Objective:To investigate the effect and safety of pancreatic extracorporeal shock wave lithotripsy (P-ESWL) in treating the chronic pancreatitis (CP) patients with main pancreatic duct (MPD) stones and to analyze the influencing factors of success of lithotripsy.Methods:Clinical data of 132 patients with CP complicated with MPD stones treated with P-ESWL in the Department of Gastroenterology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2022 to December 2023 were retrospectively analyzed, including 103 males and 29 females, aged (50.3±16.9) years. The times of P-ESWL, the success rate of stone fragmentation, the necessity of combining endoscopic retrograde cholangiopancreatograhy (ERCP), clearance rate of MPD stones, and incidence of post-P-ESWL complications (acute pancreatitis, abdominal hematoma, infection, steinstrasse, perforation, etc.) were evaluated. The factors influencing the success rate of lithotripsy were analyzed using univariate and multivariate logistic regression.Results:All patients underwent P-ESWL treatment, with (2.23±0.82) times of P-ESWL per person. The success rate of stone fragmentation was 87.1%(115/132). Of 107 CP patients (81.1%, 107/132) were treated with their first P-ESWL. Of 12 patients (9.1%, 12/132) underwent single P-ESWL, and 120 (90.9%, 120/132) underwent P-ESWL combined with ERCP. There were 95 cases (72.0%, 95/132) with effective removal of stones, and 62 (47.0%, 62/132) with complete removal of stones. Post-P-ESWL complications included eight cases (6.1%, 8/132) of acute pancreatitis, two (7.6%, 2/132) of steinstrasse complicated with acute pancreatitis and one (0.8%, 1/132) of abdominal hematoma. No infection or perforation occurred. Multivariate logistic regression analysis showed that the higher CT value of stones ( OR=1.239, 95% CI: 1.040-1.477, P=0.017) was associated with the lower success rate of stone fragmentation. Conclusion:P-ESWL is safe and effective in treating patients with CP complicated with MPD stones. The CT value of stones is a risk factor for the success rate of P-ESWL.

Objective To investigate the impacts of midazolam(MDZ)on the proliferation,migration,and invasion of esophageal cancer(EC)cells by regulating the monocyte chemotactic protein-1(CCL2)-C-C chemokine receptor 2(CCR2)signaling pathway.Methods QRT-PCR method was applied to determine the expression of CCL2 and CCR2 mRNA in EC tissue,adjacent cancer tissue,human normal esophageal epithelial cell HEEC,and EC cell Eca-109.MTT assay and colony formation were applied to measure cell proliferation.Scratch test,Transwell test,and TUNEL method were applied to determine cell migration,invasion,and apoptosis,respectively.The expression of CCL2-CCR2 signaling pathway proteins was determined using Western blot method.Results Compared with adjacent cancer tissues and normal human esophageal epithelial cells(HEEC),the mRNA and protein expression levels of CCL2 and CCR2 in cancer tissues and Eca-109 cells were increased(P＜0.05).Compared with the control group,the OD450 value,colony formation number,scratch healing rate,and invasive cell count of Eca-109 cells in the MDZ-L group,MDZ-M group,and MDZ-H group decreased,while the proportion of TUNEL positive cells increased(P＜0.05).Compared with the MDZ-H group,the OD450 value,colony formation number,scratch healing rate,and number of invasive cells in the MDZ-H+GW0742 group all increased,while the proportion of TUNEL positive cells decreased(P＜0.05).Compared with the control group,protein and mRNA expressions of CCL2 and CCR2 proteins in Eca-109 cells in the MDZ-L group,MDZ-M group,and MDZ-H group decreased(P＜0.05).Compared with the MDZ-H group,the MDZ-H+GW0742 group showed an increase in the expression of CCL2 and CCR2 proteins in Eca-109 cells(P＜0.05).Conclusion MDZ can inhibit the proliferation,migration,and invasion of EC cells by inhibiting the activation of the CCL2-CCR2 signaling pathway.

Objective To investigate the impacts of midazolam(MDZ)on the proliferation,migration,and invasion of esophageal cancer(EC)cells by regulating the monocyte chemotactic protein-1(CCL2)-C-C chemokine receptor 2(CCR2)signaling pathway.Methods QRT-PCR method was applied to determine the expression of CCL2 and CCR2 mRNA in EC tissue,adjacent cancer tissue,human normal esophageal epithelial cell HEEC,and EC cell Eca-109.MTT assay and colony formation were applied to measure cell proliferation.Scratch test,Transwell test,and TUNEL method were applied to determine cell migration,invasion,and apoptosis,respectively.The expression of CCL2-CCR2 signaling pathway proteins was determined using Western blot method.Results Compared with adjacent cancer tissues and normal human esophageal epithelial cells(HEEC),the mRNA and protein expression levels of CCL2 and CCR2 in cancer tissues and Eca-109 cells were increased(P＜0.05).Compared with the control group,the OD450 value,colony formation number,scratch healing rate,and invasive cell count of Eca-109 cells in the MDZ-L group,MDZ-M group,and MDZ-H group decreased,while the proportion of TUNEL positive cells increased(P＜0.05).Compared with the MDZ-H group,the OD450 value,colony formation number,scratch healing rate,and number of invasive cells in the MDZ-H+GW0742 group all increased,while the proportion of TUNEL positive cells decreased(P＜0.05).Compared with the control group,protein and mRNA expressions of CCL2 and CCR2 proteins in Eca-109 cells in the MDZ-L group,MDZ-M group,and MDZ-H group decreased(P＜0.05).Compared with the MDZ-H group,the MDZ-H+GW0742 group showed an increase in the expression of CCL2 and CCR2 proteins in Eca-109 cells(P＜0.05).Conclusion MDZ can inhibit the proliferation,migration,and invasion of EC cells by inhibiting the activation of the CCL2-CCR2 signaling pathway.

Objective:To investigate the effect and safety of pancreatic extracorporeal shock wave lithotripsy (P-ESWL) in treating the chronic pancreatitis (CP) patients with main pancreatic duct (MPD) stones and to analyze the influencing factors of success of lithotripsy.Methods:Clinical data of 132 patients with CP complicated with MPD stones treated with P-ESWL in the Department of Gastroenterology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2022 to December 2023 were retrospectively analyzed, including 103 males and 29 females, aged (50.3±16.9) years. The times of P-ESWL, the success rate of stone fragmentation, the necessity of combining endoscopic retrograde cholangiopancreatograhy (ERCP), clearance rate of MPD stones, and incidence of post-P-ESWL complications (acute pancreatitis, abdominal hematoma, infection, steinstrasse, perforation, etc.) were evaluated. The factors influencing the success rate of lithotripsy were analyzed using univariate and multivariate logistic regression.Results:All patients underwent P-ESWL treatment, with (2.23±0.82) times of P-ESWL per person. The success rate of stone fragmentation was 87.1%(115/132). Of 107 CP patients (81.1%, 107/132) were treated with their first P-ESWL. Of 12 patients (9.1%, 12/132) underwent single P-ESWL, and 120 (90.9%, 120/132) underwent P-ESWL combined with ERCP. There were 95 cases (72.0%, 95/132) with effective removal of stones, and 62 (47.0%, 62/132) with complete removal of stones. Post-P-ESWL complications included eight cases (6.1%, 8/132) of acute pancreatitis, two (7.6%, 2/132) of steinstrasse complicated with acute pancreatitis and one (0.8%, 1/132) of abdominal hematoma. No infection or perforation occurred. Multivariate logistic regression analysis showed that the higher CT value of stones ( OR=1.239, 95% CI: 1.040-1.477, P=0.017) was associated with the lower success rate of stone fragmentation. Conclusion:P-ESWL is safe and effective in treating patients with CP complicated with MPD stones. The CT value of stones is a risk factor for the success rate of P-ESWL.

Objective:To compare the diagnostic efficacy of 22 G fine needle aspiration (FNA) needles and 22 G end-cutting fine needle biopsy (FNB) needles for solid pancreatic lesion using both cytological and histological examination.Methods:Clinical data of 116 patients who underwent endoscopic ultrasound-guided fine needle aspiration/biopsy (EUS-FNA/FNB) at the Digestive Endoscopy Center of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from June 2022 to March 2023 were retrospectively analyzed. Sixty-three patients sampled with 22 G FNA needles were the FNA group, and 53 sampled with 22 G FNB needles were the FNB group. The diagnostic accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and cytological and histological diagnostic yield of FNA needles and FNB needles for solid pancreatic lesions were compared.Results:There were no significant differences in age, gender, lesion location, lesion size, or the number of passes between the FNA group and the FNB group ( P>0.05). There were no significant differences in the diagnostic accuracy [93.7% (59/63) VS 90.6% (48/53), P=0.730], sensitivity [93.0% (53/57) VS 90.2% (46/51), P=0.732], specificity [100.0% (6/6) VS 100.0% (2/2), P=1.000], positive predictive value [100.0% (53/53) VS 100.0% (46/46), P=1.000] and negative predictive value [60.0% (6/10) VS 28.6% (2/7), P=0.335] of combined cytology and histology in distinguishing benign and malignant lesions between the two groups. In the FNA group, the diagnostic accuracy of combined cytology and histology was higher than cytology alone [93.7% (59/63) VS 81.0% (51/63), P=0.008], and was higher than histology alone without statistical significance [93.7% (59/63) VS 87.3% (55/63), P=0.125]. In the FNB group, the diagnostic accuracy of combined cytology and histology was higher than cytology alone [90.6% (48/53) VS 69.8% (37/53), P=0.001], but not than histology alone [90.6% (48/53) VS 90.6% (48/53)， P=1.000]. For solid masses located in pancreatic body/tail, the diagnostic accuracy for malignancy by histology using FNB needles tended to be higher than that of FNA needles [100.0% (17/17) VS 81.3% (26/32), P=0.080]. Conclusion:Both FNA needles and FNB needles exhibit adequate diagnostic yield for solid pancreatic masses when combining cytology and histology. FNB needles may offer a higher histological diagnostic yield.

Objective Through the research of the disposal of clinic laboratory result information,the paper explore the methods of building up laboratory's online management system and network information system.Methods This project began with the analysis of the need of laboratory and applies computer to simulate the manual disposal process.The system framework was separated into many sub parts according to its function.VB,etc were used to program.Results The project has been gained successfully in the online managemert of two analyzers and the management of data network consisting of three laboratories.Conclusion The project has established a practical and reliable in-formation management system which matches the work mode in clinical laboratory and has novelty functions.