Bile duct injury is a question that should be highly concerned. ll the time. In general surgery with the improvement of acknowledge to the serious results after bile duct is injured, many active and effective measures are taken, which make the incidence of bile duct injuries lower. Advancing medical technology and numerous clinical experiences contribute to great improvement in treatment methods and effects on patients who have suffered bile duct injuries. At the same time, There are many new questions should be confronted with. The current conditions of treatments of iatrogenic bile duct injuries are reviewed in this article.

Objective:To investigate the effect of body mass index (BMI) on setup errors in intensity-modulated radiotherapy for cervical cancer and explore the optimal position for patients with different BMI without taking into account the rotation error and the changes in target area and adjacent organs.Methods:A total of 90 patients were divided into three groups according to their BMI: light weight group (BMI≤18.4 kg/m 2), normal weight group (18.5 kg/m 2≤BMI≤23.9 kg/m 2) and overweight group (BMI≥24 kg/m 2). Thirty patients were assigned into each group including15 patients in the supine position and 15 patients in the prone position. In total, 2 250 sets of CBCT scan data of 90 patients were obtained. The setup errors were recorded and analyzed in each group. The margins of the optimal position were calculated according to the formula of M PTV=2.5+ 0.7. Results:When BMI was not taken into account, there was no significant difference in the setup errors between the supine and prone positions in the x, y and z directions (all P>0.05). When BMI was considered, the setup error in the supine position were significantly smaller than those in the prone position in the x and y directions in the light weight group, whereas there was no significant difference in the setup errors between the supine and prone positions in the z direction ( P>0.05). The corresponding M PTV in the supine position was 4.76, 4.27 and 5.73 mm, respectively. In the normal weight group, there was no significant difference in the setup errors between the supine and prone positions in the x and y directions (both P>0.05), whereas the setup error in the prone position was smaller than that in the supine position in the z direction. The corresponding M PTV in the prone position were 6.42, 10.21 and 4.91 mm, respectively. In the overweight group, there was no significant difference in the setup errors between the supine and prone positions in the x and z directions (all P>0.05), whereas the setup error in the prone position was smaller than that in the supine position in the y direction. The corresponding M PTV in the prone position were 5.88, 5.26 and 5.32 mm, respectively. Conclusions:Without taking into account the rotation error and the changes in target area and adjacent organs, when the BMI≤18.4, the supine position is recommended. When the BMI≥18.5, it is better to choose the prone position.

Hepatic ischemia/reperfusion injury is an important restricting factor of clinical liver resection and liver transplantation.When the liver is transiently deprived of blood followed by repeffusion,a large number of various mediators are released that can lead to cellular and,eventually,organ dysfunction.This review summarizes the pathogenesis and the protection mechanisms of hepatic ischemia/reperfusion injury.

Objective To investigate the effect and mechanism of Ghrelin on the contraction and relaxation of rat small intestinal smooth muscle. Methods The effect of different concentrations of Ghrelin (0;20;40;80 μg/kg) on the small intestinal transit in vagotomized rats in vivo and Ghrelin (0.01; 0.1;0.5 ; 1.0 μmol/L) on the contraction and relaxation of rat small intestinal smooth muscle strips in vitro was observed,the locations of Ghrelin receptors (GHS-R1 a) in small intestinal muscle layers were detected by immunofluorescency. Results Ghrelin dose-dependently increases small intestinal transit (( 25.4 ± 1.0)％,(33.7 ± 1.9)％,(39.3 ±2.4)％,(44.7 ±2.1)％),enhances the contraction ((67.0 ±2.4)％,(149.5 ±3.3)％,(187.1 ±4.7)％,(213.5 ±3.4)％) and relaxation ((35.3 ± 1.1)％,(62.9 ± 3.8 ) ％,( 79.6 ± 2.7 ) ％,( 94.6 ± 2.2 ) ％ ) of smooth muscle strips mediated by carbachol.Ghrelin receptors were mainly located on membrane of the nerve cells in the muscle layers,while no receptors exist on membrane of smooth muscle cells. Conclusions Ghrelin enhances the effect of contraction and relaxation of rat small intestinal smooth muscle mediated by cholinergic neurotransmitters activating nerve cells in the enteric plexus.

Objective: To investigate the in vitro and in vivo inhibitory effects of DC (dendritic cell)-CIK (cytokine-induced killer cell) co-cultured cells combined with sorafenib against hepatocellular carcinoma cell line BEL-7402. Methods: DC and CIK cells were generated in vitro by stimulating human peripheral blood mononuclear cells with different cytokines, and then they were co-cultured. The cytotoxicity of DC-CIK co-cultured cells (DC-CIK) combined with sorafenib against BEL-7402 cells was determined by CCK8 kit. The apoptosis of BEL-7402 cells was measured by Annexin V-FITC Kit. BEL-7402-implanted tumor model was established by subcutaneous injection in nude mouse. Tumor-bearing mice were divided into normal saline control group, sorafenib group, DC-CIK group and DC-CIK+sorafenib group. The inhibitory effects were observed in different groups. Results: The cytotoxicity rate of BEL-7402 cells in DC-CIK+sorafenib group was significantly higher than those in the other two groups, with cytotoxicity rate in DC-CIK+sorafenib group being (75.24±1.91)%, which was 1.8 times that in DC-CIK group and 2.1 times that in sorafenib group (P<0.01). The apoptosis rate of BEL-7402 cells in DC-CIK+sorafenib group was significantly higher than those in the sorafenib and DC-CIK groups, with the apoptosis rate in DC-CIK+sorafenib group being (78.32±2.54)% (P<0.05). The volume of tumor in the combination group was significantly smaller than those in the other groups (P<0.05). In vivo results showed that DC-CIK+sorafenib treatment significantly inhibited the growth of BEL-7402-implanted tumors, and the inhibitory rate was (83.37 ±0.16)%, which was significantly higher than those of the other groups (P<0.01). Conclusion:DC-CIK co-cultured cells combined with sorafenib can inhibit the growth of hepatocellular carcinoma cell line BEL-7402 in vitro and in vivo. Molecular targeting therapy combined with immunotherapy may be a new way for the comprehensive treatment of hepatocellular carcinoma.

Objective To investigate the biological effects of Wnt gene in kidney cancer Caki?2 cells. Methods The Wnt gene was silenced in kidney cancer Caki?2 cells by lentivirus vector. The cell proliferate ability of cells in each group were assayed by CCK?8 kit at different time points. The apoptosis of Caki?2 cells was observed after silencing Wnt gene by transmission electron microscope. The invasion ability of each group cells was tested using Transwell chambers. The genes expression changes of Wnt/β?catenin signaling pathway and apoptosis related gene were determined by realtime PCR. Results Compared with the other two groups,the cell proliferate ability of the cells after silencing Wntgene was suppressed,and the difference was statistically significant(P<0.05). Apoptosis increased significantly in shRNA+Caki?2+Wnt group cells with silencing of Wntgene, and apoptotic body appeared in these cells. In invasive experiment,the number of emigrated cells in shRNA+Caki?2+Wnt group were significantly lower than other groups(P<0.05). The expression of Wnt mRNA,β?catenin mRNA and Bcl?2 mRNA in shRNA+Caki?2+Wnt group cells was lower than other groups(P<0.05). Conclusion Silencing of Wnt gene of kidney cancer Caki?2 cells can affect the proliferation rate of the cells, promote the cell apoptosis,and inhibit the invasion ability,which provide certain theoretical basis for the research and development of new drugs and new therapeutic targets.

Objective To observe whether hepatitis B vaccine enhance the treating effect of cyto-kine induced kill(CIK) cells on hepatitis B virus transgenic(HBV-Tg) mice. Methods The HBV-Tg mice were treated with CIK cells by peritoneal injection and hepatitis B vaccine by hypodermic injection. The HBV DNA level were tested by real-time PCR,T lymphocyte subgroup were detected by flow cytometry and the pathological diversify of hepatic tissue were observed by HE staining. Results The HBV DNA loading in peripheral blood of HBV-Tg mice decreased after CIK cells were treated and CD3~+ , CD4~+ and CD8~+ cells increased which were enhanced after CIK cells combined with hepatitis B vaccine. Conclusion Hepa-titis B vaccine enhanced the treating effect of CIK on HBV-Tg mice which may be implemented by increased the blood level of CD3~+, CD4~+ and CD8~+ cells, especially CD8~+ cells level.

BACKGROUND: Tumor-adopted immunity and gene transduction technique are used to introduce tumor necrosis factor-α vector into carrier cells, which are then re-infused into the body so that cancer cells can be killed by tumor necrosis factor-α more directly and effectively with fewer side effects on the other tissues due to high local expression.OBJECTIVE: To study the bioactivity of in vitro cultured tumor necrosis factor-α transduced tumor-infiltrating lymphocytes as well as the inhibitory effects on cancer cells of cancer-loaded rats infused in different ways.DESIGN: A randomized controlled study based on experimental animals.SEETING: Cancer Research Institute of China Medical University.MATERIALS: This study was carried out at the Cancer Research Institute and the Experimental Animal Department, China Medical University,between January 2000 and December 2001. TJ8510 cell line (human brain glioblastoma cell line) was provided by the Neurological Research Institute of Tianjin Medical University Affiliated Hospital. The experimental animals were 36 BALB/C nude mice congenitally having no thymius.METHODS: Based on the establishment of tumor necrosis factor-α retroviral transduction system and the preparation of cartier cells tumor-infil-trating lymphocytes, the monoclonal virus cell line PLC-2 and PLJC-5available were used to introduce marked gene NeoR and targeted gene tumor necrosis factor-α into tumor-infiltrating lymphocytes, respectively.Then cell proliferation, tumor necrosis factor expression and in vitro antitumor activity were examined. After cancer cell inoculation, the 36 nude mice were randomly divided into 6 groups: local infusion control group, local tumor-infiltrating lymphocytes infusion group, local tumor necrosis factor-tumor-infiltrating lymphocytes infusion group, venous infusion control group, venous tumor-infiltrating lymphocytes infusion group and venous tumor necrosis factor-tumor-infiltrating lymphocytes infusion group, and the therapeutic effects on the cancer-loaded mice were observed.proliferation and tumor necrosis factor-α expression in tumor-infiltrating oR-tumor-infiltrating lymphocytes and tumor necrosis factor-tumor-infiltrating lymphocytes was not significantly different from each other (P ＞ 0.05).NeoR-tumor-infiltrating lymphocytes, though not significantly different (P ＞0.05), significantly differ from that of tumor necrosis factor-tumor-infiltrating lymphocytes (P ＜ 0.01); moreover, tumor necrosis factor-tumor-infiltrating lymphocytes were found to express higher tumor necrosis factor-α conactivity did not significantly differ between tumor-infiltrating lymphocytes and NeoR-tumor-infiltrating lymphocytes (P ＞ 0.05), but obviously increased come of the animal experiment: 40 days after tumor necrosis factor-tumorinfiltrating lymphocytes infusion, cancer size in local tumor necrosis factortumor-infiltrating lymphocytes infusion group was found smaller than that in local infusion control group [(307±42) and (2 048±278) mm3, P ＜ 0.01],and it was also smaller in venous tumor necrosis factor-tumor-infiltrating lymphocytes infusion group than that in venous control group [(954±195)and (1 989±305) mm3 , P ＜ 0.05].CONCLUSION: Tumor necrosis factor-α gene transduced tumor-infiltrating lymphocytes could effectively express tumor necrosis factor, exerting higher and in vivo anti-tumor effects than tumor-infiltrating lymphocytes in cancer-loaded nude mice. No obvious inhibitory effects on the growth of subcutaneous solid carcinoma could be observed in nude mice after venous infusion of human brain glioblastoma tumor-infiltrating lymphocytes, but the inhibitory effects became obvious due to venous infusion of tumor necrosis factor-tumor-infiltrating lymphocytes and significant due to local tumor necrosis factor-tumor-infiltrating lymphocytes infusion, indicating that local infusion is the preferable way in the treatment of glioblastoma by immuno-gene therapy.

Objective To investigated the effect of procyanidin (PC) on the expression of cysteine proteinase -3 (Caspase -3) in type 2 diabetes mellitus SD rats with focal cerebral ischemia. Methods Following the random principle, 40 healthy Sprague - Dawley (SD) rats were numbered sequentially and randomly divided to normal rats with focal cerebral ischemia group,type 2 diabetes mellitus SD rats with focal cerebral ischemia group,PC low/ middle/ high -dose groups,with 8 rats in each group. The type 2 diabetes mellitus - MCAO model was set up. The doses of PC for low,middle and high - dose groups were 50 mg/ kg,100 mg/ kg,200 mg/ kg. Immunohistochemistry method was used to measure the activity of Caspase - 3. Results Compared with that in the normal rats with focal cerebral ischemia group[(11. 42 ±2. 52)],the expression of Caspase -3 increased in the type 2 diabetes with ischemia group[(15. 00 ± 2. 38)](t = 2. 17,P < 0. 01). Compared with that in the type 2 diabetes with ischemia group,the expression of Caspase - 3 decreased in the PC groups[(9. 38 ± 2. 00),(7. 71 ± 1. 55),(6. 96 ± 1. 57)](t = 2. 86,3. 13,3. 36,all P < 0. 01),whereby the middle and high - dose groups showed more significant decrease (t = 1. 92,2. 03,all P <0. 01) and with no statistically significant difference between the two groups(t = 1. 13,P > 0. 05). Conclusion PC can decrease the expression of Caspase - 3 protein in type 2 diabetes mellitus SD rats with focal cerebral ischemia, finally may inhibit the apoptosis.

Objective:Before the radiotherapy was performed, patients with pelvic tumors were analyzed for the consistency of bladder filling in the three steps of " Immobilization" , " CT Simulation" and " X-ray Simulation" .Methods:In 2014, 105 patients (68 cases of cervical cancer, 32 cases of rectal cancer, 3 cases of vaginal cancer and 2 cases of prostate cancer) with pelvic tumor radiotherapy were randomly assigned to monitor bladder urine volume to a target urine volume of 400 ml. First, patient were exhorted to empty the bladder, and the bladder volume meter BVI 9400 was used to measure the urine volume of the patient after emptying of the bladder. The patient immediately drank about 540 ml of water and suppressed urine, measurements were taken every 0.5 h. At the same time, when the patient complained of " urgency of urine" , bladder urine volume would be measured again and the time would also be recorded. Every other half an hour (emptying, 0.5 h after emptying, 1.0 h after emptying), when complaining of " urgency of urine" , when actually performing urine volume and time were described as: U 0 and t 0, U 0.5 and t 0.5, U 1.0 and t 1.0, U t and t, U T and T. Results:There was a statistically significant difference in gender and age, and women had stronger ability to urinate than men U 1.0( P=0.003), young people had stronger ability to urinate than middle-aged U 1.0( P=0.002). In the three-step comparison, there was no statistically difference between 1 hour after emptying urine volume U 1.0( P=0.177) and the actually performing urine volume U T ( P=0.052). And the final urine volume was concentrated at 298-526 ml. After the patient emptied the urine volume and complained of " urgency of urine" , the time slot was t=(75.2±49.9) min, with the urine volume of U t=(331.2±140.3) ml. And there was no statistically difference between U t and U T ( P=0.198) at X-ray Simulation. Conclusions:The patient emptied the bladder and immediately drank 540 ml of water. After 1 hour of suppressing urine, he complained of " urgency of urine" and achieved the target urine volume (400 ml). At this time, the bladder urine volume U 1.0 was consistency in the immobilization, CT Simulation, and X-ray Simulation.