Oddi sphincter plays an important role in preventing reflux cholangitis. There exists the controversy on application of choledochoduodenostomy in hepatolithiasis management. The present study aimed ...at evaluating long-term outcomes of choledochoduodenostomy for the treatment of hepatolithiasis.
Forty-six consecutive cases of hepatolithiasis who underwent choledochoduodenostomy were analyzed retrospectively. The pre- and postoperative rates of recurrent cholangitis and acute cholangitis severe type were compared. Paired chi-square test was applied.
The mean follow-up time was 17.3 years ranging from 1.6 to 40 years with a follow-up rate of 97.8% (45/46). High rates of remnant stones (39.1%, 18/46), recurrent stones (31.1%, 14/45), uncorrected strictures (85%, 17/20), and mortality (24.4%, 11/45) were observed in this group. Regurgitation of food debris and duodenal content into the biliary tract through the anastomosis was observed. The rate of recurrent cholangitis was equal to the preoperative period (93.3%, 42/45). The rate of acute cholangitis severe type after choledochoduodenostomy (46.7%, 21/45) increased significantly (P<0.01) when compared to the preoperative period (20.0%, 9/45).
Choledochoduodenostomy did not entirely achieve the goal of clearance of stones, correction of strictures, and removing of hepatobiliary lesions by itself. Choledochoduodenostomy without cholangioplasty resulted in an increase of severe reflux cholangitis due to the loss of the anti-reflux function of the sphincter of Oddi. Therefore, choledochoduodenostomy is not an ideal approach to reduce cholangitis in hepatolithiasis and is not the best choice in the management of hepatolithiasis.
The existing research of the flatness control for strip cold rolling mainly focuses on the calculation of the optimum adjustment of individual flatness actuator in accordance with the flatness ...deviation , which is used for general flatness control.As the basis of flatness control system , the efficiencies of flatness actuators provide a quantitative description to the law of flatness control.Therefore , the determination of actuator efficiency factors is crucial in flatness control.The strategies of closed loop feedback flatness control and rolling force feed-forward control were established respectively based on actuator efficiency factors.For the purpose of obtaining accurate efficiency factors matrixes of flatness actuators , a self-learning model of actuator efficiency factors was established.The precision of actuator efficiency factors can be improved continuously by the input of correlative measured flatness data.Meanwhile , the self-learning model of actuator efficiency factors permits the application of this flatness control for all possible types of actuators and every stand type.The application results show that the self-learning model is capable of obtaining good flatness.
In flatness measuring system, the flatness measuring signal can be affected by the deflection of flatness measuring roll. The stress on flatness measuring roll was analyzed and a deflection model for ...the flatness measuring roll was obtained by using the influence function method. The model was developed on the basis of the deformation of flatness measuring roll in rolling process and compensation curve was obtained. The results indicated that the set curve of flatness is in good agreement with the online measured curve of flatness, and good strip flatness can be obtained.
Patients with xanthogranulomatous cholecystitis sometimes exhibit imaging and intraoperative findings that are similar to those of advanced gallbladder cancer, thus these patients are easily ...misdiagnosed. The present study aimed to investigate the characteristics of xanthogranulomatous cholecystitis masquerading as gallbladder cancer that could potentially aid in the correct diagnosis of this condition.
The clinical, serological, radiological and operative features of twelve patients with obviously wall-thickening or mass-forming xanthogranulomatous cholecystitis were retrospectively analyzed. Additionally, the patient preoperative features were compared to those of 36 patients with advanced gallbladder cancers.
Twelve patients with xanthogranulomatous cholecystitis exhibited one to three episodes of acute cholecystitis within 0.5 to 7 months prior to admission to the hospital. Five of these patients exhibited concomitant choledocholithiasis, whereas no concomitant choledocholithiasis was identified in patients with advanced gallbladder cancer. The incidence of abdominal pain (χ(2) = 6.588, P = 0.010), acute cholecystitis (χ(2) = 29.176, P = 0.000), acute cholangitis (χ(2) = 6.349, P = 0.012), choledocholithiasis (χ(2) = 16.744, P = 0.000), carcinoembryonic antigen test (P = 0.007), CA125 (P = 0.001), and diffuse gallbladder wall thickening (χ(2) = 6.031, P = 0.014), continued mucosal line (χ(2) = 15.745, P = 0.000), homogeneous enhancement of mucosal line (χ(2) = 19.947, P = 0.000), submucosal hypoattenuated nodules or band (χ(2) = 18.607, P = 0.000) in computed tomography demonstrated statistically significant differences between cases of xanthogranulomatous cholecystitis and gallbladder cancer. Furthermore, all the twelve patients with xanthogranulomatous cholecystitis exhibited at least one positive computed tomography imaging feature aside from past acute cholecystitis episode, and no patient with advanced gallbladder cancer simultaneously exhibited past acute cholecystitis episode and at least one positive computed tomography imaging feature.
The accurate preoperative diagnosis of xanthogranulomatous cholecystitis includes an integrated review of past acute cholecystitis episode, choledocholithiasis, and positive computed tomography imaging features. Besides, we present an algorithm for intraoperative diagnosis.
Background：This study aimed to evaluate the effects of standard rescue procedure （SRP） in improving severe trauma treatments in China.Methods：This study was conducted in 12 hospitals located in ...geographically and industrially different cities in China.A standard procedure on severe trauma rescue was established as a general rule for staff training and patient treatment.A regional network （system） efficiently integrating prehospital rescue,emergency room treatments,and hospital specialist treatments was built under the rule for information sharing and improving severe trauma treatments.Treatment outcomes were compared between before and I year after the implementation of the SRP.Results：The outcomes of a total of 74,615 and 12,051 trauma cases were collected from 12 hospitals before and after the implementation of the SRP.Implementation of the SRP led to efficient cooperation and information sharing of different treatment services.The emergency response time,prehospital transit time,emergency rescue time,consultation call time,and mortality rate of patients were 24.24 ± 4.32 min,45.69 ± 3.89 min,6.38 ± 1.05 min,17.53 ± 0.72 min,and 33.82% ± 3.87% （n =441）,respectively,before the implementation of the standardization and significantly reduced to 10.11 ± 3.21 min,22.39 ± 4.32 min,3.26 ± 0.89 min,3.45 ± 0.45 min,and 20.49% ± 3.11%,separately （n =495,P 〈 0.05） after that.Conclusions：Staff training and SRP can significantly improve the efficiency of severe trauma treatments in China.
Various novel physical properties have emerged in Dirac electronic systems, especially the topological characters protected by symmetry. Current studies on these systems have been greatly promoted by ...the intuitive concepts of Berry phase and Berry curvature, which provide precise definitions of the topological orders. In this topical review, transport properties of topological insulator (Bi2Se3), topological Dirac semimetal (Cd3As2) and topological insulator-graphene heterojunction are presented and discussed. Perspectives about transport properties of two-dimensional topological nontrivial systems, including topological edge transport, topological valley transport and topological Weyl semimetals, are provided.
AIM: To assess the impact of Arpin protein and tight junction(TJ) proteins in the intestinal mucosa onbacterial translocation in patients with severe acute pancreatitis(SAP).METHODS: Fifty SAP ...patients were identified as study objects and then classified into two groups according to the presence of bacterial translocation(BT) in the blood i.e., BT(+) and BT(-).Twenty healthy individuals were included in the control group.BT was analyzed by polymerase chain reaction, colonic mucosal tissue was obtained by endoscopy and the expression of TJ proteins and Arpin protein was determined using immunofluorescence and western blotting.RESULTS: Bacterial DNA was detected in the peripheral blood of 62.0% of patients(31/50) with SAP.The expression of TJ proteins in SAP patients was lower than that in healthy controls.In contrast, Arpin protein expression in SAP patients was higher than in healthy controls(0.38 ± 0.19 vs 0.28 ± 0.16, P < 0.05).Among SAP patients, those positive for BT showed a higher level of claudin-2 expression(0.64 ± 0.27 vs 0.32 ± 0.21, P < 0.05) and a lower level of occludin(OC)(0.61 ± 0.28 vs 0.73 ± 0.32, P < 0.05) and zonula occludens-1(0.42 ± 0.26 vs 0.58 ± 0.17, P = 0.038) expression in comparison with BT(-) patients.Moreover, the level of Arpin expression in BT(+) patients was higher than in BT(-) patients(0.61 ± 0.28 vs 0.31 ± 0.24, P < 0.05).CONCLUSION: Arpin protein affects the expression of tight junction proteins and may have an impact on BT.These results contribute to a better understanding of the factors involved in bacterial translocation during acute pancreatitis.
The effect of γ-ray irradiation and camptothecin (CAM) on human colorectal adenocarcinoma (LS 174T) growth was examined. On inhibition of DNA synthesis of LS 174T cells, almost all combined ...treatments presented a synergistic effect, excepting that the additive effects were shown at the lowest or the highest doses of CAM prior to the γ-ray (137Cs) irradiation. The in vivo antitumor activity of 131I-NCC-CO-411 monoclonal antibody against carcinoembryonic antigen in combination with CAM was assessed by a tumor growth rate in LS 174T tumor-bearing nude mice. The tumor growth of the combined group was supra-additively suppressed in comparison with that of the individual group. The results suggest that the efficacy of radioimmunotherapy may be enhanced by combination treatment with CAM. A clinical protocol involving a combination treatment with CAM is underway.
AIM:To construct a tricistronic hepatitis C virus(HCV)replicon with double internal ribosome entry sites(IRESes)of only 22 nucleotides for each,substituting the encephalomyocarditis ...virus(EMCV)IRESes,which are most often used as the translation initiation element to form HCV replicons.METHODS:The alternative 22-nucleotide IRES,RNA-binding motif protein 3 IRES(Rbm3 IRES),was used to form a tricistronic HCV replicon,to facilitate constructing HCV-harboring stable cell lines andsuccessive antiviral screening using a luciferase marker.Briefly,two sequential Rbm3 IRESes were inserted into bicistronic p UC19-HCV plasmid,consequently forming a tricistronic HCV replicon(p HCV-rep-Neo R-h Rluc),initiating the translation of humanized Renilla luciferase and HCV non-structural gene,along with HCV authentic IRES initiating the translation of neomycin resistance gene.The s H7 cell lines,in which the novel replicon RNA stably replicated,were constructed by neomycin and luciferase activity screening.The intracellular HCV replicon RNA,expression of inserted foreign genes and HCV non-structural gene,as well as response to anti-HCV agents,were measured in s H7 cells and cells transiently transfected with tricistronic replicon RNA.RESULTS:The intracellular HCV replicon RNA and expression of inserted foreign genes and HCV nonstructural gene in s H7 cells and cells transiently transfected with tricistronic replicon RNA were comparable to those in cells stably or transiently transfected with traditional bicistronic HCV replicons.The average relative light unit in p HCV-rep-Neo R-h Rluc group was approximately 2-fold of those in the p UC19-HCV-h RLuc and Tri-JFH1 groups(1.049×108±2.747×107 vs 5.368×107±1.016×107,P<0.05;1.049×108±2.747×107 vs 5.243×107±1.194×107,P<0.05),suggesting that the translation initiation efficiency of the first Rbm3 IRES in the two sequential IRESes was stronger than the HCV authentic IRES and EMCV IRES.The fold changes of 72 h/4 h relative light units in the p HCV-rep-Neo R-h Rluc and p UC19-HCV-h RLuc groups were similar(159.619±9.083 vs163.536±24.031,P=0.7707),and were both higher than the fold change in the Tri-JFH1 group 159.619±9.083 vs 140.811±9.882,P<0.05;163.536±24.031 vs 140.811±9.882,P<0.05),suggesting that the replication potency of the Rbm3 IRES tricistronic replicon matched the replication of bicistronic replicon and exceeded the potency of EMCV IRES replicon.Replication of tricistronic replicons was suppressed by ribavirin,simvastatin,atorvastatin,telaprevir and boceprevir.Interferon-alpha 2b could not block replication of the novel replicon RNA in s H7 cells.After interferon stimulation,Mx A m RNA and protein levels were lower in s H7 than in parental cells.CONCLUSION:Tricistronic HCV replicon with double Rbm3 IRESes could be applied to evaluate the replication inhibition efficacy of anti-HCV agents.
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