Objective To study the effect of laparoscopic cholecystectomy endoscopic sphincterotomy combined with Oddi lithotomy (EST) treatment of gallbladder stone on common bile duct stones. Methods A retrospective analysis between May 2003 and June 2009 ,the combined treatment of LC and EST in 78 patients with common bile duct stones was retrospectivelly analyzed. First, bile duct stones were removed by EST, then laparoscopic cholecystectomy was performed within 5 days. Results EST was performed successfully in 76 cases (97%), failure in 2 cases, 1 case abdominal choledochojejunostomy due to the end of bile duct stenosis; one cases of common bile duct stone diameter of 1.6 cm, firm, failure of mechanical lithotripsy received common bile duct ploration T-tube drainage 76 cases of laparoscopic operation is successful, without obvious bleeding, bile leakage and other severe complications. Conclusions The advantages of EST + LC for the gallbladder stones and common bile duct stones with less trauma, faster recovery, fewer complications, and no T-tube drainage, etc; this is a safe and effective treatment.

Three cases of Good's syndrome with pulmonary lesions in our hospital from June 1,2010 to June 1,2013 were retrospective analyzed and relevant literatures were reviewed.Clinical manifestation,characteristics of pulmonary lesions,diagnosis and treatment were summarized.Abnormality of lymphocyte subpopulation to varying degrees in peripheral blood was detected in all 3 cases.However none showed hypogammaglobulinemia.If thymoma patients developed recurrent respiratory infections,Good's syndrome should be considered.Pulmonary manifestations of Good's syndrome have lesions similar to those of diffuse panbronchiolitis or interstitial lung disease.Early screening of immune competency and treatment for immunodeficiency may improve prognosis.

Alleles ; Animals ; Clustered Regularly Interspaced Short Palindromic Repeats ; genetics ; Embryonic Stem Cells ; metabolism ; Gene Knock-In Techniques ; methods ; Genes, Reporter ; genetics ; Genetic Engineering ; methods ; Genomics ; Mice

Objective:To retrospectively analyze the treatment status of tyrosine kinase inhibitors (TKI) in newly diagnosed patients with chronic myeloid leukemia (CML) in China.Methods:Data of chronic phase (CP) and accelerated phase (AP) CML patients diagnosed from January 2006 to December 2022 from 77 centers, ≥18 years old, and receiving initial imatinib, nilotinib, dasatinib or flumatinib-therapy within 6 months after diagnosis in China with complete data were retrospectively interrogated. The choice of initial TKI, current TKI medications, treatment switch and reasons, treatment responses and outcomes as well as the variables associated with them were analyzed.Results:6 893 patients in CP ( n=6 453, 93.6%) or AP ( n=440, 6.4%) receiving initial imatinib ( n=4 906, 71.2%), nilotinib ( n=1 157, 16.8%), dasatinib ( n=298, 4.3%) or flumatinib ( n=532, 7.2%) -therapy. With the median follow-up of 43 ( IQR 22-75) months, 1 581 (22.9%) patients switched TKI due to resistance ( n=1 055, 15.3%), intolerance ( n=248, 3.6%), pursuit of better efficacy ( n=168, 2.4%), economic or other reasons ( n=110, 1.6%). The frequency of switching TKI in AP patients was significantly-higher than that in CP patients (44.1% vs 21.5%, P<0.001), and more AP patients switched TKI due to resistance than CP patients (75.3% vs 66.1%, P=0.011). Multi-variable analyses showed that male, lower HGB concentration and ELTS intermediate/high-risk cohort were associated with lower cytogenetic and molecular responses rate and poor outcomes in CP patients; higher WBC count and initial the second-generation TKI treatment, the higher response rates; Ph + ACA at diagnosis, poor PFS. However, Sokal intermediate/high-risk cohort was only significantly-associated with lower CCyR and MMR rates and the poor PFS. Lower HGB concentration and larger spleen size were significantly-associated with the lower cytogenetic and molecular response rates in AP patients; initial the second-generation TKI treatment, the higher treatment response rates; lower PLT count, higher blasts and Ph + ACA, poorer TFS; Ph + ACA, poorer OS. Conclusion:At present, the vast majority of newly-diagnosed CML-CP or AP patients could benefit from TKI treatment in the long term with the good treatment responses and survival outcomes.