Intraductal papillary neoplasm of the bile duct (IPNB) is a variant of bile duct tumors characterized by papillary growth within the dilated bile duct lumen and secretion with a large amount of mucins.IPNB is an intraductal papillary cancer of the bile duct or a preinvasive lesion classified by the 2010 World Health Organization (WHO) classification.Although the specific etiology and pathogenesis are unclear,IPNB is known to two major risk factors:hepatoliathiasis and clonorchiasis.The clinical manifestations of IPNB include intermittent abdominal pain,acute cholangitis and obstructive jaundice.Results of laboratory test show abnormal liver function resulting from obstruction of bile duct,but it's not specific.The most common imaging findings for IPNB are bile duct dilatation and intraductal masses.Computed tomography,magnetic resonance image and cholangiography are usually performed to access tumor location and extension.According to morphology of the tumor epithelial cells,IPNB are classified into the pancreticbiliary,intestinal,gastric and oncocytic types.The surgical resection is a major treatment of IPNB.In principle,IPNB should be resected in a manner similar to that employed for other types of intrahepatic cholangiocarcinomas and extrabepatic bile duct carcinomas.The type of surgical procedure for IPNB depends upon tumor location and extension.Although several investigations have been conducted for illuminating molecular genetic changes during the development and progression of IPNB,the specific mechanism is still not clear,and further study is needed.

Short chain fatty acids(SCFA) are produced in the large bowel of humans by anaerobic bacterial fermentation.The main fermentative substrates are undigested dietary carbohydrates,including nonstarch polysaccharides and resistant starch(RS).SCFA are major organic acids in the lumen of the large intestine.They are preferred energy source for colonocytes.Their effects include enhancement of electrolyte uptake,stimulation of colon epithelial cell proliferation and mucosa growth,modulation of colonic immune function,nutritional support and protection of colon mucosa.Butyric acid can suppress colon neoplasm cell proliferation,induce its apoptosis and differentiation,affect proto-onc genes expression,which suggest that butyrate may be an important agent in cancer treatment.

With the development of society and living condition,the incidences of fatty liver and other diseases like hypertension,cardiovascular disease and diabetes have increasd by several factors.This review discussed the cause,mechanism and therapy of fatty liver.The emphasis was put on the object and principle of nutritional therapy.Generally,the treatment of fatty liver includes control of the underlying causes,nutritional therapy,proper physical exercise,upbeat life-rhythm and a certain workload.Plasmapheresis and oxygen therapy are the new methods.

Objective To investigate the effect of the teaching modes based on problem-based learning (PBL) and lecture-based learning (LBL) in clinical practice of hepatobiliary surgery.Methods 166 5-year program students were divided into 2 groups:PBL group (n=83)and LBL group (n=83).The performance in interrogation,physical examination,medical records and theoretical tests were analyzed.Results PBL group had better performance in all the above aspects compared to LBL group (P<0.05).Conclusions The teaching mode based on PBL is a good method,which Can inspire the students and improve their ability to solve problems in clinical practice of hepatobiliary surgery.

the effect of maintaining integrity of epithelial cells by increasing occludin protein expression,and the effect is related with the up-regulation of occludin mRNA.

Objective To explore the association of-11377 site single nucleotide polymorphism in promoter region of adiponectin gene and carotid intima-media thickness(CIMT)in patients with type 2 diabetes mellitus.Methods The adiponectin gene-11377C→G polymorphism was identified by PCR-restriction fragment length polymorphism(RFLP)in 504 patients with type 2 diabetes mellitus(250 patients with increased CIMT and254 Datients with normal CIMT). Serum lipid and fasting plasma glucose were detected by full automatic biochemical analysor.fasting serum insulin(FINS) was measured by radioimmunoassay,and serum adiponectin level was assessed by ELISA.Results The frequencies of adiponectin gene-11377C→G genotype and allele were different between type 2 diabetic patients with normal and increased CIMT(P

Adolescent ; Adult ; Aged ; Cholesteatoma, Middle Ear ; congenital ; pathology ; Female ; Humans ; Male ; Melanocytes ; Middle Aged ; Young Adult

Objective To perform modification study of cyanoacrylate (CA) medical adhesive and to select the optimal mo-difying material and the best ratio.Methods Carboxylic multi-walled carbon nanotubes (MWCNTs-COOH), multi-walled carbon nanotubes (MWCNTs), hydrophobic nano-silica, nitrile rubber, epoxy resin and polymethyl methacrylate (PMMA) were used to modify 5% triclosan/cyanoacrylate antimicrobial adhesive respectively. The bond strength, toughness and viscosity of the modified adhesive were examined in different concentrations.Results 0.064% MWCNTs-COOH, 6% nano-silica, 4% nitrile rubber and 6.4% epoxy resin all had good effects in strength modification. The bond strength were (14.71±1.48)MPa, (14.03±1.92)MPa, (14.6±1.78)MPa and (14.05±1.46)MPa respectively. 8% nano-silica had the lowest Tg of (1.1±0.24)℃ and the strongest viscosity of (15 536.68±28.4)cP. When the nano-silica concentration was 8%, the compound was very viscous and sticky. When the antimicrobial adhesive modified with 6% nano-silica, the bond strength was (14.03±1.92)MPa, the Tg was (3.6±0.68)℃, and the viscosity was (5 278.87±31.68)cP.Conclusion 6% nano-silica is the best modifying material, and has the optimal effect of modification.

Objective:To check RNA binding protein QKI-5's expression level in breast cancer cells and inhibiting effect on cancer cell proliferation.Methods:QKI-5's expression level was checked in different breast cancer cells by Western blotting,cancer cells of overexpressed QKI-5 gene could be stabilized by slow virus infection construction,MTT and FCM were used to check cell period to express QKI-5's influence on cell proliferation and period.Results:MCF-7 cells have relatively low QKI-5 expression level in three breast cancer cells,MTT experiment result has obvious reduced influence on QKI-5's expression of MCF-7 cell proliferation P＜0.05,mean-while,cell period inspection shows that overexpressed QKI-5's MCF-7 cells have obvious G1 retardant,cells in S and G2/M periods are reduced.Conclusion:High expression of QKI-5'in breast cancer could cause slow cell proliferation by inhibiting cancer cell period,hence causing limited tumor growth.

Objective To discuss the maximum tolerated dose of oxaliplatin based on 5-fluorouracil derivative in patients with locally advanced rectal cancer who underwent neoadjuvant chemoradiotherapy.Methods From Mar 2015 to Oct 2015,15 locally advanced rectal cancer patients (T3,T4/N +) who received intensity modulated radiotherapy and concurrent chemotherapy with capecitabine and oxaliplatin were enrolled in this study.The prescription dose was 50.6 Gy for gross tumor volume(GTV) and 41.8 Gy for clinical tumor volume(CTV) in 22 fractions within 30 d with concomitant boost.There were four dose-level groups of oxaliplatin as 100,110,120 and 130 mg/m2 tri-weekly and fixed capecitabine dose (825 mg/m2 bid d1-5 per week).The first 12 patients were randomly assigned into 4 groups.For the 130 mg/m3 group,another 3 patients were enrolled because of dose-limiting toxicity (DLT).Treatment related toxicities and response rates were evaluated.Results The most common adverse events(AE) were radiation enteritis,skin reactions,nausea,fatigue,urinary system AE and bone marrow suppression.There was a trend of increase by the dose level of oxaliplatin for toxicities.Groups 100,110 and 120 mg/m2 had none DLT,while group 130 mg/m2 had 1 patient for grade 3 thrombopenia and 1 patient for grade 3 nausea.Postoperative pathology showed that all patients achieved tumor downstaging,among which 0,1,2,3 cases achieved complete remission of the four groups,respectively.Conclusions The combination regimen of capecitabine and oxaliplatin is safe and effective according to the preliminary results.The maximum tolerated dose of oxaliplatin was 130 mg/m2 tri-weekly.