ObjectiveTo investigate the feasibility and safety of endoscopic retrograde cholangiopancreatography （ERCP） combined with oral cholangiopancreatography in the treatment of major duodenal papilla gallbladder polyps. MethodsA retrospective analysis was performed for the clinical data of eight patients with choledocholithiasis and gallbladder polyps who underwent ERCP and combined with oral cholangiopancreatography for major duodenal papilla cholecystectomy in Center of Digestive Endoscopy， Jilin People’s Hospital， from May 2022 to June 2024， and related data were collected， including the success rate of surgery， the technical success rate of gallbladder polyp removal， the superselective method of cystic duct， the time of operation， the time of gallbladder polyp removal， and surgical complications. ResultsBoth the success rate of surgery and the technical success rate of gallbladder polyp removal reached 100%， and of all eight patients， three patients used guide wire to enter the gallbladder under direct view， while five patients received oral cholangiopancreatography to directly enter the gallbladder. The time of operation was 51.88±12.34 minutes， and the time of gallbladder polyp removal was 23.13±10.94 minutes. The diameter of gallbladder polyp was 2‍ ‍—‍ ‍8 mm， and pathological examination showed inflammatory polyps in three patients， adenomatous polyps in one patient， and cholesterol polyps in four patients. There were no complications during or after surgery. The patients were followed up for 2‍ ‍—‍ ‍27 months after surgery， and no recurrence of gallbladder polyp was observed. ConclusionOral cholangiopancreatography is technically safe and feasible in endoscopic major duodenal papilla cholecystectomy.

BACKGROUND: The available evidence regarding the benefits of percutaneous coronary intervention (PCI) on patients receiving dialysis with coronary artery disease (CAD) is limited and inconsistent. This study aimed to evaluate the association between PCI and clinical outcomes as compared with medical therapy alone in patients undergoing dialysis with CAD in China. METHODS: This multicenter, retrospective study was conducted in 30 tertiary medical centers across 12 provinces in China from January 2015 to June 2021 to include patients on dialysis with CAD. The primary outcome was major adverse cardiovascular events (MACE), defined as a composite of cardiovascular death, non-fatal myocardial infarction, and non-fatal stroke. Secondary outcomes included all-cause death, the individual components of MACE, and Bleeding Academic Research Consortium criteria types 2, 3, or 5 bleeding. Multivariable Cox proportional hazard models were used to assess the association between PCI and outcomes. Inverse probability of treatment weighting (IPTW) and propensity score matching (PSM) were performed to account for potential between-group differences. RESULTS: Of the 1146 patients on dialysis with significant CAD, 821 (71.6%) underwent PCI. After a median follow-up of 23.0 months, PCI was associated with a 43.0% significantly lower risk for MACE (33.9% [ n  = 278] vs . 43.7% [ n  = 142]; adjusted hazards ratio 0.57, 95% confidence interval 0.45-0.71), along with a slightly increased risk for bleeding outcomes that did not reach statistical significance (11.1% vs . 8.3%; adjusted hazards ratio 1.31, 95% confidence interval, 0.82-2.11). Furthermore, PCI was associated with a significant reduction in all-cause and cardiovascular mortalities. Subgroup analysis did not modify the association of PCI with patient outcomes. These primary findings were consistent across IPTW, PSM, and competing risk analyses. CONCLUSION This study indicated that PCI in patients on dialysis with CAD was significantly associated with lower MACE and mortality when comparing with those with medical therapy alone, albeit with a slightly increased risk for bleeding events that did not reach statistical significance.
Humans ; Percutaneous Coronary Intervention/methods* ; Male ; Female ; Coronary Artery Disease/drug therapy* ; Retrospective Studies ; Renal Dialysis/methods* ; Middle Aged ; Aged ; China ; Proportional Hazards Models ; Treatment Outcome

To clarify the species, pathogenicity, and distribution of the pathogens causing the root rot of Atractylodes lancea in Hubei province, the tissue separation method was used to isolate the pathogens from root rot samples in the main planting areas of A. lancea in Hubei. Based on the preliminary identification of the Fusarium genus by the internal transcribed spacer(ITS) sequence, three housekeeping genes, EF1/EF2, Btu-F-FO1/Btu-F-RO1, and FF1/FR1, were amplified and sequenced. Subsequently, a phylogenetic tree was constructed based on these TEF gene sequences to classify the pathogens. The pathogenicity of these strains was determined using the root irrigation method. A total of 194 pathogen strains were isolated using the tissue separation method. Molecular identification using the three housekeeping genes identified the pathogens as F. solani, F. oxysporum, F. commune, F. equiseti, F. tricinctum, F. redolens, F. fujikuroi, F. avenaceum, F. acuminatum, and F. incarnatum. Among them, F. solani and F. oxysporum were the dominant strains, widely distributed in multiple regions, with F. solani accounting for approximately 54% of the total isolated strains and F. oxysporum accounting for approximately 34%. Other strains accounted for a relatively small proportion, totaling approximately 12%. The results of pathogenicity determination showed that there were certain differences in pathogenicity among strains. The analysis of the pathogenicity differentiation of the widely distributed F. solani and F. oxysporum strains revealed that these dominant strains in Hubei were mainly highly pathogenic. This study determined the species, pathogenicity, and distribution of the pathogens causing the root rot of A. lancea in Hubei province. The results provide a scientific basis for further understanding the root rot of A. lancea and its epidemic occurrence and scientifically preventing and controlling this disease.
Plant Diseases/microbiology* ; Atractylodes/microbiology* ; Phylogeny ; Plant Roots/microbiology* ; Fusarium/classification* ; China ; Virulence ; Fungal Proteins/genetics*

This study established the HPLC fingerprints, characteristic chromatograms, and a multi-component content determination method for Bidens bipinnata and B. biternata. The chemical pattern recognition analysis was then employed to clarify the characteristic indexes of quality differences between the two original plants of Bidentis Herba, providing a reference for establishing the quality standards of Bidentis Herba. HPLC was launched on an Agilent Poroshell 120 EC-C_(18) chromatographic column(4.6 mm×250 mm, 4 μm) by gradient elution with a mobile phase of 0.1% aqueous phosphoric acid-acetonitrile at a flow rate of 0.7 mL·min~(-1), detection wavelength of 270 nm, column temperature of 25 ℃, and an injection volume of 5 μL. The similarity between the fingerprints of 18 batches of Bidentis Herba samples and the common pattern(R) ranged from 0.572 to 0.933. A total of 23 chromatographic peaks were calibrated. Through comparison with the reference substances, six components(neochlorogenic acid, chlorogenic acid, isochlorogenic acid A, isochlorogenic acid B, rutin, and hyperoside) were identified and subjected to quantitative analysis. The characteristic fingerprints of B. bipinnata and B. biternata were calibrated with 20 and 17 characteristic peaks, respectively. Among them, peaks 8, 9, 22, and 23 were the characteristic peaks of B. bipinnata, and peak 7 was the characteristic peak of B. biternata, which can be used to distinguish the two original plants of Bidentis Herba. The relative standard deviation of the content of the above-mentioned six components ranged from 36% to 123%. The cluster analysis, principal component analysis, and orthogonal partial least squares-discriminant analysis(OPLS-DA) classified the 18 batches of Bidentis Herba samples into two categories. Additionally, through the analysis of variable importance in projection(VIP) under OPLS-DA, three characteristic indexes, rutin, isochlorogenic acid A, and isochlorogenic acid B, were identified. The analytical method established in this study can comprehensively evaluate the consistency of Bidentis Herba samples derived from different original plants, specifically identify the differential components between them, and effectively distinguish the two original plants of Bidentis Herba, providing a basis for the differentiation between different original plants and the quality control of Bidentis Herba.
Chromatography, High Pressure Liquid/methods* ; Drugs, Chinese Herbal/chemistry* ; Quality Control ; Bidens/chemistry*

In order to solve the problems of difficult test, high cost and long cycle in the development of large-scale airborne negative pressure isolation system, the simulation analysis of negative pressure response characteristics is carried out around various aviation conditions such as aircraft ascending, leveling and descending, especially rapid decompression, based on the computational fluid dynamics (CFD) method. The results showed that the isolation cabin could achieve -50 Pa pressure difference environment and form a certain pressure gradient. The exhaust air volume reached the maximum value in the early stage of the aircraft's ascent, and gradually decreased with the increase of altitude until it was level flying. In the process of aircraft descent, the exhaust fan could theoretically maintain a pressure difference far below -50 Pa without working; Under the special condition of rapid pressure loss, it was difficult to deal with the rapid change of low pressure only by the exhaust fan, so it was necessary to design safety valve and other anti-leakage measures in the isolation cabin structure. Therefore, the initial stage of aircraft ascent is the key stage for the adjustment and control of the negative pressure isolation system. By controlling the exhaust air volume and adjusting parameters, it can adapt to the change of low pressure under normal flight conditions, form a relatively stable negative pressure environment, and meet the needs of biological control, isolation and transport.
Aircraft ; Computer Simulation ; Aviation/instrumentation* ; Humans ; Hydrodynamics ; Air Pressure ; Equipment Design ; Pressure

OBJECTIVE: To investigate lymph node metastasis (LNM) in the prostatic anterior fat pad (PAFP) of PCa patients after robot-assisted radical prostatectomy (RARP), and analyze the clinicopathological features and prognosis of LNM in the PAFP. METHODS: We retrospectively analyzed the clinicopathological data on 1 003 cases of PCa treated by RARP in the Department of Urology of PLA General Hospital from January 2017 to December 2022. All the patients underwent routine removal of the PAFP during RARP and pathological examination, with the results of all the specimens examined and reported by pathologists. Based on the presence and locations of LNM, we grouped the patients for statistical analysis, compared the clinicopathological features between different groups using the Student's t, Mann-Whitney U and Chi-square tests, and conducted survival analyses using the Kaplan-Meier and Log-rank methods and survival curves generated by Rstudio. RESULTS: Lymph nodes were detected in 77 (7.7%) of the 1 003 PAFP samples, and LNM in 11 (14.3%) of the 77 cases, with a positive rate of 1.1% (11/1 003). Of the 11 positive cases, 9 were found in the upgraded pathological N stage, and the other 2 complicated by pelvic LNM. The patients with postoperative pathological stage≥T3 constituted a significantly higher proportion in the PAFP LNM than in the non-PAFP LNM group (81.8% ［9/11］ vs 36.2% ［359/992］, P = 0.005), and so did the cases with Gleason score ≥8 (87.5% ［7/8］ vs 35.5% ［279/786］, P = 0.009). No statistically significant differences were observed in the clinicopathological features and biochemical recurrence-free survival between the patients with PAFP LNM only and those with pelvic LNM only. CONCLUSION The PAFP is a potential route to LNM, and patients with LNM in the PAFP are characterized by poor pathological features. There is no statistically significant difference in biochemical recurrence-free survival between the patients with PAFP LNM only and those with pelvic LNM only. Routine removal of the PAFP and independent pathological examination of the specimen during RARP is of great clinical significance.
Humans ; Male ; Prostatectomy/methods* ; Robotic Surgical Procedures ; Lymphatic Metastasis ; Retrospective Studies ; Prognosis ; Prostatic Neoplasms/pathology* ; Adipose Tissue/pathology* ; Prostate/pathology* ; Lymph Nodes/pathology* ; Middle Aged ; Aged

Objective:To investigate the efficacy of neutrophil elastase inhibitor in children with acute respiratory distress syndrome（ARDS）.Methods:A total of 168 children with moderate to severe ARDS who were hospitalized in the Department of Pediatric Intensive Care Unit，the Affiliated Children′s Hospital of Xi′an Jiaotong University and Children's Emergency Center of Gansu Provincial Central Hospital from January 2022 to December 2023 were selected. Eighty-seven children receiving neutrophil elastase inhibitors were treated as the treatment group and 81 children receiving conventional treatment as the control group. The dynamic changes of general data，clinical indicators and ventilator parameters at 24 h，48 h and 72 h were compared between the two groups. Mortality at 28 days was the primary endpoint. Kaplan-Meier curve and Log-Rank test were used to evaluate cumulative survival.Results:There was no significant difference in general information and clinical characteristics between the two groups.Compared with the control group，arterial partial pressure of oxygen（PaO 2）/fraction of inspired oxygen（FiO 2）in the treatment group increased significantly at 48 h［（160.28±5.90）mmHg（1 mmHg=0.133 kPa）vs（141.04±4.01）mmHg， P<0.05］and 72 h［（227.58±6.85）mmHg vs（180.86±4.08）mmHg， P<0.05］，and the differences were statistically significant.The platform pressure in the treatment group were lower than that of the control group at 24 h［（28.18±3.95）cmH 2O（1cmH 2O=0.098 kPa）vs（30.15±7.75）cmH 2O， P<0.05］，48 h［（25.56±4.06）cmH 2O vs（29.07±5.01）cmH 2O， P<0.05］，72 h［（24.95±2.82）cmH 2O vs（27.12±6.51）cmH 2O， P<0.05］，and the differences were statistically significant. IL-8 in the treatment group were lower than that of the control group at 48 h［（78.26±14.05）ng/L vs（86.02±15.01）ng/L， P<0.05］and 72 h［（58.38±15.56）ng/L vs（68.68±18.05）ng/L， P<0.05］，and the differences were statistically significant.The survival curve showed that the cumulative survival rate of the treatment group was higher than that of the control group，the difference between the two groups was statistically significant（ χ2=4.549， P=0.033）. Conclusion:Neutrophil elastase inhibitors can reduce the lung injury of ARDS patients by inhibiting the inflammatory response induced by neutrophils，and ultimately improve the prognosis of the disease.

Objective:To analyze and summarize the medical security situation of the snowmobile,sled,and steel frame snowmobile tracks at the National Sliding Centre,and to provide experience for future event hosting and medical security work for mass ice and snow sports.Methods:Retrospective analysis of injuries and treatment of athletes participating in the International Training Week and World Cup for Ski,Sled,and Steel Frame Ski from October to November 2021(hereinafter referred to as"Inter-national Training Week"),as well as the Ski,Sled,and Steel Frame Ski events at the Beijing Winter Olympics in February 2022(hereinafter referred to as the"Beijing Winter Olympics").We referred to and drew on the"Medical Security Standards for Winter Snow Sports"to develop specific classification standards for analyzing injured areas,types of injuries,and accident locations.Results:A total of 743 athletes participated in the International Training Week and the Beijing Winter Olympics.During the com-petition,there were 58 incidents of overturning,prying,and collision,of which 28(28 athletes)were in-jured,accounting for 48.3％of the total accidents and 3.8％of the total number of athletes.Among them,there were 9 males(32.1％)and 19 females(67.9％),with an average age of(26.3±4.7)years.Among the 28 injured athletes,20 cases(71.4％)received on-site treatment for Class Ⅰ injuries,while 8 cases(28.6％)had more severe injuries,including Class Ⅱ injuries(7 cases)and Class Ⅲ injuries(1 case),which were referred to designated hospitals for further treatment.Among the 28 injured athletes,3 cases(10.7％)experienced multiple injuries,including 2 cases of 2 injuries and 1 case of 3 injuries.The most common injuries were in the ankle and toes(10/32,31.3％).Out of 28 injured athletes,one(3.6％)experienced two types of injuries simultaneously,with joint and/or ligament injuries being the most common(11/29,37.9％).The most accident prone point on the track was the ninth curve(18/58,31.0％).Conclusion:Through the analysis and summary of medical security work,it can provide better experience and reference for the future development of snowmobile,sled,and steel frame snowmobile sports in China,making the National Snowy and Ski Center truly a sustainable Olympic heritage.

Objective To observe the effects of compound sabal berry tablet on bladder discomfort(BD)after electrocision of benign prostatic hyperplasia(BPH).Methods Patients with BPH undergoing transurethral resection of the prostate were divided into treatment group and control group.The control group was treated with tamsulosin hydrochloride sustained-release capsules(0.2 mg,qd)on the day after surgery,while treatment group was treated with compound sabal berry tablets(0.5 g,tid)on basis of control group.All patients were treated for 4 weeks.The clinical curative effect,prostate symptoms,overactive bladder symptoms,changes of urodynamics[maximum detrusor pressure(MDP),maximum urine flow rate(Qmax),maximum cystometric capacity(MCC)],occurrence of BD,inflammatory response indexes[interleukin-6(IL-6),IL-17,tumor necrosis factor-α(TNF-α)]and safety were compared between the two groups.Results There were 45 cases in control group and 49 cases in treatment group.After treatment,total response rate of treatment group was higher than that of control group[95.92％(47 cases/49 cases)vs 82.22％(37 cases/45 cases)],the differences were statistically significant(P＜0.05).After treatment,international prostate symptom scores(IPSS)in treatment group and control group were(7.62±1.38)and(10.49±2.05)points;overactive bladder symptom scores(OABSS)were(2.78±0.64)and(3.92±0.72)points;MDP were(32.09±5.12)and(28.32±4.69)cmH2O;Qmax were(18.42±2.53)and(15.37±2.18)mL·s-1;MCC were(289.46±36.81)and(261.42±33.54)mL;incidence of BD were 18.37％(9 cases/49 cases)and 37.78％(17 cases/45 cases);levels of serum IL-6 were(11.34±2.09)and(15.03±2.56)pg·mL-1;levels of serum IL-17 were(30.12±4.73)and(37.57±5.01)pg·mL-1;levels of serum TNF-α were(82.06±12.95)and(98.63±15.70)pg·mL-1.The differences were statistically significant in the above indexes between the treatment group and control group(all P＜0.05).The adverse drug reactions in treatment group were mainly on dizziness,rash,nausea and diarrhea,while adverse drug reactions in control group were mainly on dizziness,rash and diarrhea.There was no significant difference in the incidence of adverse reactions between the two groups[10.20％(5 cases/49 cases)vs 8.89％(4 cases/45 cases),P＞0.05].Conclusion Compound sabal berry tablet can relieve prostate symptoms and overactive bladder symptoms,improve urodynamics,reduce BD and alleviate inflammatory response in BPH patients after transurethral resection of the prostate.