Objective To study the case of 76 patients with choledochoduodenal fistula ( CDF) ,and summarize the experience of mak-ing diagnosis and treatment. Methods From January 1999 to June 2012,76 patients with CDF were treated in our department and then was confirmed by endoscopic retrograde cholangiography ( ERCP) . All patients were classified based on the location of duodenal papilla in rela-tion to the orificium fistulae of CDF. Different therapies were used to certain CDF depending on the diameter of the orificium fistulae of CDF. Of the 76 CDF patients,70 patients (92%) required surgery. Results The fistula of 76 CDF patients have three types,and the formation of this classification was based on the position between the duodenal papilla and the orificium fistulae of CDF. Different therapies referred to cer-tain diameter of CDF,70 patients required surgery and 6 acquired pharmacotherapy. Of the 70 patients needing surgical intervention,clinical outcomes were excellent in 66 patients. Follow-up of these patients for 6 months to 10 years showed they did not suffer from further cholangi-tis. Conclusion The past history of biliary disease,upper abdominal pain,fever,and jaundice may lead to the disease of CDF. ERCP was the primary method for diagnosing this disease,and operative therapy was the primary treatment for most CDF patients.

Objective To investigate the effect of Ginkgo biloba extract on serum divalent metal transporter1 ( DMT1 ) , glucose regulated protein 75(grp75) and nerve function in patients with Parkinson disease.Methods 38 cases of patients loith parkinson disease according to different drugs were divided into experimental group and control group, 19 cases in each group.Control group was treated with levodopa and Benserazide tablet, experimental group on the basis of control group, was given Ginkgo biloba extract tablets, treatment for 4 weeks.After treatment, DMT1, grp75 and cognitive function of all patients in substantia nigra were detected.ResuIts Compared with before treatment, two groups of patients with lower DMT1 level (P<0.05), compared with control group, experimental group of patients with lower DMT1 levels (P<0.05).Compared with pre-treatment, two groups of patients grp75 level was higher (P<0.05), compared with control group, experimental group after treatment grp75 level was higher (P<0.05).Compared with before treatment, the two groups of patients with MoCA scores were higher (P<0.05), HAMD scores were lower (P<0.05).Compared with control group, experimental group after treatment MoCA scores were higher (P<0.05), HAMD scores were lower (P<0.05).ConcIusion Ginkgo biloba extract can significantly reduce the level of DMT1 in the substantia nigra of Parkinson patients, increase the level of grp75, and improve the cognitive function.

BACKGROUND:Recent research has shown that transplanted bone marrow mesenchymal stem cells(BMSCs) migrate to the injured regions and exert their therapeutic effects in cases of intracranial trauma, stroke, inflammation and degenerative disease.The specific mechanisms involved in their migration to lesions are still to be fully elucidated.OBJECTIVE:To explore the effects of stromal cells derived factor-1(SDF-1) and its receptor CXCR4 on the migration of transplanted BMSCs to ischemic brain lesions.DESIGN, TIME AND SETTING:The cytological in vivo study was performed at the Central Laboratory, Xinqiao Hospital, Third Military Medical University of Chinese PLA from February 2008 to February 2009.MATERIALS:Bone marrow samples were obtained from normal or primary affection non-involved bone marrow patients aged 15-40 years at the Department of Hematology, Xinqiao Hospital, Third Military Medical University of Chinese PLA.A total of 72 healthy male Sprague Dawley rats aged 3-4 months were supplied by the Experimental Animal Center, Research Institute of Surgery, Third Military Medical University of Chinese PLA.METHODS:Human BMSCs were isolated by combination of gradient centrifugation and different adherent time method.The transient middle cerebral artery occlusion(MCAO) was induced using intraluminal vascular occlusion in 54 rats, based on the method described by Nagasawa et al.The remaining 18 rats served as sham operation group, only inserted with thread for 10 mm depth.At 2, 4 and 8 days after cerebral ischemia, the expression of SDF-1 in the ischemic brain was determined by real time RT-PCR and immunohistochemistry in 9 rats from either group.The remaining 36 rat models of cerebral ischemia/reperfusion were equally and randomly assigned into a cell transplantation and solution control groups.1 mL human BMSCs(2?109/L cells) or 1 mL phosphate buffered saline were slowly infused through the caudal vein at 24 hours following reperfusion.MAIN OUTCOME MEASURES:CXCR4 mRNA and protein expression in human BMSCs was determined.SDF-1 mRNA and protein expression following ischemia/reperfusion were detected.Migration of transplanted human BMSCs into the damaged region was observed through immunohistochemistry.RESULTS:RT-PCR showed that human BMSCs were positive for CXCR4 mRNA.Immunocytochemistry revealed that CXCR4 mainly expressed in cell membrane and cytoplasm of human BMSCs.At 2, 4 and 8 days following cerebral ischemia/reperfusion, SDF-1 mRNA levels showed an increased tendency, and showed significant difference compared with the sham operation group(P

BACKGROUND: Transplanted bone marrow mesenchymal stem cells (BMSCs) migrate to the injured regions and exert their therapeutic effects. The specific mechanisms involved in their directional migration to lesions remain unclear. OBJECTIVE: To investigate the chemokine receptor CXCR4 and CX3CR1 expression of human BMSCs in hypoxia culture. DESIGN, TIME AND SETTING: The cytology in vitro study was performed at the Central Laboratory, Xingqiao Hospital, Third Military Medical University of Chinese PLA from February 2008 to February 2009. MATERIALS: Cells harvested from the iliac heparinized bone marrow were obtained by iliac crest aspiration from healthy adult volunteers, aged 15 to 40 years old, at the Department of Hematology, Xinqiao Hospital, Third Military Medical University of Chinese PLA. METHODS: Bone marrow was obtained by puncture. Human BMSCs were harvested by combination of density and gradient centrifugation and different adherent method. Cells at passage 3 were incubated in a 25 cm2 flask. When 70%-80% confluence was found, cells were incubated at 37 ℃ and saturated humidity in an incubator containing 3% O2, 5% CO2, 92% N2 for 48 hours, and those incubated under normal oxygen as controls. MAIN OUTCOME MEASURES: Morphology was examined by phase contrast microscopy. Cell surface markers were tested by flow cytometer. The CXCR4 and CX3CR1 mRNA expression were detected by real-time PCR. The CXCR4 and CX3CR1 protein expression were determined by Western blot assay. RESULTS: All of the cells had a fibroblast-like morphology cultured in vitro and reached 90% confluence at 12-14 days, with the presence of polarity arrangement and whirlpool-shape. Cells were uniformly positive for CD105 (99.38%) and CD29 (99.13%), but negative for CD14 and CD45. Exposure of BMSCs to 3% O2 increased expression of the CXCR4 mRNA and CX3CR1 mRNA, which were respectively 2.130 times and 2.361 times of normal culture; expression of the CXCR4 protein and CX3CR1 protein was respectively 1.69 times and 1.93 times of normal culture. CXCR4 and CX3CR1 mainly expressed in membrane and cytoplasm of human BMSCs. CONCLUSION: Hypoxia (3% O2) can upregulate the expression of CXCR4 and CX3CR1 in human BMSCs, which might be one of the machenisms underlying the migration of BMSCs.

Objective To investigate the levels of oxidative stress in liver tissues of hepatocelluar carcinoma(HCC)patients after transcatheter arterial chemotherapy(TAC).Methods Immunohistochemistry streptavidin biotinylated peroxidase(S-P)method was used to detect the cellular levels of 8-hydroxy-2'-deoxyguanosine(8-OHdG),p53 and p21~(waf1/cip1).Eighty-nine HCC patients were divided into TAC group(39 cases)and Non-TAC group(50 cases).15 Non-HCC liver tissues served as controls.Result 8-OHdG level was higher in Non-TAC group than that in TAC group in tumor tissues (F=9.516,P＜0.05),with that being the lowest in control group(F=9.516,P＜0.01);8-OHdG levels in cancer tissues were significantly higher than that in tumor surrounding tissues in both TAC group (t=7.101,P＜0.001)and Non-TAC group(t=8.020,P＜0.001),there was no significant difference of 8-OHdG levels between para-tumor tissues and controls.The levels of 8-OHdG between tumor and its surrounding tissues in TAC group(r=0.651,P＜0.001)and non-TAC group(r=0.493,P＜0.01)was in positive correlation.The difference of p53 levels in cancer tissues in TAC group and Non-TAC group were not statistically significant and p53 was not detected in para-tumor tissues.The difference of p21~(waf1/cip1) levels among TAC group,Non-TAC group and controls was statistically significant,the levels of p21~(waf1/cip1) in normal group was the highest(F=13.459,P＜0.001),followed by that in TAC and Non-TAC group in cancer tissues(TAC vs.Non-TAC group,P＜0.01);p21~(waf1/cip1) expression in normal controls was significantly higher than that in both TAC and Non-TAC group in para-tumor tissues(F=16.613,P＜0.001).The correlation of p21 ~(waf1/cip1) levels between tumor and its surrounding tissues was significant in non-TAC group(r=0.872,P＜0.001).Conclusions Oxidative stress levels in HCC tumor tissues were higher than in para-tumor tissues and non-HCC liver tissues.Cancer cells probably survive chemotherapy by fortifying oxidative stress repair mechanism.