Analysis of risk factors and prevention strategies of post-ERCP pancreatitis.

OBJECTIVE: To analyze the relevant risk factors and preventive measures for post-endoscopic retrograde cholangiopancreatography (post-ERCP) pancreatitis (PEP) so as to improve the diagnosis and treatment levels of ERCP, thus reducing the prevalence rate of PEP. PATIENTS AND METHODS: The clinical data of 278 patients receiving ERCP from January 2014 to December 2016 were retrospectively analyzed. First, the univariate analysis was conducted for the factors such as gender, age, diameter of common bile duct, whether development occurred in the pancreatic duct and other factors. Then, the multivariate logistic regression analysis was performed for factors showing statistical significance in the univariate analysis so as to analyze the independent risk factors for PEP. RESULTS: The success rate of ERCP included in the study was 97.12%. The prevalence rate of PEP was 8.27%. Univariate analysis results showed that the prevalence rate of PEP in the group of patients younger than 60 years old was higher than that in the group of patients older than 60 years old (14.14% vs. 5.03%, p = 0.016); the prevalence rate of PEP in the group of patients with intubation difficulty was higher than that in the group of patients without intubation difficulty (19.61% vs. 5.73%, p = 0.004); the prevalence rate of PEP in the group of patients with operation time more than 60 min was higher than that in the group of patients with operation time less than 60 min (18.60% vs. 6.38%, p = 0.034); the prevalence rate of PEP in the group of patients with the pancreatic duct development was higher than that in the group of patients without the pancreatic duct development (50% vs. 6.72%, p < 0.001); the prevalence rate of PEP in the group of patients placed with nasobiliary drainage catheters was not higher than that in the group of patients not placed with nasobiliary drainage catheters (18.00% vs. 2.81%, p < 0.001). The above five relevant factors were included in the logistic regression equation for the multivariate analysis, which showed that the age less than 60 years old (p = 0.002) and the pancreatic duct development (p = 0.004) were independent risk factors for PEP, and nasobiliary drainage (p = 0.003) was a protective factor for PEP. CONCLUSIONS: The occurrence of PEP is associated with the age less than 60 years old, the pancreatic duct development, intubation difficulty and overlong operation time. Among them, the pancreatic duct development and the age less than 60 years old are independent risk factors for PEP. Placing nasobiliary drainage catheters after operation, avoiding the pancreatic duct development, improving the success rate of intubation, reducing ERCP operation time and other methods, can effectively reduce the occurrence of PEP.

5-HT3A receptors are required in long-term depression and AMPA receptor internalization.

5-Hydroxytrytamine (serotonin) type 3A receptors (5-HT3ARs), as the only ligand-gated ion channels in the serotonin receptor family, are known to regulate neuronal excitation and release of GABA in hippocampal interneurons. However, their physiological role in glutamatergic synaptic plasticity remains unclear. Here, we show that deletion of the 5-HT3AR gene in transgenic mice abolished N-methyl-d-aspartate (NMDA) receptor (NMDAR)-dependent long-term depression (LTD) induced by low-frequency stimulation (LFS) in hippocampal CA1 synapses in slices, whereas the metabotropic glutamate receptor (mGluR)-dependent LTD did not change in the 5-HT3AR knockout mice. In addition, 5-HT3ARs disruption inhibited α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptors (AMPARs) internalization, without altering basal surface levels of AMPARs. However, the deletion of 5-HT3ARs did not lead to loss of synapses and structural alteration of dendritic spines. Furthermore, the concentrations of 5-HT and 5-hydroxyindoleacetic acid (5-HIAA) in the hippocampus were not affected by the deletion of 5-HT3ARs. These observations revealed an important role of 5-HT3ARs in NMDAR-dependent long-term depression, which is critical for learning behaviors.

[Effects of katamine on cardiopulmonary bypass-induced interleukin-6 and interleukin-8 response and its significance].

OBJECTIVE: To investigate the effects of ketamine on cardiopulmonary bypass-induced IL-6 and IL-8 response. METHODS: Twenty-four adult patients undergoing cardiac valve replacement were divided into control and ketamine group (n = 12). In the ketamine group, 1 mg.kg-1 ketamine was infused intravenously at the beginning of operation and CBP. Plasma levenof IL-6 and IL-8 were measured at different time after induction of anesthesia. RESULTS: In both groups, the levels of IL-6 and IL-8 increased significantly compared with those at the time before CBP (P < 0.05), but compared with those in control groups, IL-6 and IL-8 levels decreased obviously in ketamine group(P < 0.05). CONCLUSIONS: Ketamine is effective to reduce cardiopulmonary bypass-induces IL-6 and IL-8 response and protect reperfusion myocardium.

Air bronchogram in differential diagnosis of small peripheral lung cancers on CT image.

The computed tomographic (CT) images of 52 patients of small peripheral lung nodule < 3 cm proved pathologically were reviewed. Air bronchogram (AB) was found in 14 nodules on thin-section CT images, in which well or moderately differentiated small adenocarcinomas were only seen with lipidic growth. Squamous-cell, large-cell carcinomas and small benign lung nodules had no AB sign both on CT image and in pathologic specimens.

[Sensitivity in vitro of Plasmodium falciparum to chloroquine, pyronaridine, artesunate and piperaquine in south Yunnan].

The sensitivity of P. falciparum to chloroquine, pyronaridine, artesunate and piperaquine (CQ, PD, AT, PQ) was assayed using in vitro microtechnique in south Yunnan in 1990. The resistance rates were 98.7% (75/76), 27.6% (16/58), 13.8% (9/65) and 97.7% (43/44) respectively, and ID50 were 125.0, 19.0, 4.7 and 243.3 nmol/L, respectively. The resistance rate against CQ showed no change as compared to the rates against CQ 5 and 9 years ago; but the ID50 was lower. CQ-resistant P. falciparum showed a marked cross-resistance to PQ, but not to PD and AT. AT-resistant P. falciparum exhibited cross-resistance to the above-mentioned three drugs. PD-resistant P. falciparum showed no cross resistance to AT, but showed cross resistance to CQ and PQ. In comparison with chloroquine-coated plates, the plates coated with pyronaridine, artesunate or piperaquine gave similar results as the former, which were shown by the rise in schizont inhibition rates along with the rise in drug concentration. It indicates that pyronaridine-, artesunate-, and piperaquine-coated plates can be used in the assay of sensitivity of P. falciparum to the three drugs.