Hilar cholangiocarcinoma is a rare biliary malignant tumor derived from the biliary epithelial cell. The primary current treat-ments for hilar cholangiocarcinoma include surgery and chemotherapy, as well as radiation and photodynamic therapies (PDT). A com-plete resection with negative margins is the only treatment with the potential for cure and the only way to maximize survival. Howev-er, over half of the patients in the advanced stage of hilar cholangiocarcinoma lost the chance for surgery. Radiotherapy and chemo-therapy can prolong patient survival;however, these lack reliable data. Most patients who cannot be treated surgically undergo biliary stenting to relieve the biliary obstruction. The PDT is a new method to treat various malignant tumors. Several clinical studies have shown its local tumor ablation capability. Thus, PDT has broad application prospects in the treatment of unresectable hilar cholangio-carcinoma.

Objective To investigate the effect of damage control laparotomy in multiple trauma care.Methods A retrospective review was made on clinical data of 33 multiple trauma cases who received damage control laparotomy from January 2009 to June 2015.Twenty-four cases were males and 9 females, with the age range of 19-68 years(mean, 41.0 years).The trauma causes included traffic injury in 21 cases, high fall injury in 6 cases, falling object injury in 5 cases, and detonator blast injury in 1 case.Injury severity score (ISS) ranged from 14 to 64 points (mean, 27.0 points).All cases presented abdominal injury.Complicated injuries included brain injury in 10 cases, chest injury in 23 cases, and pelvic limb injury in 21 cases.All cases underwent damage control laparotomy, and then temporary abdominal closure after abdomen surgery.Abdominal closure time, intro-abdominal hypertension (IAH) or abdominal compartment syndrome (ACS), related treatment methods, hospital length of stay, and complications were recorded after operation.Results Twenty-nine cases had primary fascial closure 5-12 d after surgery.Four cases were unable to complete definitive abdominal wall reconstruction within the short term, and underwent skin grafting to form planned ventral hernia.Twelve cases developed IAH or ACS, and were cured using intra-abdominal volume increment assisted by vacuum sealing draining (VSD).Hospital length of stay was 21-70 d (mean, 31.4 d).There were wound infections in 2 cases of open fractures and abdominal incision infections in 4 cases, but all were cured after debridement plus VSD treatment.Abdominal abscess occurred in 1 case, and was cured by abdominal puncture and drainage.All cases were discharged from hospital smoothly.Conclusion Rational application of damage control laparotomy is a safe and effective treatment method for multiple trauma combined with abdominal injury.

Objective To explore the correlation between executive function and white matter lesions (WML) and the diagnostic value by clock drawing test(CDT) in patients with vascular dementia (VaD). Methods Twenty-seven VaD patients and twenty-five normal control subjects were evaluated with CDT to assess the executive function. CDT was scored according the four point method. Age-related white matter change rating scale (ARWMCrs) was used qualitatively to measure and locate the WML by cranial MRI scanning. Results 1. The scores of CDT in normal cognition health and VaD were ( 3.88 ± 0. 33 ) and ( 1.74 ± 0. 98 ). The difference between two groups was statistically significant (P＜0. 01 ). The humerous part and the point part were the earliest to decline in the VaD Patients. The scores of WML were (5.12 ± 4. 19) and ( 11.19± 3.09), respectively. There was significant difference between two groups(P ＜ 0. 01 ). The scores of CDT had significant positive correlation with MMSE scores and negative correlation with WML scores (P ＜ 0. 01 ). Conclusion The executive functional impairment in patients with VaD could be associated with the degree of WML.

A novel HBV integration site involved in hepatocarcinogenesis was investigated. The HBV DNA integration sites were detected by Alu-PCR in hepatocellular carcinoma tissues, matched surrounding liver tissues in 30 patients with hepatitis B-related hepatocellular carcinoma (HCC) and 3 cases of normal liver tissues. The integration sites and flanking sequences in human genome were sequenced and blasted, and the expression of integrated HBV genes was determined by reverse transcriptase-polymerase chain reaction (RT-PCR). The influence of the up-regulated expression of integrated genes on hepatocarcinogenesis was analyzed. Nineteen integration sites of HBV DNA into HCC tissues were obtained by RT-PCR and sequencing. These genes encoding proteins were: LOC51030, LOC157777, minichromosome maintenance complex component 3 associated protein (MCM3AP), MCTP1, SH3 and multiple ankyrin repeat domains 2 isoform 2, CCDC40, similar to HCG2033532, mitochondrial ribosomal S5 pseudogene 4. One of them was integrated into the intron of MCM3AP. RT-PCR demonstrated that the expression levels of MCM3AP mRNA in HCC tissues, matched surrounding liver tissues and normal liver tissues were in a descendent order. The ratio of MCM3AP mRNA to the GAPDH mRNA in these three tissues was 1.07375, 0.21573, 0.06747 respectively, with the difference being statistically significant among them (P<0.05). Meanwhile, the expression levels of MCM3AP mRNA from HCC tissues in which HBV DNA integrated into MCM3AP were still significantly higher than those without HBV DNA integrated into MCM3AP. It was concluded that the HBV DNA integration sites into human genome were random, and MCM3AP was a new site. The up-regulated MCM3AP mRNA may affect flanking sequences which promote the hepatocarcinogenesis.

Objective To study the effects of the HBV x gene (HBx) on the biological characteristics and the expression of DNA repair enzyme hMTH1 mRNA of the L02/HBx transgene cell model. Methods Light microscopy was used to observe the morphologic characteristics of gene-transfected cell strain Lff2/HBx that stably expressed the HBx protein and the control groups of L02 and L02/PcDNA3.1. The changes of L02/HBx on the proliferation, cell cycle and apoptosis were observed by MTT assays and flow cytometry analysis respectively. Moreover, the malignant transformation of L02/HBxwas assayed by colony formation in soft agar and the expression of DNA repair enzyme hMTH1 mRNA was assayed in each group by real-time qPCR. Results Inversion phase contrast microscope showed that the morphologic characteristics of L02/HBx had changed obviously compared with control groups. The MTT showed that L02/HBx proliferated more quickly and flow cytometry analysis indicated that HBx could accelerate the progression of cell cycle and inhibit apoptosis. Colony formation in soft agar demonstrated that the rate of colony formation of L02/HBx was remarkably higher than the L02 and the L02/peDNA3. 1 cells (P<0. 05). The real-time qPCR detection showed that the expression of hMTH1 mRNA in L02/HBx was significantly higher than that in the control groups ( P < 0. 05 ). Conclusion HBx could play an important role in the malignant transformation of L02/HBx and the over expression of hMTH1 mRNA.

Objective To investigate any correlation between cognition and auditory event-related potential (ERP) after traumatic brain injury (TBI),and to explore the diagnostic value of the P300 ERP for TBI patients.Methods Thirty TBI patients and 28 healthy subjects were recruited.Their P300 auditory event-related potentials were measured and the Montreal cognitive assessment (MoCA) was administered.Results The TBI patients' total MoCA scores and their scores on most of the sub-item components were significantly lower than those of the control subjects,though their naming and speech showed no significant difference.The TBI patients had abnormal P300 responses.Their N1,P2,N2 and P3 latencies were significantly longer and their P2 and P3 amplitudes were significantly lower than those of the control group.Stepwise regression and multivariate analysis showed that the P300 latency was significantly associated with delayed memory,impaired visual spatial executive functioning and total MoCA score.Conclusion P300 can be used as a quantitative electrophysiological index for detecting cognitive impairment in patients with TBI.

Objective To develop a sandwich enzyme-linked immunosorbent assay ( ELISA) for the determination of a humanized antibody MIL50.Methods RiVax, a mutant of RTA (a chain of ricin) expressed in E.coli, was used as the coating protein.Horseradish peroxidase (HRP) labeled IgG of goats against humans was used to determine MIL 50 captured by RiVax coated on the plate.Results Compared with ricin, RiVax could bind well with MIL50,indicating it could be used as a coating protein to determine MIL50 instead of holotoxin.Using this method, the detective limit of MIL50 in PBST (PBS containing 0.1%Tween 20) could be as low as 0.030 mg/L.The absorbance value of ELISA for MIL50 in the ser-um and homogenate of the liver , spleen, lung, kidney, muscle of rats was lower than that in PBST .Conclusion The sandwich ELISA is a sensitive method for the analysis of distribution of MIL 50 in rat tissues.

Objective To observe the changes of cognition and auditory event-related potential P300 on vascular cognitive impairment-no dementia (VCIND) patients before and after cognitive rehabilitation training,then further to explore the application value of P300 in early diagnosis of vascular cognitive impairment (VCI). MethodsA total of 57 patients with VCIND were randomly assigned to the treatment group ( n =30) and the control group ( n =27),and 30 healthy volunteers without cognitive deficits were recruited as normal group.Each patient was examined with auditory-P300 and scored with mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA) scale.The measurement indicators were analyzed and evaluated with the factors of education,age and so on. ResultsThe P300 latency in VCIND group was longer,and the amplitude lower than those in normal group before treatment (P＜0.05 ),the latency lengthening was more significant than the lowering of the amplitude ( P＜0.01 ).The cognitive assessment scale scores of MMSE,MoCA and ADL (Barther index,BI) in VCIND group were lower than those in normal group (P＜0.05),while no significant difference was revealed between the VCIND and normal groups with regard to naming and speech( P ＞ 0.05 ).A highly positive correlation between age and P300 latency as well as a significantly negative correlation between years of education and P300 latency were demonstrated( P＜0.05 ).After cognitive rehabilitation therapy the P300 latency in VCIND group was shortened,the amplitude increased (P＜0.05 ),scores of the items of cognitive scale raised(P＜0.05 ) and the change of each indicator was more statistically significant in treatment group(P＜0.05). ConclusionP300 could objectively reflect early cognitive dysfunction in VCIND patients.Early cognitive training could effectively promote cognitive function of VCI patients.

AIM:To gain the molecular mechanism of active ingredients of EGb 761(ginkgo flavones and ginkgo lides) for the inhibition against A?_(1-42) aggregation and fibrogenesis.METHODS:Circular dichroism spectra(CD) and FI-IR were used to curve-fit and analyze the change in A?_(1-42) second structure under A? aged condition and intervention of ginkgo flavones and ginkgo lides.RESULTS:Analysis that was made of 1700-1600 m(-1) amide-Ⅰ-band and curve fitting indicated that after 30 min to 72-incubation,increase of ?-sheet in A?_(1-42) by(18.5%),but the reduction of ?-sheet by(50.95%) and(36.09%) in 72 h incubation with ginko flavones and ginkgo lides,respectively.And increase of ?-turn by(56.56%) and(46.56%) in sane condition.CONCLUSION:Obviously,?-sheet turned into ?-turn.-CH_2 and-CH groups of ketones and alkanes engaged in A?_(1-42) molecular change.

Objective To investigate the calcium signal transduction pathway in hippocampal neurons of mice with vascular dementia (VaD) and the intervention effect of dihydroergocriptine (DHE). Methods The mice were subjected for ischemia-reperfusion repeatedly on bilateral common carotid arteries by knots to establish the VaD models. Animals with sham-operation were taken as control group. The treating group was administered with DHE after the establishment of VaD model. The behavior changes were observed through the step-down avoidance test and water maze test on the 29th and 30th days after operation. The resting 〔Ca 2+〕 i level of hippocampal neurons was evaluated by laser scanning confocal microscopy. RT-PCR technique was used to measure mRNA expression of CaM an CaMPKⅡ in hippocampal neurons. Results The resting 〔Ca 2+〕 i level in model group(43.50?3.00) was significantly higher than those in the sham-operation group (25.50?3.50) (P