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Objective:To study the relationship between pancreaticobiliary maljunction (PBM) with cholangiopancreatic diseases, and to evaluate the efficacy and safety using endoscopic therapy for PBM.Methods:The clinical data of 734 patients treated with ERCP at the Affiliated Hospital of Guizhou Medical University from May 2016 to April 2020 were analyzed retrospectively. Of 31 PBM patients who were finally included in this study, there were 23 patients with benign diseases and 8 patients with malignant diseases. Using the diameter of bile duct, these patients were divided into two groups: dilated bile duct group and the non-dilated bile duct group. The general characteristics of patients, incidences of cholangiopancreatic disease, endoscopic treatment, therapeutic efficacy and follow-up data were analyzed.Results:Of the 31 patients with PBM, 11 were males and 20 were females, aged (56.7±16.2) years. There were 4 patients with choledochal cyst (12.9%) and 6 patients with biliary cancer (19.4%). The incidences were significantly higher than those in non-PBM patients (0.9% and 5.3%, respectively, P<0.05). All 31 patients with PBM underwent endoscopic EST treatment, including 15 patients (48.4%) treated with endoscopic naso-biliary drainage (ENBD), 9 patients (29.0%) with endoscopic retrograde biliary drainage (ERBD), 4 patients (12.9%) with endoscopic papillary balloon dilatation (EPBD)+ ENBD, 1 patient (3.2%) with endoscopic metal biliary endoprothesis (EMBE)+ ENBD, 1 patient with ERBD+ endoscopic retrograde pancreatic drainage (3.2%), and 1 patient with EPBD+ ERBD+ EMBE (3.2%). The operative success rate was 100%. Serum AST, ALT, ALP, GGT, TBil and DBil levels of patients in the benign group and malignant group were significantly decreased postoperatively when compared with the preoperative levels (all P<0.05). One patient (3.2%) developed post ERCP pancreatitis. The preoperative and postoperative NRS scores of the patients in the benign group were 7(6, 8) points compared to 0 (0, 1) points, respectively ( P<0.05). All the 23 patients in the benign group were followed up for (25.13±12.90) months. There were no patients who were loss to follow-up. There was no malignant transformation. Three PMB patients with dilated bile ducts still had attacks of abdominal pain or jaundice. The symptoms of the remaining 20 patients were completely relieved, giving a treatment efficacious rate of 87.0% (20/23). Conclusions:PBM was closely related to choledochal cysts, biliary cancer and other diseases. Endoscopic treatment was efficacious and safe, and provided a safe and feasible treatment in preventing future cholangiopancreatic attacks.
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Objective To investigate the effect and mechanism of panax notoginseng saponins (PNS) on atrial fibrillation in rat model.Methods The rats were randomly divided into control group,atrial fibrillation group and intervention group,with 16 rats in each group.Except the control group,atrial fibrillation rat model was established in the other two groups by continuous tail vein injection of acetylcholine 66 μg/ml and calcium chloride 10 mg/ml mixture.From the first day of modeling,PNS 100 μtg/g was intraperitoneally injected in the intervention group,while the control group and atrial fibrillation group were intraperitoneally injected with saline of equal volume once a day for 7 days.After 7 days,electrocardiogram was recorded,effective refractory period was detected,and myocardial tissue was stained with Masson staining.The expression of phosphatidyl inositol 3-kinase (PI3K) and protein kinase B (AKT) in myocardial tissue was detected by Western blots.Results After 7 days,atrial fibrillation was observed in atrial fibrillation group,while the duration of atrial fibrillation in intervention group was significantly decreased (24.3 ± 2.6 s vs.43.2 ± 4.6 s,P＜0.05).The ERP time in intervention group was significantly prolonged (95.0 ± 10.0 s vs.75.5 ± 7.6 s,P＜0.05),but it was still lower than that in the control group (P＜0.05).Western blots showed that the levels of PI3K and AKT in atrial fibrillation group decreased significantly,while those in intervention group increased significantly (P＜0.05).Conclusions PNS could activate PI3K-AKT signaling pathway,reduce the degree of atrial fibrosis,improve ERP and reduce the duration of atrial fibrillation in rats with atrial fibrillation.
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Objective To explore the epidemiological status of abnormal glucose metabolism and its influential factors among middle and aged population with hypertension in Chengdu area. Methods In 2008, after adopting the methods of stratified cluster sampling, the authors investigated 4685 subjects of the middle and aged population between the age of 40-79 in Chengdu urban and rural area by checking blood pressure and oral glucose tolerance test (OGTY). Patients with previously known diabetes mellitus (DM) were only asked to perform fasting glucose and to carry out a questionnaire. Comparison of the prevalence rates of abnormal glucose metabolism in hypertensive and non-hypertensive subjects was carried out. The prevalence rates of isolated impaired glucose tolerance (I-IGT) and isolated postprandial hyperglycemia (IPH) among middle and aged subjects with hypertension were acquired and the influential factors of abnormal glucose metabolism among middle and aged subjects with hypertension were analyzed. Results The prevalence rate of abnormal glucose metabolism in the hypertensive subjects was obviously higher than that in the non-hypertensive subjects; without using OGTT, 72.9% of the pre-diubetic and 54. 4% of the new diagnosed DM patients would remain undiagnosed if fasting plasma glucose detection was used alone. Age, diabetic history of first degree relatives ,overweight or obesity were the risk factors for the development of abnormal glucose metabolism among middle and aged male subjects with hypertension in Chengdu area. Exercise training and high education level were the protective factors. Age, diabetic history of first degree relatives,abdominal obesity and hypertriglyceridemia were the risk factors for the development of abnormal glucose metabolism among middle and aged female subjects with hypertension in Chengdu area. Conclusions More than 50% of middle and aged subjects with hypertension in Chengdu area has accompanying abnormal glucose metabolism. OGTT easily discloses the abnormal status and should be a routine procedure in the diagnosis of pre-diabetes or DM in such population. Appropriate exercise, learning diabetes-related knowledge to take reasonable lifestyle, and intervention of metabolic factors such as overweight or obesity are advised. Abdominal obesity and hypertriglyceridemia play important roles in leading to abnormal glucose metabolism among middle and aged population with hypertension.
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Objective To investigate the circulatory levels of hormones and cytokines in the patients with the chronic heart failure(CHF)and the effect of naftopidil.Methods The levels of tumor necrosis factor-?(TNF-?),interleukin-1(IL-1),interleukin-6(IL-6),endothelin-1(ET-1),adrenomedullin(Adm),neuropeptide Y(NPY),calcitonin gene-related peptide(CGRP),atrial natriuretic peptide(ANP),brain natriuretic peptide(BNP)and C-type natriuretic peptide(CNP),and left ventricular fraction(LVEF)of 47 patients with CHF(CHF group)and 24 healthy subjects(control group)were measured by radioimmunoassay or echocardiography respectively.The patients were randomized to receive naftopidil(50mg Bid)in addition to routine therapy(B group,n=23)or routine therapy only(A group,n=24)for one-month.Results (1)The levels of TNF-?,IL-1,IL-6,ET-1,Adm,NPY,ANP,BNP and CNP of the CHF group were higher(P 0.05)in the levels of IL-1,IL-6,Adm,CNP and LVEF.(4)There were significantly inverse correlations between LVEF and TNF-?,ET-1,IL-6 or BNP(P