Objective To explore the diagnosis and surgical management of juxtapapillary choledochoduodenal fistula and to evaluate endoscopic retrograde cholangiopancreatography(ERCP) in the diagnosis of juxtapapillary choledochoduodenal fistula. Methods A retrospective clinical analysis was made in reference to the diagnosis and operative intervention for a total of 47 cases of juxtapapillary choledochoduodenal fistula.Results Forty seven fistula cases were diagnosed among 3*!800 patients undergoing ERCP. Thirty four cases were complicated with cholelithiasis and 19 bile duct pneumatosis. Thirty eight patients were operated on including choledocholithotomy in 7 cases and hepatojejunostomy in 31 cases, in which hilar choledochoplasty was added in 4 cases, and 5 cases underwent concomitant hepatic segmentectomy. Conclusion ERCP is the most valuable method in diagnosing and guiding surgical management in juxtapapillary choledochoduodenal fistula.

ObjectiveStromal cell-derived factor -1 (SDF-1 ) is closely related to the biological characteristics of breast cancer. We aimed to explore whether estrogen affected breast cancer by SDF-1. MethodsThe breast cancer cell line MCF-7 and MRC5 were chosen, and divided into three groups: the control group, the estrogen group and the estrogen + estrogen receptor blocker group. Each group was cultured with different physiological concentrations of 17-β estrogen at certain time, and the same alcohol concentration of 17-β estradiol at different time points, and then the enzyme-linked immunosorbent assay (ELISA) was used to measure the concentration of SDF-1 in culture medium, and the semi-quantitative reverse transcriptionpolymerase chain reaction (RT -PCR) was used to detect the expression of SDF-1 mRNA in each group.ResultsSDF-1 can be detected in the culture medium of both MCF-7 and MRC5 cell lines. All different concentrations of 17-β estradiol may increase the secretion of SDF-1 in MCF-7 cells. When adding 17-β estradiol to the concentration of 107mol/L, the secretion of SDF-1 reached the peak in 2 hours, which was 6 times and 2.7 times that of control group ( P ＜ 0.01 ). The effect could be ehminated by pure estrogen receptor ICI182,780. In addition, the mRNA expression of SDF-1 was consistent with the SDF-1 protein levels-l07 mol/L group. The expression of SDF-1 mRNA was higher than both that of the control group and the blocking group in 2 hours (P ＜ 0.05 ). ConclusionsIn some breast cancer cell lines, physiological concentrations of estrogen can increase the secretion of SDF- 1, and this effect is mainly achieved through the estrogen receptor. Estrogen can influence the biological characteristics of breast cancer by SDF-1.

Pang Zanxiang was a famous ophthalmologist of Chinese medicine. Based on his family experience and combined with his clinical practice, he has written the book Clinical practice of ophthalmology in traditional Chinese medicine. In the book, the theory of stagnation of Qi and blood leading to disease was put forward, and radix stellariae was used most frequently in treating eye disease. From literature interview, we found that pang’s experience of radix stellariae in treating eye disease was its function of replenishing vital essence to improve eyesight.

Objective: To study the vaccine potency of gene-modified tumor cells, we have constructed IL-12, H7-1 and GM-CSF express vector using retrovirus. Methods: It was transfected into EL-4 thymic lylmphoma cells respectively and the effect of gene transduction on anti-tumor immunity were investigated. Results: The tumorigenicity of EL-4/IL-12 transfectant in C57BI/6 syn- ergistical mice was decreased significantly after implanted with EL-4/IL-12 transfectant compaired with EL-4/Wt or EL-4/Neo groups (P

Animals ; Disease Models, Animal ; Female ; Human papillomavirus 16 ; Humans ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Uterine Cervical Neoplasms ; Xenograft Model Antitumor Assays

In order to study the vaccine potency of gene-modified tumor cells, IL-12 express vector was constructed by using retrovirus. The vector was transfected into EL-4 thymic lymphoma cells and the effect of transfectant on anti-tumor immunity was investigated. The tumorigenicity of EL-4/IL-12 transfectant in syngeneic C57BL/6 mice was decreased significantly after implanted with EL-4/IL-12 transfectant compared with EL-4/Wt or EL-4/Neo groups (P < 0.001). The systemic protective immunity was induced against the challenge with EL-4/Wt (in 8/10 mice) after the rejection of EL-4/IL-12 in vivo experiment, a stronger CTL activity against EL-4/Wt cells and a weak killer activity against syngeneic Lewis lung carcinoma (LLC) cells were obtained in (51)Cr release assay. In vivo depletion analysis suggested that the decreased tumorigenicity mainly depended on CD4(+), CD8(+) and NK cells. Therapeutic vaccines with EL-4/IL-12 cells could retard the growth of established EL-4/Wt tumors significantly compared with those of EL-4/Neo (P < 0.005). These studies suggested that immunotherapy and gene therapy using IL-12 is effective in hematopoietic malignancy and IL-12 has prospects of application in human cancer treatment in the near future.

Objective: To investigate the relationship between occupational stress and working ability of workers in a petroleum processing enterprise in a high altitude area. Methods: A total of 728 workers in a petroleum processing enterprise at an altitude of 2850 m were subjected to a survey using Occupational Stress Inventory (OSI) , Work Ability Index (WAI) Scale, Occupational Role Questionnaire (ORQ) , Personal Strain Questionnaire (PSQ) , and Personal Resource Questionnaire (PRQ) from May 2014 to August 2016. Results: Of the 728 workers, 55 (7.6%) had a poor working ability, moderate in 262 (35.9%) , and good in 411 (56.5%). There were significant differences in WAI between the workers with different types of work, sexes, ages, and working years (P<0.05). There was a significant difference in WAI between different occupational stress groups (P<0.05). WAI was negatively correlated with ORQ score and PSQ score (r_s=-0.387, P<0.05; r_s=-0.467, P<0.05) and positively correlated with PRQ score (r_s=0.343, P<0.05). The multiple linear regression analysis showed that high ORQ score and PSQ score were the inhibitory factors for high WAI (B=-0.058; B=-0.082) and high PRQ score was a contributing factor for high WAI (B=0.029) . Conclusion Occupational stress is an influencing factor for the working ability of workers in the petroleum processing enterprise in the high altitude area. Hypoxia in high altitude area may further reduce the working ability. In order to reduce occupational stress and improve work ability, it should be considered to strengthen skills training, improve the working environment, and pay attention to mental health.

Objective To test and evaluate the JAK2 gene V617F mutation in patients with myeloproliferative tumors based on i-densy IS-5320 platform according to ISO15189 accreditation requirements.Methods Instrument performance verification.Selected from December 2014 to February 2017, 20 cases of JAK2 V617F mutation positive peripheral blood samples from Huashan Hospital of the Shanghai FuDan University Medical College and 20 cases of peripheral blood samples with negative JAK2V617F mutation.The Realtime PCR with TaqMan MGB probe was selected as the control method to verify and evaluate the accuracy of testing JAK 2 V617F mutation on i-densy IS-5320 platform.Whole blood samples were used to evaluate the reproducibility , cross-contamination and anti-interference ability of this platform.The ability of mutation load was verified by detecting mixtures of human erythnoleukemia cells and colorectal cancer cell HCT116 with 12 different proportions.Results I-densy IS-5320 platform and TaqMan MGB probe real-time fluorescence quantitative PCR show the same result .The within-run reproducibility and between-run reproducibility are both 100%.There is no observed contamination .High bilirubin and high triglyceride blood samples have no obvious interference on mutation detection .The mutation ratio with a load as low as 0.25%could be tested stably by i-densy IS-5320 platform.The detecting peak of melting curve can reflect the ratio of JAK2 V617F mutation to some extent.Conclusions I-densy IS-5320 can detect the mutation of JAK2 V617F gene in the whole blood directly.It has high sensitivity, accuracy and stability, and is easy to operate, and also can reflect the mutation load of JAK2 V617F, which could meet the clinical requirements for the detection of mutations.

Chronic kidney disease (CKD) is a serious health problem worldwide, whereas there is still no efficient cure. The gut microbiota plays a crucial role in maintaining human health and disease resistance, and multiple studies have confirmed that the gut microbiota is closely related to the occurrence and development of CKD. Starting from the "gut-kidney axis" theory, this article provides a systematic review of the changes in gut microbiota composition and function in patients with CKD, such as a decrease in the abundance of butyrate-producing bacteria Roseburia and Faecalibacterium prausnitzii. Besides that, the article explores the mechanisms by which the gut microbiota affects CKD progression, such as inflammation and immunity, and also describes the application methods of using the gut microbiota as a therapeutic target for CKD, such as fecal microbiota transplantation, microecologics, and dietary therapy, in order to provide microbial- based targets for the clinical diagnosis and treatment of CKD.

Objective:Analysis of clustering characteristics of coronavirus disease 2019 (COVID-19) in Guangdong Province.Methods:The COVID-19 cases in Guangdong Province onset from January 1 to February 29, 2020 were collected from Chinese information system for disease control and prevention and Emergency Public Reporting System. Obtain the epidemiological survey data of the cluster epidemic situation, and clarify the scale of cluster epidemic situation, the characteristics of the index cases, family and non-family subsequent cases. Calculate serial interval according to the onset time of the index cases and subsequent cases, secondary attack rate based on the close contacts tracking results, the characteristics of different cases in the clustered epidemic were compared.Results:A total of 283 cluster were collected, including 633 index cases, 239 subsequent cases. Families are mainly clustered, the total number involved in each cluster is in the range of 2-27, M( P25, P75) are 2.0 (2.0, 4.0). During January 15 to February 29, the secondary attack rate is 2.86% (239/8 363) in Guangdong Province, the family secondary attack rate was 4.84% (276/3 697), and the non-family secondary attack rate was 1.32% (61/4 632). According to the reporting trend of the number of cases in Guangdong Province, it can be divided into four stages, the rising stage, the high platform stage, the descending stage and the low level fluctuation period. The secondary attack rate of the four stages were 3.5% (140/3 987), 2.3% (55/2 399), 2.6% (37/1 435), 1.3% (7/542), respectively. The difference was statistically significant ( P=0.003). Conclusion:COVID-19 cluster mainly occurs in families in Guangdong Province. The scale of the clustered epidemic was small; the serial interval was short; and the overall secondary attack rate was low.