Objective To explore the cause and the interventional treatment of restenosis after percutaneous transhepatic biliary stent.Methods 20 patients with biliary restenosis after percutaneous transhepatic biliary stent placement were collected.According to drainage volume from biliary tract and degree of amelioration of jaundice,post-operation hepatic function,blood,urine and stool routines,ultrasound,CT scan and cholangiography were performed to determine the nature and location of biliary restenosis,and then all cases underwent recanalization with intervention method by the exteriorized drainage tube approach.The China-made nickel-titanium alloy stents with diameter of 10 mm and length ranged from 40 mm to 80 mm were used.Results The biliary restenosis occurred in mid-inferior segment of common bile duct in 9 patients, common hepatic duct in 7 patients and hepatic porta in 4 patients. As regarding the causes of restenosis included tumor compression in 9 cases, angulation in upper segment of stent in 3 cases, obstruction in stent by bile, food or clot in 4 cases, cholangitic stenosis in 2 cases and granulation proliferation in 2 cases.The obstruction in all cases was relived by extraction through drainage tube, drug irrigation,dredging by wire, balloon dialtion or stent replacement, so that the total survival rate was beyond 6 months.Conclusion After percutaneous transhepatic biliary stent placement in treating the malignant biliary obstruction,the rate of biliary restenosis is still high,which should be attached importance to.

Objective:To investigate the expression of metabolic enzymes of fluoropyrimidines in primary colorectal cancer. Methods: Sixty-one cases of pathological confirmed primary colorectal cancer were collected in Beijing Cancer Hospital from August 2003 to February 2004. The expressions of thymidylate synthase (TS), dihydropyrimidine dehydrogenase (DPD) and orotate phosphoribosyl transferase (OPRT) were detected in paired tumor tissues and non-cancerous tissues by RT-PCR. Results: Expression of each enzyme in tumor tissues was positively correlated with that in paired non-cancerous tissues respectively. Compared with the expression of each enzyme in cancer with that in non-cancer, OPRT was higher in cancer while that of DPD and TS was comparable. The expression of OPRT was approximately 4.38-folds higher in colorectal cancer tissues than that in non-cancerous tissues (P0.000). The lowest expression of OPRT was found in mucinous carcinoma while the highest levels in poorly-differentiated adenocarcinoma. There were correlations between the ratio of tumor tissues / non-cancerous tissues OPRT expression (T/N) and metastasis to the lymph nodes (r0.36; P0.005), small vessel invasion (r0.26; P0.041) and differentiation (r-0.33; P0.009). Conclusion: The detection of three enzymes by means of RT-PCR is practical and can be used in clinical application. Our results also suggest that OPRT is a potential biomarker in predicating prognosis of colorectal cancer.

Objective To investigate the correlation between executive function(EF) and characteristic of symptom in children with Tourette′s syndrome(TS).Methods EF were measured with Wisconsin Card Sorting Test(WCST) in 53 patients with TS,and symptom characteristics were evaluated with Achenbach Child Behavior Checklist(CBCL) and Yale Global Tic Severity Scale(YGTSS).Results Compared with healthy control,TS had poor executive performances significantly in WCST(all P

Objective To evaluate the role of spinal Toll-like receptor 4 (TLR4) signaling pathway in the development of inflammatory pain in rats.Methods Thirty-six adult male Sprague-Dawley rats were divided into 3 groups (n=12 each) using a random number table:control group,inflammatory pain group and TLR4 signaling pathway inhibitor epigallocatechin gallate (EGCG) group (EGCG group).Inflammatory pain was induced by injecting 50 μl of complete Freund's adjuvant (CFA) into the ankle joint cavity of the left hindpaw of rats anesthetized with isoflurane.At 1-3 days after injection of CFA,EGCG 30 μg was intrathecally injected once a day in group EGCG.At 1,3 (30 min after intrathecal injection),5and 7 days after injection of CFA,the mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured.The ipsilateral L4.5 segments of the spinal cord were removed at 3 days after CFA injcction for determination of TLR4 expression (by Western blot) and contents of tumor necrosis factor-alpha (TNF-oα),interleukin-6 (IL-6) and IL-1β in the spinal dorsal horn (by enzymelinked immunosorbent assay).Results Compared with control group,the MWT was significantly decreased and the TWL was shortened at each time point after injection of CFA,the expression of TLR4 in the spinal dorsal horn was up-regulated,and contents of TNF-α,IL-6 and IL-1β in the spinal dorsal horn were increased in inflammatory pain group (P＜ 0.05),and no significant change was found in the parameters mentioned above in EGCG group (P＞0.05).Compared with inflammatory pain group,the MWT was significantly increased and the TWL was prolonged at each time point after injection of CFA,the expression of TLR4 in the spinal dorsal horn was down-regulated,and contents of TNF-α,IL-6 and IL-1β in the spinal dorsal horn were decreased in EGCG group (P＜0.05).Conclusion Spinal TLR4 signaling pathway is involved in the development of inflammatory pain in rats.

Guanylate binding protein-1(GBP-1) is an interferon-induced protein. To observe its antiviral effect against Hepatitis B virus (HBV) and Coxsackie virus B3 (CVB3), we constructed an eukaryotic expression vector of human GBP-1(hGBP-1). Full-length encoding sequence of hGBP-1 was amplified by long chain RT-PCR and inserted into a pCR2.1 vector, then subcloned into a pCDNA3.1(-) vector. Recombinant hGBP-1 plasmids and pHBV1.3 carrying 1.3-fold genome of HBV were contransfected into HepG2 cells, and inhibition effect of hGBP-1 against HBV replication was observed. Hela cells transfected with recombinant hGBP-1 plasmids were challenged with CVB3, and viral yield in cultures were detected. The results indicated that recombinant eukaryotic expression plasmid of hGBP-1 was constructed successfully and the hGBP-1 gene carried in this plasmid could be efficiently expressed in HepG2 cells and Hela cells. hGBP-1 inhibit CVB3 but not HBV replication in vitro. These results demonstrate that hGBP-1 mediates an antiviral effect against CVB3 but not HBV and perhaps plays an important role in the interferon-mediated antiviral response against CVB3.

To establish a replication cellular model of hepatitis B virus (HBV) and determine its application in antiviral drug evaluation,we constructed an expression plasmid which contained 1.3 copies of the HBV genome,and measured the level of viral replication after transient transfection in Huh7 cells.We then observed the effect of antiviral drug administration.1.3 fold of the HBV(ayw) gene fragment was cloned into pCR2.1 by PCR and restriction endonuclease digestion.The recombinant plasmid was trans ient transfected into Huh7 cells,HBsAg,HBeAg and HBV DNA in supernatant of Huh7 cells were measured by ELISA and real-time PCR respectively; intracellular HBV replicative intermediates and intracellular HBV transcripts were detected by Southern blot and Northern blot respectively.The antiviral effect of adefovir,a novel anti-HBV nucleotide analogue,was evaluated in this cellular model system.The results indicated that a recombinant plasmid of HBV replicon was constructed successfully; the HBV genome carried in plasmid pHBV1.3 could efficiently replicate and be expressed in Huh 7 cells,adefovir could inhibit HBV replication in this cellular model,and the inhibition was dosage-dependent.The conclusion is HBV replicon,which can initiate viral replication efficiently in hepatoma cells,may be a useful tool in the study of HBV replication and antiviral drug.

OBJECTIVETo evaluate the preliminary curative effect of interspinous injections for the diagnosis and treatment of back pain caused by lumbar kissing spine (Baastrup's disease) under fluoroscopically guiding.

METHODSFrom November 2011 to March 2013,17 patients with back pain caused by Baastrup's disease were treated with fluoroscopically-guided interspinous injections, including 7 males and 10 females with an average age of 49.6 years old ranging from 40 to 71 years old; the duration of the disease ranged from 2 to 5 years with a mean of 3.7 years. The visual analogue scale (VAS) and the lumbar segments range of motion (ROM) was analyzed at pre-operation, 2 days, 3 months and final followed-up after operation, the effects were evaluated with modified Macnab standard.

RESULTSAll patients were follow-up from 6 to 10 months with an average of 7.6 months. The pre-operative VAS was 6.41 +/- 0.94, the postoperative VAS at different time points improved significantly comparing with pre-operation,and the differences were statistically significant (P < 0.01). There was no significant difference in VAS at different time points after operation (P > 0.05). The ROM of operated segment and adjacent segment was (4.88 +/- 0.86) degrees and (6.82 +/- 0.73) degrees respectively at pre-operation. The postoperative operated segment ROM at different time points improved significantly comparing with pre-operation, and the differences were statistically significant (P < 0.05). Compared with pre-operation, there was no significant difference in adjacent segment ROM at different time points after operation (P > 0.05). According to modified Macnab, the result was excellent in 6 cases, good in 7 cases, fair in 3 cases and poor in 1 case.

CONCLUSIONFluoroscopically-guided interspinous injections is an effective method for the diagnosis and treatment of Baastrup's disease. The method has advantages of simple operation, minimal invasion and safety, satisfactory short-term and medium-term therapeutic effect; it can also effectively lessen the pain of lumbar and back.

Adult ; Aged ; Anesthetics, Local ; administration & dosage ; Female ; Humans ; Low Back Pain ; diagnosis ; diagnostic imaging ; drug therapy ; Lumbar Vertebrae ; diagnostic imaging ; drug effects ; Male ; Middle Aged ; Nerve Block ; Spinal Diseases ; diagnosis ; diagnostic imaging ; drug therapy ; Tomography, X-Ray Computed

OBJECTIVETo investigate the characteristics, diagnosis, and treatment of ovotesticular disorder of sex development (OT-DSD).

METHODSWe retrospectively analyzed 2 cases of OT-DSD treated in our hospital. The patients were 19 and 15 years old, respectively, and both received systematic physical examination and examinations of the karyotype, sex hormone, adrenocorticotropic hormone (ACTH), color Doppler ultrasonography, urethrocystoscopy, and human chorionic gonadotropin (HCG) test. Under the laparoscope, we performed surgical gonad exploration, gonadectomy, and vulvar orthopedics. Intraoperative exploration and pathology confirmed true hermaphroditism in both cases, with sex selection as female. One underwent laparoscopic resection of the ovotestis, and the other removal of the testis with the ovarian tissue reserved.

RESULTSThe patients were followed up for 12 months postoperatively, which found no abnormality in either the vulvas or the genital glands.

CONCLUSIONSurgical exploration of the gonad is the only method for the diagnosis of OT-DSD and sex selection is the key to treatment. Laparoscopic surgical exploration of the gonad and vulvar orthopedics are the first treatment options.

Adolescent ; Chorionic Gonadotropin ; Female ; Gonadal Steroid Hormones ; Humans ; Karyotype ; Laparoscopy ; Male ; Ovary ; Ovotesticular Disorders of Sex Development ; diagnosis ; surgery ; Retrospective Studies ; Testis ; surgery ; Young Adult

Objective To evaluate the feasibility of slightly acidic electrolyzed oxidizing water for the disinfection of gastrointestinal endoscopes.Methods Electrolyzed oxidizion water generator was utilized to produce the water,which was applied for the disinfection of gastrointestinal endoscopes.The disinfectant efficiency and effect were evaluated.Results A total of 215 samples were taken for bacterial culture after the disinfection.The mean sterilization efficiency of slightly acidic electrolyzed oxidized water and 2％ glutaraldehyde by machine were 99.92％ and 99.85％,respectively,while the mean sterilization efficiency were 99.85％ and 99.84％ by manual disinfection.There were no statistical significance between the two groups.The effective rates of both groups were 100％.No deformation or aging was observed in the endoscopes.The disinfectant caused no damage to the cleansing and disinfection.Conclusion It is feasible to apply slightly acidic electrolyzed oxidizing water to the disinfection of endoscopes.

Objective To investigate the relationship between the fluorouracil pathway gene and effect of chemotherapy in advanced gastric cancer after surgery. Methods 52 postoperative patients with advanced gastric cancer using FOLFOX4 6-cycles combined chemotherapy were collected to set up the database. The expression of thymidine synthase (TS), dihydropyrimidine dehydrogenase (DPD) and orotate phosphoribosyltransferase(OPRT) in tumor tissue and adjacent non-tumor tissue of 52 patients with advanced gastric cancer were measured by semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR). The influence of fluorouracil pathway gene on chemotherapy was investigated. Results The TS-mRNA level in tumor tissue was significantly higher than non-tumor tissue (0.92±0.28 vs 0.71±0.30) (t = 3.730, P =0.001).OPRT-mRNA level in tumor tissue was positively correlated with the non-tumor tissue (r =0.45, P =0.001). No correlations were observed among other gene expressions. Patients whose high OPRT-mRNA gene expression in their tumors and non-tumor tissue showed an obviously better survival (t = 3.036, P =0.003;t = 2.713, P =0.009). Patients with low DPD-mRNA gene expression survived longer than those with high DPD-mRNA gene expression in tumor tissue with statistical significance(t = 2.708, P =0.009), whereas prolonged survival was observed in patients with high DPD-mRNA gene expression in non-tumor tissue (t = 2.616, P =0.012).Conclusion There is close relationships between chemotherapy in advanced gastric cancer and the expression of DPD-mRNA, OPRT-mRNA;while the expression of TS-mRNA have no relation with the survival time.