1.Molecular Mechanism of Programmed Cell Death in Chronic Obstructive Pulmonary Disease and Traditional Chinese Medicine Intervention: A Review
Xin PENG ; Yunhui LI ; Lei LIANG ; Zheyu LUAN ; Hanxiao WANG ; Haotian XU ; Ziming DANG ; Jihong FENG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(3):304-313
Chronic obstructive pulmonary disease (COPD) is a chronic respiratory disease that poses a significant threat to global health, exhibiting high morbidity, disability and mortality rate, with its prevention and treatment situation becoming increasingly critical. The pathogenesis of COPD is complex, and the underlying cellular and molecular biological mechanisms remain incompletely elucidated. Programmed cell death (PCD) is the process wherein cells actively undergo demise to maintain internal environmental stability in response to certain signals or specific stimuli. Contemporary medical research indicates that the dysregulation of PCD patterns such as apoptosis, necroptosis, pyroptosis, autophagy, and ferroptosis is closely related to the onset and progression of COPD. Clarifying the molecular mechanisms of PCD in COPD may provide novel perspectives for in-depth understanding and prevention of the disease. Traditional Chinese medicine (TCM) is characterized by holistic regulation. In recent years, extensive research has been conducted in the TCM field focusing on modulating apoptosis, necroptosis, pyroptosis, autophagy, and ferroptosis for the treatment of COPD, yielding remarkable achievements. Therefore, this study systematically explored the molecular mechanism of PCD in COPD and reviewed the potential mechanisms and intervention status of TCM targeting PCD in COPD, aiming to provide insights and references for the clinical prevention, treatment and in-depth research of COPD.
2.Comparison of sleep EEG power spectral density between depressive episode patients and schizophrenia patients with suicidal behavior
Jingwen LIU ; Yunfei ZHOU ; Jingchu HU ; Jiaoyan ZHOU ; Junwei YANG ; Jie LIANG ; Hong XU ; Yu CANG ; Shimeng MA
Sichuan Mental Health 2026;39(1):50-57
BackgroundPatients with depressive episode and schizophrenia have a high risk of suicide. The sleep electroencephalogram power spectral density characteristics of patients with depressive episode accompanied by suicidal behavior and those with schizophrenia may be different, but there is currently a lack of direct comparative studies on these two groups of patients. ObjectiveTo compare the sleep electroencephalogram power spectral density between depressive episode and schizophrenic patients with suicidal behavior, in order to provide references for exploring predictive indicators of suicidal behavior. MethodsFrom June 2018 to December 2020, 20 patients with depressive episode and 20 patients with schizophrenia who had committed suicide within the past month and were treated at the outpatient department of Shenzhen Kangning Hospital were selected. All of them met the diagnostic criteria for depressive episode or schizophrenia as defined in the International Classification of Diseases, tenth edition (ICD-10). Using a random sampling method, 20 volunteers with matching gender and age to the patient groups were selected from the Cuiping community in Shenzhen as the control group. The subjective sleep of the patients was evaluated using the Insomnia Severity Index (ISI), the Dysfunctional Belief and Attitude about Sleep (DBAS), the Disturbing Dreams and Nightmare Severity Index (DDNSI), and the Epworth Somnolence Scale (ESS). The objective sleep of the patients was assessed using polysomnography. The sleep electroencephalogram was filtered and the power spectral density of the brain wave was analyzed and processed for all the subjects. The subjective and objective sleep conditions of the two patient groups were compared, and the sleep electroencephalogram power spectral density of the patient groups and the control group were also compared. ResultsA comparison of subjective and objective sleep conditions between patients with depressive episode accompanied by suicidal behavior and patients with schizophrenia accompanied by suicidal behavior showed no statistically significant differences (P>0.05). Comparisons of sleep electroencephalogram power spectral density in the W stage (average power of α wave, total power of δ wave, average power of δ wave, average power of θ wave), N1 stage (average power of β wave, total power of α wave, total power of δ wave), N2 stage (total power of α wave, average power of α wave, total power of δ wave, average power of δ wave), N3 stage (average power of α wave, average power of δ wave), and R stage (total power of α wave, average power of α wave, total power of δ wave, average power of δ wave) between patients with depressive episode accompanied by suicidal behavior, patients with schizophrenia accompanied by suicidal behavior, and the control group showed statistically significant differences (P<0.05 or 0.01). The total power of δ wave in the W stage and the average power of β wave and δ wave in the N1 stage were higher in two patient groups were higher than those of the control group. The total power of α wave and the average power of α wave in the N2 stage were lower than those of the control group, while the average power of δ wave was higher than that of the control group. The average power of α wave in the N3 stage of both patient groups were lower than that of the control group, while the average power of δ wave was higher than that of the control group. The total power and average power of α wave in the R stage were lower than those of the control group, while the total power and average power of δ wave were higher than those of the control group. All the differences were statistically significant. Patients with depressive episode accompanied by suicidal behavior had higher average powers of α wave, δ wave, and θ wave in the W stage compared with the control group, while the total power of α wave in the N1 stage was lower in the former group. All these differences were statistically significant (P<0.05). ConclusionThe depressive episode patients accompanied by suicidal behavior have highly overlapping sleep electroencephalogram abnormal patterns with those of schizophrenia patients, mainly manifested as a general decrease in α wave power (N2, N3, R stage) and a general increase in δ wave power (W, N1, N2, N3, R stage) as well as β wave power in N1 stage. At the same time, patients with depressive episode accompanied by suicidal behavior also show specific changes, including an increase in the average power of α and θ waves during the wakefulness period (W stage), and a decrease in the total power of α wave in N1 stage. [Funded by Guangdong Province High-level Clinical Key Specialty (with supporting funds from Shenzhen City) (number, SZGSP013); Shenzhen Key Medical Discipline (number, SZXK041); Shenzhen Clinical Medicine Research Center Project (number, 20210617155253001)]
3.Preoperative evaluation of lung function in patients with lung cancer using two-phase dual-energy CT perfusion imaging
Lifang LING ; Yizhen JIA ; Qinmin HAO ; Wenzheng XU ; Zhibo WANG ; Jun WANG ; Liang CHEN ; Mei YUAN
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2026;33(01):79-86
Objective To explore the application value of dual-phase dual-energy CT (DECT) perfusion imaging in preoperative lung function assessment of lung cancer patients. Methods Data were collected from patients with stageⅠA non-small cell lung cancer who underwent surgical treatment in the Department of Thoracic Surgery, the First Affiliated Hospital of Nanjing Medical University, from November 2022 to June 2024. All patients underwent DECT perfusion imaging and pulmonary function testing (PFT) before surgery. PFT observation indicators included ventilation function indicators such as forced expiratory volume in one second (FEV1), forced vital capacity (FVC), 1-second rate (FEV1/FVC), maximal voluntary ventilation (MVV), and diffusion function indicators such as diffusing capacity for carbon monoxide (DLCO) and DLCO per liter of alveolar volume (DLCO/VA). The software eXamine was used to obtain quantitative parameters of DECT perfusion imaging, including volume parameters and perfusion parameters of both lungs and each lung lobe. The correlation between the volume parameters and perfusion parameters of both lungs and the ventilation and diffusion function indicators of the patients, as well as the differences in quantitative parameters of each lung lobe, was analyzed. Results The end-inspiration lung volume and biphasic volume difference were strongly positively correlated with FEV1 and FVC (r=0.636, r=0.682, r=0.614, r=0.624, P<0.001) and moderately positively correlated with MVV and DLCO (r=0.499, r=0.514, r=0.549, r=0.447, P<0.001); the end-expiration lung volume was weakly negatively correlated with DLCO/VA (r=−0.295, P=0.026); the volume ratio was positively correlated with FEV1, FVC, MVV, and MVV% (r=0.424, r=0.399, r=0.415, r=0.310, P<0.05); the end-inspiration iodine content was weakly positively correlated with DLCO/VA% (rs=0.292, P=0.030); the end-expiration iodine content was weakly positively correlated with FEV1, FVC, MVV, DLCO%, and DLCO/VA (r=0.307, r=0.299, r=0.295, r=0.366, r=0.320, P<0.05) and moderately positively correlated with DLCO (r=0.439, P<0.001); the end-inspiration iodine concentration was negatively correlated with FEV1, FVC, MVV, and MVV% (rs=−0.407, rs=−0.426, rs=−0.352, rs=−0.277, P<0.05); the end-expiratory phase iodine concentration was moderately positively correlated with DLCO/VA (r=0.403, P=0.002); both the iodine concentration difference and the iodine concentration ratio were moderately positively correlated with FEV1, FEV1%, FVC, MVV, MVV% (P<0.05). The lung volume and iodine concentration ratio values were both highest in the left upper lung lobe and lowest in the right middle lung lobe; the differences in lung volume, lung volume ratio, intrapulmonary iodine content, and intrapulmonary iodine concentration were all highest in the lower lobes of both lungs and lowest in the middle lobe of the right lung. Conclusion Dual-phase DECT perfusion imaging can accurately assess overall lung function and quantify regional lung function.
4.Changes in balance and lower limb biomechanics of spastic hemiplegia under different visual deprivation and task conditions
Guanjun LIANG ; Huanlan XU ; Hewei ZHANG ; Dali ZHANG ; Qin GU ; Mingdi LI
Chinese Journal of Rehabilitation Theory and Practice 2026;32(3):345-355
ObjectiveTo investigate the effect of different visual inputs and task conditions on balance function and lower limb biomechanical characteristics in children with spastic hemiplegia. MethodsFrom March to July, 2025, 30 children aged six to nine years old with spastic hemiplegia (hemiplegia group) and 30 healthy children (control group) were selected. A 2×2×2 mixed experimental design was employed, involving groups (hemiplegia vs. healthy), tasks (single-task vs. dual-task), and vision (eyes open vs. eyes closed). One week before test, they were evaluated with Fugl-Meyer Assessment-Lower Extremities (FMA-LE), Wee Function Independent Measurement (WeeFIM) and Wechsler Intelligence Scale for Children, Fourth Edition (WISC-Ⅳ). A 3D gait analysis system and a plantar pressure testing system were used to collect spatio-temporal parameters of walking speed, stride length, cadence and step width, kinematic parameters of hip/knee/ankle joint angles, kinetic parameters of forefoot loading ratio, center of pressure (CoP) displacement, while dual-task cost (DTC) was caculated. ResultsSpatio-temporal parameters showed that under dual-task and eyes-closed conditions, walking speed and stride length decreased while step width increased in the hemiplegia group. Significant interaction effects among group, task, and vision were observed for speed, stride length, and step width (F > 4.886, P < 0.05). Kinematic parameters indicated that during dual-tasks, the hemiplegia group exhibited increased hip flexion and decreased ankle dorsiflexion; under eyes-closed conditions, knee flexion increased. The interaction of the three factors significantly affected all joint angles (F > 4.876, P < 0.05). Kinetic parameters showed that under dual-task and eyes-closed conditions, the forefoot loading ratio and anteroposterior CoP displacement decreased, while mediolateral CoP displacement increased. The interaction of the three factors significantly affected CoP displacement (F > 4.355, P < 0.05). All the DTC was significantly higher in the hemiplegia group than in the control group, except DTC of the cadence (|t| > 14.393, P < 0.001). Correlation analysis revealed that the score of FMA-LE was strongly negatively correlated with DTC (|r| > 0.731, P < 0.01). The Functional Independence Measure for Children and Working Memory Index showed moderate negative correlations with the DTC of walking speed and cadence (|r| > 0.462, P < 0.05). ConclusionThe gait and balance of children with spastic hemiplegia are concurrently influenced by dual-tasking and visual input. The superposition of visual deprivation and dual-tasks significantly exacerbates gait abnormalities. Furthermore, is strongly correlated with motor function and working memory.
5.Changes in balance and lower limb biomechanics of spastic hemiplegia under different visual deprivation and task conditions
Guanjun LIANG ; Huanlan XU ; Hewei ZHANG ; Dali ZHANG ; Qin GU ; Mingdi LI
Chinese Journal of Rehabilitation Theory and Practice 2026;32(3):345-355
ObjectiveTo investigate the effect of different visual inputs and task conditions on balance function and lower limb biomechanical characteristics in children with spastic hemiplegia. MethodsFrom March to July, 2025, 30 children aged six to nine years old with spastic hemiplegia (hemiplegia group) and 30 healthy children (control group) were selected. A 2×2×2 mixed experimental design was employed, involving groups (hemiplegia vs. healthy), tasks (single-task vs. dual-task), and vision (eyes open vs. eyes closed). One week before test, they were evaluated with Fugl-Meyer Assessment-Lower Extremities (FMA-LE), Wee Function Independent Measurement (WeeFIM) and Wechsler Intelligence Scale for Children, Fourth Edition (WISC-Ⅳ). A 3D gait analysis system and a plantar pressure testing system were used to collect spatio-temporal parameters of walking speed, stride length, cadence and step width, kinematic parameters of hip/knee/ankle joint angles, kinetic parameters of forefoot loading ratio, center of pressure (CoP) displacement, while dual-task cost (DTC) was caculated. ResultsSpatio-temporal parameters showed that under dual-task and eyes-closed conditions, walking speed and stride length decreased while step width increased in the hemiplegia group. Significant interaction effects among group, task, and vision were observed for speed, stride length, and step width (F > 4.886, P < 0.05). Kinematic parameters indicated that during dual-tasks, the hemiplegia group exhibited increased hip flexion and decreased ankle dorsiflexion; under eyes-closed conditions, knee flexion increased. The interaction of the three factors significantly affected all joint angles (F > 4.876, P < 0.05). Kinetic parameters showed that under dual-task and eyes-closed conditions, the forefoot loading ratio and anteroposterior CoP displacement decreased, while mediolateral CoP displacement increased. The interaction of the three factors significantly affected CoP displacement (F > 4.355, P < 0.05). All the DTC was significantly higher in the hemiplegia group than in the control group, except DTC of the cadence (|t| > 14.393, P < 0.001). Correlation analysis revealed that the score of FMA-LE was strongly negatively correlated with DTC (|r| > 0.731, P < 0.01). The Functional Independence Measure for Children and Working Memory Index showed moderate negative correlations with the DTC of walking speed and cadence (|r| > 0.462, P < 0.05). ConclusionThe gait and balance of children with spastic hemiplegia are concurrently influenced by dual-tasking and visual input. The superposition of visual deprivation and dual-tasks significantly exacerbates gait abnormalities. Furthermore, is strongly correlated with motor function and working memory.
6.Changes in balance and lower limb biomechanics of spastic hemiplegia under different visual deprivation and task conditions
Guanjun LIANG ; Huanlan XU ; Hewei ZHANG ; Dali ZHANG ; Qin GU ; Mingdi LI
Chinese Journal of Rehabilitation Theory and Practice 2026;32(3):345-355
ObjectiveTo investigate the effect of different visual inputs and task conditions on balance function and lower limb biomechanical characteristics in children with spastic hemiplegia. MethodsFrom March to July, 2025, 30 children aged six to nine years old with spastic hemiplegia (hemiplegia group) and 30 healthy children (control group) were selected. A 2×2×2 mixed experimental design was employed, involving groups (hemiplegia vs. healthy), tasks (single-task vs. dual-task), and vision (eyes open vs. eyes closed). One week before test, they were evaluated with Fugl-Meyer Assessment-Lower Extremities (FMA-LE), Wee Function Independent Measurement (WeeFIM) and Wechsler Intelligence Scale for Children, Fourth Edition (WISC-Ⅳ). A 3D gait analysis system and a plantar pressure testing system were used to collect spatio-temporal parameters of walking speed, stride length, cadence and step width, kinematic parameters of hip/knee/ankle joint angles, kinetic parameters of forefoot loading ratio, center of pressure (CoP) displacement, while dual-task cost (DTC) was caculated. ResultsSpatio-temporal parameters showed that under dual-task and eyes-closed conditions, walking speed and stride length decreased while step width increased in the hemiplegia group. Significant interaction effects among group, task, and vision were observed for speed, stride length, and step width (F > 4.886, P < 0.05). Kinematic parameters indicated that during dual-tasks, the hemiplegia group exhibited increased hip flexion and decreased ankle dorsiflexion; under eyes-closed conditions, knee flexion increased. The interaction of the three factors significantly affected all joint angles (F > 4.876, P < 0.05). Kinetic parameters showed that under dual-task and eyes-closed conditions, the forefoot loading ratio and anteroposterior CoP displacement decreased, while mediolateral CoP displacement increased. The interaction of the three factors significantly affected CoP displacement (F > 4.355, P < 0.05). All the DTC was significantly higher in the hemiplegia group than in the control group, except DTC of the cadence (|t| > 14.393, P < 0.001). Correlation analysis revealed that the score of FMA-LE was strongly negatively correlated with DTC (|r| > 0.731, P < 0.01). The Functional Independence Measure for Children and Working Memory Index showed moderate negative correlations with the DTC of walking speed and cadence (|r| > 0.462, P < 0.05). ConclusionThe gait and balance of children with spastic hemiplegia are concurrently influenced by dual-tasking and visual input. The superposition of visual deprivation and dual-tasks significantly exacerbates gait abnormalities. Furthermore, is strongly correlated with motor function and working memory.
7.Historical Evolution and Key Information Research on Classic Formula Puji Xiaoduyin
Lianchao ZHU ; Lyuyuan LIANG ; Jing TANG ; Jialei CAO ; Ziming XU ; Huizhen ZHANG ; Zhidan GUO ; Rongze MA ; Zhengshao ZHANG ; Bingqi WEI ; Xiubo DU ; Bingxiang MA
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(10):238-247
Puji Xiaoduyin, a specialized formula for the swollen-head epidemic, was recorded in the Catalogue of Ancient Classical Formula (the Second Batch)-Han Medicine, published in September 2023. It had been inherited and developed by medical experts of successive generations and passed down to this day. This paper sorted out the historical evolution of this formula using bibliometric methods. It also comprehensively analyzed key information on the formula name, historical origin, drug dosage, herb origin, processing methods, decocting methods, function, and clinical applications. Additionally, this paper analyzed the application of this formula in both modern and ancient times. Results showed that the formula was first recorded as "Puji Xiaodu Yinzi" in LI Dongyuan's Proven Formulas written by LI Gao from the Jin dynasty. The medicinal composition and dosage were: Scutellariae Radix and Coptidis Rhizoma (20.65 g each), Ginseng Radix et Rhizoma 12.39 g, Scrophulariae Radix, Citri Reticulatae Pericarpium, and Glycyrrhizae Radix et Rhizoma (8.26 g each), Forsythiae Fructus, Arctii Fructus, Isatidis Radix, and Lasiosphaera Calvatia (4.13 g each), Bombyx Batryticatus and Cimicifugae Rhizoma (2.891 g each), Bupleuri Radix and Platycodonis Radix (8.26 g each). These medicines were grounded to fine powder. One dose, including 20.65 g of the powder, was mixed with 600 mL of water and decocted to 300 mL. After abandoning slag, the medicine should be taken warm frequently. In the formula, Bombyx Batryticatus is stir-fired. With the effect of dispersing wind and clearing heat, removing stagnation and dissipating mass, the formula is specialized in swollen-head epidemic, pestilence, red and swelling head, face, and neck, dry mouth and tongue, as well as other diseases resulting from toxic heat stagnated in the upper jiao. The formula is widely used in treating diseases involving the respiratory, dermal, ophthalmologic, otolaryngologic, and nervous systems. The formula is most frequently used for respiratory diseases, with a wide range of symptoms including parotitis/mumps (66 times), followed by tonsillitis (28 times). In conclusion, the broadly applied formula has accurate efficacy and great development value.
8.Historical Evolution and Key Information Research on Classic Formula Puji Xiaoduyin
Lianchao ZHU ; Lyuyuan LIANG ; Jing TANG ; Jialei CAO ; Ziming XU ; Huizhen ZHANG ; Zhidan GUO ; Rongze MA ; Zhengshao ZHANG ; Bingqi WEI ; Xiubo DU ; Bingxiang MA
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(10):238-247
Puji Xiaoduyin, a specialized formula for the swollen-head epidemic, was recorded in the Catalogue of Ancient Classical Formula (the Second Batch)-Han Medicine, published in September 2023. It had been inherited and developed by medical experts of successive generations and passed down to this day. This paper sorted out the historical evolution of this formula using bibliometric methods. It also comprehensively analyzed key information on the formula name, historical origin, drug dosage, herb origin, processing methods, decocting methods, function, and clinical applications. Additionally, this paper analyzed the application of this formula in both modern and ancient times. Results showed that the formula was first recorded as "Puji Xiaodu Yinzi" in LI Dongyuan's Proven Formulas written by LI Gao from the Jin dynasty. The medicinal composition and dosage were: Scutellariae Radix and Coptidis Rhizoma (20.65 g each), Ginseng Radix et Rhizoma 12.39 g, Scrophulariae Radix, Citri Reticulatae Pericarpium, and Glycyrrhizae Radix et Rhizoma (8.26 g each), Forsythiae Fructus, Arctii Fructus, Isatidis Radix, and Lasiosphaera Calvatia (4.13 g each), Bombyx Batryticatus and Cimicifugae Rhizoma (2.891 g each), Bupleuri Radix and Platycodonis Radix (8.26 g each). These medicines were grounded to fine powder. One dose, including 20.65 g of the powder, was mixed with 600 mL of water and decocted to 300 mL. After abandoning slag, the medicine should be taken warm frequently. In the formula, Bombyx Batryticatus is stir-fired. With the effect of dispersing wind and clearing heat, removing stagnation and dissipating mass, the formula is specialized in swollen-head epidemic, pestilence, red and swelling head, face, and neck, dry mouth and tongue, as well as other diseases resulting from toxic heat stagnated in the upper jiao. The formula is widely used in treating diseases involving the respiratory, dermal, ophthalmologic, otolaryngologic, and nervous systems. The formula is most frequently used for respiratory diseases, with a wide range of symptoms including parotitis/mumps (66 times), followed by tonsillitis (28 times). In conclusion, the broadly applied formula has accurate efficacy and great development value.
9.Spinal cord stimulation for spinal cord injury from 1999 to 2025: a bibliometric analysis
Yuanyuan QI ; Haifeng GAO ; Lina LIU ; Yujie XIE ; Jing XU ; Feng GAO ; Liang CHEN ; Degang YANG ; Jun LI
Chinese Journal of Rehabilitation Theory and Practice 2026;32(4):373-386
ObjectiveTo analyze the research hotspots and development trends in the field of spinal cord stimulation (SCS) for spinal cord injury (SCI). MethodsLiterature about SCS for SCI was retrieve from the Web of Science (WOS) Core Collection database, with a time range from January, 1999 to July, 2025. VOSviewer 1.6.20 and CiteSpace 6.4.R2 were used to analyze the annual publication volume, countries, authors, institutions, journals and keywords. ResultsA total of 636 literatures were included. From 1999 to 2025, the overall publication trend in this field showed an upward trajectory, with recent years fluctuating but tending to stabilize. The country with the most publications was the United States (429 papers), followed by Russia (98 papers) and China (70 papers). The institution with the highest number of publications was the University of California, Los Angeles (76 papers), the author with the most publications was V. Reggie Edgerton (70 papers), and the journal with the most publications was Journal of Clinical Medicine (31 papers). The most frequently cited study focused on exploring the combination of epidural spinal cord stimulation with task-specific training to restore motor function in patients with complete SCI. Keyword analysis showed that the research hotspots in this field were mainly focused on neuroregulation mechanisms, recovery of motor and autonomic nervous dysfunction, artificial intelligence, closed-loop stimulation and brain-computer interface technology innovations. In recent years, the research focus gradually shifted from basic mechanisms to personalized and precise multifunctional rehabilitation strategies. ConclusionThe field of SCS for SCI has undergone phases of basic mechanism exploration and clinical application expansion. Current research hotspots and future trends focus primarily on the development of new stimulation paradigms and combined innovative technologies.
10.Mechanism of ductular reaction and related treatment strategies
Jiayan SHAN ; Huaqian XU ; Chengzhi BAI ; Liang ZHANG ; Chao DU ; Yong ZHANG ; Shanhong TANG
Journal of Clinical Hepatology 2026;42(3):733-738
Ductular reaction (DR) refers to the adaptive pathological changes that occur after hepatobiliary injury, and it is essentially a repair response involving the proliferation, fibrosis, and inflammation of biliary epithelial cell (BEC). With the understanding of the biological function of BEC, the potential value of DR in disease prognosis and treatment has gradually become a research hotspot. This article systematically reviews the molecular mechanism of DR, its potential as a therapeutic target, and future development directions, as well as novel therapies suggested by targeting these molecular mechanisms, in order to provide a new direction for overcoming current bottlenecks in the treatment of bile duct diseases.

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