Objective To explore the short-term and long-term effects ofapplication of Percutaneous Transhepatic Cholangioscopic Lithotripsy on the treatment of hepatolithiasis. Methods Eighty-threecases of hepatolithiasis were treated with the PTCSL and the other 87cases were treated with the Laparoscopic exploration lithotomy.The general clinical parameters , curative effect in the near future and long-term curative effect were anlyzed. Results No significant differences were found between the two groups in the general clinical parameters (P>0.05). The operation time,intraoperative blood transfusion volume and intraoperatve blood soss in group A were significantly shorter than those in group B(P<0.05, respectively). The original calculi residual rate was 2.4%, the eventually calculi residual rate was 4.8%and the recurrent cholangitis was4.8%in the model of PTCSL (Group A). The original calculi residual rate was 18.4%, the eventually calculi residual rate was 23.0% and the recurrent cholangitis was 23.0%in the model of Laparoscopic exploration lithotomy (Group B), with significant difference between these two groups (P<0.05). The calculi recurrence rate of group A was 12.0%,the calculi recurrence rate of group B was 22.9%,withno significant difference between these two group (P>0.05). No patients died in each group. The results of complications showed thatthe incidence of residual calculi of group A was significantly lower than that of group B (P<0.01). Conclusions Compared with the model of Laparoscopic exploration lithotomy, the PTCSL was more safe, minimally invasive and effective. The short-term efficacy of the model of PTCSL was better than that of the model of Laparoscopic exploration lithotomy.

Since Shaw et al,first reported the first case successfully treated by veno-venous bypass (VVB),there has been great controversy on the routine application of VVB during conventional liver transplantation and piggyback liver transplantation in recent decades.With the improvements on the surgical skills,surgical techniques and anesthesiology,only a small portion of patients have the indications for VVB in liver transplantation routinely.This article reviews the current publications in this topic,which may provide new insight into the liver transplantation in clinical practice.

This study was aimed to prepare sheddable PEG modified miRNA-complexing nanoparticles and investigate in vitro cellular uptake effect and in vivo distribution profile. The sheddable PEG material was synthesized through condensation. The sheddable PEG modified miRNA-complexing nanoparticles were successfully prepared by electrostatic interaction between gene vector and miRNA, and then ibuprofen was added to deshield PEG layer. The in vitro cellular uptake effect and in vivo distribution profile of nanoparticles were investigated on 4T1 model cells. As a result, the particle size of nanoparticles was 107. 7 nm and Zeta potential was 15. 8 mV. Compared to unsheddable PEG group, the cellular uptake effect by 4T1 tumor cells as well as the concentration on tumor regions was significantly improved in the sheddable PEG group. Results showed that this systen has a great potential application in the field of tumor treatment.

Objective:To evaluate the feasibility and accuracy of a multi-dimensional peripheral quick contrast sensitivity function (pqCSF) measurement established based on Bayesian probability estimation algorithm.Methods:A cross-sectional study was conducted.Nineteen eyes of 12 healthy emmetropic subjects in Zhongshan Ophthalmic Center of Sun Yat-sen University from September 2017 to March 2018 were included, with an average age of (22.92±2.91) years.The average spherical power and cylindrical power were (-0.34±0.52)D and (-0.30±0.42)D, respectively, and the average uncorrected vision acuity was≥1.0.Based on the Bayesian probability algorithm, the peak contrast sensitivity γ max, the peak spatial frequency ? max, the bandwidth β and the low contrast intercept δ were used to quickly describe the contrast sensitivity function (CSF) curve of the full spatial frequency through multi-dimensional pqCSF method.The 16 peripheral visual field positions of all subjects were tested at 6°, 12°, 18° and 24° eccentricity of the superior, inferior, the temporal and nasal visual field by the pqCSF method, but the 18° eccentricity of temporal field, which was near the physiological blind spot, was excluded.The area under Log CSF (AULCSF) of different peripheral visual fields and the Log CSF of 19 spatial frequencies (distributed at equal intervals in logarithmic units) were compared.This study followed the Declaration of Helsinki, and the study protocol was approved by an Ethics Committee of Zhongshan Ophthalmic Center of Sun Yat-sen University (No.2018KYPJ017). Written informed consent was obtained from each subject prior to any examination. Results:With the increase of eccentricity in different visual fields, the AULCSF decreased gradually, and there were significant differences in AULCSF between different eccentricities (all at P<0.05). The AULCSF of the nasal and temporal visual field at 6°, 12° and 24° eccentricity was significantly larger than that of the superior and inferior visual field (all at P<0.05). As the distance from the fovea was increased, the pqCSF, the AULCSF, and the high-frequency cutoff were all decreased, and the standard deviation of AULCSF was increased gradually. Conclusions:The pqCSF method can depict a relatively complete peripheral CSF curve of a wide peripheral visual field, and reflect the function quality of the peripheral vision comprehensively and accurately.

Objective To investigate the correlation between aryl hydrocarbon receptor (A hR) gene polymorphisms and haplotypes and susceptibility of ulcerative colitis (UC) .Methods From January 2010 to October 2017 ,at the Second Affiliated Hospital of Wenzhou Medical University ,the First Affiliated Hospital of Wenzhou Medical University , Central Hospital of Wenzhou City and Wenzhou People Hospital ,a total of 396 UC patients were recruited as the UC group .In the same period ,573 age-and gender-matched healthy individuals were taken as the healthy control group . Three single nucleotide polymorphisms (SNP) of A hR (rs10249788 ,rs2066853 ,rs2158041) were examined by modified multiple ligase detection reaction technique .The correlation between the differences in the frequency of each SNP mutant alleles ,genotypes and clinical pathological features of UC was analyzed by unconditional logistic regression analysis .Haploview 4 .2 software was applied to analyze the linkage disequilibrium (LD) . Results The frequency of mutant allele C and genotype TC+CC of AhR (rs10249788) of UC group were higher than those of the healthy control group (75 .00％ ,594/792 vs .69 .98％ ,802/1146 ;95 .45％ , 378/396 vs .91 .10％ ,522/573) ,the differences were statistically significant (odds ratio (OR)=1 .287 , 95％ confidence interval (CI) 1 .049 to 1 .579 , P=0 .016 ;OR=2 .052 ,95％ CI 1 .180 to 3 .568 , P=0 .011) .Compared with the patients with distal colitis ,the frequencies of mutant allele C and genotype TC +CC of AhR (rs10249788) were higher in the patients with extensive colitis (71 .34％ ,341/478 vs . 80 .57％ ,253/314;93 .31％ ,223/239 vs .98 .73％ ,155/157) ,and the differences were statistically significant (OR=1 .666 ,95％ CI 1 .183 to 2 .347 ,P=0 .003 ;OR=5 .561 ,95％ CI 1 .260 to 24 .530 ,P=0 .023) .The results of LD analysis indicated that rs10249788 and rs2066853 ,rs10249788 and rs2158041 , rs2066853 and rs2158041 were linked to each other (D′=0 .636 ,0 .430 and 0 .980 ;r2 =0 .270 ,0 .023 and 0 .177 ) . Compared with the healthy control group , the frequency of haplotype TAC of UC group decreased (20 .20％ ,231 .5/1146 .0 vs .16 .24％ ,128 .6/792 .0) ,however the frequency of haplotype CAC increased (14 .43％ , 165 .4/1146 .0 vs . 20 .47％ , 162 .1/792 .0 ) , and the differences were statistically significant (OR=0 .767 ,95％ CI 0 .605 to 0 .973 , P=0 .029 ;OR=1 .529 ,95％ CI 1 .204 to 1 .941 ,P<0 .01) .The results of further analysis demonstrated that the frequency of haplotype CGC was higher in patients with extensive colitis than that of patients with distal colitis (38 .69％ ,121 .5/314 .0 vs . 29 .48％ ,140 .9/478 .0) ,and the difference was statistically significant (OR=1 .511 ,95％ CI 1 .119 to 2 .040 ,P= 0 .007) ,while the frequency of haplotype TAC in patients with extensive colitis was lower than that of patients with distal colitis (12 .10％ , 38/314 .0 vs . 17 .55％ , 83 .9/478 .0 ) , and the difference was statistically significant (OR= 0 .646 ,95％ CI 0 .483 to 0 .983 , P= 0 .037) .Conclusion A hR (rs10249788) may be a potential locus affecting susceptibility to UC ,and synergistically influence the risk and the location of UC .

ObjectiveTo assess the repeatability （intra-operator variability） and reproducibility （inter-operator variability） of a new partial coherence interferometry （PCI）-based ocular biometer， Myopia Master， and its agreement with IOL Master 500 for measuring axial length （AL） and corneal curvature （K） in children aged 8-12 years. MethodsThe same operator measured school children with the Myopia Master and the IOL Master 500 in random order to assess agreement. Additionally， some of these children received measurements from another operator using the Myopia Master to assess repeatability and reproducibility. AL， flat keratometry （Kf）， steep keratometry （Ks）， mean keratometry （Km）， J₀ and J₄₅ were analyzed. The repeatability and reproducibility were assessed by the within-subject standard deviation （Sw）， test-retest repeatability （TRT）， coefficient of variation （CoV） and intra-class correlation coefficient （ICC）. The agreement between the Myopia Master and the IOL Master 500 was assessed by Bland-Altman plots and 95% limits of agreement （LoA）. ResultsBoth repeatability and reproducibility of the Myopia Master were high for AL measurements （Sw=0.02 mm， ICC=0.999； Sw=0.04 mm， ICC=0.998）， but moderate for K measurements （Sw range， 0.04 to 0.12 D， ICC range， 0.861 to 0.991； Sw range， 0.06 to 0.20 D， ICC range， 0.835 to 0.992）. There were significant mean differences between the Myopia Master and the IOL Master 500 in measurements of AL （-0.01±0.04） mm， Kf （-0.09 ± 0.15） D， Ks （-0.47±0.40） D， and Km （-0.28±0.23） D， J₀ （0.18±0.20） D and J₄₅ （-0.01±0.12） D. ConclusionsThe Myopia Master provided high repeatability and reproducibility for AL measurements in schoolchildren with myopia， but the Myopia Master and the IOL Master 500 cannot be used interchangeably in measuring AL and K.

OBJECT IVE To investigate the influential factors of direct economic burden of acute exacerbation of chronic obstructive pulmonary disease （AECOPD）patients in hospital ，and to provide related suggestions to reduce the direct economic burden of hospitalization. METHODS During Dec. 1st，2019-Oct. 31st，2020，the data of 1 923 AECOPD patients admitted into the First Affiliated Hospital of Guangzhou Medical University were collected. The information of demographic sociological characteristics，clinical characteristics and cost characteristics were collected ；descriptive analysis ，single factor regression analysis and multiple linear stepwise regression analysis were adopted to investigate the influential factors of direct economic burden of hospitalization. On the basis of literature review ，relevant suggestions were put forward to reduce the direct economic burden of AECOPD patients in hospital. RESULTS & CONCLUSIONS The median of hospitalization cost of AECOPD patients was 15 621.00 yuan. The multiple linear stepwise analysis regression analysis revealed that the influential factors of direct economic burden of AECOPD patients in descending order （by partial regression coefficient ）were the length of stay （logarithmic conversion value ）， admission to ICU ，surgical treatment ，discharge outcome ，whether to salvage ，the use of respirator ，common complications and smoking history （model F＝572.200，R2＝0.750，P＜0.001）. It is suggested to strengthen comprehensive hospital management and promote multidisciplinary cooperation to reduce hospitalization days ；strictly follow the diagnosis and treatment guidelines and clinical pathways to avoid deterioration of the condition and transfer to ICU treatment ；control indications for surgery to avoid“ask for great treatment with only miner illness ”；do a good job in the publicity and education of disease and smoking cessation ，and improve the self-management ability of patients.

ObjectiveTo explore the imbalance of paravertebral muscle group for patients with unilateral lumbar disc herniation. MethodsFrom January, 2022 to January, 2023, 30 patients with unilateral lumbar disc herniation (observation group) and 30 healthy people matching in general data (control group) were measured the tension and stiffness of multifidus and erector spinae with MyotonPRO, while the observation group was assessed with Visual Analogue Scale (VAS) for pain and Japanese Orthopaedic Association (JOA) score, and the time of disease was also recorded. ResultsThe mean of bilateral tension and hardness of multifidus and erector spinae was more in the observation group than in the control group (|t| > 5.407, P < 0.001), and the tension and hardness of multifidus and erector spinae of the affected side were more than those of the unaffected side in the observation group (|t| > 11.219, P < 0.001). The tension and hardness of multifidus and erector spinae of the affected side were positively correlated with VAS score (r > 0.942, P < 0.001), and negatively correlated with JOA score (|r| > 0.886, P < 0.001). ConclusionThe tension and hardness of multifidus and erector spinae of the affected side increase after unilateral lumbar disc herniation, resulting in asymmetry.

ObjectiveTo evaluate the inter-rater and test-retest reliability of echo intensity of ultrasound image for quality of quadriceps femoris in patients with knee osteoarthritis (KOA). MethodsFrom March to December, 2021, 33 patients with unilateral KOA in Guangdong Provincial Second Hospital of Traditional Chinese Medicine were included. Ultrasound was used to observe the cross sections of rectus femoris (RF), vastus medialis (VM) and vastus lateralis (VL), and the images were saved. Two independent raters analyzed the average gray value of the picture with the Image J. One of the raters repeated the measurement. The intra-class correlation coefficient (ICC), standard error of measurement (SEM), minimum detectable change (MDC) and coefficient of variation (CV) were calculated and the Bland-Altman charts were drawn. ResultsThe gray value was higher in the RF, VM and VL in the affected side than in the healthy side (t > 2.262, P < 0.05). The inter-rater reliability was excellent, with ICC 0.982 to 0.995, SEM 1.60 to 3.82, CV 1.49% to 5.90%, and MDC value 4.43 to 10.59. The test-retest reliability of the rater was excellent, with ICC 0.969 to 0.990, SEM 2.37 to 5.41, CV 2.22% to 4.84%, and MDC value 6.57 to 15.00. Bland-Altman charts analysis showed that the consistency was good. ConclusionThe quadriceps femoris muscle quality is different between the affected and the healthy sides in patients with unilateral KOA. It is reliable to evaluate muscle echo intensity by Image J.