Clinical efficacy of laparoscopic cholecystectomy combined with endoscopic papillary balloon dilation in treatment of gallbladder stones with common bile duct stones: A retrospective study.

BACKGROUND: The incidence of cholelithiasis has been on the rise in recent years, but the choice of procedure is controversial. AIM: To investigate the efficacy of laparoscopic cholecystectomy (LC) combined with endoscopic papillary balloon dilation (EPBD) in patients with gallbladder stones (GS) with common bile duct stones (CBDS). METHODS: The clinical data of 102 patients with GS combined with CBDS were selected for retrospective analysis and divided into either an LC + EPBD group (n = 50) or an LC + endoscopic sphincterotomy (EST) group (n = 52) according to surgical methods. Surgery-related indexes, postoperative recovery, postoperative complications, and expression levels of inflammatory response indexes were compared between the two groups. RESULTS: Total surgical time, stone free rate, rate of conversion to laparotomy, and successful stone extraction rate did not differ significantly between the LC + EPBD group and LC + EST group. Intraoperative hemorrhage, time to ambulation, and length of hospitalization in the LC + EPBD group were lower than those of the LC + EST group (P < 0.05). The rate of total complications of the two groups was 9.80% and 17.65%, respectively, and the difference was not statistically significant. No serious complications occurred in either group. At 48 h postoperatively, the expression levels of interleukin-6, tumor necrosis factor-α, high-sensitivity C-reactive protein, and procalcitonin were lower in the LC + EPBD group than in the LC + EST group (P < 0.05). At 3 d postoperatively, the expression levels of aspartate transaminase, alanine transaminase, and total bilirubin were lower in the LC + EPBD group than in the LC + EST group (P < 0.05). CONCLUSION: LC combined with EPBD and LC combined with EST are both effective procedures for the treatment of GS with CBDS, in which LC combined with EPBD is beneficial to shorten the patient's hospitalization time, reduce the magnitude of elevated inflammatory response indexes, and promote postoperative recovery.

Efficacy and safety of endoscopic submucosal dissection for early gastric cancer and precancerous lesions in elderly patients.

BACKGROUND: With advancements in the development of endoscopic technologies, the endoscopic submucosal dissection (ESD) has been one of the gold-standard therapies for early gastric cancer. AIM: To investigate the efficacy and safety ESD in the treatment of early gastric cancer and precancerous lesions in the elderly patients. METHODS: Seventy-eight elderly patients with early gastric cancer and precancerous lesions admitted to the Third Affiliated Hospital of Qiqihar Medical University were selected and classified into two groups according to the different surgical therapies they received between January 2021 and June 2022. Among them, 39 patients treated with ESD were included in an experimental group, and 39 patients treated with endoscopic mucosal resection (EMR) were included in a control group. We compared the basic intraoperative conditions, postoperative short-term recovery, long-term recovery effects and functional status of gastric mucosa between the two groups; the basic intraoperative conditions included lesion resection, intraoperative bleeding and operation time; the postoperative short-term recovery assessment indexes were length of hospital stay and incidence of surgical complications; and the long-term recovery assessment indexes were the recurrence rate at 1 year postoperatively and the survival situation at 1 year and 3 years postoperatively; and we compared the preoperative and predischarge serum pepsinogen I (PG I) and PG II levels and PG I/PG II ratio in the two groups before surgery and discharge. RESULTS: The curative resection rate and the rate of en bloc resection were higher in the experimental group than in the control group. The intraoperative bleeding volume was higher in the experimental group than in the control group. The operation time was longer in the experimental group than that in the control group, and the rate for base residual focus was lower in the experimental group than that of the control group, and the differences were all statistically significant (all P < 0.05). The length of hospital stay was longer in the experimental group than in the control group, and the incidence of surgical complications, 1-year postoperative recurrence rate and 3-year postoperative survival rate were lower in the experimental group than in the control group, and the differences were statistically significant (all P < 0.05). However, the difference in the 1-year postoperative survival rate was not statistically significant between the two groups (P > 0.05). Before discharge, PG I and PG I/PG II ratio were elevated in both groups compared with the preoperative period, and the above indexes were higher in the experimental group than those in the control group, and the differences were statistically significant (both P < 0.05). Moreover, before discharge, PG II level was lower in both groups compared with the preoperative period, and the level was lower in the experimental group than in the control group, and the differences were all statistically significant (all P < 0.05). CONCLUSION: Compared with EMR, ESD surgery is more thorough. It reduces the rate of base residual focus, recurrence rate, surgical complications, and promotes the recovery of gastric cells and glandular function. It is safe and suitable for clinical application.

[Secondary productivity of macrobenthos in rocky intertidal zone of Yushan Islands, Zhejiang Province].

In order to understand the current status of macrobenthos in intertidal zone of Yushan Islands, macrobenthos samples were collected from 5 sections in the intertidal zone in four seasons from March 2009 to January 2010, with the density, biomass, secondary productivity, and P/B value of the macrobenthos investigated by using Brey's empirical formula. The mean density of the marobenthos was 1419.5 ind x m(-2), mean biomass in ash free dry mass (AFDM) was 565.53 g x m(-2), mean annual secondary productivity was 285.58 g x m(-2) x a(-1) (AFDM), and mean annual P/B value was 0.51. The secondary productivity was mainly affected by mollusca and gastropda, with five critical species Septifer virgatus, Modiolus modiolus, Serpulorbis imbricata, Tetraclita japonica, and T. squamosa contributed 84.0% of the total. The P/B value in the study area was lower than that in other sea areas, showing that the generation turnover rate of the macrobenthos in the intertidal zone of Yushan Islands was slower, and the community structure was more stable.

[An association study of abdominal obesity and polymorphisms of UCP2 and SREBP1c genes].

OBJECTIVE: To investigate the association of -866A/G polymorphism of uncoupling protein 2 (UCP2) gene, and 54G/C polymorphism of sterol regulatory element binding protein 1c (SREBP1c) gene with abdominal obesity in the population of type 2 diabetes mellitus families. METHODS: Eligible type 2 diabetes mellitus cases from newly diagnosed and previous hospitalized patients were choson, then their family members (siblings and parents) tracked. A set of questionnaires was administered to obtain information on demographic characteristics. Physical measurements were recorded. DNA was extracted from blood samples and genotyped using polymerase chain reaction with restriction fragment length polymorphism (PCR-RFLP). Generalized estimating equation (GEE) was used to adjust for within-family correlation in analysis of relationships of factors. RESULTS: In the study population, the frequency of A allele of UCP2-866A/G polymorphism was 0.459, and of G allele 0.541; the frequency of G allele of SREBP1c 54G/C polymorphism was 0.822, and of C allele 0.178. Totally 762 participants were analyzed using GEE regression. It was shown that the odds ratio (OR) of the population with only 54G/C polymorphism of SREBP1c gene being the mutant type (GC/CC) was statistically significant while -866A/G polymorphism of UCP2 gene not being the mutant type (AG/GG) was not. The OR of the population with the opposite genotype status was 1.8 (P=0.042), and that with mutant types of both polymorphisms 3.2(P=0.001). CONCLUSION: In the population of type 2 diabetes mellitus families, only 54G/C polymorphism of SREBP1c gene being the mutant type (GC/CC) might be a moderate risk factor of abdominal obesity. When both the two polymorphisms studied are the mutant type, the risk of abdominal obesity may increase significantly.