Background:With the development of medical technology,cholangioscopy has been increasingly utilized in the diagnostic and therapeutic process of endoscopic retrograde cholangiopancreatography(ERCP).They play a significant role in the visual diagnosis and biopsy of tumors,providing more accurate and detailed information for clinicians.Aims:To evaluate the safety and effectiveness of peroral cholangioscopy combined with ERCP in biliary diseases.Methods:A total of 90 cases underwent peroral cholangioscopy and ERCP from October 2022 to October 2023 at Shanghai General Hospital,Shanghai Jiao Tong University School of Medicine were recruited retrospectively,and the clinical data were collected.The success rate,postoperative complications,and other relevant indicators were evaluated.Results:A total of 90 patients were enrolled,the preoperative diagnosis including common bile duct stones(43 cases),biliary obstruction by tumor invasion(21 cases),benign biliary stenosis(15 cases),benign ampullary tumors(6 cases),postoperative biliary stricture after liver transplantation(3 cases),primary sclerosing cholangitis(1 case),and biliary varices(1 case).The technical success rate of peroral cholangioscopy with ERCP was 100%,and the stone removal rate was 95.3%(41/43),the average operation time was(81±37)min,and the ERCP re-intervention rate within six months was 17.8%.Postoperative complications included fever(7.8%),abdominal pain(3.3%),bleeding/anemia(2.2%),and postoperative pancreatitis(2.2%).Conclusions:The combination of peroral cholangioscopy with ERCP is safe and effective for the biliary diseases with no increase in procedure-related adverse events and risks.

A case of glycogen accumulation disease type Ⅱ was reported.The patient was a 26-year-old male who presented with skeletal muscle atrophy and weakness of limbs and myocardial involvement in his youth.Laboratory and pathological data including creatine kinase,electromyography,nuclear magnetic resonance of lower limbs and muscle pathological biopsy suggested myositis changes.Enzymatic examination of peripheral blood lymphocyte filter paper showed deficiency of acid alpha glucosidase(GAA)activity.Genetic testing of GAA gene confirmed glycogen accumulation disease type Ⅱ.Genetic variation c-32-13T>G and c.1551+2T>G came from mother and father,respectively.Analyzing the characteristics of the patient could recognize and accumulate more data about glycogen accumulation disease type Ⅱ,in order to increase the understanding of the rare autosomal recessive genetic disease.

Background:With the development of medical technology,cholangioscopy has been increasingly utilized in the diagnostic and therapeutic process of endoscopic retrograde cholangiopancreatography(ERCP).They play a significant role in the visual diagnosis and biopsy of tumors,providing more accurate and detailed information for clinicians.Aims:To evaluate the safety and effectiveness of peroral cholangioscopy combined with ERCP in biliary diseases.Methods:A total of 90 cases underwent peroral cholangioscopy and ERCP from October 2022 to October 2023 at Shanghai General Hospital,Shanghai Jiao Tong University School of Medicine were recruited retrospectively,and the clinical data were collected.The success rate,postoperative complications,and other relevant indicators were evaluated.Results:A total of 90 patients were enrolled,the preoperative diagnosis including common bile duct stones(43 cases),biliary obstruction by tumor invasion(21 cases),benign biliary stenosis(15 cases),benign ampullary tumors(6 cases),postoperative biliary stricture after liver transplantation(3 cases),primary sclerosing cholangitis(1 case),and biliary varices(1 case).The technical success rate of peroral cholangioscopy with ERCP was 100%,and the stone removal rate was 95.3%(41/43),the average operation time was(81±37)min,and the ERCP re-intervention rate within six months was 17.8%.Postoperative complications included fever(7.8%),abdominal pain(3.3%),bleeding/anemia(2.2%),and postoperative pancreatitis(2.2%).Conclusions:The combination of peroral cholangioscopy with ERCP is safe and effective for the biliary diseases with no increase in procedure-related adverse events and risks.

ObjectiveFrom the perspective of energy metabolism， the mechanism of Osteoking （OK） in the treatment of myofascial pain syndrome （MPS） was revealed through systems biology prediction combined with holistic animal experimental validation methods. MethodFirstly， the key targets of MPS and their related molecular mechanisms were predicted by the systems biology method， and the core network targets were screened. Then， the network-predicted targets were verified by animal experiments. Specifically， 60 SD rats were randomly divided into normal group， model group， low， medium， and high dose OK groups （0.66， 1.31， 2.63 mL·kg^-1）， and positive celecoxib group （21 mg·kg^-1）. The MPS model was established by beating combined with a centrifugal exercise method for eight weeks. Except for two days after modeling， the intervention of OK or celecoxib was performed. After the completion of the model， the drug was administered for two weeks. The histopathological changes of trigger point muscle tissue were observed by hematoxylin-eosin staining. The content/activity of Na-K-ATP enzyme （Na⁺-K⁺-ATPase）， Ca²⁺ pump （Ca²⁺ATPase）， Ca²⁺， lactate dehydrogenase （LDH）， glutathione （GSH）， malondialal （MDA）， superoxide dismutase （SOD）， cyclic adenosine phosphate （cAMP）， and protein kinase A （PKA） in serum and/or trigger point muscle tissue in MPS rats was detected by enzyme-linked immunosorbent assay. Protein expression levels of PKA and the peroxisome proliferator-activated receptor γ coactivator 1α （PGC1α） in MPS rats were detected by immunohistochemistry. The protein expression levels of PKA， PGC1α， and mitochondrial transcription factor A （TFAM） in MPS rats were detected by Western blot. ResultThe network prediction results suggest that OK acts on the key target of energy metabolism related to the occurrence and development of MPS and may participate in the activation of the cAMP/PKA/PGC1α signaling pathway. The experimental validation results show that compared with the normal group， contracture nodules and disordered arrangement of muscle fibers appear in the trigger point muscle tissue of MPS rats. Na⁺-K⁺-ATPase， Ca²⁺ATPase， SOD activity， Ca²⁺， and GSH contents in serum and/or trigger point muscle tissue are significantly decreased （P<0.01）. Both LDH activity and MDA contents are significantly increased （P<0.01）， and the protein expression levels of cAMP， PKA， PGC1α， and TFAM are significantly decreased （P<0.01）. Compared with the model group， OK improves the histopathological morphology of trigger point muscle fibers in MPS rats， and after the intervention of OK， Na⁺-K⁺-ATPase， Ca²⁺ATPase， SOD activity， Ca²⁺， and GSH contents in serum and/or trigger point muscle tissue in MPS rats are significantly increased （P<0.05， P<0.01）. LDH activity and MDA contents are significantly reduced （P<0.05， P<0.01）. The protein expression levels of cAMP， PKA， PGC1α， and TFAM are significantly increased （P<0.05， P<0.01）. ConclusionThe mechanism of OK's intervention in MPS rats may be related to its effective activation of the cAMP/PKA/PGC1α signaling pathway， thus promoting mitochondrial energy metabolism and trigger point muscle fiber damage repair in muscle cells.

Aim To investigate the impact and mechanism of Weichang'an Pill(WCA),its ethanol extract(EE),water extract(WE),and active ingredients on the contraction of isolated rat ileum smooth muscles induced by acetylcholine(ACh). Methods In vitro tissue bath experiment,WCA,EE,WE,or their active ingredients were added under the action of ACh,and then the contraction tension of isolated ileum smooth muscle from rats was recorded. The binding affinity ofthe active ingredients to the muscarinic acetylcholine M3 receptor was explored by molecular docking. Results WCA,EE,and WE were able to considerably inhibit the excitatory contraction of the ileal smooth muscles induced by ACh. Costunolide,dehydrocostus lactone,santalol,muscone,emodin,chrysophanol,physcion,crotonoside,magnolol,and honokiol were also significantly effective against ACh-induced ileal smooth muscle contraction. Conclusions WCA,EE,WE,and their active ingredients may help to promote intestinal smooth muscle relaxation by blocking the binding of the M3 receptor on the membrane of ileal smooth muscle with ACh.

【Objective】 To analyze the testing results of platelet antibody in peripheral blood of 266 pregnant women, so as to explore the correlation of platelet antibody between adverse pregnancy and the number of pregnancies. 【Methods】 A total of 266 pregnant women, admitted to Shaanxi Provincial People′s Hospital, were selected for platelet antibody detection. They were divided into two groups according to history of adverse pregnancy, and the positive rate of platelet antibody between two groups was compared. They were divided into group A (1 pregnancy), group B (2 pregnancies) and group C (≥3 pregnancies) in parallel, and the positive rate of platelet antibody among three groups was compared 【Results】 The yield rate of platelet antibody in groups with and without adverse pregnancy was 31.81% vs 14.86%, showing statistical significance(P<0.05). The yield rate of platelet antibody of Group A, B and C was 9.09%, 21.62% and 23.65%, respectively, with The significant differences(P<0.05). The statistical analysis of inter-group χ² test demonstrated a linear trend between the number of pregnancies and platelet antibodies yielding(χ²=7.056, P<0.05). 【Conclusion】 Platelet antibody was correlated with adverse pregnancy, and the yield rate of platelet antibody in the group with adverse pregnancy was higher than that in the group without adverse pregnancy. There was a linear trend between platelet antibodies yielding and the number of pregnancies. The yield rate of antibodies gets higher as the number of pregnancies increased. Taking platelet antibody test as a routine test during pregnancy is conducive to the early detection of clinical adverse pregnancy, as well as the early prevention, early detection and early intervention of fetal/neonatal homoimmune thrombocytopenic purpura and other diseases.

Objective To discuss the activation characteristics of the prefrontal cortex of people with mild cognitive impairment （MCI） due to brain trauma during working memory tasks. Methods The psychological experiment design software E-prime was used and N-back paradigm was adopted as working memory task. Functional near-infrared spectroscopy （fNIRS） was used to detect changes in cortical oxygenated hemoglobin concentrations of 22 channels within the prefrontal lobe of 24 people with MCI due to brain trauma （study group） and 27 healthy volunteers （control group） with matching gender and age. Behavioral data, such as the number of keystroke errors and reaction time, were recorded simultaneously. Independent samples t test and non-parametric test were used to compare the mean value of oxygenated hemoglobin concentration change, the number of key errors and the mean value of reaction time of the two groups in each task. Results （1） The differences in the number of errors and reaction time between the two groups in 1-back and 2-back tasks had statistical significance （P<0.05）.The main effects of task load and group were both significant （task F=14.11, P=0.001 1; group F=10.39, P=0.001 5）. （2） During the 1-back task, the differences in oxygenated hemoglobin concentration changes of the 22 channels between the two groups had no statistical significance （P>0.05）. During the 2-back task, the differences in oxygenated hemoglobin concentration changes of the two groups in channel 2, 3, 7, 9, 10, 11, 14, 15, 18, 19, 21 and 22 had statistical significance （P<0.05）. （3） In the 1-back task, the left frontal pole and dorsolateral prefrontal area in both groups were activated. In the 2-back task, the activation areas of the control group were the left frontal pole area and the left dorsolateral prefrontal area, while that of the study group almost covered most of the left and right frontal pole areas, which were scattered and the right area was activated, too. Conclusion Patients with MCI due to brain trauma have obvious working memory impairment, and during the 2-back working memory task, the activation of the prefrontal lobe decreased, but the activation range was wider.
Brain Injuries, Traumatic/complications* ; Cognitive Dysfunction/etiology* ; Humans ; Memory, Short-Term ; Prefrontal Cortex ; Spectroscopy, Near-Infrared

Objective To study the effects of water decoction and chloroform extraction fraction before and after processing of Aconitum sinomontanum Nakai (ASN) on the analgesic and anti-inflammatoryin mice.Methods Kunming mice were randomly divided into 10 groups (10 mice in each group)according to the weight:blank control group (0.5％ methylcellulose),positive control group (10 mg · kg-1 indomethacin + 1.6 mg · kg-1 lappaconitine),the high and low dose groups of water decoction of raw ASN (0.9,0.3 g · kg-1),the high and low dose groups of water decoction processed product (0.9,0.3 g · kg-1),the high and low dose groups of chloroform extraction fraction of ASN (4.5,1.5 mg · kg-1),the high and low dose groups of chloroform extraction fraction of processed product (4.5,1.5 mg · kg-1).Hot plate was used to study the analgesic effect of water decoction and chloroform extraction fraction before and after processing of ASN.Auricular swelling induced by dimethylbenzene in mice were observed for the evaluation of anti-inflammatory effects of it.Results Analgesic activity:Inthe hot plate test,the pain threshold of high dose groups of water decoction of processed product at 30 minafter the last administration was (24.1 ± 6.3) s,the pain threshold of high dose groups of water decoction of processed product,high and low dose groups of chloroform extraction fraction of raw product,high dose groups of chloroform extraction fraction of processed product at 120 min after the last administration were(49.7 ± 9.7),(49.8 ±7.4),(47.3 ± 6.3),(45.1 ± 7.1)s,compared with blank control group,the difference were significant (all P ＜ 0.05),respectively.Anti-inflammatory activity:The swelling degree of high dose groups of water decoction of raw product,high and low dose groups of water decoction processed product,high and low dose groups of chloroform extraction fraction of raw and processed product were (16.9 ± 11.2),(15.2 ±4.8),(17.7 ±6.4),(14.2 ±4.2),(16.0 ± 4.5),(15.7 ± 5.2),(12.5 ± 5.5) mg,compared with blank control group,the difference were significant (all P ＜0.01).The each groupof processed products compared with the each group of raw product,the difference was not significant (P ＞ 0.05).Conclusion The raw Aconitum sinomontanum Nakai have strong analgesic and anti-inflammatory effects,and processed product still remain strong analgesic and anti-inflammatory effects,and have a trend to increase compared with the raw product.

Objective To analyze the occurrence of the complications after percutaneous endoscopic lumbar discectomy (PELD) for lumbar disc herniation or stenosis,and to reveal the effective prevention methods.Methods Retrospectively analyzed the clinical data of 568 cases who undertaken PELD,and all the related complications,possible causes,prevention and treatment methods were analyzed.Results There were 24 cases of complications occured in all the 568 cases treated with PELD,and the gross incidence rate was 4.23％,including 4 cases of dural laceration(0.70％),3 cases of hemorrhage of intravertebral vein plexus injury(0.53％),6 cases of postoperative wound pain (1.06％),8 cases of postoperative recurrence (1.41％),1 case with persistent symptoms after surgery (0.18％),2 cases of postoperative paresthesia(0.35％).Conclusion PELD is a minimally invasive surgery with high security and low incidence of complications.The effective preventions including careful decision-making,elaborate operation,and precise identification of the anatomical abnormality.

Objective To explore the applied value of electroencephalogram (EEG) in assessment of psychiatric impairment among patients with mental disorders due to traumatic brain injury.Methods According to the ICD-10,a total of 271 subjects were enrolled and assessed with the criterion of mental disorders due to traumatic brain injury.Activity of Daily Living Scale (ADL),Functional Activities Questionnaire (FAQ) and Social Disability Screening Schedule (SDSS) were used to evaluate the severity of patients.All the participants were tested by Wechsler Adult Intelligence Scale (WAIS) and examined by EEG.Results Totally 215 patients accomplished the study.The results of Glasgow Coma Scale (GCS),the severity of craniocerebral injury and the scores of FAQ,SDSS and ADL showed significant difference among the patients with different severity of EEG (P＜0.05).The grades of psychiatric impairment showed significant difference among the patients with different abnormal EEG (P＜0.05).Conclusion EEG can reflect the severity of craniocerebral injury,assist evaluate the social function and activity of daily living of patients with mental disorders due to traumatic brain injury,and distinguish the mild psychiatric impairment grades,which suggest that EEG has a certain reference value in the assessment of psychiatric impairment.