Objective To investigate the short- and long-term complications after endoscopic Oddi's sphincterotomy (EST) upon endoscopic retrograde cholangiopancreatography (ERCP) procedure and determine whether the size of EST correlates to the occurrence of EST complications.Methods 95 cases receiving EST in the process of ERCP in our hospital were studied and followed up. The patients were divided into large, moderate and small incision groups according to the size of EST and the states of short-term and long-term EST complications were statistically analyzed.Results The incidence of short-term complications of EST was 18. 94% (18/95). They included bleeding in the process of ERCP in 11 cases, delayed bleeding in 3, acute pancreatitis in 1, acute cholangitis in 2 and duodenal perforation in 1. All these patients but 1 with duodenal perforation were discharged after undergoing symptomatic treatments. Eleven out of the 95 patients had long-term complications (11.57 % ). These included biliary system infection in 5 cases, recurrent calculus of bile duct in 3, papilla stricture in 1 and chronic relapsing pancreatitis in 2. All 11 patients recovered after therapeutic ERCP again or symptomatic drug treatments. There was no significant difference in incidence of short-term (χ2 =2.433, P=0.296) or long-term complications (χ2 = 1.151, P=0.562) among the 3 groups. Furthermore, there was no statistical correlation between the incision size of Oddi and complications including operative bleeding (P=0.109), short-term complications (P=0.124) and longterm complications(P=0.402). Conclusion There are many short-term and long-term complications after EST, but there is no correlation between the complications and the incision size of Oddi. The occurring rate of complications might be reduced through accurate direction of papilla incision, avoidance from injury of blood vessel, keeping bile drainage unobstructed and protection of the function of Oddi sphincter as far as possible in the process of ERCP.

BACKGROUND: Brain injury can promote fracture healing is becoming an issue of concern, but the underlying mechanism remains unknown.OBJECTIVE: To establish a model of cerebral injury combined with right tibial fracture, and to investigate the cerebrospinal fluid and serum levels of calcitonin gene-related peptide, nerve growth factor and insulin-like growth factor-1.METHODS: New Zealand white rabbits were randomly divided into four groups: group A: blank control group;group B: simple brain injury group; group C: simple tibial fracture group; group D: tibial fracture combined with brain injury. The cerebrospinal fluid and serum levels of calcitonin gene-related peptide, nerve growth factor and insulin-like growth factor-1 were detected at different time points. The rabbits in the groups C and D were sacrificed at 1, 4 and 8 weeks after modeling to remove the whole tibia, and scanned by X-ray. The callus volume was calculated, and the pathological changes were analyzed.RESULTS AND CONCLUSION: The fracture healing was faster in the group D than the group C. The callus volume,trabecular width, trabecular area ratio, and the number of newly born vessels in the group D were significantly higher than those in the group C at 4 weeks after modeling (P < 0.05). The cerebrospinal fluid and serum levels of calcitonin gene-related peptide, nerve growth factor and insulin-like growth factor-1 in the group D were significantly higher than those in the group C (P < 0.05), and the cerebrospinal fluid levels reached the maximum values earlier than did the serum levels. Furthermore, in the group D, the calcitonin gene-related peptide level was increased earlier than the other two factors. To conclude, calcitonin gene-related peptide, nerve growth factor and insulin-like growth factor-1 are essential factors involved in promoting fracture healing after traumatic brain injury, and moreover calcitonin gene-related peptide shows a stronger ability than the other factors.

OBJECTIVETo estimate the contribution of known identified risk factors to breast cancer incidence and mortality in China, and provide evidence to support the prevention and control of breast cancer for Chinese females.

METHODSWe calculated the proportion of breast cancer attributable to specific risk factors. Data on exposure prevalence were obtained from Meta-analyses and large-scale national surveys of representative samples of the Chinese population. Data on relative risks were obtained from Meta-analyses and large-scale prospective studies. Cancer mortality and incidence were taken from the Third National Death Survey and from cancer registries in China.

RESULTSThe first 5 risk factors of breast cancer in China were benign breast disease (RR = 2.62), family history of breast cancer (RR = 2.39), smoking (RR = 1.86), overweight (RR = 1.60) and age at menarche (RR = 1.54). The proportion of breast cancer deaths attributable to reproductive factors, lifestyle factors, benign breast disease, the use of external hormone and family history of breast cancer was 27.84%, 23.55%, 15.09%, 3.60% and 2.49%, respectively. The total population attributable fraction (PAF) was 55.95% for risk factors in our study. Overall, we estimated that 79 862 breast cancer cases and 22 456 deaths were attributed to the five risk factors in China in 2005.

CONCLUSIONSThe prevention and control of unhealthy lifestyle factors may significantly reduce the number and death of breast cancer in China.

Breast Diseases ; complications ; Breast Neoplasms ; epidemiology ; etiology ; genetics ; China ; epidemiology ; Female ; Genetic Predisposition to Disease ; Humans ; Menarche ; Meta-Analysis as Topic ; Overweight ; complications ; Risk Factors ; Smoking ; adverse effects

Objective To investigate the influence of epidural analgesia on labor duration under the new partogram recommendations using quantile regression.Methods In this study,we recruited 300 nulliparous women at full term who were hospitalized in Department of Obstetrics and Gynecology,Tongji Medical College,Huazhong University of Science and Technology from May to September,2018.The participants who were willing to receive epidural analgesia during labor were assigned to the epidural group (n=150),and those who were not to the control group (n=150).Labor duration and delivery outcomes were analyzed by Student's t test,Mann-Whitney U test,Chi-square test and Fisher's exact test.Quantile regression models were also used to investigate the effect of epidural analgesia on labor duration.Results The median durations of first-and second-stage labor in the epidural group were 600(400-840) and 66(45-98) min,respectively,which were significantly longer than those of the control group [420(320-610) and 52(33-87) min] (Z=-4.273,P＜0.001;Z=-3.210,P=0.001).Quantile regression analysis showed that,for the first stage of labor,epidural analgesia was associated with labor prolongation,and had significant effects on all the percentiles (all P＜0.05).The regression coefficients increased (95.630-285.000) correspondingly as the percentiles of the labor duration (from 10th to 90th percentiles) increased.For the second stage of labor,epidural analgesia showed a significant impact on prolongation only between the 25th and 75th percentiles (coefficients:10.000～18.143;all P＜0.05).Although the epidural group had a significant higher episiotomy rate [46.8％(65/139) vs 33.3％(48/144),x2=5.318,P=0.021],more times of urine catheterization during labor [1(0-1) vs 0(0-1),Z=-0.974,P=0.001]and higher rate of oxytocin administration during labor [48.7％(73/150) vs 30.0％(45/150),x2=10.952,P=0.001],when compared with the control group,there was no significant difference in cesarean section rate,assisted vaginal delivery rate and neonatal outcomes between the two groups (all P＞0.05).Conclusions Epidural analgesia may associated with the prolongation of the first and second stage of labor,especially with the first stage of labor,but has no adverse effects on maternal and neonatal outcomes.

In this paper,a hypertension management system based on mobile intelligent computation is built,intorduces its overall architecture and function realization.The user side can implement collection and monitoring of body signs,behavior monitoring,hypertension riskassessment and emergence help,etc.In addition,the doctor side can assist the doctor in diagnosis service.With the help of this system,the user can know his/her physical status and make self-adjustment in time,and the doctor can quickly track the progressof the patient and provide health guidance.As a result,the personalized hypertension management for both the doctor and the patient can be achieved.

Aim To evaluate the effects of different doses of baicalin on rheumatoid arthritis (RA) in SD rats and explore the possible mechanism.Methods Firstly,the model of RA in SD rats was prepared and the hind foot swelling was measured;HE staining was used to observe the pathological changes of the knee joint synovial tissue;RT-qPCR was adopted to determine the mRNA expressions of TLR2 and MyD88 in synovial tissue;Western blot was used to determine the protein expressions of TLR2,MyD88 and NF-κB p65 aher intragastric administration of different doses of baicalin solution.Results Compared with the model,baicalin (60 and 30 mg · kg-1) could inhibit the proliferation of fibroblasts and inflammatory damages in synovial tissue,significantly cut down mRNA expressions of TLR2 and MyD88 (P ＜ 0.05) and markedly reduce protein expressions of TLR2,MyD88 and NF-κB p65 (P ＜ 0.01).Conclusion Baicalin has good effects on RA,which may be realized by inhibiting the activation of TLR2-NF-κB signaling pathway.

OBJECTIVETo evaluate the diagnostic value of serum angiopoietin-2 (Ang-2) level in pancreatic cancer patients.

METHODSSerum Ang-2 level was measured by enzyme-linked immunosorbent assays (ELISA) in samples from 116 patients with pancreatic cancer, 50 patients with chronic pancreatitis, and 50 normal control subjects.

RESULTSThe serum Ang-2 level in patients with pancreatic cancer [(1539.0 ± 449.3) ng/L] was significantly higher than those in patients with pancreatitis [(1044.6 ± 246.1) ng/L, P < 0.01] and normal control subjects [(1075.6 ± 228.2) ng/L, P < 0.01]. There was no significant difference of serum Ang-2 levels between patients with pancreatitis and normal controls. Pancreatic caner patients with lymph node metastasis had a significantly higher serum Ang-2 level [(1890.1 ± 354.9) ng/L] than those without metastasis [(1212.1 ± 224.2) ng/L, P < 0.01]. The area under ROC curve of serum Ang-2 level for diagnosis of pancreatic cancer was 0.819.

CONCLUSIONThe serum Ang-2 level can be a useful indicator for diagnosis of pancreatic cancer.

Adult ; Aged ; Angiopoietin-2 ; blood ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Pancreatic Neoplasms ; blood ; diagnosis ; pathology ; Pancreatitis ; blood ; ROC Curve ; Retrospective Studies

Severe liver dysfunction in pregnancy (SLDP) is rare but serious complications with high mortality rate. This study compared the effectiveness and safety of double-balloon catheter versus intra-amniotic injection of ethacridine lactate for the termination of second trimester pregnancy in patients with SLD. A total of 55 patients with indications of labor induction were enrolled and analyzed by retrospective control analysis method. Twenty-three cases adopted Cook double balloon dilation as Cook group, and 32 cases received intra-amniotic injection of ethacridine lactate as EL group. The primary outcome was evaluated by successful abortion rate and the difference in the induction-to-abortion interval. Secondary outcomes included liver function recovery and the frequency of adverse events. Both Cook and EL regimens were effective, with successful abortion rate of 87.0% and 93.8%, respectively (P=0.639). The induction-to-delivery interval was similar between Cook group and EL group (38.1 ± 21.5 vs. 41.3 ± 17.4, P=0.543). The liver disease status was more severe in Cook group than in EL group, but it did not show any significant difference after pregnancy termination between the two groups and the improvement rate also did not show any significant difference. Both treatments were safe and there was no significant difference in bleeding and cervical laceration adverse events between the two groups. Our study firstly compared double-balloon catheter and ethacridine lactate for the induction of labor in women with SLD during second trimester pregnancy.
Abortion, Induced ; Catheters ; Ethacridine ; administration & dosage ; Female ; Humans ; Liver Diseases ; physiopathology ; Pregnancy ; Pregnancy Trimester, Second

OBJECTIVETo assess the association between 2 single nucleotide polymorphisms (SNPs) located in exonic regions of matrix metalloproteinase-10 (MMP-10) gene and instability of carotid plaques in a Han Chinese population.

METHODSFive hundred and eighty-five patients were divided into carotid vulnerable plaque group (n=206) and stable plaque group (n=379) based on results of carotid B-mode ultrasonography. The SNPs were genotyped by real-time polymerase chain reaction using an ABI 7300 TaqMan platform.

RESULTSThe distribution of rs17435959 between the two groups was significantly different at both genotypic (GC+CC vs. GG, P=0.006, OR=2.012) and allelic levels (C vs. G, P=0.001,OR=2.160). Above differences have remained significant with binary logistic regression analysis (P=0.007, OR=2.022; P=0.002, OR=2.104). The minor allele frequency of rs17293607 was 0.56%.

CONCLUSIONAbove findings suggested that rs17435959 of the MMP-10 gene is associated with carotid vulnerable plaque in ethnic Chinese Hans. The C allele may be a susceptible predictor for carotid vulnerable plaque.

Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; genetics ; Female ; Genetic Predisposition to Disease ; Genotype ; Humans ; Male ; Matrix Metalloproteinase 10 ; genetics ; Middle Aged ; Plaque, Atherosclerotic ; enzymology ; genetics ; Polymorphism, Single Nucleotide

Objective To find the potential biomarkers of neonatal sepsis through comparing neonates with sepsis and without sepsis in serum metabolin differences.Methods Thirty neonates,who were diagnosed as sepsis from the Neonatal Center of Bayi Children's Hospital Affiliated to Beijing Military Region General Hospital during Aug.2012 to Feb.2013,were enrolled as the experimental group;while another 30 non-sepsis neonates were selected as the control group,the data of them were not significantly different from those of the experimental group.1.5 mL supernatant of radial artery blood was saved in-80 ℃ refrigerator after centrifugation in 4 ℃.Gas chromatography-mass spectrometry (GC-MS) technology was used for data acquisition after the serum sample thawinged at the room temperature and pretreated.The software of the GC-MS instrument was available for denoising,peak detection and peak area integral.Principal components analysis(PCA) model and partial least squares-discriminant analysis(PLS-DA) model were established by Matlab2011 software after the data standardized.The potential biomarkers were screened by t-test.Results The differences of the serum metabolites between sepsis neonates and non-sepsis neonates in PCA and PLS-DA model were visible.Compared with the control group by t-test,the experimental group had increased in the contents of glucose,lactic acid,urea,pyruvic acid,phenylalanine,and decreased in the contents of leucine,isoleucine,alanine,glutamine,palmitic acid,palmitoleic acid,linoleic acid,stearic acid.The sensitivity,specificity,Youden's index,compliance rate of the discriminant composited by the above metabolites were 93.33％,100.00％,0.9333 and 96.66％.Conclusions GC-MS technology can be used to detect the neonatal sepsis.The discriminant formed by the above metabolites can be used for the diagnosis of neonatal sepsis.