Objective:To evaluate the technical approach and application value of DynaCT biliary reconstruction with CT images fusion (DynaCT-CT fusion) for the treatment of complex hepatolithiasis.Methods:The data of 18 patients with complex hepatolithiasis admitted to the First Affiliated Hospital of Guangzhou Medical University from May 2022 to October 2022 were retrospectively analyzed, including 7 males and 11 females, aged (50.6±15.0) years. Preoperative DynaCT biliary reconstruction with CT images fusion was performed to guide the percutaneous transhepatic one-step biliary fistulation (PTOBF). The technical data, including the bile duct with stones identified by preoperative imaging, the actual bile duct with stones confirmed intraoperatively, the satisfied stone removal time for each targeted bile duct, the actual stone removal time for each targeted bile duct, the intraoperative identification of CT-negative stones, the postoperative complications and reoperation were analyzed.Results:In 18 patients, a total of 95 target bile ducts with stones were identified by preoperative DynaCT-CT fusion technology, involving the first, secondary and tertiary bile ducts. Preoperative CT identified 29 lesions of stones involving the first and secondary bile ducts. CT negative stones were confirmed in 5 patients by DynaCT-CT fusion. Bile duct stricture occurred in 12 patients. All procedures were completed without postoperative bile leakage or hemorrhage. A total of 82 lesions of stones were successfully removed with a removal time of (25.9±12.8) min. The satisfied stone removal time for each targeted bile duct was (10.1±7.6) min, and the actual stone removal time was (10.5±7.4) min. Immediate stone clearance was achieved in 13 patients. Biliary tract infection occurred in 2 patients, and 5 patients underwent reoperation for residual or recurrent stones.Conclusion:The DynaCT-CT fusion technology guided PTOBF is feasible and safe in patients with complex hepatolithiasis. It could effectively detect more stones, shorten the stone clearance time. DynaCT-CT fusion technology provides a new strategy for the treatment of hepatolithiasis.

Coronavirus disease 2019(COVID-19),which is caused by SARS-CoV-2,varies with regard to symptoms and mortality rates among populations.Humoral immunity plays critical roles in SARS-CoV-2 infection and recovery from COVID-19.However,differences in immune responses and clinical features among COVID-19 patients remain largely unknown.Here,we report a database for COVID-19-specific IgG/IgM immune responses and clinical parameters(named COVID-ONE-hi).COVID-ONE-hi is based on the data that contain the IgG/IgM responses to 24 full-length/truncated proteins corresponding to 20 of 28 known SARS-CoV-2 proteins and 199 spike protein peptides against 2360 serum samples collected from 783 COVID-19 patients.In addition,96 clinical parameters for the 2360 serum samples and basic information for the 783 patients are integrated into the database.Furthermore,COVID-ONE-hi provides a dashboard for defining samples and a one-click analysis pipeline for a single group or paired groups.A set of samples of interest is easily defined by adjusting the scale bars of a variety of parameters.After the"START"button is clicked,one can readily obtain a comprehensive analysis report for further interpretation.COVID-ONE-hi is freely available at www.COVID-ONE.cn.

Objective:To prepare PEG-SH modified GNPs/miR-29 nanoparticles and to investigate the proliferation and differentiation of neural stem cells induced by PEG-SH modified GNPs/miR-29 nanoparticles.Methods:PEG-SH modified GNPs/miR-29 nanoparticles were developed by oxidation-reduction method and were tested for UV absorption spectrum, particle size distribution and zeta potential of nanoparticles. A total of 15 adult male Sprague Dawley (SD) rats were used to establish spinal cord injury model by modified Allen method. The artificial miR-29 and PEG-SH modified GNPs/miR-29 nanoparticles were implanted into the injury site of spinal cord respectively. The stability of miR-29 expression was analyzed by gel electrophoresis. The neural stem cells were isolated and cultured from 10 SPF grade neonatal rats. It was identified by Nestin, GFAP and NSE antibodies. The activity and proliferation of neural stem cells in synthetic miR-29, PEG-SH GNPs and PEG-SH GNPs/miR-29 nanoparticles group was detected by CCK-8 assay. Neural stem cells were cultured with synthetic miR-29, PEG-SH GNPs and PEG-SH GNPs/miR-29 nanoparticles for 1 week. The density, length and number of neuritis were investigated.Results:The solution of PEG-SH modified GNPs showed a brownish red appearance. The spheres were in uniform distribution under transmission electron microscope. The results of UV absorption spectrum showed a single peak wave. The peak value of UV absorption was near 523 nm. The zeta potential increased gradually with the increased content of PEG-SH. The peak value of zeta potential was 22.5±5.2 mV. With the increase of content of PEG, the particle size of PEG-SH modified GNPs rapidly reached peak value at the early stage and then decreased rapidly to a relatively stable level. The synthetic miR-29 and PEG-SH modified GNPs/miR-29 nanoparticles were implanted into the injury site of spinal cord. At 0-6 h, clear band was observed in the synthetic miR-29 group. However, the band was disappeared rapidly at 12-24 h. In PEG-SH GNPs/miR-29 group, clear band were always observed. The OD values of miR-29 group were 0.34±0.17, 0.78±0.31, 1.28±0.68, 1.64±0.38 at 1, 3, 5 and 7 d after inoculation respectively. There was no significant difference in OD values compared with DMEM group. There was no significant difference in OD values among GNPs, PEG-SH GNPs, PEG-SH GNPs/miR-29 and DMEM group. The density (56.38±3.65 μm 2), length (78.25±3.72 μm) and the number [(356±34.52) /1,000×high power field] of neurites in PEG-SH GNPs/miR-29 group were higher than those in miR-29 group, PEG-SH modified GNPs group and saline group. However, there was no significant difference in the density, length and number of neurite between PEG-SH GNPs/miR-29 and serum group. Conclusion:PEG-SH modified GNPs/miR-29 nanoparticless have good biological properties. It can induce the proliferation and differentiation of neural stem cells with protective effects on miR-29.

Objective To construct a model of Graves'disease ( GD ) with ( or ) Graves'ophthalmopathy ( GO) in BALB/c mice by immunization with pcDNA3. 1/TSHR289. Methods pcDNA3. 1/TSHR289 was injected into the bilateral gastrocnemius muscle of 35 model mice and electroporation was immediately performed. 10 control mice were injected with sterile saline and electroporated, while 5 blank mice were injected with sterile saline only. Each group of mice was immunized at 1, 4, 7, and 10 weeks, respectively. Serum total T4 , TSH, TSAb, and TSBAb were measured before immunization, 2 weeks after each immunization, as well as 5 and 8 weeks after the last immunization. CT scan was used to evaluate the morphological changes of the eyes of the mice.99m TcO4- imaging was used to measure the thyroid uptake function, and the pathological changes of the thyroid and orbital tissues were evaluated by HE staining. Results After the 2nd time immunization, the serum concentrations of TT4 , TSAb and TSBAb in GD mice were significantly higher than those of control and blank groups( F=13.781, 31.435, 36.112, P<0.01, respectively).The TSH continued to be significantly lower than that of control and blank groups(F=13.966, P<0.01) . After the 4th time immunizations, the ability of uptaking99m TcO4- in GD mice thyroid was significantly enhanced compared with the control group. The thyroid goiter with a large amount of lymphocyte infiltration, and the thyroid follicle was thin. CT scan of GO mice showed thickening and swelling of the extraocular muscles, and no abnormalities in tendon and muscle attachment points. HE staining showed thickening of extraocular muscle fibers, lymphocyte infiltration of extraocular muscles and orbital tissue, increased hyaluronic acid, and infiltration of fat cells. Conclusion GD or GO model can be successfully induced by multiple intramuscular injection of pcDNA3.1/TSHR289 in BALB/c mice.

Objective Comparison of induction time on the proliferation of induced adipose-derived stem cells (ADSC) to differentiate into Schwann-like cells (iSC).Methods From March,2017 to October,2018,ADSCs were isolated from inguinal adipose tissue of healthy adult female SD rats.Flow cytometry was performed to detect ADSC positive markers CD29,CD90 and negative marker CD45.iSC induction medium was used to culture ADSC.S-100 and GFAP were detected by immunofluorescence staining to confirm that ADSC had differentiated into iSC.Morphological changes of cells were observed by inverted microscope on day 1st,4th,7th,10th,13rd,16th and 19th after induction.MTS assay was used to evaluate cell proliferation ability.Tunel staining was applied to assess cell apoptosis.Results Both S100 and GFAP were expressed in iSC.On day 7th,the cell proliferation rate was significantly slower than that before induction (A value was 0.330±0.020 vs.0.400±0.004,P＜0.05).It was negatively correlated with induction time.On day 19th,the proliferation rate of iSC was lower than 50％ of the proliferation rate before induction (A value was 0.016±0.003 vs.0.400±0.004,P＜0.05).Apoptosis of iSC was more obvious than ADSC at the same time point.Conclusion The proliferation ability of ADSC-induced iSC is optimal within 7 days after induction.

OBJECTIVE:To observe the clinical efficacy and safety of Xiaozhen zhiyang spray in the treatment of EGFRI-asso-ciated rash. METHODS:A total of 60 malignant tumor patients suffering from rash induced by EGFRI were divided into trial group (40 cases)and control group(20 cases)according to the patient's willingness. Control group didn't received any therapy for rash. Trial group received Xiaozhen zhiyang spray for several times a day according to the degree of rash as 1-2 times/d for first degree, 2-3 times/d for second degree,3-5 times/d for third degree,and the treatment course lasted for 2 weeks. Rash degree and improve-ment,itching degree and improvement,daily life quality index(DLQI)score before and after treatment as well as the occurrence of ADR were compared between 2 groups. RESULTS:before treatment,there was no statistical significance in rash and itching de-gree,or DLQI score between 2 groups(P>0.05). After treatment,rash and itching degree of trial group were improved significant-ly compared to before treatment and control group,with statistical significance(P<0.05). The total response rates of rash and itch-ing therapy in trial group were significantly higher than control group(67.50% vs. 20.00%,70.00% vs. 15.00%),with statistical significance(P<0.05). DLQI score of trial group was significantly lower than before treatment and control group,with statistical significance(P<0.05). There was no statistical significance in DLQI score of control group before and after treatment(P>0.05). No obvious ADR was found in trial group. CONCLUSIONS:Xiaozhen zhiyang spray can effectively relieve EGFRI-associated rash and itching as well as improve the quality of life for patients.

Objective To evaluate the safety and short‐term efficacy of delta‐shaped anastomosis in the Billroth‐I reconstruc‐tion of totally laparoscopic distal gastric cancer radical operation (TLDG) .Methods The clinical data in 35 patients with TLDG Delta anastomosis(TLDG group) and 35 patients with laparoscopic assisted distal gastric cancer radical operation (LADG) extraper‐itoneal anastomosis (LADG group) in the gastroenterology department of our hospital from January to December 2014 were ana‐lyzed retrospectively .The intraoperative bleeding volume ,operative time ,gastroenterological function recovery time ,hospitalization duration ,postoperative pathological examination results and hospitalization total cost were compared between the two groups .Re‐sults Seventy cases successfully completed the operation without the cases of conversion to laparotomy and death .The TLDG group had no anastomotic leakage ,bleeding and stenosis after operation ;while the LADG group had 1 case of gastroparesis ,1 case of anastomotic bleeding and 2 cases of anastomotic leakage .The introperative bleeding volume ,tumor size ,number of lymph nodes dissection and distant and proximal incisal margin distance had no statistically significant differences between the two groups (P>0 .05);the operation time ,digestive tract reconstruction time ,first exhaustion time ,time taking liquid diet and postoperative hospital stay time in the TLDG group were significantly shorter than those in LADG group (P< 0 .05) ,but the hospitalization cost was higher than that in the LADG group ,the differences were statistically significant (P<0 .05) .Conclusion The delta‐shaped anasto‐mosis technique is safe and feasible for using in LADG ,moreover has better short‐term effect .

BACKGROUND:Currently, discectomy, fusion or decompression is considered an effective and conventional method for the treatment of spinal disease. Although there have been many reports on the adverse effects of diabetes on spinal surgery, but there are stil some differences. OBJECTIVE:To systematical y evaluate the observational studies and case-control studies about the effect of diabetes on the complications of spinal surgery. METHODS:The control ed and comparative studies regarding the effect of diabetes on the results and complications of spinal surgery were searched from the database according to the inclusion criteria. The observed indicators including mortality, revision rate, surgical site infection, the incidence of venous thrombosis, blood loss, operative time and hospitalization time. Two authors participated in extracting the data and evaluating the methodology and quality of the included studies. Meta-analysis was conducted according to the guidelines of epidemiological observational studies (MOOSE). The risk assessment of the extracted data was conducted using RevMan 5.2 software. RESULTS AND CONCLUSION:Eighteen literatures, involving 2 824 063 patients, were eventual y enrol ed. The experimental result showed that the mortality, surgical site infection, incidence of venous thrombosis of diabetic patients after the spinal surgery were significantly higher than those of non-diabetic patients;the hospital stay was significantly longer than that of non-diabetic patients (P<0.05). There were no significant differences in the risk of revision, intraoperative blood loss and operation time between diabetic patients and non-diabetic patients (P>0.05). These results suggest that diabetic patients take a higher risk once accepting the spinal surgery than the non-diabetic patients. Diabetes increases the risks of postoperative mortality, surgical site infection, venous thrombosis and hospitalization time after spinal surgery.