Biliary tract cancer(BTC) is a malignart tumor which originates from biliary epithelia.Most patients with BTC present locally advanced stage or distant metastasis.Although the standard systemic chemotherapy approaches are emerging,the prognosis remains poor.Combination of gemcitabine and cisplatin can significantly prolong survival for patients,which is the standard treatment for locally advanced or metastatic BTC.Application of molecularly targeted therapies in advanced BTC is the new trend of clinical research.

Drug management system of No.1 Military Medial Project is an important component of hospital information management system. This paper introduces four pieces of application experience of drug management system and presents seven suggestions about it.

Objective To investigate the maximum epiphyseal width lateral to Klein' s line (MEWLKL) and modification of Klein's Line (namely difference value of bilateral MEWLKL) on hip plain radiographs of normal children, and to investigate the relationship between MEWLKL and modification of Klein's Line and gender and body side, respectively.Methods Anteroposterior (AP) view pelvic plain radiographs of fourteen thousand eight hundred and thirty-seven cases aged from zero to fourteen years old in Shengjing Hospital of China Medical University from 2005 January to 2014 December were reviewed.Seven thousand one hundred and forty-seven normal AP pelvic plain radiographs were included in the present study.Fourteen groups based on the age from one years old to fourteen years old were divided.One hundred cases in each age group, including fifty males and fifty females, were randomly selected.Fourteen hundred AP view pelvic plain radiographs including twenty eight hundred hips were measured.The reference value of MEWLKL and modification of Klein's line were measured using AutoCAD2007 software.the Normal distribution test were performed using Excel and SPSS19.0 software.The relationship curve between MEWLKL and modification of Klein's Line and age were drawed.The intra-group difference between MEWLKL and gender and body side were performed using t-test in normal children.The inter-group difference between modification of Klein's line and average MEWLKL were performed using one-way analysis of variance in normal children.Results The reference value of MEWLKL and modification of Klein's Line were both normal distribution.Average reference value of MEWLKL were (5.20 ± 1.92) mm, (5.04 ± 1.88) mm in male, and (5.36 ± 1.94) mm in female (P =0.000), (5.06 ± 1.87) mm on the left side, and (5.33 ± 1.96) mm on the right side (P =0.000).The curve of reference value of MEWLKL in fourteen general groups were similar to those of fourteen male groups and fourteen female groups, and reference value of MEWLKL increased with age.It was in the trough at the age of five [general groups: (3.77 ± 1.00) mm;male groups: (3.53 ± 1.00) mm;female groups: (4.01 ±0.94) mm], and it was at the peak at the age of thirteen [general groups: (7.49 ± 1.43)mm;female group: (7.84 ± 1.42) mm].It was at the peak at the age of fourteen in male groups, and the value was (7.24 ± 1.46) mm.The reference value of MEWLKL in fourteen groups and in female groups both fell slightly after the age of fourteen.There were second trough, (6.44 ± 1.86) mm to (6.38 ± 1.15) mm,at age eleven to twelve in female groups.The curves of reference value of MEWLKL on bilateral sides was very similar, and they increased with age.They were in the trough at the age of five [(3.54 ± 0.84) mm in left side and (4.00 ± 1.10) mm in right side], and they were at the peak at the age of thirteen [(7.25 ± 1.57)mm in left side and (7.72 ± 1.24) mm in right side].The curves both fell slightly after the age of fourteen.The general reference value of modification of Klein's line was (0.93 ±0.82) mm.The average value of each age group waved in the level of 1.0 mm.Statistical significance were found in comparison of two intergroups, age eight versus age seven (P =0.011), and age eleven versus age ten (P =0.04).The maximum value of modification of Klein's line in four of fourteen groups were greater than 2.0 mm, including 2.02 mm in age ten, 2.05 mm in age eleven, 2.3 mm in age thirteen, and 2.17 mm in age fourteen, respectively.Conclusion The value of modification of Klein's line in normal children can be more than 2.0 mm, and the average value waved in the level of 1.0 mm.It is not reliable to determine slipped capital femoral epiphysis using modification of Klein's line.

Objective:To investigate the preventive effect of nalmefene on sufentanil-induced cough in the patients with general anesthesia. Methods:Eighty patients with general anesthesia were randomly divided into the control group and the nalmefene group. The nalmefene group was intravenously given 0. 25μg·kg-1 hydrochloric acid natrium nalmefene 5 minutes before the induction, and physiological saline with the same capacity was given in the control group. Cough number and intensity in one minute after the injection of nalmefene were observed, and the changes of hemodynamic indices such as the blood pressure, heart rate and pulse oxygen satura-tion before the anesthesia induction (T0), 1min after sufentanil injection (T1) and after the intubation (T2) were observed and com-pared between the groups. Results:The incidence rate of cough was 37. 5% in the control group and 0% in the nalmefene group, and the incidence rate and strength of cough in nalmefene group were both lower than those in the control group (P<0. 05). The hemody-namic parameters at T1 showed notable changes when compared with those at T0 in the control group (P<0. 05), and had significant differences when compared with those in the nalmefene group (P<0. 05), and at T2, all the parameters recovered to the levels at T0. The parameters in the nalmefene group were much more steady than those in the control group (P>0. 05). Conclusion:Pretreatment with hydrochloric acid natrium nalmefene can prevent sufentanil-induced cough response during the induction of anesthesia without weakening the inhibitory effect of sufentanil on intubation response.

Objective To find the accurate incidence of vacuum phenomenon in the hip and the best projection position produced the vacuum phenomenon on plain radiograph of hip in children.Methods All pediatric anteroposterior view and frog-leg position plain radiographs of hip joints were retrieved in our hospital between January 2003 and March 2013.All subjects was between 0 and 14 years old (mean age,4.2 years old).All the plain radiographs showing the crescent,linear,and irregular lucency between the femoral head and acetabulum were included in the present study.Results A total of 16 749 cases,including 12 422 cases (5 912 boys and 6 510 girls) only taken AP view plain radiographs and 4 327 cases (1 537 boys and 2 790 girls) taken both AP view and frog-leg position plain radiographs,were taken in our hospital between January 2003 and March 2013.None of AP view plain radiographs of hips could find the vacuum phenomenon.Two hundred and fifty-eight cases (321 hips) with vacuum phenomenon of the hips were found only in the frog-leg position plain radiographs of 4 327 cases,and the constituent ratio of vacuum phenomenon in the hip joint is 5.96％ in frog-leg position plain radiographs.One thousand seven hundred and thirty-eight normal children were included in 4 327 frog-leg position radiographs,and 150 cases of vacuum phenomenon were included in 1 738 normal children,and incidence of vacuum phenomenon in normal children is 8.63％.Two thousand three hundred and sixty children with developmental dysplasia of the hip (DDH) were included in 4 327 frog-leg position radiographs,and 98 cases of vacuum phenomenon were included in 2 360 children with DDH,and incidence of vacuum phenomenon in children with DDH is 4.15％.258 cases with vacuum phenomenon included 150 cases of normal hips (58.14％),98 cases of developmental dysplasia of the hip (37.98％),5 cases of Legg-Calvé-Perthes disease (1.94％),and 1 each in solitary eosinophilic granuloma of ischium,polyostotic fibrous dysplasia of the bilateral proximal femur,hereditary multiple exostoses,congenital coxa vara and fracture of femoral neck after surgery.Three hundred and twenty-one hips in 258 cases were classified into complete type (121 hips,37.69％) and partial type (200 hips,62.31％) according to the proportion of lucency area in the hip joints and linear (159 hips,49.53％),crescent (151 hips,47.04％) and irregular (11 hips,3.43％) lucency according to the shape of lucency area in the hips.Conclusion Vacuum phenomenon of the hip in children is not very rare in frog-leg position plain radiograph.It is easier to find the vacuum phenomenon in normal hip compared to that of developmental dysplasia of the hip.The frog-leg position plain radiograph is a better projection position to obtain the vacuum phenomenon of the hip in children compared to the anteroposterior view plain radiograph.

In Western countries, the mutation status of the BRCA1 and BRCA2 genes is commonly determined for genetic counseling among members of families with a history of breast or ovarian cancer, especially for women of the Ashkenazi Jewish ethnicity. Recent studies in the Cancer Genome Atlas project have demonstrated that BRCA2 mutation carriers are more responsive to platinum-based chemotherapy among high-grade serous ovarian cancer patients. Thus, in Western countries, the mutation status of BRCA1 and BRCA2 is recognized to have an important value with which to assess cancer risk and therapeutic response. However, very limited studies of BRCA1 and BRCA2 mutations and their implications for counseling and therapeutic prediction have been conducted in China. Therefore, a potentially important genetic test that is technically simple has not benefited Chinese women with an increased risk of breast or ovarian cancer. This article summarizes the current progress in the study of BRCA1/2 mutation in China and recommends an increased effort in applying advances in genetic testing to the clinical management of Chinese patients with ovarian cancer.
Age Factors ; Asian Continental Ancestry Group ; genetics ; Disease-Free Survival ; Female ; Genes, BRCA1 ; Genes, BRCA2 ; Genetic Predisposition to Disease ; ethnology ; Genetic Testing ; Humans ; Mutation ; Ovarian Neoplasms ; drug therapy ; ethnology ; genetics ; surgery ; Platinum ; therapeutic use ; Remission Induction ; Risk ; Survival Rate

Objective: To investigate the effect of miR-219-5p on malignant phenotype of glioblastoma cells involving proliferation, apoptosis and invasion, and to preliminarily determine the candidate target genes of miR-219-5p related to the inhibition of cancer. Methods: The inverse relationship between mRNAs and miR-219-5p in glioblastoma tissues from sixty cases was obtained by analysis of miR-219- 5p expression level and mRNA expression profiling. DAVID software for functional analysis was employed to analyze the functions of the top 50 mRNAs and screen out two sets of mRNAs related to glioblastoma progression. The target genes of miR-219-5p were screened out from the two sets of miRNAs on four websites of online target-binding prediction. MTT assay, flow cytometry (FCM) assay and Transwell assay were performed to detect the effects of miR-219-5p on the proliferation, apoptosis and invasion of human glioblastoma cells, respectively. Results: Fourteen proliferation/apoptosis-related genes and five invasion-related genes were screened from glioblastoma tissues of sixty patients (P <0.001). Four genes including TWIST 1, MYO 1B , WEE 1 and SPRED 2 were predicted as potential target genes of miR-219-5p from 19 candidate genes. Functional analysis revealed that miR-219-5p could suppress the proliferation and invasion of glioblastoma cells as well as promote the apoptosis (P <0.05). Conclusion: MiR-219-5p may suppress the malignant phenotype of glioblastoma cells through multiple gene targets. © 2012 by Tumor.

AIM:To investigate the effect of different cutting centers on the visual acuity, refractive diopter and visual quality of patients undergoing laser assisted in situ keratomileusis (LASIK).METHODS: A total of 80 patients (160 eyes) with myopia treated by elective LASIK were divided into two groups.Thirty-six cases (72 eyes) with visual axis corneal reflection point (VACRP) as the cutting center were included into the VACRP group while 44 cases (88 eyes) with pupil center (PC) as the cutting center were included into the PC group.The uncorrected visual acuity (UCVA), the best corrected visual acuity (BCVA), refractive diopter, corneal aberration [total corneal and anterior corneal surface higher-order aberrations (HOA), spherical aberration (Z40), vertical coma (Z3-1), horizontal coma (totZ31) and offset of cutting centers were determined before surgery and 1mo after surgery.RESULTS: There was no difference in the probability of UCVA ≥ 0.1, BCVA and refractive diopter between the two groups at 1mo after surgery (P>0.05).The astigmatism and cutting center deviation of VACRP group were lower than those of PC group (P<0.05).The totHOA, totZ40, totZ3-1, totZ31, froHOA, froZ3-1、froZ31 and froZ40 were lower in VACRP group than PC group at 1mo after surgery (P<0.05).CONCLUSION: The UCVA of patients treated with both cutting centers for LASIK is good but VACRP has more advantages in reducing the offset of cutting center and improving postoperative visual quality.

Objective To investigate the interaction between NMDA receptor subunit 2B (NR2B) and metabotropic glutamate receptor 5 (mGluR5) in the spinal cord of morphine-tolerant rats. Methods Sixteen male SD rats weighing 220-280 g were randomly divided into 2 groups with 8 rats in each group: control group (C) and morphine group (M). In group M morphine 10μg was administered intrathecally (IT) twice a day for 7 consecutive days. In group C equal volume of normal saline was given instead of morphine. Tail flick latency (TFL) (a segment of tail 4-5 cm long was immersed in 52-53℃ hot water) was used to measure the antinocicepitve effect of morphine before and 30 min after morphine administration every morning. MPE (percentage of maximal possible effect) was calculated (pain threshold after drug administration - baseline pain threshold)/(10- baseline pain threshold)× 100% . The animals were killed at the next day after last IT administration and the dorsal half of L4-5 spinal cord was isolated and homogenized for determination of NR2B and mGluR5 protein expression by Western blot and CO-IP. Results MPE was significantly increased at 1-5 d of drug administration and returned to baseline at 7 d in group M as compared with group C. The mGluR5 protein expression was significantly up-regulated in group M as compared with group C but there was no significant difference in NR2B protein expression between the 2 groups. Conclusion There is interaction between NK2B and mGluR5 in the spinal cord of morphine-tolerant rats.

Objective To investigate the mechanisms of tumor necrosis factor-related apoptosis inducing ligand (TRAIL) combined with Triptolide in inducing the apoptosis of pancreatic cancer cells.Methods (1) The pancreatic cancer cells (MiaPaca-2 cells) were divided into 4 groups:blank control group (no drugs were added),TRAIL + Triptolide-group (only TRAIL was added),TRAIL-Triptolide + group (only Triptolide was added) and TRAIL+ Triptolide+ group (TRAIL and Triptolide were added).The vitality of cells in all the 4 groups was assessed by CCK-8.The expressions of poly ADP-ribose polymerase (PARP),cysteinyl aspartate specific proteinase-3 (Caspase-3) and Caspase-8 were detected by Western blot.The vitality of cells was detected by CCK-8 and the vitality of Caspase-8 was detected by Caspase-Glo assays after adding Z-IETD-FMK,a specific inhibitor of Caspase-8.The expressions of myeloid cell leukemia-1 (Mcl-1),Bcl-xL and Bcl-2 were detected by Western blot.(2) The MiaPaca-2 cells were divided into 8 groups:①TRAIL-Mcl-1 siRNA-group (no TRAIL was added and Mcl-1 siRNA cells were not transfected),TRAIL+ Mcl-1 siRNA-group (TRAIL was added and Mcl-1 siRNA cells were not transfected),TRAIL-Mcl-1 siRNA + group (TRAIL was not added and Mcl-1 siRNA cells were transfected)and TRAIL+ Mcl-1 siRNA+ group (TRAIL was added and Mcl-1 siRNA cells were transfected).②TRAIL-Bcl-xL siRNA-group (TRAIL was not added and Bcl-xL siRNA was not transfected),TRAIL+ Bcl-xL siRNA-group (TRAIL was added and Bcl-xL siRNA was not transfected),TRAIL-Bcl-xL siRNA + group (TRAIL was not added and Bcl-xL siRNA was transfected) and TRAIL+ Bcl-xL siRNA+ group (TRAIL was added and Bcl-xL siRNA was transfected).The vitality of the cells in all the groups was detected by CCK-8.The expressions of Caspase-3 and Caspase-8 protein were detected by Western blot.The measurement data with normal distribution were presented as (x) ± s.The comparison among groups was done by ANOVA,and the pairwise comparison was done by LSD-t test.Results (1) The vitalities of MiaPaca-2 cells in the blank control group,TRAIL + Triptolide-group,TRAIL-Triptolide + group and TRAIL + Triptolide + group were 100.0％ ± 1.1％,81.2％ ± 2.3％,78.6％ ± 3.6％and 40.1％ ± 2.5 ％,and the relative expressions of PARP protein were 0.510 ± 0.028,0.720 ±0.072,1.250 ±0.023 and 2.560 ± 0.220,the relative expressions of Caspase-3 were 0.080 ± 0.004,0.080 ± 0.003,0.110 ±0.005 and 2.720 ± 0.003,and the relative expressions of Caspase-8 were 0.070 ± 0.003,0.080 ± 0.005,0.120 ±0.003 and 0.990 ± 0.006,with significant differences among the 4 groups (F =203.607,1 457.785,332 421.900,35 437.218,P ＜ 0.05).The vitality of M iaPaca-2 cells in the TRAIL + Triptolide + group was significantly different from those in the blank control group,the TRAIL + Triptolide-group and the TRAIL-Triptolide + group (t =34.583,355.936,36.271,P ＜ 0.05).The relative expression of PARP protein of MiaPaca-2 cells in the TRAIL+ Triptolide + group was significantly different from those in the blank control group,TRAIL+ Triptolidegroup and TRAIL-Triptolide + group (t =591.784,63.739,2 268.987,P ＜ 0.05).The relative expression of Caspase-3 protein of the MiaPaca-2 cells in the TRAIL + Triptolide + group was significantly different from those in the blank control group,the TRAIL + Triptolide-group and theTRAIL-Triptolide + group (t =3 266.153,9 145.228,1 738.713,P ＜0.05).The relative expression of Caspase-8 protein of the MiaPaca-2 cells in the TRAIL+ Triptolide +group was significantly different from those in the blank control group,the TRAIL+ Triptolide-group and the TRAIL-Triptolide + group (t =663.953,l 432.878,327.584,P ＜ 0.05).The vitality of caspase-8 in the TRAIL+ Triptolide+ group was 711.0％ ± 5.1％ before adding Z-IETD-FMK,and then the vitality of MiaPaca-2 cells and caspase-8 changed to 70.0％ ± 4.8％ and 73.0％ ± 2.4％,with significant differences (t =17.956,55.027,P ＜ 0.05).The relative expressions of Mcl-1 protein in the blank control group,the TRAIL + Triptolidegroup,the TRAIL Triptolide + group and the TRAIL + Triptolide + group were 1.68 ± 0.22,2.08 ± 0.11,0.73 ±0.15 and 0.58 ± 0.18,the relative expressions of Bcl-xL protein were 0.65 ± 0.03,0.47 ± 0.03,0.32 ± 0.03and 0.26 ±0.05,the relative expressions of Bcl-2 protein were 0.65 ± 0.03,0.67 ± 0.03,0.62 ± 0.05 and 0.67 ± 0.03,with significant difference among the 4 groups (F =55.178,88.683,3.411,P ＜ 0.05).The relative expressions of Mcl-1 protein of the MiaPaca-2 cells in the TRAIL-Triptolide + group and the TRAIL+ Triptolide +group were significantly different from those of the blank control group (t =23.506,47.631,P ＜ 0.05) and the TRAIL + Triptolide-group (t =58.457,37.115,P ＜ 0.05).The relative expressions of Bcl-xL protein of the MiaPaca-2 cells in the TRAIL-Triptolide + group and the TRAIL + Triptolide + group were significantly different from those of the blank control group (t =38.105,42.219,P ＜ 0.05) and the TRAIL + Triptolide-group (t =32.476,15.814,P ＜ 0.05).The relative expressions of Bcl-2 protein in the TRAIL-Triptolide + group and the TRAIL+ Triptolide + group were not significantly different from those of the blank control group (t =4.724,1.732,P > 0.05) and the TRAIL + Triptolide-group (t =3.464,0.000,P ＞ 0.05).(2) The vitalities of MiaPaca-2 cells of the TRAIL-Mcl-1 siRNA-group,TRAIL + Mcl-1 siRNA-group,the TRAIL-Mcl-1 siRNA + group and the TRAIL + Mcl-1 siRNA + group were 100.0％ ± 2.2％,79.3％ ± 1.8％,71.2％ ± 3.2％ and 37.3％ ± 5.4％,the relative expressions of Caspase-8 protein were 0.100 ± 0.003,0.100 ± 0.005,0.100 ± 0.003 and 0.350 ±0.005,and the relative expressions of Caspase-3 protein were 0.020 ± 0.003,0.060 ± 0.003,0.020 ± 0.003 and 0.590 ±0.004,with significant differences among the 4 groups (F =136.681,2 717.391,44 471.429,P ＜0.05).The vitality of MiaPaca-2 cells of the TRAIL + Mcl-1 siRNA + group was significantly different from those in the TRAIL-Mcl-1 siRNA-group,the TRAIL + Mcl-1 siRNA-group and the TRAIL-Mcl-1 siRNA + group (t =33.937,20.207,26.689,P ＜ 0.05).The relative expression of Caspase-8 protein of the TRAIL + Mcl-1 siRNA +group was significantly different from those in the TRAIL-Mcl-1 siRNA-group,the TRAIL + Mcl-1 siRNA-group and the TRAIL-Mcl-1 siRNA + group (t =216.506,433.013,144.338,P ＜ 0.05).The relative expression of Caspase-3 protein of the TRAIL + Mcl-1 siRNA + group was significantly different from those in the TRAIL-Mcl-1 siRNA-group,the TRAIL + Mcl-1 siRNA-group and the TRAIL-Mcl-1 siRNA + group (t =329.09,458.993,987.269,P ＜0.05).The vitalities of MiaPaca-2 cells of the TRAIL-Bcl-xL siRNA-group,the TRAIL+ Bcl-xL siRNA-group,the TRAIL-Bcl-xL siRNA + group and the TRAIL+ Bcl-xL siRNA + group were 100.0％ ± 2.3％,87.2％ ± 4.1％,74.1 ± 3.7％ and 56.3％ ± 5.4％,and the relative expressions of Caspase-3 protein were 0.060 ±0.004,0.070 ± 0.003,0.060 ± 0.004 and 0.390 ± 0.003,with significant differences among the 4 groups (F =70.074,4 643.478,P ＜ 0.05).The vitality of MiaPaca-2 cells of the TRAIL + Bcl-xL siRNA + group was significantly different from those in the TRAIL-Bcl-xL siRNA-group,the TRAIL+ Bcl-xL siRNA-group and the TRAIL-Bcl-xL siRNA + group (t =24.416,41.170,18.136,P ＜ 0.05).The relative expression of Caspase-3 protein of the TRAIL + Bcl-xL siRNA + group was significantly different from those in the TRAIL-Mcl-1 siRNA-group,the TRAIL + Mcl-1 siRNA-group and the TRAIL-Mcl-1 siRNA + group (t =285.788,554.256,190.526,P ＜ 0.05).Conclusion Triptolide could induce the apoptosis of MiaPaca-2 cells by inhibiting the expressions of Mcl-1 and Bcl-xL,sensitizing TRAIL and activating Caspase-8 and Caspase-3.