Objective To evaluate the expression of peroxisome proliferator-activated receptor γ(PPARγ)and retinoid x receptorα(RXRα)in cholangiocarcinoma to explore its relation to clinicopathological factors and investigate its impact on prognosis.Methods Expression of PPARγ and RXRα was detected by immunohistochemistry in 69 cases of cholangiocarcinoma and 12 non-tumor cases.The relation of PPARγ and RXRα expression to clinicopathological parameters and prognosis was determined.Results The expression rates of PPARγ in 69 cases of cholangiocarcinoma and 12 non-tumor cases were 59.4% and 0, respectively(P＜0.05).The expression rates of RXRα in 69 cases of cholangiocarcinoma and 12 non-tumor cases were 78.3% and 20%, respectively.There were significant differences between the 2 groups in PPARγ and RXRα expression.PPARγ expression was associated with TNM clinical stages and lymph node metastasis.According to univariate survival analysis,PPARγ expression was correlated with poor prognosis(P＜0.05).There was positive correlation between PPARγ and RXRα.Conclusion The expression of PPARγis significantly correlated with the clinicopathological characteristics and biological behaviors of cholangiocarcinoma.PPARγ and RXRα expression may play an important role during tumorigenesis.

Objective To evaluate the relationship between ultrasound-assayed detrusor thickness and bladder outlet obstruction (BOO) in old men with benign prostatic hyperplasia (BPH).Methods The 106 BPH patients underwent the urodynamic examination on which the diagnosis of BOO was dependent. The obstruction was defined as the Abrams-Griffiths nomogram (A-G index)≥40 and the grade of linear passive urethral resistance relation (LinPURR)≥Ⅱ . When bladder capacity reached 150 ml, the detrusor thickness was measured by abdominal ultrasound. Results Compared with unobstructed group, the maximum flow rate and average flow rate were both lower in obstructed group [(10.1±3.0) ml/s vs. (17.4±3.1) ml/s, (5.5±2.2) ml/s vs. (11.2±2.2) ml/s, t= 10.26and 11.03, both P＜0.01]. And the residual urine volume and maximum detrusor pressure were significantly higher in obstructed group than in unobstructed group [(47.6 ± 24.3) ml vs. (17.0 ±5.6) ml, (39.3±14.4) cm H2Ovs. (26.8±8.0) cm H2O, t=6.32 and 4.07, P＜0.01 or 0.05].Detrusor thickness was positively correlated with maximum detrusor pressure (r= 0.419, P＜0.01),but negatively correlated with maximum flow rate (r =- 0.749, P＜ 0.01 ), mean flow rate (r=-0.853, P＜0.01) and voided volume (r=-0.556, P＜0.01). There was significant difference in detrusor thickness between obstructed group and unobstructed group [(3.0± 0.2) mm vs. (2.5 ±0.2) mm, t= 11.2,P＜0.05]. According to the diagnostic standard of detrusor thickness≥3.0 mm,it had a sensitivity of 90% and a specificity of 84.6%, a positive predictive value of 93.1% and a negative predictive value of 78.6%. Conclusions Detrusor thickness of 3.0 mm or greater has a certain predictive value for BOO in old men.

Objective To study the methods of matching kilovolt CBCT image with planning CT scan. Methods A total of 121 CBCT scans were matched with planning CT scan using a manual and four automatic match methods by four observers in the offline. In the manual match, the live contour was used as a surrogate for image registration. Four automatic match methods, including routine soft?tissue match, routine bone match, automatic liver match and vertebral body match, were performed using image registration sofeware. First, the stability of the sofeware was tested. Then, the reproducibility of the same automatic match method was evaluated by comparing different observers’ match results. After the manual match by four observers, the mean of the match results was used as a standard to compare with others. The differerces was test by McNemar method. Results In the uniform match factors, automatic match result would not change. The reproducibility of routine soft?tissue and bone match are best, automatic vertebral body match is better than automatic liver match. Howerver, the automatic liver match result is the most similar to manual match, the percentages of match result have an absolute error no more than 3 mm in left?right, superior?inferior and anterior?posterior directions are 84?? 3%, 77?? 7% and 92?? 6%. Conclusions Automatic liver match can be used in image?guided radiotherapy for liver cancer, however, it should be performed by experienced oncologist and technologist together in each fraction, after that, the matching result should be adjusted carefully according to live contour.

Objective To investigate the relationship between expression of P-glycoprotein (P-gp), glutathione S-transferase-π (GST-π) and chemosensitivities in lymph node metastases (LNMs) of gastrointestinal carcinomas. Methods Tumor chemosesitivities to 9 drugs was measured by MTT assay, and the expression of P-gp and GST-π were determined immunohistochemically in primary tumor (PT) and LNMs of gastrointestinal carcinomas in 54 patients. Results The P-gp expression was detected in 22% cases (k= -0.0133, P =0.8698) for beth PT and LNMs, and of GST-π in 50% (k =0. 1137, P= 0. 1496). Expression of P-gp and GST-π in LNMs were stronger eompared with PT (Z = -3. 0448, Z = -2. 1178, both P <0. 05). The inhibition rates of LNMs cells for VCR, OPT, OXA, DDP and MTX were lower than those to PT (all P < 0. 05), but for VP-16 it was higher (P < 0. 05). In PT, there were negative correlation between expression of P-gp and inhibition rates of tumor cells for 5-FU, VCR and PTX respectively (r = -0. 4142 ～ -0. 5712, all P <0. 05), and GST-π for 5-FU, VCR, OPT and PTX as well (r = -0. 3927 ～ -0. 4951, all P <0. 05). In LNMs, negative correlation between expression of P-gp and inhibition rates of tumor cells for VP-16, PTX and eADM were found statistically (r = - 0. 3802 ～ - 0. 4624, all P < 0. 05), and also GST-π for 5-FU, VCR and DDP (r = - 0. 3996 ～ - 0. 5345, all P < 0. 05). Conclusions The LNMs of gastrointestinal carcinomas are heterogeneous with respect to expression of mdr-related factors and response to chemotherapy, and more resistant than the PT for chemotherapeutants. Effective adjuvant chemotherapy in gastrointestinal cancers depends on targeting the metastatic component of the tumor.

Objective:To observe the clinical therapeutic effect of needling the acupoints of Governor Vessel and Bladder Meridian plus cupping on chronic fatigue syndrome. Methods: Fifty cases of chronic fatigue syndrome were divided into the treatment group(n= 25) and the control group(n=25). The patients in the treatment group were treated by needling Dazhui (GV 14), Zhiyang (GV 9),Xinshu (BL 15), Geshu (BL 17), Mingmen (GV 4), Shenshu (BL 23) and Changqiang (GV 1). Even reinforcing and reducing manipulation was used. Every time after the needles were withdrawn, the glass jar with thick and smooth mouth was selected to go on the back. The patients in the control group were treated by taking Chinese medicinal herbs, Caili composition, orally. Results: After 3durations of treatment, the therapeutic effects of the two groups were 92. 0% and 64. 0%respectively. There was significant difference in the therapeutic effect between the two groups(x2 =7.29,P ＜ 0.05).Conclusion: Acupuncture plus cupping is an effective method in treating chronic fatigue syndrome.

Objective:To retrospectively analyze the experience of our center in the use of marginal donor heart, and to explore the principle of use and risk control of marginal donor heart.Methods:A total of 31 patients with end-stage heart disease underwent orthotopic heart transplantation in our center from January 2018 to December 2018, including 28 cases of pure heart transplantation, 2 cases of combined heart-lung transplantation, and 1 case of combined heart-kidney transplantation. 26 of the 31 cases were marginal donor hearts. These patients were all anastomosed by a double lumen method.Results:The rates of postoperative use of ECMO, IABP and acute rejection were zero in this study. The time of cardiopulmonary bypass in the marginal donor group was significantly longer compared with the conventional donor group( P<0.05), but there was no significant difference between the two groups in terms of hospitalization time, mechanical ventilation time, ICU stay time, abnormal rate of ECG, LVEF and blood biochemical indexes(all P>0.05). The postoperative follow-up rate was 100% in the two groups. One case of combined heart-lung transplantation in the marginal donor group died of multiple organ failure in the first month after surgery. During the postoperative follow-up period, the incidence of moderate to severe tricuspid regurgitation and the incidence of recurrent heart failure were zero in the two groups. There was no significant difference in the incidence of arrhythmia, LVEF, infection and blood biochemical parameters. Conclusion:The application of marginal donor heart has no significant effect on the short-term survival rate and recovery of patients after heart transplantation, but the long-term effect needs further follow-up.

Objective:To establish a method for determintation of chlorogenic acid and linarin in Yejuhua granules by HPLC.Methods:We applied HPLC methods. The Kromasil 100-5 C18 column (250 mm×4.6 mm,5 μm) was used, the mobile phase was acetonitrile-0.4%H 3PO 4 solution (gradient elution), the flow rate was 1.0 ml/min, the dection wavelenghth was 334 nm and the column temperture was 32 ℃. Results:Chlorogenic acid and buddleoside had good linearity in the ranges of 0.30-1.50 μg ( r2=0.999 1) and 0.12-0.62 μg ( r2=0.999 8), respectively. The average recoveries were 99.70% and 96.67%, with RSD<2%, respectively. Conclusion:The method is simple, rapid, reliable, efficient, and can be used for determination of chlorogenic acid and buddleoside in Yejuhua Granules.