1.Effects of prostaglandin E2 injection into the median preoptic nucleus on body temperature in female mice and its mechanisms
Ya LI ; Yi’an SONG ; Qiaofeng JI ; Lei XU ; Jie ZHANG ; Jianhui XU ; Xiaoyu HOU
Acta Universitatis Medicinalis Anhui 2026;61(2):250-257
ObjectiveTo investigate the effects of prostaglandin E2 (PGE2) microinjection into the median preoptic nucleus (MnPO) on core body temperature in female mice, and to clarify its underlying mechanism. MethodsMicroinjection cannula were implanted into the MnPO of female mice using stereotaxic surgery.Subsequently, a multi-channel temperature acquisition system was used to simultaneously monitor rectal and brown adipose tissue (BAT) temperatures before and after intra-MnPO injections of different reagents.To investigate the thermoregulatory effects of the microinjection of PGE2 into the MnPO, 12 female C57BL/6 mice were randomly divided into a saline group (n=6) and a PGE2 group (n=6), which were injected with 0.1 μL saline and PGE2 (2.8 mmol/L), respectively.To determine whether E-series prostaglandin receptor (EP)1, EP3, and EP4 receptors mediate the thermoregulatory effects of PGE2, 15 female C57BL/6 mice were randomly divided into 3 groups (n=5 per group).Mice in each group first received an injection of 0.1 μL PGE2 (2.8 mmol/L) into the MnPO. After their body temperature returned to baseline levels, they were subsequently injected with a mixture of either EP1, EP3 or EP4 antagonist (ant) (20 mmol/L) + PGE2 (2.8 mmol/L). ResultsCompared with baseline level, the rectal temperature (P<0.01) and BAT temperature (P<0.001) of female mice both increased significantly after microinjection of PGE2 into the MnPO.Compared with the saline group, the increases in rectal temperature (P<0.001) and BAT temperature (P<0.000 1) were significantly greater in the PGE2 group of mice.Furthermore, following the injection of PGE2 into MnPO, the increase in BAT temperature was found to be significantly greater than that in rectal temperature in mice (P<0.001).Compared to the administration of PGE2 alone, co-injection of an EP3 ant + PGE2 into the MnPO of mice resulted in a significantly smaller increase in both rectal temperature (P<0.001) and BAT temperature (P<0.001).In contrast, the increases in rectal and BAT temperatures following MnPO injection of either EP1 ant + PGE2 or EP4 ant + PGE2 were not statistically significant (P>0.05). ConclusionInjection of PGE2 into the MnPO elevates BAT and core body temperature in female mice via the EP3 receptor.
2.Study on microwave radiation aggravating the impairment of cognitive functions in mice with experimental periodontitis
ZHOU Hongjin ; WANG Jianhui ; LIU Lin ; LI Hongbo
Journal of Prevention and Treatment for Stomatological Diseases 2026;34(6):541-545
Objective:
To explore the effects of microwave radiation on cognitive function and neuroinflammation in mice with experimental periodontitis, providing experimental evidence for understanding how environmental exposure may be linked to the risk of neurodegenerative diseases by modulating chronic inflammation as a shared pathological mechanism
Methods:
This study was approved by the Animal Ethics Committee of the Academy of Military Medical Sciences. C57BL/6J mice were randomly divided into a control group (C group, untreated), a microwave radiation group (R group, exposed to microwave radiation only), a periodontitis group (P group, ligation-induced periodontitis only), and a periodontitis + microwave radiation group (PR group, ligation-induced periodontitis plus microwave radiation exposure). A periodontitis model was established using the silk ligation method. Eight weeks after modeling, the R and PR groups were subjected to whole-body microwave radiation at 2 800 MHz and 10 mW/cm2 for 10 h/day for 7 consecutive days. Behavioral tests were conducted: the open field test and elevated plus maze test were used to assess anxiety-like behavior, the Y-maze test to evaluate spatial memory, and the novel object recognition test to assess learning and memory abilities. Micro-CT, hematoxylin & eosin staining (HE), and quantitative real-time polymerase chain reaction (qPCR) were used to analyze periodontal tissue pathology and local inflammation. Serum and brain levels of lipopolysaccharide (LPS), interleukin-1β (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) were measured using enzyme-linked immunosorbent assay (ELISA). The composition of the oral microbiota was analyzed based on 16S rRNA sequencing.
Results:
Behavioral tests showed that anxiety-like behavior was significantly exacerbated in the R and PR groups, and spatial and recognition memory impairments in the PR and P groups were more severe compared with the R and C groups, respectively (P < 0.05). Histological and molecular biological analyses revealed that periodontal inflammation infiltration, alveolar bone resorption, and local expression of pro-inflammatory cytokines (TNF-α, IL-1β, IL-6) were further exacerbated in the PR and P groups compared with the R and C groups, respectively (P < 0.05). ELISA results showed that in serum, LPS levels in group P and group PR were increased compared with group C and group R, respectively. The levels of TNF-α, IL-1β, and IL-6 in group PR were significantly higher than those in group P and group R, with a synergistic increase in TNF-α level (P < 0.05). In brain tissue, LPS and TNF-α, IL-1β, IL-6 levels in group P were significantly higher than those in group C; all the above indicators in group PR were significantly higher than those in group P and group R, and LPS and IL-6 levels showed a synergistic increase (P < 0.05). Oral microbiota analysis found that microwave radiation further reduced microbial diversity on the basis of periodontitis, leading to increased relative abundances of Lactobacillus and Enterococcus, and decreased relative abundances of Staphylococcus. Correlation analysis confirmed that these differential bacterial genera were positively correlated with brain inflammation levels and negatively correlated with cognitive function indicators.
Conclusion
Microwave radiation exposure can exacerbate cognitive impairment in mice with experimental periodontitis, and its mechanism may be related to aggravated local periodontal damage, disruption of oral microbiota homeostasis, and subsequent induction of systemic and central neuroinflammatory cascades.
3.Influencing Factors of Depression in Patients with Postoperative Ovarian Cancer
Jialiang YAO ; Long ZHANG ; Jianhui TIAN ; Ze LIU ; Yun YANG ; Yiyang ZHOU ; Minghua LI ; Wang YAO ; Wenfei SHI ; Xinyi LU ; Pan YU ; Enchao CONG
Cancer Research on Prevention and Treatment 2026;53(5):349-359
Objective To explore the prevalence of depressive symptoms in postoperative patients with ovarian cancer and to analyze its influencing factors from multiple dimensions, including clinical characteristics, psychological factors, and laboratory indicators. Methods A cross-sectional study was conducted, which enrolled 235 postoperative patients with ovarian cancer. Depressive status was assessed using the patient health questionnaire, and the demographic, pathological, and medical record data of the patients were collected using the generalized anxiety disorder scale, Pittsburgh sleep quality index, European organization for research and treatment of cancer quality of life questionnaire core 30, and ECOG performance status score. Peripheral blood tumor marker (CA125), routine blood test, lymphocyte subsets, and serum cytokine levels were measured. Univariate and multivariate binary logistic regression analysis were used for statistical analysis. Results The prevalence of depression in postoperative patients with ovarian cancer was 39.15% (92/235). Univariate analysis showed that ECOG score ≥ 2 points, pain, anxiety, poor sleep quality, low quality of life, low life satisfaction, tumor recurrence, six or more cycles of chemotherapy, as well as higher levels of CA125, NLR, and NAR, and lower hemoglobin levels were significantly associated with depression (all P<0.05). Multivariate binary Logistic regression analysis showed that anxiety (OR=1.975, 95%CI: 1.231-3.170), sleep efficiency (OR=4.181, 95%CI: 1.211-14.43), sleep latency (OR=34.806, 95%CI: 4.258-284.542), ECOG performance status score, cognitive function (OR=0.918, 95%CI: 0.868-0.97), and life satisfaction were independent risk factors for depression (all P<0.05). Laboratory indicators were not independent influencing factors in the multivariate Logistic regression model. Conclusion Depression in postoperative patients with ovarian cancer is influenced by physiological, psychological, and social factors. Clinical management should focus on patients with anxiety, sleep disorders, poor physical condition, and low life satisfaction, and a comprehensive prevention and treatment strategy centered on psychological intervention and taking into account symptom management and social support should be implemented.
4.A study on the application of predictive extracorporeal membrane oxygenation intraoperative support in high-risk liver transplant recipients
Zhiying LEI ; Xuyong SUN ; Yuanyuan MO ; Jianhui DONG ; Ning WEN ; Rong PENG ; Juhua ZENG ; Silin LI
Organ Transplantation 2026;17(4):618-624
Objective To investigate the clinical safety and efficacy of predictive extracorporeal membrane oxygenation (ECMO) support during liver transplantation in high-risk recipients. Methods A single-center retrospective study was conducted. A total of 35 liver transplant recipients who underwent predictive ECMO assistance during surgery at the Second Affiliated Hospital of Guangxi Medical University from January 2021 to April 2025 were included. Baseline characteristics, ECMO application, ECMO operating parameters and hemodynamic conditions during ECMO operation were analyzed. The cumulative survival rate was calculated using the Kaplan-Meier method and survival curves were plotted. Results Veno-arterial ECMO in 35 recipients was established after induction of general anesthesia. The median ECMO operation time was 8.5 h, and the success rate of weaning from ECMO was 97%. The cardiac index (CI) during the non-liver period and the new liver period was higher than that before cannulation, and CI increased during the non-liver period and before weaning (all P<0.001). The mean invasive arterial pressure and central venous pressure remained stable. No ECMO-related complications occurred in the recipients. The average survival time was (25 ± 3) months. The main causes of death were severe pulmonary infection and multiple organ failure. Conclusions For liver transplant recipients with severe cardiopulmonary dysfunction, hemodynamic disorders, or multiple organ failure risk factors, implementing predictive ECMO support during liver transplantation through active risk prediction is a safe and effective circulatory guarantee strategy.
5.Network structure analysis of the association between physical fitness indicators and anxiety and depressive symptoms among college students
BAI Jianfei, CHEN Wenjia, CAO Chunxia, LI Jianhui, CUI Shuang, ZHAI Feng
Chinese Journal of School Health 2026;47(7):966-970
Objective:
To explore the micro associations and key bridge nodes between physical fitness indicators and anxiety/depressive symptoms among college students using network analysis, so as to provide a theoretical foundation for promoting physical and mental health of college students.
Methods:
From September to October 2025, a combination of purposive sampling and cluster sampling was employed to select 2 158 college students from three universities in Xuzhou City. Seven physical fitness indicators were measured and standardized according to the National Student Physical Health Standard. The Generalized Anxiety Disorder Scale-7 (GAD-7) and the Patient Health Questionnaire-9 (PHQ-9) were used to assess anxiety and depressive symptoms. Independent samples t-test was used for intergroup comparisons of physical fitness indicators and psychological symptom scores. A gaussian graphical model (GGM) was constructed to calculate node and bridge strength, followed by stability analyses.
Results:
The detection rates of anxiety and depressive symptoms among college students were 21.3% and 24.5%, respectively. Male participants demonstrated superior performance in physical fitness indicators such as vital capacity, 50 meter sprint, and standing long jump compared to female participants, whereas females exhibited better results in the sit and reach test ( t =48.35, -44.82 , 70.21, -16.51, all P <0.01). Regarding psychological indicators, female participants showed higher scores of anxiety and depressive symptoms than males ( t =-4.15, -4.46, both P <0.01). Physical fitness and psychological symptoms were predominantly negatively correlated. "feeling tired" and "not being able to stop or control worrying" were the symptoms with the highest centrality in the network of physical fitness and phychological symptoms among college students (standardized strengths were 2.15 and 1.98, respectively). Among the bridge indicators, the "1 000 m (male)/800 m (female) run" exhibited the highest strength (0.85), outperforming "vital capacity" (0.35); it was linked to the symptom cluster primarily by negatively predicting "feeling tired" (edge weight=-0.38). The network stability was excellent of physical fitness and phychological symptoms among college students (correlation stability coefficient= 0.60 ).
Conclusions
Endurance capacity serves as the most critical bridge connecting physical and mental health, and its decline is closely related to intensified feelings of fatigue. Colleges should prioritize endurance training as a core target for promoting college students mental health.
6.Peripheral Immune Response Patterns Under Vital Qi-Strengthening and Toxin-Eliminating Therapy and Their Value in Assessing Vital Qi Deficiency in Lung Cancer Metastasis: A Group-Based Trajectory Modeling
Fan XU ; Jianhui TIAN ; Yuan YAO ; Zhenyang CHENG ; Yanhong WANG ; Bin LUO ; Jialiang YAO ; Wang YAO ; Xinyi LU ; Yuchen BAO ; Xiaoyu YANG ; Youjun LIU ; Yiyang ZHOU ; Jianchun WU ; Minghua LI ; Wenfei SHI ; Yajing CUI ; Qingzhong LIU ; Yan LI ; Yun YANG
Cancer Research on Prevention and Treatment 2026;53(9):711-717
Objective On the basis of the theory of the tumor metastatic state, this work aims to explore the metastasis trajectories and peripheral immune response patterns in patients with non-small cell lung cancer (NSCLC) receiving vital qi-strengthening and toxin-eliminating therapy (Fuzheng Juandu) and reveal the value of peripheral immunity in assessing vital qi deficiency during metastasis. Methods A retrospective study design was adopted. Patients with NSCLC admitted from January 1, 2018, to October 31, 2025 were enrolled. Data on metastasis status and peripheral immune indices were collected at the follow-up time points of one, two, three, and five years. Group-based trajectory modeling was used to fit metastasis trajectories, and the independent predictors of trajectory grouping were analyzed through multifactor and multiclassification logistic regression. Results A total of 184 patients with NSCLC were included, and three different groups of metastasis trajectories were identified, namely, the low-risk stable (46.74%, n=86), low-risk rising (13.59%, n=25), and high-risk stable (39.67%, n=73) groups. Univariate analysis revealed substantial differences in peripheral immune indices among the three trajectory groups. Multivariate analysis showed that TNM stage, absolute neutrophil count, lymphocyte count, absolute monocyte count, platelet volume, SAA:CRP ratio, and NLR were independent predictors of the low-risk rising group, whereas TNM stage, absolute monocyte count, basophil count, SII, and NLR were independent predictors of the high-risk stable group. Conclusion Under Fuzheng Juandu therapy, patients with NSCLC exhibit three distinct metastasis trajectories, each
7.Impact of Intrapartum Ultrasound as a Replacement for Vaginal Examination in Labor Assessment on Vaginal Delivery Complications
Jinhui CUI ; Xinjuan CHEN ; Liping OUYANG ; Ling LI ; Jianhui FAN ; Zeping HUANG ; Ping LI
Journal of Sun Yat-sen University(Medical Sciences) 2026;47(2):360-367
ObjectiveTo evaluate whether the use of intrapartum ultrasound (IPUS) to monitor the labor process, as alternative method of traditional vaginal examination (VE), could reduce the incidence of postpartum complications associated with vaginal delivery. MethodsA total of 360 primiparas who underwent cervical dilation balloon induction of labor (IOL) and achieved successful vaginal delivery after childbirth at the Third Affiliated Hospital of Sun Yat-sen University between January 2022 and December 2023, were included in the retrospective study with half assessed for labor progress using IPUS (n=180) and the other half using VE (n=180). The differences in the relevant indicators of the labor process and the complications of vaginal delivery were compared between the two groups of pregnant women. ResultsThere was no significant difference in the duration of membrane rupture, the first stage of labor and the second stage of labor between the two groups. However, the number of VE in the IPUS group was significantly lower [nulliparous: 4 (3-4) vs. 6 (5-8), P<0.001; multiparous: 2 (2-3) vs. 4 (3-5), P<0.001]. The IPUS group experienced a lower incidence of postpartum fever compared to the VE group [1.67%(3/180) vs. 7.22%(13/180), P=0.006], while other complications of vaginal delivery, such as fever during labor, postpartum hemorrhage (PPH), laceration, poor wound healing and uroschesis, were not significantly different (all P > 0.05). The logistic regression analysis confirmed that the use of IPUS served as a protective factor for postpartum fever with an OR of 0.06 [95% CI (0.01, 0.36); P=0.002], while the duration of membrane rupture was a risk factor [OR: 1.12; 95% CI (1.03, 1.22); P = 0.011]. ConclusionsIPUS, as an alternative to traditional VE, does not affect the progress of labor. However, it can significantly reduce the frequency of VE and the incidence of postpartum fever, thereby facilitating the rapid recovery of postpartum women, which makes it clinically valuable for application.
8.Huashi Baidu Granules Treat Influenza Viral Pneumonia by Regulating Gut-Lung Axis
Qijing LI ; Hanhui HUANG ; Yurong DENG ; Ao'ao WANG ; Jianliang LI ; Jianhui SUN ; Liyu HAO ; Zongyuan LI ; Guimin LIU ; Hongmei LI ; Luqi HUANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(23):59-69
ObjectiveTo explore the mechanism of Huashi Baidu granules in treating influenza A (H1N1) virus infection based on the gut-lung axis. MethodsBALB/c mice were randomly assigned into a blank control group, a model control group, a positive control (oseltamivir phosphate capsules, 19.5 mg·kg-1) group, and a Huashi Baidu granules (17.81 g·kg-1) group. Mice in other groups except the blank control group were instilled nasally by H1N1 viral fluid for the modeling of influenza viral pneumonia and treated with corresponding drugs once daily by gavage for 5 consecutive days. The mouse lung index was calculated, and pathological changes in the lung and colon tissue were observed. Western blot was employed to quantify the expression levels of nucleotide-binding oligomeric domain-like receptor protein 3 (NLRP3), cysteinyl aspartate-specific proteinase -1 (Caspase-1), apoptosis-associated Speck-like protein containing a CARD (ASC), gasdermin D (GSDMD), interleukin-18 (IL-18), IL-1β, and colonic tight junction protein 1 (CLDN1), and Occludin in the lung and colon tissue. Non-targeted metabolomics was employed to analyze the metabolic profiles of the lung tissue and intestinal contents. The 16S rRNA sequencing was performed to analyze the gut microbiota structure in intestinal contents. Enzyme-linked immunosorbent assay (ELISA) was employed to measure the 5-hydroxytryptamine (5-HT) levels in the serum, lung tissue, and colon tissue. ResultsCompared with the blank control group, the model control group showed elevated lung index, marked inflammatory cell infiltration and alveolar structural destruction in the lung tissue, obvious inflammatory cell infiltration and mucosal epithelial damage in the colon tissue, upregulated protein levels of NLRP3 inflammasome pathway proteins NLRP3, Caspase-1, GSDMD, IL-1β, and IL-18 in the lung and colon tissue (P<0.05, P<0.01), downregulated protein levels of CLDN1 and Occludin in the colon tissue (P<0.05, P<0.01). Compared with the model control group, Huashi Baidu Granules reduced the lung index (P<0.01), alleviated pathological damage in the lungs and colon, inhibited the expression of NLRP3, Caspase-1, GSDMD, IL-1β, and IL-18 in lung and colon tissue (P<0.05, P<0.01), and upregulated the expression of CLDN1 and Occludin in the colon tissue (P<0.05, P<0.01). Metabolomics analysis showed that Huashi Baidu Granules downregulated the 5-HT pathway and arachidonic acid metabolism pathway in the lung and colon tissue, while upregulating nucleotide metabolism and TCA cycle. Compared with the blank control group, the model control group exhibited elevated levels of 5-HT in the serum, lung tissue, and colon tissue (P<0.01). The intervention with Huashi Baidu Granules lowered the levels of 5-HT in the serum (P<0.05) and the lung and colon tissue (P<0.01). Huashi Baidu Granules increased the diversity of gut microbiota, enriched beneficial bacteria such as Blautia, and inhibited pathogenic bacteria such as Desulfovibrio. ConclusionHuashi Baidu Granules significantly alleviate lung inflammation and pathological damage in mice infected with influenza A (H1N1) virus, reshape the intestinal microecology, and repair the intestinal barrier. It may exert cross-organ regulation by inhibiting the cascade of "gutogenic 5-HT release-circulatory transport-pulmonary 5-HT receptor activation-NLRP3 inflammasome assembly." It exerts therapeutic effects on influenza viral pneumonia through the gut-lung axis. This study provides a modern biological interpretation for the TCM theories of interior-exterior relationship between the lung and large intestine and simultaneous treatment of the lung and intestine.
9.Changes in hemoglobin and related influencing factors in patients with liver failure undergoing artificial liver support therapy
Ying LIN ; Li CHEN ; Fei PENG ; Jianhui LIN ; Chuanshang ZHUO
Journal of Clinical Hepatology 2025;41(1):104-109
ObjectiveTo investigate the changing trend of hemoglobin (Hb) and related influencing factors in patients with liver failure after artificial liver support system (ALSS) therapy. MethodsA total of 106 patients with liver failure who were hospitalized and received ALSS therapy in our hospital from January to December 2018 were enrolled and analyzed in terms of clinical data and red blood cell parameters such as Hb, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), and red blood cell distribution width-coefficient of variation (RDW-CV). A one-way repeated-measures analysis of variance was used for comparison of continuous data with repeated measurement between groups, and the paired t-test was used for comparison between two groups. The Kruskal-Wallis H test was used for comparison of continuous data with skewed distribution between multiple groups, the Mann-Whitney U test was used for further comparison between two groups. Univariate and multivariate linear regression analyses were used to identify the influencing factors for the reduction in Hb after ALSS therapy. ResultsThe 106 patients with liver failure received 606 sessions of ALSS therapy, and Hb was measured for 402 sessions before and after treatment. There was a significant reduction in Hb after ALSS therapy in the patients with liver failure (97.49±20.51 g/L vs 109.38±20.22 g/L, t=32.764, P<0.001). Longitudinal observation was further performed for 14 patients with liver failure, and the results showed that the level of Hb was 108.50±21.61 g/L before the last session of ALSS therapy, with certain recovery compared with the level of Hb (103.14±19.15 g/L) on the second day after ALSS, and there was an increase in Hb on day 3 (102.57±21.73 g/L) and day 7 (105.57±22.04 g/L) after surgery. The level of Hb in patients with liver failure on the second day after ALSS decreased with the increase in the number of ALSS sessions (F=8.996, P<0.001), while MCV and MCH gradually increased with the increase in the number of ALSS sessions (F=9.154 and 13.460, P=0.004 and P<0.001), and RDW-CV first gradually increased and then gradually decreased (F=4.520, P=0.032); MCHC showed fluctuations with no clear trend (F=0.811, P=0.494). The multivariate linear regression analysis showed that the duration of ALSS therapy, the mode of ALSS therapy, and initial treatment were independent risk factors for the reduction in Hb after ALSS therapy. ConclusionALSS therapy can influence the level of peripheral blood Hb in patients with liver failure, and patient blood management should be strengthened for patients with liver failure who are receiving ALSS therapy.
10.Clinical features of patients with recurrent primary common bile duct stones after cholecystectomy
Jianhui LU ; Yongli LI ; Ruifang GUO ; Rongquan XUE
Journal of Clinical Hepatology 2025;41(1):118-126
ObjectiveTo investigate the general situation, dietary factors, and clinical features of patients with recurrent primary common bile duct stones, and to provide a basis for effective prevention of stone recurrence. MethodsA retrospective analysis was performed for 23 730 patients who underwent cholecystectomy due to cholelithiasis in Department of Hepatobiliary, Pancreatic and Spleen Surgery, Inner Mongolia People’s Hospital, from January 2013 to December 2023, and according to the presence or absence of recurrence of primary common bile duct stones after surgery, 334 patients were divided into recurrence group. The recurrence group was further analyzed based on sex in terms of recurrence rate, recurrence cycle, recurrence age, recurrence type, and general, disease, imaging, and dietary factors. The independent-samples t 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. ResultsThere were 334 cases of recurrence of primary bile duct stones after cholecystectomy, with a recurrence rate of 1.41%, and the highest frequency of recurrence cycle was observed in 10 years after surgery, with a significant difference in recurrence cycle between the male and female patients (t=5.238, P<0.001). There was a significant difference in the recurrence rate of stones after surgery between the patients with simple gallstones and those with gallbladder and common bile duct stones at initial diagnosis (1.23% vs 2.76%, χ2=42.104, P<0.001). The patients with recurrence aged >60 years accounted for the highest proportion in the whole population and in both male and female populations, and 92% were Han residents; 10% of the patients with recurrence had a family history of gallstones, and as for comorbidities, the patients with hypertension accounted for the highest proportion. Among the patients with recurrence, the patients with smoking or drinking accounted for 76.7% and 10.3%, respectively. As for body weight, 63.8% of the patients with recurrence had a normal body mass index (BMI), and 23.2% of the patients were overweight; compared with body weight at the time of the first gallbladder surgery, a reduction in body weight was observed in 60.1% of the patients with recurrence, while an increase in body weight was observed in 22.9% of the patients with recurrence. There were significant differences between the male and female patients with recurrence in age composition, ethnicity, the type of place of residence, comorbidities, smoking, drinking, BMI, and the change in body weight (all P<0.001). As for the type of stone recurrence, the ratio of multiple stones, solitary stones, and muddy stones was 74∶15∶11, and the stone size of <1 cm, 1-2 cm, and >2 cm accounted for about 40.5%, 48.8%, and 10.6%, respectively. As for the surgical procedure, the patients undergoing laparotomy accounted for 66.1%, and those undergoing laparoscopy accounted for 33.9%. The patients with various types of dyslipidemia accounted for a percentage of<30%. There were significant differences between the male and female patients with recurrence in the type of stones at initial onset, the type and size of stones, and surgical procedure (all P<0.001). Imaging data showed that 4 patients had an abnormal structure of the bile duct, manifesting as long and curve cystic ducts, and 73.1% of the patients had common bile duct dilatation after surgery. The follow-up of dietary factors showed irregular diets in 55.8% of the patients with recurrence. As for the dietary structure, meat and staple food accounted for 43.8% and 37.8%, respectively, which showed a sex difference, with meat in male patients and staple food in female patients; 64.1% of the patients with recurrence had a high-salt and high-oil diet; 59.8% of the patients had changes in diet after the first surgery for stones, among whom 80% were able to have a regular diet, and the patients with a regular diet accounted for 92%. ConclusionThere is a relatively low recurrence rate of primary common bile duct stones in this area, and there is no sex difference. The peak of recurrence is 10 years after surgery, and recurrence of stones is mainly observed in the population aged >60 years. The analysis of dietary and clinical features can help doctors and patients to further understand the characteristics of the recurrence of primary common bile duct stones and provide a basis for subsequent targeted prevention.


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