Objective To study the value of helical multi-phase contrast scanning in the preoperative evaluation of cholangiocarcinoma hilar.Methods Pre-and post-contrast CT scanning of upper abdomen were performed in 26 cases with hepatic portal cholangiocarcinoma.Arterial phase scan of the whole liver began at 30 s after initial injection of contrast medium and the portal venous phase scan started at 70 s.15 of 26 cases underwent additional delayed phase scans began at 3~4 min.Thin thickness(3~5 mm)scanning of hepatic portal was used in each post-contrast phase scanning.The location,size,enhancement patterns of the lesions and the extent of the tumor involvement were observed and surgical resecetability was evaluated.Results All of 26 lesions were detected in helical multi-phase contrast scanning. 16 lesions enhanced on the arterial phase. On the portal venous phase, all lesions were enhanced and marked enhancement was seen in 19 lesions. Prolonged enhancement was seen in 15 lesions on the delayed phase scanning. The accuracy of evaluating surgical respectability was 84.62%. Conclusion Multi-phase contrast scanning combined with thin thickness scanning can demonstrate obviously the location and enhanced patterns of hepatic portal cholangiocarcinoma, the accuracy in evaluating surgical respectability is improved, and it is helpful in choosing the preoperative treatment program and assessing the prognosis.

Objective To investigate the effect of livzon weisanlian(bismuth agent 0.22g,bid+tinidazole,0.5g,bid+clarithromycin 0.25g,bid) for 7 days for eradication of H.pylori and infection of patients suffering from chronic gastritis and peptic ulcer in Huannai area.Methods Four pieces of gastric mucosa were taken out by gastroscopy,two pieces of them from gastric antrum 3～5cm near pylori and the others from gastric body.All of them were detected for H.pylori and biopsy and smear.If both the former and the one of the later are all positive the patient was diagnosed with H.pylori and treated with livzon weisanlian.Results The positive of CSG is 81.6%,CAG is 63%,GU is 90.8% and DU is 93.3%.Conclusion The positive rate of patients suffering from chronic gastritis and peptic ulcer in Huainan area is high.The eradicative rate with livzon weisanlian is also high and it shows that livzon weisanlian is feasible to treat chronic gastritis and peptic ulcer.

Objective To explore the mechanism for the increase in reactive oxygen species regulated by p47phox of nicotinamide adenine dinucleotide phosphate (NADPH) oxidase subunit in peripheral blood mononuclear cells (PBMCs) after oxygen therapy in premature infants.Methods According to different volume fractions of oxygen,premature infants less than 32 weeks were divided into 3 groups:fractional concentration of inspired oxygen (FiO2) ＜ 30％ was low concentration oxygen group,FiO2 between 30％ and 40％ as middle concentration oxygen group,and FiO2 ＞ 40％ as high concentration oxygen group.Premature infants less than 32 weeks without oxygen was control group.After 48 h,3 mL blood was collected via radial artery from each group,PBMCs and serum were separated.Then intracellular reactive oxygen species (ROS) by confocal laser scanning microscopy,malondialdehyde (MDA) within serum by thiobarbituric acid colorimetric,and the location and activation rate of p47phox through immunofluorescence.Results After premature infants were exposed to oxygen,as the oxygen volume fraction was increasing,ROS and MDA gradually rised.More PBMCs with p47phox translocated to membrane,then the translocation rate of p47phox also increased.Compared with the control group,ROS were significantly higher(q =4.48,6.5,16.22,all P ＜ 0.05) among the other 3 groups ; MDA significantly increased as well(q =5.08,8.22,12.76,all P ＜ 0.05) ; the activation rate of p47phox also had significant differences (x2 =134.008,P ＜ 0.05);compared with the middle concentration oxygen group,the high concentration oxygen group had higher ROS and MDA(q =15.03,4.53,all P ＜ 0.05) ; the activation rate of p47phox increased significantly(x2 =19.26,P ＜ 0.05).Conclusions After oxygen exposure,p47phox translocated to membrane may regulate the NADPH oxidase-derived ROS increase in extremely premature infants.

Objective: To investigate the innate immune response of influenza virus-infected glial cells,the transcription levels in chemokines in mouse microglia and astrocytes were detected which pre-infected by human H1N1 or avian H5N1 influenza viruses.Methods: The glial cells isolated from neonatal mice cerebral cortex were cultured and further microglia and astrocytes were purified.The primary mouse microglia and astrocytes were infected in vitro by H1N1 or H5N1 influenza viruses in a multiplicity of infection (MOI) 2.Eight hours post infection,the influenza virus nucleoprotein (NP) was detected by immunofluorescence to identify the proportion of infected cells.The cellular RNA were extracted at 6 h and 24 h to detect the transcriptional level of chemokines by semi-quantitative RT-PCR.Results: More than 95% of the microgha and astrocytes which isolated from mice were infected.The transcription levels of CCL-3,CCL-5,CXCL-2,CXCL-9 and CXCL-10 from infected microglia and astrocytes were upregulated.Futhermore,the mRNA level of CXCL-10 increased much more.In addition,avian H5N1 influenza virus could induce more stronger upregulation of those chemokines than human H1N1 did.Conclusion: The mouse microglia and astro cytes which are infected by H1N1 influenza virus or H5N1 influenza virus could induce upregulation of transcription level of chemokines.

Objective:To systematically review and synthesize qualitative studies on the experiences of information communication in the treatment decision-making process for patients with end-stage renal disease (ESRD) .Methods:Electronic databases, including PubMed, CINAHL, Embase, Cochrane Library, Medline, China National Knowledge Infrastructure, WanFang data, and VIP, were searched for studies on information communication experiences among ESRD patients during their treatment decision-making process up to March 1, 2023. The quality of the included studies was evaluated using the 2016 version of the Joanna Briggs Institute's qualitative research quality assessment criteria. A Meta-synthesis approach and NVivo 12.0 software were utilized for data synthesis.Results:Eleven studies were included, from which 28 themes related to information communication were extracted, integrated into six new categories, and synthesized into three consolidated findings: attitudes towards information communication during the treatment decision-making process for ESRD patients, needs for information communication during the treatment decision-making process, and the impact of information communication on treatment decision-making for ESRD.Conclusions:Information communication is crucial in the decision-making process for ESRD patients regarding treatment. Healthcare professionals should encourage patient involvement in information communication, meet their information needs, and establish diversified mechanisms of information communication to guide patients in choosing the best treatment options.

Objective:To explore the effects of Jianpi Bushen Jiedu Prescription on the proliferation and migration of hepatocellular carcinoma cells; To discuss its possible mechanism.Methods:Using human highly metastatic liver cancer cell line (HCCLM3) as the research object, they were randomly divided into control group and TCM group (100, 200, 400, 800, 1 600, 3 200 μg/ml Jianpi Bushen Jiedu Prescription) and Western medicine group (2.5, 5, 10, 20, 40 μmol/L sorafenib) using a random number table method. Cell viability was detected using cell counting reagent (CCK-8) method; HCCLM3 cells were divided into control group and TCM (Jianpi Bushen Jiedu Prescription 800 μg/ml) group and combined group (Jianpi Bushen Jiedu Prescription 800 μg/ml +sorafenib 20 μmol/L). Western blot method was used to detect the protein expressions of kinase/signaling transducer and transcriptional activator (JAK2/STAT3) pathway related proteins (p-JAK2, JAK2, p-STAT3, STAT3) in each group.Results:Compared with the control group, viability and mobility of HCCLM cell in TCM group and Western medicine group decreased ( P<0.01 or P<0.05); compared with the control group, the protein expressions of P-JAK2, JAK2, P-STAT3 and STAT3 in the TCM group and the combined group decreased ( P<0.05), and the JAK2 protein expression in the combined group was lower than that in the TCM group ( P<0.05). Conclusion:Jianpi Bushen Jiedu Prescription can inhibit the proliferation and migration of HCC cells by regulating JAK2/STAT3 pathway.

Objective:To evaluate the effects of different exercises on patients with chronic kidney disease based on network Meta-analysis so to provide a basis for medical and nursing staff to develop exercise programs.Methods:Randomized controlled trials on the effects of different exercises on patients with chronic kidney disease were electronically searched in databases such as Web of Science, PubMed, Embase, Cochrane Library, China Biology Medicine disc, WanFang Data, and China National Knowledge Infrastructure. The search period was from January 1, 2000, to March 1, 2023. Two researchers conducted literature screening, data extraction, and literature quality evaluation independently. The data was analyzed by using R software in conjunction with the gemtc package and plotted by using Stata software.Results:A total of 52 articles were included, with a cumulative sample size of 3 127 cases, involving three types of exercise (aerobic, resistance, and combined). The network Meta-analysis showed statistically significant differences between the three exercise methods and routine nursing in delaying renal function progression and improving cardiovascular endurance ( P<0.05). In controlling blood pressure and improving walking ability, the effects of three exercise methods were all superior to routine nursing, and the differences were statistically significant ( P<0.05). The area under the cumulative ranking probability curve showed that aerobic exercise>resistance exercise>combined exercise in terms of delaying renal function progression. In controlling blood pressure, resistance exercise>aerobic exercise>combined exercise. In terms of improving cardiovascular endurance, aerobic exercise>resistance exercise>combined exercise; In terms of improving walking ability, resistance exercise>combined exercise>aerobic exercise. Subgroup analysis showed that ≥ 24 weeks was the optimal intervention period for aerobic exercise. Resistance exercise intervention for ≥ 12 weeks could lower blood pressure, and intervention for ≤12 weeks could improve walking ability. However, when the intervention time was longer than 24 weeks, combined exercise had an excellent effect. Conclusions:Aerobic exercise is an excellent way to delay renal function progression and improve cardiovascular endurance. Resistance exercise is the optimal exercise method for controlling blood pressure and improving walking ability. Medical and nursing staff should choose appropriate types of exercise based on the patient's medical needs.

Extra-articular distal tibial fractures as a result of high-energy damage are often comminuted or displaced, frequently accompanied by severe soft tissue injuries.Poor blood supply and various complications make the treatment more difficult,affecting life quality of the patients.The main goals of the treatment are to abtain a healed,well-aligned fracture,functional range of motion of the ankle joint and minimizing complications.It is generally recommended that surgical treatment be performed in the proper context of local conditions to facilitate early functional exercise.Plate fixation and intramedullary nail fixation are the common options for closed fractures.This article focuses on the two treatment methods and some important auxiliary technologies in both domestic and foreign, hoping to provide some references for clinical treatment.

Depression is a mental disorder with high morbidity, disability and relapse rates. Ginkgo biloba extract (GBE), a traditional Chinese medicine, has a long history of clinical application in the treatment of cerebral and mental disorders, but the key mechanism remains incompletely understood. Here we showed that GEB exerted anti-depressant effect in mice through regulating gut microbial metabolism. GBE protected against unpredictable mild stress (UMS)-induced despair, anxiety-like and social avoidance behavior in mice without sufficient brain distribution. Fecal microbiome transplantation transmitted, while antibiotic cocktail abrogated the protective effect of GBE. Spatiotemporal bacterial profiling and metabolomics assay revealed a potential involvement of Parasutterella excrementihominis and the bile acid metabolite ursodeoxycholic acid (UDCA) in the effect of GBE. UDCA administration induced depression-like behavior in mice. Together, these findings suggest that GBE acts on gut microbiome-modulated bile acid metabolism to alleviate stress-induced depression.
Humans ; Mice ; Animals ; Depression/drug therapy* ; Gastrointestinal Microbiome ; Plant Extracts ; Ginkgo biloba