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Objective To discuss the operation timing,clinical efficacy and safety of endoscopic retrograde cholangiopancreatography (ERCP) in the treatment of acute biliary pancreatitis.Methods Retrospective analyzed the clinical data of 65 acute biliary pancreatitis patients in First People's Hospital of Jiangxia District,Wuhan city form October 2015 to July 2017,there were 45 males and 30 females,the age was (46.35 ± 8.95) years (range,25-72 years).All patients were treated with ERCP,and divided into 24-72 h group (the time from onset to ERCP treatment 24-72 h) 16 cases,72-120 h group (the time from onset to ERCP treatment 72-120 h) 25 cases and ≥ 120 h group(the time from onset to ERCP treatment ≥ 120 h) 34 cases,recorded and compared the clinical indexes during and after operation,laboratory indexes before and after treatment,incidence of surgical complications,recurrence rate and mortality.The measurement data with normal distribution were expressed as mean ± standard deviation (Mean ± SD),the F test was used for comparison among the three groups,and the t test was used for comparison between the two groups,the count data were compared by x2 test,and the rank sum test was used to compare the incidence of surgical complications.Results The abdominal pain relief time,amylase recovery time,length of stay and hospitalization expenses of the 24-72 h group were (4.48 ± 1.29) d,(3.59 ± 1.22) d,(7.24±1.55) d and (1.55 ±0.31) ten thousand yuan respectively,the 72-120 h group were (7.35 ± 1.76) d,(4.91 ±1.37) d,(13.61 ±2.13) d,(2.02 ±0.37) ten thousand yuan respectively,the ≥120 h group were (11.21 ±2.02) d,(8.86±1.95) d,(21.58±2.86) d,(2.49±0.52) ten thousand yuan respectively,with significant differences between any two groups(P ＜0.05).The serum amylase,total bilirubin,c-reactive protein and white blood cell levels of the 24-72 h group were (319.65 ±58.93) U/L,(14.22 ± 2.84) μmol/L,(31.12 ± 5.35) mg/L and (6.84 ± 1.17) × 109/L respectively,the 72-120 h group were (362.87 ±63.37) U/L,(16.39 ± 3.14) μmol/L,(37.34 ± 6.12) mg/L and (7.93 ± 1.36) x 109/L respectively,the ≥ 120 h group were (452.61 ± 75.49) U/L,(20.28 ± 3.67) μmol/L,(46.19 ± 6.98) mg/L and (9.77 ± 1.52) x 109/L respectively,with significant differences between any two groups (P ＜ 0.05).The incidence of surgical complications,recurrence rate and mortality of the 24-72 h group were 25.00％ (4/16),12.50％ (2/16) and 0 (0/16) respectively,the 72-120 h group were 24.00％ (6/25),12.00％ (3/25) and 0 (0/25) respectively,the ≥120 h group were 29.41％ (10/34),20.59％ (7/34) and 5.88％ (2/34) respectively,with significant differences between 24-72 h group,72-120 h group and ≥ 120 h group (P ＜ 0.05);But there was no significant difference between the 24-72 h group and the 72-120 h group (P ＞0.05).Conclusion In the treatment of acute biliary pancreatitis within 24-72 h and 72-120 h are safe and effective,but the improvement of laboratory indexes within 24-72 h ERCP treatment is more obvious,the length of stay is shorter,the hospitalization expenses is more provincial,and with more clinical advantage.
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Objective To analyze the variations of surface(S) region,basic core promoter (BCP) and precore (preC) regions in genomes of hepatitis B virus (HBV) from patients with coexistence of hepatitis B surface antigen (HBsAg) and hepatitis B surface antibody (anti-HBs).Methods S region,BCP and preC regions in genomes of HBV were amplified and sequenced in 62 HBV-infected patients including 27 HBsAg-positive/anti-HBs-positive patients (double positive group) and 35 HBsAg-positive/ anti-HBs-negative patients (single positive group).The sequencing results and amino acid variants in these regions were analyzed.Difference of means between groups was compared by t test.Sample rate and variation rate were compared by chi-square test.Results One hundred and fifty-six amino acids mutations within the S region were detected in 27 patients of double positive group and 100 mutations in 35 patients of single positive group.The mutation rate in double positive group was significantly higher than those in single positive (2.56％ vs 1.26％,x2 =32.07,P＜0.05).The amino acid variants in double positive group were much higher than those in single positive group within major hydrophilic region (MHR),especially in the first loop area of a-determinant in S region (4.76 ％ vs 1.02 ％,x2 =11.58,P＜0.05).The mutation rate of A1762T/G1764A in BCP in double positive group was significantly higher than those in single positive group (59.3％ vs 28.6％,x2 =5.895,P＜0.05).The mutation rate of A1846T in preC region was higher in double positive group than those in single positive group (40.7％ vs 17.1％,x2-4.265,P＜0.05).The mutation rate of A1762T/G1764A+G1896A in double positive group was also higher than that in single positive group (37.0％ vs 14.3％,x2 =4.302,P＜0.05).Conclusions The mutation rates of S region,especially in the first loop area within a-determinant,BCP and preC regions which are related with hepatocellular carcinoma development in HBsAg and anti-HBs double positive group are higher than those in HBsAg single positive group in chronic HBV infected patients.
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Objective Increased serum uric acid level is associated with type 2 diabetes (T2DM) through the mechanism of oxidative stress.As the rate-limiting enzyme in the degradation of purines in humans,xanthine oxidoreductase (XOR)catalyzes the final two reactions of purine catabolism,oxidizing hypoxanthine to xanthine,and xanthine to uric acid.The aim of this study is to investigate the association between serum XOR activity and T2DM.Methods A total of 270 patients with T2DM and 140 age-and-gender-matched health controls were enrolled in the study.The clinical examinations such as weight and height were conducted in the morning after an overnight fast.Serum XOR activity and other biochemical parameters like triglyceride,total cholesterol,high density lipoprotein cholesterol,fasting plasma glucose and uric acid levels were measured.Results Serum XOR activity was significantly elevated in T2DM patients compared with that in the controls (31.2 ± 8.91 vs 4.6 ± 0.91 U/L,P ＜0.01).Serum XOR activity was significantly elevated in T2DM patients complicated with lower extremity arterial disease compared to that in patients without lower extremity arterial disease (42.1 ± 8.43 vs 23.7 ± 5.31 U/L,P ＜ 0.01).Conclusion High XOR activity plays an important role in onset and development of T2DM.
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Objective To discuss the relationship between the substype of peripheral blood CD8 lymphocyte in patients with chronic hepatitis virus B and clinic condition and the replication of HBV. Methods CD45RO, CD45RA and CD28 of peripheral blood CD8 lymphocyte were detected by flow cytometry with multicolor fluorescence technology in 107 patients with chronic hepatitis virus B and 20 healthy volunteers. Results The total quantity of CD8 lymphocyte in patientswith chronic hepatitis virus B was not different from that in controls. The percent of CD3+ CD8+/CD45R0+ cells in patients with chronic active hepatitis was significantly higher than that of the control (15.7?3. 35)% vs( 8. 56?1. 12)% , P