Objective:To vealuate the effect of percutaneous transhepatic insertion of biliary setents(PTIBS) and arterial chemoenbolization for treatment of malignent biliary obstruction(MBO).Methods:Twelve patients with MBO were treated with PTIBS,following by arterial chemoenbolization in two weeks,one time each months.Results:Fourteen stents were placed in 12 cases.The total serum bilirubin level declined from 534?120 umol/L to 45?23 umol/L in 11 patients.The survival rate of 6 and 12 monthes were 83.3% and 50% respectively.Two cases were reobsturcted after 5 months of first stent implacemnt and were retreated by insertion of second stents.The total thirty-five times arterial chemoembolization was performed in 12 cases with remarkable effect.Conclusion:PTIBS combined arterial chemoembolization was an safe ;effective interventional treatment for MBO. [

BACKGROUND:Thyroid-stimulating hormone receptor is an autoantigen shared by thyroid follicuar cells and ocular orbital tissues,and cytokines plays an important role on the pathogenesis of Graves ophthalmopathy(GO) . It is still a puzzle that the relation of cytokines and thyroid-stimulating hormone receptor in the pathogenesis of GO. OBJECTIVE:To study the influence of various cytokines on the expression of thyroid-stimulating hormone receptor in the process of adipogenesis of in vitro cultured orbital adipose cells in GO patients. DESIGN,TIME AND SETTING:A single sample observation was carried out in the Central Laboratory,Department of Ophthalmology,Sun Yat-sen University(Guangzhou,Guangdong,Province) from September 2003 to March 2004. MATERIALS:Orbital adipose cells were obtained from eight serious GO patients undergoing orbital decompression. Recombinant human interleukin 2(IL-2) ,IL-4,IL-6,IL-10,and interferon ?(IFN-?) were purchased from PEORO TECH EC Company. METHODS:Orbital adipose cells were cultured and treated by groups. IL-2,IL-4,IL-6,IL-10 and IFN-? was added to the culture media in the experimental group,while no any cytokine was given in the untreated group,and orbital adipose cells were primarily cultured in the control group. The cells were all collected twelve days later. MAIN OUTCOME MEASURES:The expression of thyroid-stimulating hormone receptor was examined with reverse transcriptase-polymerase chain reaction,and the content of cyclic adenosine monophosphate was measured with simultaneous radioimmunoassay. The quantitation of adipose in cells was detected by staining intracytoplasmic lipids with oil red O. RESULTS:The expression of thyroid-stimulating hormone receptor was significantly higher in cells treated with IL-2,IL-4,IL-6 and IL-10 than that in the untreated cells and in the cells treated with IFN-?. Treatment of GO orbital adipose cells with IL-2,IL-4,IL-6 and IL-10 during differentiation resulted in significantly greater cyclic adenosine monophosphate production by different degrees. The highest production achieved in the treatment with IL-6,which was two times as many as control group. The cyclic adenosine monophosphate production was significantly lower in the cells treated with IFN-? than in the untreated cells. CONCLUSION:IL-6,IL-4 and IL-10 can upregulate the expression of thyroid-stimulating hormone receptor in the orbital adipose cells of GO patients,and stimulate adipose differentiation. Conversely,IFN-? can restrain this process.

OBJECTIVE:To provide reference for the establishment of prevention and control measures for medication errors. METHODS:Based on JCI standard,51 cases of medication error reported by ADE information platform of our hospital in 2012 were summarized,and analyzed in terms of error type,error time,working life of responsible person,etc. The prevention and con-trol strategies were introduced. RESULTS:Referring to related requirements of JCI standard,medication errors reduced significant-ly during 2013-2014 through personnel training and education,system improvement and process optimization. CONCLUSIONS:Medication errors surveillance and control is important for the promotion of rational use of drugs. JCI standard has played an impor-tant role in monitoring and preventing medication errors.

Objective To establish a model of renal artery and vein blockage and detect the real time change of ascorbic acid in the renal cortex in vivo.Methods Sixteen rabbits were randomly divided into experiment and control groups(8 in each).Under anesthesia,the left kidney and artery-vein were dissociated and a microdialysis probe was inserted into the renal cortex.After being balanced for 60 minutes,the change of ascorbic acid in the renal cortex was detected.Ischemia was achieved by clamping the renal pedicle for 60 minutes followed by reperfusion for another 60 minutes in the experiment group.While in the control,the same procedure was performed during a same time interval without clamping the renal pedicle.Microdialysis samples were collected before,during,and after the ischemia in the rabbits,and then ascorbic acid in the microdialysates were real-time measured by an electrochemical method.Results The concentrations of ascorbic acid in the microdialysates were(18.9?7.5)?mol/L,(24.8?11.3)?mol/L,and(23.3?8.9)?mol/L respectively before,during,and after the renal warm ischemia.In the experiment group,the concentration of ascorbic acid was increased rapidly by 31.2% (24.8-18.9)/18.9] following ischemia(P0.05).Conclusions Ascorbic acid is a sensitive indicator of renal ischemia/reperfusion.The level of ischemia in renal context can be monitored in real time by detecting the concentration of ascorbic acid in vivo using microdialysis-electrochemical method.The method can be used for the further studies on ischemia/reperfusion.

Objective To investigate the change of glucose metabolism in warm ischemia/reperfusion injured kidney of rabbits in vivo by microdialysis and real-time electrochemical detection.Methods A total of 20 New Zealand rabbits were divided into experiment and control groups(10 in each).After anesthesia by intravenous injection of barbitone,an oblique incision under the 12th rid was made in the animals to expose the right kidney and the right renal artery and vein.Afterwards,a microdialysis probe was placed into the dorsal renal cortex along the long axle of the kidney.After 60 minutes to equilibrate,an electrochemical detection system was used to continuously determine the concentration of glucose in the renal cortex before ischemia.Then,ischemia/reperfusion injury model was established by clamping the renal pedicle for 60 minutes followed by perfusion for 60 minutes.The control group received the same intervention without clamping the renal pedicle.The glucose concentration of the microdialysis samples were analyzed before,during,and after the ischemia.Results The reaction of the glucose electrode to the electric current was linearly correlated with the concentrations of glucose,and the rate of microdialysis probe recycling was(63.6?2.1)%.The concentration of glucose in the renal cortical interstitial samples were(1.89?0.37),(0.69?0.12),and(0.62?0.14)mmol/L respectively before,during,and after the warm ischemia.During the ischemia phase,the mean concentration of glucose decreased by(36.7?2.4)% from the base level(LSD test,P=0.000).The glucose concentration of the experimental group was significantly lower than that in the control at both ischemia and reperfusion phases(t=-11.975,P=0.000;t=-11.993,P=0.000,respectively).Conclusions In vivo microdialysis combined with electrochemical detection provides a sensitive and real-time method for measuring the glucose concentration in warm ischemia/reperfusion injured kidney,which can suggest the ischemic condition of the renal cortex.

31 patients from Anhui province maternal and child health care with cesarean scar pregnancy ( CSP ) treated with UAE ( before or after uterine curettage) were analyzed retrospectively. 12 subjects with a definite diag-nosis of CSP were offered preventive UAE. 1 case of an emergency rupture of the CSP patient was offered emergen-cy interventional therapy. The other eight patients,who were misdiagnosed as having an intrauterine pregnancy,with the symptoms of active vaginal bleeding were treated with emergency UAE after uterine curettage. The results showed all the 31 patients with CSP were resolved successfully without hysterectomy and had a significant decrease on the data ofβ-HCG. 24 patients received preventive UAE combined with methotrexate followed by uterine curet-tage. 3 patients received a excision of the scar in the uterus after UAE. 4 patients had a UAE combined with conser-vative medication. Results showed that UAE might be an effective means of treating CSP, including treatment in an emergency setting. It decreases the incidence rate of hysterectomy.

OBJECTIVEThis study aimed to detect the difference in the expression levels of autolysin atIS gene of Streptococcus gordonii (S. gordonii) at different growth stages and pH values, as well as to analyze the factors regulating atlS gene expression in S. gordonii.

METHODSS. gordonii wild strains (ATCC 35105) were collected at different growth stages (early exponential phase, mid-exponential phase, late exponential stage, and platform stage) and pH values (pH 7 and pH 5.5), and total RNA was extracted by using a conventional method. Fluorescence quantitative polymerase chain reaction (FQ-PCR) was used to measure the relative mRNA expression of atlS gene, with bacterial 16S rRNA as internal reference, for a comparison of the mRNA levels of atlS gene expression in S.gordonii at different growth stages and pH values.

RESULTSFQ-PCR results showed that atlS gene expression increased with gradually increasing growth stage under neutral conditions and was higher than that under acidic conditions (P < 0.05).

CONCLUSIONThe atlS gene expression in S. gordonii is influenced by growth stage and pH value factors.

Objective The clinical value of ifrst-trimester standard ultrasound views in screening for fetal structural abnormalities. Methods From September 2008 to March 2011, transabdominal sonographic screening by standard ultrasound views was performed in 3 134 viable singleton pregnancies during the ifrst trimester at Beijing Obstetrics and Gynecology Hospital. Used the following views:(1) Fetal proifle;(2) Neck sagittal;(3) Skull and brain;(4) Thorax;(5) Abdomen;(6) Bladder;(7) Upper limbs, and (8) Lower limbs. The women underwent 20-to 24-week and 28-to 32-week ultrasound examination if the anatomical survey was normal during the ifrst trimester. Follow-up was obtained by reviewing of the birth records from hospital charts. Results Sixteen prenatal abnormalities were detected at 11-to 13-week scan (including one case of encephalocele and meningoceles, one case of endothelial cushion defect and single umbilical artery, one case of ectopia cordis, gastroschisis, and spinal abnormalities, two cases of exencephaly, one case of anencephaly, one case of gastroschisis and lower limb malformation, two cases of omphalocele, one case of encephalocele, ectopia cordis, and gastroschisis, one case of single ventricle, one case of endothelial cushion defect, four cases of hyhrop). All of the 13 women decided on termination of pregnancy. Three suspected structural abnormalities (hydrops) detected at the ifrst-trimester scan were found as normal after birth. Seven cases were diagnosed at 20-to 24-week scan (including one case of dextrocardiac and double outlet right ventricle;two cases of endothelial cushion defects;one case of trisomy 21 with VSD;one case of omphalocele, one case of short ulna and radial with wrist distortion, and one case of club foot). One case of diaphragmatic hernia was detected at 32-week scan. Two cases (one case of cardiac defects and one case of ear deformity) were identified after birth. Of all the 3 134 fetuses, follow-up was obtained in 2 822 cases, 312 cases were excluded from the analysis because the outcome of their pregnancy could not be traced. Twenty-three fetuses with at least one major structural defect detected by prenatal ultrasonography were confirmed by follow-up. The sensitivity of the standard first-trimester ultrasound views was 56.5%(13/23), speciifcity was 99.9%(2 796/2 799), CR was 99.6%(2 812/2 822), and the false negative rate was 43.5%(10/23). Conclusions The standard views of the ifrst trimester are feasible and effective in screening the major fetal abnormalities including exencephaly, anencephaly, gastroschisis, omphalocele, ectopia cordis and single ventricle. However, ultrasound screening in early pregnancy still has some limitations, continuous scanning in different stages of pregnancy is necessary.

In recent years, Shenyi Capsule has been proven to have certain anti-angiogenic effects, and to be effective to many cancers, but its effects on advanced esophageal cancer are scarcely studied.

Objective To explore the differences in behavior of anxiety individuals and the normal control under different feedback (positive feedback,negative feedback).Methods 400 university students were investigated using self-rating anxiety scale(SAS) and state anxiety inventory (SAI) and the data were analyzed with balloon analogue risk task.Results The score of anxiety group(24.28±6.12) was significantly lower (t=-2.25,P＜0.05) than that of control group(29.80±7.26) in the number of busting balloons.But in the number of busting balloons of positive and negative feedback condition,scores of anxiety group and control group were not significantly different(t=-1.82,P＞0.05;t=-1.78,P＞0.05).Conclusions Influence of anxiety on decision-making often manifests as risk aversion.