Biliary Tract Diseases ; Humans ; MicroRNAs

Objective To evaluate the efficacy and safety of retrograde wire in chronic total occlusion with calcification.Methods 4 patients with chronic total occlusion with calcification were selected.3 RCA and 1 LAD as CTO target vessel.Side branches proximal to the occlusion waspresent in all patients,2 of 4 with extreme tortuosity,1 of 4 with ostial occlusion in LAD.At the support of 150cm Finecross microcatheter,all patients were treated with the retrograde technique,with 3 of 4 as primary strategy,1 of 4 as immediately after antegrade failure.Results Retrograde wire crossed the collaterals and successfully delivered distal to the occlusion in all patients.Epicardial collateral from LCX to RCA was accessed in 1 patient,and septal in 3 of 4 patients.Reverse CART technique was applied in 2 of 4 patients,and subsequent exteriorization of the retrograde wire via the antegrade guide was completed.Kissing of antegrade and retrograde microcatheters inside antegrade guide was completed and antegrade wire crossed the CTO lesion via retrograde microcatheter in 1 patient.Both retrograde and antegrade wires could not cross the CTO lesion in 1 patient with extreme tortuosity and severe calcification,and the RCA CTO lesion was not opened in this patient.Overall successful rate was 75％.Drug eluting stents were implanted in 3 successfully recanalized vessels.All patients had no complications during procedure and subsequent hospitalization.Conclusion The retrograde approach was used with high degree of success and safety in chronic total occlusion with calcification.

Objective To discuss the intervention effect of cognition therapy for perioperative patients of digestive tract with depression and/or anxiety symptoms.Methods 135 patients with digestive tract operation were randomly divided into intervention group and non-intervention group.The patients in intervention group accepted cognition therapy.The Mores of SDS and SAS,the curative effect and hospitalized time were compared among the two groups and the norlns of our country at last.Results (1)The scores of SDS and SAS in the two group patients in pre-operation were no difference(P＞0.05),but all were significantly higher than those of the norms of our country(P＜0.01).It indicated that patients have evident depression and/or anxiety symptoms pre-operation. (2)Compared with pre-operation,the scores of SDS and SAS in the intervention group patients showed significantly lower after operation(P＜0.01),which returned to the norms of our country(P＞0.05),and showed lower than those of the non-intervention group predominantly (P＜0.01).This indicated that cognition therapy can relieve the depression and/or anxiety symptoms of the perioperative patients.(3)Though the therapeutic effect of the two group are similar(P＞0.05),but the hospitalized fime decurated in the intervention group predominantly(P＜0.01).Conclusion The periopexative patients of digestive tract had obvious depression and/or anxiety symptoms.Cognition therapy could relieve the depression and/or anxiety sympmms of the perioperative patients,this was helpful for patients to recover early.

Objective To compare the influences of different dilution titers on the ANA detection by the indirect immunofluores‐cence assay(IIF) in children for investigating the necessity of reducing serum initial dilution titer .Methods Serum ANA was detec‐ted by using the indirect immunofluorescence assay at a serial of dilution titer in 110 healthy controls and the results were compared with the results of specific ANAs by the linear immunoassay (LIA);meanwhile the ANA‐LIA results in clinical children patients with ANA‐IIF negative were also analyzed .Results With the dilution titers gradual decrease from 1∶80 ,1∶40 and 1∶20 in the samples of the health group ,the positive detection rates of ANA‐IIF were risen ,which were 7 .3% ,9 .1% and 10 .9% respectively , but the differences were not statistically significant (P>0 .05) ,the weak‐positive rates were 7 .3% ,15 .5% and 31 .8% respective‐ly ,the differences were statistically significant (P<0 .01) .Among 110 healthy children under going the physical examination ,the specific ANA was detected out in 8 samples ,the positive rate was 7 .3% .Among 8 positive cases at the dilution titer of 1∶80 by the IIF method ,specific ANA was in 2 cases;in 4 added cases of fluorescence ANA positive samples at the dilution titers of 1∶40 and 1∶20 ,specific ANA was in 1 case .If with any positive of ANA‐IIF(1∶80) or ANA‐LIA as the ANA positive ,the ANA positive rate was risen from 7 .3% to 12 .7% .In the clinical samples among 29 cases of ANA‐IIF(1∶80) negative autoimmune liver disease related autoantibody detection ,the specific ANA‐LIA positive was detected in 5 cases (17 .2% ) .Conclusion Reducing the initial ti‐ter of children serum is unable to obviously increase the ANA‐IIF positive detection rate ,on the contrary increases the non‐specific weak positive .Therefore ,clinical laboratory does not change the dilution titer of children routine ANA sample .The detection by combining with the specific ANA‐LIA spectrum is conducive to find ANA .

ObjectiveTo study the method,indications, advantage and shortcoming of laparoscopic repair of inguinal hernia. MethodsFrom Jun. 1995 to Jun. 2000,50 patients with inguinal hernia were treated with laparoscopy. There were 34 indirect inguinal hernia, 9 direct inguinal hernia and 7 concealed hernia. The transabdominal preperitoneal laparoscopic mesh repair of hernia(TAPP) was performed in 34 patients. Closure of the internal orifice of hernia was performed in 7 patients. Totally extraperitoneal repair was performed in 9 patients. ResultsAll cases were operated successfully. The mean operation time was 59.3(15～180) mins. The average length of postoperative stay was 5.4(3～7)days. There were no death record and no conversion operation. There was one early failure owing to the use of too small a piece of mesh. There has been no long-term recurrence. ConclusionThe results indicate that mesh repair of hernias is a satisfactory technique with a low recurrence rate and a low major complication rate.

To better evaluate neuromuscular function of patients with stroke related motor dysfunction, we proposed an effective corticomuscular coherence analysis and coherent significant judgment method. Firstly, the related functional frequency bands in the electroencephalogram (EEG) were extracted via wavelet decomposition. Secondly, coherence were analysed between surface electromyography (sEMG) and sub-bands extracted from EEG. Further more, a coherent significant indicator was defined to quantitatively describe the similarity in certain frequency domain and phase lock activity between EEG and sEMG. Through the analysis of corticomuscular coherence during knee flexion-extension of stroke patients and healthy controls, we found that the stroke patients exhibited significantly lower gamma-band corticomuscular coherence in performing the task with their affected leg, and there was no statistically significant difference between their unaffected lag and the healthy controls, but with the rehabilitation training, the bilateral difference of corticomuscular coherence in patients decreased gradually.
Case-Control Studies ; Electroencephalography ; Electromyography ; Exercise Therapy ; Humans ; Knee ; physiology ; Muscle, Skeletal ; physiology ; Range of Motion, Articular ; Stroke Rehabilitation

Objective To discuss the clinical application of homemade airway exchange catheter on the extubation of patients with difficult tracheal intubation in intensive care unit(ICU). Methods Sixty-two patients with difficult tracheal intubation who failed their initial extubation trial were randomly divided into conventional group (31 cases)and observation group(31 cases). The patients in the conventional group received routine extubation process,while the patients in the observation group were extubated under the guidance over a homemade airway exchange catheter. The changes in heart rate(HR),blood pressure,respiratory rate(RR)and pulse blood oxygen saturation(SpO2)were compared at 12 hours after extubation,so as the re-intubation rate,intubation success rate at first attempt and re-intubation time in two groups,and the tolerance and complications after extubation were observed. Results After extubation,the HR,blood pressure and RR were increased significantly(all P<0.05), and the SpO2 was much lower in conventional group(P<0.05),while those parameters were changed little and basically in the normal ranges in the observation group. At 12 hours after extubation,the re-intubation rate was much lower(6.45%vs. 25.81%,P<0.05)in the observation group,with shorter re-intubation time(seconds:27±14 vs. 49±28,P<0.01),higher intubation success rate at first attempt(90.32%vs. 54.84%,P<0.01)and better tolerance (77.4% vs. 61.3%,P<0.05)compared with those in the conventional group. There was no severe complication in the observation group,and there were 1 cases of glottic edema with cricothyroid membrane puncture,2 cases of broncheal mucous membrane bleeding and 2 cases of bucking in the conventional group. Conclusion Compared with conventional extubation process,the extubation over homemade airway exchange catheter can increase the rate of extubation,reduce re-intubation rate and the re-intubation time,with favorable tolerance and no occurrence of serious complications,and is one of the safe and effective extubation strategies in patients with difficult tracheal intubation in ICU.

Objective To explore the expression of antigen activated of macrophages ( MΦ) of bone marrow and its clinical significance in pancytopenia patients with positive bone marrow mononuclear cells (BMMNC)-Coombs test ( immunorelated pancytopenia, IRP) . Methods Sixty-one IRP patients, 10 severe aplastic anemia (SAA) patients and 13 healthy controls were enrolled in this study. The categories of auto-antibodies(IgG, IgM) on BMMNC(CD_(34)~+/CD_(15)~+/GlycoA~+ hematocytes), the quantity (CD_(68)~+/CD_(45)~+)% and expression of antigen activated ( CD_(69) ) of MΦ ( CD_(68)~+ CD_(69)~+/CD_(68)~+ ) % in bone marrow of all cases and controls were measured by fluorescence activated cell sorting( FACS). Results The quantity and expression ratio of activated antigen of bone marrow ( BM ) MΦ in IRP patients [ ( 0. 57 ± 0. 30 ) % and ( 40. 30 ± 18.49)%] were respectively significantly higher than those in SAA [ (0.46 ± 0. 08)% and ( 32. 44 ± 19.37)%] and healthy controls [ (0. 44 ± 0. 69)% and (29.71 ± 11. 67 )% ] ( both P < 0. 05 ). The quantity presented high-positive correlation with the expression ratio of activated antigen of BM MΦ ( r = 0.89, P<0. 01). Patients with IRP were classified into two subgroups according to the quantity of MΦ: Group A (MΦ≥0. 5% , 34 cases) and Group B ( MΦ <0. 5% , 27 cases). Thirty-two cases (94. 12%) were with auto antibody ( IgG) in Group A, while only 2 (7. 41% ) with auto antibody ( IgG) in Group B. There was significant difference in expression ratio of activated antigen of BM MΦ between Group A (49. 19 ± 16. 63) % and Group B (29. 11 ± 14. 30) % ( P < 0. 05 ) , but no difference was found between Group B and the control group (P >0. 05). Total curative rates at 3 and 6 month (47. 06% and 79. 41% ) of Group A were better than those of Group B (22.22% and 51.85%). Thirty-four IRP patients with autoantibody ( IgG) ( + ) were divided into two subgroups according to the quantity of MΦ: high level group ( >0. 75% , 9 cases) and low level group( <0. 75% , 25 cases) , 24 cases (96% ) in MΦ low level group were found auto-antibody (IgG) on one hemotopoietic cell lineage, 1 on two lineages, while 8 (88. 89% ) in MΦ high level group were detected auto-antibody (IgG) on two cell lineages, and 1 on three cell lineages. Expression ratio of activated antigen (56. 12 ± 15. 11) % was much higher in MΦ high level group than that in MΦ low level group (44. 58 ± 18. 16)% (P < 0. 05 ). The count of red blood cell concentration of hemoglobin and platelet in peripheral blood in MΦ high level group were respectively lower than those in MΦ low level group, while the percentage of Ret, the level of total bilirubin and indirect bilirubin, the ratio of erythroid of sternal bone marrow in MΦ high level group were higher than those in MΦ low level group. Conclusion The expression of activated antigen of BM MΦ was enhanced in IRP especially with autoantibody (IgG) , which might be involved in damage process of hemotopoietic cell.

Objective To explore the efficacy of quantitative susceptibility mapping (QSM) in the assessment of osteoporosis and the impact factors on the QSM values.Methods A total of 105 volunteers (35 males and 70 females) were recruited in this study.The height,weight,waistline and hipline were measured,and the body mass index was calculated.All the subjects underwent MRI-based QSM and quantitative computed tomography (QCT).The measurement of QSM and QCT values was performed on L3 vertebrae body.According to QCT value,the subjects were divided into three groups (normal,osteopenia and osteoporosis).According to age,the subjects were divided into group I (21-30 years old),group 2 (31-40 years old),group 3 (41-50 years old),group 4 (51-60 years old),and group 5 (＞60 years old).Differences among all groups were compared using one-way ANOVA or Kruskal-Wallis.Results According to QCT value,54 subjects were normal,22 osteopenic and 29 osteoporotic.The QSM value for the subjects with osteoporosis [148.60(109.42,188.81)ppb] was significantly higher than that of normal (P＜0.001)and the osteopenia (P＜0.001).The QSM value for the subjects with osteopenia was significantly higher than the normal (P＜0.001).The coefficient of QSM and BMD was-0.749 (P＜0.001).Multiple linear regression showed age was the independent influence factor for QSM value (r=0.72,P＜0.001),whereas the gender,BMI,waistline and hipline showed no significant difference (P＞0.05).With the increasing of age,the QSM value showed a gradual increasing trend.And there were significant differences of QSM values among the different age groups (P＜0.001).The QSM value of 138.98 (100.37,183.84)ppb for group 5 (＞60 years old) was significantly higher than that of group 1,group 2,and group 3 (P＜0.001).There is no difference between group 5 and group 4 (P＞0.05).The QSM value of 96.62(28.62,143.99)ppb for group 4 (51-60 years old) was significantly higher than that of group 1 and group 2 (P＜0.001).And there was no difference between group 4 and group 3 (P＞0.05).The QSM value of group 1,group 2,and group 3 showed no significant difference (P＞0.05).Conclusions The QSM of bone is feasible in the assessment of osteoporosis and has the potential to be a biomarker providing new insights into osteoporosis.And age is the critical factor affecting QSM value.

The ketogenic diet, a non-pharmacotherapy, simulates the state of fasting to induce the liver to metabolize fatty acids into ketones as fuel source. It also possesses anti-inflammatory effects and impacts the occurrence and progression of various diseases among which is polycystic ovary syndrome(PCOS). Ketogenic diet effectively manages body weight, improves ovarian function, regulates metabolic disorder, and enhances mental health. The growing body of evidence substantiates the safety and efficacy profile.