Objective To explore the expression and the clinical significance of neural cadherin (N-cadherin) in perihilar cholangiocarcinoma. Methods The expression of N-cadherin was detected by immunohistochemical method in 26 patients with perihilar cholangiocarcinoma and 5 samples of normal bile duct tissues. The expression of N-cadherin was also compared by Western blotting assay between perihilar cholangiocarcinoma and paraneoplastic tissues. Results The im-munohistochemical results showed that positive expression of N-cadherin was observed in 14 of 26 patients with perihilar cholangiocarcinoma and in 6 of 26 paraneoplastic samples (53.84%vs 23.08%, P<0.05). There was 0 N-cadherin expres-sion in normal bile duct tissues. The positive rate of N-cadherin expression was higher in low differentiated group than that in middle and well differentiated groups. The result of Western blotting assay showed that N-cadherin expression was signifi-cantly higher in perihilar cholangiocarcinoma than that in the paraneoplastic tissues (0.88 ± 0.12 vs 0.43 ± 0.09, P < 0.05). Conclusion N-cadherin may be involved in the occurrence and development of perihilar cholangiocarcinoma.

Objective: To investigate the possible mechanism of neuroprotection produced by taurine supplement on brain in young rats. Methods: In vitro, taurine treatment or co-treatment with sodium selenite that produced significant neuronal apoptosis was used in cultured cortical neurons to examine the neuroprotection effect using MTT assay and DNA fragmentation electrophoresis. In vivo, female weanling Sprague Dawley rats were divided into four groups, eight rats per group. The treated groups were fed on diets with different contents of taurine respectively, and the control group was fed on taurine unsupplemented diets. The experiment lasted five weeks. Results: Taurine significantly increased neuronal survival in dose-dependent manner. The typical DNA ladder pattern could be prevented by taurine. Taurine could elevate brain wet weight, and significantly increased the level of taurine, protein and AChE in brain. Conclusion: It is proposed that the neuroprotection effect of taurine could be achieved by modulating expression of related genes and blocking neuronal apoptosis.

Objective To identify the risk factors for early postoperative cognitive dysfunction (POCD) in the elderly patients undergoing spinal surgery.Methods One hundred and fifty ASA Ⅱ or Ⅲ patients,aged ≥65 yr,undergoing elective spinal surgery under general anesthesia,were studied.Venous blood samples were taken at 1 day before operation and 7 days after operation to determine the concentration of serum S-100B protein.Cognitive function was assessed by Mini-Mental State Examination (MMSE) at 1 day before operation and 7 days after operation.The patients were diagnosed as having POCD if MMSEpre-MMSEpost ≥ 3.The patients were divided into POCD group and non-POCD group.Age,body weight,sex,education,type of operations,complications,preoperative TCM syndrome type,MMSE score at 1 day before operation and 7 days after operation,duration of operation,emergence time,and intraoperative blood loss,cardiovascular events,and amount of fluid infused per hour were recorded.The risk factors for POCD were analyzed using multivariate logistic regression analysis.Results Thirty-eight patients developed early POCD (25.3％).The resuhs of logistic regression analysis showed that age ≥ 70 yr,elementary education or below,duration of operation ≥5 b,and the number of hypotension occurred during operation≥3 were the risk factors for early POCD.Conclusion Age≥70 yr,elementary education or below,duration of operation ≥ 5 h,and the number of hypotension occurred during operation ≥ 3 are the risk factors for early POCD in the elderly patients undergoing spinal surgery.

Objective To investigate the effect of acupuncture on gap junction protein Cx43 expression in the hippocampal region in ischemia/reperfusion rats.Methods Wistar rats were randomized into normal, model, non-point acupuncture and acupuncture groups. A rat model of focal cerebral ischemia/reperfusion was made by modified middle cerebral artery thread occlusion. The model, non-point acupuncture and acupuncture groups were separately divide into four subgroups: 30, 60, 180 and 360 min ischemia/reperfusion, 10 rats each. The middle and lateral lines of vertex were given electroacupuncture in the acupuncture group of rats. A subcostal fixed point 10 mm above the iliac crest on the affect side was selected as an acupuncture point in the non-point acupuncture group. The model group was not treated. Cx43 protein expression was determined by an immunohistochemical method.Results There was a statistically significant difference in the behavior disorder (Bederson’s) score between the acupuncture group and the non-point acupuncture or model group after different times of cerebral ischemia/ reperfusion (P<0.05). There was a statistically significant difference in hippocampal Cx43 content between model, acupuncture or non-point acupuncture group and the normal group and between the acupuncture group and the model or non-point acupuncture group after different times of cerebral ischemia/reperfusion (P<0.05).Conclusions Acupuncture can inhibit the overexpression of Cx43, intervene in cerebral ischemia-reperfusion injury and produce a neuroprotective effect in ischemic brain injury.

OBJECTIVETo investigate the clinical value of MRI examination in congenital anorectal malformation (CARM).

METHODForty-four cases with operatively proved anorectal malformation from May 2008 to May 2012 in the authors' hospital were reviewed. Of the 44 cases, 25 were males and 19 females, their age ranged from 1 day to 2 years. MRI was performed in all patients.

RESULTOf all 44 cases, 15 cases had high imperforate anus (34%), rectum blind end were above PC line, the distance of rectum blind end and anus nest was (29.12 ± 2.35) mm; 8 cases had median imperforate anus (18%), rectum blind ends were near PC line, the distance of rectum blind end and anus nest was (18.98 ± 2.21) mm; 21 cases had low imperforate anus (48%), rectum blind ends were below PC line, the distance of rectum blind end and anus nest was (7.54 ± 1.08) mm. Twenty-five cases with fistula in 44 cases were confirmed by rectal angiography and surgery, accounting for 57%. In 13 cases with fistula, the lesion could be clearly demonstrated on MRI, in the remaining 12 cases with fistula, the lesion could not be visualized clearly or no image development occurred on MRI. Of all 44 cases, 1 case had tethered cord with filum terminale lipoma, 1 case had tethered cord, 2 cases had syringomyelia, 1 case had right kidney agenesis, 1 case had hydrocele. In 44 cases of multi-planar MRI imaging could clearly show the perianal muscles developmental situation, 36 cases had perianal muscles dysplasia, amd showed levator ani muscle, puborectalis and anal sphincter asymmetry, muscle belly slim.

CONCLUSIONMRI examination has a high clinical value in CARM diagnosis, can help accurately judge the anal atresia type, display the presence and running of most of the fistula, and diagnose perianal muscle development and other systems malformations, finally provide a reliable diagnostic basis for surgical program and prognostic assessment.

Abnormalities, Multiple ; Anal Canal ; abnormalities ; surgery ; Anus, Imperforate ; complications ; diagnosis ; surgery ; Child, Preschool ; Female ; Fistula ; epidemiology ; etiology ; Humans ; Infant ; Infant, Newborn ; Magnetic Resonance Imaging ; Male ; Perineum ; pathology ; Rectum ; abnormalities ; surgery ; Retrospective Studies ; Urinary Fistula ; epidemiology ; etiology