Objective:To investigate the impact of Wenyang Ligong Decoction on pregnancy outcomes after transcervical resection of adhesions (TCRA) in patients with intrauterine adhesions (IUA).Methods:A retrospective cohort study was conducted to collect clinical data from 151 patients with IUA who underwent TCRA in the Reproductive Medicine Department of the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine between January 2020 and January 2023. Patients were divided into a Traditional Chinese medicine (TCM) group (79 patients) and a control group (72 patients) based on whether they received Wenyang Ligong Decoction after TCRA. The TCM group received estrogen and progesterone sequential therapy post-surgery, combined with Wenyang Ligong Decoction for 2-3 menstrual cycles. The control only received sequential treatment with estrogen and progesterone.Pregnancy outcomes one year after surgery were compared between the two groups. After adjusting for confounding factors using multivariate Cox regression analysis, the effect of Wenyang Ligong Decoction on pregnancy outcomes after TCRA in patients with IUA was observed.Results:The live birth rate [54.43%　(43/79)], the ongoing pregnancy rate [56.96% (45/79)], and the clinical pregnancy rate [52.03% (49/79)] were higher in the TCM group than in the control [26.39% (19/72), P<0.001; 30.56% (22/72), P=0.001;37.50% (27/72), P=0.003], with statistically significant differences. There were no statistically significant differences in early abortion rate and late abortion rate between the TCM group and the control (all P>0.05). According to the stratified analysis by preparation methods, in the natural conception group, the live birth rate [60.78% (31/51)], the ongoing pregnancy rate [62.75% (32/51)], and the clinical pregnancy rate [68.63% (35/51)] in the TCM group were significantly higher than those in control group [21.43% (12/56), P<0.001; 26.79% (15/56), P<0.001; 33.93% (19/56), P<0.001]; there were no statistically significant differences in early miscarriage rate and late miscarriage rate between the two groups (both P>0.05). In the assisted reproductive technology group, there were no statistically significant differences in live birth rate, ongoing pregnancy rate, clinical pregnancy rate, early miscarriage rate, and late miscarriage rate between the two groups (all P>0.05). According to the stratified analysis by age, in the <35-year-old patients, the live birth rate [66.00% (33/50)], the ongoing pregnancy rate [70.00% (35/50)], and the clinical pregnancy rate [74.00% (37/50)] in the TCM group were significantly higher than those in control group [41.30% (19/46), P=0.015; 47.83% (22/46), P=0.027; 54.35% (25/46), P=0.044]; there were no statistically significant differences in early miscarriage rate and late miscarriage rate between the two groups (both P>0.05). In the ≥35-year-old patients, the live birth rate [34.48% (10/29)], the ongoing pregnancy rate [34.48% (10/29)], and the clinical pregnancy rate [41.38% (12/29)] in the TCM group were significantly higher than those in control group [0%, P=0.001; 0%, P=0.001; 7.69% (2/26), P=0.004]; there were no statistically significant differences in early miscarriage rate and late miscarriage rate between the two groups (both P>0.05).Univariate Cox regression analysis showed that age, number of previous uterine cavity interventions, IUA score, degree of IUA, and endometrial thickness after TCRA were independent risk factors for live births, and age, IUA score, degree of IUA, intima thickness after TCRA, and treatment group were the influencing factors of persistent pregnancy (all P<0.05). After adjusting for confounding factors, multivariate Cox regression analysis showed that Wenyang Ligong Decoction significantly improved the live birth rate ( HR=3.19, 95% CI: 1.77-8.11, P=0.001) and the rate of continuous pregnancy ( HR=3.66, 95% CI: 1.80-7.48, P<0.001) in patients with IUA. Conclusion:Wenyang Ligong Decoction can significantly improve pregnancy outcomes after TCRA in patients with IUA.

Objective To investigate the value of serum long noncoding RNA small nucleolar RNA host gene 7(lncRNA SNHG7)and microRNA(miR)-34a-5p expression in the diagnosis and prognostic evaluation of bloodstream infection(BSI).Methods A total of 193 suspected BSI patients admitted to the emergency department of Guangxi Wuzhou Red Cross Hospital from March 2022 to March 2023 were collected as the study subjects.After diagnosis,BSI patients were included as the infection group(n=100),and non BSI patients were included as the non infection group(n=93).After 28 days of treatment,BSI patients were separated into a death group(n=32)and a survival group(n=68)based on their prognosis.The real time fluorgenic quantitative PCR(qRT-PCR)method was applied to detect the expression levels of serum lncRNA SNHG7 and miR-34a-5p.The Target Scan Human website was applied to predict the targeting relationship between miR-34a-5p and lncRNA SNHG7.Pearson method was applied to analyze the correlation between serum lncRNA SNHG7 level and miR-34a-5p level.Multivariate Logistic regression was applied to analyze the influencing factors of prognosis in patients with BSI.Receiver operating characteristic(ROC)curve was applied to analyze the prognostic value of serum lncRNA SNHG7 and miR-34a-5p.Results The serum lncRNA SNHG7 level(1.47±0.35)in the infection group was obviously higher than that in the non infection group(1.03±0.15),and the miR-34a-5p level(0.85±0.21)was obviously lower than that in the non infection group(1.02±0.13),and the differences were statistically significant(t=11.203,6.703,all P<0.05).Compared with survival group,the serum lncRNA SNHG(1.68±0.21 vs 1.37±0.19),C-reactive protein(CRP)(85.74±9.16mg/L vs 63.18±7.68mg/L),procalcitonin(PCT)levels(56.37±8.72ng/ml vs 34.69±5.54ng/ml),albumin(92.51±10.18g/L vs 65.27±7.24g/L),Acute Physiological and Chronic Health Evaluation(APACHE II)scores(28.15±5.12scores vs 16.35±4.31scores)of the death group were obviously higher,and serum miR-34a-5p level(0.67±0.14 vs 0.93±0.16)was obviously lower,the differences were statistically significant.(t=7.357～15.340,all P<0.05).LncRNA SNHG7 had a targeted binding site with miR-34a-5p,and lncRNA SNHG7 was negatively correlated with miR-34a-5p(r=-0.568,P<0.05).Serum lncRNA SNHG7 and miR-34a-5p were prognostic factors for BSI patients(all P<0.05).The area under the curve(AUC)of serum lncRNA SNHG7,miR-34a-5p,and their combined evaluation of prognosis in BSI patients was better than that of serum lncRNA SNHG7 and miR-34a-5p detected sepatately(Z=0.001,2.304,all P<0.05),with sensitivity and specificity of 78.12%and 97.06%,respectively.Conclusion The serum lncRNA SNHG7 level in BSI patients is obviously elevated,while the serum miR-34a-5p level is obviously reduced.The two are closely related to the prognosis of BSI patients,and the combination of the two has good evaluation value for the prognosis of BSI patients.

Objective:To investigate the impact of Wenyang Ligong Decoction on pregnancy outcomes after transcervical resection of adhesions (TCRA) in patients with intrauterine adhesions (IUA).Methods:A retrospective cohort study was conducted to collect clinical data from 151 patients with IUA who underwent TCRA in the Reproductive Medicine Department of the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine between January 2020 and January 2023. Patients were divided into a Traditional Chinese medicine (TCM) group (79 patients) and a control group (72 patients) based on whether they received Wenyang Ligong Decoction after TCRA. The TCM group received estrogen and progesterone sequential therapy post-surgery, combined with Wenyang Ligong Decoction for 2-3 menstrual cycles. The control only received sequential treatment with estrogen and progesterone.Pregnancy outcomes one year after surgery were compared between the two groups. After adjusting for confounding factors using multivariate Cox regression analysis, the effect of Wenyang Ligong Decoction on pregnancy outcomes after TCRA in patients with IUA was observed.Results:The live birth rate [54.43%　(43/79)], the ongoing pregnancy rate [56.96% (45/79)], and the clinical pregnancy rate [52.03% (49/79)] were higher in the TCM group than in the control [26.39% (19/72), P<0.001; 30.56% (22/72), P=0.001;37.50% (27/72), P=0.003], with statistically significant differences. There were no statistically significant differences in early abortion rate and late abortion rate between the TCM group and the control (all P>0.05). According to the stratified analysis by preparation methods, in the natural conception group, the live birth rate [60.78% (31/51)], the ongoing pregnancy rate [62.75% (32/51)], and the clinical pregnancy rate [68.63% (35/51)] in the TCM group were significantly higher than those in control group [21.43% (12/56), P<0.001; 26.79% (15/56), P<0.001; 33.93% (19/56), P<0.001]; there were no statistically significant differences in early miscarriage rate and late miscarriage rate between the two groups (both P>0.05). In the assisted reproductive technology group, there were no statistically significant differences in live birth rate, ongoing pregnancy rate, clinical pregnancy rate, early miscarriage rate, and late miscarriage rate between the two groups (all P>0.05). According to the stratified analysis by age, in the <35-year-old patients, the live birth rate [66.00% (33/50)], the ongoing pregnancy rate [70.00% (35/50)], and the clinical pregnancy rate [74.00% (37/50)] in the TCM group were significantly higher than those in control group [41.30% (19/46), P=0.015; 47.83% (22/46), P=0.027; 54.35% (25/46), P=0.044]; there were no statistically significant differences in early miscarriage rate and late miscarriage rate between the two groups (both P>0.05). In the ≥35-year-old patients, the live birth rate [34.48% (10/29)], the ongoing pregnancy rate [34.48% (10/29)], and the clinical pregnancy rate [41.38% (12/29)] in the TCM group were significantly higher than those in control group [0%, P=0.001; 0%, P=0.001; 7.69% (2/26), P=0.004]; there were no statistically significant differences in early miscarriage rate and late miscarriage rate between the two groups (both P>0.05).Univariate Cox regression analysis showed that age, number of previous uterine cavity interventions, IUA score, degree of IUA, and endometrial thickness after TCRA were independent risk factors for live births, and age, IUA score, degree of IUA, intima thickness after TCRA, and treatment group were the influencing factors of persistent pregnancy (all P<0.05). After adjusting for confounding factors, multivariate Cox regression analysis showed that Wenyang Ligong Decoction significantly improved the live birth rate ( HR=3.19, 95% CI: 1.77-8.11, P=0.001) and the rate of continuous pregnancy ( HR=3.66, 95% CI: 1.80-7.48, P<0.001) in patients with IUA. Conclusion:Wenyang Ligong Decoction can significantly improve pregnancy outcomes after TCRA in patients with IUA.

Objective To investigate the value of serum long noncoding RNA small nucleolar RNA host gene 7(lncRNA SNHG7)and microRNA(miR)-34a-5p expression in the diagnosis and prognostic evaluation of bloodstream infection(BSI).Methods A total of 193 suspected BSI patients admitted to the emergency department of Guangxi Wuzhou Red Cross Hospital from March 2022 to March 2023 were collected as the study subjects.After diagnosis,BSI patients were included as the infection group(n=100),and non BSI patients were included as the non infection group(n=93).After 28 days of treatment,BSI patients were separated into a death group(n=32)and a survival group(n=68)based on their prognosis.The real time fluorgenic quantitative PCR(qRT-PCR)method was applied to detect the expression levels of serum lncRNA SNHG7 and miR-34a-5p.The Target Scan Human website was applied to predict the targeting relationship between miR-34a-5p and lncRNA SNHG7.Pearson method was applied to analyze the correlation between serum lncRNA SNHG7 level and miR-34a-5p level.Multivariate Logistic regression was applied to analyze the influencing factors of prognosis in patients with BSI.Receiver operating characteristic(ROC)curve was applied to analyze the prognostic value of serum lncRNA SNHG7 and miR-34a-5p.Results The serum lncRNA SNHG7 level(1.47±0.35)in the infection group was obviously higher than that in the non infection group(1.03±0.15),and the miR-34a-5p level(0.85±0.21)was obviously lower than that in the non infection group(1.02±0.13),and the differences were statistically significant(t=11.203,6.703,all P<0.05).Compared with survival group,the serum lncRNA SNHG(1.68±0.21 vs 1.37±0.19),C-reactive protein(CRP)(85.74±9.16mg/L vs 63.18±7.68mg/L),procalcitonin(PCT)levels(56.37±8.72ng/ml vs 34.69±5.54ng/ml),albumin(92.51±10.18g/L vs 65.27±7.24g/L),Acute Physiological and Chronic Health Evaluation(APACHE II)scores(28.15±5.12scores vs 16.35±4.31scores)of the death group were obviously higher,and serum miR-34a-5p level(0.67±0.14 vs 0.93±0.16)was obviously lower,the differences were statistically significant.(t=7.357～15.340,all P<0.05).LncRNA SNHG7 had a targeted binding site with miR-34a-5p,and lncRNA SNHG7 was negatively correlated with miR-34a-5p(r=-0.568,P<0.05).Serum lncRNA SNHG7 and miR-34a-5p were prognostic factors for BSI patients(all P<0.05).The area under the curve(AUC)of serum lncRNA SNHG7,miR-34a-5p,and their combined evaluation of prognosis in BSI patients was better than that of serum lncRNA SNHG7 and miR-34a-5p detected sepatately(Z=0.001,2.304,all P<0.05),with sensitivity and specificity of 78.12%and 97.06%,respectively.Conclusion The serum lncRNA SNHG7 level in BSI patients is obviously elevated,while the serum miR-34a-5p level is obviously reduced.The two are closely related to the prognosis of BSI patients,and the combination of the two has good evaluation value for the prognosis of BSI patients.

Objective:To compare the outcomes of percutaneous transhepatic one-step biliary fistulation (PTOBF) lithotripsy for type Ⅱa hepatolithiasis performed via the left or right lobe.Methods:A retrospective study was conducted on 79 patients with type Ⅱa hepatolithiasis treated in the First Affiliated Hospital of Guangzhou Medical University from January 2018 to December 2020, including 38 males and 41 females, aged (52.9±14.0) years. All patients had received PTOBF lithotripsy in single channel and divided into left lobe group ( n=40) and right lobe group ( n=39) according to different puncture approaches. Clinical data in immediate and final stone clearance rate, operation time of lithotripsy, intraoperative blood loss, postoperative complications (ascites, biliary tract infection), postoperative hospitalization time, reactive pleural effusion rate, the number of lithotripsy procedures and target bile duct dilatation diameter were compared between the two groups. Results:Compared with left lobe group, right lobe group had higher immediate stone clearance [51.3%(20/39) vs 22.5%(9/40)], less lithotripsy procedures [(2.4±1.0) vs (1.9±1.0)], but had longer postoperative hospitalization time [5(3, 6)d vs 3(2, 6)d] and higher reactive pleural effusion rate [23.1%(9/39) vs 2.5%(1/40)], the differences were all statistically significant (all P<0.05). No significant difference was found in target bile duct dilatation diameter, final stone clearance rate, intraoperative blood loss, postoperative complication rate, and operation time of lithotripsy (all P>0.05). Conclusions:Compared to the left lobe approach, right lobe approach could be prioritized in PTOBF lithotripsy for type Ⅱa hepatolithiasis, considering its higher immediate stone clearance and less lithotripsy procedures, but this surgical approach should pay attention to the occurrence of reactive pleural effusion.

Objective:Examining the risk factors for stone recurrence after percutaneous transhepatic one-step biliary fistulation (PTOBF) and lithotripsy for hepatic bile duct stones.Methods:The clinical data of 70 patients with hepatic bile duct stones combined with bile duct stenosis who underwent PTOBF lithotripsy at the First Hospital of Guangzhou Medical University from September 2016 to February 2023 were analyzed retrospectively, including 28 males and 42 females with the age of (48.9±17.5) years old. The patients were divided into two groups according to stone recurrence: recurrence group ( n=25) and non-recurrence group ( n=45). Clinical data such as age, gender, medical history, number of surgeries, and time with tube were recorded. Follow-up was performed by telephone and outpatient review. Multifactorial logistic regression was used to analyze the influencing factors of stone recurrence. Results:Univariate analysis showed statistically significant differences between the age, stone length diameter, number of stones, stage I undischarged stenosis, and number of surgeries between patients in the recurrent and non-recurrent groups (all P<0.05). Multifactorial logistic regression analysis showed that stone length ≥20 mm ( OR=4.389, 95% CI: 1.111-17.340, P=0.035), stage I undischarged stenosis ( OR=4.638, 95% CI: 1.170-18.385, P=0.029), and multiple number of operations ( OR=1.842, 95% CI: 1.031-3.290, P=0.039) had a high risk of stone recurrence after PTOBF lithotripsy in patients with hepatic bile duct stones. Conclusion:Stone length ≥20 mm, stage I unresolved stenosis, and number of surgeries were independent risk factors for stone recurrence in patients with hepatobiliary stones combined with bile duct stenosis after PTOBF and lithotripsy for hepatic bile duct stones.

Objective:To investigate the therapeutic effect of percutaneous transhepatic one-step biliary fistulation (PTOBF) combined with rigid choledochoscopy in the treatment of benign hepatic bile duct strictures.Methods:The clinical data of 46 patients with hepatic ductal stenosis and stones undergoing PTOBF combined with rigid choledochoscopy at the First Hospital of Guangzhou Medical University between September 2016 and September 2022 were retrospectively analyzed, including 20 males and 26 females, aged (48.5±17.6) years. The location of stones and strictures, stone retrieval rate, postoperative complications, stricture release rate, stone recurrence rate, and reoperation rate were analyzed to access the safety and effectiveness of this procedure.Results:A total of 58 sites of stenoses were found in 46 patients, and PTOBF lithotripsy combined with rigid choledochoscopy were performed for 77 times. The early postoperative complication rate was 19.6% (9/46), and the stenosis release rate was 93.5% (43/46). The mean follow-up time was (28.1±19.6) months, the complete stone retrieval rate was 91.3% (42/46), the stone recurrence rate was 19.6% (9/46), the reoperation rate was 8.7% (4/46), and the long-term postoperative complication rate was 6.5% (3/46).Conclusion:PTOBF combined with rigid choledochoscopic stenoplasty for benign hepatic duct strictures is a safe and feasible procedure to reduce the stone recurrence and long-term postoperative complications.

Hepatolithiasis refers to a disease with stones located in bile ducts above the bifurcation of the left and right hepatic ducts. It is a common benign biliary duct disease. Hepatolithiasis is often associated with intrahepatic bile duct strictures. Due to its complex etiology and pathological changes, its treatment remains a hot topic for debate and research in biliary surgery. In recent years, new treatments have been introduced, but they are all faced with problems such as high recurrence rate, postoperative restenosis rate and reoperation rate. This article reviews the recent progress of surgical management of biliary strictures in the treatment of hepatolithiasis, including the use of hepatectomy, biliary plastic surgery, choledochoenterostomy, choledochoscopy and endoscopic retrograde cholangiopancreatography biliary stent placement to provide a up-to-date view surgical treatment of hepatolithiasis associated with biliary strictures.

OBJECTIVE: To establish a rapid and accurate "on/off" switch technique consisted of 3'-phosphorothioate-modified allele-specific primers and exo+ polymerase to screen the G719S and T790M mutations of epidermal growth factor receptor (EGFR) gene. The switch was used to identify cervical cancer patients who are sensitive to tyrosine kinase inhibitor (TKI). METHODS: Allele-specific primers targeting recombinant wild-type and mutation-type templates were designed with 3' terminal phosphorothioate modification. Two-directional primer extension was carried out using Pfu polymerase. The G719S and T790M mutations were detected by the technique among cervical cancer tissues. The results were verified by Sanger sequencing. RESULTS: No mutation was detected among the 80 cervical cancer cases, and the results were consistent with that of Sanger sequencing. No significant difference was found between the frequencies of the G719S and T790M mutations between the patient and the control groups (P> 0.05). CONCLUSION A sensitive "on/off" switch technique for detecting the two EGFR mutations was established. The G719S and T790M mutations are not associated with cervical cancer.
Carcinoma, Non-Small-Cell Lung ; Drug Resistance, Neoplasm ; ErbB Receptors ; genetics ; Female ; Genes, erbB-1 ; Humans ; Lung Neoplasms ; Mutation ; Protein Kinase Inhibitors ; Uterine Cervical Neoplasms ; genetics

Objective To construct the recombinant pMD19-exon18-exon20 plasmid containing locus G719S and T790M of EGFR gene associated with cervical cancer,which may provide a template for preparing the mutant recombinant vector of EGFR gene.Methods Using the healthy human genome DNA as templates,the segments of exon 18 and exon 20 of EGFR gene were amplified by two pairs of specific primers which were designed based on the sequences of overlapping and complementary area.The amplified segments were linked by overlap PCR.The products of linked exon18-exon20 were further inserted into the vector pMD19-T.The constructed recombi nant pMD19-exon18-exon20 plasmid was finally transformed into competent cells E.coli DH5α and then identified by PCR with bacterial solution and genome sequencing.Results The amplified fragments of exon18 and exon20 were clearly appeared at 778 bp and 596 bp and the fused product of exon18-exon20 was showed at 1 374 bp on agarose gel electrophoresis.The recombinant plasmid of fusion EGFR gene was consistent with the expected results via bacterial PCR assay and DNA sequencing.Conclusion We successfully fused the segments of exon18 with exon20 and constructed the recombinant expression vector of EGFR gene by using overlap PCR method.