Objective To investigate whether endoscopic ultrasonography (EUS) can be an alternative method for diagnostic endoscopic retrograde cholangiopancreatography (ERCP) by comparing the ability of EUS versus CT and transabdominal ultrasonography (TUS) in the diagnosis of muddy stones of the common bile duct. Methods A prospective study was conducted for 53 patients suspected of muddy stones of the common bile duct who attended Nanxishan Hospital of Guangxi Zhuang Autonomous Region from July 2019 to December 2021, and all patients underwent EUS, TUS, and CT before ERCP. With ERCP and endoscopic sphincterotomy (EST) for removing muddy stones of the common bile duct as the gold standard for the diagnosis of muddy stones of the common bile duct, EUS, TUS, and CT were compared in terms of their ability to display the muddy stones of the common bile duct. The chi-square test or the Fisher's exact test was used for comparison of categorical data between groups. Results In the 53 patients, EUS, TUS, and CT had a positive rate of 88.68%, 50.94%, and 62.26%, respectively, in detecting muddy stones of the common bile duct. As for the positive results confirmed by EST under ERCP, EUS had a sensitivity of 93.75%, a specificity of 60.00%, and an accuracy of 90.57% in detecting muddy stones of the common bile duct, while TUS had a sensitivity of 56.25%, a specificity of 100.00%, and an accuracy of 60.38% and CT had a sensitivity of 66.67%, a specificity of 80.00%, and an accuracy of 67.92%. There was a significant difference between EUS and CT in the accuracy in detecting muddy stones of the common bile duct ( χ 2 =8.26, P =0.004), and there was also a significant difference in diagnostic accuracy between EUS and TUS ( χ 2 =13.05, P < 0.001). Conclusion EUS is more accurate than TUS and CT in the diagnosis of muddy stones of the common bile duct, and instead of ERCP, EUS is thus recommended for suspected muddy stones of the common bile duct when TUS and CT fail to identify the lesions in clinical practice, so as to make a confirmed diagnosis and reduce related costs and complications.

Objective: To analyze the epidemiological distribution of new occupational pneumoconiosis (hereinafter referred as pneumoconiosis) in Henan Province from 2006 to 2020. Methods: Clinical data of newly recruited pneumoconiosis cases from 2006 to 2020 in Henan Province were retrospectively analyzed. Results: A total of 9 624 cases of newly diagnosed pneumoconiosis were reported in Henan Province in the past 15 years, of which 98.6% were males. The number of cases had two peaks, one in 2009-2011 and the other in 2014-2017. There were 12 types of pneumoconiosis of all reported cases except for mica pneumoconiosis, in which coal workers' pneumoconiosis and silicosis accounted for 96.0%. The incidence of phase Ⅰ, Ⅱ and Ⅲ pneumoconiosis was 64.7%, 21.0% and 14.3%, respectively. The incidence of phase Ⅱ and Ⅲ silicosis was higher than that of coal miners' pneumoconiosis (56.3% vs 22.7%, P<0.01). Patients with pneumoconiosis were mainly distributed in Zhengzhou City, Sanmenxia City, Luoyang City, Pingdingshan City and Hebi City, accounting for 85.0%. The enterprises involved were mainly mining industry, large- and medium-sized enterprises, state-owned enterprises and collective enterprises. The top five position of patients were coal miners, rock drillers, excavators, coal mixed workers and pure coal miners, total accounting for 72.0%. There were 196 enterprises reported ≥10 cases, accounting for 17.2% of all enterprises and 80.3% of the total of newly diagnosed pneumoconiosis cases. The median (M) of onset age of new cases was 49 years old, and the M of onset of working age was 16 years. The onset age of silicosis was younger (M: 49 vs 48 years old, P<0.05), while the onset of working age was longer (M: 10 vs 20 years, P<0.05), compared with that of coal workers' pneumoconiosis. Conclusion: The incidence of pneumoconiosis in Henan Province were disease clustering distribution, regional distribution, industry of enterprise, enterprise scale, enterprise type, nature and working position distribution of enterprises. And it showed the characteristics of group incidence. The prevention and control treatment of pneumoconiosis should be strengthened in key areas, key enterprises and key diseases and jobs.

【Objective】 To investigate the regulatory effect of JAK2/STAT3 signaling pathway inhibitor AG490 on the functional phenotype of M2-like macrophages and its effects on proliferation, apoptosis, migration, and invasion of gastric cancer cells. 【Methods】 Human mononuclear cell line THP-1 was induced to differentiate into M0 macrophages by PMA in vitro. The M1-like phenotype was induced by LPS and IFN-γ, and M2-like phenotype was induced by IL-4 and IL-13, respectively, and identified by immunofluorescence labeling CD68, CD86 and CD206. The mRNA expressions of CD163, Arg1, CCL22, PPARγ, IL-10, IL-20 and TNF-α were determined by RT-qPCR. The expressions of key proteins in JAK2/STAT3 signaling pathway were detected by Western blotting. M2-like macrophages were treated with JAK2/STAT3 inhibitor (AG490) to observe the expression level of marker genes for M2 like phenotype. Macrophages were co-cultured with gastric cancer cells, and the effects of the macrophages on proliferation, migration, invasion, and apoptosis of gastric cancer cells were detected by CCK-8 method, healing assay, transwell intracellular Matrigel invasion assay, and flow cytometry. The xenograft tumor model of MKN45 gastric cancer in nude mice was prepared, and the tumor size and quality were observed for 20 days after the model was established. 【Results】 THP-1 cells were induced into M1-like macrophages and M2-like macrophages. M1-like marker (CD86) and M2-like marker (CD206) were identified by flow cytometry. The P38MAPK, JAK2, p-STAT3/STAT3 protein levels of M2-like macrophages treated with AG490 were significantly reduced. The mRNA expression levels of Arg1, CCL22, PPARγ and IL-10 were significantly reduced in the group of M2-like macrophages treated with AG490. Co-culture of M2-like macrophages with gastric cancer cells could promote gastric cancer cell viability, increase migration and invasion ability, and inhibit apoptosis. When the group of M2-like macrophages treated with AG490 was co-cultured with gastric cancer cells, the proliferation activity of MKN-45 cells and MGC823 was significantly lower than that in M2 group (1.047±0.062 vs. 1.426±0.076, 1.149±0.006 vs. 1.301±0.015). Compared to M2 group, the migration (100.0%±5.73% vs. 72%±3.85%) and invasion ability (100.0%±7.40% vs. 60%±6.54%) of MGC823 gastric cancer cells in AG490 treatment group were significantly reduced. The apoptosis rate of MGC823 cells in the AG490 treated group was significantly higher than that in M2 group (27.51%±0.70% vs. 20.82%±0.92%). In the nude mouse xenograft tumor model, the volume and weight of the transplanted tumor collected at day 20 were significantly lower in AG490 treated group than in M2 group (736.04±182.34 vs. 1 080.5±250.57)mm³, (0.64±0.11 vs. 0.87±0.17)g. 【Conclusion】 AG490 downregulates the activation level of JAK2/STAT3 signaling pathway in M2-like macrophages, inhibits M2-type polarization, partially reverses the cancer-promoting function of M2-like macrophages, inhibits proliferation, migration and invasion of gastric cancer cells, and induces apoptosis. The JAK2/STAT3 signaling pathway can be further studied as a potential therapeutic target for gastric cancer.

Objective:To analyze the effects of empowerment psychological care intervention on the negative emotions, mental toughness and quality of life of the direct caregivers of children with epilepsy.Methods:A total of 150 direct caregivers of 150 children with epilepsy in the Department of Neurology, Anhui Provincial Children's Hospital from September to December 2019 were recruited, and divided in to control group ( n=74) and experimental group ( n=76) by random number table method. The control group was given conventional psychological nursing, while the experimental group was given empowerment psychological care. The negative mood, mental toughness and quality of life of the direct caregivers were compared between the two groups. Results:After intervention, the scores of Anxiety Self-Rating Scale (SAS) and Self-rating Depression Scale (SDS) of the experimental group were lower than those of the control group, the scores of the WHO Quality of Life Assessment Instrument (WHOQOL-100) and the Psychological Resilience Scale (RSA) were higher than those of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Empowerment psychological care can significantly improve the mental state of the direct caregivers of children with epilepsy and improve their mental toughness and quality of life.

Objective Toinvestigatethediagnosticvalueof3DGSPACEsequencewith3Dreconstructiontechniqueinevaluationof posterolateralcomplexofthekneejoint.Methods 30kneejointsofhealthyvolunteersweresubjectedtoMRIconventionalsequences andSPACEsequencewith3Dreconstructiontechnique.AdoubleblindmethodwasusedtocompareMRIroutineand3DGSPACEsequence imagesontheposteriorlateralcomplexofthekneejoint.Theeffectoftwoscanningmethodsonthelateralcollateralligament,popliteal tendonandpoplitealligamentwasanalyzedbyrankandtest.Results Ithadstatisticaldifferencebetweentwogroupsindisplayof posterolateralcomplex(P＜0.01).Thedisplayeffecton3DGSPACEsequenceforthelateralcollateralligament,poplitealtendonand poplitealligamentwasbetterthanthatontheconventionalMRIsequence.Conclusion 3DGSPACEsequencewith3Dreconstruction techniquecancompletelydisplaytheconfigurationanddirectionofposterolateralcomplex,whichcanimprovetherateofshowingligament obviously.

Objective To evaluate the curative efficacy of multimodality for severe pulmonary infection (SPI) following kidney transplantation (KT).Methods Fifty-seven cases of SPI following KT were treated with multimodality therapy in our hospital between Jan.2014 and Jan.2017.The outcome and data were analyzed and evaluated retrospectively.Results Of these 57 patients,45 cases were cured (41 cases were alive with functioning grafts,and 4 cases had grafts loss).The pulmonary lesions in 4 cases of pulmonary fungal infection were improved and oral anti-fungal drugs were continuously given after discharge.The symptoms in one case of tuberculosis were obviously improved and anti-tuberculosis treatment was given continuously after discharge.There were 5 deaths,including 2 deaths due to functioning grafts loss.Two cases abandoned treatment during therapy because of financial problem.Pathogens could be detected in only 29 cases.Conclusion SPI after KT is an acute important complication with rapid progression.Early and prompt treatment with combined antibiotics,antifungal drugs as well as antivirus is essential.The keys to successful rescue for SPI should also include immunosuppressant reduction,intravenous immunoglobulin and nutrition support.The combined therapy is successful and could reduce mortality of SPI obviously.

Objective To compare the clinical efficacy of robotic low anterior resection (R-LAR) and laparoscopic low anterior resection(L-LAR) for rectal cancer.Methods The case-control studies for comparing the clinical efficacy of R-LAR and LLAR for rectal cancer were retrieved from databases,including PubMed,OVID,Springer,Wanfang and VIP,till June 2016.The studies were selected in accordance with inclusion and exclusion critera,and the data were extracted and evaluated by two researchers.The RevManS.3 software was used for Meta-analysis.Results A total of 7 studies including 1 126 patients with rectal cancer were included,592 cases in the R-LAR group and 534 cases in the L-LAR group.Compared with the L-LAR group,in the R-LAR group the operation time was longer (MD=33.84,95％ CI:4.25-63.43,P =0.03),the conversion rate was lower (OR =0.10,95％CI:0.03-0.36,P=0.000 5),and more lymph nodes were dissected (MD=1.24,95％CI:0.31-2.17,P=0.009).No statistically significant difference was found in length of hospital stay,intraoperative blood loss,distance from distal margin to tumor and incidence rate of postoperative anastomotic leakage between the two groups (P ＞ 0.05).Conclusion Compared with L-LAR,RLAR is characterized by longer operation time,lower conversion rate and more thoroughly removing lymph nodes.And the length of hospital stay,intraoperative blood loss,distance from distal margin to tumor and incidence rate of postoperative anastomotic leakage of R-LAR are similar to those of L-LAR.

Objective To investigate the effects of dexmedetomidine (DEX) on the mRNA expression of triggering receptor expressed on myeloid cells 1 (TREM-1) in peripheral blood mononuclear cells of rats with acute obstructive suppurative cholangitis (AOSC).Methods Sixty healthy male Wistar rat models of AOSC induced by complete common bile duct ligation and injection of E.coli into the bile duct through an intubation tube were replicated successfully.After modeling,the peripheral blood was collected and mononuclear cells were isolated and cultured.According to random number table method,the mononeuclear cells were divided into model group (no drug added in culture of mononuclear cells) and low,medium and high dose DEX groups (final concentrations 0.4,0.8,1.2 μg/L DEX were in low,medium and high DEX mononuclear cell cultures,respectively).After the mononuclear cells were cultured for 24 hours,the levels of tumor necrosis factor-α (TNF-α),interleukins (IL-1 and IL-6) in the supernatant of the cultured mononuclear cells were detected by enzyme linked immunosorbent assay (ELISA).The level of C-reactive protein (CRP) was detected by immunity transmission turbidimetry.The expression of TREM-1 mRNA in the mononuclear cells was detected by reverse trantscription-polymerase chain reaction (RT-PCR).Results Compared with the model group,the levels of TNF-α,IL-1,IL-6,CRP were decreased,the TREM-1 mRNA expressions were down-regulated in the different DEX dose groups,and the degrees of descent in medium and high dose groups were more significant than those in low dose group [TNF-oα (ng/L):95.5±8.6,88.9±5.3 vs.131.1 ± 14.2;IL-1 (ng/L):53.5±8.3,48.3 ± 6.7 vs.73.7 ± 12.8;IL-6 (ng/L):266.9±26.2,252.1 ± 17.7 vs.349.9±40.4;CRP (ng/L):4.3 ± 1.1,3.9 ±0.7 vs.5.6 ± 1.7;TREM-1 mRNA (A value):0.43 ± 0.18,0.39 ± 0.16 vs.0.65 ±0.25,all P ＜ 0.05].Conclusion DEX can down-regulate the expression of TREM-1 mRNA and inhibit the formation and secretion of inflammatory factors TNF-α,IL-1,IL-6 and CRP in peripheral blood mononuclear cells of rats with ASOC.

Background and purpose:This study aimed to estimate the spike-effect of domestic nanometer activated carbon on the radical operation for early stage low-lying rectal cancer. Methods:From Jan. 2013 to Dec. 2015, 66 patients with early stage low-lying rectal cancer were randomly divided into two groups:study group and control group. The patients of study group were treated with injection of carbon nanoparticles suspension in tumor vicinity before the operation. This study compared the total number of lymph node, the scale percentage of micro lymph node between two groups. SLNs of study group were obtained for pathological examination. Results:The differences in the total number of lymph node and the scale percentage of micro lymph node between two groups were statistically signiifcant (P<0.05). The diagnostic sensitivity and false-negative rate were 90.9%and 3.8%, respectively. Conclusion:Local injection of nanometer activated carbon around the tumor is important to the metastasis lymph node resection, especially to SLN biopsy in the radical operation for rectal cancer.

OBJECTIVETo investigate the effect of parenteral nutrition support with a lipid emulsion formulation (containing soybean oil, medium chain triglycerides, olive oil, and fish oil [SMOF]) in intensive care patients following major gastrointestinal surgeries.

METHODSAccording to a randomized, prospective and case-controlled design, 72 intensive care patients following major gastrointestinal surgeries between January and December, 2014 were randomized equally into SMOF group and control group to receive parenteral nutrition support with SMOF and medium or long chain lipid emulsion, respectively. Before and at 4 and 9 days after commencement of parenteral nutrition support, the patients were examined for alanine aminotransferase (ALT), total bilirubin (TBIL), albumin (propagated), C-reactive protein (CRP), interleukin 6 (IL-6), and endotoxin levels. The patients' average length of stay in intensive care unit (ICU), the days of using antibiotics, and the incidence rate of postoperative complication were recorded.

RESULTSOn day 4 postoperatively, the levels of CRP and IL-6 were significantly lower in SMOF group than in the control group (t=2.669 and 2.676, respectively; P<0.05), and on day 9, the patients in SMOF group showed significantly lower levels of ALT, TBIL, CRP and IL-6 (t=2.487, 3.497, 3.762, 2.180, respectively; P<0.05) than the control group, but ALB and endotoxin levels remained comparable between the two groups. The average length of stay in ICU and the days of using antibiotics were significantly shorter in SMOF group than in the control group (t=2.94 and 2.17, respectively; P<0.05); SMOF group showed a lower incidence of postoperative infections than the control group, but the difference was not statistically significant (χ² =1.047, P>0.05).

CONCLUSIONFor intensive care patients following major gastrointestinal surgeries, postoperative parenteral nutrition support with SMOF can effectively reduce the release of inflammatory mediators, protect important visceral functions, reduce postoperative complications, shorten the length of ICU stay, and improve the prognosis of the patients.

Alanine Transaminase ; blood ; Bilirubin ; blood ; C-Reactive Protein ; chemistry ; Critical Care ; Digestive System Surgical Procedures ; Fat Emulsions, Intravenous ; therapeutic use ; Fish Oils ; Humans ; Interleukin-6 ; blood ; Olive Oil ; Parenteral Nutrition ; Plant Oils ; Prospective Studies ; Soybean Oil ; Triglycerides