Objective To explore the selection of palliate operation styles for unresectable malignant obstructive jaundice diseases. Methods The clinical data of 112 cases of unresectable malignant obstructive jaundice diseases in the last 5 years were analyzed retrospectively. Results The rate of operation mortality was 7.1％ and the incidence rate of post-operative cholangitis was 17.3 ％.The survival time in the Roux-en-Y choledochojejunostomy group was (9.4±1.6) months, and there were no significant differences among laparotomy stent internal drainage group[(9.8±12.5)months]and the PTCD stent internal drainage group [(9.0± 3.1)months]. But survival time in the laparotomy bridge internal drainage group [(6.8±1.7)months]was significantly lower (P＜0.05). The survival times in the ERCP stent drainage group [(3.5±2.2)months]and exploratory laparotomy group [(2.8±2.7)months]were even more significantly lower (P＜0.01).Conclusion As a palliative operation for unresectable malignant obstructive jaundice diseases, Roux-en-Y choledochojejunostomy applies to the middle and distal obstruction,laparotomy stent internal drainage applies to hilar obstruction,ERCP stent drainage only applies to distal obstruction,and PTCD stent internal drainage applies to any part obstruction of the bile duct. The Roux-en-Y choledochojejunostomy, laparotomy stent internal drainage, and PTCD stent internal drainage would improve the life time and life quality of these patients.

ObjectiveTo analyze the influence of Jianpi Yuwei decoction combined with omeprazole on ulcer area， gastrointestinal symptoms， and serum trefoil factor family 2 （TFF2） in patients with gastric ulcer （symptom of deficiency-cold in spleen and stomach）. MethodA total of 100 patients with gastric ulcer of symptom of deficiency-cold in spleen and stomach admitted to the Second Affiliated Hospital of Heilongjiang University of Chinese Medicine from May 2020 to April 2022 were regarded as the research subjects. They were randomly grouped into two groups according to the number table method. 50 cases in the control group received omeprazole treatment， while 50 cases in the traditional Chinese medicine （TCM） group received Jianpi Yuwei decoction treatment on the basis of the control group. The clinical efficacy， periodic gastrointestinal symptom score， serum cytokines， gastrin indexes， and ulcer area of the two groups were compared. ResultAfter treatment， the total treatment efficiency of the TCM group was 94.00% （47/50）， while the total effective rate of the control group was 76.00% （38/50）. The total effective rate of the TCM group was higher than that of the control group （χ²=6.353， P<0.05）. After treatment， the scores of periodic upper abdominal pain， bloating， acid reflux， and belching symptoms in both groups decreased （P<0.05）. Compared with that in the control group after treatment， the score of periodic upper abdominal pain， bloating， acid reflux， and belching symptoms in the TCM group decreased more significantly （P<0.05）. After treatment， the levels of TFF2 increased in both groups （P<0.05）， and C-reactive protein （CPR） and tumor necrosis factor （TNF-α） decreased （P<0.05）. Compared with the control group after treatment， the TCM group showed a more significant increase in TFF2 levels （P<0.05）， and CRP and TNF-α levels decreased more significantly （P<0.05）. After treatment， the levels of motilin （MTL）， gastrin （GAS）， cholecystokinin （CCK）-33， and ulcer area decreased in both groups （P<0.05）. Compared with those in the control group after treatment， the levels of MTL， GAS， CCK-33， and ulcer area in the TCM group decreased more significantly （P<0.05）. ConclusionJianpi Yuwei decoction combined with omeprazole can reduce the ulcer area， alleviate periodic gastrointestinal symptoms， and increase serum TFF2 level in patients with gastric ulcer of symptom of deficiency-cold in spleen and stomach， with remarkable effects.

Background::Exercise, as the cornerstone of pulmonary rehabilitation, is recommended to chronic obstructive pulmonary disease (COPD) patients. The underlying molecular basis and metabolic process were not fully elucidated.Methods::Sprague-Dawley rats were classified into five groups: non-COPD/rest ( n = 8), non-COPD/exercise ( n = 7), COPD/rest ( n = 7), COPD/medium exercise ( n = 10), and COPD/intensive exercise ( n = 10). COPD animals were exposed to cigarette smoke and lipopolysaccharide instillation for 90 days, while the non-COPD control animals were exposed to room air. Non-COPD/exercise and COPD/medium exercise animals were trained on a treadmill at a decline of 5° and a speed of 15 m/min while animals in the COPD/intensive exercise group were trained at a decline of 5° and a speed of 18 m/min. After eight weeks of exercise/rest, we used ultrasonography, immunohistochemistry, transmission electron microscopy, oxidative capacity of mitochondria, airflow-assisted desorption electrospray ionization-mass spectrometry imaging (AFADESI-MSI), and transcriptomics analyses to assess rectal femoris (RF). Results::At the end of 90 days, COPD rats’ weight gain was smaller than control by 59.48 ± 15.33 g ( P = 0.0005). The oxidative muscle fibers proportion was lower ( P < 0.0001). At the end of additional eight weeks of exercise/rest, compared to COPD/rest, COPD/medium exercise group showed advantages in weight gain, femoral artery peak flow velocity (Δ58.22 mm/s, 95% CI: 13.85-102.60 mm/s, P = 0.0104), RF diameters (Δ0.16 mm, 95% CI: 0.04-0.28 mm, P = 0.0093), myofibrils diameter (Δ0.06 μm, 95% CI: 0.02-0.10 μm, P = 0.006), oxidative muscle fiber percentage (Δ4.84%, 95% CI: 0.15-9.53%, P = 0.0434), mitochondria oxidative phosphorylate capacity ( P < 0.0001). Biomolecules spatial distribution in situ and bioinformatic analyses of transcriptomics suggested COPD-related alteration in metabolites and gene expression, which can be impacted by exercise. Conclusion::COPD rat model had multi-level structure and function impairment, which can be mitigated by exercise.