Objective To summarize the clinical features,diagnosis,treatment and prognosis of hepatolithiasis complicating cholangiocarcinoma. Methods From June 1958 to March 2011,709 cases of hepatolithiasis were admitted to Department of General Surgery,Peking University Third Hospital.The cases concomitant with cholangiocarcinoma were reviewed. Results 20 of 709 (2.8％ ) hepatolithiasis cases developed cholangiocarcinoma.17 cases (85％,17/20) were followed-up for 2 years (0 - 15 years).The hepatolithiasis course before the malignant diagnosis was 15 ± 1 1 years (3 -38 years).14 cases had frequent episodes of cholangitis,15 cases had liver cirrhosis.Preoperative diagnosis was established by CT,MRCP,B-ultrasound and tumor markers in 55％ (11/20) cases.4 cases underwent radical resection,7 received palliative resection,9 cases received conservative treatment.In radical resection,one lost to follow-up,one survived one year,two for 5 years.In palliative resection,2 lost to follow-up,two survived one year,one survived 3 years, one for 5 years. None in conservative group survived more than one year.Conclusions Cholangiocarcinoma developed from hepatolithiasis with a long history,frequent cholangitis,liver cirrhosis,especially in cases with imige showing thickness of bile duct or mass and rising tumor markers (CA19-9,CA125,CEA).The cases undergoing radical resection may have a favorable prognosis.

Objective To investigate the effect of seasonal and meteorological factors on the onset of stroke in Qinghai Plateau area.Methods Patients with stroke admitted to Qinghai Provincial People's Hospital from December 1,2011 to November 30,2016 were enrolled retrospectively.The meteorological data provided by Qinghai Meteorological Bureau were used to analyze the distribution of the number of cases in different seasons in Qinghai area and the relationship between the incidence of stroke and plateau meteorological factors.Results A total of 9 412 patients with acute ischemic stroke were enrolled,aged 15～95 years.There were significant statistical differences in the number of cases of ischemic stroke,cerebral hemorrhage,and subarachnoid hemorrhage in different seasons (all P ＜ 0.05).Among them,the number of cases with ischemic stroke increased first and then gradually decreased with the changes of spring,summer,fall and winter,while cerebral hemorrhage and subarachnoid hemorrhage showed a trend of decreasing first and then increasing gradually.There were significant differences in the number of cases in different relative humidity,temperature,and temperature differences (all P ＜ 0.05).Conclusion There are seasonal differences in the incidence of stroke in the plateau area,which may be associated with the influence of plateau meteorological factors.

Objective To investigate the relationship between peripheral blood mtDNA content and acute coronary syndrome. Methods A total of 244 patients who received coronary angiography(CAG)was enrolled in this study. They were divided into acute coronary syndrome(ACS)group(n=183)and control group(n=61)ac-cording to the CAG results. A quantitative real-time PCR-based method was used to measure relative content of mtDNA in peripheral blood. According to lesion blood vessel counts ,ACS patients were divided into single lesion group,double lesion group and three lesions group. Gensini score was used to quantitatively evaluate the severity of coronary stenotic lesions. Then we analyzed the relationship of mitochondrial DNA content with the lesion counts and the Gensini score. Results The ACS group had a lower mtDNA content ,as compared to controls (P <0.001).The lesion blood vessel count and mtDNA content in the single ,double and three vascular lesions group were all significanlty lower than that of the control group(P<0.05)and that of the double,three vascular lesions group were both significantly lower than that of the single vascular lesion group(P<0.05). According to the Gensi-ni score,all patients were divided into four groups,where with mtDNA content was decreased with the increase of the Gensini score(P < 0.01). The linear regression analysis showed that Gensini score was negatively correlated with mtDNA content(r=-0.644,P<0.001). ROC curve analysis showed that the area under the curve of mtDNA content for ACS diagnosis was 0.855(P<0.001),with the sensitivity and specificity of 0.756 and 0.833,respec-tively. Conclusion MtDNA content is closely associated with ACS and the Gensini score ,the latter indicating the severity of coronary stenotic lesions. MtDNA content detection has its value in the diagnosis of ACS.

Objective:To explore the family resilience resources in parents of children with congenital pseudarthrosis of the tibia (CPT) , so as to provide a reference for formulating nursing intervention to improve their family resilience.Methods:From December 2020 to January 2021, purposive sampling was used to select 13 father or mother of children with CPT in the Department of Orthopedics of Hunan Children's Hospital as the research object. Semi-structured interviews were conducted with parents of children with CPT using the phenomenological method in qualitative research. Colaizzi 7-step method was used to organize, summarize, analyze and refine the data.Results:The family resilience resources of parents of children with CPT were reflected in three aspects, namely, personal resources, family resources and social resources.Conclusions:Family resilience interventions should make full use of their own resources when implemented in parents of children with CPT. Individualized continuous intervention should be provided by taking into account the learning ability and psychological state of the children's parents and in combination with specific needs. The intervention target should include as many family members as possible, and strengthen the establishment of a diversified support system to help parents of children with a large number of social resources.

Objective To study the effects of the myristoyl-glycine modified peptide which derived from the second intracellular loop of sphingosine 1-phosphate receptor 3 (S1PR3) on activation of mitogenactivated protein kinases (MAPKs) pathway.Methods The phosphorylation levels of JNK and ERK in THP-1 cells were detected by western blot after GPS-725.017 stimulation.Statistical data analysis was conducted by multivariate analysis of variance.Results Western blot showed that 10 min after 30 μmol/L or 50 μmol/L GPS-725.017 stimulated,phosphorylation of ERK significantly increased in comparison with the solvent-treated group [30 μmol/L group:(3.10 ± 0.27) vs.(7.98 ± 0.45),P ＜ 0.01;50 μmol/L group:(4.78 ±0.44) vs.(25.98 ±2.32),P ＜0.01];after 50 μmol/L GPS-725.017 stimulated THP-1 cells for 5 min,10 min,20 min or 30 min,p-ERK or p-JNK level raised at different time points (P ＜0.01vs.solvent group).Conclusions GPS-725.017,a kind of myristoyl-glycine modified peptide derived from S1 PR3,could traverse cytomembrane and activate MAPKs pathway.This study provides an implication of targeting S1PR3 for clinical therapy on inflammatory diseases or sepsis.

Objective To observe the application effect of transcutaneous acupoint electrical stimulation in the psychological craving and protracted abstinence symptoms of alcohol-dependent pa-tients.Methods A total of 120 male alcohol-dependent patients who completed the acute alcohol withdrawal phase and were hospitalized in the Department of Alcoholism in Hunan Brain Hospital were selected as the study subjects.They were divided into conventional drug group,transcutaneous acu-point electrical stimulation group and placebo group according to different treatment methods,with 40 patients in each group.The conventional drug group was treated with benzodiazepine drugs for re-placement and reduction and supportive symptomatic treatment.The transcutaneous acupoint electri-cal stimulation group was treated with conventional treatment combined with transcutaneous acupoint electrical stimulation.The placebo group was treated with conventional treatment combined with simu-lated transcutaneous acupoint electrical stimulation.The Self-rating Anxiety Scale(SAS),Self-rating Depression Scale(SDS),Alcohol Urge Questionnaire(AUQ),Visual Analogue Scale(VAS),Pittsburgh Sleep Quality Index(PSQI)score and recurrence conditions were compared before and af-ter treatment among the three groups.Results After treatment,the SAS,SDS,AUQ and VAS scores of the three groups were lower than those before treatment,and the above scores of the transcu-taneous acupoint electrical stimulation group were lower than those of the conventional drug group and placebo group(P＜0.05).After treatment,the scores of sleep quality,the time to fall asleep,sleep duration,sleep efficiency,sleep disturbance,hypnotic drugs,daytime dysfunction and total PSQI score of the three groups were lower than those before treatment,and the above scores of the transcutaneous acupoint electrical stimulation group were lower than those of the conventional drug group and placebo group(P＜0.05).The recurrence rate of the transcutaneous acupoint electrical stimulation group was lower than that of the conventional drug group and placebo group(P＜0.05).Conclusion Compared with conventional treatment and simulated transcutaneous electrical stimulation,transcutaneous acu-point electrical stimulation is more effective in reducing the severity of protracted abstinence symp-toms such as anxiety,depression and insomnia,and is also beneficial in reducing patients'psycho-logical craving,thereby reducing the recurrence rate.

Objective To observe the application effect of transcutaneous acupoint electrical stimulation in the psychological craving and protracted abstinence symptoms of alcohol-dependent pa-tients.Methods A total of 120 male alcohol-dependent patients who completed the acute alcohol withdrawal phase and were hospitalized in the Department of Alcoholism in Hunan Brain Hospital were selected as the study subjects.They were divided into conventional drug group,transcutaneous acu-point electrical stimulation group and placebo group according to different treatment methods,with 40 patients in each group.The conventional drug group was treated with benzodiazepine drugs for re-placement and reduction and supportive symptomatic treatment.The transcutaneous acupoint electri-cal stimulation group was treated with conventional treatment combined with transcutaneous acupoint electrical stimulation.The placebo group was treated with conventional treatment combined with simu-lated transcutaneous acupoint electrical stimulation.The Self-rating Anxiety Scale(SAS),Self-rating Depression Scale(SDS),Alcohol Urge Questionnaire(AUQ),Visual Analogue Scale(VAS),Pittsburgh Sleep Quality Index(PSQI)score and recurrence conditions were compared before and af-ter treatment among the three groups.Results After treatment,the SAS,SDS,AUQ and VAS scores of the three groups were lower than those before treatment,and the above scores of the transcu-taneous acupoint electrical stimulation group were lower than those of the conventional drug group and placebo group(P＜0.05).After treatment,the scores of sleep quality,the time to fall asleep,sleep duration,sleep efficiency,sleep disturbance,hypnotic drugs,daytime dysfunction and total PSQI score of the three groups were lower than those before treatment,and the above scores of the transcutaneous acupoint electrical stimulation group were lower than those of the conventional drug group and placebo group(P＜0.05).The recurrence rate of the transcutaneous acupoint electrical stimulation group was lower than that of the conventional drug group and placebo group(P＜0.05).Conclusion Compared with conventional treatment and simulated transcutaneous electrical stimulation,transcutaneous acu-point electrical stimulation is more effective in reducing the severity of protracted abstinence symp-toms such as anxiety,depression and insomnia,and is also beneficial in reducing patients'psycho-logical craving,thereby reducing the recurrence rate.

Objective To elucidate the bidirectional causal relationship between lipid profiles and colorectal cancer(CRC)by using the two-sample and two-step Mendelian randomization(MR)methods,and to explore the mediating role and proportion of immune cells as intermediary factors.Methods The pooled statistical data related to the study were screened,and 179 lipids and CRC were analyzed using two-sample and two-step MR with the inverse variance weighted method.Simultaneously,the causal effect was verified via Bayesian weighted MR.Two-step MR analysis was conducted to determine whether a mediated effect was exerted on immune cell traits.Sensitivity,heterogeneity,and pleiotropy analyses were performed to verify the reliability of the study results.Results The causal relationship between nine lipid traits and CRC was preliminarily identified,and no reverse causal effect was found(P>0.05).The validity of the results was verified via Bayesian weighted MR(P<0.05).Twenty-seven types of immune cells were suggested to exert a causal effect on CRC.The causal effect of phosphatidylcholine(O-18:2_20:4)on CRC was determined via mediation analysis(OR:0.8579,95% CI=0.7395-0.9952,P=0.0429).The CD127-mediated proportion on CD45RA+CD4+T cells was 9.14% (β=-0.1052,P=0.0155).Conclusion A causal relationship exists between lipid traits and CRC,and the intervention of CD127 on CD45RA+CD4+T cell helps phosph-atidylcholine reduce the risk of CRC.