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Objective:To investigate the risk factors for acute cholangitis after endoscopic retrograde cholangiopancreatography (ERCP) and to construct its nomogram.Methods:Clinical data of patients who underwent ERCP for common bile duct stones in the First Hospital of Lanzhou University from January 2014 to December 2019 were retrospectively analyzed. A total of 95 patients with acute cholangitis after the operation (the acute cholangitis group) were included and 285 patients without acute cholangitis after the operation (the non-acute cholangitis group) were selected by random sampling at 1∶3 via the software. Logistic regression analysis was used to evaluate the risk factors for acute cholangitis after ERCP. A nomogram model was established to predict the incidence of acute cholangitis after ERCP based on the results of multivariate analysis.Results:Univariate analysis showed that there were significant differences in age, combination with diabetes, levels of alanine aminotransferase, alkaline phosphatase and glucose, roughness in gallbladder wall, bile duct diameter, stenosis in lower bile duct, proportion of patients who underwent endoscopic retrograde biliary drainage and endoscopic nasobiliary drainage between the two groups ( P<0.05). Logistic multivariate regression analysis showed that advanced age ( OR=1.108, 95% CI:1.079-1.138, P<0.001), combination with diabetes ( OR=4.524, 95% CI:1.299-15.758, P=0.018), roughness in gallbladder wall ( OR=2.495, 95% CI:1.106-5.630, P=0.028), increased bile duct diameter ( OR=1.303, 95% CI:1.181-1.437, P<0.001), and stenosis in lower bile duct ( OR=4.192, 95% CI:2.508-7.005, P<0.001) were independent risk factors for acute cholangitis after ERCP. Based on the results of multivariate analysis, the nomogram of acute cholangitis after ERCP was established. The area under the receiver operator characteristic curve was 0.887. Conclusion:Advanced age, combination with diabetes, rough gallbladder wall, increased diameter of bile duct and stenosis in lower bile duct are independent risk factors for acute cholangitis after ERCP. Clinicians can make clinical intervention based on the nomogram of risk factors above to improve the prognosis of patients.
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Objective @#To observe the clearance of smear layer on the root canal wall in different action time by scanning electron microscope (SEM), and to determine the optimal amount of time using sonically activated irrigation to wash root canal in clinic. @*Methods@# Fifty-six ex vivo human anterior teeth with single straight root canal were selected. After routine mechanical preparation, they were divided into two experimental groups according to different irrigating agents: saline group and EDTA group. Each group was assisted by VDW sonic activation EDDY. The saline group was divided into three subgroups according to the irrigating time: 5 s, 30 s and 50 s; EDTA group was divided into six subgroups according to the irrigating time: 5 s, 10 s, 20 s, 30 s, 40 s and 50 s. The control group did not undergo root canal irrigation. After irrigation, the root was cut longitudinally. The smear layer of crown, middle and apical of root canal wall was observed by SEM.@* Results@# After irrigating for 30 seconds, there was a significant difference between the normal saline group and the control group and the 5 second group (P<0.05), and there was no difference in the middle and apical part (P>0.05). After 50 seconds, there was a significant difference in the score of the smear layer between the apical area and the other groups (P<0.05). After irrigating for 5 seconds or 10 seconds in EDTA group, there was a significant difference between the scores of the crown and middle area of the root canal and the control group (P<0.05), and there was no significant difference in the apical area (P>0.05). There was a significant difference between the 20-40 second group and the first two groups (P<0.05). There was a significant difference between the 50 second group and the other groups (P<0.05). Comparing the cleaning effect on the smear layer after 50 seconds of irrigating between the two experimental groups, the whole root canal showed significant statistical difference (P<0.05). @*Conclusion @#The EDTA-assisted sonic activated device used for 50 seconds has the best cleaning effect.
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BACKGROUND: Through exercise and/or hypoxia to increase the body's stress level and timing of hypoxia, so as to improve the body's adaptation level to exercise and/or hypoxia. However, little was known concerning the effects of acute exercise and/or hypoxia on vascular endothelial cell growth factor (VEGF) expression in skeletal muscles.OBJECTIVE: To study the effects of acute exercise and/or hypoxia on VEGF expression in rats' gastrocnemius muscles. DESIGN, TIME AND SETTING: The randomized controlled animal experiment was performed at the Clinical Laboratory, People's Hospital of Jiangsu Province, between September 2005 and September 2006.MATERIALS: Totally 108 health male SD rats were randomly divided into 6 groups, namely, normoxia quiet, normoxia high intensity, normoxia moderate intensity, hypoxia quiet, living high-training low high intensity and living high-training low high intensity moderated intensity groups, with 12 animals in each group.METHODS: In acute normoxia exercise models, rats were performed adaptive activity at 48 hours prior to experiment. The high intensity exercise was comprised of 50 m/minx1.5 min training with 2 minutes rest. The moderate intensity exercise was 30 m/min×30 min. Hypoxia environment was produced by using low oxygen instrument to simulate hypoxia training, with hypoxia for 3 days, 22 h/d, 12.8% altitude, with 22 ℃ temperature and 55% humidity. In acute training low-living high models, rats were placed in above hypoxia environment after high intensity Or moderate intensity exercise. Four rats were sacrificed at hours 0, 2 and 4 after training, and the gastrocnemius muscles were obtained.MAIN OUTCOME MEASURES: The expression of VEGF in rats' gastrocnemius muscles was detected by using western-blot.RESULTS: Hypoxia and acute normoxia exercise enhanced the expression of VEGF, hypoxia after exercise weakened exercise-induced VEGF expression, and the exercise with long time and common intensity induced the higher level VEGF expression. The expression of VEGF was the most at the time points of instantaneousness and 2 hour after exercise, the sorting of the recovery speed of VEGF changes from fast to slow was: hypoxia or training low-living high and normoxic exercise. CONCLUSION: The expressions of VEGF in rats' skeletal muscles induced by acute exercise and/or hypoxia belong to the effect of immediate-early, with existing intensity-threshold, which recovery speed is inversely proportional to the expression amplitude;"training low-living high" may be able to enhance the adaptation of skeletal muscles to sports.
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Anaerobic threshold (AT) and maximal oxygen uptake (Vo_2max) were determined according to ventilation and gas exchange measurements during graded cycling in 26 athletes and were compared with cardiac condition and function measured by 2-dimensional echocardiography exercise test in corresponding with HR at and above AT. There are significant correlations between Dd and VO_2max and between cardiac function (such as SV, CO, UMO and so on) and VO_2, but the correlations are higher in the same than in different subjects of the same HR. It suggests that the physiological individualities including cardiac function and other peripheral factors are so different that the VO_2max, AT, cardiac condition and function should be measured respectively to evaluate aerobic capabilities of each athlete, thus guiding the training and selection of athletes.