Comparatively lower postoperative hepatolithiasis risk with hepaticocholedochostomy versus hepaticojejunostomy

BACKGROUND: Optimal surgical technique plays a key role in preventing the postoperative recurrence of hepatolithiasis. Tian et al developed the subcutaneous tunnel and hepatocholangioplasty using the gallbladder (STHG) technique and applied it in hepatolithiasis patients who had an approximately normal gallbladder and sphincter of Oddi. However, the technique is controversial. In the present study, a canine model was established for hepatocholangioplasty (HC) and hepaticojejunostomy (HJ) to simulate STHG and Roux-en-Y cholangiojejunostomy in the clinic, respectively. Then, the alterations of bile components in the vicinity of the anastomosis were compared. This may provide an experimental guide for choosing an optimal technique for the treatment of hepatolithiasis in the clinic. METHODS: The animals were randomly separated into a control group (5 dogs) and a model group (stenosis of the common bile duct; 24 dogs). The 24 dogs in the model group were randomly divided into an HC group and an HJ group (12/group). Bile was collected from the bile duct at I and 5 months after the operation, and the bile components were determined. RESULTS: The levels of total bile acid, cholesterol, total bilirubin, and phospholipid in the HC group were higher than those in the HJ group (P<0.05). However, no statistical difference was seen in unconjugated bilirubin and calcium ions. The mucin level in bile in the HC group was lower than that in the HJ group at 5 months after the operation (P<0.05). The postoperative lipid peroxidation level was remarkably lower than that in the HJ group (P<0.05). However, the superoxide dismutase level was remarkably higher than that in the HJ group (P<0.05). Finally, a significant difference was found in the positive bacterial culture rate in bile between the groups. CONCLUSION: Changes of bile components near the anastomosis after HC might be more preferable for preventing hepatolithiasis formation than HJ.

A suggestion for the animal model of liver transplantation

The Editor welcomes submissions for possible publication in the Letters to the Editor section that consist of commentary on an article published in the Journal or other relevant issues.

Influencing factors of anxiety in isolated population under COVID-19 and clinical observation of acupuncture intervention

Objective To investigate the anxiety of isolated people under the epidemic of 2019-novel coronavirus infection,analyze its related factors,and evaluate the clinical efficacy of acupuncture intervention in isolated people with acute anxiety Methods From March 31,2022 to September 9,2022.

Analysis of non-alcoholic fatty liver disease differences from metabolic dysfunction-associated fatty liver disease based on clinical features

Objective To explore the clinical features of fatty liver disease (FLD) from non-alcoholic fatty liver disease(NAFLD) to metabolic dysfunction-associated fatty liver disease (MASLD),so as to elucidate its clinical application value under three renames.

Clinical efficacy of Modified Shuyu Pill for mild and moderate Alzheimer’s disease and its effects on expressions of IL-1β/NF-κB/miR-146a in peripheral blood

Objective To explore the clinical efficay of Modified Shuyu Pill(MSP)for treatment of mild and moderate Alzheimer’s disease(AD)and its effect on the expressions of interleukin-1β(IL-1β)/nuclear factor-kappa B(NF-κB)/microRNA-146a(miR-146a)in peripheral blood.Methods Totally 52 patients with mild and moderate AD were randomly assigned to the treatment group and the control group,26 in each group.Patients in the treatment group took MSP,15 mL each time,twice a day,while those in the control group took Donepezil,5 mg each time,once before bedtime.The therapeutic course for all was 12 weeks.Mini-mental State Examination(MMSE)scale,Alzheimer's Disease Assessment Scale-Cognitive Subscale(ADAS-Cog),and Activity of Daily Living(ADL)scale were evaluated before and after treatment.Pattern and Element of Syndrome of Alzheimer's Disease(AD-PES-11)scale and clinical efficacy of TCM syndromes were assessed.Spearman correlation analysis was used to analyze the correlation between the score of AD-PES-11 scale and neuropsychological test scales.Serum levels of IL-1βand NF-κB were detected using enzyme linked immunosorbent assay(ELISA).The level of miR-146a was detected by fluorescence quantitative PCR.Besides,adverse reactions were observed during the treatment.Results Compared with before treatment in the same group,the score of MMSE significantly increased after treatment(P<0.01),and the scores of ADAS-Cog and ADL significantly decreased in the two groups after treatment(P<0.01).Compared with before treatment,the scores of AD-PES-11 scale,scores of Shen deficiency,Pi deficiency,medullary decrease,phlegm turbidity,and blood stasis significantly decreased after treatment in the treatment group(P<0.05,P<0.01).In the control group,the score of Pi deficiency increased significantly after treatment(P<0.05).Compared with the control group,the scores of AD-PES-11 scale,Shen deficiency,Pi deficiency,phlegm turbidity,and blood stasis decreased significantly in the treatment group after treatment(P<0.01).The total effective rate was 69.23%(18/26 cases)in the treatment group,with statistical difference as compared with that of the control group[7.69%(2/26 cases)].Statistical difference existed in clinical efficacy between the two groups(P<0.01).Correlation analysis showed that there was a negative correlation between MMSE score and Pi deficiency score/total scores(P<0.05,P<0.01).There was a positive correlation between ADAS-Cog score/ADL score and Pi deficiency/medullary decrease/total scores(P<0.05,P<0.01).Compared with before treatment,the levels of IL-1βand NF-κB decreased in both groups after treatment(P<0.05,P<0.01).The treatment group was superior to the control group in reducing IL-1βand NF-κB content(P<0.05).Compared with before treatment,the level of miR-146a decreased after treatment in the two groups(P<0.05,P<0.01).No obvious adverse reactions were observed during the treatment.Conclusion MYP can effectively improve the cognitive function and ADL of mild and moderate AD patients,improve their TCM symptoms and signs,and its mechanism may be related to inhibiting the expressions of IL-1β/NF-κB/miR-146a in peripheral blood and blocking inflammatory reactions.

Clinical characteristics and progression risk factors for hepatitis B-related acute-on-chronic liver failure in elderly patients

Objective To investigate the clinical characteristics and risk factors for the progression of acute-on-chronic liver failure(ACLF)associated with hepatitis B in elderly patients.Methods A total of 168 elderly patients with hepatitis B-related acute-on-chronic liver failure (HBVACLF)at Tianjin Third Central Hospital who met the diagnostic criteria of the Asian Pacific Association for the Study of the Liver (APASL)-ACLF were enrolled.

Clinical value of myositis antibodies in patients with connective tissue disease-associated interstitial lung diseases

Objective To investigate the clinical significance of detection of myositis-specific antibodies(MSAs)and myositis-associated antibodies(MAAs)in patients with connective tissue disease-associated interstitial lung diseases(CTD-ILD).Methods Serum samples of 120 patients with CTD-ILD admitted to the Department of Respiratory,Affiliated Drum Tower Hospital of Nanjing University Medical College from December 2016 to April 2018 were collected for analysis.The patients included 45 with polymyositis/dermatomyositis(PM/DM),36 with Sjogren s syndrome(SS)and 39 with undifferentiated connective tissue disease(UCTD).There were 37 males and 83 females with an average age of(56±11)years.Thirty-two patients with non-CTD-ILD,10 males and 22 females with an average age of(42±17)years,were enrolled as the control group.Euroline Autoimmune Inflammatory Myopathies 16 Ag kit was used for detecting MSAs and MAAs,and the positive rates of serum MSAs and MAAs were calculated.

Effects of electroacupuncture at different time during reperfusion on the expression of Bcl-2and Beclin1 in myocardial tissue in rats with myocardial ischemia reperfusion injury

Objective To compare the effects of electroacupuncture (EA) at different time during reperfusion on the expression of autophagy-related protein Bel-2 and Beclinl in myocardial tissue in rats with myocardial ischemia reperfusion injury ( MIRI), and to explore the autophagy-related mechanism of EA on protecting MIRI.

Pulmonary extranodal natural killer/T-cell lymphoma: clinical analysis of three cases

Objective To improve the understanding of pulmonary involvement of extranodal natural killer/T-cell lymphoma(ENKTL)by analyzing the clinical manifestations,imaging and pathological features of this disease.Methods Three cases of ENKTL,proven by pathological diagnosis in Fuzhou General Clinical Medical College of Fujian Medical University,were retrospectively analyzed.Results All of the 3 cases were males,aged 74,61 and 49 years,respectively.The main clinical symptoms included cold and fever.One patient had nasal congestion and runny nose.Chest CT showed multiple lung nodules(n=3),masses(n=2)and patchy shadows(n=2),with irregular lesions and clear boundaries.The 3 cases had been misdiagnosed as community acquired pneumonia,and treated with intravenous injection of moxifloxacin.ENKTL was confirmed by CT-guided percutaneous biopsy with immunohistochemical staining,which showed that 3 cases were positive for CD56,CD2,in situ hybridization for EBV encoded RNA(EBER),while negative for CD20,and 2 cases were positive for CD3,Granzyme B;and 1 case was positive for T-cell intracytoplasmic antigen-1.All 3 patients received chemotherapy,but 2 patients died,one of rejection 1 month later after bone marrow transplantation.One patient had improved after chemotherapy with follow-up.Conclusion ENKTL should be considered when patients presented with fever,multiple lung nodules or consolidations which were non-responsive to antibiotics.Lung biopsy was the key to diagnosis.

Effect of electroacupuncture on the bio-chemical indices of bone and bone collagen metabo-lism and TNF-α in osteoporosis model rats without ovaries

Objective To explore the mechanisms of electroacu-puncture(EA) on postmenopausal osteoporosis(PMO).Methods Sixty female SD rats aged 6 months were selected,resected double ovaries and fed for 90 days in order to make the model of experimental osteoporosis,and then,they were randomly divided into a model control

Effects of Wenhua Juanbi decoction on proliferation,apoptosis and Hotair/Wnt1/β-catenin pathway in the synovial membrane of collagen-induced arthritis mice

Objective Taking collagen-induced arthritis(CIA)mice as experimental subjects,in vivo experiments were conducted to analyze the therapeutic mechanism of Wenhua Juanbi Decoction(WHJBD)in preventing and treating rheumatoid arthritis(RA)from the perspective of Hotair/Wnt1/β-catenin signaling pathway.

Effects of electroacupuncture with "intestinal disease prescription" on NLRP3 inflammasome and intestinal mucosal barrier in rats with acute ulcerative colitis

Objective To observe the effects of electroacupuncture(EA) with “intestinal disease prescription” on the intestinal mucosal barrier and NLRP3 inflammasome in rats with dextran sulfate sodium (DSS)-induced acute ulcerative colitis (UC),and explore the underlying mechanism of EA with “intestinal disease prescription”for the treatment of UC.

The efficacy of modified Banxia Xiexin decoction on patients with functional dyspepsia and its impact on gastric function

Objective To investigate the efficacy of Modified Banxia Xiexin Decoction on patients with functional dyspepsia (FD) and its impact on gastric function.Methods From June 2021 to December 2022,at the Department of Gastroenterology,Wenzhou Central Hospital,a total of 56 patients with FD who met the diagnostic criteria of RomeⅣwere prospectively enrolled.

Application of the Second Revision of the International Staging System(R2-ISS)in the prognostic assessment of newly diagnosed multiple myeloma

Objective To investigate the prognostic value of the Second Revision of the International Staging System (R2-ISS) in patients with newly diagnosed multiple myeloma(NDMM).Methods The retrospective study was performed in 326 NDMM patients with immunomodulatory drugs and/or proteasome inhibitors as the first-line treatment attending the Department of Hematology,Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University,Nanjing,China,from December 2012 to March 2022.

Correlation of carotid plaque with changes in serum uric acid and urine albumin/creatinine ratio in patients with type 2 diabetes mellitus

Objective To investigate the association between carotid plaque and changes in uric acid and albumin/creatinine ratio in type 2 diabetes mellitus (T2DM)patients.Methods A total of 210 patients with T2DM were enrolled in this study from six communities in Ningxia from June to September 2018.FPG,HbA_1c,fasting C peptide (FC-P),serum uric acid (SUA),creatinine(CR),UAlb and other indexes were collected,and carotid ultrasonography was performed.

Effect of moxibustion on colonic low-grade inflammatory response in rats with diarrhea-predominant irritable bowel syndrome based on mast cell degranulation

Objective To observe the effects of moxibustion on colonic mast cell degranulation and inflammatory factor expression in rats with diarrhea-predominant irritable bowel syndrome(IBS-D),and explore the potential mechanism of moxibustion in treating IBS-D.Methods In forty-five rat pups born from 5 healthy SPF-grade pregnant SD rats,8 rats were randomly selected as normal group,and the remaining 37 rats were intervened with maternal separation,acetic acid enema,and chronic restraint stress to establish the IBS-D model.The successfully modeled 32 rats were then randomly assigned to a model group,a ketotifen group,a moxibustion group,and a moxibustion-medication group,with 8 rats in each group.The rats in the ketotifen group were intervened with intragastric administration of ketotifen solution(10 mL/kg).

Effect of Qingjie Huagong decoction on the pyroptosis of pancreatic acinar cell and intestinal barrier in mice with acute pancreatitis

Objective To explore the mechanism of regulating circRNA homeodomain-interacting protein kinase 3(circHipk3) by Qingjie Huagong Decoction (QJHGD) to alleviate acute pancreatitis (AP) alveolar cell scorching and protect the intestinal barrier in acute pancreatitis.

Correlation between serum KIM-1,NGAL and diabetic kidney disease remission after gastric bypass surgery in obese patiens

Objective To investigate the correlation between serum renal injury molecule-1 (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL) in the remission of diabetic kidney disease (DKD) after gastric bypass surgery in obese DKD patients.Methods Seventy-nine obese patients with DKD who received gastric bypass surgery in our hospital from January 2021 to January 2022 were selected and divided into DKD remission group (n=47) and DKD non-remission group (n=32)according to whether UACR decreased to normal level after surgery.Preoperative and postoperative general data were collected and biochemical indices.

Effect of risk stratification of chronic kidney disease on left ventricular hypertrophy in patients with type 2 diabetes mellitus

Objective To investigate the predictive value of chronic kidney disease (CKD) risk stratification for left ventricular hypertrophy (LVH) in patients with type 2 diabetes mellitus (T2DM).Methods A total of 506 patients with T2DM hospitalized in the Department of Endocrinology of Gansu Provincial People's Hospital from October 2021 to October 2022 were enrolled in this study.

Acupoint application for Hashimoto's thyroiditis with liver-qi stagnation:a randomized controlled trial

Objective To observe the clinical efficacy and safety of acupoint application for Hashimoto's thyroiditis (HT)with liver-qi stagnation.Methods One hundred and fifty patients of HT with liver-qi stagnation were randomly divided into an acupoint application group(75 cases,11 cases were excluded,5 cases dropped out) and a control group (75 cases,12 cases excluded,3 cases dropped out).