BACKGROUND:Biliary stent restenosis is one of the main long-term complications following biliary stent restenosis implantation,which affects its application.OBJECTIVE:To evaluate the reasons for the biliary stent restenosis and to explore corresponding prevention methods.METHODS:A computer-based online search of MEDLINE,Cochrane library,CNKI and VIP between January 1989 and August 2009 was performed to search related articles with the key words of "biliary metal stent,reobstruction,and interventional therapy".Literatures related to biliary stent restenosis were selected,in the same field,the articles published lately or published by authoritative journals were preferred.A total of 171 articles were searched and 22 documents were included according to inclusion and exclusion criteria.RESULTS AND CONCLUSION:Tumor growth,gallstone formation and inflammatory hyperplasia are the main reasons for restenosis following biliary metal stent implantation.The interventional therapy is an effective way for the patients of stent restenosis.Simultaneously,the therapeutic efficacy and living quality of patients can be improved by noticing preoperative conditions,in-time detecting and controlling biliary infection,reducing complications as well as strengthening postoperative combined therapy.

BACKGROUND:It generally thought that based on cholangiography,biliary tract stents implantation can achieve a same long-term therapeutic efficacy as resection,and obtain good clinical outcomes in treating hilar cholangiocarcinoma when combined with percutaneous portcatheter system.OBJECTIVE:To evaluate the clinical methods of double interventional therapy and the biocompatibility between stent and host in hilar cholangiocarcinoma following stant implantation.METHODS:The databases of MEDLINE,Cochrane library,CNKI and VIP were retrieved with deadline of August 2009.Medium survival time and jaundice decrease rate,complication rate as well as biocompatibility between stent and host were sewed as assessment index.Clinical studies addressing double interventional therapy for treating proximal bile duct cancer were included,and animal studies were excluded.A total of 156 literatures were obtained initially by computer,and 25 literatures were included in further analysis.RESULTS AND CONCLUSION:In vitro test showed that stents carrying antibiotic,silver,or Escherichia coil,which may prevent adhesion of bacteria,however,it obtained poor clinical results.Chitosan is a natural cationic polymer and possess good biocompatibility,antibiosis and biodegradability.For the compare of the therapeutic effectiveness among different surgical procedure,it found that the decrease of total bilirubin were more faster in the internal and external drainage group than the resection group,however,the difference had no statistically significance.According to the Kaplan-Meier survival analysis,the medium survival time of 7 patients in the resection group was 16 months.The 1,3,5 years survival rate were 57.1%(4/7),28.6%(2/7),14.3%(1/7),respectively.Among the double interventional therapy group,the medium survival time of 19 patients was 18 months,and the 1,3,5 years survival rate were 52.6%(10/19),27.8%(5/19),15.8%(3/19),respectively.The medium survival time was 12 months in 14 patients of the control group,with 1,3,5 years survival rate of 57.1%,28.6%,14.2%,respectively.The results demonstrated that biliary tract stents implantation combined with percutaneous portcatheter system can improve life quality and prolong survival time of patients with hilar cholangiocarcinoma.

Right ventricular (RV) function is very important for patients with respiratory and cardiovascular disorders resulting in RV impairments. Since RV has complex geometry of the chamber, it is difficult to accurately measure the RV volumetric parameters with conventional imaging modalities, especially those with dilated and abnormal RV. With the emergence and wide use of new noninvasive imaging modalities in accessing the cardiac anatomy and function, real-time three-dimensional echocardiography (RT3DE), multi-detector row computed tomography (MDCT) and new MRI sequences, noninvasive quantitative assessment of the RV function has attracted more and more worldwide attention.

Objective To study the role and mechanism of A2AR activation in tau hyperphosphorylation after brain injury.Methods SD rats were cultured with no specific pathogen level.SH-SY5Y was cultured.The rats were treated with CGS21680 solution and DMSO and SH-SY5Y respectively.The CGS21680 solution and sb216763, H-89, or Only add ZM241385, the control group plus DMSO, compared with each group tau hyperphosphorylation.Results The phosphorylation level of tau protein in SH-SY5Y cells was significantly higher than that in the control group (P<0.05).The phosphorylation level of tau protein in the primary hippocampal neurons of rats was significantly higher than that of the control group (P<0.05).The levels of tau protein phosphorylation in group 2 and group 3 were significantly higher than those in control group (P<0.05).The expression of tau in group 4 and group 5 was statistically significant (P<0.05)There was no significant difference in phosphorylation level between the two groups.Conclusion A2AR activation can activate kinase A and GSK-3β after brain injury, leading to tau hyperphosphorylation.

AIM: To investigate the phenomenon that miR-let-7d regulates the proliferation and invasion abilities of the lung cancer cells through nuclear receptor peroxisome proliferator-activated receptors γ (PPARγ).METHODS: The relation between PPARγ and microRNA was analyzed by bioinformatics.The plasmid reporter assay was used to verify that PPARγ was the target of miR-let-7d.The lung cancer cell line with low expression of PPARγ was selected from different lung cancer cell lines by Western blot.The regulatory role of miR-let-7d in the lung cancer cells was determined by dual luciferase labeling and Western blot.The effect of miR-let-7d on the proliferation ability of lung cancer cells was detected by colony formation assay, the effect of miR-let-7d on the invasive ability of lung cancer cells was detected by Transwell invasion assay.RESULTS: The results of bioinformatic analysis showed that miR-let-7d regulated the expression of PPARγ, and the 3'UTR of PPARγ contained 2 functional miR-let-7d binding sites, indicating that PPARγ is a direct target of miR-let-7d.miR-let-7d was able to directly regulate the expression of PPARγ at mRNA and protein levels.Transfection of miR-let-7d inhibitor promoted the proliferation and invasion abilities of lung cancer cells by increasing the expression of PPARγ.CONCLUSION: miR-let-7d increases the expression of tumor suppressor PPARγ to inhibit the proliferation and invasive abilities of lung cancer cells.

Objective To observe the clinical therapeutic effects of BaDuanJin exercise on patients with scapulohumeral periarthritis.Methods 72 patients were randomly divided into therapeutic group and control group,with 36 cases in each group.The patients in control group were treated with electroacupuncture and those in therapeutic group were treated with electroacupuncture and BaDuanJin exercise for 4 weeks.Pain degree(VAS)and shoulder ROM(Melle Scores)were evaluated before therapy,2 weeks and 4 weeks after therapy.The patients were followed up for 3 months.Results The VAS scores and Melle scores of both groups after therapy(both at two weeks and four weeks)showed significant difference than those before thempy.The scores after 4 weeks therapy were better than those of 2 weeks therapy.The effects of therapeutic group after 3 months showed better result than controls,but without statistical difference(P>0.05).Conclusion BaDuanJin,as a mild exercise had favorable therapeutic effccts on patients with scapulohumeral periarthritis.

Diffuse lower-grade glioma is a diversified group of infiltrative brain tumors comprising WHO grades II and III astrocytomas, oligodendrogliomas, and mixed oligoastrocytomas. These tumors exhibit a wide range of clinical heterogeneity;thus, histopathological classification does not adequately predict clinical outcomes. In recent years, a number of molecular markers closely related to the clini-cal features and prognosis of gliomas have been discovered. These molecular markers include isocitrate dehydrogenase (IDH) muta-tion, chromosome 1p/19q codeletion, ATRX mutation, TERT promoter mutation, and MGMT promoter methylation. Furthermore, nu-merous studies focusing on the integrated molecular classification of diffuse lower-grade gliomas combined with these molecular markers have been conducted. Results indicate that integrated molecular pathological classification can improve the diagnostic and prognostic accuracy and facilitate therapeutic formulation. This paper reviews the research progress on integrated molecular classifica-tion of diffuse lower-grade gliomas.

Pain has been defined as an unpleasant sensory and emotional experience that is associated with actual or potential tissue damage,or is described in terms of such damage.Pain individual difference increases the complexity of clinical diagnosis and treatment of pain.China started relatively late on pain research and standardized pain treatment.It is necessary for further research on pain related to the clinical problem,the development of pain translational medicine,and improvement of clinical quality.The paper carries on the review.

Objective: To observe the influence on curative effect of aescine in curing Lumbar intervertebral disc prolapse(LIDP) before and after operation. Methods: 184 cases of patients with LIDP were divided into two groups. 96 cases in curative group began to be used 10mg of aescin by adding to infusion of iv drip bid 3 days before the operation, and contie for 6-8 days it. 88 cases in control group were only operated.Results: Curative group was superior to control group in lysis of pain, postoperative La feeling and improvement of muscle strength. The excellent and better rates in two groups are 72.91%, 91.67% and 43.18%, 85.22%. The excellent rate of curative group is higher than that of control group( P 0.05). There is no serious bad reaction of drug in curative group.Conclusion: Aescin used before and after operation is good to recovery of nervous function after LIDP operation.

Objective To investigate the expression level of monocytes ATP-binding cassette transporter A1(ABCA1) stimulated by oxidized low-density lipoprotein (ox-LDL) in patients with coronary heart disease (CHD) for exploring the mechanism of ABCA1 in the pathogenesis of atherosclerosis (AS). Methods Human monocytes of patients in CHD group (n=42) and normal control group (n=40) were isolated by density gradient centrifugation with separating medium (1.077). ABCA1 was labeled by immune reaction PE fluorescence, then the expression of ABCA1 before and after being incubated with the ox-LDL (30mg/L) for 24 hours was investigated by flow cytometer, and the changes in ABCA1 expression were observed. The differences between the two groups and the correlation between ABCA1 expression and blood lipids were analyzed. Results The high-density lipoprotein cholesterol (HDL-C) and apolipoprotein A1 (apoA1) levels in CHD group (1.15?1.40 and 1.19?0.17, respectively) were significantly lower than that in control group (1.36?0.40 and 1.34?0.22, respectively, P0.05). Conclusions ABCA1 expression in the patients with CHD may be inhibited by high concentration of ox-LDL. The lowered expression of ABCA1 and the abnormal lipids spectrum may decrease the reverse cholesterol transport (RCT), and contribute to the development of AS and CHD.