Congenital bronchobiliary fistula: A case report and review of the literature

BACKGROUND Congenital bronchobiliary fistula is a rare developmental abnormality with an abnormal fistula between the respiratory system and biliary tract. The aim of this report is to analyze and summarize the clinical features and experience of diagnosing and treating congenital bronchobiliary fistula(CBBF) occurring in the neonatal period.CASE SUMMARY The onset of symptoms was 3 d after birth in our patient with progressive cyanosis and respiratory distress, and a large amount of green fluid was noticed in her respiratory secretion. We performed computed tomography(CT),fiberoptic bronchoscopy, and cholangiography to make a diagnosis, as well as fistulography with a bronchoscope for the first time. These examinations provided us with valuable images to make a correct diagnosis. The fistula was dissected and removed with excellent results. Surgical removal of the fistula was successful, and the baby recovered well and was discharged. She has been followed for 4 mo without any signs of discomfort.CONCLUSION The main symptom of CBBF is bile-like sputum. CT, bronchoscopy,fistulography, and intraoperative cholangiography can provide important evidence for diagnosis. Surgical resection of the fistula is the first choice of treatment.

Simulation of inclined dendrites under natural convection by KKS phase field model based on CUDA

In this work,Al-4.5wt.%Cu was selected as the research object,and a phase field-lattice Boltzmann method(PF-LBM)model based on compute unified device architecture(CUDA)was established to solve the problem of low serial computing efficiency of a traditional CPU and achieve significant acceleration.This model was used to explore the evolution of dendrite growth under natural convection.Through the study of the tip velocities,it is found that the growth of the dendrite arms at the bottom is inhibited while the growth of the dendrite arms at the top is promoted by natural convection.In addition,research on the inclined dendrite under natural convection was conducted.It is observed that there is a deviation between the actual growth direction and the preferred angle of the inclined dendrite.With the increase of the preferred angle of the seed,the difference between the actual growth direction and the initial preferred angle of the inclined dendrite shows a trend of increasing at first and then decreasing.In the simulation area,the relative deflection directions of the primary dendrite arms in the top right corner and the bottom left corner of the same dendrite are almost counterclockwise,while the relative deflection directions of the other two primary dendrite arms are clockwise.

Discordance analysis for apolipoprotein and lipid measures for predicting myocardial infarction in statin-treated patients with coronary artery disease:a cohort study

BACKGROUND The optimal apolipoprotein or lipid measures for identifying statin-treated patients with coronary artery disease(CAD)at residual cardiovascular risk remain controversial.This study aimed to compare the predictive powers of apolipoprotein B(apoB),non-high-density lipoprotein cholesterol(non-HDL-C),low-density lipoprotein cholesterol(LDL-C),apoB/apolipoprotein A-1(apoA-1)and non-HDL-C/HDL-C for myocardial infarction(MI)in CAD patients treated with statins in the setting of secondary prevention.METHODS The study included 9191 statin-treated CAD patients with a five-year median follow-up.All measures were anal-yzed as continuous variables and concordance/discordance groups by medians.The hazard ratio(HR)with 95%CI was estimated by Cox proportional hazards regression.Patients were classified by the clinical presentation of CAD for further analysis.RESULTS The high-apoB-low-LDL-C and the high-non-HDL-C-low-LDL-C categories yielded HR of 1.40(95%CI:1.04–1.88)and 1.51(95%CI:1.07–2.13)for MI,respectively,whereas discordant high LDL-C with low apoB or non-HDL-C was not associa-ted with the risk of MI.No association of MI with discordant apoB versus non-HDL-C,apoB/apoA-1 versus apoB,non-HDL-C/HDL-C versus non-HDL-C,or apoB/apoA-1 versus non-HDL-C/HDL-C was observed.Similar patterns were found in patients with acute coronary syndrome.In contrast,no association was observed between any concordance/discordance category and the risk of MI in patients with chronic coronary syndrome.CONCLUSIONS ApoB and non-HDL-C better predict MI in statin-treated CAD patients than LDL-C,especially in patients with acute coronary syndrome.ApoB/apoA-1 and non-HDL-C/HDL-C show no superiority to apoB and non-HDL-C for predict-ing MI.

灸法用于癌症治疗的选穴规律分析

Objective:To summarize the rules of acupoint selection in treatment of cancer with moxibustion by analyzing the articles of relevant clinical trials in recent years in China,so as to provide the references for acupoint selection of moxibustion for cancer.Methods:The articles of clinical trials for treatment of cancer with moxibustion were retrieved from China National knowledge Infrastructure(CNKI),VIP Chinese Journal Service Platform(VIP)and Wanfang Data Knowledge Service Platform(Wanfang)from 1st January 2015 to 30th June 2021.Using EpiData software,the data were extracted and exported in Excel.The analysis was performed with IBM SPSS Statistics 23 software.Results:A total of 516 articles were collected,including 533 prescriptions with 164 acupoints involved.The high-frequency acupoints were similar among 7 types of cancers and these acupoints mostly acted on supporting the antipathogenic qi,replenishing qi and regulating the spleen and stomach.Regarding meridian tropism,the acupoints from the conception vessel,the governor vessel and bladder meridian were dominant in treatment of cancer with moxibustion.In terms of location distribution,the selected acupoints were generally distributed on the chest,abdomen,lumbar region and the upper back of the body.Based on cancer related symtomes in different systems,the use frequency of Zusanli(ST36)was the highest for the symptoms of the immune,digestive,circulatory and motor systems;that of Feishu(BL13)was the highest for the respiratory system symptoms and that of Guanyuan(CV4)was the highest for the urinary system symptoms.The cluster analysis of high-frequency acupoints showed that the acupoints of moxibustion for cancer generally work on cultivating yang,supporting the antipathogenic qi,strengthening the spleen and harmonizing the stomach,and were selected in association with the clinical symptoms of different cancers.

Effects of different courses of moxibustion treatment on intestinal flora and inflammation of a rat model of knee osteoarthritis

Objective:This study was done to determine the effects of different courses of moxibustion on a rat knee osteoarthritis(KOA)model,and explore the dose–effect relationship of moxibustion on KOA from the perspectives of intestinal flora and inflammatory factors.Methods:Wistar rats were randomly divided into five groups:normal,model,moxibustion for 2 weeks,moxibustion for 4 weeks and moxibustion for 6 weeks groups(n=5 each group).A KOA rat model was induced by monosodium iodoacetate,and moxibustion intervention was performed at the acupoints“Dubi”(ST35)and“Zusanli”(ST36),once every other day.Pathologic changes in the cartilage of rat knee joints were assessed after intervention,and fecal samples were subjected to 16 S r RNA high-throughput sequencing for microbial diversity analysis.Results:Damage to the knee articular cartilage was obvious in the model group,which also had increased levels of pro-inflammatory factors,decreased levels of anti-inflammatory factors,and intestinal flora disorders with decreased diversity.The degree of cartilage damage in the 4 and 6 weeks of moxibustion groups was significantly improved compared with the model group.The 4 and 6 weeks of moxibustion groups also demonstrated reduced levels of interleukin-1βand tumor necrosis factor-a and increased levels of interleukin-10(P<0.05).Both the abundance and diversity of the intestinal flora were increased,approaching those of the normal group.Abundances of probiotics Eubacterium coprostanoligenes group and Ruminococcaceae UCG-014 increased,while that of the pathogenic bacteria Lachnospiraceae NK4 A136 group decreased(P<0.05).Although the abundance of Lachnospiraceae NK4 A136 group decreased in the 2 weeks of moxibustion group compared with the model group(P<0.05),there was no statistically significant difference in serum inflammatory factors,flora species diversity or degree of pathological damage compared with the model group.Conclusion:Moxibustion treatment led to significant improvements in the intestinal flora and inflammatory factors of rats with KOA.Moxibustion treatment of 4 and 6 weeks led to better outcomes than the 2-week course.Moxibustion for 4 and 6 weeks can regulate intestinal flora dysfunction with increased probiotics and reduced pathogenic bacteria,reduce pro-inflammatory factors and increase antiinflammatory factors.No significant differences were seen between the effects of moxibustion for 4 weeks and 6 weeks.