ABSTRACT
Primary biliary cholangitis (PBC) is an autoimmune liver disease manifesting as cholestasis and is often observed in the middle-aged and elderly women. About 50% of the patients have fatigue and itching, and 20% have depression or mood changes. In recent years, a number of studies have shown that the non-specific symptoms of patients with primary biliary cholangitis (PBC), such as fatigue, itching, and cognitive changes, are associated with the structural and functional changes of the central nervous system. Early identification of preclinical PBC patients through brain imaging changes may be one of the ways for the early diagnosis of this disease.
ABSTRACT
Primary biliary cholangitis (PBC) is an autoimmune liver disease manifesting as cholestasis and is often observed in the middle-aged and elderly women. About 50% of the patients have fatigue and itching, and 20% have depression or mood changes. In recent years, a number of studies have shown that the non-specific symptoms of patients with primary biliary cholangitis (PBC), such as fatigue, itching, and cognitive changes, are associated with the structural and functional changes of the central nervous system. Early identification of preclinical PBC patients through brain imaging changes may be one of the ways for the early diagnosis of this disease.
ABSTRACT
ObjectiveTo investigate the efficacy of endoscopic retrograde cholangiopancreatography (ERCP) in the treatment of acute obstructive suppurative cholangitis (AOSC), and to examine the results of bile bacterial culture and drug susceptibility test. MethodsA retrospective analysis was performed on 150 AOSC patients who were admitted to the Fifth Affiliated Hospital of Zunyi Medical University from November 2009 to November 2014. All patients underwent ERCP. The bile of patients was collected during treatment. Antibiotics were chosen according to the results of bile bacterial culture and drug susceptibility test. The efficacy of ERCP was assessed. Comparison of continuous data between groups was made by independent-samples t test, while comparison of categorical data by chi-square test. ResultsThe rate of successful intubation was 92% (138/150), and the rate of effective drainage was 94.2% (130/138). After treatment, the 130 patients treated with effective drainage had significantly reduced total bilirubin and direct bilirubin (60.3±43.4 μmol/L vs 110.2±53.1 μmol/L, t=8.56, P＜0.05; 35.5±23.6 μmol/L vs 65.5±33.2 μmol/L, t=8.65, P＜0.05) and a significantly reduced percentage of neutrophils (65.2% vs 83.4%, χ2=11.85, P＜0.05). The results of bile bacterial culture showed that Gram-negative bacteria were found in 85.7% (78/91) of positive specimens. The β-lactam antibiotics with enzyme inhibitor could be used as the preferred drug, and carbapenems as second-line drugs. ConclusionECRP is a simple and effective therapy for AOSC. Antibiotics, chosen based on the results of bile bacterial culture, can quickly relieve symptoms of poisoning and prevent drug resistance.
ABSTRACT
ObjectiveTo investigate the efficacy of endoscopic retrograde cholangiopancreatography (ERCP) in the treatment of acute obstructive suppurative cholangitis (AOSC), and to examine the results of bile bacterial culture and drug susceptibility test. MethodsA retrospective analysis was performed on 150 AOSC patients who were admitted to the Fifth Affiliated Hospital of Zunyi Medical University from November 2009 to November 2014. All patients underwent ERCP. The bile of patients was collected during treatment. Antibiotics were chosen according to the results of bile bacterial culture and drug susceptibility test. The efficacy of ERCP was assessed. Comparison of continuous data between groups was made by independent-samples t test, while comparison of categorical data by chi-square test. ResultsThe rate of successful intubation was 92% (138/150), and the rate of effective drainage was 94.2% (130/138). After treatment, the 130 patients treated with effective drainage had significantly reduced total bilirubin and direct bilirubin (60.3±43.4 μmol/L vs 110.2±53.1 μmol/L, t=8.56, P＜0.05; 35.5±23.6 μmol/L vs 65.5±33.2 μmol/L, t=8.65, P＜0.05) and a significantly reduced percentage of neutrophils (65.2% vs 83.4%, χ2=11.85, P＜0.05). The results of bile bacterial culture showed that Gram-negative bacteria were found in 85.7% (78/91) of positive specimens. The β-lactam antibiotics with enzyme inhibitor could be used as the preferred drug, and carbapenems as second-line drugs. ConclusionECRP is a simple and effective therapy for AOSC. Antibiotics, chosen based on the results of bile bacterial culture, can quickly relieve symptoms of poisoning and prevent drug resistance.