Objective To explore the effective therapeutic methods for hepatolithiasis.Methods We retrospectively analyzed the clinical material of 89 hepatolithiasis patients who underwent surgical therapy.Among the 89 patients,53 patients were treated with T-tube drainage(including 3 patients with left hepatic lobe or quadrate lobe resection),and 36 patients were treated with bile duct-intestinal anastomosis(including 6 patients with left hepatic lobe or quadrate lobe resection).Results Recurrence rate of postoperative angiocholitis in the two groups was 50.0% and 22.2% respectively,and the reoperation rate was 28.0% and 8.3% respectively.Conclusion The key to prevent recurrent angiocholitis and reduce the reoperation rate is to relieve biliary tract stricture,remove the focus of infection and provide unobstructed bile duct drainage.

BACKGROUND:The two main cages used in anterior cervical surgery are titanium cages and poly(ether-ether-ketone) cages, but it is stil controversial in imaging performances and clinical outcomes.
OBJECTIVE:To systematical y evaluate imaging performances and clinical outcomes between titanium cages and poly(ether-ether-ketone) cages in anterior cervical discectomy and fusion surgery.
METHODS:The Cochrane library (issue 5, 2013), Medline database, EMBASE, CNKI and Wanfang database were retrieved by computer. The deadline of al the retrieves concerning control study of uses of titanium cages and poly(ether-ether-ketone) cages was June 1st, 2013. Two reviewers assessed literatures independently, and the meta-analysis was conducted by RevMan 5.2 software.
RESULTS AND CONCLUSION:A total of four literatures including 235 patients, 128 of titanium cages and 107 of poly(ether-ether-ketone) cages, were included. Meta-analysis results showed that there was no statistical y significant difference between the groups in fusion rates, subsidence and dislocation rates of short-term fol ow-up and clinical outcomes (al P>0.05). There were statistical y significant differences between the groups in subsidence and dislocation rates of long-term fol ow-up (P<0.05). Poly(ether-ether-ketone) cage group was superior to titanium cages group in maintenance of cervical curvature and intervertebral height. This meta-analysis showed that poly(ether-ether-ketone) cages had good fusion rates and clinical outcomes, less subsidence and dislocation rates, and can better maintain cervical curvature and intervertebral height compared with titanium cages.

Objective To establish a screening system of efficient small interfering RNA (siRNA) target sites directed against truncated region of human cytomegalovirus (HCMV) UL54 gene (UL54S) with siRNA expression vectors. Methods Two small hairpin RNA (shRNA) expression vectors targeting truncated region of HCMV UL54 gene were constructed based on pAVU6 + 27 vector, and cotransfected into AD293 cells with the fusion protein expression vectors pUL54S-enhanced green fluorescent protein (EGFP). The levels of mRNA and EGFP were evaluated by means of reverse transcription-polymerase chain reaction (RT-PCR), fluorescence microscopy and flow cytometry so as to assess the inhibitory efficiency of siRNA. Analysis of variance was applied to analyze the variance of total fluorescence intensity to screen out the efficient target sites of siRNA.Results shRNA expression vector psiUL54-2 and fusion protein expression vector pUL54S-EGFP were cotransfected into AD293 cells. The EGFP expression level in pUL54S-EGFP/psiUL54-2 cotransfected group was lower than that in pUL54S-EGFP/pAVU6 +27 cotransfected group after 48 h of transfection. Gel analysis showed that the mRNA relative level of UL54S was 19.6 after 48 h of psiUL54-2/pUL54S-EGFP cotransfection, which was significantly lower than those in pUL54S-EGFP/psiUL54-1 group (96.6) and control group (100.0). Cotransfection of psiUL54-1/pUL54S-EGFP for 48h didn't show any effects on the expression of fusion protein UL54S-EGFP (P>0. 05).While psiUL54-1/pUL54S-EGFP cotransfection inhibited the expression of fusion protein UL54S-EGFP(19.43×104±2.29×104vs27.89×104±5.50×104, P<0.01).Conclusion Thescreening system of efficient siRNA targeting truncated region of HCMV UL54S is established successfully. The 1532th-1550th nucleotide acids of UL54S coding sequence are efficient siRNA target sites.

Objective To assess the influencing factors of the progression of carotid atherosclerotic stenosis using color Doppler flow imaging (CDFI). Methods From January 2009 to December 2014, a total of data 279 consecutive patients first assessed by CDFI as moderate stenosis of carotid atherosclerosis (stenosis rate 50 -69%)and regularly reexamined with CDFI at 12,24 and 36 months after initial examination were enrolled retrospectively. The residual diameter of vascular lesions and the changes of hemodynamic parameters were documented,and they were divided into either a progression group (n = 40)or a non-progression group (n = 239,and the non-progression group was divided into steady group[n = 210]and improved group [n = 29])according to whether the degree of stenosis progressed into severe stenosis (stenosis rate 70 -99%)or occlusion. The effects of the risk factors for common cerebrovascular disease and taking lipid lowering drugs (atorvastatin 20 mg/ d)on stenosis progression were compared in patients between the 2 groups. There were significant differences in hypertension,smoking and the regular use of atorvastatin . The effects of those factors on the progression of carotid stenosis were compared further through Logistic regression analysis. Results The residual vascular diameters of stenosis at 24,and 36 months were reduced obviously in the progression group compared with those of the non-progression group. There was significant difference (all P < 0. 05),and both the stenotic sites and distal peak systolic flow velocity ratio were significantly higher than those of the steady group and improved group (all P < 0. 05). Among the risk factors for cerebrovascular disease,hypertension (OR,2. 686,95% CI 1. 120 -6. 442,P = 0. 027)and smoking (OR,2. 265,95% CI 1. 081 -4. 746,P = 0. 030)were the major risk factors for affecting the progression of carotid stenosis. Regularly taking atorvastatin was a protective factor of delaying the progression of carotid stenosis (OR,0. 383,95% CI 0. 178 -0. 827,P = 0. 015). Conclusions CDFI may objectively evaluate the progression of carotid stenosis. Smoking and hypertension are the independent risk factors for affecting the progression of carotid stenosis,and regularly taking atorvastatin contributes to delay the progression of carotid stenosis.

Abstract: Objective To investigate the prevalence and pathogenic characteristics of Yersinia enterocolitica infection in children with diarrhea under 5 years of age in western Yunnan, and to provide a basis for the prevention and treatment of infectious diarrhea in children. Methods Feces were collected from under five-year-old children with diarrhea in the First Affiliated Hospital of Dali University from 2020 to 2021. Clinical information of the cases was also collected. Yersinia enterocolitica was isolated from the samples after cold enrichment on selective culture plates, and the pathogenic characteristics of Yersinia enterocolitica were analyzed by biological type and serotype and virulence gene detection. Results A total of 397 feces were collected. Seven strains of Yersinia enterocolitica were isolated in three samples, and the prevalence of Yersinia enterocolitica infection was 0.76% (3/397). Among the three positive samples, two Yersinia frederiksenii or Yersinia intermedia were isolated in specimen No. 212 , and five Yersinia enterocolitica were detected in specimens No. 24 and 226. Two Yersinia enterocolitica isolated from one sample were biological type 1A, and the virulence gene test results were ail-/ystA-/ ystB+ /yadA-/virF-, which were non-pathogenic Yersinia enterocolitica. Three Yersinia enterocolitica isolated from the other sample were biological type 3, serotype O∶3 (rfbc+), and virulence gene detection results were ail+/ystA+/ystB-/yadA+ /virF+, which were pathogenic Yersinia enterocolitica. While pathogenic Yersinia enterocolitica was detected from feces of children with diarrhea at 11 months of age with a infection rate of 0.50%(2/397). Conclusion Sporadic infection of pathogenic Yersinia enterocolitica was found in under five-year-old children in western Yunnan Province. It is necessary to strengthen the monitoring and research of Yersinia enterocolitica.

This article was aimed to study the sedative and hypnotic effects of different eluents of Shuangxiatang (SXT). The effects of SXT water decoction, water eluent, 20%, 70% and 95% alcohol eluent on spontaneous ac-tivity and the sleeping induced by subthreshold dose of pentobarbital sodium were measured. The results showed that the SXT decoction, 20% and 95% alcohol eluent can significantly decrease the number of rearing in mice with the percentage of 78.5%, 78.3% and 62.5%, respectively. SXT water eluent and 70% alcohol eluent can significantly decrease the spontaneous activity of mice (P < 0.01), the number of rearing (P < 0.01) and grooming time (P < 0.05). SXT water decoction can significantly shorten sleep latency (P < 0.05), prolong sleep time (P <0.05), and increase rates of sleeping in mice. SXT water eluent can significantly shorten sleep latency in mice (P< 0.05), increase rates of sleeping in mice. SXT water decoction and water eluent have the sedative and hypnotic effects. And the effects are more than alcohol eluents.

Objective To investigate the effect of Candida albicans and its components on the expression level of human beta-defensin-2 mRNA (HBD-2) in keratinocytes in vitro. Methods Different components of Candida albicans were isolated by lyticase, repeated freezing and thawing, sonication, and centrifugation. The keratinocytes and HaCaT cell lines were co-cultured with Candida albicans and its cellular components for 24 h. The expression level of HBD-2 mRNA was detected by reverse-transcription polymerase chain reaction (RT-PCR). Results Low expression level of HBD-2 mRNA in the unstimulated keratinocytes and HaCaT cells was detected. The HBD-2 mRNA expression levels in the keratinocytes stimulated by Candida albicans, the extract of its cell wall, and pure mannan were significantly increased (P 0.05). Conclusions Candida albicans, the extract of cell wall of Candida albicans, and commercial mannan can increase the expression level of HBD-2 mRNA in keratinocytes.

Objective To quantitatively analyze the early warning value of laboratory indexes for death risk in children with criti ‐cal hand foot and mouth disease (HFMD) .Methods The univariate and multivariate Logistic regression analysis were conducted to explore the independent risk factors of death in critical HFMD children .Then the area under receiver operating characteristic curve (AUC) was applied to give the comprehensive assessment of the test model ,as well as the early warning capacity and the optimal cut‐off level of laboratory indexes in critical HFMD children .Results The AUC of the Logistic regression model (Y ) established based on white blood cell ,neutrophil ,myoglobin ,creatinine for early predicting the death risk in critical HFMD children patients was 0 .847 (95% CI :0 .783 - 0 .911) ,which indicating that its diagnostic value was superior to single index .Conclusion The diag‐nostic value of the Y model established based on four indexes of white blood cell count ,neutrophile granulocytes count ,myohemo‐globin and creatinine is superior to any single index ,which has the better early warning value for the death risk in children with crit‐ical HFMD .

Objective To explore the mechanism of the catdioprotection of isoflurane delayed preconditioning on myocardial ischemia reperfusion injury in rabbits.Method Thirty male New Zealand white rabbits,weighing 2.0 to 2.5 kg,were randomly divided into three groups(ten for each group):Control group(group C),I/R group(I/R group) ,2.0% isoflurane group(group S) .Group S was exposed to 2.0% isoflurane-100% oxygen for2 h.Group C and I/R group were exposed 2 h to 100% oxygen served as untreated controls.Twenty-four hours later I/R group and group S underwent 40 rain of coronary occlusion followed by 2 h of reperfusion.Blood samples were taken from arterial line at 20 min before occlusion(T1) ,20 rain after occlusion(T2) ,40 rain after occlusion(T3) ,1 h after reperfusion(T4) and 2 h after reperfusion(TS) for determination of plasma IL-10 levels and TNF-alevels by ELISA.At the end of the reperfusion,infarct size and area at risk were defined by Evans and TTC staining.The heart was harvested and levels of the nuclear factor kappa β(NF-κB)activity were determined by Western Blot,and ultrastructures were observed by electron microscopy.The data was expressed as,and were analyzed by using oneway ANOVA test with SPSS 13.0.P value less than 0.05 indicated statistical significance.Results The NF-κB activity of group S was significantly lower than that of group I/R(P<0.05).Group S significantly(P<0.05)reduced infarct size(19.7%±2.8% in group S) of the left ventricular area at risk as compared with control (37.8 %±1.7 % in I/R group).The injury of I/R group was worse than that of group S from the changes of the cellular structure under light microscope.Group S had a lower levels of TNF-α and also had a higher level of IL-10.Conclusions Isoflurane can inhibit NF-κB activity during myocardial ischemia reperfusion and modulate the cytokine expression,which may be one of molecular mechanisms of Isoflurane delayed preconditioning on cardioprotection.

Objective To investigate the role of opioid receptors in the protective effects of isoflurane-induced delayed preconditioning against myocardial ischemia-reperfusion (I/R) injury in rabbits. Methods Forty male New Zealand white rabbits weighing 2.0-2.5 kg were randomly assigned into 4 groups ( n = 10 each) : group I sham operation (S); group II I/R; group Ⅲ isoflurane + I/R (Iso) and group IV Iso + naloxone + I/R (Nal). Myocardial I/R was induced by 40 min occlusion of left anterior descending branch (LAD) of coronary artery followed by 120 min reperfusion. In group Ⅲ (Iso) 2% isoflurane in 100% O2 was inhaled for 2 h and I/R was produced 24 h later. In group IV (Nal) naloxone 6 mg/kg was given iv 10 min before 2 h of 2% isoflurane inhalation and I/R was produced 24 h later. At the end of 120 min reperfusion, infarct size (IS) and area at risk (AAR) were determined by Evan's blue and TTC staining. Myocardial ultrastructure was examined by electron microscopy. The phosphorylated p38MAPK protein expression in myocardium was determined by Western blot. Results The IS was significantly smaller in group Iso ( Ⅲ ) ( 19.7% ± 2.8%) than in I/R group ( II ) (37.8% ±1.7%) (P<0.05). The phosphorylated p38MAPK protein expression in myocardium was significantly lower in group Iso than in group I/R. Microscopic examination showed less myocardial damage in Iso group than in group I/R. The protective effects of delayed preconditioning by isoflurane was prevented by naloxone pretreatment. ConclusionOpioid receptors may be involved in the protective effects of delayed preconditioning by isoflurane against myocardial I/R injury.