Objective To investigate the clinical application value of combined pancreaticobiliary brushing under endoscopic retrograde cholangiopancreatography(ERCP)in the treatment of hepatopancreatic ampulla malignant tumours.Methods We retrospectively analyzed 59 patients from January 2013 to December 2023 for ERCP treatment of hepatopancreatic ampulla tumours,and performed combined pancreaticobiliary brushing(combined pancreaticobiliary brushing group,n=10)and biliary duct brushing alone(biliary duct brushing group,n=49)respectively,then compared the positive pathological detection rate of hepatopancreatic ampulla malignant tumours,the magnitude of bilirubin reduction,and the occurrence of postoperative complications between the two groups.Results The positive detection rate of combined pancreaticobiliary brushing for diagnosing ampulla malignant tumours was 70.0％(7/10),and the positive detection rate of biliary duct brushing alone was 22.4％(11/49),and the positive detection rate of pathology in the two groups was statistically significant(P＜0.05);No significant statistical difference was observed in the decrease of bilirubin between the two groups(P＞0.05);There were three cases of post-operative complications in the biliary duct brushing group.There were no postoperative complications in the combined pancreaticobiliary brushing group.Conclusion Compared with bile duct brushing alone,combined pancreaticobiliary brushing is more helpful for the diagnosis of malignant tumours,and does not increase the incidence of complications.It is worthy for clinical application.

Objective To investigate the clinical application value of combined pancreaticobiliary brushing under endoscopic retrograde cholangiopancreatography(ERCP)in the treatment of hepatopancreatic ampulla malignant tumours.Methods We retrospectively analyzed 59 patients from January 2013 to December 2023 for ERCP treatment of hepatopancreatic ampulla tumours,and performed combined pancreaticobiliary brushing(combined pancreaticobiliary brushing group,n=10)and biliary duct brushing alone(biliary duct brushing group,n=49)respectively,then compared the positive pathological detection rate of hepatopancreatic ampulla malignant tumours,the magnitude of bilirubin reduction,and the occurrence of postoperative complications between the two groups.Results The positive detection rate of combined pancreaticobiliary brushing for diagnosing ampulla malignant tumours was 70.0％(7/10),and the positive detection rate of biliary duct brushing alone was 22.4％(11/49),and the positive detection rate of pathology in the two groups was statistically significant(P＜0.05);No significant statistical difference was observed in the decrease of bilirubin between the two groups(P＞0.05);There were three cases of post-operative complications in the biliary duct brushing group.There were no postoperative complications in the combined pancreaticobiliary brushing group.Conclusion Compared with bile duct brushing alone,combined pancreaticobiliary brushing is more helpful for the diagnosis of malignant tumours,and does not increase the incidence of complications.It is worthy for clinical application.

Objective To explore the network structure of anxiety,depression and sleep among individuals under long-term high-altitude exposure.Methods A total of 303 subjects who had resided at high altitudes for more than 6 months on end were selected.The insomnia severity index(ISI),patient health questionnaire(PHQ-9),and generalized anxiety disorder scale(GAD-7)were employed to assess insomnia,depression and anxiety before network analysis was conducted to identify the central and bridge nodes in the symptom network.Results The incidence of moderate or severe depression,anxiety and insomnia were 38.9％[95％confidence interval(CI):33.4％-44.5％],23.1％(95％CI:18.3％-27.9％),and 18.5％(95％CI:14.1％-22.9％),respectively."Noticeability of sleep problems by others"had the highest expected influence centrality,followed by"sleep maintenance""uncontrollable worry""restlessness"and"sleep problems".Five bridge symptoms were identified:"sad mood""sleep problems""restlessness""feeling afraid"and"trouble relaxing".Conclusion Sleep-related symptoms play a crucial role in the overall network structure,serving as both central and bridge nodes.Additionally,the"feeling down or depressed"acts as a bridge node and holds importance in the comorbidity network of anxiety and depression.Targeting these key symptoms through intervention and prevention strategies may improve the psychological well-being of individuals with long-term residence in high-altitude regions.

Objective To investigate the clinical features of patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Delta variant infection and abnormal liver function in Guangdong Province, China. Methods The patients with SARS-CoV-2 Delta variant infection who belonged to the same chain of transmission in Guangdong Province (Guangzhou and Foshan) and were admitted to Guangzhou Eighth People's Hospital, Guangzhou Medical University from May 21 to June 18, 2021 were enrolled in this study, and the judgment criteria for liver function were alanine aminotransferase (male/female) > 50/40 U/L, aspartate aminotransferase > 40 U/L, total bilirubin > 26 μmol/L, gamma-glutamyl transpeptidase > 60 U/L, and alkaline phosphatase (ALK) > 125 U/L. Abnormality in any one item of the above criteria was defined as abnormal liver function, and such patients were included in analysis (the patients, aged < 18 years, who had a mild or moderate increase in ALP alone were not included in analysis). Clinical data were compared between the patients with normal liver function and those with abnormal liver function, and the etiology and prognosis of abnormal liver function were analyzed. The Mann-Whitney U test was used for comparison of continuous data between two groups; the chi-square test was used for comparison of categorical data between two groups. Results Among the 166 patients with SARS-CoV-2 Delta variant infection, 32 (19.3%) had abnormal liver function with mild-to-moderate increases in liver function parameters, and compared with the normal liver function group, the abnormal liver function group had a significantly higher proportion of critical patients ( χ 2 =38.689, P < 0.001) and significantly higher age and inflammatory cytokines [C-reactive protein type, serum amyloid A, and interleukin-6 (IL-6)](all P < 0.05). Among the 32 patients with abnormal liver function, 13 patients had abnormal liver function on admission (defined as primary group), while 19 patients had normal liver function on admission but were found to have abnormal liver function by reexamination after treatment (defined as secondary group). For the primary group, the evidence of abnormal liver function was not found for 3 patients (3/13, 23.1%), and the possibility of toxic liver injury directly associated with SARS-CoV-2 infection was considered. Among the 19 patients in the secondary group, 9 (47.4%) had mild/common type and 10 (52.6%) had critical type, and all critical patients had the evidence of liver injury indirectly caused by the significant increases in C-reactive protein type, serum amyloid A, and IL-6 and hypoxemia; the evidence of abnormal liver function was not found for only 1 patient (1/19, 5.3%), and the possibility of toxic liver injury directly associated with SARS-CoV-2 infection was considered. All 32 patients with abnormal liver function had [JP2]significant reductions in liver function parameters after treatment including liver protection. Conclusion As for the patients with SARS-CoV-2 Delta variant infection who belong to the same chain of transmission in Guangdong Province, the critical patients show a significantly higher proportion of patients with abnormal liver function than the patients with other clinical types, and other factors except SARS-CoV-2 infection and indirect injury caused by SARS-CoV-2 infection are the main cause of liver injury.

AIM: To construct recombinant adenovirus vector containing brain derived neurotrophic factor, (BDNF) gene using bacterial homogenous recombination, and investigate the expression in expanded rat mesenchymal stem cells (rMSC) in vitro. METHODS: BDNF gene and proBDNF gene were subcloned into adenovirus shuttle plasmid pAdTrack-CMV containing enhanced green fluorescent protein gene (EGFP) expression cassette, forming shuttle vector of pAdTrack-BDNF, and pAdTrack-proBDNF, and co-transformed into BJ5183 bacterial cells with adenovirus backbone vector pAdEasy-1 using chemical transformation. After the recombinant adenovirus vector was obtained, the identified recombinant adenovirus plasmid DNA was digested with Pac I and transfected to 293 cells to package recombinant adenovirus particles. rMSC were infected by recombinant adenovirus and EGFP expression was detected using fluorescent microscope. Infection efficiency was assessed by flow cytometrics. Western blotting identified expression of Ad -proBDNF and Ad-BDNF in rMSC. rMSC infected with Ad -proBDNF and Ad-BDNF were induced to differentiate into neuron-like cells. rMSC infected with Ad -proBDNF and Ad-BDNF were injected into nude mice and assessd in vivo. RESULTS: We successfully constructed the recombinant adenovirus Ad -proBDNF and Ad-BDNF that expressed in expanded rMSC in vitro.CONCLUSION: Recombinant adenovirus high-effectively mediates Ad -proBDNF and Ad-BDNF expression in expanded rMSC in vitro and in vivo.