Objective To observe the effect of self-formulated Tongluo Yizhi formula on memory deficits and endoplasmic reticulum stress (ERS) in rats with vascular dementia (VD) and its mechanism. Methods Fifty SPF-grade Wistar rats were randomly divided into sham surgery group,model group,TLYZF low-dose (12.5 mg/kg/d) group,TLYZF medium dose (25 mg/kg/d) group and TLYZF high-dose (50 mg/kg/d) group,with 10 rats in each group. Except for the Sham group,other rats were subjected to modified bilateral carotid artery ligation to construct VD models. After 4 weeks of TLYZF intervention,Morris water maze experiment was used to evaluate the learning and memory abilities of rats.Hematoxylin eosin staining was used to detect the pathological structure of the hippocampus.Nissl staining was used to detect hippocampal neuronal damage.In situ end transfer enzyme labeling staining was used to detect hippocampal neuronal apoptosis.Enzyme-linked immunosorbent assay was used to detect the content of inflammatory factors in hippocampal tissue.Protein immunoblotting was used to detect apoptosis of hippocampal tissue cells and the expression of ERS related proteins.Results Compared with the Sham group,the average escape latency of the model group was prolonged(t=14.059),the number of crossing the platform was reduced(t=8.534),the hippocampal neurons were disorderly arranged,the morphology was fuzzy,the cytoplasmic vacuolization,the nuclear pyknosis,the inflammatory cell infiltration increased,the number of Nissl bodies decreased(t=17.131),and the neuronal apoptosis rate increased(t=17.701). The contents of tumor necrosis factor-α (TNF-α),interleukin-1 β (IL-1β) and IL-6 increased(t=6.541,6.957,10.014),the expression of Bcl-2 associated X protein (Bax),cleaved caspase-3,glucose-regulated protein 78 (GRP78),phosphorylated endoplasmic reticulum kinase (p-PERK)/PERK,phosphorylated eukaryotic initiation factor 2α (p-eIF2α)/eIF2α,activating transcription factor 4 (ATF4) and CCAAT/enhancer binding protein (C/EBP) homologous protein (CHOP) increased(t=13.548～76.468),while the expression of B-cell lymphoma-2 (Bcl-2) proteinwas decreased (t=39.691),and the difference were statistically significant (all P<0.05),respectively. Compared with the model group,the average escape latency of TLYZF-treated rats was shortened(t=2.476,7.266,11.306),the number of platform crossing was increased(t=2.187,4.471,6.932),the hippocampal neurons were relatively regular,the nucleus was clear,the inflammatory cell infiltration was significantly reduced,the content of Nissl bodies was increased(t=4.359,9.477,11.449),the apoptosis rate of neurons was decreased(t=3.631,6.145,7.580),the contents of TNF-α,IL-1β and IL-6 were decreased (t=2.382～8.293),the expression of Bax(t=4.696,16.250,20.250),cleaved caspase-3(t=15.205,27.000,26.833),GRP78(t=5.918,13.139,13.741),p-PERK/PERK(t=13.416,14.230,17.889),p-eIF2α/eIF2α(t=20.152,39.346,50.750),ATF4(t=12.093,24.395,22.946)and CHOP protein((t=21.592,19.207,22.136)decreased,while Bcl-2 protein increased(t=7.474,20.761,35.350),the differences were statistically significant (all P<0.05),respectively,and the high-dose group had the best therapeutic effect.Conclusion Self-formulated Tongluo Yizhi formula could reduce the apoptosis and inflammatory injury of hippocampal neurons in VD rats,and its mechanism may be related to inhibiting ERS mediated by PERK.

Objective To analyze the expression of serum mannose binding lectin associated serine protease 1(MASP1)and protein kinase D2(PRKD2)in locally advanced cervical cancer(LACC)patients,and their relationship with the efficacy of neoadjuvant chemotherapy(NACT).Methods The clinical data of 98 LACC patients(LACC group)treated with NACT in the hospital from March 2019 to April 2021 were retrospective-ly selected,and they were divided into effective group(n=76)and ineffective group(n=22)according to the efficacy.Fifty patients with early cervical cancer diagnosed and treated in the same period were selected as the early cervical cancer group,and 50 female health examination subjects were selected as the healthy control group.Enzyme-linked immunosorbent assay was applied to detect serum levels of MASP1 and PRKD2.Logis-tic regression analysis was applied to analyze the influencing factors of NACT efficacy.The evaluation value of serum MASP1 and PRKD2 on the efficacy of NACT were analyzed by the receiver operating characteristic curve.Results The serum levels of MASP1 and PRKD2 in the LACC group were higher than those in the ear-ly cervical cancer group and the control group,and the differences were statistically significant(P＜0.05).The serum levels of MASP1 and PRKD2 in LACC group were correlated with International Federation of Gy-necology and Obstetrics(FIGO)stage and pathological grade,and the serum levels of MASP1 and PRKD2 in patients with FIGO stage Ⅲ and pathological grade G3 were higher(P＜0.05).FIGO stage Ⅲ proportion,se-rum MASP1 and serum PRKD2 levels in NACT ineffective group were higher than those in effective group(P＜0.05).FIGO stage Ⅲ,serum MASP1 and serum PRKD2 were independent risk factors for NACT efficacy in LACC patients(P＜0.05).The area under the curve of serum MASP1 and PRKD2 combined to evaluate the efficacy of NACT was 0.883(95％CI:0.828-0.935),which was larger than 0.802(95％CI:0.761-0.846)and 0.825(95％CI:0.764-0.852)predicted by the single index,and the difference were statistically significant(Z=4.111,5.012,both P＜0.001).Conclusion Level of serum MASP1 and PRKD2 in LACC pa-tients are increase,which are independent risk factors affecting the efficacy of NACT.Combined detection of MASP1 and PRKD2 has high predictive value for NACT efficacy.

Objective To investigate the clinical efficacy of Modified Yinhuo Guiyuan Huayu Formula(MYGHF)in diabetic retinopathy(DR)patients with yin deficiency and blood stasis syndrome and to observe its regulatory effects on the nuclear factor κB(NF-κB)signaling pathway.Methods A total of 100 DR patients(200 eyes)with yin deficiency and blood stasis syndrome admitted to the Fourth People's Hospital of Hengshui from January 2019 to April 2020 were equally randomized into a control group(50 cases,100 eyes)and an observation group(50 cases,100 eyes)using a random number table.Both groups were required to conduct intensive glycemic control.The control group was treated with conventional western medicine of lecithin-bound iodine,while the observation group received additional MYGHF for 3 months.Parameters of traditional Chinese medicine(TCM)syndrome scores,key components of NF-κB signaling pathway[NF-κB p65,inhibitor of kappa B kinase(IKK),inhibitor kappa B(IκB)],angiogenesis-related factors[fibroblast growth factor 21(FGF21),vascular endothelial growth factor(VEGF),angiopoietin 2(Ang2)],and efficacy indicators[glycated hemoglobin(HbA1c),fasting blood glucose(FBG),homeostasis model assessment of insulin resistance(HOMA-IR),visual field grayscale value,and best-corrected visual acuity(BCVA)]in the two groups were evaluated before treatment and 1 and 3 month(s)after treatment.After treatment,the clinical efficacy and safety of the two groups were assessed.Results(1)After 3 months of treatment,the total effective rate was 88.00%(44/50)in the observation group versus 70.00%(35/50)in the control group,demonstrating significantly superior therapeutic effects of TCM syndrome differentiation in the observation group(tested by chi-square test,P＜0.05).(2)At 1 and 3 month(s)after treatment,both groups showed reduced scores for TCM symptoms of blurred vision,dizziness and tinnitus,soreness and weakness of waist and knees,and feverish sensation in the palms and soles compared to the baseline levels(all P＜0.05).The observation group exhibited significantly greater reductions in these symptom scores than the control group at both time points(all P＜0.05).(3)The protein expression levels of NF-κB p65,IKK were decreased and IκB was increased in both groups at 1 and 3 month(s)after treatment compared to the baseline levels(all P＜0.05),and the observation group demonstrated more pronounced improvement of these key pathway components compared to the control group(all P＜0.05).(4)The levels of angiogenesis-related factors of FGF21,Ang2,and VEGF were significantly reduced in both groups at 1 and 3 month(s)compared to the baseline levels(all P＜0.05),and the observation group showed superior decreases compared to the control group(all P＜0.05).(5)The efficacy indicators of HbA1c,FBG,HOMA-IR,visual field grayscale values,and BCVA were improved in both groups at post-treatment 1 and 3 month(s)compared to the baseline levels(all P＜0.05),and the observation group achieved significantly superior improvement in all indicators compared to the control group(all P＜0.05).(6)The total incidence of adverse reactions was 2.00%(1/50)in the observation group versus 8.00%(4/50)in the control group,with no statistically significant difference between groups(P＞0.05).Conclusion MYGHF effectively alleviates clinical symptoms in patients with DR of yin deficiency and blood stasis type,and is effective on modulating angiogenesis-related factors and suppressing NF-κB signaling pathway activation,demonstrating satisfactory efficacy and good safety profile.

Objective:To quantitatively evaluate the changes of the sciatic nerve of rabbits following acute cold exposure and intraperitoneal lavage rewarming therapy by applying shear wave elastography（SWE）technology.Methods:Thirty healthy adult New Zealand white rabbits，weighing approximately（4.0 ± 0.2）kgResults:Body temperature comparison：the body temperature of all 3 groups decreased at T2 compared to T1，with statistically significant differences（all P<0.05）. By T4，the body temperature of all groups had returned to normal，showing no significant differences compared to T1（ P>0.05）. The peritoneal lavage + rewarming platform group showed a faster recovery rate in body temperature during T2-T3 compared to both the rewarming platform group and the blank control group，with statistically significant differences（all P<0.05）. There were no significant differences in the recovery rate between the rewarming platform group and the blank control group during T2-T3（all P>0.05）. Comparison of conventional ultrasound parameters：the longitudinal width，cross-sectional area，and perimeter of the sciatic nerve showed statistically significant differences between T2 and T1（all P<0.05）. No significant differences were observed between T3 and T4，or between T1 and T4（all P>0.05）. Comparison of SWE parameters：T2 phase showed an increase in SWE values of the sciatic nerve，with statistically significant differences in the maximum（Emax）and average（Emean）Young's modulus compared to T1 and T4（all P<0.05）. No significant differences were observed between T1 and T4（all P>0.05）. Transmission electron microscopy results：under acute cold exposure，the sciatic nerve showed swelling，with vacuole formation visible in the axons. After peritoneal lavage rewarming therapy，the morphology of the sciatic nerve returned to normal. Conclusions:Following acute cold exposure，the rabbit's sciatic nerve exhibits contraction，with increased stiffness，which can be quantitatively assessed using conventional ultrasound combined with SWE. Peritoneal lavage therapy is an effective rewarming method that significantly enhances the rewarming rate.

Objective To observe the effect of self-formulated Tongluo Yizhi formula on memory deficits and endoplasmic reticulum stress (ERS) in rats with vascular dementia (VD) and its mechanism. Methods Fifty SPF-grade Wistar rats were randomly divided into sham surgery group,model group,TLYZF low-dose (12.5 mg/kg/d) group,TLYZF medium dose (25 mg/kg/d) group and TLYZF high-dose (50 mg/kg/d) group,with 10 rats in each group. Except for the Sham group,other rats were subjected to modified bilateral carotid artery ligation to construct VD models. After 4 weeks of TLYZF intervention,Morris water maze experiment was used to evaluate the learning and memory abilities of rats.Hematoxylin eosin staining was used to detect the pathological structure of the hippocampus.Nissl staining was used to detect hippocampal neuronal damage.In situ end transfer enzyme labeling staining was used to detect hippocampal neuronal apoptosis.Enzyme-linked immunosorbent assay was used to detect the content of inflammatory factors in hippocampal tissue.Protein immunoblotting was used to detect apoptosis of hippocampal tissue cells and the expression of ERS related proteins.Results Compared with the Sham group,the average escape latency of the model group was prolonged(t=14.059),the number of crossing the platform was reduced(t=8.534),the hippocampal neurons were disorderly arranged,the morphology was fuzzy,the cytoplasmic vacuolization,the nuclear pyknosis,the inflammatory cell infiltration increased,the number of Nissl bodies decreased(t=17.131),and the neuronal apoptosis rate increased(t=17.701). The contents of tumor necrosis factor-α (TNF-α),interleukin-1 β (IL-1β) and IL-6 increased(t=6.541,6.957,10.014),the expression of Bcl-2 associated X protein (Bax),cleaved caspase-3,glucose-regulated protein 78 (GRP78),phosphorylated endoplasmic reticulum kinase (p-PERK)/PERK,phosphorylated eukaryotic initiation factor 2α (p-eIF2α)/eIF2α,activating transcription factor 4 (ATF4) and CCAAT/enhancer binding protein (C/EBP) homologous protein (CHOP) increased(t=13.548～76.468),while the expression of B-cell lymphoma-2 (Bcl-2) proteinwas decreased (t=39.691),and the difference were statistically significant (all P<0.05),respectively. Compared with the model group,the average escape latency of TLYZF-treated rats was shortened(t=2.476,7.266,11.306),the number of platform crossing was increased(t=2.187,4.471,6.932),the hippocampal neurons were relatively regular,the nucleus was clear,the inflammatory cell infiltration was significantly reduced,the content of Nissl bodies was increased(t=4.359,9.477,11.449),the apoptosis rate of neurons was decreased(t=3.631,6.145,7.580),the contents of TNF-α,IL-1β and IL-6 were decreased (t=2.382～8.293),the expression of Bax(t=4.696,16.250,20.250),cleaved caspase-3(t=15.205,27.000,26.833),GRP78(t=5.918,13.139,13.741),p-PERK/PERK(t=13.416,14.230,17.889),p-eIF2α/eIF2α(t=20.152,39.346,50.750),ATF4(t=12.093,24.395,22.946)and CHOP protein((t=21.592,19.207,22.136)decreased,while Bcl-2 protein increased(t=7.474,20.761,35.350),the differences were statistically significant (all P<0.05),respectively,and the high-dose group had the best therapeutic effect.Conclusion Self-formulated Tongluo Yizhi formula could reduce the apoptosis and inflammatory injury of hippocampal neurons in VD rats,and its mechanism may be related to inhibiting ERS mediated by PERK.

Objective:To quantitatively evaluate the changes of the sciatic nerve of rabbits following acute cold exposure and intraperitoneal lavage rewarming therapy by applying shear wave elastography（SWE）technology.Methods:Thirty healthy adult New Zealand white rabbits，weighing approximately（4.0 ± 0.2）kgResults:Body temperature comparison：the body temperature of all 3 groups decreased at T2 compared to T1，with statistically significant differences（all P<0.05）. By T4，the body temperature of all groups had returned to normal，showing no significant differences compared to T1（ P>0.05）. The peritoneal lavage + rewarming platform group showed a faster recovery rate in body temperature during T2-T3 compared to both the rewarming platform group and the blank control group，with statistically significant differences（all P<0.05）. There were no significant differences in the recovery rate between the rewarming platform group and the blank control group during T2-T3（all P>0.05）. Comparison of conventional ultrasound parameters：the longitudinal width，cross-sectional area，and perimeter of the sciatic nerve showed statistically significant differences between T2 and T1（all P<0.05）. No significant differences were observed between T3 and T4，or between T1 and T4（all P>0.05）. Comparison of SWE parameters：T2 phase showed an increase in SWE values of the sciatic nerve，with statistically significant differences in the maximum（Emax）and average（Emean）Young's modulus compared to T1 and T4（all P<0.05）. No significant differences were observed between T1 and T4（all P>0.05）. Transmission electron microscopy results：under acute cold exposure，the sciatic nerve showed swelling，with vacuole formation visible in the axons. After peritoneal lavage rewarming therapy，the morphology of the sciatic nerve returned to normal. Conclusions:Following acute cold exposure，the rabbit's sciatic nerve exhibits contraction，with increased stiffness，which can be quantitatively assessed using conventional ultrasound combined with SWE. Peritoneal lavage therapy is an effective rewarming method that significantly enhances the rewarming rate.

Objective:To analyze the clinical value of 18F-FDG PET/MR for precise localization of epileptogenic foci in patients with refractory epilepsy. Methods:From February 2019 to December 2021, 81 patients (52 males, 29 females; age (30.0±10.9) years) with refractory epilepsy confirmed in Ruijin Hospital Shanghai Jiao Tong University School of Medicine were retrospectively enrolled. All patients underwent preoperative PET/MR exam, and the possible position of the epileptogenic foci were determined by PET/MR imaging and pre-surgical evaluation, then the stereoelectroencephalography (SEEG) electrodes were implanted. Surgery was performed, and outcome was assessed by using a modified Engel classification two years after surgery. χ2 test was used to compare the detection rates of MRI and PET/MR fusion imaging in localizing epileptogenic foci and the detection rates of epileptogenic foci in temporal lobe epilepsy (TLE) and extratemporal lobe epilepsy (ETLE) by PET/MR. Results:MRI correctly localized seizure foci in 38 patients, with the detection rate of 46.91%(38/81), while PET/MR detected seizure foci in 73 patients, with the detection rate of 90.12%(73/81; χ2=35.05, P<0.001). There were 63 TLE and 18 ETLE patients. The detection rate of PET/MR in localizing seizure foci in TLE patients was 95.24%(60/63), which was significantly higher than that in ETLE patients (13/18; χ2=5.94, P=0.015). After 2 years follow-up, the postoperative efficacy rate of TLE patients with Engel grades Ⅰ-Ⅱ was 76.19%(48/63), which was 13/18 of ETLE patients ( χ2=0.12, P=0.731). Conclusion:Hybrid PET/MR imaging can accurately locate epileptogenic foci, especially for MRI negative lesions, which provides precision imaging information for surgical planning and improves surgical success rate.

Objective To explore the potential influencing factors and complex pathways affecting rehabilitation effect for children with autism spectrum disorder(ASD)from the perspective of parental efficacy in doctor-patient communication,and to provide evidence for improving the quality of rehabilitation service for children with ASD. Methods An anonymous face-to-face questionnaire survey was conducted to collect general demographic information of parents of children with ASD at designated rehabilitation institutions in Gansu province.The data included paren-tal efficacy in doctor-patient communication,parental compliance of treatment and children's rehabilitation out-comes were collected.A structural equation model was used to explore the impact mechanism of parental commu-nication efficacy on the rehabilitation outcomes of children with ASD. Results Data from 519 parents at 37 rehabilitation institutions across 13 cities/counties in Gansu province were collect-ed.Significant positive correlations were found between parental efficacy in doctor-patient communication,doc-tor-patient relationships,parental compliance with treatment and rehabilitation outcomes for children with ASD(P＜0.05).Through structural equation model analysis,the standardized direct effect of children with ASD from parents'doctor-patient communication efficacy was 0.151(P=0.023).The mediating effect of doctor-patient rela-tionship and parental compliance with treatment were 0.160(P=0.001)and 0.111(P=0.001),respectively,with a chained mediating effect of 0.035(P=0.001).The pathway"parental efficacy in doctor-patient communica-tion → doctor-patient relationship → ASD child's rehabilitation outcome"accounted for the highest proportion of the total mediating effect,at 52.29%. Conclusion Parental doctor-patient communication efficacy may positively impact on the rehabilitation outcomes of chil-dren with ASD directly,and indirectly through the doctor-patient relationship and parental compliance with treat-ment.Rehabilitation institutions should focus on fostering parental communication skills and enhancing high-quality and humanized rehabilitation services.

The objective of this study was to examine the effects of electroacupuncture on the expression of ATP-binding cassette transporter A1(ABCA1),ATP-binding cassette transporter G1(ABCG1),and class B type Ⅰ scavenger receptor(SR-B Ⅰ)genes and proteins in peritoneal macrophages of atherosclerotic rabbits.The study aimed to explore the mechanism underlying the treatment of atherosclerosis(AS)with electroacupuncture.Methods Twenty-six male New Zealand rabbits were randomly divided into the negative control group(n=7)and the modeling group(n=19)using a random number table method.The negative control group rabbits were fed a regular diet,while the modeling group was induced with a combination of high-fat feed and common carotid artery balloon injury surgery to create an AS model.After successful modeling,the rabbits in the modeling group were further divided into the model group,the electroacupuncture group,and the atorvastatin group,with 6 rabbits in each group.The rabbits in the electroacupuncture group received electroacupuncture at"'Neiguan'(PC6)","'Zusanli'(ST36)",and"'Guanyuan'(ST25)"acupoints,using a density wave,a current of 1 mA,and a frequency of 4 Hz/20 Hz,once a day.The needle was retained for 20 minutes each time,and a total of 4 courses of treatment were conducted,with 6 days per course.The rabbits in the atorvastatin group were administered atorvastatin calcium tablet suspension(1 mg/kg)orally once a day,for 6 days per course,with a total of 4 courses.After the interventions,HE staining was performed to observe the morphological changes in the common carotid artery tissue of the rabbits.Peritoneal macrophages were collected from the rabbits,and the mRNA expression levels of ABCA1,ABCG1,and SR-B Ⅰ were measured using real-time fluorescence PCR.The protein expression levels of ABCA1,ABCG1,and SR-B Ⅰ were detected using Western blotting.Results The negative control group exhibited smooth intima of common carotid artery in rabbits,while the model group displayed damaged intima of common carotid artery,thickened artery walls,and the formation of atherosclerotic plaques.The electroacupuncture group and atorvastatin group showed significant improvements in wall thickening and a reduction in plaque area.Compared with the negative control group,the mRNA and protein expressions of ABCA1,ABCG1,and SR-B Ⅰ in peritoneal macrophages of rabbits in the model group were reduced(P＜0.01).Compared with the model group,the electroacupuncture group and atorvastatin group exhibited increased mRNA and protein expressions of ABCA1,ABCG1,and SR-B Ⅰ in abdominal macrophages of rabbits(P＜0.01).Furthermore,the atorvastatin group demonstrated increased mRNA levels of ABCG1 and SR-B Ⅰ,as well as increased protein expressions of ABCA1,ABCG1,and SR-B Ⅰ in peritoneal macrophages of rabbits,in comparison to the electroacupuncture group(P＜0.01).Conclusion Electroacupuncture can enhance the expressions of ABCA1,ABCG1,and SR-B Ⅰ mRNA and protein in abdominal macrophages of AS rabbits,thereby promoting the process of cholesterol reverse transport.This may be one of the mechanisms underlying the effectiveness of acupuncture in the treatment of AS.

Objective:To investigate the influencing of preoperative biliary drainage on surgery-related complications after pancreaticoduodenectomy.Methods:The retrospective case-control study was conducted. The clinical data of 267 patients with periampullary space-occupying lesion who were admitted to Beijing Friendship Hospital of Capital Medical University from January 2016 to July 2020 were collected. There were 166 males and 101 females, aged 61 (range, 54?84)years. Observation indicators: (1) comparison of preoperative situations in patients with and without preoperative biliary drainage; (2) comparison of intraoperative and postoperative situations in patients with and without preoperative biliary drainage; (3) methods and efficacy of preoperative biliary drainage; (4) factors influencing surgery-related complications after pancreaticoduodenec-tomy. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were represented as M(rang) or M( Q1, Q3), and comparison between groups was conducted using the Mann-Whitney U test. Count data were described as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test. Univariate analysis was conducted using the corresponding statistical methods based on data type. Multivariate analysis was conducted using the Logistic stepwise regression model. Results:(1) Comparison of preoperative situations in patients with and without preoperative biliary drainage. Of the 267 patients, there were 104 cases with preoperative biliary drainage and 163 cases without preoperative biliary drainage. Cases with malignant tumor, cases with borderline tumor, cases with chronic pancreatitis were 89, 13, 2 in patients with preoperative biliary drainage, versus 111, 41, 11 in patients without preoperative biliary drainage, showing significant differences in pathology type between them ( χ2=10.652, P<0.05). (2) Comparison of intraoperative and postoperative situations in patients with and without preoperative biliary drainage. There was no significant difference in operation time, volume of intra-operative blood loss, postoperative complications, grade B pancreatic fistula, grade C pancreatic fistula, biliary leakage, abdominal or gastrointestinal bleeding, incidence of abdominal infection, white blood cell count at postoperative day 1, white blood cell count at postoperative day 3, neutrophil-to-lymphocyte ratio at postoperative day 1, neutrophil-to-lymphocyte ratio at postoperative day 3, C-reactive protein-albumin ratio at postoperative day 1, C-reactive protein-albumin ratio at post-operative day 3, duration of hospital stay between the 104 patients with preoperative biliary drainage and the 163 patients without preoperative biliary drainage ( P>0.05). (3) Methods and efficacy of preoperative biliary drainage. Of the 104 patients with preoperative biliary drainage, there were 40 cases receiving endoscopic nasobiliary drainage with drainage time as (12±2)days, there were 38 cases receiving percutaneous transhepatic cholangial drainage with drainage time as (7±1)days, and there were 26 cases receiving endoscopic retrograde biliary drainage with drainage time as (19±2)days. The total bilirubin, direct bilirubin, aspartate transaminase, alanine aminotrans-ferase in 104 patients were (223±18)μmol/L, (134±11)μmol/L, (112±10)U/L, (160±16)U/L before biliary drainage and (144±13)μmol/L, (84±8)μmol/L, (79±8)U/L, (109±12)U/L after biliary drainage, showing significant differences in the above indicators ( t=3.544, 3.608, 2.523, 2.509, P<0.05). (4) Factors influencing surgery-related complications after pancreatocoduodenectomy. Results of multi-variate analysis showed that operation time was an independent factor influencing surgery-related complications after pancreaticoduodenectomy ( odds ratio=1.005, 95% confidence interval as 1.002?1.008, P<0.05). Conclusions:Preoperative biliary drainage does not increase the incidence of complications related to pancreaticoduodenectomy in patients with periampullary space-occupying lesion. Operation time is an independent factor influencing postoperative surgery-related complications.