Objective To evaluate the efficacy and safety of small-middle endoscopic sphincterotomy combined with endoscopic papillary balloon dilation for patients with extrahepatic bile duct stone. Methods The patients with special duodenal papilla included 38 cases, and those with normal duodenal papilla 143 cases. 38 patients had received SEST + EPBD, 143 had received MEST + EPBD. Results 181 patients had received SMEST + EPBD in our hospital and the related data were retrospectively analyzed. All 181 patients were successfully removed, the success rate was 100.00 %. There was no perforation occurred postoperatively, but mild acute pancreatitis occurred in 8 patients (4.42 %, 8/181) and bleeding occurred in 9 patients. The three major early complications rate were 9.93 %(17/181), which was cured by the conservative management. Conclusion SMEST plus EPBD is a safe and effective treatment for extrahepatic bile duct stone, with retaining the feature of sphincter of duodenal papilla, especially for patients with special duodenal papilla.

OBJECTIVE:To establish a method for determining the main contents and entrapment efficiency in the bruc-ine nanostructured lipid carrier(NLC). METHODS:HPLC was adopted to determine the main content,sephadex gel filtration meth-od was employed to separate free drug in brucine NLC to determine the entrapment efficiency. The column was Dikma C18 with the mobile phase of mobile phase A(methanol)-mobile phase B [water-acetic acid-triethylamine(230∶2.4∶0.3,V/V/V)](30∶70,V/V)at the flow rate of 1 ml/min,the detection wavelength was 265 nm,volume was 10 μl and temperature was 30 ℃. RESULTS:The linear range of brucine was 4.00-80.00μg/ml(r=0.999 9);RSDs of precision,stability and reproducibility tests were≤1.67%;av-erage recoveries of content determination and sephadex gel filtration method were respectively 99.66%(RSD=0.45%,n=9) and 99.75%(RSD=1.74%,n=9);and the average entrapment efficiency was 69.92%. CONCLUSIONS:The method is simple,re-producible and efficient,and can be used for the determination of main contents and entrapment efficiency in brucine NLC.

Summarize the application of SOAP in the medical field and find out its problems in the course of traditional Chinese medicine, to explore the significance and value of SOAP in teaching practice in TCM. Organize relevant literature and discuss the application of SOAP in the course of Chinese medicine. SOAP is widely used in various aspects of medicine, and there are still some problems in the course of TCM. The use of SOAP model for teaching and assessment has important practical significance and value in the course of Chinese medicine internal medicine practice, and SOAP emphasize the practice of the post competence oriented teaching, which is worth promoting.

Objective:To investigate the clinical characteristics, treatment and prognosis of QARS1 gene related glutaminyl-tRNA synthetase deficiency.Methods:To summarize and analyze the clinical manifestations, imaging, laboratory examination, genetic variant characteristics and treatment of three patients from the Fujian Medical University Affiliated Union Hospital, the 900th Hospital of People's Liberation Army, the First Medical Center of People's Liberation Army General Hsopital carrying compound heterozygous variations in QARS1 gene with a long-term follow-up in China. A literature search was conducted using Wanfang, Weipu, China National Knowledge Infrastructure (CNKI) and Pubmed databases with the keywords "QARS", "QARS1" and "glutaminyl-tRNA Synthetase"(up to December 2019). Results:Case 1, a female 53 days of age, was admitted to the Fujian Medical University Affiliated Union Hospital for treatment because of the complaint of repetitive seizures for one month after birth and fever for one day. The seizure occurred within the first 2 hours of life with multiple forms and often had a status as persisted from hours to days. The seizures were resistant to many anti-epilepsy drugs (AED) and ketogenic diet but later controlled by clonazepam. However, she died at the age of seven years. Case 2 (younger brother of case 1), a one-hour-old boy, was hospitalized because of seizures after birth for 1 hour. Intrauterine growth retardation was discovered during late-pregnancy. The boy presented seizures and microcephaly immediately after birth, and his epilepsy was pharmacoresisitant. Case 3, an 8-month-old girl, was admitted due to recurrent convulsions for nearly two months. The girl had mild developmental retardation and hypotonia after birth. The infantile spasm was observed at her age of 6 months and disappeared under treatment with Vitamin B6, vigabatrin combined with adreno-cortico-tropic-hormone and magnesium sulfate. However, the seizure pattern turned to tonic seizures later. She was seizures free now with clobazam and zonisamide treatment. All of them manifested as a syndrome composed of severe global developmental retardation, progressive microcephaly, hypotonia from the very beginning, mild hypoproteinemia and diffuse brain atrophy. Genetic studies revealed compound heterozygous variations of QARS1 gene which were not reported previously . A review of the literature reported a total of 22 patients from 18 unrelated families all over the world. Except for 5 cases without epilepsy,all the patients shared very similar clinical manifestations as classic pentalogy. The recommended effective treatment for epilepsy has not been reported yet. Conclusions:Glutaminyl-tRNA synthetase deficiency caused by QARS1 gene variations manifested as a clinical syndrome′s pentalogy, characterized by microcephaly, cerebral atrophy, intractable early-onset epileptic encephalopathy, global developmental retardation and severe muscle hypotonia.

Through the screening of blood donors, detection of pathogen antigen and antibody, full coverage of nucleic acid detection, the risk of infectious blood transfusion has been reduced to a very low level. Especially, pathogen inactivation technology (PRT) has played an irreplaceable role in ensuring blood safety. The best way to inactivate pathogens is not only to effectively remove the target pathogens in the blood, but also to maintain the activity of active ingredients in the blood to the maximum extent, and it doesn′t affect the effect of blood therapy. In this paper, the development of pathogen inactivation technology is summarized, and the influence of pathogen inactivation treatment on the quality of blood components is discussed. It provides references for improving or developing new processing technology.

Objective:To understand the profile type of serum Epstein-Barr virus (EBV) antibodies in children with infectious mononucleosis (IM), and to analyze the significance of viral capsid antigen (VCA) IgG antibody affinity in the diagnosis of IM.Methods:Retrospective analysis was performed on the results of the serum anti-EBV antibody profile and plasma EBV nucleic acid test of 150 hospitalized children with IM diagnosed in Beijing Children′s Hospital, Capital Medical University, from May 2016 to May 2019.Anti-EBV antibody profiles, including anti-VCA-IgG, anti-VCA-IgM, anti-early antigen (EA) IgA, anti-EBV nuclear antigen (EBNA) IgG, and anti-VCA-IgG affinity, were detected by enzyme-linked immunosorbent assay (ELISA). Plasma EBV nucleic acids were detected by real-time quantitative PCR.Results:There were mainly two types of anti-EBV antibody profiles in 150 children with IM: (1)130 cases who were positive for anti-VCA-IgM/IgG, negative for anti-EBNA-IgG and positive for anti-VCA-IgG antibodies with low affinity, accounting for 86.7% (130/150 cases), of which 50 cases were positive for anti-early antigen IgA; (2)18 cases who were negative for anti-VCA-IgM, positive for anti-VCA-IgG, negative for anti-EBNA-IgG and positive for anti-VCA-IgG antibody with low affinity, accounting for 12.0% (18/150 cases), of which 5 cases were positive for anti-EA IgA.EBV DNA was measured in 132 children, with a posi-tive rate of 37.9% (50/132 cases).Conclusions:There were several types of serum EBV antibody profiles in children with IM, 12.0% of patients with IM in this study were negative for anti-VCA-IgM, and the diagnosis of IM was confirmed by the affinity of anti-VCA IgG.