Objective To evaluate the efficacy and safety of early endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic sphincterotomy (EST) in patients of acute biliary pancreatitis (ABP).Methods Databases including PubMed,EMBASE,Cochrane library,CBM,CNKI,WanFang data and VIP data were searched with " Endoscopic retrograde cholangiopancreatography" "Endoscopic sphincterotomy" "ERCP" "Pancreatitis" "Biliary pancreatitis" resection up to September 2017.Randomized controlled trails (RCTs) conternming the comparison of ERCP with EST versus conservative management in ABP patients were enrolled in the study.Two reviewers independently screened literature,extracted data,and assess the risk of bias of the included studies.The Meta-analysis was conducted by RevMan 5.3 software.Results A total of 10 RCTs involving 1 752 cases were included in the Metaanalysis.The results of Meta-analysis showed that compared with the control group,early ERCP with EST reduced the systemic complication rate of ABP (RR =0.66;95％ CI:0.47-0.93;P ＜ 0.05).However,there were no significant differences in overall mortality,local complication rate,and ERCP related complication rate in ABP between early and selected ERCP with EST treat (P ＞ 0.05).Subgroup analyses indicated that early ERCP with EST therapy reduced the mortality of severe acute biliary pancreatitis (SABP),ABP with biliary obstruction and within 24 hours of admission (RR =0.48,0.35,0.25;95％ CI:0.24-0.96,0.17-0.74,0.09-0.73;P ＜ 0.05);decreased the local and systemic complication rate of SABP,ABP with biliary obstruction (RR =0.56,0.54,0.51,0.51;95％ CI:0.37-0.86,0.33-0.91,0.32-0.81,0.32-0.80;P ＜ 0.05);reduced the local and systemic complication rate of SABP (RR =0.42,0.47;95％ CI:0.25-0.70,0.25-0.87;P ＜0.05) and shortened the hospital stay of SABP (MD =-11.22 d;95％ CI:-16.09--6.36;P ＜ 0.01).However,there were no significant differences of overall complication rate in ABP without biliary obstruction and hospital stay in MABP.Conclusion Early ERCP with EST therapy appears to be safe and effective for ABP patients.

Objective To investigate the relationship between the marrow edema and general clinical index,quadriceps muscle area,and the meniscus grade of knee osteoarthritis(OA).Methods 72 patients were collected with knee OA in our hospital, underwent X-ray and routine MRI examination of knee, and the same X-ray and MRI were reviewed at 12 months later in different time point.The K-L grading, bone marrow edema score, meniscal grading and VAS score of each knee joint were evaluated.The t-test and Rank-sum test were used to compare the two groups of general data, Spearman was used to perform bivariate correlation analysis.Results The age and VAS score of bone marrow edema group at the initial follow-up were significantly lower than those without edema group(P<0.05),the degree of marrow edema was moderately correlated with age and VAS score, and was not significantly correlated with other indexes.12 months later, BMI and the area of quadriceps femoris in the group with marrow edema were different from those in the group without bone marrow edema(P<0.05), the degree of marrow edema was moderately correlated with age, quadriceps area and VAS.Conclusion The range of marrow edema was related to age, quadriceps area, BMI index and VAS score in MRI.The MRI measurement could reflect the progression of knee OA more than that of X-ray.It also revealed some factors related to the progression of knee OA.

Objective To investigate the role of monocyte subsets in the pathogenesis of type 2 diabetes mellitus(T2DM), the expression was detected on lipoprotein-associated phospholipase A2(LP-PLA2) mRNA in peripheral blood monocytes subsets of type 2 diabetic patients. Methods After the peripheral blood of 32 type 2 diabetic patients and 22 healthy controls were collected,the percentages of the monocytes subsets were detected by flow cytometry. The expression of LP-PLA2 mRNA in monocytes subsets were detected by PCR. After monocyte subsets of healthy subjects were induced into macrophages and stimulated by the serum of type 2 diabetic patients for 24h,LP-PLA2 mRNA expression was detected. Results Compared with the control group, the percentage of classical monocytes in T2DM group was decreased, while the LP-PLA2 mRNA expression and percentage of nonclassical,intermediate monocytes were significantly increased(all P<0.05). In addition,the homeostasis model assessment for insulin resistance index was positively correlated with LP-PLA2 mRNA expression in non-classical(P<0.05)and intermediate monocytes(P<0.01)of type 2 diabetic patients. Compared with type 2 diabetic patients without carotid atherosclerosis, the levels of LP-PLA2 mRNA in intermediate and nonclassical monocytes were significantly higher than those in type 2 diabetic patients with carotid atherosclerosis(P<0.05). The level of LP-PLA2 mRNA in non-classical monocytes-derived macrophages stimulated with the serum of type 2 diabetic patients was significantly higher than that in the control group(P<0.05). Conclusion Monocytes subsets from type 2 diabetic patients are abnormally skewed toward to intermediate and non-classical monocytes with high expression of LP-PLA2 mRNA,which may play an important role in the pathogenesis of type 2 diabetes mellitus and atherosclerosis.

Objective To investigate serum alpha2-Heremans-Schmid glycoprotein ( AHSG ) level and its relationship with associated clinical parameters in subjects with simple overweight and obesity. Methods Forty-nine subjects with obesity ( OB group) , 176 subjects with overweight ( OW group) , and 327 individuals with normal weight ( NW group) were randomly enrolled. The clinical data were collected and serum levels of AHSG and adiponectin ( APN) were determined by ELISA. The associations of serum AHSG level with other clinical parameters were assessed by Pearson correlation analysis and multiple linear regressive model. Results Serum AHSG levels were higher in OW and OB groups than that in NW group[(276. 30 and 302. 10 vs 241. 60)μg/ml], being especially higher in OB group (P<0. 05 or P<0. 01). Serum AHSG level in NW group was positively associated with fasting plasma glucose, homoeostasis model assessment of insulin resistance index, C-reactive protein (CRP), triglycerides, and free fatty acids ( FFA ) , but negatively associated with age and APN. In OW and OB groups, AHSG was also positively associated with body mass index, waist hip ratio(WHR), and low density lipoprotein cholesterol(P<0. 05 or P<0. 01) except the aforementioned clinical parameters. In multiple linear regression model, AHSG was positively associated with WHR, CRP, and FFA, and was negatively associated with APN ( P<0. 05 or P<0. 01). Conclusion The raised AHSG level in overweight and obese subjects may be a risk factor for obesity-related diseases.

Objective To investigate the characteristics of hepatitis C viurs (HCV)infection and its genotypes in Yancheng area . Methods A total of 20 185 cases of subjects receiving healthy examination were collected ,and fasting blood levels of serum anti‐HCV were detected .Clinical data of patients with HCV infection were statistically analysed .HCV genotypes and levels of HCV RNA were detected ,and their clinical prognosis was judged by type‐B ultrasonic .Results The total infection rate of HCV was 1 .22% .The infection rate of male was higher than that of female and the infection rate was increased with the elevation of age .The genotype 1b was accounted for 73 .17% .The results of type‐B ultrasonic shown that all patients infected with genotype 6 and 1b/2a HCV only had liver damage .80 .77% of patients infected with genotype 2a HCV had liver damage ,which was higher than that of patients infected with 16 and 3a+3b genotypes .Conclusion Most of HCV infected patients are male ,and the infection rate might be increased with the elevation of age .The prognosis is in various different genotypes of HCV ,which indicates that the prognosis could be evaluated by genotyping .

The association between serum fetuin A and diabetic nephropathy (DN) in patients with type 2 diabetes mellitus(T2DM) was investigated.Serum levels of fetuin-A and adiponectin were measured by ELISA and the clinical data were collected in 101 T2DM patients with normal albuminuria (NA group),87 patients with microalbuminuria (MA group),44 patients with overt albuminuria (OA group),and 130 normal control subjects (NC group).Fetuin-A levels increased progressively from NC,NA,MA,to OA groups,and there were significant differences among groups(P＜0.05 or P＜0.01).Fetuin-A level in patients was positively associated with duration of illness,urinary albumin to creatinine ratio (ACR),fasting blood glucose,2-hour postprandial blood glucose,and C-reactive protein(CRP,P＜0.05 or P＜0.01),but was negatively associated with age and adiponectin (all P＜ 0.01).Multiple stepwise regression analysis indicated that duration of diabetes,fetuin-A,CRP,and adiponectin were independent determinants for ACR (all P ＜ 0.01).Fetuin-A may be involved in the development and pathogenesis of DN by proinflammatory effects and repressing adiponectin production.

Objective To sum up the techniques of radiofrequency ablation assisted laparoscopic liver resection .Methods A ret-rospective analysis was done based on the clinical data of 16 patients undergone radiofrequency ablation assisted laparoscopic liver resection from July 1 ,2011 to July 30 ,2012 .Results Sixteen patients were all received successful total laparoscopic liver resection . Anatomical liver resection was carried out on 5 patients including 2 left hemihepatectomy ,2 left lateral segmentectomy ,1 right pos-terior lobectomy ,and 11 patients underwent nonanatomical hepatectomy .None was transected under regional hepatic blood inflow occlusion .The mean operation time was 125 minutes(range 35-335 minutes) ,mean blood loss 310 mL(range 20~1 100 mL) ,and mean hospital stay 9 days(range 5 to 16 days) .No operation death and postoperative complications occurred .The patients were fol-lowed up for 2 to 12 months ,1 recurrence was found in patients with Ⅶ segment hepatocellular carcinoma 60 day after operation . Conclusion The application of radiofrequency ablation assisted laparoscopic liver resection can effectively control the resection mar-gin hepatic blood inflow to ensure the success of operation and reduction of complications .

Objective:To study the effect of OSAHS on adult nasal-cycle.Method:The nasal cycle of 20 healthy adults,18 patients of snoring and 22 patients of OSAHS were examined with acoustic rhinometry,which was performed every 30 minutes in 7 hours.Result:The ratio of nasal cycle in healthy adults was(19/20,95.0%), in snoring patients was(15/18,83.0%),in patients of OSAHS was(15/22,68.2%). The mean alteration amplitude of nasal cycle in healthy adults was significantly larger than that in patients with OSAHS (P<0.05).The distribution of the healthy adults and patients with OSAHS between the typical cycle categories was significantly different(P<0.05).Conclusion:The characteristics of nasal-cycle in of OSAHS patients were different with healthy adults,which maybe owing to change of physical function of nasal cavity.

OBJECTIVE: To study the effect of OSAHS on adult nasal-cycle. METHOD: The nasal cycle of 20 healthy adults, 18 patients of snoring and 22 patients of OSAHS were examined with acoustic rhinometry, which was performed every 30 minutes in 7 hours. RESULT: The ratio of nasal cycle in healthy adults was (19/20, 95.0%), in snoring patients was (15/18, 83.0%), in patients of OSAHS was (15/22, 68.2%). The mean alteration amplitude of nasal cycle in healthy adults was significantly larger than that in patients with OSAHS (P < 0.05). The distribution of the healthy adults and patients with OSAHS between the typical cycle categories was significantly different (P < 0.05). CONCLUSION The characteristics of nasal-cycle in of OSAHS patients were different with healthy adults, which maybe owing to change of physical function of basal cavity.
Adult ; Aged ; Case-Control Studies ; Female ; Humans ; Male ; Middle Aged ; Nasal Cavity ; physiopathology ; Nose ; physiopathology ; Rhinometry, Acoustic ; Sleep Apnea, Obstructive ; physiopathology ; Snoring ; physiopathology

OBJECTIVE: To investigate the anatomical structures of cranial nerves in the cerebellopontine angle region to offer anatomical data for clinical operation. METHOD: A total of 52 adult cadaveric heads fixed in 10% formalin were used for this study. After cutting cerebellum and meningeal between transverse and sigmoid sinus, simulate operating method of retrosigmoid approach to observe the cranial nerves. RESULT: External diameter and length of left V, VII, VIII, IX cranial nerves are (2.54 +/- 0.84) mm and (6.79 +/- 2.51) mm, (1.18 +/- 0.31) mm and (9.89 +/- 2.66) mm, (2.17 +/- 0.52) mm and (9.92 +/- 2.61) mm, (0.77 +/- 0.24) mm and (10.34 +/- 3.12) mm respectively. External diameter and length of right V , VII, VIII, IX cranial nerves are (2.52 +/- 0.86) mm and (6.91 +/- 2.66) mm, (1.14 +/- 0.31) mm and (10 +/- 2.96) mm, (2.13 +/- 0.63) m and (10.09 +/- 2.93) mm, (0.790.29) mm and (10.17 +/- 3.06) mm. intermedius nerve locate between facial nerve and acoustic nerve, external diameter of intermedius nerve is (0.47 +/- 0.91) mm (left) and (0.37 +/- 0.07) mm (right). Length of vagal nerve is (10.44 +/- 2.57) mm (left), (9.91 +/- 2.91) mm (right), rootlets of f vagal nerve is 6.37 +/- 2.26 (left) and 6.33 +/- 2.38 (right). external diameter of accessory nerve is (0.76 +/- 0.16) mm (left) and (0.81 +/- 0.19) mm (right). CONCLUSION This study provide anatomical data for retrosigmoid approach in the cerebellopontine angle region.
Adult ; Cerebellopontine Angle ; anatomy & histology ; Cranial Nerves ; anatomy & histology ; Cranial Sinuses ; anatomy & histology ; surgery ; Facial Nerve ; anatomy & histology ; Glossopharyngeal Nerve ; anatomy & histology ; Humans ; Vestibulocochlear Nerve ; anatomy & histology