Objective To evaluate the effect of progesterone (PROG) on promoting peripheral nerve collateral growth and nerve regeneration after terminolateral neurorrhaphy (TLN). Methods Thirty-six female SD rats were from nine to ten weeks old and weighed from 250 to 270 grams. They were randomly divided into two groups by different drugs they were administrated, the PROG group and the control group. Both groups were subdivide into three groups respectively, PROG four weeks group, PROG eight weeks group, PROG twelve weeks group, control four weeks group, control eight weeks group and control twelve weeks group. There were six subjects in every subgroups. First, both groups were performed ovariectomy. Then, two weeks later, TLN was operated. In the PROG group, the left peroneal nerve was transected, then an 1mm epineukral window was created on the neighbouring. The distal end of peroneal nerve was sutured to the windowed tibial nerve by means of end-to-side attachment. In the control group, nerve TLN was performed as in the PROG group, 0.2ml (10mg/ml) PROG and tea-oil (the solvent of PROG) was injected by subcutaneous injection for days in PROG group and control group respectively. Electrophysiological, histolgicial and morphological examinations were measured at 4,8, and 12 weeks after the operation. Results Regeneration of peroneal nerve occurred in both groups. All the data were analysed by factorial designed analysis of variance. The output demonstrated that there was a signficant difference in the quality of regeneration of peroneal between PROG group and control group (P

Objective To explore the success rate and failure risk factors of biliary stenting on the patients with type Ⅰor Ⅱ duodenal malignant stricture treated by self-expandable metallic stent (SEMS). Methods A total of 36 patients with unresectable duodenal stricture after endoscopic SEMS placement be-tween February 2010 and February 2014 at Xijing Digestive Disease Hospital were enrolled.These patients underwent ERCP biliary metal stenting subsequently due to the malignant biliary stenosis.The clinical and imaging features of these patients were retrospectively analyzed.Results ERCP biliary stenting was suc-cessfully completed in 66.7% of patients with previous duodenal SEMS treatment.The success rates of pa-tients with type Ⅰ and Ⅱ duodenal stricture were 88.0% and 18.2% respectively(P <0.001).The suc-cess rates of patients with different lengths of duodenal stenosis were 88.9% for <3.5 cm and 44.4% for ≥3.5 cm (P =0.005).Compared with 80 or 90 mm duodenal stent,patients with 60 mm stent had a higher completion rate for ERCP biliary stent (88.0% VS 18.2%,P <0.001).Multivariate logistic regression a-nalysis revealed that length of duodenal stenosis ≥3.5 cm and 80 or 90 mm duodenal stent were independent factors for failure of ERCP in patients with previous SEMS placement.Conclusion For unresectable DMS patients with SEMS placement,subsequently ERCP biliary metal stenting is safe and effective.The length of duodenal malignant stenosis and longer duodenal stent are high-risk factors for the failure of ERCP biliary stenting.

Objective To investigate the role of endoscopic retrograde cholangiopancreatography (ERCP) management in the diagnosis and treatment and illustrate clinical features of non-iatrogenic hemobi lia.Methods A total of 35 patients diagnosed as hemobilia via endoscope from August 2009 to September 2012 were reviewed retrospectively.Patients with iatrogenic causes of hemobilia were excluded in this study.Results The clinical features of hemobilia mainly included jaundice (77.1％),abdominal pain (62.9％),hematemesis (5.7％),melena (2.9％) and hematochezia (2.9％).Quincke triad was found in 4 patients with hemobilia.Hemobilia were caused by hepatobiliary malignancies in 29 patients and benign biliary tract diseases in the other six.Biliary obstruction caused by hemobilia was successfully ameliorated by ERCP in 34 patients.Postoperative pancreatitis ocurred in 1 patient.Conclusion The common noniatrogenic causes of hemobilia were hepatobiliary and pancreatic malignancies.ERCP is recommended as the initial management to confirm the hemobilia and solve biliary obstruction.

Objective:To detect expression level of miR-410 in patients with systemic lupus erythematosus (SLE),and to expose the role of miR-410 and its target genes by bioinformatics methods.Methods:Expression level of miR-410 were detected by quantitative RT-PCR in peripheral blood mononuclear cells of SLE patients,and miR-410 sequence,its target genes and Genecards database were analyzed,and analysis of GO enrichment and KEGG Pathway was further performed.Results:miR-410 expression was significantly reduced in SLE patients,and its nucleotide sequence was highly conserved among species.These genes that were predicted to be regulated by miR-410 and associated with LE pathogenesis,included FASLG,CSF2,IFNAR2,MAPK1,PLCG2,IL4 and other genes.Analysis of GO enrichment revealed that miR-410's target genes were involved in cell growth,proliferation,programmed cell death,cell differentiation,immune system development and other biological activities.Analysis of KEGG Pathway showed that the target genes of miR-410 were significantly enriched in a series of signaling pathways including pathways in cancer,cytokine-cytokine receptor interaction,glioma,melanoma,TGF-β and JAK-STAT signaling pathway.Conclusion:miR-410 maybe directly regulate its target molecules,mediate various signal pathway networks,thus participate in the occurrence and development of SLE.

Objective To investigate the efficacy and complications of therapeutic ERCP for patients over 80 years. Methods Data of 80 patients aging over 80 years, who tnderwent therapeutic ERCP from August 2007 to August 2009 were retrospectively studied. The etiology, complications and therapeutic effects were evaluated. Results A total of 51 patients (63. 8% ) were accompanied by cardiovascular diseases, and 43 patients were diagnosed as having malignant bile duct stricture (53. 8% ). The overail therapeutic efficacy was 96. 3%. The incidence of post-operative complications was 12. 5% (10/80). Occurrence of complications in patients with malignant tumors ( 18. 6% ) was significantly higher than that in patients with bile duct stones (5.6% ,P ＜0. 05). Incidence of complications in those with cardiopulmonary diseases was similar with that in patients without (11.8% vs. 13.8%,P＞0.05). Conclusion Age more than 80should not be considered as contraindication of ERCP. Therapeutic ERCP is effective in senior patients. Patients with advanced ages shows a relatively high incidence of complication after ERCP, which may not be related to other accompanying diseases.

Objective To analyze the risk factors of post-ERCP pancreatitis (PEP) and to evaluate the relationship between cannulation time and PEP.Methods The data of cannulation time in 1 625 patients who underwent ERCP from 2010 to 2012 were retrospectively studied.The risk factors associated with PEP were analyzed by univariate and multivariate Logistic regression analysis.The effect of different cannulation time on PEP was evaluated.Results The incidence of overall PEP was 4.6％ (75/1 625) including 4.1％ (67/1 625)of mild and 0.5％ (8/1 625)of moderate-to-severe.Univariate analysis revealed that diabetes mellitus (P =0.02),choledocholithiasis (P =0.02),malignant biliary stenosis (P =0.007),duodenal stenosis (P =0.029),precut (P＜0.01),cannulation time ≥ 8 min (P＜0.01),blood platelet count ≥ 180× 109/L(P =0.089),alkaline phosphatase ≥ 120 U/L (P =0.083) and total bilirubin ≥ 17.1 μmol/L (P =0.094)were associated with PEP.Multivariate analysis revealed that precut (OR=1.93,95％CI:1.10-3.39,P=0.022),cannulation time ≥8 min (OR =3.50,95％CI:2.00-6.13,P＜0.01) and duodenum stenosis (OR=2.92,95％CI:1.08-7.86,P=0.034) were independent risk factors of PEP.Within 30 min of cannulation,longer cannulation time was accompanied with higher PEP rate.Conclusion The cannulation time is an independent risk factor of PEP.Overall PEP is increased when cannulation time is more than 8 min.

Background The use of adaptive optics (AO) system in ophthalmic clinic and basic studies has increased in recent years.However,there are few reports on the stability of ocular aberrations after correction.Objective This study was to analyze the stability of aberration after correction by observing the repeatability of ocular aberration measurements.Methods Forty-one postgraduate school students and volunteers who meet the conditions were included from February to April 2014.The Zernike aberration coefficients including astigmatism (Z2-2,Z22),defocus (Z02),trefoil (Z33,Z3-3),coma (Z3-1,Z13),spherical aberration (Z40) and the value of root mean square (RMS) including 3rd-order to 7th-order aberrations,total higher-order aberrations (HOAs) and total ocular aberrations (TOAs) were measured by using AO system.The repeatability and stability of these data after corrected with AO system were analyzed.The repeatability was evaluated by ANOVA,within-subject standard deviation (Sw),repeatability (r) and intra-class correlation coefficients (ICC).The stability was evaluated by the nonparametric Friedman's rank test.Results AO system showed excellent repeatability on Z2-2,Z22,Z20 and TOA RMS (ICC＞ 0.9),good repeatability on Z13,Z33,Z3-3,Z40,3rd-order RMS,4th-order RMS,HOA RMS (ICC ＞ 0.75),poor repeatability on Z3-1,5th-order RMS,6th-order RMS,7th-order RMS (ICC ＜ 0.75).Repeatability (2.77 Sw) values ranged from 0.009 mm (7th-order RMS) to 0.163 mm (Z31).After low-order ocular aberrations were corrected,It was founded that Z2-2,Z22 reached stable state at the 4th second;Z02 was stable at the 6th second;Z3-3 and Z33 reached stable state at the 4th second and third second,separately;Z13 was stable from 3rd-second to 9th-second,Z3-1 was stable at the 4th-second.Z40 and HOA RMS were stable at the third second and fifth second,respectively.The Z2-2,Z02,Z22,Z3-3,Z3-1,Z33,Z40 and HOA RMS were significantly different among different time points before and after low-order aberrations correction (all at P ＜ 0.05).Z2-2,Z22,Z20 reached stable state at the 4th-second,3rd-second and 5th-second,respectively;Z3-3,Z33 reached stable state at the 2nd-second and 3rd-second,respectively;Z3-1and Z40 reached stable state at the 2nd-second;HOA RMS reached stable state at the 5th-second.Conclusions After correcting the human ocular aberration,different aberrations can reach stable state at different time.The time of Z02,Z22,Z3-3,Z3-1,Z40reaching stable state after 2nd-order to 5th-order ocular aberrations correction was earlier than those of lower-order aberrations correction.

OBJECTIVETo investigate the plasma level of extracellular histones in patients with silicosis, and to explore the role of extracellular histones in the pathogenesis of pulmonary fibrosis in silicosis.

METHODSSixty-two patients with silicosis were enrolled as the silicosis group, consisting of 23 patients with stage I silicosis, 25 with stage II silicosis, and 14 with stage III silicosis; sixty workers who had a history of occupational exposure to silica dust for more than 2 years and had not been diagnosed with silicosis were enrolled as the silica dust exposure group; sixty-five healthy workers without a history of occupational exposure to dust were enrolled as healthy controls. Enzyme-linked immunosorbent assay was applied to measure the plasma levels of plasma extracellular histone (H4) and transforming growth factor-β(TGF-β).

RESULTSCompared with healthy controls [(0.82±0.67) μg/ml], the silica dust exposure group[(4.14±2.85) μg/ml] and silicosis group[(9.50±5.04) μg/ml] had significant increases in plasma level of H4 (P<0.01). The plasma level of H4 was significantly correlated with the stage of silicosis(r=0.8955, P=0.0388). The silicosis group had a significantly higher plasma level of TGF-β than the silica dust exposure group and healthy controls(P <0.05). In the patients with silicosis, the plasma level of H4 was significantly correlated with that of TGF-β(r=0.5375, P<0.01).

CONCLUSIONThe plasma level of extracellular histones increases significantly in the pathogenesis of silicosis, and extracellular histones may play an important role in the progression of fibrosis in silicosis.

Case-Control Studies ; Disease Progression ; Dust ; Histones ; blood ; Humans ; Occupational Exposure ; Silicon Dioxide ; Silicosis ; blood ; pathology ; Transforming Growth Factor beta ; blood

Objective:To investigate the outcome and prognostic factors associated with endoscopic retrograde cholangiopancreatography (ERCP) in patients with primary sclerosing cholangitis (PSC).Methods:PSC patients admitted to Xijing Hospital from May 2009 to May 2020 were included. Data of demographics, clinical symptoms, laboratory and imaging tests, and ERCP consultations were collected to explore the population characteristics and clinical efficacy of ERCP treatment, and to follow up disease progression, transplant-free survival, and overall survival .Results:A total of 74 patients with PSC were included in this study, with a median age of 53 years, 54.1% (40/74) male. Patients combined with bile duct dominant stenosis, inflammatory bowel disease (IBD), and another autoimmune liver disease were 32.4% (24/74), 18.9% (14/74), and 17.6% (13/74), respectively, and those undergoing ERCP were 36.5% (27/74). Logistic regression analysis showed that high total bilirubin ( OR=12.33, 95% CI: 1.24-122.63, P=0.032) and bile duct dominant stenosis ( OR=24.67, 95% CI: 3.40-178.88, P=0.002) were independent high-risk factors for ERCP consultation. The operation and clinical success rates of ERCP were both 96.3% (26/27). As of the last follow-up, the proportions of patients progressing to cirrhosis, bile duct cancer, liver transplantation and death were 9.5% (7/74), 4.1% (3/74), 5.4% (4/74) and 18.9% (14/74), respectively. The five-year survival rate of the follow-up patients ( n=54) was 83.3%. The differences in transplant-free survival ( P=0.933) and overall survival ( P=0.608) between ERCP patients and non-ERCP patients were not statistically significant. Transplant-free survival of those who were companied with pruritus ( HR=5.30, 95% CI: 1.50-18.90, P=0.010) was shorter. Conclusion:PSC patients have higher proportion of IBD and less autoimmune liver disease. Higher proportion of patients with higher total bilirubin or bile duct dominant stenosis receive ERCP. While the short-term efficacy of ERCP is satisfactory, the long-term prognosis is still suboptimal. Patients with pruritus have a shorter transplant-free survival.

Objective To investigate the clinical outcome of pancreatic pseudocyst(PPC)treated with non-surgical methods,and to compare the efficacy and safety between percutaneous drainage and endoscopic drainage in the management of PPC.Methods From February 2010 to July 2017,clinical data of patients with PPC,who received percutaneous drainage or endoscopic drainage,were retrospectively analyzed.The symptom relief rate,short-term and long-term radiologic remission rate,complication rate, recurrence rate and length of hospital stay were compared between patients treated by ultrasound guided percutaneous drainage(percutaneous group),by endoscopic ultrasonography-guided drainage(EUS group)and by endoscopic retrograde pancreatography guided transpapillary drainage(ERP group).Two independent samples t test,one-way analysis of variance,non-parametric test and Fisher′s exact test were performed for statistical analysis.Results A total of 153 patients were treated and the operation was successfully conducted in 148 patients(96.7%),of whom 39 were in percutaneous group,73 in EUS group and 36 in ERP group.The median follow-up time was 26 weeks(two weeks to 358 weeks).The symptom relief rate,long-term radiographic remission rate,complication rate,recurrence rate and retreatment rate of percutaneous group,EUS group and ERP group were 87.2%(34/39),79.5%(58/73),80.6%(29/36);81.5%(22/27),88.6%(39/44),66.7%(16/24);17.9%(7/39),28.8%(21/73),16.7%(6/36);15.0%(3/20),13.8%(8/58),10.0%(2/20);and 10.3%(4/39),8.2%(6/73),2.8%(1/36),respectively.There was no statistically significant difference among three groups (all P> 0.05).The short-term radiographic remission rate of ERP group was significantly lower than those of percutaneous group and EUS group(46.7%,14/30 vs 77.1%,27/35 and 87.7%,64/73),and the differences were statistically significant(χ2 =6.442 and 19.450,both P<0.01).The median hospital stay of percutaneous group was longer than those of EUS group and ERP group(14.0 days vs 9.0 days and 8.0 days),and the differences were statistically significant(Z= -3.687 and -2.630,both P<0.01).Conclusions The efficacies of percutaneous drainage and EUS-guided drainage are both better than ERP,and they are effective and safe methods especially for the patients with complication of pseudocysts and necrosis debris in pseudocysts.However,the hospitalization time of percutaneous drainage is longer. In addition,percutaneous drainage can be an alternative method after failed endoscopic drainage.