Objective To investigate the effect of palliative surgical treatment and minimally invasive biliary drainage of hilar cholangiocarcinoma.Methods Retrospectively collected 244 hilar cholangiocarcinoma patients clinical data in Affiliated Hospital of Qiingdao University between Jan.1,2008 to Dec.31,2011.Survival accoding to different treatment methods was compared using Kaplan-Meier method.The continuous measurement data were analyzed using the one-way ANOVA and the U test.The categorical variable were analyzed using the chi-square test or Fisher exact test.Result Among 244 patients, the R1/R2 resection group in 93 patients, the endoscopic retrograde biviar drainage group in 69 patients, the percutaneous transhepatic cholangial drainage group in 82 patiens.Three groups of median survival time and l-, 2-, 3-year survival rate and median survival time were (13.5 months, 8.9 months, 8.6 months), (63.0％, 24.7％, 7.4％), (33.3％, 3.3％, 0), (32.4％,4.2％, 0), respectively.There was significant difference in the survival time between R1/R2-resections and endoscopic retrograde biviary drainage treatments (P ＜ 0.001).R1/R2-resections and percutaneous transhepatic cholangial drainage treatments were statistical differences in survival time (P ＜ 0.001).Endoscopic retrograde biviary drainage and percutaneous transhepatic cholangial drainage treatments were no statistical differences in survival time (P =0.971).Conclusions Palliative surgical treatment for hilar cholangiocarcinoma patients had a more significant effect.Endoscopic retrograde biviary drainage and percutaneous transhepatic cholangial drainage of minimally invasive jaundice reducing method for prognosis in patients with hilar cholangiocarcinoma was same.

SIRT1 is an NAD+-dependent histone deacetylase,involved in many physiological processes,such as cell aging,apoptosis and differentiation.Recent studies have shown that SIRT1 plays a significant role in tumor formation and progression.It deacetylates a wide range of histone and non-histone substrates and regulates gene expression and protein activity that are associated with neoplastic apoptosis and proliferation.

Objective To compare the clinical result of Da Vinci robot-assisted distal pancreatectomy(RDP) and laparoscopic distal pancreatectomy(LDP), and to evaluate the clinical application experience of Da Vinci robotassisted spleen-preserving distal pancreatectomy.Methods From March 2013 to June 2015, totally 12 patients undergone RDP and 22 patients undergone LDP in our department were analyzed retrospectively.Results Intraoperative blood loss, hospitalization duration and postoperative fast time in RDP group was less than that in LDP group, the spleen-preserving rate and hospitalization expenses were higher in RDP group(P ＜ 0.05).There was no statistically significant difference in the rate of surgery duration and incidence of postoperative complication between two groups (P ＞ 0.05).The following-up period was 1-28 months with a mean of (9.94 ± 8.99) months, 1 case of peritoneal infection occurred in RDP group, 1 case of survival with tumor recurrence and 3 case suffered peritoneal infection in LDP group.Others were no metastasis, recurrence or death.Conclusions RDP is safe and feasible, the short-term prognosis is better than that of LDP.It has advantages of cleat 3 D visual field, stability in control,less invasive,and quick recovery.It is worth further clinical use.

Objective To investigate the feasibility of labeling mice spleen lymphocytes with superparamagnetic iron oxide(SPIO)and in vitro MR imaging of the labeled cells.Methods Spleen lymphocytes of 5 mice were isolated and then labeled with SPIO of 100,50,25,15,10,5 μg/ml,which was previously prepared with PLL.Prussian blue staining was performed to show the intracellular iron.Cell viability was compared among fresh,labeled and unlabeled cells.Different concentrations of mice spleen lymphocytes were screened using 3.0 T MR on T2WI,T2 * WI and SWI sequences in vitro.Cell viability was compared using independent-sample t test between groups.The MRI values among different groups were compared using one-way ANOVA.Results SPIO prepared with PLL could successfully label mice spleen lymphocytes,the optimum concentration of SPIO was 5 μg/ml.The Prussian blue staining showed intracellular blue spots and a labeling efficiency of(93.6 ± 2.1)％.Three groups of fresh,labeled and unlabeled cells showed a Trypan blue staining result of(94.8 ± 3.1)％,(88.7 ± 2.7)％,and(88.9 ±3.2)％,respectively; no statistically significant difference was found in cell viability between labeled and unlabeled lymphocytes(t =0.281,P ＞ 0.05); however,the cell viability of fresh cells were statistically significant higher than the labeled and unlabeled lymphocytes(t =8.125 and 7.253 respectively,P ＜0.05for all).Among the T2 WI,T2 * WI and SWI sequences under the same concentrations of cells,the SWI sequence was the most sensitive.Conclusions The mice spleen lymphocytes can be effectively labeled with SPIO with no impact on cell viability,and MR can be used to track these labeled cells in vitro.The SWI sequence is the most sensitive.

Objective: To explore the effect of cognitive-behavioral therapy combined with family rehabilitation therapy on improving depression patients. Methods: Totally 82 depressive patients admitted to our hospital from February 2016 to January 2017 were randomly divided into the control group and the observation group according to the random number table method, with 41 cases in each group. Patients in the control group were treated with family rehabilitation therapy, while the patients in the observation group were treated with cognitive behavioral therapy on the basis of family rehabilitation therapy. After 12 months of intervention, the patients in the observation group were treated with cognitive behavioral therapy. The treatment efficiency, psychological status, coping style and medication compliance of the two groups were compared. Results: After intervention the scores of Self-rating Depression Scale (SDS) and Hamilton Depression Scale (HAMD) in the observation group were (31.08±4.83), (14.14±3.52) points respectively, which were significantly lower than (36.97±2.73), (16.68 ±2.14) points of the control group (t=-6.789,-3.948, P < 0.01). The effective rate of the observation group was 97.56% (40/41), which was significantly higher than 70.05% (32/41) of the control group, and the difference was statistically significant (χ²=5.581, P<0.05). The scores of "problem solving" and "help seeking" items in the observation group were (1.66±0.18) and (1.81±0.21) respectively, significantly higher than (1.39±0.11), (1.48±0.13) of the control group; "avoidance" and "self-blame" items were (1.33±0.12) and (1.47±0.14) respectively, significantly lower than (1.58±0.19), (1.48±0.13) in the control group, and the difference was statistically significant (t=-8.349-8.555, P < 0.05). After treatment, the compliance of the observation group was significantly better than that of the control group (χ²= 8.902, P < 0.05). Conclusion Cognitive behavioral therapy combined with family rehabilitation therapy for depression patients can effectively improve the bad mood of patients, improve their medication compliance, and achieve better clinical treatment results.

Objective : To study the effect of lipopolysaccharide ( LPS) -induced immune system activation on syn- aptic structure and DISC1. Methods : 40 rats were divided into 4 groups，which were PBS group，PBS + MK-801 group，LPS group and LPS + MK-801 group．The rats in LPS group and LPS + MK-801 group were administrated with LPS solution (0. 2 mg / kg，i．p．BIW) for 6 times in total， the rats in PBS group and PBS + MK801 group were administrated with PBS．At the third time when the rats were administrated with LPS solution，the rats in PBS + MK-801 group and LPS + MK-801 group were administrated with MK-801 solution (0. 5 mg / kg，i．p．BIW) for a total of 4 times，the rats in PBS group and LPS group were adminis- trated with saline．The head shaking and the open field tests were then evaluated in the rats．Immediately，the rats were sacrificed，and their brain were saved for testing. RT-qPCR , Golgi staining，immunohistochemistry and ELISA kits were used to detect DISC1 gene expression，dendritic spine status，microglia activation and inflammatory cytokine content in cortex，respectively. gene expression in the cortex of rats with schizophrenia． Results : Compared with the PBS group，the expression of DISC1 gene of the rats in the PBS + MK-801 group increased (P ＜0. 01) ，the score of head shaking increased (P ＜0. 01) ，and the distance of the open field increased (P ＜0. 000 1) ; As well as the LPS + MK-801 group，compared with the LPS group，the expression of DISC1 gene increased (P＜0. 000 1) ，the head shaking score and the distance of the open field increased (P＜0. 000 1) . In addition，compared with the PBS + MK-801 group，the expression of DISC1 gene， the shaking head score and the open field distance of the LPS + MK-801 group further improved (P ＜0. 000 1) . Furthermore，compared with PBS group and PBS + MK-801 group，the content of iba1 in the cortex of LPS group and LPS + MK-801 group significantly increased (P ＜0. 05 ) ，the content of inflammatory cytokines significantly increased (P＜0. 05) ，and the length and density of dendritic spines significantly decreased (P＜0. 05) ． Conclusion The activation of the immune system induced by LPS can contribute to the susceptibility of schizophrenia model， and the possible mechanism is that it cooperates with MK-801 to increase the expression of DISC1 gene，which ulti- mately leads to abnormal mental behavior in rats.

Objective To study the clinical, endoscopic and pathological features of gastrointestinal and mesenteric reactive nodular fibrous pseudotumor (RNFPT). Methods A retrospective analysis was conducted on data of 24 RNFPT patients in Nanjing Drum Tower Hospital admitted from October 2008 to June 2016. The clinical, endoscopic, pathological and immunohistochemical characteristics were analyzed. Results Among the 24 patients, 16 complained about discomfort in the upper abdomen and 10 had a history of surgery or trauma. Twenty-one had isolated masses and 3 had multiple masses, with diameter of 0. 5-4. 0 cm. Endoscopically, the tumors were mainly hard submucosal masses with broad base, and smooth surface with no mucosal bridge. Seventeen patients underwent endoscopic ultrasonography, which showed low echoes in lesions and nonuniform echoes partly. Among them, 13 lesions derived from muscularis, 4 others from submucosa. Microscopically, the tumors had clear boundary with no envelope, and most areas showed disorderly arranged spindle cells and extensively collagenous degenerated mesenchyma. The spindle cells had shuttle fibroblast-like morphology and elongated nucleus with no visible necrosis or mitosis. Inflammatory cells scattered between the tumor cells, and lymphoid follicles and calcium deposition could be seen in local areas. Immunohistochemically, SMA was focally positive in 7 cases and only 4 cases expressed CD117 scattered. Desmin, Dog-1, CD34, ALK-1 and S-100 were all negative, and Ki-67 proliferation index was lower than 1％. Conclusion RNFPT has diverse clinical manifestations, with a good prognosis and unlikely recurrences, and should be distinguished from spindle cell tumors.

BACKGROUNDPrevious studies have demonstrated interhemispheric functional connectivity alterations in schizophrenia. However, the relationship between these alterations and the disease state of schizophrenia is largely unknown. Therefore, we aimed to investigate this relationship using voxel-mirrored homotopic connectivity (VMHC) method.

METHODSThis study enrolled 36 schizophrenia patients with complete remission, 58 schizophrenia patients with incomplete remission and 55 healthy controls. The VMHC was calculated based on resting-state functional magnetic resonance imaging data. Differences in VMHC among three groups were compared using one-way analysis of variance. A brain region with a significant difference in VMHC was defined as a region of interest (ROI), and the mean VMHC value in the ROI was extracted for the post hoc analysis, i.e., pair-wise comparisons across the three groups.

RESULTSVMHC in the visual region (inferior occipital and fusiform gyri) and the sensorimotor region (paracentral lobule) showed significant differences among the three groups (P < 0.05, a false discovery rate method corrected). Pair-wise comparisons in the post hoc analysis showed that VMHC of the visual and sensorimotor regions in schizophrenia patients with complete remission and incomplete remission was lower than that in healthy controls (P < 0.05, Bonferroni corrected); however, there was no significant difference between the two patient subgroups.

CONCLUSIONSInterhemispheric functional connectivity in the sensorimotor and visual processing pathways was reduced in patients with schizophrenia, but this reduction was unrelated to the disease state; thus, this reduction may serve as a trait marker of schizophrenia.

Adult ; Brain ; physiology ; Brain Mapping ; Female ; Humans ; Image Processing, Computer-Assisted ; Magnetic Resonance Imaging ; Male ; Schizophrenia ; physiopathology ; Sensorimotor Cortex ; physiology ; Visual Pathways ; physiology

Objective    To investigate the diagnostic value and safety of electromagnetic navigation bronchoscopy combined with radial endobronchial ultrasound in peripheral pulmonary nodules. Methods    The clinical imaging, surgical and pathological data of 60 patients with 76 peripheral pulmonary nodules who underwent electromagnetic navigation bronchoscopy combined with radial endobronchial ultrasound guided biopsy in the Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School from June 2020 to June 2021 were retrospectively analyzed. The diagnosis rate and complications were analyzed and summarized. The 76 pulmonary nodules were divided into a small pulmonary nodules group (10 nodules, diameter≤1 cm) and a pulmonary nodules group (1 cm

¹⁷⁷Lu- prostate specific membrane antigen (PSMA) radio-ligand therapy has been approved abroad for advanced prostate cancer and has been in several clinical trials in China. Based on domestic clinical practice and experimental data and referred to international experience and viewpoints, the expert group forms a consensus on the clinical application of ¹⁷⁷Lu-PSMA radio-ligand therapy in prostate cancer to guide clinical practice.