Objective:To investigate the efficacy of primary closure versus T-tube drainage in patients with common bile duct stones after laparoscopic common bile duct exploration and stone extraction. Methods:Fifty-two patients with common bile duct stones who received treatment at The Second Affiliated Hospital of Guizhou Medical University between February 2021 and February 2023 were included in this study. All patients underwent laparoscopic common bile duct exploration and stone extraction and then were divided into two groups ( n = 26 per group) using a randomized controlled trial design with allocation based on a random number table. The control group received T-tube drainage postoperatively, whereas the observation group underwent primary suture treatment. Both groups were observed for 3 days postoperatively to compare various postoperative clinical indicators, including serum levels of cortisol, adrenaline, C-reactive protein, interleukin-6, direct bilirubin, total bile acid, alkaline phosphatase, and gamma-glutamyl transferase, and the occurrence of postoperative complications. Results:The operative time in the observation group was significantly shorter than that in the control group [(105.30 ± 5.89) minutes vs. (121.36 ± 5.86) minutes, t = 9.86, P < 0.001]. The intraoperative blood loss in the observation group was significantly less than that in the control group [(40.31 ± 4.53) mL vs. (45.20 ± 4.76) mL, t = 3.80, P < 0.001]. The length of hospital stay in the observation group was significantly shorter than that in the control group [(12.01 ± 2.86) days vs. (14.32 ± 2.73) days, t = 2.98, P = 0.005]. The gastrointestinal function recovery time in the observation group was shorter than that in the control group [(31.42 ± 2.59) days vs. (37.62 ± 2.63) days, t = 8.57, P < 0.001]. The bile drainage volume in the observation group was less than that in the control group [(168.69 ± 15.41) mL vs. (275.62 ± 15.32) mL, t = 25.09, P < 0.001]. The serum level of cortisol in the observation group was significantly higher than that in the control group [(469.63 ± 20.62) mmol/L vs. (359.65 ± 19.87) mmol/L, t = 19.58, P < 0.001]. The serum level of adrenaline in the observation group was significantly higher than that in the control group [(274.62 ± 20.21) ng/L vs. (198.64 ± 20.16) ng/L, t = 13.57, P < 0.001]. The serum level of C-reactive protein in the observation group was significantly higher than that in the control group [(3.42 ± 0.37) mg/L vs. (2.74 ± 0.25) mg/L, t = 7.77, P < 0.001]. The serum level of interleukin-6 in the observation group was significantly higher than that in the control group [(112.36 ± 8.94) μg/L vs. (87.62 ± 8.63) μg/L, t = 10.15, P < 0.001]. The serum level of direct bilirubin in the observation group was significantly lower than that in the control group [(24.52 ± 4.62) μmol/L vs. (35.62 ± 4.87) μmol/L, t = 8.43, P < 0.001]. The serum level of total bile acid in the observation group was significantly lower than that in the control group [(10.62 ± 4.21) U/L vs. (17.64 ± 4.16) U/L, t = 6.05, P < 0.001]. The serum level of alkaline phosphatase in the observation group was significantly lower than that in the control group [(100.21 ± 10.24) mg/L vs. (112.74 ± 11.25) mg/L, t = 4.20, P < 0.001]. The serum level of gamma-glutamyl transferase in the observation group was significantly lower than that in the control group [(122.36 ± 8.94) μg/L vs. (142.62 ± 5.63) μg/L, t = 9.78, P < 0.001]. The incidence of complications in the observation group was significantly lower than that in the control group [7.69% (2/26) vs. 30.77% (8/26), χ2 = 4.46, P = 0.035]. Conclusion:Compared with T-tube drainage, primary closure following laparoscopic common bile duct exploration and stone extraction can reduce patient stress responses, improve liver function, shorten postoperative recovery time, and result in a lower incidence of complications.

Objective:To investigate the effects and significance of acute and chronic trauma on brain degree centrality (DC) in patients with post-traumatic stress disorder (PTSD) who lost their only child at resting state.Methods:Retrospectively, the study enrolled a total of 51 parents with PTSD, including 35 PTSD parents whose children was lost in emergencies (acute bereaved PTSD group) and 16 PTSD parents whose children was lost of chronic causes such as diseases (chronic bereaved PTSD group). Fifty local adults were also included as healthy controls (HC group). The clinical administered PTSD scale(CAPS) was used to evaluate the severity of the subjects' clinical symptoms.Resting-state functional magnetic resonance imaging(fMRI) data of all subjects were collected and DC values were calculated.SPSS 22.0 software was used for statistical analysis.Covariance analysis was performed among three groups, while post hoc was performed between any two groups.What's more, correlation analyses were utilized between abnormal brain regions and the scores of CAPS.Results:Significant group effects were found in multiple regions, including the right inferior temporal gyrus (MNI: x, y, z=66, -27, -21), right temporal pole (MNI: x, y, z=54, 15, -9), right orbital inferior frontal gyrus (MNI: x, y, z=42, 21, -15), bilateral medial superior frontal gyri (MNI: right x, y, z=6, 63, 12; left x, y, z=-3, 60, 18), left inferior parietal angular gyrus (MNI: x, y, z=-45, -36, 51) and left postcentral gyrus (MNI: x, y, z=-45, -33, 51). Compared with HC group, the DC of two patient groups increased in the right inferior temporal gyrus (MNI: acute x, y, z=63, -27, -21; chronic x, y, z=63, -21, -27); the DC of acute bereaved PTSD group decreased in the right temporal pole (MNI: x, y, z=45, 21, -15) and the right orbital inferior frontal gyrus (MNI: x, y, z=48, 24, -12), while the DC of chronic bereaved PTSD group decreased in the left inferior parietal angular gyrus (MNI: x, y, z=-45, -36, 51) and left postcentral gyrus (MNI: x, y, z=-45, -33, 51). Compared with chronic bereaved PTSD group, the DC of acute bereaved PTSD group increased in the left inferior parietal angular gyrus (MNI: x, y, z=-33, -39, 42) and left postcentral gyrus (MNI: x, y, z=-45, -33, 51), while decreased in the right temporal pole (MNI: x, y, z=51, 12, -9), right orbital inferior frontal gyrus (MNI: x, y, z=42, 21, -15) and bilateral medial superior frontal gyri (MNI: left x, y, z=0, 57, 15; right x, y, z=3, 57, 15). In chronic bereaved PTSD group, the DC of the left postcentral gyrus was negatively correlated with C1 (avoid trauma-related thoughts, feelings) score in CAPS ( r=-0.606, P=0.028). In acute bereaved PTSD group, the DC of the left medial superior frontal gyrus was negatively correlated with D4 (high vigilance) score ( r=-0.416, P=0.020). Conclusion:There exist functional abnormalities of multiple brain regions in acute and chronic bereaved parents with PTSD.The high arousal symptoms of the former may be related with the abnormalities of prefrontal-amygdala neural circuit, while the latter show higher avoidance which may be associated with the dysfunction of somatosensory brain regions such as postcentral gyrus.

Objective:To investigate the effect of coping style on the gray matter volume in patients with post-traumatic stress disorder (PTSD) who lost their only child, and the mediating role of gray matter volume in evaluating the influence of coping style in clinical symptoms of these parents.Methods:A total of 57 parents with PTSD (PTSD group) and 162 parents without PTSD (non-PTSD group) who lost their only child from September 2016 to March 2017 were enrolled from Jiangsu Province, China. Brain MRI data at resting state were collected. Voxel-based multiple regression analysis was performed to confirm the brain areas in which coping style main effect, diagnosis main effect and their interaction had significant influences in gray matter volumes. Correlations among gray matter volume of brain areas related to coping style, coping style scale scores, and clinician-administered PTSD scale (CAPS) scores were analyzed. Structural equation modeling was used to analyze the mediating role of gray matter volume in the influence of coping style in clinical symptoms of parents lost their only child.Results:(1) The coping style main effect did not significantly influence the gray matter volume in all subjects, and the diagnosis main effect had significant influence in gray matter volume in the right lingual gyrus; their interaction had significant influence in gray matter volume in the right peritalar fissure cortex and lingual gyrus. The positive coping style in the PTSD group had significant influence in the gray matter volumes of the right peritalar fissure cortex and lingual gyrus. (2) In the PTSD group, the scores of positive coping style were positively correlated with the gray matter volumes of the right talus fissure and the lingual gyrus ( P<0.05); the scores of positive coping style, and the gray matter volumes of the right talus fissure and the lingual gyrus were negatively correlated with scores of CAPS-C 5 and CAPS-C ( P<0.05). (3) In the PTSD group, positive coping style can positively predict the gray matter volumes of the right talus fissure and the lingual gyrus; the gray matter volumes of the right talus fissure and the lingual gyrus can negatively predict the avoidance-related symptoms. Conclusion:Positive coping style has influence in the gray matter volumes of the right talar fissure and lingual gyrus of PTSD patients lost their only child; and less positive coping style may affect the brain areas related to visual information processing, thus aggravating avoidance-related symptoms of PTSD patients.

OBJECTIVE: To carry out G-banded chromosomal karyotyping and chromosomal microarray analysis (CMA) for a fetus featuring multiple malformations. METHODS: The fetus was found to have increased nuchal thickness, generalized edema, asymmetric lower limbs, tetralogy of Fallot, nasal bone anomaly and cleft palate. Following amniocentesis, G-band karyotyping and CMA were carried out. RESULTS: The fetus had a karyotype of 47,XX,+i(12)(p10) [14]/46,XX[6]. CMA has identified a 33.9 Mb duplication at 12p13.33-p11.1, which was suggestive of tetrasomy 12p. CONCLUSION Combined chromosomal karyotyping and CMA can delineate the origin of abnormal chromosomal fragments during prenatal diagnosis. The fetus was diagnosed with Pallister-Killian syndrome.

Objective To observe the effects of hyperventilation on jugular bulb pressure and optic nerve sheath diameter during RALRP. Methods Twenty patients undergoing elective RALRP were enrolled in this study. After hyperventilation of General anesthesia,we monitored and recorded changes of Heart rate(HR),mean arterial pressure (MAP),end-tidal carbon dioxide (ETCO2),arterial oxygen tension (PaO2),arterial carbon dioxide tension(PaCO2),peak airway pressure(PIP),JBP and ONSD in 5 minutes after intubation(T0),Trendelenberg posture in 15 minutes (T1),the established pneumoperitoneum in 30,60,90 minutes (T2,T3,T4) and termination of pneumoperitoneum in 15 minutes in supine position(T5)respectively. Results Compared with T0, JBP increased at T1 ~ T5(P < 0.05). ETCO2 and PaCO2 of T1 ~ T5 were lower than those of T0(P < 0.05)during hyperventilation. After establishment of Trendelenburg posture and pneumoperitoneum,PIP values increased at T1~T4 than that at T0 (P < 0.05),However,ONSD increased from T3 to T5 compared with T1 to T2 (P < 0.05). Conclusion Through over-ventilation,pneumoperitoneum and Trendelenburg posture,JBP and PIP can increase, and ONSD becomes wider evendually.

Comparison of the institutional setup, policies and adverse event report mechanism for medical risk control in the countries of UK, USA, Canada, and Australia by means of browsing information on their official websites. It is found that these countries maintain a national patient safety authority, coupled with a tiered management at national, local, medical institutions and NGOs level; the USA pattern features laws and regulations, that of UK and Australia features guidelines as policy guarantee for medical safety; these countries regulate adverse event reporting by either government leadership or cooperation with trade associations. Inspirations from this study suggest China to enhance institutional construction, complete regulations, and advocate the culture for medical safety, and to build the national-level reporting and study system for medical safety events, and improve medical risk management.

Objective To discuss the influence of psychological nursing on the therapeutic effect of patients with newly diagnosed type 2 diabetes. Methods Patients (60 cases) who received psychological nursing were set as the nursing group. Patients (65 cases) who did not received psychological nursing were set as the control group. The number of patients who received early insulin treatment and whose fasting plasma glucose return to normal value on the 7th and 30th days after treatment was observed. Results The number of patients who received early insulin treatment and whose fasting plasma glucose return to normal value on the 7th and 30th days after treatment in the nursing group was higher than that of the control group (P<0.01). Conclusions Psychological nursing of patients with newly diagnosed type 2 diabetes could make patients obey doctors' advice and accept early insulin treatment to control plasma glucose and delete the toxicity of high concentration of plasma glucose as soon as possible.

The validity of (99m)Tc-YIGSR, a novel receptor radio-tracer, in imaging the Ehrlich ascites tumor was evaluated. YIGSR, a pentapeptide of laminin, was labeled with (99m)Tc by using a bifunctional chelator S-Acetly-NH(3)-MAG(3). The MIBI was labeled with (99m)Tc by following the kit instruction. The mice of tumor group were intravenously injected 1-2 mCi of (99m)Tc-YIGSR or (99m)Tc-MIBI via caudal vein, immobilized and imaged under a Gamma camera. The same procedure was performed in mice of blockade group, in which the unlabeled YIGSR was previously injected to block the receptor-recognition sites, and inflammation group serving as control. The reverse-phase Sep-Pak C(18) chromatogram was found to have an essentially complete conjugation between YIGSR and S-Acetly-NH(3)-MAG(3). The conjugated YIGSR could be radio-labeled successfully with (99m)Tc at room temperature and neutral pH, with a radio-labeling yield of 62%. Without the chelator S-Acetly-NH(3)-MAG(3), the YIGSR was labeled with (99m)Tc at an efficiency of 4%. The imagological study revealed obvious tumor accumulation of (99m)Tc-YIGSR 15 min after the injection, and the uptake peaked after 3 h with a tumor-to-muscle ratio (T/M) of 11.36. The radio-tracer was slowly cleared up and resulted in a T/M of 3.01 at the 8th h after the injection. As for blocked group, the tumor uptake of radiotracer was significantly lower, with the highest T/M being 4.61 after 3 h and 0.89 after 8 h. The T/M was 3.72 at the 3rd h and 1.29 at the 8th h after the (99m)Tc-YIGSR injection in the inflammatory group. The T/M was significantly higher in tumor group than in inflammatory group or control group (P<0.001). In the 99mTc-MIBI group, the T/M was 1.40 at the 3rd h and 0.55 at the 8th h after the injection, which showed a significant difference as compared with (99m)Tc-YIGSR (P<0.001). It is concluded that YIGSR can be successfully radiolabelled by using S-Acetly-NH(3)-MAG(3). (99m)Tc-YIGSR has many advantages in tumor imaging, such as quick and clear visualization, high sensitivity and specificity, and satisfactory target/non-target ratio (N/NT). It promises to be tumor radio-tracer.
Animals ; Carcinoma, Ehrlich Tumor ; diagnostic imaging ; Mice ; Radioactive Tracers ; Radionuclide Imaging ; Radiopharmaceuticals ; Receptors, Laminin ; metabolism ; Technetium Tc 99m Mertiatide ; Technetium Tc 99m Sestamibi

The validity of (99m)Tc-YIGSR, a novel receptor radio-tracer, in imaging the Ehrlich ascites tumor was evaluated. YIGSR, a pentapeptide of laminin, was labeled with (99m)Tc by using a bifunctional chelator S-Acetly-NH(3)-MAG(3). The MIBI was labeled with (99m)Tc by following the kit instruction. The mice of tumor group were intravenously injected 1-2 mCi of (99m)Tc-YIGSR or (99m)Tc-MIBI via caudal vein, immobilized and imaged under a Gamma camera. The same procedure was performed in mice of blockade group, in which the unlabeled YIGSR was previously injected to block the receptor-recognition sites, and inflammation group serving as control. The reverse-phase Sep-Pak C(18) chromatogram was found to have an essentially complete conjugation between YIGSR and S-Acetly-NH(3)-MAG(3). The conjugated YIGSR could be radio-labeled successfully with (99m)Tc at room temperature and neutral pH, with a radio-labeling yield of 62%. Without the chelator S-Acetly-NH(3)-MAG(3), the YIGSR was labeled with (99m)Tc at an efficiency of 4%. The imagological study revealed obvious tumor accumulation of (99m)Tc-YIGSR 15 min after the injection, and the uptake peaked after 3 h with a tumor-to-muscle ratio (T/M) of 11.36. The radio-tracer was slowly cleared up and resulted in a T/M of 3.01 at the 8th h after the injection. As for blocked group, the tumor uptake of radiotracer was significantly lower, with the highest T/M being 4.61 after 3 h and 0.89 after 8 h. The T/M was 3.72 at the 3rd h and 1.29 at the 8th h after the (99m)Tc-YIGSR injection in the inflammatory group. The T/M was significantly higher in tumor group than in inflammatory group or control group (P<0.001). In the 99mTc-MIBI group, the T/M was 1.40 at the 3rd h and 0.55 at the 8th h after the injection, which showed a significant difference as compared with (99m)Tc-YIGSR (P<0.001). It is concluded that YIGSR can be successfully radiolabelled by using S-Acetly-NH(3)-MAG(3). (99m)Tc-YIGSR has many advantages in tumor imaging, such as quick and clear visualization, high sensitivity and specificity, and satisfactory target/non-target ratio (N/NT). It promises to be tumor radio-tracer.
Carcinoma, Ehrlich Tumor/*radionuclide imaging ; Radioactive Tracers ; Radiopharmaceuticals/*diagnostic use ; Receptors, Laminin/*metabolism ; Technetium Tc 99m Mertiatide/*diagnostic use ; Technetium Tc 99m Sestamibi/*diagnostic use

The validity of 99mTc-YIGSR, a novel receptor radio-tracer, in imaging the Ehrlich ascites tumor was evaluated. YIGSR, a pentapeptide of laminin, was labeled with 99mTc by using a bifunctional chelator S-Acetly-NH3-MAG3. The MIBI was labeled with 99mTc by following the kit instruction. The mice of tumor group were intravenously injected 1-2 mCi of 99mTc-YIGSR or 99mTc-MIBI via caudal vein, immobilized and imaged under a Gamma camera. The same procedure was performed in mice of blockade group, in which the unlabeled YIGSR was previously injected to block the receptor-recognition sites, and inflammation group serving as control. The reverse-phase Sep-Pak C18 chromatogram was found to have an essentially complete conjugation between YIGSR and S-Acetly-NH3-MAG3. The conjugated YIGSR could be radio-labeled successfully with 99mTc at room temperature and neutral pH, with a radio-labeling yield of 62%. Without the chelator S-Acetly-NH3-MAG3, the YIGSR was labeled with 99mTc at an efficiency of 4%. The imagological study revealed obvious tumor accumulation of 99mTc-YIGSR 15 min after the injection, and the uptake peaked after 3 h with a tumor-to-muscle ratio (T/M) of 11.36. The radio-tracer was slowly cleared up and resulted in a T/M of 3.01 at the 8th h after the injection. As for blocked group, the tumor uptake of radiotracer was significantly lower, with the highest T/M being 4.61 after 3 h and 0.89 after 8 h. The T/M was 3.72 at the 3rd h and 1.29 at the 8th h after the 99mTc-YIGSR injection in the inflammatory group. The T/M was significantly higher in tumor group than in inflammatory group or control group (P＜0.001). In the 99mTc-MIBI group, the T/M was 1.40 at the 3rd h and 0.55 at the 8th h after the injection, which showed a significant difference as compared with 99mTc-YIGSR (P＜0.001).It is concluded that YIGSR can be successfully radiolabelled by using S-Acetly-NH3-MAG3.99mTc-YIGSR has many advantages in tumor imaging, such as quick and clear visualization, high sensitivity and specificity, and satisfactory target/non-target ratio (N/NT). It promises to be tumor radio-tracer.