It is a consensus to place stent after cutting bile duct in the hepatobiliary surgery in the past.However,as the development of bile physiological research and surgical technique,especially the raise of medical concepts of rapid recovery,the negative effects which are caused by the placement of stent have been taken seriously gradually.Up to now,whether the stent should be placed after the bile duct is cut has no definite answer yet.

Objective; To elucidate the mechanism of the role of ER-a in fat metabolism by regulating the expression of ER-a in SD rats marrow mesenchymal stem cells during differentiating into adipocytes in vitro. Methods ;SD rats marrow mesenchymal stem cells were separated and cultivated. The ER-a was transfected into the rBMSCs in group one. Tamoxifen Citrate was used to restrain the expression of ER-a in group two, the group without any treatment was used as control. Western blot was used to identify the difference of ER-a expression among different groups and Oil-Red-0 staining was employed to identify the adipocytes in vitro. Results; There was significant difference between the number of lipids and different groups (P <0. 01) ,the number of lipid droplet changed concomitantly with ER-a: Low-expression ER-a group > Control group > High-expression ER-a group. Conclusion; ER-a in SD rats marrow mesenchymal stem cells may restrain the adipocyte differentiation.

With advancements in the field of cancer stem cells,the hypothesis that colon cancer originates from stem cells has not only been introduced but also receives substantial supports by separating a subpopulation of colon cancer cells through primitive cells markers.Unlike most non-tumourigenasis colon cancer cells,these tumor-initiating cells have many specific characters both in vitro and in vivo.An improved understanding of drug resistance based on cancer stem cells and molecular pathways that regulate proliferation and differentiation of gastrointestinal cancer stem cells could doubtless translate into new therapeutic strategies.

Sunitinib malate (SU11248 ,Sutent) is an orally available small-molecule multitargeted tyrosine kinase inhibitor that has potent anti-angiogenic and antitumour activities.In 2006 sunitinib was approved by FDA for imatinib intolerant gastrointestinal stromal tumors (GIST) patients or imatinib resistant GIST patients.This article review the molecular-based mechanism,the mechanism of resistance,the biomarker,the clinical trials and the adverse effects of sunitinib in the treatment of imatinib-resistant GIST.

Objective To compare the influence of cardiopulmonary bypass(CPB) on brain injury in the infants with compli‐cated congenital heart disease(CHD) and simple CHD by analyzing and monitoring the perioperative cerebral electric impedance co‐efficient ,serum S‐100βprotein and neuron specific enolase (NSE) .Methods Forty infants with CHD were randomly selected and divided into two groups:the complicated group(n=20 ,13 cases of tertralogy of fallot ,7 cases of transposition of great arteries) and the simple group(n=20 ,8 cases of atrial septal defect ,12 cases of ventricular septal defect) .Blood samples were taken and the cere‐bral electric impedance coefficients before operation(T1 ) ,at 10 min after CPB(T2 ) ,immediately after aortic clamping(T3 ) ,aortic o‐pening(T4 ) ,end of CPB(T5 ) ,at 5 h(T6 ) and 24 h (T7 ) after CPB were measured by the BORN‐BE noninvasive brain edema moni‐tor .Serum levels of S‐100βprotein and NSE were detected by ELISA .Results There was no statistically significant difference in the cerebral electric impedance coefficient ,S‐100βprotein and NSE before surgery(P>0 .05) .The cerebral electric impedance coef‐ficient ,S‐100βprotein and NSE were significantly increased from the beginning to the end of CPB(P< 0 .05) ,and gradually de‐creased after CPB(P<0 .05) .The cerebral electric impedance coefficient ,S‐100βprotein and NSE were obviously higher in the com‐plicated group than those in the simple group at the same time points(P<0 .05) .The cerebral electric impedance coefficient was re‐spectively correlated with S‐100βprotein and NSE .Conclusion The influence of CPB on brain injury in complicating CHD infants is more serious than that in simple CHD infants .The BORN‐BE noninvasive brain edema monitor can be used during CPB periopera‐tive period in complicating CHD infants for conducting the real time monitoring in order to reduce brain damage .

Currently refractory and relapsed mantle cell lymphoma (MCL) continues to develope a poor prognosis, and the treatment remains a significant clinical challenge. The use of bortezomib in clinic provides a novel method for the treatment of refractory and relapsed MCL. This review summarizes the mechanism and efficiency of bortezomib in the treatment of MCL and the strategies for overcome of bortezomib resistance.

According to Traditional Chinese Medicine, the functional structure of human body is composed of five functional subsystems which are based on the five-organs concept, and the relationship between them could be expatiated with Wu-Xing (Five-Elements) theory. Wu-Xing system is taken as our research object. The dynamic model has the characteristic of self-organization. There is only one stable point with local stability in the five-dimensional space. There exists an instability domain in the five-dimensional space. The stability domain is unbounded; it contains some special subdomains, including rectilineal subdomains, ray subdomains and line subdomains. In some ray subdomains, there exists comeback summits, the peak value of the comeback summit is comeback threshold. The existence of the comeback threshold means that, if the human body wants to go back to the healthy state from a certain special state which corresponded to the initial conditions located in a domain with comeback summit, it has to get across the comeback threshold. The comeback threshold is the division of the healthy state and the sub-healthy state. Some research work is done to investigate the response of the Wu-Xing dynamic model to the impact stimulation, and results in the decrease of the system's comeback threshold. There are 3 manners to achieve this goal, and they tally with the principle of the Wu-Xing system and the experimental rules in clinic.

Primary lymphoma of bone (PLB) refers to non-Hodgkin lymphoma (NHL),which is an uncommon extranodal lymphoma,accounting for 1 % of all NHL,5 % of extranodal lymphoma and 7 % of primary bone tumor. Currently,the diagnostic criteria of PLB includes a primary focus in a single bone; positive histological diagnosis; and no evidence of distant soft tissue or distant lymph node involvement. The diversity,hereditery,and lower incidence of PLB make it difficult to diagnose. In order to decrease the rate of misdiagnosis and missed diagnosis,the clinical,pathological,and imaging characteristics of PLB in this study are analyzed.

Objective:To explore the effectiveness and recurrence prevention of esomeprazole at different doses in the patients with reflux esophagitis ( RE) . Methods:Totally 240 patients with RE were divided into mild or severe group with 120 cases in each accord-ing to the illness severity. The two groups were respectively divided into four groups according to the random number table, namely the full dose treatment group, half dose treatment group, intermittent treatment group and on-demand treatment group. The groups were fol-lowed up for 6 months, and GERD-HRQI scores, the recurrence rate and incidence of adverse reactions in all the groups were com-pared. Results:After the 6-month follow-up, the differences in the GERD-HRQI scores, recurrence rate and incidence of adverse re-actions among the groups with different doses were statistically significant (P<0. 05). The GERD-HRQI scores and RE recurrence rate in on-demand treatment group were significantly higher than those in the other groups(P<0. 05), and the incidence of adverse re-actions in the total dose treatment group was significantly higher than that in the other groups (P<0. 05). Conclusion: Intermittent treatment with esomeprazole at small dose can effectively prevent RE recurrence, reduce the incidence of adverse reactions and treat-ment costs, which is worthy of promotion.

Objective By measuring the concentrations of serum IL-2,IL-4,IL-8 and TNF-αin chronic bronchitis patients before and after the acupoint sticking therapy which was also called winter disease treated in summer to investigate the effect of therapy on serum concentrations of IL-2,IL-4,IL-8 and TNF-α.Methods 30 cases of patients diagnosed with chronic bronchitis in paracmasia and did not recieve other related treatment were randomly divided into acupoint application therapy group (treatment group)and the control group.The treatment group was giventhree Fuacupoint sticking therapy,the control group was given thecomfortacupoint sticking therapy.Serum IL-2,IL-4,IL-8 and TNF-αconcentrations were compared between the 2 groups before and after treatment.Results In the treatment group,the serum IL-2 concentration of patients after treatment was significantly higher than that before treatment(P <0.05),IL-8 and TNF-αconcentrations were significantly lower than those before therapy(P <0.05).Af-ter treatment,serum IL-2,IL-4 levels were significantly higher than those in the control group(P <0.05 )while IL-8 and TNF-αwere significantly lower than those of the control group(P <0.05 ).Conclusion Acupoint sticking therapy in summer for winter diseases effectively increase the concentration of serum IL-2 in patients with chronic bronchitis,reduced IL-8,TNF-α concentra-tions,and enhance their own immunity ability,reduce the degree of inflammation.