Gallbladder-duodenal fistula,a severe complication of cholecystitis caused by gallstones,is clinically rare.Its clinical presentation lacks specificity,and conventional preoperative imaging often fails to establish a definitive diagnosis.This report describes a case where a gallbladder-duodenal fistula was diagnosed using oral microbubble ultrasound contrast agent for gastric-duodenal contrast-enhanced ultrasound,providing a novel approach for diagnosing this condition.
Humans ; Biliary Fistula/diagnostic imaging* ; Contrast Media ; Duodenal Diseases/diagnostic imaging* ; Gallbladder Diseases/diagnostic imaging* ; Intestinal Fistula/diagnostic imaging* ; Ultrasonography

Objective: To study the clinicopathological and genetic features of natural killer (NK)-cell enteropathy for better understanding of this rare disease and prevention of its misdiagnosis. Methods: Two cases of NK-cell enteropathy were diagnosed in the First Affiliated Hospital of Zhengzhou University, China from October 2017 to February 2021. The clinical characteristics, morphology, immunohistochemistry, Epstein-Barr virus-encoded RNA (EBER) in situ hybridization and T cell receptor gene rearrangement were analyzed. The patients were followed up by a telephone interview. Results: The patients were both male, aged 40 and 28 years, respectively. Both patients were admitted to the hospital for an annual checkup without obvious gastrointestinal symptoms. The endoscopy showed that the gastric body of case 1 had a mucosal bulge, small area of congestion and erosion, while the rectum of case 2 had congestion and erosion. Microscopically, the lesions of the 2 cases were relatively limited. Many lymphoid cells infiltrated within the lamina propria of the mucosa and into the muscularis mucosa in case 2. In case 1, the glands were reduced in the lesion, and the glandular cavity was slightly compressed and deformed. There was no infiltration or destruction of the glands in either case. Lymphoid cells were atypical, with medium-to-large cell sizes. Their cytoplasm was medium-to-slightly abundant and appeared eosinophilic or translucent. In case 2, characteristic eosinophilic granules were seen in the cytoplasm of a few cells. The nuclei in both cases were round, oval and irregular, with fine chromatin, inconspicuous nucleoli, and no mitotic figures were noted. Necrosis was seen in case 1 while both cases had no central growth or destruction of blood vessels. Immunophenotyping showed that CD56, granzyme B and TIA-1 were positive in both cases, part of the cells was CD3-positive, and some cells were weakly CD4-positive in case 2. The CD5, CD8, CD30, ALK and B-lineage markers (CD20, CD79α) were all negative. The Ki-67 proliferation index was about 60% and 30%, respectively. Both cases were EBER negative. TCR gene rearrangement was polyclonal. Follow-up showed that none of the 2 patients had any special treatments and stayed well. Conclusions: NK-cell enteropathy is rare, with biological behaviors similar to benign tumors, and occasional recurrence. Its histology and immunophenotype are easily confused with NK/T cell-derived lymphomas. Combination of its unique endoscopic features, EBER negativity, polyclonal TCR gene rearrangement and good prognosis can confirm the diagnosis and avoid misdiagnosis and overtreatment.
Epstein-Barr Virus Infections ; Herpesvirus 4, Human/genetics* ; Humans ; Immunophenotyping ; Killer Cells, Natural ; Lymphoproliferative Disorders ; Male

The impact of intestinal flora on human and animal health and diseases has attracted much attention both at home and abroad in recent years. The intestinal flora constitutes the intestinal microecosystem and plays an important role in physiological activities such as nutrition, metabolism, growth and development, barrier protection, and immunity. In this article, the relationship between intestinal dysbiosis and psychiatric diseases has been reviewed from two aspects:metagenomic characterization of intestinal microflora diversity in neurological diseases and validation of the relationship between intestinal flora and psychiatric diseases by fecal bacteria transplantation in germ-free mice. In addition, the microbial-gut-brain axis theory has been proposed in recent years, which links the nerve-endocrine-immune system to form a two-way signaling pathway. Intestinal flora plays an important role in regulating the central nervous system by promoting neurotransmitter release, endocrine, and immunity. The system plays an important role. Changes in intestinal flora mainly affect the host's nervous system through vagus nerve pathways, endocrine pathways, immune pathways, etc, thereby triggering or aggravating depression, autism, Alzheimer's disease, schizophrenia, Parkinson's disease, etc. This article reviews the relationships between host-related neurological abnormalities, intestinal flora imbalance and mental diseases, and discusses the research methods, research progress, and mechanism of the correlation between intestinal flora imbalance and mental diseases to research progress on microbe-gut-brain axis.

Catalpol is the main active ingredient of an extract from Radix rehmanniae, which in a previous study showed a protective effect against various types of tissue injury. However, a protective effect of catalpol on uterine inflammation has not been reported. In this study, to investigate the protective mechanism of catalpol on lipopolysaccharide (LPS)-induced bovine endometrial epithelial cells (bEECs) and mouse endometritis, in vitro and in vivo inflammation models were established. The Toll-like receptor 4 (TLR4)/nuclear factor-κB (NF-κB) signaling pathway and its downstream inflammatory factors were detected by enzyme-linked immunosorbent assay (ELISA), quantitative real-time polymerase chain reaction (qRT-PCR), western blot (WB), and immunofluorescence techniques. The results from ELISA and qRT-PCR showed that catalpol dose-dependently reduced the expression of pro-inflammatory cytokines such as tumor necrosis factor α (TNF-α), interleukin (IL)-1β, and IL-6, and chemokines such as C-X-C motif chemokine ligand 8 (CXCL8) and CXCL5, both in bEECs and in uterine tissue. From the experimental results of WB, qRT-PCR, and immunofluorescence, the expression of TLR4 and the phosphorylation of NF-κB p65 were markedly inhibited by catalpol compared with the LPS group. The inflammatory damage to the mouse uterus caused by LPS was greatly reduced and was accompanied by a decline in myeloperoxidase (MPO) activity. The results of this study suggest that catalpol can exert an anti-inflammatory impact on LPS-induced bEECs and mouse endometritis by inhibiting inflammation and activation of the TLR4/NF-κB signaling pathway.
Animals ; Cattle ; Chemokines/genetics* ; Cytokines/genetics* ; Endometritis/drug therapy* ; Epithelial Cells/drug effects* ; Female ; Inflammation/prevention & control* ; Iridoid Glucosides/therapeutic use* ; Lipopolysaccharides/pharmacology* ; Mice ; NF-kappa B/physiology* ; Signal Transduction/drug effects* ; Toll-Like Receptor 4/physiology*

Objective :To explore influence of Xingnaojing injection on levels of nitric oxide (NO) ,insulin-like growth fac-tor 1 (IGF-1) ,macrophage migration-inhibitory factor (MIF) and its therapeutic effect in patients with hypertensive cere-bral hemorrhage (HCH).Methods :A total of 96 HCH patients treated in our hospital were selected .According to random number table ,they were randomly and equally divided into routine treatment group and Xingnaojing group ,both groups were treated for two weeks .Levels of serum inflammatory factors ,NO ,IGF-1 ,MIF and United states national institutes of health stroke score (NIHSS) before and after treatment ,and therapeutic effect were compared between two groups .Re-sults :Compared with before treatment ,after treatment ,there were significant reductions in levels of CRP ,TNF-α ,IL-6 , MIF and NIHSS score ,and significant rise in levels of NO and IGF-1 in two groups ,P＝0.001 all ;compared with routine treatment after treatment ,there were significant reductions in levels of CRP [ (18.59 ± 4.90) mg/L vs.(12.48 ± 2.56) mg/L] ,TNF-α [ (29.45 ± 5.80) μg/ml vs.(23.02 ± 6.89) μg/ml] ,IL-6 [ (97.56 ± 21.25) μg/ml vs.(88.56 ± 20.12) μg/ml] ,MIF [(50.78 ± 4.90) ng/L vs.(42.02 ± 6.12) ng/L] and NIHSS score [(7.45 ± 2.23) scores vs.(5.12 ± 1.23) scores] ,and significant rise in levels of NO [ (43.56 ± 5.88) μmol/L vs.(50.46 ± 6.39) μmol/L] and IGF-1 [ (55.78 ± 6.03) nmol/L vs.(61.56 ± 8.02) nmol/L] in Xingnaojing group , P＜0.05 or ＜0.01. After treatment ,total effective rate of Xingnaojing group was significantly higher than that of routine treatment group (93.75% vs.72.92%,P＝0.006). Conclusion : Xingnaojing injection can significantly reduce inflammation level ,improve cerebral neurological function and clinical therapeutic effect in HCH patients .

OBJECTIVEThe effects of arsenic exposure from drinking water, arsenic metabolism, and arsenic methylation on blood pressure (BP) were observed in this study.

METHODSThe BP and arsenic species of 560 participants were determined. Logistic regression analysis was applied to estimate the odds ratios of BP associated with arsenic metabolites and arsenic methylation capability.

RESULTSBP was positively associated with cumulative arsenic exposure (CAE). Subjects with abnormal diastolic blood pressure (DBP), systolic blood pressure (SBP), and pulse pressure (PP) usually had higher urinary iAs (inorganic arsenic), MMA (monomethylated arsenic), DMA (dimethylated arsenic), and TAs (total arsenic) than subjects with normal DBP, SBP, and PP. The iAs%, MMA%, and DMA% differed slightly between subjects with abnormal BP and those with normal BP. The PMI and SMI were slightly higher in subjects with abnormal PP than in those with normal PP.

CONCLUSIONOur findings suggest that higher CAE may elevate BP. Males may have a higher risk of abnormal DBP, whereas females have a higher risk of abnormal SBP and PP. Higher urinary iAs may increase the risk of abnormal BP. Lower PMI may elevate the BP. However, higher SMI may increase the DBP and SBP, and lower SMI may elevate the PP.

Adult ; Arsenic ; analysis ; metabolism ; toxicity ; Blood Pressure ; drug effects ; China ; Drinking Water ; analysis ; chemistry ; Environmental Exposure ; Female ; Humans ; Male ; Methylation ; drug effects ; Middle Aged ; Water Pollutants, Chemical ; analysis ; toxicity ; Young Adult

The present study was designed to search for compounds with analgesic activity from the Schizophyllum commune (SC), which is widely consumed as edible and medicinal mushroom world. Thin layer chromatography (TLC), tosilica gel column chromatography, sephadex LH 20, and reverse-phase high performance liquid chromatography (RP-HPLC) were used to isolate and purify compounds from SC. Structural analysis of the isolated compounds was based on nuclear magnetic resonance (NMR). The effects of these compounds on voltage-gated sodium (NaV) channels were evaluated using patch clamp. The analgesic activity of these compounds was tested in two types of mouse pain models induced by noxious chemicals. Five phenolic acids identified from SC extracts in the present study included vanillic acid, m-hydroxybenzoic acid, o-hydroxybenzeneacetic acid, 3-hydroxy-5-methybenzoic acid, and p-hydroxybenzoic acid. They inhibited the activity of both tetrodotoxin-resistant (TTX-r) and tetrodotoxin-sensitive (TTX-s) NaV channels. All the compounds showed low selectivity on NaV channel subtypes. After intraperitoneal injection, three compounds of these compounds exerted analgesic activity in mice. In conclusion, phenolic acids identified in SC demonstrated analgesic activity, facilitating the mechanistic studies of SC in the treatment of neurasthenia.
Analgesics ; administration & dosage ; chemistry ; isolation & purification ; Animals ; Humans ; Hydroxybenzoates ; administration & dosage ; chemistry ; isolation & purification ; Mice ; Neurasthenia ; drug therapy ; genetics ; metabolism ; Schizophyllum ; chemistry ; Voltage-Gated Sodium Channel Blockers ; administration & dosage ; chemistry ; isolation & purification ; Voltage-Gated Sodium Channels ; genetics ; metabolism

The aim of this study is to prepare hyaluronic acid (HA) modified core-shell liponanoparticles (pHA-LCS-NPs) as gene delivery system and investigate its gene transfection efficiency in human retinal pigment epithelium (ARPE-19) cells in vitro. The pHA-LCS-NPs was prepared by firstly hydrating dry lipid film with CS-NPs suspension to get LCS-NPs, then modifying the lipid bilayer with HA by amidation reaction between HA and dioleoyl phosphatidylethanolamine (DOPE). Its morphology, particle size and zeta potential were investigated. XTT assay was used to evaluate the cell safety of different vectors in vitro. The gene transfection efficiency of pHA-LCS-NPs modified with different contents of HA was investigated in ARPE-19 cells with green fluorescent protein (pEGFP) as the reporter gene. The results showed that the obtained pHA-LCS-NPs exhibited a clear core-shell structure with the average particles size of (214.9 +/- 7.2) nm and zeta potential of (-35 +/- 3.7) mV. The 24 h cumulative release of gene from pHA-LCS-NPs was less than 30%. After 48 h incubation, gene transfection efficiency of pHA-LCS-NPs/pEGFP was 1.81 times and 3.75 times higher than that of CS-NPs/pEGFP and naked pEGFP, respectively. Also no obvious cytotoxicity was observed on pHA-LCS-NPs. It suggested that the pHA-LCS-NPs might be promising non-viral gene delivery systems with high efficiency and low cytotoxicity.
Cell Survival ; Gene Transfer Techniques ; Genes, Reporter ; Genetic Vectors ; Green Fluorescent Proteins ; metabolism ; Humans ; Hyaluronic Acid ; chemistry ; pharmacology ; Lipids ; Nanoparticles ; Particle Size ; Phosphatidylethanolamines ; chemistry ; pharmacology ; Retinal Pigment Epithelium ; drug effects ; Transfection

To analyze the gE gene sequence of varicella-zoster virus (VZV) strains of different clades and subclades currently circulating in China. Eighteen skin lesion fluid swabs or skin scab pieces from patients with chickenpox or shingles were obtained from Beijing, Changchun, Lhasa and Urumqi between December 2010 and June 2011. The genotype of the virus strains was determined by a group of single nucleotide polymorphism (SNP) located in 15 ORFs, and the full-length gE genes of 18 strains representing all the clades in the study was amplified by PCR and sequenced. In addition to the synonymous mutations and non-synonymous mutations that were reported in the literature, there were 3 novel non-synonymous mutations (C56T, C1109T, C917A) and 4 new synonymous mutations (C54T, T1075C, T816C, G279A) found in the 8 strains analyzed. We found the VZV strains of clade 5 in Xinjiang for the first time,and the genotypes of some VZV strains circulating in Chagnchun could not be determined by the present methods. The analysis of gE gene sequences,revealed a novel non-synonymous mutations in the e1 and c1 epitopes, corresponding to the amino acid change of serine to tyrosine.
Adolescent ; Adult ; Aged ; Base Sequence ; Chickenpox ; virology ; Child ; China ; Female ; Genotype ; Herpesvirus 3, Human ; classification ; genetics ; Humans ; Male ; Middle Aged ; Molecular Sequence Data ; Mutation, Missense ; Open Reading Frames ; Sequence Analysis, DNA ; Viral Envelope Proteins ; genetics ; Viral Proteins ; genetics ; Young Adult