Improvement of inflammatory response and gastrointestinal function in perioperative of cholelithiasis by Modified Xiao-Cheng-Qi decoction

BACKGROUND In the perioperative period of biliary surgery,various factors can induce the release of a large number of inflammatory factors,leading to an imbalance in proinflammatory and anti-inflammatory responses and resulting in gastrointestinal(GI)dysfunction.Enhanced Recovery After Surgery protocols in biliary surgery have been shown to reduce the stress response and accelerate postoperative recovery.It is crucial to reduce the inflammatory response and promote the recovery of GI function after biliary surgery,both of which are the basis and key for perioperative care and postoperative recovery.AIM To better understand the effects of Modified Xiao-Cheng-Qi decoction(MXD)on inflammatory response and GI function in the perioperative management of cholelithiasis and their correlation.METHODS This was a prospective randomized placebo-controlled trial,in which 162 patients who received biliary tract surgery were randomly assigned to three groups:MXD group,XD group,and placebo-control group.The observed parameters included frequency of bowel sounds,time of first flatus and defecation,time of diet,and amount of activity after surgery.The serum levels of C-reactive protein(CRP),interleukin(IL)-6,IL-10,serum amyloid A protein(SAA),and substance P were measured by the enzyme-linked immunosorbent assay.Then,the spearman correlation coefficient was used to analyze the relationship between the indicators of GI function and inflammation.RESULTS Compared to the placebo-control,improvements in GI function were observed in the MXD groups including reduced incidence of nausea,vomiting,and bloating;and earlier first exhaust time,first defecation time,and feeding time after surgery(P<0.05).On the 1st and 2nd d after surgery,IL-6,CRP and SAA levels in MXD group were lower than that in placebo control,but substance P level was higher,compared to the control(P<0.05).Functional diarrhea occurred in both MXD and XD groups without any other adverse effects,toxic reactions,and allergic reactions.Diarrhea was relieved after the discontinuation of the investigational remedies.Bowel sounds at 12 h after surgery,the occurring time of the first flatus,first defecation,postoperative liquid diet and semiliquid diet were significantly correlated with levels of IL-6,CRP,SAA and substance P on second day after surgery(P<0.05).CONCLUSION Treatment with MXD can relieve inflammatory response and improve GI function after surgery.Moreover,there are significant correlations between them.Furthermore,it does not cause serious adverse reactions.

Biliary complications associated with weight loss,cholelithiasis and choledocholithiasis

Biliary complications like cholelithiasis and choledocholithiasis are more common in bariatric surgery patients due to obesity and rapid weight loss.Patients with a body mass index>40 face an eightfold risk of developing cholelithiasis.Postbariatric surgery,especially after laparoscopic Roux-en-Y gastric bypass(LRYGB),30%of patients develop biliary disease due to rapid weight loss.The aim of this review is to analyze the main biliary complications that occur after bariatric surgery and its management.A review of the literature was conducted mainly from 2010 up to 2023 with regard to biliary complications associated with bariatric patients in SciELO,PubMed,and MEDLINE.Patients undergoing LRYGB have a higher incidence(14.5%)of symptomatic calculi post-surgery compared to those undergoing laparoscopic sleeve gastrectomy at 4.1%.Key biliary complications within 6 to 12 months post-surgery include:Cholelithiasis:36%;Biliary colic/dyskinesia:3.86%;Acute cholecystitis:0.98%-18.1%;Chronic cholecystitis:70.2%;Choledocholithiasis:0.2%-5.7%and Pancreatitis:0.46%-9.4%.Surgeons need to be aware of these complications and consider surgical treatments based on patient symptoms to enhance their quality of life.

Analysis of the Effect of Laparoscopic Versus Open Cholecystectomy in Patients with Cholelithiasis and the Effect on CRP and IL-1βLevels

Objective:To evaluate the therapeutic effect of laparoscopic cholecystectomy(LC)and open cholecystectomy(OC)on cholelithiasis.Methods:92 cases of cholelithiasis patients admitted to the hospital in the past 2 years were selected and grouped by random number table;the observation group was treated with LC;the reference group was treated with OC,and the inflammatory factor and other indexes were compared.Results:The total effective rate of the observation group was higher than that of the reference group,and the perioperative indexes were better than that of the reference group(P<0.05).Preoperatively,the C-reactive protein(CRP)and interleukin-1β(IL-1β)levels and immune function indexes of the two groups were compared,and no difference was seen(P>0.05).At 5 days postoperatively,the CRP and IL-1βlevels of the observation group were lower than those of the reference group,and the immune function indicators were higher than those of the reference group(P<0.05).The complication rate of the observation group was lower than that of the reference group(P<0.05).Conclusion:LC can increase the effective rate of cholelithiasis patients,improve their perioperative indexes,reduce the inflammatory response,protect patients’immune function,and ensure higher surgical safety.

Research Progress of Ethnic Medicine in the Treatment of Cholelithiasis

In a broad sense, ethnic medicine includes Han traditional Chinese medicine, folk medicine and ethnic minority medicine;ethnic medicine in a narrow sense refers to ethnic minority medicine. It is a medicine developed by ethnic minorities in order to survive and reproduce and in the process of fighting diseases. Culture, based on its own language, life experience and cultural traditions, has its own understanding and theoretical system of disease naming, etiology and pathogenesis, treatment principles and treatment methods, which is a major feature of my country’s medical care. Among them, ethnic medicine has unique advantages and good clinical efficacy in the prevention and treatment of cholelithiasis. Therefore, this paper focuses on summarizing the characteristic theories and diagnosis and treatment experience of Tibetan medicine, Mongolian medicine, Miao medicine, Yao medicine, and Beijing medicine in ethnic medicine by sorting out and summarizing the relevant materials in this regard, so as to provide new ideas for improving the treatment of cholelithiasis and enriching clinical drug selection.

Laparoscopic Surgery and Modified Xiaoyan Lidan Decoction:An Effective Combination for Treating Cholecystitis with Cholelithiasis

Objective:To assess the clinical effects of combining laparoscopic surgery with Modified Xiaoyan Lidan Decoction in patients diagnosed with cholecystitis and cholelithiasis.Methods:Following the guidelines of the double-blind method,86 cases of cholecystitis with cholelithiasis were randomly divided into two groups,each comprising 43 cases.Both groups underwent laparoscopic surgery,with the observation group additionally receiving Modified Xiaoyan Lidan Decoction.A comparative analysis was conducted on clinical treatment effectiveness,general observation indicators,Traditional Chinese Medicine(TCM)syndrome scores,and the occurrence of adverse reactions between the two groups.Results:The observation group demonstrated a significantly higher overall clinical treatment effectiveness compared to the control group(P<0.05).The clinical symptom improvement time and hospitalization time were shorter in the observation group,and the pain score and TCM syndrome score after treatment were lower than those in the control group(P<0.05).No statistically significant difference was observed in the total reaction values(P>0.05).Conclusion:The combined application of laparoscopic surgery and Modified Xiaoyan Lidan Decoction can enhance clinical treatment efficiency for patients with cholecystitis and cholelithiasis.It facilitates a quicker improvement in clinical symptoms without causing serious adverse reactions,suggesting its potential for widespread adoption.

罕见抗-Di^(b)致严重胎儿新生儿溶血病的实验室检测与相关研究

目的对1例高频抗体导致的胎儿新生儿溶血病(hemolytic disease of the fetus and newborn,HDFN)进行检测、鉴定及配血。方法对患儿进行新生儿溶血试验,对母亲进行血清学意外抗体鉴定,并对母亲红细胞进行常见高频抗原鉴定;对检出抗体进行IgG分型检测,并用流式细胞术进行单核细胞体外吞噬致敏红细胞试验,以检测抗体相关的吞噬率;对患儿母亲、父亲及舅舅进行相关红细胞血型基因测序;利用稀释的母亲血浆和抗人球卡法,在献血者中进行大规模相合血液的筛选。结果产妇鉴定为Di(b-)稀有血型,产生了抗-Di b(效价512)并导致了严重的HDFN;抗-Di b亚型分型为IgG1和IgG2型,单核细胞体外吞噬效率为88.83%(74.7/84.09);产妇亲属中没有相合献血者,后续从5520名献血者中筛选到2例Di(b-)相合血液,患儿接收输血治疗后康复出院。后续在51334名献血者中筛查到17名Di(b-)献血者,该数据表明Di(b-)在广州地区献血者中的分布频率约为三千分之一(0.033%,17/51334)。结论综合利用血型血清学及分子生物学方法诊断了抗-Di b所致的严重HDFN,建立了1种有效大规模筛查Di(b-)稀有血型的方法并找到相合血液,为建立Di(b-)稀有血型库奠定了基础。

4DI110型空压机的技术改造与操作优化

文章通过介绍新引进的4DI110型离心式空压机(以下简称“空压机”)试运行阶段开始以来的运行情况和气温变化对空压机出口流量造成的影响,分析空压机出口流量随气温变化而变化的规律,指出空压机防喘阀V3004阀不能自动调节出口压力,影响空分装置工况的稳定。为实现空压机出口压力的稳定,对其防喘阀V3004阀采取增设自动旁路阀V3008阀的技术改造,同时优化和完善相关逻辑控制并阐述了空压机经技术改造后的操作优化和取得的实际效果。

Current management of concomitant cholelithiasis and common bile duct stones

The management policy of concomitant cholelithiasis and choledocholithiasis is based on a one-or two-stage procedure.It basically includes either laparoscopic cholecystectomy(LC)with laparoscopic common bile duct(CBD)exploration(LCBDE)in the same operation or LC with preoperative,postoperative and even intraoperative endoscopic retrograde cholangiopancreatography-endoscopic sphincterotomy(ERCP-ES)for stone clearance.The most frequently used worldwide option is preoperative ERCP-ES and stone removal followed by LC,preferably on the next day.In cases where preoperative ERCP-ES is not feasible,the proposed alternative of intraoperative rendezvous ERCP-ES simultaneously with LC has been advocated.The intraoperative extraction of CBD stones is superior to postoperative rendezvous ERCP-ES.However,there is no consensus on the superiority of laparoendoscopic rendezvous.This is equivalent to a traditional two-stage procedure.Endoscopic papillary large balloon dilation reduces recurrence.LCBDE and intraoperative ERCP have similar good outcomes.The risk of recurrence after ERCP-ES is greater than that after LCBDE.Laparoscopic ultrasonography may delineate the anatomy and detect CBD stones.The majority of surgeons prefer the transcductal instead of the transcystic approach for CBDE with or without T-tube drainage,but the transcystic approach must be used where possible.LCBDE is a safe and effective choice when performed by an experienced surgeon.However,the requirement of specific equipment and advanced training are drawbacks.The percutaneous approach is an alternative when ERCP fails.Surgical or endoscopic reintervention for retained stones may be needed.For asymptomatic CBD stones,ERCP clearance is the firstchoice method.Both one-stage and two-stage management are acceptable and can ensure improved quality of life.

Pregnane receptor gene polymorphisms,pathogenic bacteria distribution and drug sensitivity,and TCM dyndrome differentiation in patients with cholelithiasis

Objective:To investigate the distribution of pathogens and drug resistance in bile and the association between the pregane X receptor(PXR) gene polymorphisms,traditional Chinese medicine(TCM) syndromes and the risk of cholesterol gallstone disease(CGD).Methods:A total of 392 samples were enrolled in this study from January 2014 to February 2015.among which 192 patients were with CGD.and 200 samples were healthy.Strains were isolated and susceptibility testing was the disk diffusion method susceptibility testing.The patients were divided into hepatochlic hygropyrexia.stagnation of liver-qi.and the accumulation of damp.The PXR gene polymorphisms were analyzed by polymerase chain reaction-restriction fragment length polymorphism.The association between the PXR gene polymorphisms and the risk of CGD was examined by logistic regression analysis.Results:A total of 192 cases were detected in 230 of bile culture pathogens,including Grain-negative bacteria 133(57.83%),Gram-positive bacteria76(33.04%),and fungi 21(9.13%).The top five pathogens were Escherichia coli,Klebsiella pneumoniae.Enterococcus faecalis,Candida albicans,and Enterococcus feces,ot which 110 cases was of single infection.48 cases of mixed infection of two strains,eight cases of mixed infection of three bacteria.Among 59 Escherichia coli,the yield extended-spectrum beta-laetamases had 40(67.80%).The hepatochlic hygropyrexia was the most TCM syndrome,followed by stagnation of liver-qi.and the accumulation of damp was least.Different pathogens and the rs6785049 genotypes distributed differently in cholelithiasis patients with different TCM syndromes(P<0.05).In hepatochlic hygropyrexia patients the Gram-negative bacteria was most.There was significant differences between CGD group and control group in rs6785049(P<0.001).Comparison with wild-type portable GG.GA genotype increased the risk of the occurrence of gallstones(OR=0.40.95%CI:0.16-0.79);likewise,carrying the GA + AA genotype also increased the risk(OR=0.38,95%CI:0.19-0.81).There was no significant differences in rs2276707,rs3814055 site polymorphic loci alleles in CGD group and control group.Conclusions:In the treatment of cholelithiasis,bile samples should be collected for bacterial culture and sensitivity test,and drugs should be strictly chosen based on the results.The rs6785049 polymorphisms in PXR gene may increase the risk of gallstones ontogeny,and gallstones can he early detected and prevented by detecting genotypes.rs6785049 polymorphisms in PXR gene may has relationship with TCM syndromes.

借助DIS实验突破教学难点——以“磁场对通电导线的作用力”为例

教材中直接得出安培力的公式,该知识点难度较大,传统实验现象不够明显且只能定性探究,学生无法真正理解该物理规律和公式。传统实验加DIS实验可对物理规律进行定性和定量的探究,有利于学生物理学科核心素养的培养。

用DIS电磁定位魔板探究平抛运动的教学设计

随着数字化信息系统在中学物理教学中的逐步融入,我国中学物理实验呈现智能化、现代化的发展趋势.以DIS电磁定位魔板为实验装置,通过科学探究的关键环节,设计探究平抛运动的教学流程.实践发现传感器实验也适合做科学探究,能够充分提升学生科学探究和推理论证的能力.

嗜热链球菌c-di-AMP合成酶的结构预测

作为一种新兴第二信使分子,c-di-AMP具有全局调控胞内渗透压平衡、DNA损伤和生物膜形成等生理功能。本实验室在实验前期筛选出了一株高产胞外多糖的嗜热链球菌菌株S-3,但未对其进行c-di-AMP信号通路研究。本研究在嗜热链球菌S-3全基因组中筛选出c-di-AMP合成酶(StDAC),对其二级结构进行预测,结果显示St DAC二级结构包含42.98%α-螺旋、15.32%β-折叠和38.30%无规则卷曲。利用SWISS-MODEL和Modeller对StDAC进行单模板和多模板同源建模,由SWISS-MODEL建立的模型通过了Ramachandran、Errat和Verify-3D评估,表明其结构较为合理;而Modeller建立的模型仅通过了Ramachandran评估,总体结构评分较低。本研究预测的嗜热链球菌StDAC三维模型为解析其结构和功能奠定了基础。

乳酸菌第二信使分子c-di-AMP研究进展

微生物依赖信号识别和信号传递来感知并响应外界环境变化。c-di-AMP作为第二信使分子在信号传导过程中发挥着关键作用,其通过酶、转录调控因子和核糖开关等受体靶标来调控细胞生长、生物膜形成、K^(+)稳态、DNA完整性、细胞壁合成和脂肪酸合成等与生理功能相关的基因和蛋白的表达。尽管对于c-di-AMP代谢调控在枯草芽孢杆菌、单增李斯特氏菌和金黄色葡萄球菌等细菌中的研究较为深入,但对其在乳酸菌中的研究却相对较少。基于此,文章重点关注乳酸菌中cdi-AMP的代谢及其在K^(+)稳态和抑制甘氨酸甜菜碱转运中的信号传导作用;同时,通过总结现有研究中的乳酸菌c-di-AMP代谢调控,深化对乳酸菌第二信使分子信号调控的认知。

Burden of gallstone disease in the United States population:Prepandemic rates and trends

BACKGROUND Gallstone disease is one of the most common digestive disorders in the United States and leads to significant morbidity,mortality,and health care utilization.AIM To expand on earlier findings and investigate prepandemic rates and trends in the gallstone disease burden in the United States using national survey and claims databases.METHODS The National Ambulatory Medical Care Survey,National Inpatient Sample,Nationwide Emergency Department Sample,Nationwide Ambulatory Surgery Sample,Vital Statistics of the United States,Optum Clinformatics®Data Mart,and Centers for Medicare and Medicaid Services Medicare 5%Sample and Medicaid files were used to estimate claims-based prevalence,medical care including cholecystectomy,and mortality with a primary or other gallstone diagnosis.Rates were age-adjusted(for national databases)and shown per 100000 population.RESULTS Gallstone disease prevalence(claims-based,2019)was 0.70%among commercial insurance enrollees,1.03%among Medicaid beneficiaries,and 2.09%among Medicare beneficiaries and rose over the previous decade.Recently,in the United States population,gallstone disease contributed to approximately 2.2 million ambulatory care visits,1.2 million emergency department visits,625000 hospital discharges,and 2000 deaths annually.Women had higher medical care rates with a gallstone disease diagnosis,but mortality rates were higher among men.Hispanics had higher ambulatory care visit and hospital discharge rates compared with Whites,but not mortality rates.Blacks had lower ambulatory care visit and mortality rates,but similar hospital discharge rates compared with whites.During the study period,ambulatory care and emergency department visit rates with a gallstone disease diagnosis rose,while hospital discharge and mortality rates declined.Among commercial insurance enrollees,rates were higher compared with national data for ambulatory care visits and hospitalizations,but lower for emergency department visits.Cholecystectomies performed in the United States included 605000 ambulatory laparoscopic,280000 inpatient laparoscopic,and 49000 inpatient open procedures annually.Among commercial insurance enrollees,rates were higher compared with national data for laparoscopic procedures.CONCLUSION The gallstone disease burden in the United States is substantial and increasing,particularly among women,Hispanics,and older adults with laparoscopic cholecystectomy as the mainstay treatment.Current practice patterns should be monitored for better health care access.

外卖包装材料对我国青年群体暴露DBP和DiBP的影响

青年群体是外卖食品最大的消费群体,外卖包装材料中的污染物对青年群体的危害不容忽视。文章分析了外卖包装材料对我国青年群体暴露邻苯二甲酸二正丁酯(DBP)和邻苯二甲酸二异丁酯(DiBP)的影响,结果表明,发泡聚苯乙烯(PS)餐盒中DBP和DiBP的浓度(2986.27 ng/g和1345.20 ng/g)显著高于聚丙烯(PP)餐盒、纸质餐盒和锡纸餐盒,青年人群使用PS餐盒暴露DBP和DiBP的暴露量约为使用纸质餐盒和锡纸餐盒的2~5倍,青年人群经外卖餐盒暴露DBP和DiBP的暴露量占经饮食途径暴露DBP和DiBP暴露总量的1.72%~9.49%,占体内DBP和DiBP暴露总量的0.09%~0.47%。外卖包装材料是青年人群暴露DBP和DiBP的重要来源之一。

Hepatolithiasis:Epidemiology,presentation,classification and management of a complex disease

The term hepatolithiasis describes the presence of biliary stones within the intrahepatic bile ducts,above the hilar confluence of the hepatic ducts.The disease is more prevalent in Asia,mainly owing to socioeconomic and dietary factors,as well as the prevalence of biliary parasites.In the last century,owing to migration,its global incidence has increased.The main pathophysiological mechanisms involve cholangitis,bile infection and biliary strictures,creating a self-sustaining cycle that perpetuates the disease,frequently characterised by recurrent episodes of bacterial infection referred to as syndrome of“recurrent pyogenic cholangitis”.Furthermore,long-standing hepatolithiasis is a known risk factor for development of intrahepatic cholangiocarcinoma.Various classifications have aimed at providing useful insight of clinically relevant aspects and guidance for treatment.The management of symptomatic patients and those with complications can be complex,and relies upon a multidisciplinary team of hepatologists,endoscopists,interventional radiologists and hepatobiliary surgeons,with the main goal being to offer relief from the clinical presentations and prevent the development of more serious complications.This comprehensive review provides insight on various aspects of hepatolithiasis,with a focus on epidemiology,new evidence on pathophysiology,most important clinical aspects,different classification systems and contemporary management.

城轨交通DI型弹条接触疲劳断裂机理研究

以DI型弹条为研究对象,基于实验得到正常行车状态下弹条的频域特性,采用有限元仿真对弹条进行失效特性分析。研究表明,弹条的断裂为疲劳断裂,表面缺陷产生的应力集中是弹条发生疲劳断裂的主要原因;在正常行车条件下,弹条和钢轨均在360 Hz和700 Hz附近产生峰值,其中钢轨的垂向及横向振动频谱变化趋势基本一致;弹条安装深度过大将导致弹条与铁垫板接触点产生一定应力集中,在长期强迫振动激励作用下弹条容易发生疲劳折断。

Cholelithiasis in Children with Sickle Cell Disease in Ouagadougou Pediatric Hospital

Introduction: Sickle cell disease (SCD) causes chronic hemolysis which is a risk factor for cholelithiasis. Its development may lead to severe and life-threatening complications. Objective: Determine the prevalence of cholelithiasis, the conditions of diagnosis and related factors. Materials and Method: We retrospectively reviewed records of 110 patients with sickle cell disease followed up in Charles de Gaulle University Pediatric Hospital from January 2003 to December 2013, including 103 patients who had abdominal ultrasonography. Results: Cholelithiasis prevalence was 24.3%. The mean age of patients was 10.8 years, (range 3 to 15 years). Sex ratio was 2.1. In 88% cases, cholelithiasis was diagnosed based on the characteristic symptoms of right hypocondrial pain, fever and icterus. Most factors associated with cholelithiasis were as follows: age above 10 years (OR = 4), occurrence of at least three (03) vaso-occlusive crises per year (OR = 7.6), history of blood transfusion (OR = 8), right hypochondrial pain (OR = 4.5) and icterus (OR = 15). Only 20% of patients suffering from a symptomatic cholelithiasis underwent laparoscopic cholecystectomy and results were conclusive. Conclusion: Patients with sickle cell disease, especially those aged above 10, should be routinely tested for cholelithiasis using abdominal ultrasonography at least once a year. Because of the difficulties in managing evolutive complications in case of an emergency in our context, we advocate laparoscopic cholecystectomy of any cholelithiasisas soon as it is diagnosed in children with sickle cell disease.

First results of CO_(2) dispersion interferometer on EAST tokamak

A dispersion interferometer(DI)has been installed and operates on the Experimental Advanced Superconducting Tokamak(EAST).This DI system utilizes a continuous-wave 9.3μm CO_(2)laser source to measure line-averaged electron densities accurately.In contrast to conventional interferometers,the DI does not require substantial vibration isolations or compensating systems to reduce the impact of vibrations in the optical path.It also employs a ratio of modulation amplitudes,ensuring it remains immune to the variations in detected intensities.Without a variation compensation system,the DI system on EAST reaches a density resolution of less than1.8×10^(-2)πrad and a temporal resolution of 20μs.The measurements made by the POlarimeterINTerferometer(POINT)system and the far-infrared hydrogen cyanide(HCN)interferometer are remarkably consistent with the DI’s results.The possibility of fringe jumps and the impact of refraction in high-density discharge can be significantly decreased using a shorter wavelength laser source.A rapid density change of 3×10^(19)m^(-3)during 0.15 s has been measured accurately in shot No.114755 of EAST.Additionally,the DI system demonstrates dependability and stability under 305 s long-pulse discharges in shot No.122054.

Liver fat accumulation measured by high-speed T2-corrected multiecho magnetic resonance spectroscopy can predict risk of cholelithiasis

BACKGROUND Liver fat accumulation is associated with increased cholesterol synthesis and hypersecretion of biliary cholesterol,which may be related to the development of cholelithiasis.AIM To investigate whether liver fat accumulation measured by high-speed T2-corrected multi-echo magnetic resonance spectroscopy(MRS)is a risk factor for cholelithiasis.METHODS Forty patients with cholelithiasis and thirty-one healthy controls were retrospectively enrolled.The participants underwent high-speed T2-corrected multi-echo single-voxel MRS of the liver at a 3T MR scanner.The proton density fat fraction(PDFF)and R2 value were calculated.Serum parameters and waist circumference(WC)were recorded.Spearman’s correlation analysis was used to analyze the relationship between PDFF,R2,and WC values.Multivariate logistic regression analysis was carried out to determine the significant predictors of the risk of cholelithiasis.Receiver operating characteristic curve(ROC)analysis was used to evaluate the discriminative performance of significant predictors.RESULTS Patients with cholelithiasis had higher PDFF,R2,and WC values compared with healthy controls(5.8%±4.2%vs 3.3%±2.4%,P=0.001;50.4±24.8/s vs 38.3±8.8/s,P=0.034;85.3±9.0 cm vs 81.0±6.9 cm,P=0.030;respectively).Liver iron concentration extrapolated from R2 values was significantly higher in the cholelithiasis group(2.21±2.17 mg/g dry tissue vs 1.22±0.49 mg/g dry tissue,P=0.034)than in the healthy group.PDFF was positively correlated with WC(r=0.502,P<0.001)and R2(r=0.425,P<0.001).Multivariate logistic regression analysis showed that only PDFF was an independent risk factor for cholelithiasis(odds ratio=1.79,95%CI:1.22-2.62,P=0.003).ROC analysis showed that the area under the curve of PDFF was 0.723 for discriminating cholelithiasis from healthy controls,with a sensitivity of 55.0%and specificity of 83.9%when the cut-off value of PDFF was 4.4%.CONCLUSION PDFF derived from high speed T2-corrected multi-echo MRS can predict the risk of cholelithiasis.