简介：AbstractBackground:Gallbladder and biliary tract cancer (GBTC) has greatly damaged the health of patients and is accompanied by a dismal prognosis. The worldwide distribution of GBTC shows extensive variance and the updated data in China is lacking. This study was to determine the current status, trends, and predictions in the burden of GBTC over the past 30 years in China.Methods:This was a descriptive, epidemiological, secondary analysis of the Global Burden of Disease, Injuries, and Risk Factor Study 2019 data. Data including incidence, prevalence, mortality, and disability-adjusted life years (DALYs) of GBTC in China by year, age, and sex were assessed. Joinpoint regression analysis was conducted to evaluate trends of disease burden due to GBTC from 1990 to 2019. Nordpred age-period-cohort analysis was applied for the projection of mortality and incidence due to GBTC from 2019 to 2044.Results:Nationally, there were 38,634 (95% uncertainty interval [UI]: 27,350–46,512) new cases and 47,278 (95% UI: 32,889–57,229) patients due to GBTC, causing 34,462 (95% UI: 25,220–41,231) deaths, and 763,584 (95% UI: 566,755–920,493) DALYs in 2019. Both cases and rates of burden owing to GBTC were heavier among males and at old age. From 1990 to 2019, the age-standardized rates of incidence, prevalence, mortality, and DALYs of GBTC generally increased from 1990 to 2019, with average annual percentage change at 0.8% (95% confidential interval [CI]: 0.6–1.0%), 1.3% (95% CI: 1.1–1.5%), 0.4% (95% CI: 0.2–0.6%), and 0.2% (95% CI: 0.1–0.4%), respectively. Even though the age-standardized incidence rate and age-standardized mortality rate in both sexes were predicted to decline gradually from 2019 to 2044, the number of new cases and deaths were expected to grow steadily.Conclusions:GBTC is becoming a major health burden in China, particularly among males and older individuals. Given the aging population and increasing burden, effective strategies and measurements are urged to prevent or reduce the number of new cases and deaths of GBTC.

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简介：技术突破推进了诊断成像的时间、空间的决定，并且3维(3-D)重建技术被介绍了进日常临床的实践。虚拟内视镜检查法(VE)是在3-D空格放大代表性的图象的感觉的一种非侵略的技术，提供病理学的区域和他们的包围结构的精确空间关系。许多计算机算法能被用来产生3-D图象，利用螺线计算了断层摄影术或磁性的回声成像(MRI)的在也固有的信息。VE图象通过空机关启用endoluminal航行，因此模仿常规内视镜检查法。几临床的研究验证了虚拟膀胱镜检查的诊断用途，它在膀胱肿瘤的察觉有高敏感和特性率。在肾盂，输尿管和尿道的虚拟探索的出版经验令人鼓舞却仍然少见。VE是一只保险箱，能与ureteropelvic连接阻塞在病人的长期的后续被使用的非侵略的方法，膀胱肿瘤和输尿管或尿道狭窄。它的主要限制是无能为组织病理学说的检查和联系电离放射危险提供活体检视织物标本(除非MRI被使用)。在endoluminal狭窄或阻塞的情况中，然而，VE向头部地允许虚拟endoluminal航行并且对小型机关枪的一种尾耳的片断。得出结论，VE提供评估泌尿道的一个不太侵略的方法，特别为比放射线学者不太熟悉代表性的成像的临床医生。

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简介：Objective:Tostudythetechniquesofplacementofmemoryalloyplatinggoldbiliarystentandplasticstentforpalliationofmalignantandbenignbiliaryobstruction,andtoassessitsclinicaleffectiveness.Methods:Thepatientsinplasticstentgroupincludedpaplillaofduodenuminflamationalstrictures(n=24),commonbileductinflammationalinferiorsegmentstrictures(n=4),choledocholithiasis(n=5),bileleak(n=11),bileductsurgeryinjurey(n=7)andpancreaticcarcinoma(n=1).Thepatientsinplatinggoldstentgroupincludedcommonbileductcarcinoma(n=5)andpancreaticcarcinoma(n=6).Underfluoroscopicguidancethestentwasinsertedintobiliaryobstructionsitesfromoralcavityinallcases.Complications,liverfunctionandbloodserumamylasewereinvestigatedduringthestudyperiod.Results:Successfulstentplacementwasachievedinallcases.Afteroperationof7days,ingoldbiliarystentgroups,theratesofdecreaseofbloodserumtotalbilirubin,glutamic-pyruvictransaminase,r-glutamyltranspeptidaseandalkalinephosphatasewere67.16%,58.37%,40.63%and41.54%respectively.Inplasticstentgroup,theratesofdecreaseofSTB,ALT,r-GTandAKPwere53.24%,55.03%,37.15%,34.12%respectively.Earlycomplicationincludedpost-ERCPpancreatitisandcholangititis.Occlusionofstentwasthemajorlatecomplication.Conclusion:Memoryalloyplatinggoldbiliarystentandplasticstentweresafeandefficaciousmethodsformalignantandbenignbiliaryobstruction,andcouldimprovepatient'slivingquality.Plasticstentwasanefficientcomplementfortherapyofbileleakandbileductinjury.

简介：ComparisonsintheratesofstomachandcoloncancerbetweencountriesoftheEastandthoseoftheWestsuggestthatdietaryfactorsplayasignificantroleincarcinogenesisofthegastrointestinaltract.However,ithasbeendifficulttoclarifywhichofthemanyfactorsthatinfluencecarcinogenesisareinfactalteredbydiet.Geneticdeterminants,dietaryhabits,

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简介：瞄准：与胆汁的病理为pyogenic肝脓肿(PLA)调查可行性和laparoscopic外科的治疗学的效果。方法：从2004年1月到2010年10月，有与胆汁的病理会议入口标准相结合的PLA的31个病人在我们的医院里收到了外科的管理。31个病人，13经历了laparoscopic外科(LS组)，18经历了开的外科(OS组)。包括操作时间，intraoperative血损失，手术后的复杂并发症率，一些手术后的医院停留，和脓肿复发率的临床的数据回顾地在二个组之间被分析并且比较。结果：所有病人收到了全身的抗菌素治疗。四个病人在手术前经历了指导超声的经皮的导管排水。手术后的复杂并发症发生在5个病人(16.1%，5/31)在LS组包括2并且3在OS组。一个病人在OS组在普通胆汁管和另一吃的肝脓肿复发保留了演算。没有保留的演算和肝脓肿复发发生在LS组。在二个组，在perioperative时期期间没有死亡。在时间，intraoperative血损失和输送，手术后的复杂并发症率和脓肿复发在二个组之间评估的操作没有重要差别。口头的吸入更早(1.9

简介：BACKGROUND:Thecorticospinaltractisthecorestructureofcerebralcontrolofextremitymovementandplasticity,whichareprerequisitesformovementrehabilitationafterbraininjury.Themeasurementandassessmentofplasticitychangeswithinthecorticospinaltracthasbecomeoneofthekeygoalsinthisfield.OBJECTIVE:Toexploretheeffectsofbiotinylateddextranamine(BDA)asaneuraltracerintheratcorticospinaltractandthepossibilitiesofassessingplasticitywithinthecorticospinaltract.DESIGN:Anobservationalexperiment.SETTING:DepartmentofAcupunctureofChineseMedicalCollege,ChongqingMedicalUniversity,DepartmentofNeurology,theSecondAffiliatedHospital,ChongqingMedicalUniversity.MATERIALS:EighteenmaleadultSpragueDawley(SD)ratsofcleangrade,weighing200-250g,wereprovidedbytheexperimentalanimalcenterofChongqingMedicalUniversity.Theanimalproceduresinthisstudywereinaccordancewiththeanimalethicsstandards.BDAwasprovidedbyVectorLaboratoriesCompany(USA,catalogueSp-1140;serialnumberR0721).METHODS:ThisexperimentwasperformedintheLaboratoryofChongqingMedicalUniversitybetweenSeptemberandDecember2006.AdultSDratswereusedintheexperimentand15%BDAwasinjectedslowlywithamini-syringethroughtworound(3mmdiameter)holesintotheleftsensoryandmotorcortex.Thecenterofoneholewaslocated3mmanteriorfromtheanteriorfontaneland1.5mmleftofthemidline;thesecondholewaslocated1.5mmposteriorfromtheanteriorfontaneland4mmleftofthemidline.Threeinjectionsweremadeateachholeatthreedifferentlevels:1.4,1.2,and1mmventralfromthesurfaceoftheflatskull.After14days,thebrainsandspinalcordswereremovedandfrozen.SectionswerecutonacryostatandBDAtransportationabsorbedbyaxonswasobservedunderafluorescencemicroscope.MAINOUTCOMEMEASURES:AxonalabsorptionandtransportationofBDAwasobservedunderfluorescencemicroscope.RESULTS:EighteenS

简介：AIM:Todiscusstheclinicalsignificanceofpostoperativegastrointestinaldecompressioninoperationonlowerdigestivetract.METHODS:Threehundredandsixty-eightpatientswithexcisionandanastomosisoflowerdigestivetractweredividedintotwogroups,i.e.thegroupwithpostoperativegastrointestinaldecompressionandthegroupwithoutpostoperativegastrointestinaldecompression.Clinicaltherapeuticoutcomeandincidenceofcomplicationwerecomparedbetweentwogroups.Furthermore,aninvestigationonapplicationofgastrointestinaldecompressionwascarriedoutamong200generalsurgeons.RESULTS:Thevolumeofgastricjuiceindecompressiongroupwasabout200mLeverydayafteroperation.Bothgroupshadalowergirthbeforeoperationthaneverydayafteroperation.Nodifferenceinlengthofthefirstpassageofgasbyanusanddefecationafteroperationwasfoundbetweentwogroups.Theoverallincidenceofcomplicationswasobviouslyhigherindecompressiongroupthaninnon-decompressiongroup(28%vs8.2%,P<0.001).Theincidenceofpharyngolaryngitiswasupto23.1%.Therewasalsonodifferencebetweentwogroupsregardingthelengthofhospitalizationafteroperation.Themajority(97.5%)ofgeneralsurgeonsheldthatgastrointestinaldecompressionshouldbeplacedtillpassageofgasbyanus,andonly2.5%ofsurgeonsthoughtthatgastrointestinaldecompressionshouldbeplacedfor2-3dbeforepassageofgasbyanus.Nobody(0%)deemeditunnecessaryforplacinggastrointestinalcompressionafteroperation.CONCLUSION:Applicationofgastrointestinaldecompressionafterexcisionandanastomosisoflowerdigestivetractcannoteffectivelyreducegastrointestinaltractpressureandhasnoobviouseffectonpreventingpostoperativecomplications.Onthecontrary,itmayincreasetheincidenceofpharyngolaryngitisandothercomplications.Therefore,itismorebeneficialtotherecoveryofpatientswithoutundergoinggastrointestinaldecompression.

简介：瞄准：调查怎么在老鼠orthotopic肝移植减少胆汁的复杂并发症的发生。方法：165只男Wistar老鼠的一个总数随机被划分成三个组：组A，有修改二手铐的技术的orthotropic肝移植；组B，没有移植，胆汁管被切并且重建；并且组织C，仅仅剖腹术被执行。基于为胆汁的重建使用的途径，组A被划分成二亚群:A1(n=30)，管管重建，和A2(n=30)，管十二指肠重建。在胆汁管复杂并发症上学习动脉重建的影响，组B被划分成四亚群：B1(n=10)，有肝的动脉结扎的管管重建，B2(n=10)，没有肝的动脉结扎的管管重建，B3(n=10)，有肝的动脉结扎的管十二指肠重建，和B4(n=10)，没有肝的动脉结扎的管十二指肠重建。样品被收获在操作以后或在重要胆汁的复杂并发症被发现的时间的14d。结果：在组A，anhepatic阶段是13.7??€?‥吗？？

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简介：Exosomes是endocytic起源的nanoparticles，由由他们调制cell-to-cell通讯的能力的优点正在吸引增加的注意的无数房间人口藏匿了。他们也在许多免疫学的问题正在吸引注意，包括autoimmunity和，特别地调整cytokine和chemokine激活的他们的能力。主要胆汁的肝硬化(PBC)被认为一个模型自体免疫疾病，它对胆汁的上皮的房间有高度集中的细胞毒素的回答。我们与PBC和30健康控制(HC)从29个病人从血浆孤立exosomes，并且用一个前vivo系统在mononuclear房间人口在co-stimulatory分子表示和cytokine生产上学习了这些exosomes的效果。我们也与HCexosomes相比在PBC识别了microRNA(miRNA)人口。我们此处报导尽管exosomes不改变cytokine生产，他们显著地确实在介绍抗原的人口上改变co-stimulatory分子表示。进一步，我们在CD14+单核白血球上表明了那CD86起来调整的表情，而在CD11c+上起来调整的CD40由从有PBC的病人的exosomes的树枝状的房间。另外，有在有PBC的病人的传播exosomes的miRNA表示的差别。这些数据基于co-stimulatory分子玩的观察有重要重要性在T房间激活的规定的一个微分角色。我们的观察显示从PBC的异常exosomes有选择地在介绍抗原的房间的不同子集导致co-stimulatory分子的表示。这些改变可以在自体免疫的肝疾病的致病包含。

简介：AIM:Toevaluateshort-termoutcomesfollowingintraoperativebiliarylavageforhepatolithiasis.METHODS:Atotalof932patientswhowereadmittedtotheWestChinaMedicalCenterofSichuanUniversitybetweenJanuary2010andJanuary2014andunderwentbileductexplorationandlithotomywereretrospectivelyincludedinourstudy.Thepatientsweredividedintothelavagegroupandthecontrolgroup.Relatedpre-,intra-,andpostoperativefactorswererecorded,analyzed,andcomparedbetweenthetwogroupsinordertoverifytheeffectsofbiliarylavageontheshort-termoutcomeofpatientswithhepatolithiasis.RESULTS:Amongstthepatientswhowereincluded,678patientswithhepatolithiasiswereincludedinthelavagegroup,andtheother254patientswereenrolledinthecontrolgroup.Dataanalysesrevealedthatpreoperativebaselineandrelatedintraoperativevariableswerenotsignificantlydifferent.However,patientswhounderwentintraoperativebiliarylavagehadprolongedpostoperativehospitalstays(6.67dvs7.82d,P=0.024),higherhospitalizationfees(RMB28437.1vsRMB32264.2,P=0.043),higherpositiveratesofbacterialculturesfromblood(13.3%vs25.8%,P=0.001)andbile(23.6%vs40.7%,P=0.001)samples,andincreasedusageofadvancedantibiotics(26.3%vs38.2%,P=0.001).Inaddition,inthelavagegroup,morepatientshadfever(>37.5℃,81.4%vs91.1%,P=0.001)andhyperthermia(>38.5℃,39.7%vs54.9%,P=0.001),andhigherwhitebloodcellcountswithin7daftertheoperationcomparedtothecontrolgroup.CONCLUSION:Intraoperativebiliarylavagemightincreasetheriskofpostoperativeinfection,whilenotsignificantlyincreasinggallstoneremovalrate.

简介：WemadeclinicalobservationsonthetherapeuticeffectofacupunctureonacuteupperrespiratorytractinfectionandcomparedwiththeeffectofparacetamolandAntondine,Theresultshowedthatacupuncturetherapycouldallayfevermorerapidlythandrugs,solongasthedifferentiationofsyndromesiscorrectandtheacupointisselectedproperly.

简介：我们决定了在prostatic演算和更低的尿道之间的关联症状(LUTS)，以及prostatic演算的预先安排的因素。为LUTS在我们的诊所介绍了的1527个病人，802经历了完全的评估，包括transrectalultrasonography，voidedbladder-3标本和国际prostatic症状分数(IPSS)。有prostatic演算的335个病人和没有prostatic演算的467个病人的一个总数分别地被划分成演算和没有演算组。严重LUTS和prostatic演算的预兆的因素用uni/multivariate分析被决定。全面IPSS分数是15.7卤9.2在演算和没有演算组织的9.2和14.1卤，分别地(P=0.013)。最大的流动率是12.1卤6.9和14.2卤8.2mLs?1在演算和没有演算组织，分别地(P=0.003)。在为预言严重LUTS的因素的univariate分析上，在年龄的差别(P=0.042)，prostatic演算(P=0.048)并且前列腺炎(P=0.018)是统计上重要的。在multivariate分析上，然而，没有因素是重要的。在为预先安排的multivariate分析上prostatic演算的因素，在年龄的差别(P<0.001)并且前列腺体积(P=0.001)是重要的。到我们的知识，有prostatic演算的病人抱怨更严重的LUTS。然而，prostatic演算不是严重LUTS的一个独立预兆的因素。因此，不仅因为prostatic演算而且因为年龄和另外的因素，有prostatic演算的人有更严重的LUTS。另外，老年和大前列腺体积是为prostatic演算的独立人士预先安排因素。

简介：我们在朝鲜良性的prostatic增生(BPH)在更低的尿道症状(LUTS)上分析了肥胖的效果病人。这是multicenter，在朝鲜在四个中心进行的代表性的、未来的学习。有对BPH第二等的LUTS的602个人的一个总数被包括。BPH/LUTSs盒子是有8削尖的国际前列腺症状分数(IPSS)的40年的人。高度，重量和腰圆周被测量。在602个病人之中，156个病人在90厘米上面有腰圆周，代表中央肥胖，并且215个病人在25kgm-2上面有一个身体团索引。腰圆周断然与前列腺体积被相关(P=0.034)。有腰圆周的人>90厘米富有经验1.36褶层与腰圆周90厘米与人相比增加了严重LUTS(95%CI0.82鈥?.41)的风险。前列腺体积断然与中央肥胖在人与紧急和nocturia被相关。在与BPH诊断的朝鲜的人的这张人口，中央肥胖而非全面肥胖似乎是LUTS的更重要的预言者与BPH相关。

简介：Object:Toinvestigatetherelationshipbetweenchlamydiatrachomatis(CT)andurogenitalinfection.Method:PositiverateofCTinpatientswithinflammationofurogenitaltractwassignificantlyhigherthanthosewithoutinflammation(P<0.05).Result:Therewasstatisticaldifferenceinthemalesnomattertheywerepatientswithinflammationofurogenitaltractornot(P>0.05),whiletherewasnostatisticaldifferenceinfemales(P>0.05).Theincidenceoftheinfectionwashighamongthoseagingfrom21-50yearsold.Conclusion:TheclinicalmanifestationsofCTinfectionwereobscure,soweshouldexamineCTinpatientswhohavenosymptoms,especiallyinfemalesandthoseofhigh-riskpopulation.

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