Objective:To assess the safety of a novel domestically developed direct visualization system of peroral cholangiopancreatoscopy for the exploration of biliary tract.Methods:Clinical data from 384 patients with biliary tract diseases who underwent endoscopic retrograde cholangiopancreatography (ERCP) at the Endoscopy Center of Shanghai Xuhui District Central Hospital from November 2017 to December 2022 were retrospectively analyzed. Patients were categorized into 2 groups based on the type of cholangioscope: the novel cholangiopancreatoscopy system group ( n=159) and the SpyGlass group ( n=225). In the novel cholangiopancreatoscopy system group, the new direct visualization system of China-made peroral cholangiopancreatoscopy was used for bile duct exploration, while the SpyGlass group utilized the SpyGlass system for bile duct inspection. Propensity score matching (PSM) was used as a nearest-neighbor method with a caliper of 0.01 to minimize confounding factors, resulting in a balanced sample of 122 patients in each group after matching. The primary outcome was the incidence of short-term complications, with secondary outcomes including technical success rates and post-treatment outcomes. Results:After PSM, there were no significant differences in baseline characteristics between the two groups ( P>0.05). Regarding short-term postoperative complications, pancreatitis occurred in 1.6% (2/122) of patients in the novel cholangiopancreatoscopy system group and 7.4% (9/122) in the SpyGlass group. The new system significantly reduced the incidence of post-procedure pancreatitis ( χ2=4.665, P=0.031). The cholecystitis was absent in the novel cholangiopancreatoscopy system group, while it occurred in 0.8% (1/122) cases in the SpyGlass group, with no significant difference between the two groups after the procedure ( P=1.000). Regarding technical success rate, the novel system group achieved a rate of 99.2% (121/122), while the SpyGlass group achieved 97.5% (119/122) ( P=0.622). A slightly higher success rate was observed in the novel system group.There were 81 cases of postoperative biliary drainage in the novel cholangiopancreatoscopy system group and 74 cases in the SpyGlass group. Conclusion:The novel direct visualization system of peroral cholangiopancreatoscopy is safer than SpyGlass in the exploration of biliary system diseases. Endoscopists are encouraged to choose the appropriate cholangioscopy system based on individual patient characteristics for the direct visualization, diagnosis, and treatment of biliary diseases.

OBJECTIVE: To investigate the effect of aquaporin 5 (AQP5) on Toll-like receptor 4 (TLR4)/myeloid differentiation factor 88 (MyD88)/nuclear factor κB (NF-κB) signaling pathway in Sjögren syndrome (SS) rats. METHODS: The SS gene expression data sets GSE406611 and GSE84844 were extracted from the Gene Expression Omnibus (GEO), and the AQP5 mRNA expression was analyzed by R software. The rat SS model was constructed. The successfully modeled rats were divided into SS group, SS+NC group, and SS+pc group, 10 rats in each group; and 10 rats were set as Normal group. The rats in the SS+NC group were injected with 10 μg of rno-pcDNA3.1-AQP5-NC at the submandibular gland, subcutaneously every day for 28 days. The rats in the SS+pc group were injected with 10 μg of rno-pcDNA3.1-AQP5 at the submandibular gland, subcutaneously every day for 28 days. The enzyme-linked immunosorbent assay (ELISA) kit was used to detect the content of tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) in the serum. High-throughput sequencing was used to identify the target genes. Quantitative real-time PCR (qPCR) and Western blot were used to detect the mRNA and protein expressions of AQP5, TLR4, MyD88, and NF-κB in the rat submandibular gland tissue. RESULTS: In the SS dataset GSE406611 and GSE84844, the mRNA expression of AQP5 in SS was significantly reduced. Compared with the Normal group, the content of TNF-α and IL-1β in the serum, the mRNA and protein expressions of TLR4, MyD88, and NF-κB in the SS group were significantly increased, the mRNA and protein expressions of AQP5 were significantly decreased. After overexpression of AQP5, the content of TNF-α and IL-1β in the serum, the mRNA and protein expressions of TLR4, MyD88, and NF-κB in the SS+pc group were significantly decreased, the mRNA and protein expressions of AQP5 were significantly increased. The differences were statistically significant (all P < 0.05). CONCLUSION The expression of AQP5 is involved in the progression of SS. Increasing the expression of AQP5 can significantly inhibit inflammatory stress and reduce the pathological damage of submandibular gland tissue. This may be related to the inhibition of TLR4/MyD88/NF-κB conduction.
Animals ; Toll-Like Receptor 4/genetics* ; Myeloid Differentiation Factor 88/genetics* ; Aquaporin 5/metabolism* ; Sjogren's Syndrome/genetics* ; Signal Transduction ; NF-kappa B/metabolism* ; Rats ; Rats, Sprague-Dawley ; Interleukin-1beta/metabolism* ; Female

Objective:To assess the safety of a novel domestically developed direct visualization system of peroral cholangiopancreatoscopy for the exploration of biliary tract.Methods:Clinical data from 384 patients with biliary tract diseases who underwent endoscopic retrograde cholangiopancreatography (ERCP) at the Endoscopy Center of Shanghai Xuhui District Central Hospital from November 2017 to December 2022 were retrospectively analyzed. Patients were categorized into 2 groups based on the type of cholangioscope: the novel cholangiopancreatoscopy system group ( n=159) and the SpyGlass group ( n=225). In the novel cholangiopancreatoscopy system group, the new direct visualization system of China-made peroral cholangiopancreatoscopy was used for bile duct exploration, while the SpyGlass group utilized the SpyGlass system for bile duct inspection. Propensity score matching (PSM) was used as a nearest-neighbor method with a caliper of 0.01 to minimize confounding factors, resulting in a balanced sample of 122 patients in each group after matching. The primary outcome was the incidence of short-term complications, with secondary outcomes including technical success rates and post-treatment outcomes. Results:After PSM, there were no significant differences in baseline characteristics between the two groups ( P>0.05). Regarding short-term postoperative complications, pancreatitis occurred in 1.6% (2/122) of patients in the novel cholangiopancreatoscopy system group and 7.4% (9/122) in the SpyGlass group. The new system significantly reduced the incidence of post-procedure pancreatitis ( χ2=4.665, P=0.031). The cholecystitis was absent in the novel cholangiopancreatoscopy system group, while it occurred in 0.8% (1/122) cases in the SpyGlass group, with no significant difference between the two groups after the procedure ( P=1.000). Regarding technical success rate, the novel system group achieved a rate of 99.2% (121/122), while the SpyGlass group achieved 97.5% (119/122) ( P=0.622). A slightly higher success rate was observed in the novel system group.There were 81 cases of postoperative biliary drainage in the novel cholangiopancreatoscopy system group and 74 cases in the SpyGlass group. Conclusion:The novel direct visualization system of peroral cholangiopancreatoscopy is safer than SpyGlass in the exploration of biliary system diseases. Endoscopists are encouraged to choose the appropriate cholangioscopy system based on individual patient characteristics for the direct visualization, diagnosis, and treatment of biliary diseases.

In order to promote the development of grassroots hospitals through targeted assistance,ZhuJiang Hospital of Southern Medical University took the lead in responding in Guangdong Province and established a tight-ly-knit specialty alliance belonging to Zhujiang.It introduces the construction content,principles and measures of Zhujiang Tightly-Knit Specialty Alliance,and proposes a dual-promotion management model for the tightly-knit Spe-cialty Alliance.A comprehensive comparison of the changes in specialized technical capabilities and medical quality of Guangning County People's Hospital before and after aid shows that the close specialist alliance has achieved initial results in effectively promoting the sinking of resources and improving the medical technology capabilities and quality of member units.It is of great practical significance for further promoting the development of specialist alliances and filling the shortcomings of primary medical institutions.

In order to promote the development of grassroots hospitals through targeted assistance,ZhuJiang Hospital of Southern Medical University took the lead in responding in Guangdong Province and established a tight-ly-knit specialty alliance belonging to Zhujiang.It introduces the construction content,principles and measures of Zhujiang Tightly-Knit Specialty Alliance,and proposes a dual-promotion management model for the tightly-knit Spe-cialty Alliance.A comprehensive comparison of the changes in specialized technical capabilities and medical quality of Guangning County People's Hospital before and after aid shows that the close specialist alliance has achieved initial results in effectively promoting the sinking of resources and improving the medical technology capabilities and quality of member units.It is of great practical significance for further promoting the development of specialist alliances and filling the shortcomings of primary medical institutions.

In order to promote the development of grassroots hospitals through targeted assistance,ZhuJiang Hospital of Southern Medical University took the lead in responding in Guangdong Province and established a tight-ly-knit specialty alliance belonging to Zhujiang.It introduces the construction content,principles and measures of Zhujiang Tightly-Knit Specialty Alliance,and proposes a dual-promotion management model for the tightly-knit Spe-cialty Alliance.A comprehensive comparison of the changes in specialized technical capabilities and medical quality of Guangning County People's Hospital before and after aid shows that the close specialist alliance has achieved initial results in effectively promoting the sinking of resources and improving the medical technology capabilities and quality of member units.It is of great practical significance for further promoting the development of specialist alliances and filling the shortcomings of primary medical institutions.

In order to promote the development of grassroots hospitals through targeted assistance,ZhuJiang Hospital of Southern Medical University took the lead in responding in Guangdong Province and established a tight-ly-knit specialty alliance belonging to Zhujiang.It introduces the construction content,principles and measures of Zhujiang Tightly-Knit Specialty Alliance,and proposes a dual-promotion management model for the tightly-knit Spe-cialty Alliance.A comprehensive comparison of the changes in specialized technical capabilities and medical quality of Guangning County People's Hospital before and after aid shows that the close specialist alliance has achieved initial results in effectively promoting the sinking of resources and improving the medical technology capabilities and quality of member units.It is of great practical significance for further promoting the development of specialist alliances and filling the shortcomings of primary medical institutions.

In order to promote the development of grassroots hospitals through targeted assistance,ZhuJiang Hospital of Southern Medical University took the lead in responding in Guangdong Province and established a tight-ly-knit specialty alliance belonging to Zhujiang.It introduces the construction content,principles and measures of Zhujiang Tightly-Knit Specialty Alliance,and proposes a dual-promotion management model for the tightly-knit Spe-cialty Alliance.A comprehensive comparison of the changes in specialized technical capabilities and medical quality of Guangning County People's Hospital before and after aid shows that the close specialist alliance has achieved initial results in effectively promoting the sinking of resources and improving the medical technology capabilities and quality of member units.It is of great practical significance for further promoting the development of specialist alliances and filling the shortcomings of primary medical institutions.

In order to promote the development of grassroots hospitals through targeted assistance,ZhuJiang Hospital of Southern Medical University took the lead in responding in Guangdong Province and established a tight-ly-knit specialty alliance belonging to Zhujiang.It introduces the construction content,principles and measures of Zhujiang Tightly-Knit Specialty Alliance,and proposes a dual-promotion management model for the tightly-knit Spe-cialty Alliance.A comprehensive comparison of the changes in specialized technical capabilities and medical quality of Guangning County People's Hospital before and after aid shows that the close specialist alliance has achieved initial results in effectively promoting the sinking of resources and improving the medical technology capabilities and quality of member units.It is of great practical significance for further promoting the development of specialist alliances and filling the shortcomings of primary medical institutions.

In order to promote the development of grassroots hospitals through targeted assistance,ZhuJiang Hospital of Southern Medical University took the lead in responding in Guangdong Province and established a tight-ly-knit specialty alliance belonging to Zhujiang.It introduces the construction content,principles and measures of Zhujiang Tightly-Knit Specialty Alliance,and proposes a dual-promotion management model for the tightly-knit Spe-cialty Alliance.A comprehensive comparison of the changes in specialized technical capabilities and medical quality of Guangning County People's Hospital before and after aid shows that the close specialist alliance has achieved initial results in effectively promoting the sinking of resources and improving the medical technology capabilities and quality of member units.It is of great practical significance for further promoting the development of specialist alliances and filling the shortcomings of primary medical institutions.