Objective To investigate the clinical efficacy of two types of duodenum-preserving pancreatic head resection (Beger procedure and Berne procedure) for chronic pancreatitis with mass in the head of the pancreas.Methods The clinical data of 46 patients with chronic pancreatitis and mass in the head of the pancreas who were admitted to the Affiliated Hospital of Guiyang Medical College from September 2008 to April 2012 were retrospectively analyzed.There were 24 patients received Beger procedure (Beger group),and 22 received Beme procedure (Berne group).The complications,life quality and pain after the operation were evaluated.Patients were followed up via phone call and out-patient examination till April 2013.The measurement data were analyzed using the Mann-Whitney U test,and the constituent ratios were compared using the chi-square test.Results The operation time and volume of blood loss were (377 ± 21) minutes and (746 ± 129) mL in the Beger group,and (323 ± 17) minutes and (577 ± 111)mL in the Berne group,with significant difference between the 2 groups (U=14.0,88.0,P ＜0.05).Four patients in the Beger group and 1 in the Berne group were complicated with pancreatic leakage,with no significant difference between the 2 groups (x2=0.714,P ＞ 0.05).The scores of life quality evaluation (physical condition,work capacity,cognitive ability,emotion,social competence and overall life quality) were 82 ± 14,74±24,90 ± 18,78±20,83 ± 18,73 ± 18 in the Beger group,and 79 ± 16,71 ±20,92 ±21,76 ± 18,80 ±21,70 ± 16 in the Berne group,with no significant difference between the 2 groups (U =177.5,183.5,187.5,178.0,189.5,192.0,P ＞ 0.05).The scores of symptom evaluation (fatigue,nausea and vomitting,pain,anorexia,dyspnea,sleep disorders,obstipation,diarrhea,financial worries) were 28 ± 16,24 ± 10,20±12,23 ± 14,4 ± 1,32 ± 12,6 ±2,18 ± 14,36± 18 in the Beger group,and 26 ± 18,26 ±20,22 ± 16,26 ± 16,3 ± 1,30 ± 10,5 ± 1,16 ± 12,38 ± 20 in the Berne group,with no significant difference between the 2 groups (U=194.5,215.5,182.5,180.5,213.0,199.0,195.0,184.5,181.5,P＞0.05).In the Beget group,19 patients did not have acute onset of pain,and 5 patients had acute onset of pain once a year; 6 patients were administered antalgesic occasionally.In the Berne group,20 patients did not have acute onset of pain,and 2 patients had acute onset of pain once a year; 4 patients were administered antalgesic occasionally,with no significant difference between the 2 groups (x2=0.485,0.041,P ＞ 0.05).All the patients were followed up,and the median time of follow-up was 36.3 months.No perforation of duodenum and steatorrhea was observed.No patient died perioperatively.Conclusion The clinical efficacy of the Berne procedure is similar to that of the Beger procedure,while the Berne procedure has advantages of easy manipulation and less operation time.

Comprehensive treatment dominated by surgery is the mainstay in the treatment of hepatic cancer,and hepatectomy is still the most effective treatment method.Bile duct reconstruction after hepatectomy is still the difficult point for the treatment of hepatic cancer complicated by bile duct invasion.A 45-year-old patient with hepatic cancer and gallstone was admitted to the Affiliated Hospital of Guiyang Medical College,magnetic resonance cholangiopancreatography and enhanced computed tomography indicated that intrahepatic duct was dilated and tumor had invaded both left and right hepatic ducts.Cholecystectomy,mesohepatectomy,duct to duct anastomosis of left hepatic duct and common hepatic duct,duct to duct anastomosis of right hepatic duct and cystic duct were performed during the operation.The patient was cured 2 weeks after surgery.

Objective:To investigate the feasibility of transradial artery approach for coronary angiography and for bilateral carotid angiograohy at the same time.Methods:There vdere 39 patients(remale 18 and male 21)with a mean age of 65 years(range 49-72).Transradial artery approach for coronary angiography was performed,at the same time,selective bilateral carotid angiography was performed with Simmons catheter.Results:Thirty-seven patients completed the selective coronary angiography and bilateral carotid angiography successfully,and 2 failed.The success rate was 94.5%,and no complications occurred.Comlmiom:Transradial artery approach for selective bilateral carotid angiograohy is safe and feasible.

Objective: To investigate the prevalence and influencing factors of hepatitis C virus (HCV) infection among drug users in Baoshan District, Shanghai Municipality, so as to provide insights into strengthening HCV intervention among drug users. Methods: Drug users under community management in Baoshan District from 2017 to 2023 were recruited. Demographic information, drug use behaviors, sexual behaviors and receipt of intervention service were collected through questionnaire surveys. Blood samples were collected for HCV antibody testing, and the prevalence of anti-HCV antibody was analyzed. Factors affecting the prevalence of anti-HCV antibody among drug users were analyzed using a multivariable logistic regression model. Results: A total of 2 801 drug users were surveyed, including 2 233 males (79.72%) and 568 females (20.28%). The majority of drug users were aged 40 to <60 years (1 663 drug users, 59.37%). The prevalence of anti-HCV antibody was 28.35%, showing an overall upward trend from 2017 to 2023 (P<0.05). Multivariable logistic regression analysis showed that females (OR=1.468, 95%CI: 1.169-1.844), 40 years and over (40 to <50 years, OR=2.441, 95%CI: 1.838-3.242; 50 to <60 years, OR=2.377, 95%CI: 1.787-3.161; 60 to 97 years, OR=1.637, 95%CI: 1.163-2.304), using traditional drugs (OR=2.488, 95%CI: 1.967-3.147) or mixed drugs (OR=2.950, 95%CI: 1.974-4.409), having injected drugs (not share needles, OR=3.649, 95%CI: 2.849-4.673; share needles, OR=3.532, 95%CI: 1.851-6.738) and never using condoms during sexual contacts with spouses/cohabitants in the past year (OR=1.975, 95%CI: 1.354-2.879) were associated with a higher prevalence of anti-HCV antibody; the educational level of high school/technical secondary school (OR=0.483, 95%CI: 0.280-0.835) or college and above (OR=0.280, 95%CI: 0.129-0.608) was associated with a lower prevalence of anti-HCV antibody. Conclusions The prevalence of anti-HCV antibody among drug users in Baoshan District showed an upward trend from 2017 to 2023. Gender, age, educational level, type of drugs, history of drug injection and never using condoms during sexual contacts with spouses/cohabitants were influencing factors for prevalence of anti-HCV antibody among drug users.

ObjectiveTo investigate the expression of CD90 in human intrahepatic cholangiocellular carcinoma and its association with lymph node metastasis and poor prognosis. MethodsA total of 49 samples of intrahepatic cholangiocellular carcinoma tissue and 49 samples of adjacent tissue were collected after surgical resection in The Affiliated Hospital of Chengde Medical College from March 2013 to March 2016, and 40 normal liver tissue samples were selected as control. Immunohistochemistry was used to measure the expression of CD90 in each sample, and its association with clinical indices, survival, and prognosis of patients with intrahepatic cholangiocellular carcinoma was analyzed. The t-test was used for comparison of continuous data between two groups; the chi-square test was used for comparison of categorical data between two groups, the Kruskal-Wallis H test was used for comparison between three groups and further comparison between two groups. The Kaplan-Meier curve was used to analyze postoperative recurrence and survival, and the log-rank test was used for comparison. Results The moderately positive expression rate of CD90 was 65.31% in intrahepatic cholangiocellular carcinoma tissue, 30.61% in adjacent normal tissue, and 0% in normal liver tissue, suggesting that the intrahepatic cholangiocellular carcinoma tissue had a significantly higher moderately positive expression rate of CD90 than adjacent normal tissue and normal liver tissue (P＜0.05). The expression of CD90 was associated with TNM stage and hilar lymph node metastasis in the patients with intrahepatic cholangiocellular carcinoma (χ2=12837 and 17.824, both P＜0.001). The patients with negative/weakly positive expression of CD90 had significantly higher relapse-free survival rate and overall survival rate after surgery than those with moderately/strongly positive expression (χ2=3.845 and 4.152, P=0025 and 0.021). ConclusionCD90 is highly expressed in human intrahepatic cholangiocellular carcinoma tissue, which is associated with hilar lymph node metastasis and poor prognosis and plays an important role in tumor development, progression, and metastasis.

Objective:To develop an UPLC-MS/MS method for the determination of paeoniflorin, tetramethylpyrazine, nobiletin, paeonol, amygdalin and ligustilide in Gexia-Zhuyu Decoction. Methods:Isocratic elution was carried out with mobile phase consisting of methanol- 4 mM ammonium formate. The separation was performed on Waters XTerra MS C18 (2.1 mm × 50 mm, 3.5 μm), and the mass spectrometer was operated in the positive and negative ionization electrospray (ESI) mode using multiple monitoring (MRM) for analysis of six components. Quantitative analysis by external standard method. The precursor to product ion transitions monitored for paeoniflorin, tetramethylpyrazine, nobiletin, paeonol, amygdalin and ligustilide were m/z 525.0→449.1, 137.1→55.1, 403.0→373.0, 167.2→149.4, 456.5→323.3 and 191.1→91.1, respectively. Results:Paeoniflorin, tetramethylpyrazine, nobiletin, paeonol, amygdalin and ligustilide were all analyzed exactly, the linear ranges were 0.000 2-0.012 8, 0.000 8-0.051 2, 0.000 1-0.006 4, 0.000 2-0.012 8, 0.000 6-0.038 4, 0.000 1- 0.006 4 ng, respectively. The r were 0.999 3, 0.997 5, 0.999 6, 0.992 6, 0.995 5 and 0.999 1, respectively. The recoveries of six analytes ranged from 98.00% to 105.3% and the relative standard deviations ( RSD) were all below 2.47%. Conclusions:This method was sensitive, which could be applied for the determination of paeoniflorin, tetramethylpyrazine, nobiletin, paeonol, amygdalin and ligustilide in Gexia-Zhuyu Decoction.

Objective:To study the changes the changes of cytokine expression the aqueous humor of patients with macular edema secondary to branch retinal vein occlusion (BRVO-ME) before and after intravitreal ranibizumab (IVR).Methods:A prospective clinical study. From June 2018 to June 2021, 31 eyes of 31 patients with non-ischemic BRVO-ME diagnosed by ophthalmic examination in Department of Ophthalmology, Beijing Hepingli Hospital were included in the study. Among them, 15 males had 15 eyes, and 16 females had 16 eyes. Age was 70 (65, 72) years; the course of disease was 10 (9, 15) days. All of them were first-time patients. All eyes were treated with IVR once a month for 3 consecutive months. At the end of each IVR treatment, 0.1 ml aqueous humor was extracted immediately. The concentrations of vascular endothelial growth factor (VEGF), interleukin-6 (IL-6), monocyte chemoattractant protein-1 (MCP-1), intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) in aqueous humor were detected by flow cytometry. The concentrations of cytokines in aqueous humor before and after treatment were compared by Kruskal-Wallis or Wilcoxon signed-rank test. Spearman correlation analysis was performed on the correlation between VEGF and MCP-1 expression level in aqueous humor before treatment.Results:The concentrations of VEGF and ICAM-1 in aqueous humor were significantly lower at 1 month after treatment compared with that before treatment, and at 2 months after treatment compared with that at 1 month after treatment ( Z=4.03, 3.25, 2.50, 3.48; P<0.05); the concentrations of IL-6 and VCAM-1 increased and the concentration of MCP-1 decreased, but there was no significant difference ( Z=-0.21, 1.42, 0.86, -0.53, 0.92, -1.57; P>0.05). Spearman correlation analysis showed that there was a strong positive correlation between VEGF and MCP-1 in aqueous humor before treatment ( r=0.78, P<0.001). Conclusion:The concentrations of VEGF and ICAM-1 in aqueous humor significantly decrease after IVR treatment in BRVO-ME; the concentrations of IL-6, MCP-1 and VCAM-1 do not obviously change.

Objective To investigate the clinical and magnetic resonance imaging(MRI)features of Trousseau's syndrome(TS)with acute cerebral infarction,so as to improve the accuracy of diagnosis of this disease.Methods Fifty-three cases of TS with clinically confirmed acute multiple brain infarction(AMBI)and 52 cases of TS without AMBI were enrolled,and the head MRI,primary tumor imaging and clinical data of the patients were retrospectively analyzed.The clinical and MRI features and thrombus types of the 2 groups were compared.Results There were significant differences in the types of thrombus between the 2 groups(P=0.001),while there were no significant differences in gender,age,whether they had hypertension,diabetes mellitus,hyperlipidemia,basic cardiovascular diseases or not,preventive medication use,abnormal coagulation function,or D-dimer level(all P＞0.05).The primary tumor type of 105 TS patients was mainly adenocarcinoma.MRI of the head of 53 TS with AMBI patients showed that the distribution area of acute and subacute infarct foci was bilateral anterior circulation in 16 cases,bilateral anterior circulation+bilateral posterior circulation in 17 cases,bilateral anterior circulation+unilateral posterior circulation in 4 cases,and unilateral anterior circulation in 16 cases.Enhancement scans were performed in 23 cases,of which 11 cases showed some infarct foci appeared enhanced and 12 cases did not show significant enhancement.Twenty-eight cases did not show meaningful stenosis of the cerebral arteries,4 cases showed stenosis occlusion of the cerebral arteries,and all lesions did not conform to cerebrovascular distribution.Twenty-four cases of arterial thrombosis(10 cases of carotid artery thrombosis,3 cases of lower-extremity arterial thrombosis,5 cases of cerebral arterial ring thrombosis,1 cases of pulmonary artery thrombosis,1 case of renal artery thrombosis,and 4 cases of subclavian artery thrombosis)and 3 cases of venous thrombosis(deep vein thrombosis of the lower extremities)were found among the patients with visualized thrombosis.The D-dimer level was increased in different degrees.Conclusion Multiple speckled and patchy acute anterior and posterior cerebral infarcts involving bilateral cerebral and cerebellar cortex,subcortical areas and hemi-oval centers with lesions not conforming to cerebrovascular distribution are the characteristic manifestations of MRI of the head in the combination of malignant tumors with TS.Adenocarcinoma is the main malignant tumor,and the combination of D-dimer index can improve the accuracy of diagnosis.

Objective To investigate the changes in the expression of complement C3,high mobility group protein B1(HMGB1),and glutathione peroxidase 4(GPX4)in brain tissue at different time points after cerebral ischemia-reperfusion injury in rats.Methods A total 72 SPF male SD rats were randomly divided into a sham operation group(36 rats)and a model group(36 rats).A rat model of middle cerebral artery occlusion was established using thread occlusion,and then the rats from the model group were further assigned into 4 subgroups with reperfusion time for 3,6 and 24 h and 3 d,respectively,with 9 rats in each subgroup.Zea Longa scoring was used to assess neu-rological function.R2StarMap imaging,diffusion-weighted imaging(DWI),T1 weighted imaging,and T2 weighted imaging were performed on all the rats.The volume of abnormal DWI signals were detected and the volume of cerebral infarction was measured.The original R2StarMap images were post-processed to generate R2*pseudo color images,and then the R2*values of the areas with blood supply from bilateral middle cerebral artery were measured to detect iron deposition in the brain.The protein expression of C3,HMGB1,and GPX4 was detected by Western blotting.Results The sham operation group showed no neurological damage,while the model group had a significant increase in neurological function scores at 3,6 and 24 h and 3 d after modeling when compared to the sham surgery group(P＜0.05).While the size of right cerebral infarct was in-creased significantly at 3,6 and 24 h and 3 d in the rats of the model group(P＜0.05).The R2*value of the area with blood supply from the right middle cerebral artery in the model group was significantly higher than that in the left side at 3,6 and 24 h and 3 d(P＜0.05,P＜0.01),and it was also obviously higher than that in the right side of the sham operation group at these time points(P＜0.05,P＜0.01).The R2*ratio of the right and left blood supply areas in the model group at 3,6 and 24 h and 3 d was also statistically higher than that in the sham operation group at corresponding time points(1.82±0.82 vs 1.12±0.31,P＜0.05;1.31±0.26 vs 1.04±0.14,P＜0.05;1.94±0.74 vs 1.06±0.10,P＜0.01;1.99±0.39 vs 1.02±0.11,P＜0.01).Compared with the sham operation group,the expression levels of C3 and HMGB1 was significantly increased in the model group at 3,6 and 24 h and 3 d,while that of GPX4 was notably reduced(P＜0.01).Conclu-sion Cerebral ischemia-reperfusion injury impairs the neurological function of rats and signifi-cantly affects the cerebral expression of complement C3,HMGB1,and GPX4.

Objective To determine the impact of hypertension on the outcomes of patients with COVID-19. Methods This matched cohort study was conducted among a total 442 patients with COVID-19 admitted in Honghu People's Hospital and First Affiliated Hospital of Nanchang University between January 1 to March 18, 2020, including 61 patients with hypertension and 381 normotensive patients. To minimize the effects of the confounding factors including age, gender and other comorbidities, we excluded patients with comorbidities other than hypertension, and matched the patients with and without hypertension for age and gender at a 1:1 ratio. We analyzed the clinical characteristics, laboratory findings and clinical outcomes of in 32 matched pairs of patients with and without hypertension. Results Compared with the normotensive patients, COVID-19 patients with hypertension were more likely to develop bacterial infections (P=0.002) and had higher neutrophil counts (P=0.007), neutrophil/lymphocyte ratio (P=0.045), and lactate dehydrogenase levels (P=0.035). A greater proportion of patients had bilateral patchy opacities on chest CT (P=0.012) in the hypertension group than in the normotensive group. COVID-19 patients with hypertension group were more likely to receive antibiotics (P=0.035) and corticosteroid therapies (P=0.035). Conclusion Hypertension increases the risk of bacterial infection in patients with COVID-19. Hypertensive patients with COVID-19 have higher neutrophil counts and neutrophil/lymphocyte ratios and are more likely to require treatment with antibiotics. Hypertensive patients with COVID-19 should therefore take cautions to avoid bacterial infections.