Objective:To analyze the safety and efficacy of percutaneous transhepatic endoscopic holmium laser lithotripsy combined with papillary muscle balloon dilation (PTBL-PBD) in the treatment of refractory common bile duct (CBD) stones.Methods:Clinical data of eight patients with CBD stones who underwent PBD treatment in the Department of Interventional and Vascular Surgery of Wanning People's Hospital from March 2023 to October 2024 were retrospectively collected, including seven males and one female, aged 71.6±6.9 years. Under local anesthesia, a passage was established through percutaneous transhepatic biliary puncture, combined with holmium laser lithotripsy and balloon lithotripsy. Two weeks after the operation, angiography was performed to evaluate the therapeutic effect. Bile culture of bacteria were collected from the patients. Symptoms including fever, jaundice, abdominal pain and complications of the patients after the operation were recorded. The white blood cell (WBC) count, hypersensitive C-reactive protein (CRP), total bilirubin, aspartate aminotransferase (AST), alanine aminotransferase (ALT) one week before and one week after the operation were analyzed. All patients were followed up.Results:Eight patients successfully completed the surgery. No residual stone in the biliary system were observed in the imaging two weeks after the operation in six of the patients, and the biliary drainage tubes were successfully removed. Residual stone were observed in two of the patients, which were completely removed through re-treatment with balloon lithotripsy. Biliary bacterial infection occurred in four cases after the operation, including three cases with Escherichia coli and one with Klebsiella pneumoniae. One case with postoperative biliary hemorrhage was managed with coil embolization for hemostasis. The symptoms such as fever, jaundice and abdominal pain of the patients were all relieved after the operation. The WBC count decreased from 14.3±2.8 ×10 9/L before the operation to 6.1±1.3 ×10 9/L, and the high-sensitivity CRP decreased from 58.7±15.2 mg/L to 8.4±3.6 mg/L. Total bilirubin decreased from 102.2±27.7 μmol/L to 17.6±5.5 μmol/L, AST decreased from 137.6±36.7 U/L to 30.4±9.9 U/L, and ALT decreased from 141.3±44.9 U/L to 32.4±10.8 U/L. Two patients were followed up for 24 months, five for 12 months, and one for 6 months. No long-term complications such as stone recurrence or bile duct stenosis were observed during the follow-ups, and there were no clinical symptoms such as fever, jaundice, or abdominal pain. Conclusion:The treatment of refractory common bile duct stones with PTBL-PBD has less trauma and high safety, and could be suitable for high-risk patients who have failed with endoscopic approaches or cannot tolerate general anesthesia.

Objective:To analyze the safety and efficacy of percutaneous transhepatic endoscopic holmium laser lithotripsy combined with papillary muscle balloon dilation (PTBL-PBD) in the treatment of refractory common bile duct (CBD) stones.Methods:Clinical data of eight patients with CBD stones who underwent PBD treatment in the Department of Interventional and Vascular Surgery of Wanning People's Hospital from March 2023 to October 2024 were retrospectively collected, including seven males and one female, aged 71.6±6.9 years. Under local anesthesia, a passage was established through percutaneous transhepatic biliary puncture, combined with holmium laser lithotripsy and balloon lithotripsy. Two weeks after the operation, angiography was performed to evaluate the therapeutic effect. Bile culture of bacteria were collected from the patients. Symptoms including fever, jaundice, abdominal pain and complications of the patients after the operation were recorded. The white blood cell (WBC) count, hypersensitive C-reactive protein (CRP), total bilirubin, aspartate aminotransferase (AST), alanine aminotransferase (ALT) one week before and one week after the operation were analyzed. All patients were followed up.Results:Eight patients successfully completed the surgery. No residual stone in the biliary system were observed in the imaging two weeks after the operation in six of the patients, and the biliary drainage tubes were successfully removed. Residual stone were observed in two of the patients, which were completely removed through re-treatment with balloon lithotripsy. Biliary bacterial infection occurred in four cases after the operation, including three cases with Escherichia coli and one with Klebsiella pneumoniae. One case with postoperative biliary hemorrhage was managed with coil embolization for hemostasis. The symptoms such as fever, jaundice and abdominal pain of the patients were all relieved after the operation. The WBC count decreased from 14.3±2.8 ×10 9/L before the operation to 6.1±1.3 ×10 9/L, and the high-sensitivity CRP decreased from 58.7±15.2 mg/L to 8.4±3.6 mg/L. Total bilirubin decreased from 102.2±27.7 μmol/L to 17.6±5.5 μmol/L, AST decreased from 137.6±36.7 U/L to 30.4±9.9 U/L, and ALT decreased from 141.3±44.9 U/L to 32.4±10.8 U/L. Two patients were followed up for 24 months, five for 12 months, and one for 6 months. No long-term complications such as stone recurrence or bile duct stenosis were observed during the follow-ups, and there were no clinical symptoms such as fever, jaundice, or abdominal pain. Conclusion:The treatment of refractory common bile duct stones with PTBL-PBD has less trauma and high safety, and could be suitable for high-risk patients who have failed with endoscopic approaches or cannot tolerate general anesthesia.

A field investigation was conducted on the floral syndrome and breeding system of Corydalis edulis located in natural populations in campus of Anhui Normal University by out-crossing index, pollen-ovule ratio, artificial pollination and bagging experiment. The results showed that the plant was in bloom from March to May and flowering span among populations was 72 days. The flowering span for a raceme was 14-24 days. The life span of one single flower was approximately 5-10 days. Spatial positioning of stigma and anthers were spatially desperation on the day of anthesis. The filaments were shorter than the styles through pollen vitality and stigma receptivity experiments. A self-pollination breeding system was reflected by OCI 3, pollinators were required sometimes; A complex cross bred was indicated by P/O = 857.14, combined with the results of the bagging and artificial pollination experiment, the breeding system of C. edulis was mixed with self-pollination and outcrossing. The special floral structure and pests destroying may have a certain impact on seed-set rate.
Breeding ; Corydalis ; physiology ; Flowers ; physiology ; Pollination ; physiology ; Reproduction ; physiology

Objective To compare the change of mineral element in Tibet herb Halenia ellipitica D. Don before and after the seeds matured. Method We separately collected the cultivated Halenia ellipitica D. Don of several different districts in Qinghai province before and after the seeds matured and analyzed the contents of mineral elements as potassium, sodium, calcium, magnesium by atom absorb spectrum instrument. Results and Conclusion The calcium, magnesium and potassium, sodium elements nutriment has an antagonistic characteristic. The sodium and phosphorus elements nutriment has a coordination characteristic of the cultivated Halenia ellipitica D. Don in Qinghai province during the growth period.

Animals ; Blood Pressure ; physiology ; Hemodynamics ; physiology ; Hypertension, Portal ; blood ; metabolism ; physiopathology ; Liver Cirrhosis, Experimental ; blood ; metabolism ; physiopathology ; Male ; Neuropeptide Y ; blood ; metabolism ; Portal Pressure ; physiology ; Rats ; Rats, Sprague-Dawley ; Sodium ; urine

OBJECTIVETo assess the feasibility of laparoscopic total mesorectal excision (TME) for low or ultralow anterior resection of rectal cancer.

METHODSExcision of the mesorectum and low (ultralow) colo-anal anastomoses were performed laparoscopically in 62 patients with low rectal cancer based on the concept of TME and double stapling technique (DST).

RESULTSSixty-two operations with TME and DST were performed in a totally laparoscopic manner, and only one was converted to open procedures because of dysfunction of coagulation. The operative time was 125 min (110-210 min) and the operative blood loss 20 ml (5-80 ml). The time for bowel function recovery and post-operatively dietary intake was 1-2 days. Twenty-eight patients received postoperative analgesics. Average hospital stay was 8 days (5-14 days). Complications were observed in only 2 of the 62 patients, one had suffered from urinary retention and the other, anastomotic leakage.

CONCLUSIONSTotally laparoscopic excision of the mesorectum for low or ultralow anterior resection of rectal cancer is a minimally invasive technique with sphincter preservation, less postoperative pain, and rapid recovery.

Adult ; Aged ; Aged, 80 and over ; Anal Canal ; surgery ; Anastomosis, Surgical ; methods ; Colon ; surgery ; Female ; Humans ; Laparoscopy ; Male ; Middle Aged ; Rectal Neoplasms ; surgery ; Treatment Outcome

Objective To investigate the patterns of mesorectum lymph node (LN) metastases of rectal cancer. Methods Rectal cancer specimens obtained by total mesorectum excision were treated with lymph node revealing solution to retrieve all the nodes, and examined by routine pathology and immunohistochemical staining. Results A total of 443 LN in 26 specimens were harvested, with 128 nodes(28 9%)in 23 cases (88 5%) found positive. Positive nodes with the size less than 5 mm accounted for 59%. Among the 23 metastatic cases, there were 14 cases with tumors locating in the posterior wall, 69 out of 71 positive nodes were found along the superior rectal artery. In the other 9 cases, tumors were found in the lateral wall, 29 out of 57 positive nodes were found around ipsilateral branches of superior rectal artery,7 were around the contralateral branches, 4 were around the ipsilateral branches of middle rectal artery. Conclusions Most positive LN were less than 0 5 cm in diameter. LN metastasis of rectal cancer have close relationship with tumor location. Tumors in the posterior wall tend to spread upward along the superior rectal artery, while tumors in the lateral wall may have upward and lateral LN metastases simultaneously, with most metastatic LN found ipsilaterally.