Safety and efficacy of endoscopic retrograde cholangiopancreatography for common bile duct stones in liver cirrhotic patients.

In order to investigate the safety and efficacy of endoscopic retrograde cholangiopancreatograpy (ERCP) in liver cirrhosis patients with common bile duct stones, we retrospectively analyzed data of 46 common bile duct stones patients with liver cirrhosis who underwent ERCP between 2000 and 2008. There were 12 cases of Child-Pugh A, 26 cases of Child-Pugh B, and 8 cases of Child-Pugh C. 100 common bile duct stones patients without liver cirrhosis were randomly selected. All the patients were subjected to ERCP for biliary stones extraction. The rates of bile duct clearance and complications were compared between cirrhotic and non-cirrhotic patients. The success rate of selective biliary cannulation was 95.6% in liver cirrhotic patients versus 97% in non-cirrhotic patients (P>0.05). The bile duct clearance rate was 87% in cirrhotic patients versus 96% in non-cirrhotic patients, but the difference was not statistically significant. Two liver cirrhotic patients (4.35%, 2/46) who were scored Child-Pugh C had hematemesis and melena 24 h after ERCP. The hemorrhage rate after ERCP in non-cirrhotic patients was 3%. The hemorrhage rate associated with ERCP in Child-Pugh C patients was significantly higher (25%, 2/8) than that (3%, 3/100) in non-cirrhotic patients (P<0.01%). There was no significant difference between these two groups in the rate of post-ERCP pancreatitis (PEP) and cholangitis. ERCP is safe and effective for Child-Pugh A and B cirrhotic patients with common bile duct stones. Hemorrhage risk in ERCP is higher in Child-Pugh C patients.

A general strategy for recycling polyester wastes into carboxylic acids and hydrocarbons.

Chemical recycling of plastic wastes is of great significance for sustainable development, which also represents a largely untapped opportunity for the synthesis of value-added chemicals. Herein, we report a novel and general strategy to degrade polyesters via directly breaking the Calkoxy-O bond by nucleophilic substitution of halide anion of ionic liquids under mild conditions. Combined with hydrogenation over Pd/C, 1-butyl-2,3-dimethylimidazolium bromide can realize the deconstruction of various polyesters including aromatic and aliphatic ones, copolyesters and polyester mixtures into corresponding carboxylic acids and alkanes; meanwhile, tetrabutylphosphonium bromide can also achieve direct decomposition of the polyesters with ß-H into carboxylic acids and alkenes under hydrogen- and metal-free conditions. It is found that the hydrogen-bonding interaction between ionic liquid and ester group in polyester enhances the nucleophilicity of halide anion and activates the Calkoxy-O bond. The findings demonstrate how polyester wastes can be a viable feedstock for the production of carboxylic acids and hydrocarbons.

Short-term effects of exposure to ambient PM2.5 and its components on hospital admissions for threatened and spontaneous abortions: A multicity case-crossover study in China.

BACKGROUND: The adverse effects of short-term exposure to PM2.5 and its components on hospital admissions for threatened and spontaneous abortions (TSAB) are still controversial. METHODS: Data on daily hospitalizations for TSAB and PM2.5 and its components, including sulfate (SO42-), nitrate (NO3-), ammonium salt (NH4+), organic matter (OM), and black carbon (BC), were collected from January 2015 to December 2021 (total 2,557 days) in five cities in China. Case-crossover analyses were conducted to investigate the short-term associations between PM2.5 and its components and TSAB. Additionally, the modification effects by age (<35 and ≥35 years), season (cold and warm seasons), and the "Three-Year Action Plan to Win the Blue Sky Defense War" (before and after implementation) on the above associations were further conducted. RESULTS: For each 10 µg/m3 (1 µg/m3 for BC) increase, the strongest relative risks (95% confidence intervals) of hospitalization for TSAB were 1.011 (1.001-1.021) for PM2.5 in lag02, 1.060 (1.003-1.120) for SO42- in lag02, 1.035 (1.000-1.070) for NO3- in lag02, 1.065 (1.009-1.124) for NH4+ in lag02, 1.047 (1.008-1.088) for OM in lag01 and 1.029 (1.005-1.054) for BC in lag02 (all P <0.05). Furthermore, significant modifying effects of age and the Action Plan were found. The effects of NO3- (lag2), NH4+ (lag2), and BC (lag2) were more pronounced in mothers aged ≥35 years and the effects of PM2.5 (lag4), NO3- (lag4), NH4+ (lag4), OM (lag4), and BC (lag4) was more pronounced in the period before the Action Plan was implemented (all P modification <0.05). CONCLUSION: Short-term exposure to ambient PM2.5 and its components (SO42-, NO3-, NH4+, OM, and BC) was related to increased risks of hospitalization for TSAB. The effects were more pronounced in mothers aged ≥35 years and the period before the Action Plan.

Multiple regression analysis of perinatal conditions, physical development, and complications in assisted reproduction singletons.

BACKGROUND: There is no clear clinical conclusion on whether assisted reproductive technology (ART) increases maternal and child risk and affects infant birth and development. This study aimed to perform a multiple regression analysis of the perinatal maternal and infant conditions in an assisted reproductive singleton pregnancy and the physical development and complications of such infants at 6 months old. METHODS: This study enrolled 145 singleton pregnant women who were admitted to Luohe Central Hospital between December 2017 and December 2019 to undergo in vitro fertilization and embryo transfer as a research group, and 160 singleton pregnant women who were naturally conceived at the same time and delivered at our hospital were selected as the control group. The relevant data of the patients were collected, and the perinatal conditions, neonatal complications, physical development and NBN score of infants aged 6 months were compared between the two groups. Multivariate logistic regression was used to analyze risk factors for perinatal complications in assisted reproduction singleton pregnancy. RESULTS: The incidence of complications in the perinatal period in the study group was significantly higher than that in the control group (P<0.05). However, there was no significant difference in the incidence of complications such as very low birth weight, respiratory distress, neonatal hemolysis, hyperbilirubinemia, hypoglycemia, infectious pneumonia and neonatal asphyxia between the two groups (P>0.05). Likewise, at 6 months of age, the infants in the research group showed no significant difference to the control group in physical development indicators, including weight, head circumference, body mass index, height and NBN score (P>0.05). The analysis of the unconditional multivariate logistic regression model revealed hypertension during pregnancy, placental previa, premature membrane rupture, gestational age <32 weeks, and very low birth weight as risk factors that affect perinatal complications in patients with assisted reproductive singleton pregnancy (P<0.05). CONCLUSIONS: The incidence of complications in perinatal patients with assisted reproductive singleton pregnancy is higher than that of natural singleton pregnancy, but there is no significant difference in physical development, NBN score and complications of 6 months old infants.

Endoscopic diagnosis and treatment of biliary leak in patients following liver transplantation: a prospective clinical study.

BACKGROUND: Orthotopic liver transplantation has been widely used in patients with end-stage liver disease within the last two decades. However, the prevalence of biliary complications after liver transplantation remains high. The most common short-term biliary complication may be biliary leak. So, we examined 13 patients with biliary leak after liver transplantation, attempting to evaluate the role of endoscopic diagnosis and treatment of biliary leak and the incidence of bile duct stricture after healing of the leak. METHODS: Six cases of T-tube leak and seven cases of anastomosis leak complicating liver transplantation were enrolled in this prospective study. Six patients were treated by endoscopic plastic stent placement, two by nasobiliary catheter drainage, two by papillosphincterotomy, and three by nasobiliary catheter drainage combined with plastic stent placement. Some patients received growth hormone treatment. RESULTS: The bile leak resolution time was 10-35 days in 10 patients with complete documentation. The median time of leak resolution was 15.3 days. Four cases of anastomosis stricture, three cases of common hepatic duct and one case of multiple bile duct stenosis were detected by follow-up nasobiliary catheter cholangiography or endoscopic retrograde cholangiopancreatography. CONCLUSIONS: Endoscopic nasobiliary catheter or plastic stent placement is a safe and effective treatment for bile duct stricture occurring after bile leak resolution in most liver transplantation patients. Nasobiliary catheter combined with plastic stent placement may be the best choice for treating bile leak, because, theoretically, it may prevent the serious condition resulting from accidental nasobiliary catheter dislocation, and it may have prophylactic effects on upcoming bile duct stricture, although this should be further confirmed.

Clinical study on application of Chinese herbs during the perioperative period of laparoscopic cholecystectomy.

OBJECTIVE: To explore the effect of Chinese herbs during the perioperative period of laparoscopic cholecystectomy (LC). METHODS: Three hundred and sixty patients of chronic lithic cholecystitis (LCCT) were randomly assigned to two groups by lottery, 180 patients in each group. During the peri-operative period, the control group was treated with conventional Western medicine and placebo. The treated group was given the same conventional Western medicine and Chinese herbal decoctions, with Shitong mixture No. 1 added before LC, and Liujunzi decoction added after LC for three days. The operation time, body temperature after LC, white blood cell count, wind-breaking time after operation, as well as the changes of tongue coating in the first three post-operative days were recorded. RESULTS: There was no significant difference between the two groups in operation time (P>0.05), while the improvement in body temperature recovery, wind-breaking time and changes of tongue coating in the treated group were better than those in the control group (P<0.01). CONCLUSION: Applying Chinese herbs during perioperative period of LC could effectively benefit early recovery in such patients.

Optimized PEI-based Transfection Method for Transient Transfection and Lentiviral Production.

Polyethyleneimine (PEI), a cationic polymer vehicle, forms a complex with DNA which then can carry anionic nucleic acids into eukaryotic cells. PEI-based transfection is widely used for transient transfection of plasmid DNA. The efficiency of PEI-based transfection is affected by numerous factors, including the way the PEI/DNA complex is prepared, the ratio of PEI to DNA, the concentration of DNA, the storage conditions of PEI solutions, and more. Considering the major influencing factors, PEI-based transfection has been optimized to improve its efficiency, reproducibility, and consistency. This protocol outlines the steps for ordinary transient transfection and lentiviral production using PEI. © 2017 by John Wiley & Sons, Inc.