Objective To investigate the feasibility, safety and clinical effect of percutaneous transhepatic bipolar radiofrequency catheter ablation in treating malignant obstructive jaundice. Methods Twenty patients with inoperable malignant biliary obstruction were enrolled in this study. Of the 20 cases , 2 had biliary stent re-occlusion. Percutaneous transhepatic bipolar radiofrequency catheter ablation was carried out in all patients. The ablation power was 5 - 12 W, single ablation time was 60 - 120 s, the average duration of ablation was 4.66 min (1.5 - 8.5 min), and the mean effective ablation extent was 5.76 cm (4 -10 cm). After ablation, balloon catheter was inserted to dilate the occluded segment, which was followed by implantation of biliary metal stent. The clinical efficacy , safety and complications were recorded. Results Percutaneous transhepatic bipolar radiofrequency catheter ablation was successfully completed in all the 20 patients. Implantation of biliary metal stent was performed in 17 patients , among them balloon dilatation was employed in 11 patients before stent implantation , simple balloon dilatation with no stent implantation was employed in one patient, and ablation was adopted after biliary stent re-occlusion occurred in two patients. After the ablation, no complications such as biliary fistula, biliary tract infections, liver penetrating injuries, peritonitis, etc. occurred. Biliary drainage was successfully completed in all patients. The median follow-up period was three months(0.5-10 months); the stent patency rate at the end of one and three months was 100% (19/19) and 79% (11/14) respectively. The one-month and 3-month survival rate was 95% (19/20) and 93% (14/15) respectively. During the follow-up period, 8 of the 20 patients were alive and 12 died. The median survival time was 144 days (13 - 330 days) and the median time of stent patency was 60 days (30-210 days). Of the 12 fatal patients, 8 died of cachexia with multi- system failure although their total bilirubin level was not elevated during the follow- up period. Conclusion For the treatment of malignant obstructive jaundice, percutaneous transhepatic bipolar radiofrequency catheter ablation is a newly-developed, safe and feasible means. Clinically, this technique has already achieved some certain effect although its long-term results need to be further evaluated.

Atherosclerosis is the pathological basis of ischemic stroke. Peripheral blood leukocytes are involved in the occurrence and progression of atherosclerosis and cause vascular endothelial injury. A series of changes of peripheral immune cel take place after acute ischemic stroke and cause inflammatory cel infiltrating into the brain tissue. The elevated leukocyte count is closely associated with the occurrence and prognosis of coronary atherosclerotic heart disease. Studies have also shown that the elevated leukocyte count may influence the occurrence of ischemic stroke, neurological deficit, recurrence, and death. This article reviews the relationship between peripheral blood leukocytes and ischemic stroke.

Induced pluripotent stem cell is a landmark in the stem cell study field, which has rapidly developed in the past 10 years.By obtaining induced pluripotent stem cells from somatic cell, and then differentiating into cardiomyocyte, various cardiomyocyte disease models could be established,which can be used for research of disease mechanisms, drug screening and gene therapy.This review introduces the successfully established cardiomyocyte disease models from human induced pluripotent stem cells, and points out the problems and prospects.

Objective:To determine aristolochic acid A. in Caulis Aristolochiae Manshuriensis and its preparation. Methods: TLCS Refleciton Saw Tooth Method was used. ? s=323nm. narrow slot: 0.4?0.4nm S X=3.Results: The recovery was 99.86%. RSD was 2.04%. Conclusion: This method is suitable for the content determination of aristolochiae acid A in various traditional Chinese medicine comprising Caulis Aristolochiae Manshuriensis.

Retrospective study was carried out in 93 cases of endometrial carcinoma admitted to our hospital since Jan. 1985 to Dec. 1994. Thirty five cases were older than 60 years, and 24 cases were younger than 50 years. All of the cases had pathological diagnosis and were staged according to FIGO. When compared with the younger group, the rate of older patients with stage Ⅰa was higher (11.4% in younger and 45.4% in older, P

Objective To evaluate the sensitivity and specificity of anti-cyclic citrullinated peptide antibody(anti-CCP)and rheumatoid factor(RF)in patients with rheumatoid arthritis(RA).Methods Anti-CCP antibody was measured in sera from 75 human,including 27 RA patients,40 other rheumatic diseases and 8 healths.Anti-CCP was measured by enzyme-linked immunosorbent assay(ELISA).Results The sensitivity of anti-CCP antibody was 70.4%,with a high specificity(93.8%)in RA.The positive rates of anti-CCP antibody have no difference in the patients within 2 years and exceed 2 years from onset.Anti-CCP antibody wasn't correlated with RF,ESR and CRP.Conclusion Anti-CCP antibody has better sensitivity and specificity for rheumatoid arthritis,combining anti-CCP antibody and RF can increase diagnosis sensitivity and specificity of RA,indicating it is a useful laboratory marker for early diagnosis of rheumatoid arthritis.

Objective To construct a self-assessment system of patient safety by nurses.Methods Using self-designed questionnaires of self-assessment system of patient safety by nurses,29 nursing safety management experts were selected.Delphi method was adopted to carry out two rounds of interview.The self-assessment system of patient safety by nurses was built.The importance of the indicators went on weight analysis with specialist sorting.Results The system included 3 first-level indicators,9 secondlevel indicators,48 third-level indicators.The coefficient of variation of the indicators was ＜ 0.20,and the coordination coefficient was 0.25.Conclusions The initial construction of system of self-assessment patient safety by nurses has the advantages of focused expert advice,with scientific results,and is reliable.It can be used for nurses' self-assessment of the security situation in patients.

Thyroid hormone insensitivity syndrome is an inherited syndrome characterized by high serum concentrations of thyroid hormone,accompanied by normal or slightly high serum TSH concentration due to the reduced responsiveness of target tissues to thyroid hormone.Thyroid hormone insensitivity syndromes are related to gene mutations of thyroid hormone receptors,thyroid hormone cell transport defect,and thyroid hormone metabolism defect.This article reviews the progress of pathogenesis,diagnosis,and therapeutics of thyroid hormone insensitivity syndrome.

Objective To explore the clinical features of sentinel polyps (rectal polyps with proximal colon carcinoma) and its correlation with proximal colon carcinoma.Methods From January 2003 to December 2013,the clinical features of 963 hospitalized patients with rectal polyps were retrospectively analyzed.According to whether the patient with colon carcinoma,the clinical data of rectal polyps patients were divided into pure polyps group (n=855) and sentinel polyps group (n 108).The characteristics under endoscopy,clinical pathological features,treatment and prognosis of the two groups were observed.Chi square test was performed for differences comparison between groups.Results The length of stay in hospital of 963 patients was from four to 33 days,the average age was (49.7 ± 9.4) years,and the majority of the patients were male (n=610,63.3％).A total of 785 patients (81.5％) had non-specific abdominal symptoms,such as frequency or habit change of defecation,hematochezia,abdominal pain,abdominal distension.The relatives within three generation of 78 patients (8.1 ％) were diagnosed with tumor and some relatives of the patients diagnosed with familial adenomatous polyposis (2.2％,21/963).The positive rate of tumor marker of sentinel polyps group was higher (69.4％,75/ 108) than that of pure polyps group (6.8％,58/855; x2 =316.285,P＜0.01).The proximal colon carcinoma of patients with sentinel polyps appeared as neoplasma with circumferential growth,there was no specific appearance between distal rectal polyps and proximal colon carcinoma.When compared with pure polyps group,most polyps of sentinel polyps group were in maximum diameter over 1 cm (61.1％ (66/108) vs 46.9％ (401/855)),multi polyps (n＞5,38.9％ (42/108) vs 11.8％ (101/855)) and adenomatous polyp (83.3％ (90/108) vs 35.6％(304/855),x2=7.752,55.595 and 90.544,all P＜ 0.01).Majority of the proximal colon carcinoma with rectal polyps was papillary adenocarcinoma and tubular adenocarcinoma which was account for 75.9％ (82/108).Some were mucinous carcinoma and signet ring cell carcinoma.Most of the proximal colon carcinoma with rectal polys did not penetrate the serosa layer (Duk A-+Duk B,59.3％,64/108) and with little distant metastasis (Duke D,17.6％,19/ 108).Ninty-five point six percent (817/855) of patients with pure polyps underwent endoscopic treatment and all of them were cured and discharged.Forty-one point seven percent (45/108) of patients of sentinel polyps group accepted the radical operation and 19.4％ (21/108) received endoscopic submucosal dissection.Conclusions If multiple,maximum diameter over 1 cm and adenomatous rectal polyps were detected under colon endoscope,the possibility of carcinogenesis of the polyps or the proximal colon should be awared.If the endoscope is difficult to go further or the patient can not tolerate the whole colon examination,the patient should be followed up in short-term and complete the whole colon examination.

OBJECTIVE:To prepare red sage gel for implantation and to establish a method for its quality control.METHODS:With carbamer934as vehicle,2%red sage gel was prepared;a HPLC method for the determination of tanshinone in gel was established.RESULTS:The calibration curve of tanshinoneⅡ A was linear in the concentration range of16.59～33.18ng/ml,Y=9723X—2569(n=5),r=0.9987.CONCLUSION:The preparation of red sage gel was simple,its quality was stable;the method of quality control was rapid and accurate.