Objective To explore clinical strategies of treating in bile microlithiasis-associated cholangitis and preventing the recurrence of ursodeoxycholic acid(UDCA).Methods Forty-one cases of bile microlthiasis-associated cholangitis from January 2006 to July 2007 Were analyzed and followed up.All patients underwent endoscopic therapy who were divided into UDCA group(21 cases)and non-UDCA group (20 cases)according to the use of UDCA or not besides endoscopic therapy.After using UDCA for 12 months,the complications and the incidence rate of recurrent cholangitis in each group were compared.Results Forty-one cases had no serious complications after endoscopic therapy.None had recurrent cholangitis in UDCA group,4 cases in non-UDCA group got recurrent cholangitis.One case developed pancreatitis.There was statistical significance between the two groups(P=0.021).Conclusion Endoscopic therapy is a safe and effective treatment of bile microlithiasis-associated cholangitis,and UDCA can prevent the recurrent cholangitis effectively after endoscopic therapy.

Delphian lymph node is a part of Ⅵlymph node.According to the latest research ,the metasta-sis rate in papillary thyroid carcinoma ( PTC) is up to nearly 20%.Meanwhile ,the Ⅵlymph node is usually con-sidered as the sentinel lymph node of PTC metastasis .Most scholars believe that .Delphian lymph nodes may have certain clinical significance in the development process of PTC .This article aims to summarize the research pro-gress in clinical relations between the Delphian node and papillary thyroid carcinoma .

Objective:To comprehensively analyze the current research status, hotspots, and development trends in the field of fatigue in maintenance hemodialysis patients both domestically and internationally in order to provide reference for future research directions.Methods:Relevant literature on the fatigue status of maintenance hemodialysis patients from the establishment of the database to the publication before December 30, 2022 was retrieved through CNKI, VIP database, Wanfang database, and Web of ScienceTM core collection database, and visualized using CiteSpace 6.1.R3 for analysis.Results:A total of 152 Chinese articles and 110 English articles were included. Analysis showed that foreign publications were first published in 1996, while domestic publications were first published in 2011, and the number of publications has shown a significant upward trend since 2017. The research focus at home and abroad mainly focuses on the influencing factors and intervention measures of fatigue in dialysis patients. Foreign researchers have paid more attention to the correlation between "depression" emotions and the positive intervention of aerobic exercise. In addition, China is actively exploring traditional Chinese medicine therapy aromatherapy to alleviate patient fatigue.Conclusions:In the future, clinical workers should pay attention to fatigue assessment in maintenance hemodialysis patients and explore the influencing factors of fatigue through large-scale longitudinal studies, in order to better provide intervention targets for the treatment of fatigue; Simultaneously conduct high-quality prospective intervention studies to maximize the improvement of fatigue status in such patients and form standardized guidelines for promotion and application.

OBJECTIVE To systematically evaluate the risk factors for cefoperazone/sulbactam-induced coagulation dysfunction in adult patients. METHODS Retrieved from CNKI， VIP， CBM， Wanfang data， PubMed， Embase and Cochrane Library， randomized controlled trial （RCT）， case-control study or cohort study about cefoperazone/sulbactam-induced coagulation dysfunction in adult patients were collected from the inception to Apr. 30th， 2023. After literature screening， data extraction and quality evaluation， meta-analysis was carried out by using RevMan 5.3 software. RESULTS A total of 13 studies were included， among which 11 studies were case-control studies， and 2 studies were cohort studies， involving 18 387 patients in total. Meta- analysis showed that the proportion of advanced age [OR＝2.04， 95%CI （1.14， 3.64）， P＝0.02]， liver insufficiency [OR＝5.95， 95%CI （4.21， 8.40）， P＜0.000 01]， renal insufficiency [OR＝3.51， 95%CI （3.04， 4.05）， P＜0.001]， hypoproteinemia [OR＝ 1.90， 95%CI（1.37， 2.62）， P＜0.001]， poor diet [OR＝7.25， 95%CI （5.13， 10.24）， P＜0.000 01]， daily dose of cefoperazone/ sulbactam ≥9 g [OR＝3.95， 95%CI （2.45，6.37）， P＜0.001]， medication duration of cefoperazone/sulbactam ≥10 d [OR＝2.43， 95%CI （1.81， 3.28）， P＜0.001]， combined use of anticoagulant drugs [OR＝2.84， 95%CI （2.03， 3.97）， P＜0.001]， combined with malignant tumor [OR＝1.60， 95%CI （1.20， 2.15），P＜0.001] in patients with abnormal coagulation function were significantly higher than those with normal coagulation function. CONCLUSIONS Advanced age， liver insufficiency， renal insufficiency， complicated with malignant tumors and hypoalbuminemia， combined use of anticoagulant drugs， poor diet， daily dose ≥9 g， and medication duration≥10 days are risk factors for coagulation dysfunction caused by cefoperazone/sulbactam.