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Objective@#To improve the awareness of emergency biliary obstruction (BO) disease, and to further improve the diagnosis and treatment ability of BO patients.@*Methods@#Data of the etiology, clinical manifestations, imaging data, laboratory tests, and emergency treatment outcomes in 63 BO patients were retrospectively analyzed.@*Results@#Common bile duct stones were the most common cause of BO patients (63.49%), followed by cholangiocarcinoma (19.05%); the most common clinical manifestations of BO patients were jaundice (90.48%), abdominal pain (87.30%), and fever (53.97%); the diagnostic ability of computed tomography (CT) and magnetic resonance cholangiopancreatography (MRCP) in patients with BO was significantly higher than that of ultrasound (P<0.05), but there was no significant difference between CT and MRCP (P=1.000); compared with benign group, hemoglobin and albumin in malignant group were significantly lower, while total bilirubin and direct bilirubin were higher, with statistically significant difference (P<0.05). Most patients in BO patients improved after treatment, and the mortality rate of BO patients was 3.17%(2/63) at the end of emergency visit.@*Conclusions@#Common bile duct stones and cholangiocarcinoma are still the most common causes of emergency BO patients. The most common clinical manifestations of patients with emergency BO are jaundice, abdominal pain, and fever. Better than abdominal ultrasound, CT and MRCP have comparable diagnostic capabilities in the diagnosis of emergency BO patients. Anemia, hyperbilirubinemia and hypoproteinemia are alarm indicators for malignant tumors in emergency BO patients. Most patients can temporarily get better at the end of emergency visit.
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Objective To improve the awareness of emergency biliary obstruction (BO) disease,and to further improve the diagnosis and treatment ability of BO patients.Methods Data of the etiology,clinical manifestations,imaging data,laboratory tests,and emergency treatment outcomes in 63 BO patients were retrospectively analyzed.Results Common bile duct stones were the most common cause of BO patients (63.49％),followed by cholangiocarcinoma (19.05％);the most common clinical manifestations of BO patients were jaundice (90.48％),abdominal pain (87.30％),and fever (53.97％);the diagnostic ability of computed tomography (CT) and magnetic resonance cholangiopancreatography (MRCP) in patients with BO was significantly higher than that of ultrasound (P ＜ 0.05),but there was no significant difference between CT and MRCP (P =1.000);compared with benign group,hemoglobin and albumin in malignant group were significantly lower,while total bilirubin and direct bilirubin were higher,with statistically significant difference (P ＜ 0.05).Most patients in BO patients improved after treatment,and the mortality rate of BO patients was 3.17％ (2/63) at the end of emergency visit.Conclusions Common bile duct stones and cholangiocarcinoma are still the most common causes of emergency BO patients.The most common clinical manifestations of patients with emergency BO are jaundice,abdominal pain,and fever.Better than abdominal ultrasound,CT and MRCP have comparable diagnostic capabilities in the diagnosis of emergency BO patients.Anemia,hyperbilirubinemia and hypoproteinemia are alarm indicators for malignant tumors in emergency BO patients.Most patients can temporarily get better at the end of emergency visit.
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Objective:To assess the effect of B group vitamins on cerebrovascular diseases, and also to evaluate the relationship between B group vitamins and homocysteine(Hcy). Methods:Using the words homocysteine,folic acid,folate,cerebrovascular dis-ease,B group vitamins and randomized controlled trial as the keywords,PubMed,the Cochrane library,WanFang Database,VIP and CNKI were searched. The randomized controlled trials about preventive effect of folic acid,vitamin B12or vitamin B6on cerebrovascular disease occurring published between 1998 and July 2016 were searched by manually retrieving relevant journals. Two reviewers inde-pendently screened the trials,extracted the data and evaluated the quality of included trials. The Cochrane Collaboration's RevMan 5.3 software was used for the statistical analysis. Results:Twelve trials involving 36 053 patients were included. The results of meta-analysis showed that B group vitamins could lower the risk of stroke(RR=0.90,95% CI:0.82-0.99,P=0.02). The sensitivity a-nalysis conducted after the exclusion of low-quality trials did not change the overall results, and B group vitamins could lower plasma Hcy concentration (MD= -3.40,95% CI:-4.21--2.59, P<0.000 01). Conclusion: B group vitamins can lower plasma Hcy concentration,and lower the risk of stroke. B group vitamins supplementation should be recommended for the secondary prevention of stroke. The results of this study still need more reasonable design combined with strict implementation of larger samples of randomized double-blind controlled trials.
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Objective To study the proliferation and apoptosis of related proteins in pathological liver tissues of alcohol-induced mice,and establish a model and time-evolution rule of liver cell apoptosis,which can be used to guide the clinical treatment of acute alcoholic liver injury.Methods A total of 30 male KM mice were fed in a clean grade animal room at the Capital Medical University and then randomly (random number) separated into two groups.The 10 mice in the normal group were fed without ethanol,while the other 20 mice in the experimental group were given a one-time grant of 50％ ethanol (12 mL/kg) by gavage.The mice in the experimental group were killed at two time points,6 h for 10 mice and 12 h for the other 10,after the intragastric administration.Hematoxylin and eosin (HE) staining was used to observe the morphological changes of liver in mice.The concentrations of T-ERK,p-ERK,PKC,p-PKC and caspase-3 were determined by the Western-blot method.The data were analyzed by Analysis of variance (ANOVA) method using statistical software SPSS 11.5 and criterion P ＜ 0.05 is chosen to determine differences that are statistically significant.Results By observing the behavioral changes and morphological indexes of mice,we confirmed the success of the model for acute alcoholic liver injury.During the process of re-building the model,no mice died.The mice in the experimental group appeared in drunken states,such as sleepiness and slowness of movement.Compared to the normal group,the experimental subgroup at the 6 h point showed no difference statistical significant; while the experimental subgroup at the 12 h point showed obvious histological changes in tissues,including the disorder of hepatic lobule structure and fatty vacuolization of hepatocytes.At the same time,in the experimental subgroup at the 12 h point,both P-ERK and P-PKC significantly decreased [(2.41 ±0.38),(0.97 ±0.25),F=4.82,P＜0.05; (0.16 ±0.00),(0.08 ± 0.01),F =29.63,P ＜ 0.05],but caspase-3 significantly increased [(0.30 ± 0.02),(0.11 ± 0.01),F =34.38,P ＜ 0.05].Conclusions In mice after intragastric administration of large doses of alcohol,the hepatic cell apoptosis appeared mainly after 6 h but before 12 h,therefore 6 ～ 12 h might be the time window to inhibit the cell apoptosis of mice' s acute liver injury from alcohol induction.
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OBJECTIVE:To investigate the recent use of immunosuppressive agents for renal transplantation patients during our hospital.METHODS:Case history of124renal transplantation patients in our hospital in2004was reviewed ret-rospectively,and the categories and the associated costs of immunosuppressive agents were statistically analyzed,which were compared with that of2000.RESULTS:In2004,patients’mean hospitalization cost was74462.77yuan and mean immuno-suppressive agents cost was25809.93yuan,increased by75.12%and175.35%,respectively as compared to2000.Of the total drug costs,the immunosuppressive agents accounted for61.37%in2004and46.4%in2000.Dominated the first3places in the list of DDDs of immunosuppressive agents in2004were Methylprednisolone,ciclosporin A and dehydrocortisone,respec-tively.CONCLUSIONS:As compared with2000,the application categories and costs of neotype immunosuppressive agents for renal transplantation patients in our hospital increased in2004,thus to find a more effective immunosuppressive remedy that of less adverse drug reaction and lower cost is of great significance.