Objective To investigate the effects of preoperative biliary drainage ( PBD ) on the morbidity and mortality of pancreaticoduodenectomy in patients with malignant obstructive jaundice in the lower bile duct. Methods Clinical data of 74 cases undergoing pancreaticoduodenectomy from Jan. 2000 to Dec. 2005 with preoperative total bilirubin level over 85 μmol/L were collected and retrospectively analyzed. Comparison was performed between patients receiving PBD and those not. Before surgery. The parameters sincluding perioperative situation, in-hospital death rate, post-operative complications and were calculated to evaluate the influence of pre-operative biliary drainage on the outcomes. Univariate analysis and Logistic analysis were used to identify the risk factors for post-operative complications. Results Forty (40/74) cases received PTCD procedure. The total bilirubin was significantly reduced from (338. 10±88. 38 )μwnol/L to ( 228. 50±82.24) μ,mol/L in PTCD population and was significantly lower than ( 328. 60±93. 02) μmol/L of the non-PTCD group. There was no significance between the two groups in terms of total complications and individual complication Logistic regression analysis showed that preoperative TB over 340 μmol/L and blood loss over 600 ml were important risk factors for post-operative complications. Conclusion High pre-operative total bilirubin over 340 μmol/L increases the risk of post-operative complications in the patients with malignant jaundice. Preoperative biliary drainage is useful to reduce the total bilirubin and improve the hepatic function of the patients. Prolonged pre-operative biliary drainage could be considered in the patients with high preoperative bilirubin,poor nutritional condition and impaired coagulation to enhance the tolerance of surgery.

Ezrin protein function as molecular linker between the actin-cytoskeleton and the plasma membrane,which involves in the formation of microvilli and the maintenance of cello-morphology, movement, adhereance as well as survival, intimate studies of its structure and function have been done. At present many studies indicate that Ezrin involves in the tumor development and tumor metastasis,relate to prognosis. To study Ezrin protein in tumor will provide us other way and standard for diagnose and treatment of tumor and prognostic evaluation.

Objective · To evaluate the clinical characteristics of endometrial pathology in postmenopausal women with asymptomatic thickened endometrium. Methods · A retrospective review was conducted of the patients between October 2013 and October 2015 in the International Peace Maternity & Child Health Hospital. The postmenopausal women with asymptomatic thickened endometrium of 5 mm or more found by transvaginal ultrasonography were recruited. They underwent hysteroscopy and endometrial sampling to analyze the relationship between endometrial pathology and endometrial thickness. Results · A total of 257 patients were recruited. The average age was 61.3 years old, the average menopause period was 122 months, and the average endometrium thickness was 8.6 mm. The endometrial pathology included normal atrophic endometrium, endometrial polyp, submucous myoma, intrauterine adhesion, uterine septum, endometrial hyperplasia and endometrial cancer. The most common pathological type was endometrial polyp, accounting for 66.9% of the all patients and 83.9% (172/205) of all pathological types. Three cases of adenocarcinoma (1.2%) were diagnosed. There was significant difference in endometrial thickness among normal endometrium, endometrial polyp and endometrial cancer (P<0.05). The endometrium in endometrial cancer was the thickest, which was (13.20±5.38) mm averagely. There was significant difference in ages among the pathological types (P=0.004). Conclusion · There are few patients of malignancy among asymptomatic postmenopausal women with thickened endometrium. Follow-up visits were recommended to these women.

Objective To investigate the relationship between fractional exhaled nitric oxide (FENO) and asthma predictive index (API) in infants under 3 years of age. Methods Totally 62 cases (under 3 years of age) who were hospitalized from June 2015 to June 2016 and had more than 3 times wheezing over the past year were enrolled in this study. They were divided into two groups according to API:API positive group with 37 cases and API negative group with 25 cases. FENO levels and peripheral blood eosinophil levels were detected and skin prick allergy test (inhalation and ingestion of allergens)was done in all selected children, did skin prick allergy test (inhalation and ingestion of allergens), simultaneous detected peripheral blood eosinophil levels. The parents of the children were investigated by questionnaire to know the children′ history about atopic dermatitis (such as urticaria, eczema, etc) and parents′ wheezing history. Above information was recorded and statistics analysis was made. Results There were no significant differences between two groups in atopic dermatitis inhalation and ingestion of allergens (P<0.01 or <0.05). The level of FENO in API positive group and API negative group was (16.70 ± 11.07), (13.52 ± 11.01) ppb(1 ppb=1 × 10- 9 mol/L), and there was significant difference (P<0.01). Conclusions There are associations between FENO and API, and they have good reference value in predicting the risk of asthma.

AIM: To study apoptosis and related genes expressions of cardiomyocytes in sinoaortic-denervated(SAD) rats. METHODS: SAD or sham-operation (Sham) was performed in male SD rats at the age of 10 weeks. After 16 weeks, apoptotic cells were stained in situ by terminal dexynucleotidyl-transferase mediated-dUTP nick end labeling (TUNEL). All stained results were analysised using computer image analysis techniques. Protein products and mRNA of Bcl-2, Bax, Fas and Fas-L were assessed by quantitative immunohistochemistry and RT-PCR. RESULTS: The numbers of apoptotic cardiomyocytes were significantly increased in SAD rats, the expressions of Bcl-2 were significantly decreased, whereas Bax,Fas and Fas-L were significantly increased in SAD rats. THZ]CONCLUSIONCONCLUSION: Apoptosis and dysregulation of gene expressions may be involved in the cardiomyocytes remodeling in SAD rats.

Objective To investigate the energy intakes and energy consumption in continuous ambulatory peritoneal dialysis (CAPD) patients,and to identify the possible influence factors for overweight and obesity of CAPD patients.Methods A total of 115 CAPD patients were enrolled from May to December 2011 in Peking University Third Hospital.Based on body mass index (BMI),they were divided into normal group (18.5 kg/m2 ≤ BMI < 24 kg/m2,n =61) and obese group (BMI ≥ 24 kg/m2,n =54).Three-day dietary intakes including dietary energy,protein,fat,and carbohydrates intakes were collected.Glucose absorption from dialysate was measured.Three-day activities were recorded for the calculation of resting energy expenditure (REE) and total energy expenditure (TEE).Body composition of the patients was analyzed.Results There were no significant differences in age,height,dietary energy intake,protein intake,carbohydrate intakes,lean tissue mass,and hydration status between the two groups.Glucose absorption from dialysate and dietary fat intake were significantly higher in the obese group than in the normal group [(1 920.5 ± 506.3) kJ/d vs.(1 673.6 ±535.6) kJ/d,x2 =2.536,P=0.013; (62.5 ±19.8) g/dvs.(53.1 ±18.7) g/d,x2=2.575,P =0.011].Although REE was higher in the obese group as compared with the normal group [(5 066.8 ±1 029.3) kJ/d vs.(4 556.4 ± 799.1) kJ/d,x2 =2.979,P =0.004],there was no significant difference in TEE between the two groups [(7 819.9 ±728.0) kJ/d vs.(7 803.2 ± 1 092.0) kJ/d,x2 =0.770,P =0.939].Logistic regression showed that glucose absorption from dialysate and dietary fat intakes were risk factors for obesity in the study population (OR =1.003,95％ CI =1.000-1.007,P =0.029 ; OR =1.024,95％ CI =1.003-1.046,P =0.027).Conclusions Obese CAPD patients may absorb more glucose from peritoneal dialysate and consume more fat than non-obese CAPD patients,but TEE is not significantly different.It indicates that obese CAPD patients are at positive energy balance.Less use of high glucose dialysate and more physical exercises are recommended for these patients.

BACKGROUND:Although there is a general consensus with regard to the treatment of Rockwood types I, II, IV, V and VI injuries, the treatment of type III injury is inconsistent. OBJECTIVE: The aim of this systematic review was to evaluate the efficacy and safety of implant fixation and conservative treatment for Rockwood type III acromioclavicular dislocation. METHODS:Studies were identified from databases (PubMed, Embase, Cochrane Library, China Biological Medicine, VIP, CNKI and Wanfang Database) up to May 2015. Eligible studies that investigated and compared the effectiveness and/or complications of implant fixation and conservative treatment for Rockwood type III acromioclavicular dislocation and provided sufficient data were included. RESULTS AND CONCLUSION:In total, eight studies were included. Implant fixation (n=207) included the Bosworth technique, Clavicle Hook Plate technique, the TightRopeTM system (titanium plate and Arthrex fiber suture), Weaver-Dunn technique (coracoacromial ligament displacement, instead of coracoclavicular ligament fixation), Phemister technique (Kirschner wire fixation) and the use of a poly dioxanone sutures cord. The conservative treatments (n=137) consisted of immobilisation management with a sling, Kenny-Howard brace, or with a sling and clavicle fastening taping tape or a simple brake, or with a sling or tape. There were no significant differences in the Constant score (P=0.90) and infection rate (P=0.07) between the two groups. The rate of satisfaction with aesthetic outcomes was higher in the implant fixation group (P < 0.000 01), although the incidence of coracoclavicular ligament calcification was also higher (P=0.03) in this group. The time to resumption of normal work and normal activities was shorter after conservative treatment than that after implant fixation treatment. However, implant fixation could return to the game faster. These results indicate that both implant fixation and conservative treatments can result in satisfactory levels of shoulder function; however, the rehabilitation time was shorter after conservative treatment. Although implant fixation results in superior aesthetics, the risk of coracoclavicular ligament calcification is higher than that with conservative treatment. Time to resumption of normal work and normal activities was shorter after conservative treatment.

Objective To study proliferation,secreted cytokines,immune phenotypes and cytotoxicity on Raji cells by cytokine induced killer (CIK) cells co-cultured with dendritic cells (DC).Methods The mononuclear cells from peripheral blood of healthy individuals were extracted,then cultured the cells under 5 ％ CO2 at 37 ℃ for 2 hours.DC were induced from suspended cells,and CIK cells were from adherent cells.After 9 days of nurturing,two types of cells were mixed.CIK cells were cultured alone as the control.The cytotoxic activity of CIK and DC-CIK cells were detected by MTT assay.The morphologies,proliferation,secreted cytokines,and immune phenotypes of the two cells in day 0,3,6,9,12,15 in culture were monitored.Results In day 12 in culture,comparing with CIK cells,DC-CIK cells significantly enhanced the proliferation rate [(42.44±2.68) fold vs (30.01±2.05) fold] (t =11.64,P ＜ 0.05) and had increased IL-2,IFN-γ,IL-12 and TNF-α secretion [(124.34±12.57) ng/L vs (56.32±6.58) ng/L,(496.60±95.32) ng/L vs (247.80± 69.45) ng/L,(84.92±6.07) ng/L vs (24.18±3.31) ng/L,(380.6±45.95) ng/L vs (196.61±24.19) ng/L] (t =15.16,P ＜ 0.05; t =6.67,P ＜ 0.05; t =27.78,P ＜ 0.05; t =11.20,P ＜ 0.05),and there were more CD3+ CD8+ cells and CD3+ CD56+ cells in the co-culture [(71.79±1.73) ％ vs (60.37±3.24) ％,(48.54±3.30) ％ vs (33.07±2.22) ％](t =9.83,P ＜ 0.05; t =12.30,P ＜ 0.05),and DC-CIK cells had a significandy increased cytotoxicity on Raji cells in vitro at the same ratio of effector cells to target cells.Conclusion CIK cells have higher proliferation rate and cytotoxicity against Raji cells when co-cultured with DC.

Angioplasty, Balloon, Coronary ; adverse effects ; Humans ; Male ; Middle Aged ; Platelet Aggregation Inhibitors ; therapeutic use ; Postoperative Hemorrhage ; drug therapy

Acute Disease ; Aneurysm, Dissecting ; complications ; Aortic Aneurysm, Thoracic ; complications ; Female ; Humans ; Myocardial Infarction ; etiology