Hilar cholangiocarcinoma should be identified from other malignant tumors and/or benign disease involving the hilum which may present similar image features.Clinal stage need to be further studied. Radical resection should be recommended in multidisciplinary treatment of hilar cholangiocarcinoma. The patients who were received initial surgical drainage and/or local recurrence after initial surgical resection of hilar cholangiocarcinoma, should actively be given the opportunity of radical reoperation, with potential long-term survival. Extended surgical resection resulted in increased rate of R0 resections and significantly improved survival. However, it also significantly increased the risk of serious postoperative complications, which must be balanced between survival advantage and surgical risk.

OBJECTIVE:To observe the curative effect of Qingyan lifei mixture on cough with lung heat.METHODS:190 patients with cough with lung heat were randomly divided into two groups:104 cases in treatment group were assigned to receive Qingyan lifei mixtures 100 mL?time-1 bid,and 86 in control group to receive Qingfei yihuo tablets(4 tablets?time-1 bid).The course of treatment was 10 days for both groups.RESULTS:The total effective rate was 89.42% in treatment group versus 75.58% in control group,and the difference between the two groups was significant(P

Objective To evaluate the use of endovascular aortic repair(EVAR) and open aortic surgery(IAS) for treatment of abdominal aortic aneurysm.Methods A retrospective review of patients treated with EVAR or IAS between 2002 and 2007 was performed.The occurrence rate of perioperative complications,morbidity and mortality,survival rate,quality of life,and cost of treatment were compared.Results Forty-two patients(30INS,12EVAR) were treated.Operating time,the intraoperative blood loss,and intraoperative blood transfusion were less in EVAR group than in the IAS group(P

Objective To study the clinical effects of endovascular stent-graft repair for thoracic aortic aneurysm(TDA).Methods The clinical records of 32 patients with thoracic aorta dissecting aneurysm,including 26 men and 6 women,who underwent endovascular repair were retrospectively analyzed.The characteristics,location,and anatomic condition of dissecting aneurysm were evaluated using CTA before operation.Under general or local anesthesia,32patients underwent endovascular repair under dynamic DSA.For those patient,8 Talent,22 Yuhengjia(Beijing) and 2 Microinvasive(Shanghai) stent grafts were used.Results Among them 32 patients the distance between entry tear and left subclavian artery was

As a successful mode of hospital reform, the hospital group offers the key to the solution of some major problems hindering the development of hospitals. The objective of setting up a hospital group is to better realize the strategic goals of the hospitals. While hospital groups have different types and formation patterns, the key to success lies in the operating mechanism and management standards. Organizational and cultural building is of great significance to the long-term development of hospital groups.

Objective To evaluate the diagnostic value of microRNA-499 (miR-499)levels in acute myocardial infarction (AMI)diagnosis.Methods Retrieve Articles,Wanfang,China Knowledge Network,NCBI PubmMed,EMBSASE database 2010~2015 years met the inclusion criteria published abroad in relation to miR-499 diagnosis ten cases of human AMI litera-ture.The quality of the sudies was evaluated by QUADAS tools through a comprehensive analysis of the random effects model effect size,the use of meta-disc 1.4 software for statistical analysis software.Results Ten studies met the included criteria.The summary estimates for miR-499 diagnosis of MI sensitivity was 83% (95% CI,0.81 ~ 0.85),specificity of 81% (95% CI,0.78~0.83),positive predictive value of 4.53 (95% CI,3.12~ 6.58),negative predictive value was 0.22 (95% CI,0.14~0.33),diagnostic odds ratio 22.73 (95% CI,10.78~47.93).The area under the curve (AUC)for miR-499 was 0.90 with Q value of 0.84.Conclusion MiR-499 has high diagnostic value for acute myocardial infarction.

0.05) . Tube re-adhesion rate was 10.7% and 17.9% (P

Objective To study the effect of cumulus cell apoptosis on the structure of human oocyte cultured in vitro and to probe into the reason why cumulus cell apoptosis rate can be used clinically to predict the developmental potential of oocyte. Methods Cumulus-enclosed oocyte complexes (COCs) at the GV stage were cultured in vitro. The apoptosis rate of cumulus cells for every COC was evaluated with HE staining, DAPI staining and TUNEL labeling methods. Oocytes were divided into two groups according to their cumulus cell apoptosis rate. Structure of oocytes was observed under light microscope and transmission electron microscope. Mature oocytes at MⅡ stage were fertilized and cultured in vitro for two days. Then the embryos were evaluated according to their morphology under light microscope.Results The oocytes with low cumulus cell apoptosis rate had a normal structure and a promising developmental potential, while the oocytes with high cumulus cell apoptosis rate had deformed structures and a poor developmental potential. Some deformed oocytes had uneven perivitelline space. For oocytes with a small perivitelline space, the organelle development was slow compared with those with a large perivitelline space. Some had unevenly piled organelles. Secondary lysosomes and large space probably caused by the decopmounding of lysosomes were found in the ooplasm of these oocytes. The deformed oocytes appeared to have lots of swollen mitochondria with blurred cristae and membrane. Some of these oocytes had fractured first polar bodies and abnormally thick or thin zona pellucida. The cell junctions and microvilli of cumulus cells reduced as well. Conclusion The effect of cumulus cell apoptosis on the structure of oocyte cultured in vitro was revealed. The reason why cumulus cell apoptosis rate prognosticated the developmental potential of oocyte was demonstrated in the aspect of oocyte structure.

Objective To assess the methods and points of transvaginal ultrasound - guided partly microwave ablation (MWA) on polycystic ovary syndrome(PCOS). Methods 22 patients with PCOS underwent transvaginal ultrasound - guided MWA with 18G PTC needle on part of ovarian interstitium. Results The one - shot achievement of earlier period ratio was 20% with 5 cases. The other 17 cases underwent injecting 400ml normal saline or pressure on inferior belly. Then the one - shot achievement ratio was 81.2% . The average puncture time was respectively 3.8 and 1.7. Conclusion Transvaginal ultrasound -guided puncture on polycystic ovary appears realtime and safe with little complications. Also it can improve the puncture achievement ratio by better means.

ObjectiveTo investigate the effect of sevoflurane anesthesia in the neonatal period on cognitive function and acetylcholinesterase(AChE) activity in hippocampus in developmental stages in rats.Methods Eighty 7 day-old SD rats weighing 12-16 g were randomly divided into 5 groups( n ＝ 16 each):groups A and B inhaled 3 ％ sevoflurane in oxygen for 6 and 2 h respectively; groups C and D inhaled 1.5 ％ sevoflurane in oxygen for 6 and 2 h respectively; group E inhaled oxygen only.The cognitive function was assessed using Morris water maze test in weaning period(16-21 day-old) and sexual maturity period (55-60 day-old) respectively.The rats were sacrificed at 30 min after Morris water maze test was finished at 21 and 60 d after birth,and the hippecampus were removed for determination of AChE activity using colorimetry method.ResultsCompared with group E,escape latency was prolonged during 17-20 d after birth in group A,and at 18,19 d after birth in groups B and C,and at 18 d after birth in group C,and AChE activity increased at 21 d after birth in group A( P < 0.05 or 0.01 ).Compared with group A,escape latency was shortened at 19,20 d after birth,and AChE activity decreased at 21 d after birth in groups B and C( P < 0.05 or 0.01).Compared with groups B and C,escape latency was shortened at 19,20 d after birth in group D( P < 0.05).There were no significantly differences in probe time in original platform quadrant,frequency of crossing the original platform and AChE activity at 60 d after birth and escape latency during sexual maturity period among the 5 groups( P ＞ 0.05).ConclusionSevoflurane anesthesia in the neonatal period can reversible decrease the congnitive function in developmental stages in rats in concentration and time dependent manners,and the mechanism may be related to increasing the AChE activity in hippocampus.