Purpose To evaluate the diagnostic accuracy of abdominal plain scan and contrast-enhanced multi-slice CT after orally diluted iodide in time segment(Post-ODI ANCCE-MSCT)for gastrointestinal fistula(GIF)secondary to acute pancreatitis(AP).Materials and Methods A total of 108 patients with late AP in the prospective and continuously collected database of Hunan Provincial People's Hospital from January 2017 to December 2022 were retrospectively extracted.Their demographic information and clinical features were recorded and GIF were screened by Post-ODI ANCCE-MSCT.The comprehensive clinical diagnosis results within 5 days thereafter were used as reference standards.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of Post-ODI ANCCE-MSCT for diagnosing GIF secondary to AP were calculated using a four-cell table,and the consistency of the two methods was evaluated by Kappa test and McNemar's test.Results Sensitivity was 91.5%(95%CI 78.7%-97.2%),specificity was 98.4%(95%CI 90.0%-99.9%),positive predictive value was 97.7%(95%CI 86.5%-99.9%),negative predictive value was 93.8%(95%CI 84.0%-98.0%),and the accuracy was 95.4%(95%CI 91.4%-99.3%),respectively.The Kappa value was 0.905,and P value was 0.375 via McNemar's test.Conclusion Post-ODI ANCCE-MSCT can diagnose GIF secondary to AP in a simple,non-invasive,rapid and accurate way,and provide earlier,more accurate and reliable image basis for clinical diagnosis and treatment.

Objective:To evaluate the efficacy of modified open necrosectomy (MON) and small incision combined with nephroscopic operation (SINO) in the "one-step" treatment for infected pancreatic necrosis (IPN).Methods:The clinical data of 28 patients with IPN undergoing " one-step" surgery in Hunan Provincial People's Hospital from December 2012 to December 2022 were retrospectively analyzed, including 17 males and 11 females, aged (53.2±13.0) years old. The general information, characteristics of pancreatitis and other clinical data of patients were collected. The white blood cell count, neutrophil count, hematocrit, C-reactive protein (CRP) and other laboratory indicators were compared before and 7 days after surgery. Patients were followed up by outpatient or telephone review.Results:Among the patients, 16 were treated with MON and 12 with SINO. All procedures were successfully completed. Compared to preoperative data, white blood cell count [9.6(6.7, 12.6)×10 9/L vs. 12.7(8.2, 16.6)×10 9/L] and CRP 48.0(25.5, 86.4) mg/L vs. 60.0(23.6, 86.8) mg/L] decreased after surgery (both P<0.05). In MON group, three patients could tolerate fat diet, nine restored physical self-maintenance, and nine returned to occupation after surgery. In SINO group, three patients could tolerate fat diet, six restored physical self-maintenance, and three returned to occupation after surgery. The mortality of 28 patients was 10.7% (3/28). None of patients had incisional hernia. No major complications occurred in MON group. In SINO group, one patient developed new organ failure, two suffered postoperative bleeding requiring intervention, and four suffered new hollow visceral perforation or gastrointestinal fistula. Conclusion:Both MON and SINO are safe and feasible for one-step treatment in patients with IPN.

Objective: To investigate the application value of real-time virtual sonography(RVS)in the diagnosis and treatment of complicated hepatolithiasis. Methods: The retrospective and descriptive study was conducted. The clinical data of 10 patients with complicated hepatolithiasis who were admitted to Hunan Provincial People′s Hospital between October 2017 and March 2018 were collected. There were 3 males and 7 females, aged from 40 to 69 years, with an average age of 57 years. Patients received abdominal color Doppler ultrasound examination, magnetic resonance cholangiopancreatography, and upper abdominal spiral computed tomography (CT) thinly scanning + enhanced examination. Data of CT examination were imported into RVS. RVS was used to locate hepatolithiasis, relationship between stones and vessels, anatomy of bile ducts and vessels in hepatic hilus. Surgical methods included RVS-guided hilar cholangiotomy, biliary stricturoplasty, bilateral hepatojejunostomy, hepatic segmentectomy (lobectomy), and hepatolithotomy. Observation indicators: (1) surgical and postoperative situations; (2) typical case analysis; (3) follow-up. Follow-up using outpatient examination was performed to detect residual stones up to June 2019. Measurement data with skewed distribution were represented as M(range). Count data were described as absolute numbers. Results: (1) Surgical and postoperative situations: 10 patients underwent RVS-guided surgeries successfully for complicated hepatolithiasis, with successful match in RVS (difference between CT images and ultrosound images <2 mm). No residual stone was identified by choledochoscope during operation. The operation time and volume of intraoperative blood loss were 285 minutes (range, 210-360 minutes) and 200 mL (range, 100-600 mL), respectively. No blood transfusion was needed during the operations. The duration of hospital stay was 20.5 days (range, 14.0-29.0 days). There was no perioperative death. One patient had postoperative biliary leakage and abdominal infection, and was cured after conservative treatment. (2) Typical case analysis: the tenth patient, female, 60 years old, was diagnosed with complicated hepatolithiasis, and was prepared to undergo hepatolithotomy+ quadrate lobectomy and hilar cholangioplasty+ bilateral hepatojejunostomy. Preoperative CT images and intraoperative color Doppler ultrasound images of the patient were fused and matched on the sagittal section of the portal vein and the cross section of the right branch of portal vein, and stones and important vessels were marked on the images. After accurate positioning, a curette was used to remove the stones. Removal of biliary stones through hepatic parenchyma and peripheral dilated bile ducts was conducted at the site where stones obviously existed. After the stones were removed, the intrahepatic bile duct and hilar bile duct merged. The left end of the bile duct split was confirmed by real-time ultrasound. After location of portal vein was determined by ultrasound, vascular plastic surgery was perfomed to avoid stenosis. (3) Follow-up: 10 patients were followed up for 6-12 months, with a median follow-up time of 8 months. One of 10 patients was suspected residual stones at the right peripheral hepatic anterior lobe by postoperative angiography at 2 months after surgery, and was not removed stones by choledochoscope. The patient had no recurrent symptoms after T-tube removal. The other 9 patients had no residual stones. Conclusion RVS applied in complicated hepatolithiasis is helpful for the precise intraoperative diagnosis, and the surgical treatment can be safe and effective.

Objective To investigate the ambiguity results distribution of HLA-A,B and DRB1 gene sequence-base typing in Guangxi population and to propose the way to resolve.Methods HLA-A,B and DRB1 genes of 1 000 donors in the Guangxi branch bank of China'bone marrow bank were genotyped by PCR-SBT,and then the ambiguity results distribution of the three loci was analyzed.The typing ambiguities resultswere resolved by high-resolution polymerase chain reaction-sequence-specific primers(PCR-SSP) and group specific sequencing primer(GSSP) methods,respectively.Results Among 1 000 samples,at least 1 locus in HLA-A,B and DRB1 genes in 96.7％ samples appeared the ambiguity results,in which the proportions of HLA-A,B and DRB1 loci appearing ambiguity results were 65.7 ％,58.8 ％ and 77.2 ％ respectively.For the samples of detected ambiguity results,single using the GSSP method could resolve the ambiguity typing results of 87.37％ HLA-A,93.54％ HLA-B and 60.49％ HLA-DRB1,using high-resolution PCR-SSP could resolve the ambiguity typing results of 12.63 ％ HLA-A,4.76 ％ HLA-B and 15.29 ％ HLA-DRB1,and the rest 1.70 ％ HLA-B and 24.22 ％ HLA-DRB1 ambiguity results were resolved by both GSSP and high-resolution PCR-SSPs method.Conclusion GSSP and high-resolution PCR-SSPs methods have high abilities to solve HLA ambiguity results both locate inside and outside the sequencing region,respectively.GSSP and high-resolution PCR-SSPs methods are supplement for each other,which can effectively resolve the problem of ambiguity results in high resolution HLA typing.

Gastric cancer is one of the most common malignancies worldwide; however, the molecular mechanism in tumorigenesis still needs exploration. BCL2L11 belongs to the BCL-2 family, and acts as a central regulator of the intrinsic apoptotic cascade and mediates cell apoptosis. Although miRNAs have been reported to be involved in each stage of cancer development, the role of miR-24 in GC has not been reported yet. In the present study, miR-24 was found to be up-regulated while the expression of BCL2L11 was inhibited in tumor tissues of GC. Studies from both in vitro and in vivo shown that miR-24 regulates BCL2L11 expression by directly binding with 3'UTR of mRNA, thus promoting cell growth, migration while inhibiting cell apoptosis. Therefore, miR-24 is a novel onco-miRNA that can be potential drug targets for future clinical use.
Animals ; Apoptosis ; genetics ; Apoptosis Regulatory Proteins ; deficiency ; genetics ; Base Sequence ; Bcl-2-Like Protein 11 ; Cell Line, Tumor ; Cell Movement ; genetics ; Cell Proliferation ; genetics ; Down-Regulation ; genetics ; Gene Silencing ; Male ; Membrane Proteins ; deficiency ; genetics ; Mice ; MicroRNAs ; genetics ; Proto-Oncogene Proteins ; deficiency ; genetics ; Rats ; Stomach Neoplasms ; genetics ; pathology

In order to better construct important diseases of traditional Chinese medicine ( TCM ) clinical re-search base , and strengthen the construction of medical and clinical research of TCM information sharing sys-tem, Hubei Provincial Hospital of Traditional Chinese Medicine has constructed research type clinic. The con-struction idea of research type clinic is the mode of real world TCM clinical research . The construction of research type clinic mode was from three aspects, which were the clinical research, health management and distinctive diagnosis and treatment .

Objective To evaluate the clinical efficacy and safety of antofloxacin hydrochloride tablet for the treatment of acute bacterial infections. Methods A multi-center randomized control, double blind and double dummy clinical trial was conducted; levofloxacin tablet was chosed as controlled drug. The duration of treatment was 7-14 days in both groups. Results A total of 719 patients were enrolled in the study, in which 359 patients treated with antofloxacin and 360 patients treated with levofloxacin were included. Three hundred and thirty and 337 patients completed the study and met with all the criteria for perprotocol analysis, respectively. By the end of chemotherapy, the cured rates in per protocol set (PPS)population were 79.7% and 77.4%, the effective rates were 95.2% and 96. 7%, and the bacterial clearance were 96. 7% and 97. 5% for the treating and control group, respectively. The clinical and bacterial efficacy of antofloxacin and levofloxacin was comparable by the analysis of infectious sites. Three hundred and fifty-seven and 356 patients in antofloxacin and levofloxacin groups were evaluated the safety.The drug adverse events occurred both in 10. 1%, and drug adverse reactions accurred in 7. 8% and 7.9%patients in the two groups. The most common drug adverse reactions were mild gastroenteric symptoms. No QTc prologation was detected in all the patients. One patient in each group had mild blood glucose increase at the end of therapy, but the glucose returned to normal level without any intervention. No statistic significant difference between the two groups in clinical efficacy and safety was detected (P＞0.05).Conclusions Antofloxacin hydrochloride tablet was effective and safe for the treatment of acute bacterial infections.

Objective To understand the prevalence of alcohol dependence in individuals living in Guangxi Zhuang Autonomous Region,China. Methods From July 2007 to December 2007,21290 subjects aged more than 15 were randomly selected for 6 Prefecture-level cities and 10 counties by stratified multi-stage cluster sampling method. All subjects were investigated by face to face interview. The Chinese version of Composite International Diagnostic Interview (CIDI3.0) Provided by the Chinese Center for Disease Control And Prevention was used as the screening tool and the diagnoses were made with the 10th edition of international classification of Disease Criteria. Results 18 219 subjects completed the screening,the Completion rate was 85.58‰. The general point prevalence and the general lifetime prevalence of alcohol dependence in individuals living in Guangxi was both 4.50‰. The general lifetime prevalence was higher in rural (6.17‰) than in urban (1.85‰) ( RR =0.31,95% CI =0. 17 ～0.57, P=0. 000) ,higher in men (8.59‰) than in women (0. 33‰) ( RR =0.04,95% CI =0. 01 ～ 0.13, P = 0.000 ) and higher in Zhuang (9.63‰) than in Han(1.95‰) ( RR = 5. 01,95% CI = 3.02 ～8.34, P = 0.000). The lifetime prevalence of alcohol dependence tends upwards as age increasing (P＜0.05 ) and it differs in different marital status,higher in divorce groups (P ＜ 0.05). Conclusion Schizophrenia, Depression disorder, Alcohol dependence disorder are the most common mental disorders and have become the public health problem in Guangxi. To do this,it is necessary to carry out targeted research in prevention and rehabilitation.

To evaluate the treatment effect of the late avascular necrosis of femoral head with concentrated autologous bone marrow and impaction autologous bone graft. The clinical data of 35 patients with late avascular necrosis of femoral head treated with the above methods was analyzed retrospectively with the University of Pennsylvania staging system, and evaluated with Harris hip score system. Among the 35 patients, there were 8 at stage Ⅲ, 23 at stage Ⅳ and 4 at stage Ⅴ. The preoperative Harris hip scores ranged from 43-72 with the average scores of 49. The patients were followed up for at least one year with the mean time of 2 years and 3 months. Two patients (preoperative at stage Ⅴ) had received total hip replacement duo to severe pain and ostarthritis. The imageology in 5 patients showed that the femoral head appearance collapsed little compared with that before operation, but their subjective feelings were well. All the femoral heads of left patients remained the shape after operation, complains of pain disappeared or lessened. The overall successful rate was 94% (33/35). In Harris scale, there was 1 patient with 92 scores, 17 with 80-89 scores, 3 with 70-79 scores and 2 patients

Objective To study the mutation of FUT1 and FUT2 genes in para-Bombay individual.Methods Direct DNA sequencing of FUT1 and FUT2 gene coding region were analyzed in two individuals with para-Bombay phenotype.Results One individual lost one of the three AG repeats located at nucleotides 547~552 of the FUT1 gene, whereas two of the three T repeats located at nucleotides 880~882 were deleted in the other.Conclusion Two frame-shift mutations of FUT1 gene are responsible for the H antigen deficiency