Objective To investigate the value of endoscopy in the diagnosis and treatment of biliary obstructions on different sites with variable causes. Methods The clinical records of biliary drainages under duodenoscope in 104 patients with biliary obstruction from October 1998 to November 2002 was reviewed retrospectively. Results Drainage was successfully completed in 97 patients, with a success rate of 93.3%(97/104). The patients were relieved of their symptoms of biliary obstruction (abdominal pain, jaundice and fever), and the effective rates of ENBD and ERBD were 93.0% (66/71) and 93.3% (28/30), respectively. Conclusions Endoscopic drainage for biliary obstruction has advantages of minimal invasion, rapid recovery, short hospital stay and apparent efficacy. Emphasis should be placed on the site of drainage and proper selection of operative method to further elevate its success rate.

OBJECTIVE:To establish a method for the simultaneous determination of uracil,hypoxanthine,xanthine,uridine and adenosine in Eisenia foetida. METHODS:HPLC was performed on the column of Venusil XBP C18 with mobile phase of 50%methanol-0.01 mol/L potassium dihydrogen phosphate solution(gradient elution)at a flow rate of 1.0 ml/min. The detection wave-length was 254 nm with a column temperature at 30 ℃,and the injection volume was 10 μl. RESULTS:The linear range was 0.05-1.60 μg for uracil(r=0.9991),0.05-1.60 μg for hypoxanthine(r=0.9993),0.002-0.010 μg for xanthine(r=0.9991), 0.0075-0.24 μg for uridine(r=0.9999)and 0.0250-0.80 μg for adenosine(r=0.9990);RSDs of precision,stability and accuracy tests were lower than 3%;recoveries were 98.30%-100.76%(RSD=0.8%,n=9),98.68%-100.96%(RSD=0.8%,n=9), 95.16%-97.67%(RSD=0.9%,n=9),96.15%-99.57%(RSD=1.5%,n=9)and 96.39%-101.93%(RSD=1.8%,n=9),respective-ly. CONCLUSIONS:The method is simple and stable with good reproducibility,and can be used for the simultaneous determina-tion of uracil,hypoxanthine,xanthine,uridine and adenosine in E. foetida.

AAIM:To investigate the effect of atorvastatin ( ATO) on electrical remodeling, atrial ion channel protein expression and cardiac function in atrial tachypacing rabbits, and to explore the potential electrical mechanism of ATO in the prevention of atrial fibrillation.METHODS:The rabbits were subjected to atrial tachypacing at 600 min-1 in the absence or presence of treatment with atorvastatin (ATP and ATO groups) for 48 h, and the other 10 as sham group without pacing ( NP group) .The tachypacing model was performed by attaching pacing and testing electrodes to left atrial and connecting with custom animal cardiac pacemaker in the open-chest situation.The animals in ATO group were pretrea-ted with ATO for 7 d and continued during tachypacing.Serial atrial effective refractory period ( AERP) was measured in each rabbit at baseline, 8 h, 16 h, 24 h, 32 h, 40 h and 48 h with different cycle lengths.The changes of cardiac func-tions and cardiac structure were observed by cardiac ultrasonic cardiogram before and after atrial tachypacing.The expres-sion of atrial ion channel proteins CaLα1 and Kv4.3 was detected by Western blotting.RESULTS:Compared with NP group, AERP at cycle lengths of 150 and 200 ms, the adaption of AERP, and the levels of CaLα1 and Kv4.3 expression were all decreased in ATP and ATO group, especially in ATP group.Left atrial dimension ( LAD) was increased in pacing groups as compared with NP group (P<0.05) after pacing delivery for 48 h, while no difference between the formers was observed.No significant change of the left ventricular dimension ( LVD) and ejection fraction ( LVEF) among groups be-fore and after pacing was found.CONCLUSION:Atrial tachypacing significantly shorten AERP, resulting in poor adap-tion of AERP, while ATO pretreatment significantly attenuates the atrial electrical remodeling in rabbits, but had no effect on cardiac structure.ATO suppresses the down-regulation of atrial ion channel proteins CaLα1 and Kv4.3 expression after 48 h, which may be the potential ionic mechanism of atrial electrical remodeling for ATO.

Objective To evaluate the function of regulatory T (Treg)cells in peripheral blood from patients with psoriasis, and to explore the possible role of the STAT3 signaling pathway in Treg cell dysfunction. Methods Totally, 81 patients with psoriasis vulgaris, who all presented with chronic plaques and had a psoriasis area and severity index (PASI)score of 10 - 30, were enrolled into this study. Forty-six healthy blood donors served as the control group. Venous blood samples were collected from these subjects followed by isolation of Treg cells and responder T (Tresp)cells. Flow cytometry was performed to determine the proportion of Treg cells in peripheral blood as well as that of cells secreting phosphorylated-STAT3(p-STAT3), interferon γ(IFN-γ), tumor necrosis factor α(TNF-α)and interleukin 17(IL-17)in Treg cells, and quantitative real-time PCR (qRT-PCR)to measure the expression levels of IFN-γ, TNF-α and IL-17 mRNAs in Treg cells. Some Treg cells and Tresp cells were cultured in vitro alone or in combination, and flow cytometry was conducted to estimate cellular proliferative activity on day 7 after stimulation with IL-2. Some patient-derived Treg cells were classified into several groups to be cultured alone or in combination with Tresp cells with or without the presence of the STAT3 pathway inhibitor, Stattic V (10 or 50 μg/L), for 7 days. Subsequently, flow cytometry was performed to evaluate the proliferative activity of Tresp cells, and qRT-PCR to measure the expression levels of IFN-γ, TNF-α and IL-17 mRNAs in Treg cells. Results No significant differences were observed in the proportion of Treg cells in peripheral blood between the patient group and control group (6.437% ± 0.186% vs. 6.812% ± 0.241%, t = 1.224, P >0.05). Compared with control-derived Treg cells, the patient-derived Treg cells showed significantly decreased proliferative activity and inhibitory effects on Tresp cells, but increased proportion of cells secreting p-STAT3, IFN-γ, TNF-α and IL-17 (all P < 0.05). After the treatment with 50 μg/L Stattic V, a significant increase was observed in the inhibitory effect of patient-derived Treg cells on Tresp cells (inhibition rate: 61.670% ± 4.640% vs. 28.820% ± 11.490%, P < 0.05), but a significant decrease in the mRNA expressions of IFN-γ (2-△△C t: 1.654 ± 0.879 vs. 23.350 ± 6.721, P <0.05), TNF-α(0.850 ± 0.705 vs. 4.847 ± 1.525, P < 0.05)and IL-17(0.572 ± 0.135 vs. 3.095 ± 0.650, all P < 0.05)in patient-derived Treg cells compared with untreated patient-derived Treg cells. Conclusions The negative regulatory effect of Treg cells on Tresp cells is decreased in patients with psoriasis, which may be associated with abnormal activation of the STAT3 signaling pathway, and inhibition of the pathway may restore the function of Treg cells to a certain extent.

Objective To analyze the clinical features of takayasu's arteritis in elderly patients for improving their general management.Methods Twenty-six patients,aged over 60 years,with takayasu's arteritis were enrolled.The clinical manifestations and medical records were collected in detail and analyzed retrospectively.Results The mean age of the patients in our study was 64.0±3.8 years,four males and twenty-two females.Of all patients,nine were accompanied by coronary heart disease,seven by primary hypertension,four by diabetes mellitus,two by arrhythmia and one by subacute infective endocarditis.The frequent clinical manifestations were hypertension (n = 21,81%),dizzy (n=12.46%),chest pain (n=9,35%),pulselessness or weak pulse (n=7,27%).The clinical classification of this group showed brachiocephalic artery type (n = 8,30%),abdominal aorta type (n=4,15%),extensive type (n=11,58%) and pulmonary artery type (n=3,12%).Ten patients had elevated ESR level,six had elevated CRP level and fourteen had elevated ASO level.Two patients with diabetes mellitus died of serious complications.Conclusions Takayasu's arteritis in the elderly is usually accompanied by other cardiovascular diseases and risk factors.It is important to enhance the comprehensive treatment of these patients.

This report presented the endemic status of schistosomiasis in the People’s Republic of China at a national level in 2015,and analyzed the data collected from the national schistosomiasis prevention and control system and 457 national schis?tosomiasis surveillance sites. Among the 12 provinces(municipality,autonomous region)endemic for schistosomiasis japonica in P. R. China,5 provinces(municipality,autonomous region),i.e.,Shanghai,Zhejiang,Fujian,Guangdong and Guangxi, had achieved transmission interruption,and 7 provinces of Sichuan,Yunnan,Jiangsu,Hubei,Anhui,Jiangxi and Hunan had achieved transmission control by the end of 2015. There were 453 endemic counties(city,district)covering 252 million peo?ple,specifically including 29 980 endemic villages of 68.61 million people at risk of infection. Among the 453 endemic counties (city,district),75.72%(343/453)and 24.28%(110/453)reached the criteria of transmission interruption and transmission control,respectively. By the end of 2015,it was estimated of 77 194 cases of schistosomiasis,which were decreased by 33.23%compared with 115 614 cases in 2014. No acute schistosomiasis cases were reported in 2015. There were 30 843 advanced schis?tosomiasis cases documented in 2015. A total of 8 736 036 individuals received schistosomiasis examinations and 3 606 individu?als were parasitologically diagnosed,which were decreased by 56.40%compared with 8 270 cases in 2014. An Oncomelania hu?pensis snail survey was performed in 19 965 endemic villages and the snails were found in 5 609 villages,accounting for 28.09%of total villages,with 31 newly detected villages with snails. The snail survey covered an area of 593 572.66 hm2 and snails were found in an area of 173 462.50 hm2,including a newly detected area of 666.04 hm2. No infected snails were found in 2015. A to?tal of 879 373 bovines were raised in the schistosomiasis endemic regions. Of them,526 062 bovines received stool examina?tions,resulting in 315 infected bovines. There were 170 438 schistosomiasis cases receiving drug treatment in 2015,with 2 449 696 individuals undergoing expanded chemotherapy. There were 318 bovines with schistosomiasis receiving drug treatment,with 483 213 bovines undergoing expanded chemotherapy. A total of 144 305.52 hm2 area was subject to snail control by using mollus?cicides,with an actual molluscicide?treated area of 69 221.57 hm2,and 4 572.06 hm2 snail habitats were treated by environmen?tal modification. Based on the data from the 457 national schistosomiasis surveillance sites,the mean Schistosoma japonicum in?fection rate was 0.05% and 0.04% in humans and bovines,respectively. No infected snails were found in all the surveillance sites. The results demonstrate a decline in the endemicity of schistosomiasis in P. R. China and the country reached the criteria of transmission control at the national level. However,the endemic situation of schistosomiasis is unstable in some regions with newly?reached transmission control,and further control and effective surveillance should be strengthened to consolidate the achievements and reduce the endemic situation of schistosomiasis in P. R. China.

Objective:To explore influence of hyperglycemia on hospitalization and follow‐up prognosis in patients with acute ST elevation myocardial infarction (STEMI ) undergoing direct percutaneous coronary intervention (PCI) .Methods :A total of 218 patients ,who were diagnosed as STEMI and received emergency PCI within 12h af‐ter onset from our hospital ,were enrolled .According to blood glucose level at hospitalization and OGTT results , they were divided into normal blood glucose (NBG) group (n= 108) ,hyperglycemia group (n= 60) and diabetes mellitus (DM) group (n=50) .Cardiac function indexes were evaluated ;Logistic regression analysis was used to an‐alyze influencing factors for mortality in these patients .Results:Compared with NBG group , the in‐hospital mortal‐ity was significant rise (1.9% vs .10.0% ) in DM group ;there were significant rise in percentages of ≥double‐vessel coronary disease (41.2% vs .68.8% vs .66.7% ) and ≥2 stents implanted (14.72% vs .50.0% vs .55.6% ) in women in hyperglycemia group and DM group (P<0.05 or <0.01);Multi‐factor Logistic regression analysis indi‐cated that Killip class ,NT‐proBNP ,number of diseased vessels and body mass index were independent risk factors of in‐hospital mortality of these patients (OR=1.012~5.923 ,P<0.05 all) ,and female was a strong independent risk factor for in‐hospital mortality and mortality within one‐year follow‐up (OR=20.376 ,7.227 ,P<0.01 both) .Con‐clusion:The mortality significantly rises in STEMI patients undergoing emergency PCI complicated with hyperglyce‐mia ,especially in female patients .

Objective To investigate whether miR-122 is a target of oxymatrine against HBV. Methods HepG2.2.15 cells were incubated with culture medium containing different concentrations of oxymatrine. The cyto-toxicity of oxymatrine was determined by cck-8 assay. The surface antigen of HBV (HBsAg),antigenof HBV (HBeAg)and HBV DNA in supernatant and intracellular miR-122 were determined in HepG2.2.15 cells after incu-bation with culture medium containing oxymatrine for 72 h. Results The survival percentage of HepG2.2.15 cells under different concentrations of oxymatrine was higher than 95% when the concentration of oxymatrine was lower than 4 mg/mL. After treatment with oxymatrine for 72 h,the secretion of HBsAg and HBeAg,the level of HBV DNA in the supernatant were reduced. The intracellular miR-122 in oxymatrine experience group was 3.5 times higher than that in the negative control group. Conclusions Oxymatrine might be used to inhibit viral replication and antigen expression by enhancing the expression of miR-122 in HepG2.2.15 cells.

Objective To investigate the changes of thyroid hormone in peritoneal dialysis patients and analyse its impact factors, as well as the therapeutic effects of small dose of thyroxine.Methods 150 uremic patients in Hunan Provincial People’s Hospital from December 2013 to December 2014 were selected, 70 cases of uremia non-dialysis patients were divided into group A, while 80 uremia peritoneal dialysis for more than half a year were divided into group B.70 cases healthy examinees during the same period in our hospital were selected as control group ( group C ) . The total triiodothyronine (T3), total thyroxine (T4), free triiodothyronine (FT3), free thyroxine (FT4), thyroid stimulating hormone (TSH), hemoglobin (Hb), serum albumin (ALB), total cholesterol (TC), triglyceride (TG), serum creatinine (SCr), C reactive protein (CRP) and left ventricular ejection fraction ( LVEF) , subjective global assessment of nutritional act ( SGA) and other indicators were detected in three groups.Patients in group B were divided into two sub-groups according to thyroid hormone levels: B1 group had normal thyroid level while B2 abnormal.And the administration of small dose of thyroid hormone was given to patients in group B2, and the effect of the administration was evaluated by the above indexes.Results The FT3 in group A and B were significantly lower than that in group C (P<0.01).There were significant differences of levels of ALB, CRP, SGA between group B1 and group B2, and the FT3 level in group B was significant correlated with SGA, ALB, LVEF(r=0.815,P<0.001;r=0.780,P<0.001;r=0.953,P<0.001).After treated with small dose of thyroid hormone, FT3 and LVEF were improved while FT4, TSH, ALB, SGA, CRP were not improved in group B2.Conclusion The thyroid hormone level in patients with continuous ambulatory peritoneal dialysis decreases which is dominated with FT3.The decreased thyroid level is significantly correlated with nutrition ( ALB, SGA) and left ventricular function.The administration of small dose of thyroid hormone can improve the left ventricular systolic function.

OBJECTIVETo analyze the effects of three surgical operations in the treatment of Pilon fracture of Rüedi-Allgower type III, and put forward the best therapeutic method.

METHODSThe clinical data of 33 patients with Pilon fracture who received surgical operations (plaster immobilization group, 10 cases; distal tibia anatomical plate group, 11 cases; external fixation with limited internal fixation group, 12 cases) from October 2009 to January 2012 were analyzed. There were 5 males and 5 females, ranging in age from 24 to 61 years in the plaster immobilization group. There were 7 males and 4 females, ranging in age from 21 to 64 years in the distal tibia anatomical plate group. There were 7 males and 5 females, ranging in age from 23 to 67 years in the external fixation with limited internal fixation group. The Ankle X-ray of Pilon fracture after operation, ankle score, early and late complications were collected. Bourne system was used to evaluate ankle joint function.

RESULTSAfter 8 months to 3 years follow-up, it was found that three kinds of treatment had significant differences in the outcomes and complications (P < 0.05): the external fixation with limited internal fixation group got the best results. The number of anatomic reduction cases in the external fixation with limited internal fixation group (7 cases) and the distal tibia anatomical plate group (8 cases) was more than the plaster immobilization group (2 cases). According to the ankle score, 8 patients got an excellent result, 3 good and 1 poor in the limited internal fixation group ,which was better than those of distal tibia anatomical plate group (5 excellent, 4 good and 2 poor) and the plaster immobilization group (3 excellent, 4 good and 3 poor). The number of early and late complications in the external fixation with limited internal fixation group was more than those in the plaster immobilization group and the distal tibia anatomical plate group (P< 0.05).

CONCLUSIONTreatment of external fixation with limited internal fixation in the treatment of Pilon fracture of Rüedi-Allgower type III is effective and safe.

Adult ; Aged ; Case-Control Studies ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Tibial Fractures ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed ; Treatment Outcome ; Young Adult