Objective To study the difference of IGF-1,Bcl-2,survivin and Ki-67 protein expression in reactive and neoplastic astrocytes and the significance of them.Methods Immunohistochemistry and tissue microarray techniques were used to determinate the expression of IGF-1,Bcl-2,survivin and Ki-67 protein in normal brain tissues, astrocytes proliferation,low-grade astrocytomas, and high-grade astrocytomas.Results The expression of IGF-1,Bcl-2,survivin and Ki-67 protein were all negative in control group.The positive expression rates of them in reactive astrocytes were 28.9%, 26.7%, 26.7% and 22.2%,respectvely; and in low-grade astrocytomas were 63.8%, 50.0%, 53.2%,70.2%; in high-grade astrocytomas were 88.9%, 79.2%, 88.1%,95.2%.IGF-1,Bcl-2,survivin and Ki-67 all had significant difference among the three experimental groups(P

Objective To evaluate efficacy and safety of Iodine-125 seeds used in brachytherapy for cholangiocarcinoma.Methods A total of 65 cases of cholangiocarcinoma patients were diagnosed and treated with ERCP.The Iodine-125 seeds were implanted into bile duct cavity by self-made carrier (applicator) in various ways, and Iodine-125 seeds were replaced to improve the local irradiation dose.Follow-up was regularly made through endoscopy and ultrasonography to evaluate feasibility, efficacy and complications.Results Self-expanding metal stents, single or double plastic stents were successfully placed in 65 patients.At first , single row of Iodine-125 seeds were inserted to 59 patients, double row Iodine-125 were inserted to 6 patients , and the average activity of the first irradiation was 5.775 mCi.Iodine-125 were replaced in 4 patients after three months, in 41 patients after six months, in 5 patients after one year.The total dose was up to 14 mCi.In the follow-up of 6-35 months, the longest survival time was 35 months in two patients, where the Iodine-125 seeds were replaced 3 times as a whole and there was no serious complications.Conclusion Iodine-125 brachytherapy on cholangiocarcinoma by ERCP, where biliary stents and Iodine-125 seeds can be replaced at any time , is convenient, less invasive and can obviously prolong survival time.

By taking the course of laboratory hematology in Curtin University in Australia as an ex-ample, this paper introduced the characteristics of its teaching mode, teaching contents, teaching methods, assessment methods and laboratory practice. The advantages and disadvantages of education characteristics between Australia and China were compared and analyzed on the training methods and the training objec-tives, respectively. The education characteristics of laboratory hematology in Curtin University provided an important inspiration for our education reform in the field of medical laboratory in the future.

Objective To investigate the value of susceptibility weighted imaging (SWI) in the diagnosis of hemorrhagic diffuse axonal injury (DAI). Methods A retrospective study was conducted on 20 patients with DAI who received MRI examination at day 3 post-injury.MRI sequences included T1WI,T2WI,fluid attenuated inversion recovery ( FLAIR),diffusion weighted imaging (DWI) and SWI.There were 15 patients with the Glasgow Coma Scale (GCS) score≤8,three with GCS score of 9-12 and two with GCS of 13-15.The location and quantity of hemorrhage focus were counted.The area of hemorrhage focus was measured on each MR sequence.Differences of detection rate of hemorrhage focus on each sequence were compared by using X2 test.The correlation between DAI related bleeding area and GCS score was analyzed. Results DAI related hemorrhage focus showed a larger number in superficial cerebrum than that in posterior cranial fossa and in deep cerebrum.The detection rate of hemorrhage focus on SWI was the highest,as compared with other sequences ( P ＜ 0.05 ).Bleeding area and GCS score showed a negative correlation (r =-0.921,P ＜ 0.01 ). Conclusion SWI is very sensitive in detection of the intracerebral hemorrhage focus in the acute period of traumatic DAI.

Objective To explore the difference between laparoscopic transabdominal preperitoneal hernia repair (TAPP) and open preperitoneal hernia repair for the treatment of inguinal hernia under local anesthesia.Methods A total of 64 cases with inguinal hernia underwent hernia repair in Beijing Daxing District Hospital of Capital Medical University from January 2014 to January 2015 were retrospectively analyzed.Thirty-four cases in test group were applied with TAPP and used D(9 * 13) mesh to repair for inguinal hernia,and 30 cases in traditional group with open preperitoneal hernia repair which used D10 mesh to repair for inguinal hernia.Results All operations were successfully completed.There was statistically significant difference in operation time(P =0.000),postoperative activity time(P =0.000),postoperative hospitalization time (P =0.003) and pass flatus time (P =0.000) between these two groups.There was no statistically significant difference in wound seroma(P =0.216),hematoma (P =1.000),analgesics (P =0.090) and recurrence rate of the first year (P =1.000).Conclusions Both TAPP and tension free repair of inguinal hernia under regional anesthesia are safe and effective methods for the treatment of inguinal hernia,which has its advantages.Surgeon should choose the suitable procedure according to patient's condition reasonably.

Objective To observe the effect of surface electromyographic biofeedback (sEMG-BFB) combined with routine swallow training on dysphagic patients with cerebral infarction at recovery stage.Methods Fiftyone dysphagic patients with cerebral infarction were randomly divided into two groups:control group (26 cases) and biofeedback training group (25 cases).The control group was given routine training including orofacial function training,balloon dilatation and behavioral swallowing training,while the biofeedback training group was given behavioral swallowing training was conducted with the guidance of sEMG-BFB in addition to the routine training.Before and after the treatment,videofluoroscopy swallowing study (VFSS) was performed to observe the opening of upper esophageal sphincter (UES).Functional oral intake scale (FOIS) was used to evaluate swallow function.Results Before treatment,there were no significant difference between the two groups in terms of FOIS score and UES opening (P ＞0.05).The FOIS score increased in both groups after treatment (P ＜ 0.05),and the FOIS score was higher in the biofeedback training group than that of the control group (P ＜ 0.05).After treatment,the number of UES complete opening and incomplete opening was 18 and 8,respectively,in the control group,versus 20 and 5,respectively,in the biofeedback training group.UES opening improved in both groups after treatment (P ＜ 0.05).Conclusion Routine swallowing training combined with sEMG-BFB can benefit the dysphagic patients with cerebral infarction for their UES opening and swallowing ability at recovery stage.

Objective To investigate the effect of laparoscopic cholecystectomy (LTCBDE) in treatment of patients with secondary extrahepatic bile duct stones. Methods Eighty-seven cases of our hospital patients with secondary to extrahepatic bile duct stones were randomly divided into the laparoscopic bile duct exploration and T tube drainage surgery (LCBDE) treatment group and the laparoscopic transcystic duct exploration of common bile duct lithotomy (ltcbde) treatment group. The observation focused on the operation time, bleeding volume , postoperative transfusion , postoperative drainage time , postoperative hospitalization time , cost of hospitalization, postoperative recovery time and complications compared clinical efficacies. Results LTCBDE group of patients in operation time (2.1 ± 0.5) was longer than that of the control group (1.6 ± 0.4), (P <0.001), while the bleeding volume, postoperative fluid volume, postoperative drainage time, postoperative hospitalization time, hospitalization expenses and postoperative recovery time were (17.4 ± 5.4), (6 550.4 ± 1 076.9), (3.5. 1.6), (4.1 ± 1.7), (12 243.5 ± 2 379.6), (11.3 ± 3.5) were lower than that of the group LCBDE (22.1 ± 7.5), (8 304.2 ± 1 394.8), (32.9 ± 10.4), (6.4 ± 2.4), (14 098.1 ± 2 897.3), (16.1 ± 5.7) P, respectively (P values were defined as 0.001, 0, 0, 0.015, 0.001, 0 individually); LTCBDE group of patients with bile leakage, acute peritonitis rates were 1/46,1/46,in which those were lower than the corresponding LCBDE in 6/41, 7/41 (P values were 0.033, 0.016, separately). Conclusion According to indications, LTCBD surgery has the advantages of less injury, less cost, less complications and so on. It has important significance to improve the condition of patients with secondary extrahepatic bile duct stones.

Objective To explore the effects of modified balloon dilatation therapy for treating upper esophageal sphincter dysfunction after a brainstem stroke.Methods Ten healthy adult volunteers and 20 dysphagic patients with upper esophageal sphincter dysfunction after a brainstem stroke were recruited.The 20 patients were divided into a balloon dilatation therapy group of ten who were treated with catheter balloon dilatation therapy, and a control group of ten who received conventional therapy.All were given block-designed task fMRI scans guided by a matched visual presentation system before and after the treatment.Results Widespread activation was observed in both hemispheres, including the bilateral cerebral cortex, the brainstem and the cerebellum, but the activated areas were significantly smaller in the stroke patients before treatment.After the treatment, seven patients in the balloon dilatation group were totally orally fed, while only three patients in the control group recovered totally oral intake.After dilatation, significantly more regions were activated, including the anterior cingulate, insula, supplementary motor area, precuneus and the frontal lobe.They were activated with relatively low voxels in the treatment group, while in the control group significant activation was observed only in the precuneus after treatment.Conclusion Modified balloon dilatation therapy can increase activation of the cortex and subcortical structures related to swallowing, promoting better swallowing function.

Objective To establish WeChat official account-based platform for evidence dissemination,and to evaluate the effects of the platform.Methods The WeChat official account-based platform for evidence dissemination was established,and big data analysis and sampling survey were adopted to analyze information and its communication effects published from December,2014 to September,2016.Results Totally 22 369 followers used the platform and conducted 404 232 hits on its pages in total.The most frequent searches were Evidence and Knowledge of evidence-based nursing.The WeChat Communication Index was 433.07.The overall evaluation score was 4.34± 0.67.Conclusion WeChat official account-based platform for evidence dissemination can promote the accessibility of evidence and receives high evaluation score from followers.

Objective To compare the clinical effect of laparoscopic and open umbilical hernia repair for adult umbilicalhernia.Methods Eighty-threepatients with adult umbilical hernia admitted to People's Hospital of Beijing Daxing District from Feb.2008 to Jan.2017 were randomly divided into laparoscopic umbilical hernia repair group (n =38) and open umbilical hernia repair group (n =45).Patients in laparoscopic umbilical hernia repair group accepted laparoscopic umbilical hernia repair with intraperitoneal onlay mesh (n =38),while patients in open umbilical hernia repair group accepted traditional umbilical hernia repairtreatment.Operation time,hospital stay,blood loss,seroma/hematoma formation,wound infection,incomplete bowel obstruction and recurrence were compared between the two groups with the software of SPSS 22.0.The outpatient consultation was performed at 2 weeks,1 month,3 months,and 6 months after operation.The follow-up contents were wound condition,pain,and whether there were any masses in the umbilicus.After every 3 months of telephone follow-up or outpatient review,whether there were any masses in the umbilicus,the average follow-up time was 14 months.Results All operations were successfully completed.The operation time of laparoscopic umbilical hernia repair group was shorter than open umbilical hernia repair group [(31 ± 8) min vs (48 ± 10) min,P ＜ 0.01],and hospital stay were significantly shortened in laparoscopic umbilical hernia repair group (P ＜ 0.05).The amount of bleeding of the laparoscopic umbilical hernia repair group decreased significantly than open umbilical hernia repair group [(40 ± 18) ml vs (62 ± 25) ml,P ＜ 0.01].The postoperative painof the laparoscopic umbilical hernia repair group was mild than open umbilical hernia repair group (P ＜ 0.05).The postoperative complications include seroma,wound infection and incomplete bowel obstruction.There were no significant differences between the two groups of seroma,incision infection and recurrence (P ＞ 0.05).The difference of the incidence of incomplete bowel obstruction between the two groups was statistically significant (P =0.019) . The total postoperative complication rate was significantly lower in laparoscopic umbilical hernia repair group than in open umbilical hernia repair group(x2 =5.328,P =0.021).Conclusions Laparoscopic umbilical hernia repair has short operation time,less bleeding,and satisfactory postoperative pain.It is worthy of advocacy for umbilical hernia patients who can tolerate general anesthesia.