Recently, the incidence of hilar cholangiocarcinoma (HC) has gone up. Preoperative imaging evaluation plays an important role in guiding clinician to make reasonable operating program. MR cholangiopancreatography (MRCP) can make accurate preoperative classification of HC, and,combined with conventional MR scans, is able to perform an all-in-one examination, making accurate overall preoperative evaluation of HC.

Purpose:To study the reversal effects on multidrug resistance in multidrug-resistent bladder cell lines BIU-87/ADM. Methods:The degree of drug-resistence was detected by MTTmethod; the concentration of ADM in cells BIU-87 and BIU-87/ADM was detected after the cells were treated by carvedilol and ADM. Results:Pretreatment by carvedilol increased the concentration of ADM in BIU-87/ADM cells, ,and the concentration was much higher than that in those cells treated by ADM only. Conclusions:Carvedilol can enhance the cytotoxic effect of ADM,and can reverse the multidrug resistance in bladder cancer lines BIU-87/ADM.

Purpose:To study the expression of TopoⅡ gene in multidrug resistant cells of human bladder cancer. Methods:The degree of drug resistance was detected by MTT method ;the expression of TopoⅡ gene in cell lines BIU 87/ADM and BIU 87 was detected with reverse transcriptase polymerase chain reaction. Results:The cell lines BIU 87/ADM were 56.4 times more resistant to ADM than the cell lines BIU 87;the expression of TopoⅡ gene was poorly positive in BIU 87/ADM but strongly positive in BIU 87 cells. Conclusions: The decreased expression of TopoⅡ gene in BIU 87/ADM cells might contribute to the development of multidrug resistance of human bladder cancer.

To establish a new kind of minimally invasive surgical model of transurethral prostate enucleation operation and method that makes the operation easier and reduces the surgeon learning curve.According to the order and the path of surgical operation,prostate enucleation operation is split into 4 different modules named as A,B,C,D,and it is called modular transurethral enucleation of the prostate.The operation mode optimizes the process of operation design, modularizes the contents of surgical procedures,processes,and reduces the difficulty of the operation,and simplifies the surgical procedure,which can effectively shorten the operation time and make it easy for beginners to carry out and control the procedure.It has a great popularization value.

Objective Fecal biomarkers have emerged as an important tool for assessing and monitoring disease activity in patients with inflammatory bowel disease ( IBD) .We aimed to investigate the diagnostic value of fecal neopterin and calprotectin in pa-tients with active inflammatory bowel disease and made comparison with that of serum C-reactive protein ( CRP) . Methods A total of 151 consecutive patients with IBD (84 CD and 67 UC) provided 2 gram fecal samples for the measurement of fecal neopterin( FNP) and calprotectin( FCP) concentrations and 2 milliliter blood samples for the serum C-reactive protein measurement before undergoing a colonoscopy.ELISA was applied in the measurement.Clinical disease activities were scored independently according to the Best Crohn′s Disease Activity Index(CDAI) in patients with CD, while the Modi-fied Mayo Scores in patients with UC.Comaprison was made in the relativity of each fecal marker and IBD activity score, the optimum value of diagnosing IBD acitivity as to each fecal marker, as well as sensitivity, specificity, moreover, receiver operating characteristic curve ( ROC) was drawn.50 healthy volunteers who received a normal colonoscopy were also enrolled as the control group and asked to give a 2 gram fresh stool sample. Results The FNP and FCP concentrations in patients with IBD were significantly higher than those in healthy control group(P<0.05).Both FNP and FCP concentrations differed significantly in clinically active IBD when compared with those in patients with inactive disease( P<0.001) .In CD patients, the correlation coefficients of FNP and FCP with CDAI were 0.55 and 0.59, respectively(P<0.001).In UC patients, the correlation coefficients of FNP and FCP with Mayo scores were 0.74 and 0.77, respectively( P<0.001) .The correlation coefficients of serum CRP in CD and UC patients with clinical scores were 0.49 and 0.60, respectively(P<0.001).The area under the ROC curve(AUC) of FNP and FCP for the diagnosis of clinical activity in pa-tients with CD were 0.75 and 0.80, respectively.The AUC of FNP and FCP in UC patients were 0.85 and 0.90, respectively.The AUC of serum CRP in patients with CD and UC were 0.65 and 0.74, respectively.When combined FNP with FCP, the AUC in pa-tients with CD and UC were 0.85 and 0.92, respectively. Conclusion FNP is a novel reliable and non-invasive biomarker to evalu-ate clinical disease activity in patients with IBD as accurate as FCP, It is advisable to combine FNP with FCP to evaluate disease activi-ty in patients with IBD.

Background:Peroral endoscopic myotomy(POEM)is a novel minimally invasive endoscopic technique for treatment of esophageal achalasia(EA). It has been demonstrated to be safe and effective in several short-term clinical studies, however,studies focusing on its mid- and long-term outcome are rare. Aims:To investigate the mid-and-long term efficacy of POEM in EA patients. Methods:A retrospective analysis was performed in 41 EA patients who underwent POEM in the Department of Gastroenterology and Hepatology of Nanjing General Hospital of Nanjing Military Region from Jul. 2012 to Dec. 2013. All these patients were followed up periodically for clinical symptoms(Eckardt score),maximum esophageal diameter and lower esophageal sphincter pressure(LESP),and the intra- and post-operative complications and recurrence were recorded. Results:POEM was successfully completed in all 41 EA patients,the mean operative time was(69. 5 ± 20. 6)min(range 35-125 min),and the mean length of hospital stay was 3. 5 days. Compared with the pre-operative data,the post-operative Eckardt score,maximum esophageal diameter and LESP during follow-up(mean 26. 3 months, range 19-36 months)were significantly decreased(P all < 0. 05). Procedure-related complications were seen in 6 patients (14. 6% );the clinical success rate was 95. 1%(39 / 41)and the recurrence rate was 2. 4%(1 / 41). Conclusions:POEM is safe and effective in mid-and-long term follow-up with low recurrence rate. It might become the first-line therapy for EA,and the long-term efficacy and complications need further follow-up study.

AIM: The aim of this study was to determine the relationship between PAI-1,TIMP-1 gene expression and renal tubulointerstitial fibrosis(TIF) of ureteral obstruction ,and the interfering effects of hepatocyte growth factor (HGF) treatment. METHODS: Sixty rats were divided into normal control, sham operation,unilateral ureteral obstruction(UUO),and rhHGF treated groups (received 0 5 mg?kg -1 ?d -1 HGF for twenty-one days), and were sacrificed at postoperative day 3, 7, 14, 21. The levels of PAI-1, TIMP-1 mRNA were measured by RT-PCR. MMP2 and MMP9 activities were detected by substrate zymography, and renal fibrosis was assessed by measuring tissue hydroxyproline. RESULTS: Compared to controls, expression levels of PAI-1,TIMP-1 mRNA were significantly increased in UUO rats, and this was accompanied by decreased activities of MMP2 and MMP9 and increase in tissue hydroxyproline content. HGF treatment significantly decreased expressions of PAI-1, TIMP-1 mRNA, increased MMP2 and MMP9 activities,and decreased tissue hydroxyproline content in the obstructive kidney. CONCLUSIONS: These results indicate that the increases in PAI-1, TIMP-1 mRNA expression may be the major cause of sustained decreased matrix degradation during the development of tubulointerstitial fibrosis after unilateral ureteral obstruction. rhHGF efficiently ameliorates renal tubulointerstitial injury by the reduction of PAI-1,TIMP-1 mRNA expression, and increasing MMP2, MMP9 activities. [

Objective:To explore the clinical phenotypic features and genetic variation characteristics of children with epilepsy-aphasia spectrum due to GRIN2A gene variants confirmed by second-generation sequencing. Methods:The clinical data of 5 children with epilepsy-aphasia spectrum with epileptic onset diagnosed in the Department of Neurology, Children′s Hospital Affiliated to Zhengzhou University, from February 2019 to November 2022 were retrospectively analyzed. Whole-exome genome sequencing of the probands using a second-generation sequencing method confirmed that all 5 cases were children with the GRIN2A gene variant. The characteristics of the GRIN2A gene variants were analyzed. Results:Among the 5 children diagnosed with epileptic aphasia spectrum due to GRIN2A gene variants, the male-to-female ratio was 4∶1, and the age range of onset was 1.5-4.4 years. The clinical phenotype included seizures in all cases, language and intellectual developmental deficits in 4 cases, and attention deficit hyperactivity disorder in 3 cases. The seizures were manifested as focal seizures or secondary generalized seizures, and were effectively controlled with antiepileptic drugs. Among the 5 children, gene variant of case 1 was originated from a paternal heterozygous variant, and cases 2-5 had de novo variants, which were c.2107C>T (p.Gln703 *) nonsense variant, c.2284G>A (p.Gly762Arg) missense variant, c.2197del (p.Ala733Glnfs *3) shifted coding variant, c.2511G>A (p.Trp837 *) nonsense variant, and c.1651+1G>C shear site variant, respectively. None of the 5 loci were reported in the literature. Conclusions:Epilepsy-aphasia spectrum is an epilepsy syndrome with a complex onset, and may have different phenotypes at different genetic variant loci, with focal seizures or secondary generalized seizures, which can be effectively controlled with anti-seizure medication. The GRIN2A gene variant is the genetic etiology of the epileptic aphasia spectrum.

【Objective】 To evaluate the safety and efficacy of long-term indwelling of Allium ureteral stent in the treatment of ureteral stricture. 【Methods】 The clinical data of patients who underwent endoscopic Allium ureteral stent implantation for ureteral stricture in our hospital during Aug.2020 and Dec.2022 were retrospectively analyzed, and the surgical conditions and adverse events were recorded. The data of serum creatinine, blood urea nitrogen, glomerular filtration rate (GFR) and renal pelvis width under ultrasound were compared before surgery and 1, 3, 6 and 12 months after surgery. 【Results】 A total of 52 patients with ureteral stricture of 1.1 (0.7, 2.0)cm were included. All operations were successful. The operation time was 82.5 (70, 114)min, intraoperative blood loss 20 (10, 20)mL, and postoperative hospitalization stay 1 (1, 2) day. During the follow-up of (13.2±7.8) months, 14 patients had stent displacement, 5 had stone obstruction of stent tubes, 7 had occasional hematuria after movement, 9 had intermittent lumbar and abdominal pain, and 1 had recurrent urinary tract infection. The serum creatinine, blood urea nitrogen and renal pelvis width of 1 month, 3, 6 and 12 months after surgery were significantly decreased, while GFR was significantly increased. 【Conclusion】 Long-term indwelling of Allium ureteral stent is effective in the treatment of ureteral stricture, but the high incidence of stent displacement should arouse attention.

With the heavier burden of cardiovascular disease, an abundance of papers emerge every year in the research hotspots, which cover a wide range of types and content. In order to let readers interested in the cardiovascular field quickly understand the research hotspots and research frontier, it is necessary to sort out and summarize the research topic in time. According to the discipline classification, we screened papers in cardiovascular field from the Essential Science Indicators (ESI) hot papers published in 2019. Methods such as bibliometrics, statistical description, hierarchical induction, analysis and interpretation were used a step further to reveal the context and characteristics of research in the field of cardiovascular diseases, summarize the latest progress and development direction in this field, and provide information and hints for the expansion of future research directions. A total of 297 papers were finally included, which were mainly in the field of clinical medicine; The country with the most publications was the United States, while China ranked the fifth in terms of contribution; the research institution with the highest number of published papers was Harvard University;
Bibliometrics ; Cardiovascular Diseases ; China ; Humans ; United States