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Cholelithiasis is a common and frequent disease of the digestive system, and its incidence rate tends to increase with the improvement of living standards. Patients suffering from both gallbladder stones and common bile duct stones account for 5%-15%. Choledocholithiasis can cause a series of serious complications such as acute cholangitis and biliary pancreatitis. Choledocholithotomy is the main method for the treatment of choledocholithiasis, but there is still a high recurrence rate after surgery. The recurrence of choledocholithiasis seriously affects the life of patients and increases their economic burden. With reference to the latest published clinical studies, this article summarizes the influencing factors for the recurrence of choledocholithiasis from the aspects of anatomical factors, stone-related factors, biliary factors, and surgical factors, so as to provide a reference for the treatment of choledocholithiasis and the prevention of its recurrence.
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ObjectiveTo investigate the effect of Qingre Lidan granules in preventing the recurrence of choledocholithiasis after laparoscopy combined with choledochoscopy through a retrospective cohort study. MethodsA total of 337 inpatients with choledocholithiasis （including those with cholecystolithiasis at the same time） who underwent laparoscopy combined with choledochoscopic lithotomy in The First Affiliated Hospital of Dalian Medical University from January 1， 2010 to December 31， 2020 were enrolled， and related clinical data were collected. According to the follow－up results， the patients were divided into exposure group （conventional treatment+Qingre Lidan granules） with 225 patients and non－exposure group （conventional treatment） with 112 patients. The recurrence of choledocholithiasis and the administration of Qingre Lidan granules were recorded in detail for both groups. The recurrence rate of choledocholithiasis and the time to recurrence were observed for both groups， and the risk factors for the recurrence of choledocholithiasis were analyzed. The independent－samples t test was used for comparison of normally distributed continuous data between two groups， and the Mann－Whitney U test was used for comparison of non－normally distributed continuous data between two groups； the chi－square test or the Fisher’s exact test was used for comparison of categorical data between two groups. The Kaplan－Meier curve was used to estimate the cumulative probability of choledocholithiasis recurrence in the two groups， and the Log－rank test was used for comparison between two groups. ResultsA total of 26 patients experienced the recurrence of choledocholithiasis after laparoscopy combined with choledochoscopy， with 12 patients （5.33%） in the exposure group and 14 （12.5%） in the non－exposure group， and the exposure group had a significantly lower recurrence rate than the non－exposure group （χ2=5.394， P=0.020）. The exposure group had a significantly longer mean time to the recurrence of choledocholithiasis than the non－exposure group （40.1±26.7 months vs 19.2±13.5 months， t=2.383， P=0.017）. The Kaplan－Meier curve analysis showed that the non－exposure group had a significantly higher cumulative recurrence rate than the exposure group in different periods of time （P<0.05）. The multivariate logistic regression analysis showed that common bile duct diameter ≥14 mm （odds ratio 〔OR〕=2.935， P=0.031） and multiple calculi （OR=2.911， P=0.029） were independent risk factors for the recurrence of choledocholithiasis after laparoscopy combined with choledochoscopic lithotomy. ConclusionQingre Lidan granules can effectively reduce the recurrence rate of choledocholithiasis and prolong the time to the recurrence of choledocholithiasis after laparoscopy combined with choledochoscopy and has a certain clinical effect in preventing the recurrence of choledocholithiasis after surgery.
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Objective:To summarize the clinical characteristics of patients with coronavirus disease 2019 (COVID-19) infected with Delta variant, so as to provide further references for clinical diagnosis and treatment.Methods:A real-world study was conducted to analyze the characteristics of 166 COVID-19 patients infected with Delta variant at Guangzhou Eighth People’s Hospital, Guangzhou Medical University.Results:The study enrolled 5 asymptomatic cases, 123 non-severe cases (mild and moderate type), and 38 severe cases (severe and critical type). Among these patients, 69 (41.6%) were male and 97 (58.4%) were female, with a mean age of 47.0±23.5 years. Thirty-nine cases (23.5%) had received 1 or 2 doses of inactivated vaccine. The incidence of severe COVID-19 cases was 7.7% in 2-doses vaccinated patients, which was lower than that of 11.5% in 1-dose and 26.8% in unvaccinated patients. The proportion of severe cases in 2 dose-vaccinated patients was 7.7%, which was lower than that of 11.5% in 1-dose vaccinated patients and 26.8% in unvaccinated patients, but the difference was not significant ( P>0.05). The most common clinical symptom was fever (134 cases, 83.2%), and 39.1% of cases presented with high-grade fever (≥39 °C); other symptoms were cough, sputum, fatigue, and xerostomia. The proportion of fever in severe cases was significantly higher than that of non-severe cases (97.4% vs. 76.4%, P<0.01). Similarly, the proportion of severe cases with high peak temperature (≥39 ℃) () was also higher than that of non-severe cases (65.8% vs. 30.9%, P<0.01). The median minimal Cycle threshold (Ct) values of viral nucleic acid N gene and ORFlab gene were 20.3 and 21.5, respectively, and the minimum Ct values were 11.9 and 13.5, respectively. Within 48 h of admission, 9.0% of cases presented with decreased white blood cell counts, and 52.4% with decreased lymphocyte counts. The proportions of increased C-reactive protein, serum amyloid A, interleukin 6, and interleukin 10 were 32.5%, 57.4%, 65.3%, and 35.7%, respectively. The proportions of elevated C-reactive protein, serum amyloid A and interleukin-6 in severe cases were significantly higher than those in non-severe cases ( P<0.01). Logistic regression analysis showed that older age and higher peak temperature were associated with a higher likelihood of severe cases ( OR>3, 95% CI: 2-7, P<0.01). In terms of treatment, traditional Chinese medicine (TCM) was used in 97.6% of non-severe cases and 100% in severe cases. Other treatments included respiratory and nutritional support, immunotherapy (such as neutralizing antibodies and plasma of recovered patients). The median times from admission to progression to severe cases, of fever clearance, and of nucleic acid conversion were 5 days, 6 days and 19 days, respectively. No deaths were reported within 28 days. Conclusions:The symptoms of Delta variant infection in Guangzhou are characterized by a high proportion of fever, high peak temperature, long duration of fever, high viral load, a long time to nucleic acid conversion, and a high incidence of severe cases. The severe cases exhibit a higher percentage of elderly patients, a longer duration of fever and have a higher fever rate and a higher hyperthermia rate than non-severe cases. Age and hyperthermia are independent risk factors for progression to severe disease. The combination of TCM and Western medicine can control the progression of the disease effectively.
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Objective To investigate the application value of CT perfusion (CTP) imaging for the revascularization treatment in adult patients with Moyamoya disease.Methods Adult patients with Moyamoya disease underwent revascularization in the Department of Neurosurgery,Wuhan No.1 Hospital from July 2009 to December 2016 were analyzed retrospectively.CTP and clinical evaluation were performed before and after 3-6 months of procedure.The modified Rankin Scale (mRS) was used to assess the functional outcomes.Results A total of 20 patients were enrolled in the study,including 9 females and 11 males,aged 29 to 73 years,with an average of 53.5 years.The initial symptom was ischemic stroke in 10 patients,transient isehemic attack in 7 patients,and hemorrhagic stroke in 3 patients.All patients underwent superficial temporal artery-middle cerebral artery bypass grafting plus encephalomyo-synangiosis under general anesthesia.All patients have different degrees of improvement in cerebral blood flow after procedure,and the CTP parameters were significantly improved compared with those before procedure (all P ＜0.05).The clinical symptoms were significantly improved in 3 cases (15％) and recovered in 13 cases (65％) at 6 months after procedure.The proportion of the mRS score 0-2 was significantly higher than that before procedure (90.0％ [18/20] 对 50.0％ [10/20];x2 =7.619,P =0.006).Conclusion CTP can evaluate the cerebral perfusion status in various vascular areas through hemodynamic parameters in early stage,which can effectively guide the operation mode of Moyamoya disease,and evaluate the changes of cerebral perfusion status after procedure as a means of follow-up of the disease.
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Objective To observe the effects of Suhuang Zhike capsules(SZC) on the guinea pig model of cough variant asthma(CVA), and to explore its therapeutic mechanism. Methods Fifty guinea pigs were randomly divided into normal control group, model group, prednisone acetate tablets group, and high-and low-dose SZC groups. With reference to the related literatures, we set up the guinea pig model of CVA. The observation indexes included cough frequency, lung histopathology, the percentage of eosinophils in bronchoalveolar lavage fluid (BALF), and the serum levels of interleukin 4(IL-4), interferon gamma(IFN-γ), tumor necrosis factor alpha (TNF-α), and immunoglobumin E(IgE). Results Compared with the normal control group, the cough frequency of the model group was significantly increased(P<0.05); compared with the model group, the cough frequency of high-dose SZC group was reduced obviously(P < 0.05). Compared with the normal control group , the percentage of eosinophils in BALF of the model group was significantly increased(P < 0.05); the percentage of eosinophils of the three medication groups was lower than that of the model group (P<0.05). The pathological changes of lung tissue in the medication groups were relieved compared to the model group. Compared with the normal control group, the serum IL-4, TN F-α and IgE levels of the model group were increased significantly (P < 0 . 05); compared with the model group , the serum IL-4 and TN F-α levels of prednisone acetate tablets group were significantly decreased, and the serum TNF-α and IgE levels of high-dose SZC group were decreased significantly (P < 0.05). Conclusion SZC could reduce the serum, TNF-α and IgE levels , and relieve the cough symptom, airway inflammation and the lung tissue pathology in CVA guinea pig, so as to achieve the therapeutic effect on CVA.
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Objective Parainfluenza virus is an important pathogen of lower respiratory tract infections in infants and young children.This study was to search for a method for rapid culture and identification of human parainfluenza viruses from nasal swabs. Methods Nasal swab specimens were collected from 0-5 years old children with acute respiratory tract infection.The specimens were inoculated onto 96 plates with prefabricated LLC-MK2 cells and then centrifuged for 1 hour at 3000 r/min and also inoculated using the traditional culture method, followed by addition of virus mainte-nance medium containing 4 μg/mL TPCK trypsin.The cytopathic effect was observed daily, and hemagglutination and blood absorption tests were done at 2, 5, and 8 days after inoculation.In case of posi-tive result of either test, the specimen was subjected to immunofluo-rescence staining. Results Six strains of parainfluenza virus were isolated from the 83 nasal swab specimens, with a positive rate of 7.2%.There was a significant difference in the rate of separation be-tween the rapid and traditional culture methods after 2 days of culturing (7.2%vs 0%, P<0.05).The infected cells produced a cy-topathic effect that characterized by syncytium and crush formation.Hemagglutination and blood adsorption tests were positive at 4℃and negative at the room temperature.Immunofluorescence staining exhibited specific apple green fluorescence. Conclusion The method for rapid culture and identification of human parainfluenza viruses in nasal swab specimens was successfully established, which can be used to obtain and identify parainfluenza viruses with virulence and biological activity in 2 days.
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Objective To explore the expression and clinical significance of microRNA-7 (miR-7) in serum of ovarian cancer patients.Methods Serum samples of 42 ovarian patients confirmed by pathological histology and 40 healthy women who underwent a physical exam were collected from January 2011 to January 2012 in the Sixth People's Hospital of Foshan Nanhai District of Guangdong Province.Expression levels of miR-7 in the serum samples of the two groups were examined using reverse transcription-real time polymerase chain reaction (RT-PCR).The relationship between the expression of miR-7 and the clinicopathologic feature of ovarian was analyzed.Results Compared with the controls,the expression of miR-7 in the serum of ovarian cancer patients was significantly reduced (0.246 ± 0.017 vs.0.488 ± 0.042),with a significant difference (t =11.23,P =0.01).The expression of miR-7 in the serum of ovarian cancer patients was related to the clinical stage (t =10.12,P =0.01),pathological type (t =6.90,P =0.02),differentiation degree (t =4.46,P =0.03),regional lymph node or distant metastasis (t =5.62,P =0.02),but it was not related to the age (t =0.03,P =0.83).The patients with high miR-7 expression had better overall survival than the patients with low miR-7 expression (36.7 months vs.24.3 months),with a significant difference (x2 =6.04,P =0.02).Conclusion The expression of miR-7 in serum of ovarian cancer patients is down regulated,which may be helpful for the overall assessment of ovarian carcinoma.miR-7 may be one of the important prognostic indicators for ovarian carcinoma.
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Objective To explore the effect of duraphat varnish on reducing orthodontic tooth enamel demineralization around brackets.Methods We Selected 30 patients aged 12 to 14 years old in orthodontic Departrnent of Shenyang Stomatological Hospital from Jan 2011 to Dec 2013 and carried out rectification scheme to pull out the first premolar after test.The full mouth dental were divided into four parts by the quadrant and the first premolars of different groups were coated with Tooth Mousse,Fluor Protector and saline (as control group),duraphat varnish (as experimental group) respectively.Every group included 30 teeth.Three months later,We observed the demineralization of the teeth.The enamel decalcification of all quarters were detected by DI-AGNOdent.Results The rate of enamel demineralization in the experimental group was 10.0％,that in the Tooth Mousse group was 13.3％,the 0.1％ Fluor Protector group 23.3％,the saline group 53.3％.There were significant statistical difference of the rate of enamel demineralization between the Duraphat varnish group and 0.1％ Fluor Protector group,and that between the Duraphat varnish group and the saline group (P ＜ 0.01).There was no statistical difference of that between the Duraphat varnish group and the Tooth Mousse group (P ＞0.05).There were no statistical difference of DIAGNOdent reading between the experimental group and the control groups before bonding(P ＞ 0.05).After bonding,one month later and three months later,there was no statistical difference of DIAGNOdent reading between the Duraphat varnish group and the Tooth Mousse group (P ＞ 0.05).There was significant statistical difference of that between the Duraphat varnish group and 0.1％ Fluor Protector group(P ＜ 0.01).Conclusion Duraphat varnish can reduce the tooth enamel demineralization more effectively than 0.1％ Fluor Protector and saline in orthodontic treatment,and also can be used for children who were wearing fixed orthodontic appliances.
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Objective To investigate nasomaxlllary complex facial soft tissue changes after the treatment with maxillary protraction appliance with skeletal Class Ⅲ malocclusion with a retruded maxilla.Methods Thirty growing subjects with skeletal Class Ⅲ malocclusions with maxillary retrognathism were selected and treated by facial mask(male 15,female 15,with an average age of 10.5).They were given a maxillary protraction treatment with face mask for 6-8 months.Cephalometric measurements about nasomaxillary complex soft tissue changes were analyzed to draw the statistic conclusion.Results After maxillary protraction treatment,PraY,nasofrontal angle,As-Y,UL-Y,UL-E,S-Ns-Sn increased (P ＜ 0.01) ; M-Y increased (P ＜ 0.05) ; LL-E,PosY,nasolabial angle decreased (P ＜ 0.05).There were no significant differences in the Ns-Y and columella-tip angle.Conclusion After maxillary protraction treatment,nasomaxillary complex area becomes more marked.Both the nasomaxillary complex soft tissue and lower facial profile are dramatically improved.The combining effect of these two changes results in a more harmony profile.
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This study was aimed to observe the effect of Tao-He Cheng-Qi Decoction (THCQD) on tissue injury of different organs among rats with sepsis. A total of 100 Kunming male SD rats of clean grade were randomly divided into five groups, which were the normal control group, model 6 h control group, model 12 h control group, THCQD 6 h group and THCQD 12 h group. The normal control group received no treatment. The classic CLP method was ap-plied in the establishment of sepsis rat model in other groups. Intragastric administration of saline 1 ml/100 g (weight) was given to each rat in the model group every day. Intragastric administration of THCQD 1 ml/100 g (weight) was given to each rat in the THCQD group every day. The model was established after 7 days. Tissue speci-mens of lung, heart, kidney, liver, and small intestine were collected at 6 h and 12 h after modeling, respectively. Pathomorphological changes of each group were observed by light microscopy and electron microscope. The results showed that compared with the model group at the same time point, pathomorphological changes of tissues of the lung, heart, kidney in THCQD group were not significant. However, pathomorphology of tissues of the liver and small intestine changed significantly in the THCQD 12h group. And there were statistical differences (P < 0.05) between two groups in the score of pathomorphology. It was concluded that THCQD had protective effect on tissues of the liv-er and small intestine among rats with sepsis. However, the mechanism is not clear and requires further research.
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Objective To explore the value of glypican-3(GPC-3)mRNA and paternally expressed 10(PEG10)mRNA in peripheral blood in diagnosis of metastasis in hepatocellular carcinoma(HCC). Methods With SYBR Green I as fluorescence signal,real-time fluorescent quantitative reverse transcription-polymerase chain reaction was employed to detect the expression of GPC-3 mRNA and PEG10 mRNA in peripheral blood from patients with HCC with metastasis(n=8),HCC without metastasis(n=12)and hepatic cirrhosis(n=11),and receiver operator characteristics curve(ROC)and specific parameters were adopted to analyse their value in predictive and exclusive diagnosis. Results The expression of GPC-3 mRNA and PEG10 mRNA in HCC with metastasis was significantly higher than that in HCC without metastasis and in hepatic cirrhosis(P<0.05),while there was no significant difference in the expression of GPC-3 mRNA and PEG10 mRNA between HCC without metastasis and hepatic cirrhosis.In single test,the sensitivities in the differential diagnosis between HCC with metastasis and HCC without metastasis were 66.7%for GPC-3 mRNA and 72.2%for PEG10 mRNA,and the specificities were 91.7%and 91.7%.respectively.The areas under ROC were 0.748 for GPC-3 mRNA and 0.812 for PEG10 mRNA.With two markers in parallel test,the sensitivity,specificity,negative likelihood and diagnostic accuracy were 90.7%,84.O%,0.11 and 83.3%,respectively.In serial test,the sensitivity,specificity,positive likelihood and diagnostic accuracy were 60.5%,98.7%,45.5 and 73.3%,respectively. Conclusion Detection of GPC-3 mRNA and PEG10 mRNA in peripheral blood may help to predict blood metastasis and extrahepatic metastasis of HCC,and PEG10 mRNA works better than GPC-3 mRNA.The serial test of GPC-3 mRNA and PEG10 mRNA is helpful to the predictive diagnosis of peripheral blood metastasis of HCC.
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Objective To evaluate the application of high-throughput shell vial assay in a clinical laboratory for detection of respiratory viruses from patients with ILI in Guangzhou between January and June, 2009. Methods Six hundred and fifty-two pharyngeal swab specimens were taken from ILI patents. Centrifugation-enhanced shell vials including 4 cell lines (MDCK, Hep-2, LLC-MK2 and MRC-5) were used for culture of respiratory viruses for 2-3 days. The cultures were identified by observation of cytopathic effect (CPE) , hemmaglution or hemmadsorption test as well as immunofluorescence staining. Results A total of 161 swab samples (24.69% ,161/652) were shown to have any one of the 5 common respiratory viruses including influenza A viruses ( 38. 51% , 62/161 ), influenza B virus ( 54. 65% , 88/161 ), parainfluenza viruses (4. 96% , 8/161 ) , adenovirus ( 1. 24% , 2/161 ), and respiratory syncytial virus (0. 62% ,1/161). The turnaround time was 2d for influenza viruses, 3d for adenovirus and parainfluenza viruses respectively. Conclusions (1) The shell vial method was effective, rapid and high throughout for the detection of respiratory viruses in clinical laboratories.(2)Influenza viruses were dominant in the swab samples from patients with ILI in Guangzhou between January and June with the highest appearance in the summer influenza B vires was the most common pathogen in patients with ILI in this study.
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OBJECTIVE: To screen and analyze items of the second-generation sub-health questionnaire through various item analysis methods, so as to provide basic data for the further study of sub-health measuring scale. METHODS: The investigation and analysis was completed in Southem Medical University between November 2006 and May 2008. A total of 6 000 college students were selected as the investigation targets with cluster sampling method from a medical university in Guangzhou. 6 000 questionnaires were assigned to them in which the answerer was asked about their somatic symptoms, psychological symptoms and social symptoms, with 5 599 valid ones obtained. Eighty three items were analyzed through five methods based on dispersion, correlation coefficient, factor analysis, t-test and Cronbach's g. RESULTS: At last, 63 items were selected to constitute the item pool of the sub-health scale, which were nominated over 4 times according to the nomination summary of the 5 methods.CONCLUSION: All the 63 items kept in the second-generation sub-health questionnaire feature satisfactory sensibility, representation, independence, significance and intemal consistency, which can accordingly lay a good foundation for the further study of the sub-health measuring scale.
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Objective To establish the normal parameters of psychometric measures such as the number connection tests A(NCT-A)and digit symbol tests(DST)in assessment of minimal hepatic en- cephalopathy(MHE).Methods One hundred and sixty healthy volunteers(aged 25 to 64 years;educa- tional level＞9 years)were divided into＜35 ys,35～44 ys,45～54 ys and 55～64 ys groups.All of the healthy volunteers were assessed with NCT-A and DST to establish the normal value of age-related parameters,which can be used for diagnosis of MHE in patients with liver cirrhosis.Two standard devi- ation of the normal mean was used as a diagnostic criterion for MHE.One hundred and six cirrhotic patients were assessed with these parameters.Results The parameters of NCT-A were(25.1?4.6) sec in＜35 ys group,(32.1?6.8) sec in 35～44 ys group,(38.6?7.1)sec in 45～54 ys group or (49.3?6.3)sec in 55～64 ys group.The scores of DST were 49.9?4.7 in＜35 ys group,44.6?4.8 in 35～44 ys group,38.5?5.0 in 45～54 ys group or 35.4?4.7 in 55～64 ys group.Thirty one out of 106 cirrhotic patients were diagnosed as MHE based on these parameters.Conclusion The NCT- A and DST are psychometric assessments for diagnosis of MHE.Age-based normal paramerters of NCT- A and DST are needed to be established.
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Objective To study the inhibitory effect of oxymatrine on hepatitis B virus(HBV) in vitro. Methods Microparticle enzyme immunoassay, bDNA signal amplification assay was used for determining secrected HBsAg/HBeAg in the culture medium, HBV DNA from core particles in the cytoplasm and MTT colorimetric assay was used to assay the oxymatrine cytotoxity. Results The inhibitory rates of HBsAg and HBeAg were 40.57% and 48.27% by oxymatrine at the concentration of 2 000 ?g/ml. At 100～2 000 ?g/ml, it can remarkably decrease the level of viral core associated HBV DNA in the cytoplasm. No significant toxicity was shown in such concentrations. Conclusion Oxymatrine has a potential anti HBV activity in vitro.
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Objective To investigate the expression of CD14, the receptor of lipopolysaccharide (LPS) on Kupffer cell membrane during the course of CCl4-induced liver injury and its role in activation of Kupffer cells. Methods The experimental rats were hypodermically administered CCl4 twice weekly for up to 8 weeks. Kupffer cells were isolated from the liver of normal and CCl4-treated rats by the combined ‘collagenase-pronase’ perfusion method and discontinuous density gradient centrifugation. On the following day after isolation, the cells were incubated with RPMI-1640 containing various doses of LPS for 6 h. The tumor necrosis factor (TNF-?) in the supernatants was measured by ELISA. The expression of CD14 mRNA on Kupffer cells was determined by RT-PCR. The plasma levels of endotoxin were determined by chromogenic substrate limulus amebocyte lysate assay. Results Baseline TNF-? production of Kupffer cells isolated from CCl4-treated rats in 4 and 6 weeks was significantly higher than that of controls (P