Purpose To explore the clinicopathological features of cholangitis lenta.Methods The clinical data of 12 patients with cholangitis Lenta were collected,HE staining,his-tochemical staining and immunohistochemistry were used to de-tect the clinicopathological changes in 12 cases of cholangitis lenta,and the relevant literature was reviewed.Results All the 12 patients with cholangitis Lenta had acute history and ab-normal liver function,9 cases(75.0％)had abnormal white blood cell count,11 cases(91.7％)had abdominal infection,8 cases(66.7％)had systemic inflammatory response syndrome(SIRS)and 8 cases(66.7％)were diagnosed as sepsis.The common pathological manifestations included spotty necrosis(100％),piecemeal necrosis(100％),confluent necrosis(75.0％),bridging necrosis(66.7％),hepatocyte and capil-lary cholestasis(75.0％),and mild edema in portal area(33.3％).12 cases showed proliferation of bile ductules around the portal area,inspissated bile in dilated bile ductules and no cholestasis in interlobular bile ducts.12 cases had the basis of primary liver disease.2 patients(16.7％)died after being transferred to another hospital for treatment,and 10 patients(83.3％)survived,which lasted for 7 to 55 months.Conclu-sion Cholangitis Lenta shows unique clinical manifestations and morphological features,it is often accompanied by underly-ing diseases.The pathological manifestation of cholangitis Lenta in liver biopsy suggests that patients may have sepsis and/or ab-dominal infection,and therefore its diagnosis should be com-bined with clinical features,laboratory examination and imaging manifestations.

OBJE CTIVE To explore the rational application and management of antibiotics in burn department of our hospital based on disease diagnosis related groups （DRGs）. METHODS Patients discharged from the burn department of our hospital from July 2020 to June 2021 were selected as the research objects to collect DRG data. The overall application of antibiotics in DRG group with more than 10 cases were analyzed ，and the application of antibiotics in typical disease groups were evaluated horizontally and vertically. RESULTS Among 3 732 discharged cases in the burn department of our hospital ，a total of 3 515 cases were included in 66 DRG groups ，21 DRG groups of which were included in the study. Among 21 DRG groups ，the maximum antibiotics use density （AUD）of antibiotics was 102.20 DDDs/（100 person·d）in AH 11 group，the utilization ratio of antibiotics was 100％，and the combined use rate of antibiotics was 81.82％；case-mix index （CMI）value was 11.49. The minimum AUD was 1.01 DDDs/（100 person·d）in XR 19 group，the utilization ratio of antibiotics was 5.06％，and the combined use rate of antibiotics was 0；CMI value was 0.81. Within the same core group ，AUD increased with the increase of CMI. The horizontal comparison and analysis of WB 11 group showed that there was a large gap in AUD among different physicians. The vertical comparison of AUD in WB11 group showed relatively small changes over time. CONCLUSIONS The horizontal and vertical evaluation of antibiotics based on DRGs can provide new clues for the control of antibiotics and help to realize the fine specialized management of antibiotics.

OBJECTIVE: To assess the application value of mapping allele with resolved carrier status (MaReCs) technique for preimplantation genetic testing (PGT). METHODS: The characteristics of MaReCs for PGT and outcome of patients were retrospectively analyzed. RESULTS: Compared with those who could not use the technique, carriers who have used the MaReCs technique were younger, had significantly higher level of anti-Mullerian hormone, more antral follicles, occytes, mature occytes, biopsied embryos and euploid embryos, and lower risks for de novo chromosomal abnormality (P<0.05). It was necessary for couples with fewer oocytes, mature oocytes and balstocyst to preserve discarded embryos to facilitate the test. Carriers who have used the MaReCs technique had higher clinical pregnancy rate and abortion rate compared with those undergoing routine PGT, albeit no significant difference was found between the two groups (P> 0.05). Carriers undergoing MaReCs test could preferentially select embryos with normal chromosome structures for the transfer. CONCLUSION Application of MaReCs has a prerequisite for having a minimum number of occytes and biopsied embryos and using discarded embryos sometimes. MaReCs is efficient for the detection of carrier status of embryos and attaining higher rate of pregnancy and live birth, which can significantly improve the outcome for couples carrying chromosomal translocations.
Alleles ; Aneuploidy ; Blastocyst ; Female ; Fertilization in Vitro ; Genetic Testing ; Humans ; Pregnancy ; Preimplantation Diagnosis ; Retrospective Studies ; Translocation, Genetic

Objective: To study the immune regulation function of high expressing interleukin-10 (IL-10) in B cells on CD4⁺T-cells in periodontitis mouse model. Methods: Twenty-four 7-weeks-old female C57BL/6 mice were randomly and equally assigned into 4 groups: the healthy control group (HC group, n=6), the ligation combined Porphyromonasgingivalis (Pg) infection group (P group, n=6), the ligation combined Pg infection with non-stimulated B cell transfer group (P+NSB group, n=6) and the ligation combined Pg infection with stimulated B cell transfer group (P+SB group, n=6). Ligation combined Pg infection of the maxillary second molar was used to induce periodontitis of mice. The exogenous non-stimulated B cells or stimulated B cells were injected into the palate gingivalat the 5th day after ligation, and all mice were sacrificed at the 14th day. HE stain was used to detect the histological of periodontal tissues, toluidine blue stain was used to analysis the alveolar bone loss, immunofluorescence stain was used to detect the expression of CD4⁺T-cell and IL-10, immunohistochemical was used to detect the expression of receptor activator of NF-κB ligand (RANKL) and IL-1β. Results: Results of HE staining showed that more hyperplasia of gingival epithelium and the alveolar bone resorption in P group, P+NSB group and P+SB group compared with HC group. Results of toluidine blue staining showed that the alveolar bone losses in P group [(0.668±0.041) mm²], P+NSB group [(0.750±0.039) mm²] and P+SB group [(0.517±0.038) mm²] were significantly increased compared with that in HC group [(0.336±0.029) mm²](F=146.051, P<0.01), and the alveolar bone resorption was significantly increased in P+NSB group compared with that in P group (F=146.051, P<0.01). However, compared with P+NSB group and P group, the alveolar bone loss in P+SB groupwas significantly decreased (F=146.051, P<0.01). Results of immunofluorescence staining showed that CD4⁺T-cells expressed in P group [(287.5±37.9) cell/mm²], P+NSB group [(314.6±53.3) cell/mm²] and P+SB group [(185.4±42.9) cell/mm²] were higher than that in HC group [(12.5±13.7) cell/mm²)(F=71.284, P<0.01). Compared with P group and P+NSB group, CD4⁺T-cells expression in group P+SB was decreased (F=71.284, P<0.01). IL-10 levels were increased in P group [(111.7±20.4) cell/mm²], P+NSB group [(126.7±15.1) cell/mm²] and P+SB group [(191.0±22.6) cell/mm²] compared with that in HC group [(22.7±4.3) cell/mm²] (F=98.516, P<0.01), and the IL-10 expressed in P+SB group was significantly higher than those in P+NSB group and P group. Results of immunohistochemical tests showed that RANKL expressions in gingival tissues among P group [(674.0±71.5) cell/mm²], P+NSB group [(831.0±97.5) cell/mm²] and P+SB group [(420.1±40.8) cell/mm²] were significantly higher than that in HC group [(69.3±29.1) cell/mm²] (F=154.886, P<0.01). However, it dramatically decreased in P+SB group compared with those in P group and P+NSB group.The IL-1βexpression in P group [(447.8±40.8) cell/mm²], P+NSB group [(512.5±38.2) cell/mm²] and P+SB group [(281.6±32.4) cell/mm²] were significantly higher than that in HC group [(50.8±20.9) cell/mm²], and it also higher in P+NSB group compared with in P group. However, it decreased in P+SB group compared with those in P group and P+NSB group (F=221.185, P<0.01). Conclusions High expression IL-10 in B cell smight inhibit alveolar bone loss, RANKL and IL-1β expressions and CD4⁺T-cell infiltration through IL-10.

OBJECTIVE: To explore the effect of chromosomal translocations on the composition of embryonic chromosomes and its mechanism. METHODS: For 52 couples with one partner carrying a chromosomal translocation, results of next generation sequencing of all embryos derived from 61 cycles were divided into different groups based on the type of translocations, gender of the carrier, and maternal age. Effect of parental chromosomal translocations on the composition of embryonic chromosomes of each group was analyzed. RESULTS: A significant difference was found between carriers of reciprocal and Robertsonian translocations in terms of proportion of abnormal embryos and structurally normal chromosomes (63.3% vs. 27.5%, and 1.1% vs. 0.3%, respectively). Compared with male carriers, there was an increase in the rate of abnormalities for female carriers (67.2% vs. 58.3% for reciprocal translocations, and 45.5% vs. 13.8% for Robertsonian translocations). The risk for chromosomal abnormality also increased with the maternal age. No significant difference was found in the proportion of abnormal embryos between carriers divided by involvement of acrocentric chromosomes or terminal chromosomal breakpoints. CONCLUSION The types of parental translocation, gender of carrier, maternal age, and interchromosomal effect have certain effect on the composition of embryonic chromosomes.
Chromosomes, Human ; genetics ; Female ; Genetic Carrier Screening ; Humans ; In Situ Hybridization, Fluorescence ; Male ; Maternal Age ; Pregnancy ; Preimplantation Diagnosis ; Translocation, Genetic

Objective To investigate the effect of small dose methoxamine on parturient′s circulation stability and neonate during anesthesia of cesarean section .Methods Two hundreds and eighty-five cases of cesarean section under combined spinal epi-dural anesthesia in the hospital from January 2014 to June 2016 were selected and divided into 3 groups .The group A was intrave-nously injected by 1 mg of methoxamine hydrochloride instantly after anesthesia ,the group B by 2 mg ,while the group C was intra-venously injected by 2 mL of normal saline .The basic values at calmness after entering the operation room (T0 ) ,systolic blood pres-sure (SBP) and heart rate(HR) at horizontal position immediately after anesthesia(T1 ) ,at 1 min(T2 ) ,5 min(T3 ) after anesthesia , at 1 min(T4 ) before fetus delivery and at 5 min after fetus delivery (T5 ) were recorded ,and neonatal umbilical arterial blood pH value ,blood gas indicators and Apgar score at 1 min after delivery were also recorded .The parturient appearing the adverse reac-tions such as nausea and vomiting during operation were observed .Results HR at T2 in the group B and C was significantly in-creased ,then decreased significantly (P<0 .05) ,while which at T1 in the group A began to decrease and HR at the various time points of T2 -T4 were significantly lower than those in the group B and C ,moreover had no big fluctuation (P<0 .05);SBP at T2 in 3 groups was significantly decreased compared with that at T0 (P<0 .05) ,but SBP at the various time points of T2 -T4 in the group A were significantly higher than those in the group B and C (P<0 .05);umbilical vein blood pH ,blood gas indexes and Ap-gar score at 1 min after birth had no statistically significant differences between the group A and B (P>0 .05) ,but which in the group C were significantly lower than those in the group A and B (P<0 .05);the adverse reaction rate in the group A was 2 .11% , which was significantly lower than 9 .47% in the group B and 13 .68% in the group C (P<0 .05) .Conclusion Small dose of me-thoxamine can effectively maintain the parturient′s hemodynamic stability after combined spinal epidural anesthesia in cesarean sec-tion and has no adverse effect on neonate .

Objective To investigate the epidemiological characteristics of traumatic cervical spinal cord injury (TCSCI) in ICU.Method The data of patients with TCSCI admitted from October 2010 to March 2016 in the intensive care unit were retrospectively studied.The general epidemiological data included:gender,age,marital status,occupation,cause of injury,injury severity,injured segment (ASIA grade),and complications were collected.Results There were 109 patients identified to have TCSCI with mean age of 53.72 ± 14.86 years (25.69％ patients in the range of 60-69 years old).The male to female ratio was 9:1,and the most were married.The majority of individuals were retired (30.27％),and the main causes of injury were traffic accidents and tumble.The C5 segment of the spine was the most vulnerable to be injured,and then the C4 segment was the nest in turn.There were up to 30.28％ patients suffered from multiple injuries,and 26.61％ patients also had a craniocerebral injury.Bedsore and respiratory system complications were the two leading complications,and 83 patients suffered from at least one system dysfunction with respiratory dysfunction accounted for 98.79％ and circulatory dysfunction accounted for 65.06％.Fifty-one patients presented more than two system dysfunctions (46.79％).Twenty patients (18.35％) died.Conclusion Patients with TCSCI in ICU presented specially characteristic features.Traffic accidents were the main cause of TCSCI,and fall accidents were one of the main causes in the elderly.The mortality of TCSCI was high,especially in males.The complication rate was relatively high and the most common complications were water and electrolyte disturbance and respiratory dysfunction.Multiple organ dysfunction incidences might be associated with the ASIA grades.

Pulmonary embolism (PE) refers to the endogenous or exogenous emboli blocking pulmonary trunk or branches, causing clinical and pathophysiological syndrome of pulmonary circulation disorder, the incidence rate is high. Sometimes PE patients were lack of specific symptoms and signs, or without any symptoms, which often result in misdiagnosis, un-timely diagnosis, and the delay of treatment. A PE case with syncope, vomiting and shock, which was proved to be pulmonary artery trunk and branch wide embolism later, was presented so as to improve the understanding of the disease.

Objective To evaluate combined sampling at multiple sites of gastric mucosa for Helicobacter pylori (HP) culture.Methods A total of 258 patients with upper gastrointestinal symptoms received 13C-urea breath test between August 2014 and May 2015.During endoscopy,gastric mucosa biopsy samples from the lesser curvature of the antrum (A),the greater curvature of the antrum (B),gastric angle (C) and the body of the stomach (D) were collected to isolate HP strains.The positive rates of HP based on combined sampling and single site sampling were compared with a Nemenyi test.Results Consistency between 13C-urea breath test and HP culture was 82.56％.There was significant difference between the single site sampling and two-site sampling in the positive rate of HP,except for the body of the stomach (P＜0.05).There was significant difference in the positive rate of HP between the single site sampling and three-site sampling (P ＜ 0.05).There was no significant difference between any two-site sampling in the lesser curvature of the antrum and the body of the stomach,gastric angle and the body of the stomach,the greater curvature of the antrum and the body of the stomach,and any three-site sampling (P＞0.05).Conclusion The combined sampling of the lesser curvature of the antrum and the body of the stomach have the highest cost-effectiveness in HP culture compared with the single site sampling and three-site sampling.

Objective To investigate the effects of ginkgo flavone on the expression of NF-κB and TLR4 in the liver of mice with nonalcoholic fatty liver disease (NAFLD). Methods 120 KM mice were randomly divided into the control group, model group, as well as high, medium and low dosage of ginkgo flavone groups. The animal model of NAFLD in mice was constructed with high fat diet. The pathological changes of liver, liver index , the serum TNF-α, IL-6 , TG , NF-κB and TLR4 in hepatic tissue was observed after 8 weeks of administration. Results Compared with the model group, the level of liver index, serum TG, TNF-α, IL-6 and the expression of NF-κBp65 in the ginkgo flavone groups dramatically decreased 8 weeks after the administration. And the hepatic steatosis was milder. There was no statistical differences in the expression of TLR4 between the ginkgo flavone groups and the control group (P > 0.05). Conclusions These results suggested the closely relationship between TLR4/NF-κB inflammatory pathway and NAFLD. Ginkgo flavone had the therapeutical effects on NAFLD by anti-inflammatory and lipid-lowering action, but no effect was observed on the expression of TLR4 in hepatic tissue.