The RBF values in the kidney of affected side or healthy side were measured,the difference of which between before operation and three months after operation was compared.Results The RBF value and GFR data in the renal cortex of healthy side had positive correlation (r=0.638,P＜0.05).In the affected side of kidney,the RBF value of remaining renal tissue [(291.5 ± 37.3) ml/(100g·min)] compared with that of preoperative renal tissue [(237.8 ± 46.2) ml/(100g·min)]increased about 53.7 ml/(100g · min) (P＜0.05).In the healthy side of kidney,the RBF value of renal tissue [(241.1 ± 50.3) ml/(100 g · min)] compared with that of preoperative renal tissue [(290.4 ± 51.8) ml/(100 g·min)] decreased about 49.3 ml/(100 g·min) (P＜0.05).Conclusion ASL can be used to evaluate renal function,and it is valuable to evaluate renal perfusion function after laparoscopic partial nephrectomy of RCC.

Objectives To investigate the ability of T1 mapping and intravoxel incoherent motion imaging (IVIM) parameters for evaluating renal allografts at the early stage after renal transplantation. Methods This prospective study protocol was approved by the local ethics committee, and written informed consent was obtained from all subjects. Sixty two recipients 2 to 4 weeks after kidney transplantation and 20 healthy volunteers (control group) underwent routine MRI, T1 mapping, and IVIM imaging (11 b values, 0 to 700 s/mm2). Recipients were divided into two groups base on their estimated glomerular filtration rate (eGFR):37 recipients with good allograft function (eGFR≥60 ml·min-1·1.73 m-2) and 25 recipients with impaired allograft function (eGFR<60 ml·min-1·1.73 m-2). The ADC, true diffusion coefficient (ADCslow), pseudo-diffusion coefficient (ADCfast), perfusion fraction (f) and T1 values were measured on both cortex and medulla. Differences among groups were compared using the one-way analysis of variance. Correlations between eGFR and the parameters in renal allografts were assessed by using Pearson correlation analysis. ROC was performed to assess the diagnostic utilities of using these parameters to discriminate allografts with impaired function from good function. Results Excepting for cortical T1, ADCfast and medullary T1, f values, allografts with good function showed no differences in other parameters compared with healthy control. Excepting for medullary T1 and ADCfast,the other values showed significantly differences in allografts with impaired function compared to allografts with good function (all P<0.05). Excepting for medullary f and ADCfast values, allografts with impaired function showed significantly differences in the parameters compared with good function group(all P<0.05). In renal allografts, excepting for medullary T1, ADCfast, and f values, cortical T1 exhibited a negative correlation with renal function, and there was a significant positive correlation between eGFR and other parameters. Cortical T1 value showed high sensitivity(91.9%) to discriminate renal allografts with different function, with the threshold of 17.36 × 102 ms, and ADC value showed high specificity(96.0%)with the threshold of 1.98 × 10-3 mm2/s. Conclusion T1 mapping and IVIM technique may be useful for detecting renal allograft dysfunction, and be a reliable imaging for evaluating and monitoring allograft function.

Objective To explore the correlationships between microperfusion diffusion indexes derived from intravoxel incoherent motion(IVIM)and perfusion values measured by arterial spin labeling (ASL)in renal allograft. Methods A total of 76 renal allograft recipients and 26 age-matched volunteers (group 0)were included in this prospective study. All subjects were underwent conventional MRI, IVIM and ASL MRI which were performed in the oblique-sagittal plane. Seventy-six recipients were divided into two groups based on the estimated glomerular filtration rate(eGFR):recipients with good allograft function(group 1, eGFR≥ 60 ml · min-1 · 1.73m-2,n=44)and recipients with impaired allograft function(group 2, eGFR<60 ml · min-1 · 1.73m-2,n=32). Three IVIM indexes values, including true diffusion coefficient(ADCslow), pseudo-diffusion coef fi cient(ADCfast), perfusion fraction(PF), and one ASL index value of renal cortex(renal blood flow, RBF)were measured. One-way analysis of variance and the least significant difference were used to compare the different of each cortical index values among three groups. Correlations between the ADCslow, ADCfast, PF, RBF and eGFR as well as the correlation among the indexes were evaluated using Pearson correlation coefficients. Results For cortical ADCslow, ADCfast, PF and RBF values, allografts with good function and impaired function showed significantly differences compared healthy controls(all P<0.01). In allografts with good function, cortical ADCslow,ADCfast,PF showed no significantly differences compared with controls(all P>0.05), but RBF value was significantly lower(P<0.05). The ADCslow, ADCfast, PF and RBF values of renal cortex were significantly lower in allografts with impaired function compared to allografts with good function(all P<0.01). In renal allografts, there were significant positive correlations between cortical ADCslow, ADCfast, PF, RBF value and eGFR(r values were 0.604, 0.552, 0.579 and 0.673, all P<0.01). Cortical ADCfast and PF value exhibited a significant correlation with RBF for recipients(r values were 0.501 and 0.423, all P<0.01). Conclusion Cortical ADCfast and PF values derived from IVIM and RBF measured by ASL show a significant positive correlation in renal allografts.

Objective:To investigate the effect of linalutide on adipocytokine, blood glucose and renal function in diabetic nephropathy (DN) patients.Methods:One hundred DN patients diagnosed and treated by Chengdu Second People′s Hospital and Chunxi Community Health Service Center of Jinjiang District and Shuyuan Community Health Service Center of Jinjiang District from January 2018 to June 2019 were selected and divided into metformin group (48 cases) and combined group (52 cases) according to different treatment regimens. Metformin group was treated with metformin, the combined group was treated with linalutide on the basis of metformin group, and both groups were treated for 12 weeks. The therapeutic efficacy, adipocytokine index adiponectin (ADPN), secretory-type curl-related proteins-5(SFRP5), omentin-1; blood glucose index fasting blood glucose (FBG), 2 h postprandial blood glucose (2hPBG), glycosylated hemoglobin (HbA 1c), fasting insulin (FINS), insulin resistance index(HOMA-IR), and renal function index urinary albumin excretion rate (UAER), albumin creatinine ratio(ACR), liver-type fatty acid binding protein(L-FABP) were compared between the two groups and the prognosis was analyzed. Results:The total effective rate in the combined group at 4, 8 and 12 weeks were higher than those in the metformin group and the longer treatment, the higher total effective, there were statistical differences ( χ2 group = 4.61, χ2 time point = 78.57, P<0.05). Before treatment, there were no significant differences in serum FBG, 2hPBG, HbA 1c, FINS, HOMA-IR, ADPN, SFRP5, omentin-1, urine UAER, ACR and L-FABP between the two groups ( P>0.05). After treatment, the levels of serum FBG, 2hPBG, HbA 1c, FINS, HOMA-IR, urine UAER, ACR and L-FABP in the combined group were lower than those in the metformin group: (7.17 ± 1.62) mmol/L vs. (8.75 ± 2.11) mmol/L, (5.54 ± 1.11)mmol/L vs. (6.56 ± 1.08) mmol/L, (6.63 ± 0.92)% vs. (7.95 ± 0.89)%, (7.12 ± 1.17) mU/L vs. (8.72 ± 1.58)mU/L, 3.52 ± 0.88 vs. 4.04 ± 0.70, (28.65 ± 3.22) mg/24 h vs. (65.42 ± 6.85) mg/24 h, (56.24 ± 7.68) μg/mg vs. (92.68 ± 9.29) μg/mg, (8.62 ± 1.08) μg/(g·Cr) vs. (14.62 ± 1.85) μg/(g·Cr); the levels of ADPN, SFRP5 and omentin-1 were higher than those in the metformin group: (14.53 ± 2.43) mg/L vs. (10.21 ± 2.12) mg/L, (12.81 ± 2.31) μg/L vs. (8.75 ± 2.18) μg/L, (48.49 ± 5.28) μg/L vs. (36.57 ± 4.32) μg/L, there were statistical differences ( P<0.05). After treatment, the incidence of end-point events in the combined group was 7.69% (4/52), which was lower than that in the metformin group 22.92% (11/48), and there was statistical differences ( χ2 = 4.57, P<0.05). The survival analysis showed that the survival time and median survival time after treatment in the combined group were higher than those in the metformin group ( P<0.05). Conclusions:Linalutid can effectively improve blood glucose level and renal function in DN patients, and has obvious effect on adipocykine secretion, which is conducive to improve prognosis.