Hilar cholangiocarcinoma is a malignant disease in the main left or right hepatic ducts,ductus hepaticus communis or their confluence.The treatment for hilar cholangiocarcinoma remains a challenge because of the aggressive nature of the disease and the absence of effective treatments besides surgical resection.Hilar cholangiocarcinoma is diagnosed by its clinical manifestations,tumor markers and results of imaging studies.Problems as the necessity of preoperative hepatic bile drainage and decision making of proper treatment remain controversial.Here,we will review the current advances in the management of hilar cholangiocarcinoma,so as to provide theoretical basis and new ideas for clinical treatment.

Objective To establish a rate model of stable orthotopic liver transplantation using three-cuff technique.Methods 28 dead rats were dissected and the causes for death and the complication analyzed after liver transplantation using three-cuff method.Results The main postoperative complications included:bleeding,stenosis of liver superior vena cava,portal venous thrombus,respiration duct obstruction,gastrectasia,pneumothorax,adhesion of liver to diaphragm.Conclusion Most of 8 kinds of complications were related with operation.

T helper 17 cells (Th17) are a novel subset of CD4+ T cells that undergo differentiation from naive CD4 T cells through the activation of a key nuclear transcription factor,retinoic-acid-receptor-related orphan receptor γt (RORγt),and in the presence of multiple cytokines,such as transforming growth factorβ1 (TGF-β1),interleukin6 (IL-6),as well as IL-23.Th17 cells induce their biological effect by secreting IL-17A and other cytokines.Research has demonstrated that Th17 cells have an intimate relationship with acute/chronic transplant reactions and that Th17 cell lineages have the possibility to become the new target for treating transplant rejections.Identification of Th17 cells also provides an additional strategy for inducing immune tolerance.

Objective To develop a method for simultaneous determination of benzodiazepines in human whole blood by SPE-Micellar electrokinetic capillary chromatography.Methods With the Clenbuterol as internal standard,Oasis column was used to extract the drugs from whole blood.The separation was performed on a fused-silica capillary of 75?m ID?50.2cm(40cm of effect length).The running buffers were sequentially used as 15mmol/L phosphates→15mmol/L sodium borate(pH8.2)→30 mmol/L SDS,and 18% methanol served as an organic modifier.Sample solution was injected with pressure mode,and the running voltage was 25kV.The detection wavelength was set at 230nm.Results The linear ranges of the calibration curves were from 0.02 to 1.6?g/ml,and the limits of detection ranged between 5 ng/ml and 50 ng/ml.The within-day and between-day precision was less than 12%.Conclusion The method developed for determination of benzodiazepines in human whole blood is effective,simple and reliable,with which 9 benzodiazepines may be simultaneously separated.

Objective To provide a specific,sensitive,reproducible HPLC method for the determination of doxepin in urine and whole blood with doxapram as the internal standard.Methods The sample preparation was simple and time-saving by using an Oasis pretreatment cartridge.Separations were achieved by a Lichrospher  100 RP-18e (250mm?4.0mm,5?m)column kept at 50 ℃,and the DAD detector was set at 230nm and 250nm.Results The detection limit was 2 ng/ml in urine and whole blood.The results showed excellent linearity.The relative standard deviation of between-day and within-day assay was Less than 6.75%,and absolute recoveries were higher than 85%.Conclusion The method for determination of doxepin in urine and whole blood is effective,simple and reliable,which may be applicable to the practical cases.

Objective To explore more safe and effective method for the treatment of common bile duct stones combined with cavernous transformation of the portal vein (CTPV).Methods We report 2 cases of post-treated patients in this series.In order to avoid severe bleeding caused by dissection of bile duct,we applied different methods to remove common bile duct stones compared with traditional operation.We removed common bile duct stones in one patient through cystic duct approach during operation.Two years later,we performed endoscopic duodenal incision (endoscopic sphincterotomy,EST) for him because of lower common bile duct stenosis with sand like stone.Another patient,on the other hand,we conducted the duodenal papilla incision during operation and removed common bile duct stones with choledochoscope through the bottom of common bile duct.Result Of the two patients,all of the three kinds of operation had good curative effects.Conclusions For the patients with common bile duct stones combined with CTPV,we should select appropriate treatments to avoid dissection of bile duct in front of the dilated and tortuous collateral veins during the operation,which is the key to guarantee the safety and success of the operation.EST is the preferred method of the treatment.Open operation with choledochoscopy via cystic duct approach or duodenal papilla incision through distal common bile duct to perform stone extraction also appears to be effective and safe.

Liver transplantation is one of the main treatments for acute and chronic liver failure currently.In recent years,with the lack of donor liver transplantation and the in creasing number of patients,the major donator of liver transplant is brain dead patients.In brain-dead state,organ functions de cline gradually.Changes in hemodynamics and immunity could lead to inflammation and alter hormone release.Organ survival and patients'prognosis can be unpredictable.The study of the above phenomenal mechanisms is still at an early stage.This article summarized the current liver transplant treatments by explai ning the pathophysiology of donor organ damage and reviewing the prognosis.The aim of this article was to provide a perspective for future study on this topic.

By evaluation of academic designed experiment performance in Bio-Analytic Chemistry from ten different evaluating indicators including literature search, experimental design, and experimental report and so on. The quantitative analysis results indicate the average is 87.8, the standard deviation is 5.0,the difficulty index is 0.88,the dipartite degree is 0.12 and the confidence coefficient of the assess is 0.9423. The designed experimental assessment can inspire the students’experimental goaheadism, cultivate their ability to analyze and solve problems,and promote their innovative consciousness and practice skills.

On the development of Bio-analytic chemistry curricula,to enhance the build- ing of teaching staff,improve the teaching content according to the developmental trend of model chemistry,adopt multiform methods to explore new teaching pattern,improve the teaching quality based on the manage,the course on Bio-analytic chemistry has became more systematized and standardized.

BACKGROUND:Establishing the animal model of membranous nephropathy is of importance to figure out the pathogenesis of membranous nephropathy.
OBJECTIVE:To investigate the expression of nephrin and podocin in the model of membrane nephropathy in rats, and to investigate their relationships with the pathogenesis of membranous nephropathy.
METHODS:A total of 40 Sprague-Dawley rats were equivalently randomized into model and control groups. Rats in the model group were in premunity by given subcutaneous and multi-point injection of 1 mg cationic bovine serum albumin firstly dissolved in 0.5 mL normal saline and then ful y emulsified with the equal incomplete Freund’s adjuvant for 1 week, and 16 mg/kg cationic bovine serum albumin was injected via vein tails, once every other day for 4 weeks. The same volume of normal saline was injected into the controls. The mRNA expressions of nephrin and podocin in renal tissues were detected using real-time PCR, and biochemical indicators and morphological observation were measured at 2 and 4 weeks after modeling.
RESULTS AND CONCLUSION:(1) In the model group, the total amount of urine and serum albumin levels were significantly decreased accompanying with overt proteinuria, and the serum creatinine, urea nitrogen, cholesterol and triglyceride levels were significantly increased al in a time-independent manner compared with the control group (P<0.01), and the difference was significant (P<0.05). (2) The pathological examination showed that rats in the model group had different degrees of renal tubular dilatation, glomerular basement membrane thickening, mesangial cel s and stromal hyperplasia, which was typical of membranous nephritis. (3) Moreover, the mRNA expressions of podocin and nephrin in the model group were lower than those in the control group. (4) In conclusion, the decreased expressions of podocin and nephfin may disturb the integrity of the slit membrane of podocytes giving rise to the damage of glomerular filtration barrier, and proteinuria appears in final.