AIM: To study factors influencing mannitol to induce blood brain barrier (BBB) opening. METHODS: By constant flow pump, mannitol with different concentration (20% and 25%) was infused into left internal carotid artery of adult Wistar rats via their left external carotid artery at different speed and time. Firstly, after mannitol with a concentration of 25% was transfused, the optimal open time of BBB was investigated using Evans blue as an indicator by injection at different time (0, 2, 4, 6, and 8 min). Then influences of concentration of mannitol, speed of infusion, and change of time on mannitol to induce BBB opening were studied. Finally, death rate was counted according to sex and body weight in order to observe the influence of sex and body weight on tolerance of rats. RESULTS: The open degree of BBB was optimal after 2 min when 3.6 ml mannitol with a concentration of 25% was infused in 30 s at a speed of 0.12 ml?s -1 . However, mannitol with a concentration of 20 % did not almost have any effect on opening of BBB. Slowing of infusion speed or shortening of infusion time of mannitol reduced opening degree of BBB. Body weight affected rat tolerance to mannitol, and the tolerance of the rat was higher in those with higher weight. CONCLUSION: The factors influencing mannitol to induce BBB opening are as follows: concentration, infusion speed, and keeping time of mannitol. And the tolerance to mannitol is not concerned with the sex of the rats, but the body weight of the rats.

Iatrogenic traumatic biliary stricture is one of the difficult points in the biliary surgery,and operation is the only definitive treatment. The operative opportunity,surgical procedure and techniques are important for the prognosis.From January 1998 to December 2011,173 patients with iatrogenic traumatic stricture were admitted to the Eastern Hepatobiliary Surgery Hospital. According to the Bismuth classification of traumatic biliary stricture,10 patients were in type Ⅰ,22 in type Ⅱ,87 in type Ⅲ,38 in type Ⅳ and 16 in type Ⅴ.Excision of the traumatic stricture with end-to-end anastomosis was performed on 19 patients.Of the 173 patients,154 were treated by Roux-en-Y duodenojejunostomy, and 8 of them received additional hemihepatectomy or partial hepatectomy.A total of 155patients were followed up,with a median time of 74 months,the total excellent and good rate was 94.8％ ( 147/155 ).Surgery is the most effective therapy for iatrogenic traumatic biliary stricture. Optimal timing, reasonable surgical methods, strictly following the principle of biliary surgery and perfect operative skills are key points for a better prognosis.

Objective:To analyze the genetic test results and ultrasonographic markers of 41 fetuses with short femurs and their relationship.Methods:This study retrospectively analyzed 41 fetuses who were diagnosed with short femurs by ultrasound during 19-37 gestational weeks and underwent prenatal genetic examination at the First Affiliated Hospital of Zhengzhou University from January 2018 to June 2019. According to the results of genetic examination, these cases were divided into three groups after excluding three cases of variants of unknown significance: genetically normal group, chromosome variation (including chromosomal aneuploidy and pathogenic or likely pathogenic copy number variations) group, and gene mutation (including pathogenic or likely pathogenic gene mutations) group. According to the head circumference (HC), abdominal circumference (AC) and femur length (FL), Z FL, FL/HC, FL/AC, ΔZ H-F and ΔZ H+A-2F for each fetus were calculated. One-way ANOVA and LSD- t test were used for statistical analysis. Results:(1) Among the 41 fetuses with short femurs, there were 28 in the genetically normal group, five in the chromosome variation group, three with chromosome variations of unknown significance and five in the gene mutation group. (2) In the genetically normal, chromosome variation and gene mutation groups, Z FL values were -2.78±0.77, -4.36±0.69 and -4.69±0.70; FL/HC ratios were 0.178±0.011, 0.170±0.010 and 0.131±0.022; FL/AC ratios were 0.197±0.013, 0.186±0.011 and 0.151±0.017; ΔZ H-F values were 2.49±1.09, 3.53±1.28 and 8.17±1.30; ΔZ H+A-2F values were 4.44±2.00, 6.78±2.20 and 14.28±1.26, respectively. The differences in Z FL values between the genetically normal group and the chromosome variation group as well as the gene mutation group were statistically significant (both P<0.05); so were the differences in FL/HC, FL/AC and ΔZ H-F values between the gene mutation group and the genetically normal group as well as the chromosome variation group (all P<0.05) and in any pairwise comparison of ΔZ H+A-2F among the three groups (all P<0.05). Conclusions:The genetic etiology of fetal short femurs is mainly related to chromosomal variations (including chromosomal aneuploidy and pathogenic or likely pathogenic copy number variations) and gene mutation. In fetuses with chromosome variation and gene mutation, the degree of the femoral development delay relative to the development of HC and AC is worse than that in the normal genetic results group.

AIM: To inverstigate the protective effects of procyanidin on myocardial ischemia reperfusion injury in rats. METHODS: Myocardial ischemia reperfusion injury models were established by the ligation of left desending coronary artery for 40 min and referfusion for 120 min in rats, and the influence of procyanidin on enzymes of myocardial, myocardial infarction size and lipid peroxide were observed. RESULTS: Procyanidin decreased myocardial creatine phosphokinase (CPK) and lactate dehydrogenase (LDH) release significantly diminished myocardial infarction size, raised the activity of superoxide dismutase (SOD), reduced malondialdehyde (MDA) content in myocardial and serum in comparison with the control. CONCLUSION: Procyanidin has a protective effect on myocardial ischemia reperfusion injury. The action is related to the inhibition of the free radical and subsequent lipid peroxidation.

Objective To investigate the effects of interferon alpha?2b(IFNα?2b)on serum Hepcidin in hepatitis C patients and its mechanism. Methods Hepatitis C patients were divided evenly into treatment group and control group according to whether they had received treatment with IFNα?2b in the past 3 months. The serum hepci?din was compared between the two groups. HepG2 cells and LO2 cells were treated for 24 hours at varied levels of IFNα?2b(0,50,100,200,400μL)and real?time PCR was used to detect the hepcidin,interleukin?6(IL?6)and signal transduction and transcription activator 3(STAT3)mRNA expression of cells. The protein levels of STAT3 and phosphorylated STAT3(pSTAT3)were measured by Western blot. The changes of these indexes were observed with the gradual increase of IFNα?2b levels. Results Serum Hepcidin level in the treatment group was significantly lower than the control(P<0.05). IFNα?2b inhibited the Hepcidin mRNA in HepG2 cells and LO2 cells. pSTAT3 was significantly decreased with the increased levels of IFNα?2b(P<0.05),and the expression of IL?6 and STAT3 had no significant changes with the increase of IFNα?2b. Conclusion The serum Hepcidin levels can be decreased because IFNα?2b suppresses the expression of Hepcidin,and its mechanism may be related with inhibited STAT3 pathway activation.

OBJECTIVE:To compare the efficacy and safety of low molecular weight heparin and rivaroxaban in the preven-tion of deep venous thrombosis after spinal surgery. METHODS:Totally 276 patients with high risk factors after spinal surgery were randomly divided into control group and observation group. The patients in the two groups were used elastic stockings to physi-cally prevent deep venous thrombosis from the postoperative first day to continue 3 months;based on it,control group was subcuta-neously injected with 1 low molecular weight heparin from the postoperative first day,once a day. Observation group was orally treated with 1 Rivaroxaban tablet,once every night. The treatment course for 2 groups was 2 weeks. The clinic data was observed, including clinical efficacy,superficial femoral vein diameter(FSV),popliteal vein diameter(POPV),prothrombin time(PT),fi-brinogen degradation products(FIB)and D- dimer(DD)before and after treatment,incidence of deep venous thrombosis and ad-verse reactions. RESULTS:There were no significant differences in the total effective rate and deep venous thrombosis and inci-dence of ADR between 2 groups(P>0.05). After 3 months,compared with before,there were no significant differences in the FSV and POPV between 2 groups (P>0.05);POPV in control group was significantly lower than before and observation group, there was statistical significance(P<0.05). After 1 week,compared with before,there was no significant difference in the PT be-tween 2 groups(P>0.05);the FIB and D-D were significantly higher than before,there was statistical significance(P<0.05), however,there were no significant differences between 2 groups(P>0.05);after 4 weeks,PT in 2 groups was significantly high-er than before,there was statistical significance(P<0.05),however,there were no significant differences between 2 groups(P>0.05);FIB and D-D were significantly higher than before,and observation group was lower than control group,there was statisti-cal significance(P<0.05). CONCLUSIONS:Both efficacy and safety of low molecular weight heparin and rivaroxaban in the pre-vention of deep venous thrombosis after spinal surgery are good. However,rivaroxaban is better than low molecular weight heparin in improving blood coagulation function.

Objective To investigate the influence of miR-106b on Wnt/β-catenin pathway in HCC cells. Methods QGY-7703 and HepG2 cells were transfected with miRNA mimics or inhibitors. TOP/FOP luciferase ratio assay was used to test the Wnt/β-catenin pathway activity. The expression of downstream targeted genes of Wnt/β-catenin pathway were examined by Real-time PCR. The accumulation of β-catenin in nuclears were measured by Western blotting. Results Ectopic expression of miR-106b dramatically increased the average TOP/FOP ratio and the mRNA expression of downstream targeted genes in QGY-7703 and HepG2 cells. Compared with that in control cells , miR-106b over-expression promoted the nuclear β-catenin accumulation in QGY-7703 cells. Clonclusion MiR-106b activated Wnt/β-catenin pathway in HCC cells.

Objective To observe the therapeutic effects of the parenchymal malignancies treated with argon-helium cryoablation percutaneouslly.Methods 49 foci in 45 patients with malignancies were treated with argon-helium cryoablation percutaneouslly.The temperature in the cryoablated area was dynamically recorded.The size and coverage of ice-balls formed were monitored.The imaging changes were observed.The shrinkage of tumor was followed 3 months post-cryoablation.The foci were divided into two groups in size:less than or equal to 3 cm and more than 3 cm.The chi-square test and spearman analysis were used by SPASS 11.0 software.Results The temperature in the cryoablated area descended fast to below-130℃ in a minute and relatively kept maintaince about-150℃ or so in the whole procedure.It ascended to 15℃ in a minute after rewarming.The ice-balls were formed within 50 seconds after cryoablation in 87.5% foci.And it increased in size as the time going.The coverages of the iceball more than or equal to and less than 80% were 72.7%、27.3% and 26.3%、73.7% in groups of less than or equal to 3 cm and more than 3 cm,respectively(P＜0.05).The ice-ball was demonstrated as arc hyperechogenicity with shadow and round-like low density on sonography and CT imaging,respectively.The shrinkage more than 50%of the foci was 81.8% and 30.6% in the groups of less than or equal to and more than 3 cm three months after the cryoabalated procedure(P＜0.01).Conclusion It is an actual/exact and convient way for the pereutaneous argon-helium cryoablation in treating malignancy.It can be used in the management of the parenchymal malignancy whole body.

Objective: To systematically evaluate the impact of acupuncture on exercise-induced fatigue (EIF). Methods: Scopus, Springer Link, Web of Science, PubMed, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Academic Journal Full-text Database (Wanfang), Chongqing VIP Database (CQVIP), and China Biology Medicine Disc (CBM) were systematically searched to identify randomized controlled trials (RCTs) studying acupuncture treatment of EIF from the inception till August 2020. The risk of bias in the included studies was assessed using the Cochrane handbook. RevMan 5.3 was used to conduct statistical analysis on the extracted data. Results: A total of 11 RCTs were included for meta-analysis, involving 531 patients. It was revealed that acupuncture produced more significant effects in alleviating subjective fatigue [standardized mean difference (SMD)=-3.08, 95％ confidence interval (CI) (-4.35, -1.81), P<0.001], increasing the hemoglobin content [weighted mean difference (WMD)=3.89, 95％CI (1.37, 6.42), P=0.003], reducing the lactate dehydrogenase content [WMD=-10.63, 95％CI (-17.67, -3.59), P=0.003], reducing the blood lactic acid content [SMD=-2.65, 95％CI (-4.47, -0.83), P=0.004], and down-regulating the levels of serum creatine kinase [SMD=-0.79, 95％CI (-1.10, -0.48), P<0.001] and blood urea nitrogen [WMD=-1.47, 95％CI (-1.84, -1.11), P<0.001] than the control groups. Conclusion: Based on the existing evidence, acupuncture can be recognized as effective in improving EIF and is worthy of promotion in clinical settings.

Endoscopic ultrasound-guided biliary drainage (EUS-BD) has been gradually developing and has replaced the percutaneous transhepatic bile duct drainagebecause of its safety and effectiveness, and it has become an effective alternative plan after endoscopic retrograde cholangiopancreatography treatment failure in patients with benign and malignant biliary obstruction. In clinical operation, the surgeons can choose the appropriate surgical method according to the patient's own condition and anatomical characteristics. This paper summarized the clinical application and research progress of EUS-BD technology by collecting relevant literatures published in recent years.