Type Ⅰ congenital biliary dilatation is a congenital biliary duct defect disease.It is also called congenital choledochocele cyst (CCC).Endoscopic ultrasonography (EUS),magnetic resonance cholangiopacreatography (MRCP) and endoscopic retrograde cholangiopancreatography (ERCP) are very important for the diagnosis.Operation is generally regaded as the best choose.It is recommended that cholecystectomy + choledochal cyst excision + hepatic duct jejunum Roux-Y anastomosis is the chief therapeutic method.This article reviews the pathogenesis,classifications,diagnosis and treatment of the disease.

Objective To investigate the related factors affecting prognosis of patients with colorectal cancer undergoing palliative resection.Methods The clinical data of 345 patients with colorectal cancer who underwent palliative resection at the First Affiliated Hospital of Guangxi Medical University between January 2007 and December 2011 were retrospectively analyzed.Patients selected the emergent operations or restrictive operation based on the conditions of patients,and then received chemotherapy,radiotherapy and biotherapy.Chemotherapy regimens included FOLFOX4 (5-FU/CF + oxaliplatin) regimen,XELOX (capecitabine + oxaliplatin) regimen and FOLFIRI (5-FU + CF + irinotecan) regimen.Biotherapy regimens included molecular targeted therapies using bevacizumab and cetuximab.The follow-up was applied to patients by outpatient examination,telephone interview and correspondence once every 3 months up to March 1,2014.The survival curve was drawn by the Kaplan-Meier method.The survival rate was analyzed using the Log rank test.The multivariate analysis was done using the COX regression model.Results Of the 1 930 patients,345 patients received palliative resection with a percentage rate of 17.876％.Among the 345 patients,104 patients received emergent operations and others received restrictive operations.After operation,178 patients received adjuvant treatment,FOLFOX4 regimens were done on 85 patients,XELOX regimens on 32 patients,FOLFIRI regimens on 20 patients,radiotherapy on 17 patients and molecular targeted therapies on 24 patients.Seven patients died in the perioperative period and other patients were followed up for 3.0-82.0 months with a median time of 14.0 months.The 1-,3-and 5-year survival rates and the mean survival time were 49.57％,11.88％,6.38％ and 22.6 months,respectively.The results of univariate analysis showed that the CEA levels,bowel obstruction,primary tumor resection,peritoneal implantation,distal metastasis,lymph node metastasis,tumor differentiation,postoperative adjuvant therapy were related factors affecting the prognosis of patients undergoing palliative resection (x2=3.742,18.795,37.641,13.470,4.228,5.835,4.108,6.875,P ＜0.05).The results of multivariate analysis showed that the bowel obstruction,without primary tumor resection,peritoneal implantation,low-differentiation of tumor and without postoperative adjuvant therapy were the independent risk factors affecting the prognosis of patients undergoing palliative resection (RR =1.674,2.273,1.947,1.582,1.342,95％ confidence interval:1.193-2.485,1.646-4.376,1.497-3.587,1.184-2.382,1.032-2.074,P ＜ 0.05).Conclusion The low-differentiation of tumor,peritoneal implantation,bowel obstruction,without primary tumor resection and without postoperative adjuvant therapy are the independent risk factors affecting the prognosis of patients with colorectal cancer undergoing palliative resection.

Adult ; Drug Resistance, Microbial ; Female ; Humans ; Male ; Middle Aged ; Pneumonia ; complications ; microbiology ; Silicotuberculosis ; complications ; microbiology

AIM:To conduct the relevance analysis of serum Dickkopf-1 (Dkk-1) and bone mineral density (BMD) in the different ages of female populations.METHODS: The women volunteers (n=100, 20~80 years old) were selected and divided into young group (20~39 years old), middle age group (40~59 years old) and elderly group (60~80 years old).The serum levels of Dkk-1 in the 3 groups of volunteers were detected by ELISA.In the middle age group, 25 people of 45~55 years old were selected and divided into postmenopausal group and premenopausal group to de-tect the serum level of Dkk-1 in the 2 groups of volunteers by ELISA.The BMD was measured by the method of dual energy X-ray absorptiometry.The differences of Dkk-1 expression levels among different ages of female populations, and the rele-vance with BMD were compared.RESULTS:With the increase in age, the serum Dkk-1 expression level increased ( P<0.05), and BMD were reduced (P<0.05).The blood level of Dkk-1 and BMD negatively correlated (P<0.05) in the 3 groups of volunteers.The serum levels of Dkk-1 and BMD had stronger negative correlation in postmenopausal women group than that in premenopausal women group.CONCLUSION:With the increase in age, the expression level of serum Dkk-1 increases and the BMD level decreases, which contribute to a risk of osteoporosis.In the same age range, the postmeno-pausal women express higher level of Dkk-1, and the decreased BMD is more obvious, which contribute to a greater risk of osteoporosis.The increased level of Dkk-1 also inhibits bone formation and promotes bone resorption.It may become a new target for preventing and treating osteoporosis.

ObjectiveTo evaluate the application of quantitative sensory testing(QST) in hemodialysis (HD) patients with peripheral neuropathy.MethodsThe values of the quantitative sensory testing and sensory conduction velocity at different locations of extremities in 40 cases of the HD patients and 40 normal persons were recorded.ResultsAccording to the control group,without symptoms group and with symptoms group,the thermal threshold(TT) and vibratory threshold (VT) at the four different locations of extremities were increased,thresholds of the later two groups were significantly higher than those of normal controls (P ＜ 0.05 ).Especially finger warm and vibratory thresholds,hypothenar heat pain thresholds,instep heat pain and vibratory thresholds,calf cold pain and vibratory thresholds were significantly difference between with symptoms group and normal control group (P＜0.01 ).Finger cool and warm thresholds,instep heat pain thresholds,thresholds of calf warm,cold pain and heat pain,and vibratory thresholds at the four different locations of extremities were significantly difference between wthout symptoms group and with symptoms group (P＜ 0.05).The SCV values of the median nerve,tibial nerve and lateral popliteal nerve were significantly difference between HD patients group and normal control(P ＜0.05 ).The total abnormal rate of QST was 65％,with symptoms group was 77.27％,total abnormal rate of SCV was 55.0％,with symptoms group was 68.18％.The total abnormal rate of QST were significantly higher than those of SCV (P＜0.01 ).ConclusionQST is a sensitive method for diagnosis of uremic neuropathy.

Objective:To evaluate the accuracy of lung ultrasound score (LUSS) in predicting emerging hypoxemia after tracheal extubation in the patients in postanesthesia care unit (PACU).Methods:A total of 333 patients of both sexes, aged 18-89 yr, of American Society of Anesthesiologist physical statusⅠ-Ⅲ, scheduled for elective abdominal surgery, were included in the study.Lung ultrasound examinations were performed before operation (T 0) and on admission to PACU (T 1), and the LUSS were recorded as LUSS 0 and LUSS 1.Arterial blood gas analysis was conducted at 20 min after tracheal extubation, and oxygenation index (PaO 2/FiO 2) were recorded.Patients were divided into 2 groups according to the oxygenation index: PaO 2/FiO 2<300 mmHg group (hypoxemia group), and PaO 2/FiO 2≥300 mmHg group (non-hypoxemia group). Multivariate logistic regression analysis and the receiver operating characteristic curve were used to evaluate the accuracy of LUSS 1 in predicting the emerging hypoxemia after extubation in the patients in PACU. Results:The incidence of emerging hypoxemia in PACU after extubation was 9.0%.Multivariate logistic regression analysis indicated that LUSS 1 and body mass index were independent risk factors for emerging hypoxemia after extubation in the patients in PACU.The area under the ROC curve for LUSS 1 was 0.873 ( P<0.001, 95%CI 0.812-0.935). The patients with LUSS 1<7 had a lower risk of hypoxemia after extubation (LR -=0.15, 95%CI 0.05-0.45), and the patients with LUSS 1>10 had a higher risk of hypoxemia after extubation (LR + =17.25, 95%CI 7.35-40.51). Conclusion:LUS can effectively predict the development of hypoxemia after tracheal extubation in the patients in PACU.

At present, China has not yet established a comprehensive standard and evaluation system specifically for occupational health engineering ventilation inspection. In order to meet the requirements for the design of occupational-disease-prevention facilities, the evaluation of occupational disease hazard control effectiveness, and the protective facilities, the Guangdong Provincial Occupational Health Technical Quality Control Center developed the Guangdong Province Occupational Health Engineering Ventilation Inspection Work Specification (Trial) by referring domestic and international standards and norms related to occupational health engineering, industrial ventilation design manuals and professional literature, using brainstorming and experience-based methods. The work specification covers the key detection indicators of ventilation systems, and comprehensively covers the core links of occupational health engineering ventilation testing. The relevant indicators mainly include: detection of air velocity control; wind speed and air volume of exhaust hoods and exhaust vents of ventilation facilities; detection of wind pressure, wind speed and air volume inside the ventilation duct; fresh air volume detection; and calculation and evaluation of ventilation frequency. The specification is highly practical, indicting scientific and advanced principles, and ensures the fairness and reliability of the testing process and results. Its implementation will effectively promote the standardization and professionalism of occupational health engineering ventilation testing, providing robust technical support for safeguarding workers' health.

Background: Glycolytic function is obviously related to the proliferation, metastasis and drug resistance of colorectal cancer, and there is still a lacking of corresponding indicators for quantitatively evaluating the level of glycolysis. Aims: To investigate the correlation between

Objective To analyze the phenotypic characteristics of LAP+CD4+ T lymphocytes and investigate their molecular mechanisms in colorectal cancer ( CRC ) microenvironment. Methods Fifty colorectal cancer patients treated in our two hospitals from January 2014 to May 2014 were included in this study. Their tumor tissues and adjacent normal tissues, peripheral blood samples, and peripheral blood samples of 25 healthy donors ( HD) were collected to isolate the lymphocytes. The different expressions of CCR7, CD45RA, Foxp3, CTLA?4, CCR4 and CCR5 in LAP+CD4+ T and LAP-CD4+ T lymphocytes were analyzed by flow cytometry ( FCM) . Results The FCM assay detected that the percentage of LAP+CD4+ T cells in peripheral blood of the CRC patients were significantly higher than that of HD [(9.44±3.18)%versus (1.49±1.00)%, P<0.001]. In addition, significantly more LAP+CD4+ T cells were also recruited into tumor tissue than those in the tumor?adjacent normal tissue [(11.76±3.74)% versus (3.87±1.64)%, P<0.001]. LAP+CD4+ T cells in the tumor?adjacent normal tissue and peripheral blood of both HDs and CRC patients mainly displayed a central memory phenotype. However, effector memory lymphocytes were predominant in the tumor tissue.In the tumor tissue, the expression of Foxp3 in the LAP+CD4+ T cells was (3.87±1.12)%, significantly lower than that in the LAP-CD4+ T cells (16.70±2.61)%, (P<0.001); the expression of CTLA?4 in the LAP+CD4+ T cells was (36.36±19.14)%, significantly higher than the (19.60± 8.91)% in the LAP-CD4+ T cells ( P<0. 001); the expression of CCR4 in the LAP+CD4+ T cells was (37.72±11.14)%, significantly higher than the (30.06±9.14)% in the LAP-CD4+ T cells (P<0.001);and the expression of CCR5 in the LAP+CD4+ T cells was (18.86±7.10)%, significantly higher than the (13.92±3.31)% in the LAP-CD4+ T cells (P<0.001). Conclusions LAP+CD4+ T cells with low expression of Foxp3 and high expressions of CTLA?4, CCR4 and CCR5 are tend to be enriched and accumulated in the tumor tissue. The unique phenotypic characteristics make these cells a distinct subset of lymphocytes, apparently different from the traditional CD4+CD25+ Treg cells.