Objective To investigate the safety and efficacy of stent insertion combined with high-intensity focused ultrasound(HIFU) ablation for malignant obstructive jaundice caused by pancreatic carcinoma.Methods From January 2013 to February 2017,a total of 80 patients with malignant obstructive jaundice caused by pancreatic carcinoma underwent biliary stent insertion in our center,who were divided into combined treatment(stent insertion with HIFU ablation) group(n=38) and solitary stent insertion group(n=42).The stent patency time and survival time were compared between the two groups.Results Relief of jaundice were archived in all patients in both groups.Cholangitis was observed in 7 cases in both two groups.Reobstruction of stent was observed in 15 patients in both two groups.The median stent patency time was 179 days in combined treatment group and 119 days in solitary stent insertion group(P<0.01);the median survival time was 209 days in combined treatment group and 145 days in solitary stent insertion group,the differences were significant(P<0.01).Based on the univariate and multivariate Cox regression analyses,the predictors of prolonging survival included subsequent HIFU ablation after stent insertion and earlier tumor stage(P<0.05).Conclusion Combined biliary stent insertion and HIFU ablation is a safe and effective method for malignant obstructive jaundice caused by pancreatic carcinoma,and seems to extend stent patency time and survival when compared with biliary stent only.

AIM:To study intravenous transplantation of human mesenchymal stem cells (hMSCs) on the life span and pathological change of SOD1-G93A amyotrophic lateral sclerosis (ALS) mice. METHODS:hMSCs were cultured and expanded from heparinized bone marrow cells from healthy donors and the purity and features were identified with FCM. hMSCs (3×10~6) resuspended in 0.3 mL DMEM or 0.3 mL DMEM only were injected into the tail vein of genotyped SOD1-G93A ALS mice. The mice were evaluated for signs of motor deficit with 4-point scoring system according to Weydt and the onset and life span were assessed. The pathological change was observed with Nissl staining and number of motor neuron was counted. RESULTS:The onset symptoms in untreated SOD1-G93A ALS mice appeared at (156.6±3.6) d of age and the average life span was (188.3±3.5) d. hMSCs transplantation delayed the onset of ALS type symptoms about 14 d and prolonged the life span about 18 d compared to the untreated SOD1-G93A littermates. The loss of motor neurons in untreated mice was much faster and severer than that in hMSCs transplanted mice. At 16 th week and 20 th week,motor neurons of untreated mice were significantly fewer than those of transplanted mice. β-globin gene in brain was detected in transplanted ALS mice. CONCLUSION:hMSCs migrate to central nervous system after intravenous transplantation,prolong the life span and delay the onset and motor neuron loss in SOD1-G93A ALS mice.

AIM: To observe the effect of Baoxin capsules on hemodynamics of ischemic myocardium of dogs. METHODS: Fed Baoxin capsule for continuous three days, left anterior descending branch of the coronary artery of the dogs were ligated to observe the change of cardiac output, blood pressure and ?dp/dt max in different time of myocardial ischemia. RESULTS: Baoxin capsules increased the blood flow obviously, and increased left ventricular function simultaneously, the difference with ischemic group is significant (P

Objective To obtain a single toxin component from the jellyfish Cyanea capillata and provide a foundation for the further study on bioactivity and function of the serine proteases from C.capillata.Methods Primers designed with restriction enzyme were used to amplify the coding region of cDNAs (CcSP1, CcSP2 and CcSP3).PCR fragments were ligated with the pET-24a( +) vector to construct the recombinant plasmids (pET24a-CcSP1, pET24a-CcSP2 and pET24a-CcSP3).After screening and identification,the recombinant plasmids were transformed into the Rosetta (DE3).plysS for protein expression.After induction with IPTG, SDS-PAGE and Western-blot were used to detect the expression of the recombinant proteins.Results SDS-PAGE showed that the proteins of rCcSP1, rCcSP2 and rCcSP3 were expressed in a single band at about 34 kDa, 42 kDa and 42kDa, respectively.Western-blot detection with anti-His antibody further confirmed that these recombinant proteins were His-tagged CcSP1, CcSP2 and CcSP3 fusion protein were obtained.Conclusion Prokaryotic recombinant plasmids of C.capillata serine proteases are contructed and recombinant proteins are obtained, which establishes the foundation for future study on the function of serine proteases from jellyfish.

Objective:To investigate the calcium-phosphate metabolic condition in maintenance hemodialysis patients with chronic kidney disease (CKD), and to observe the effect of large dose calcitriol on secondary hyperparathyroidism (SHPT).
Methods:We tested and compared the serum levels of calcium, phosphate, intact parathyroid hormone (iPTH), and alkaline phosphatase (AKP) in hemodialysis patients at different hemodialysis time (Group A with hemodialysis period≤3 years and Group B with hemodialysis period>3 years). We also detected those indexes before and after treating SHPT with large dose calcitriol. Twenty SHPT patients were divided into Group I (enlargement of parathyroid gland or nodule detected by color Doppler ultrasound) and Group II (normal parathyroid gland detected by color Doppler ultrasound).
Results:In the maintenance hemodialysis patients, the serum phosphate was (2.11±0.38) mmol/L and iPTH was (581.11±487.75) pg/mL. The serum level of iPTH in Group B was higher than that in Group A [(828.13±690.39) pg/mL vs (477.94±324.73) pg/mL, P<0.001]. In Group I, the serum level of iPTH [before vs after:(2471.7±898.3) pg/mL vs (2510.4±825.7) pg/mL] and AKP [before vs after:(524.2±18.8)U/L vs (511.3±19.3)U/L] did not change after the treatment of large dose calcitriol (P>0.05). In Group II, the serum level of iPTH [before vs after:(1358.5±302.8) pg/mL vs (369.3±43.4) pg/mL, P<0.001] and AKP [before vs after:(565.9±23.9)U/L vs (234.8±21.1)U/L, P<0.001] decreased signiifcantly after the treatment of large dose calcitriol.
Conclusion:Patients with longer time of hemodialysis have a higher level of iPTH. Large dose calcitriol can improve the clinical syndrome of SHPT, and decrease the level of iPTH and AKP in SHPT patients with normal parathyroid gland.

ProTide technology is a kind of prodrug design strategy invented by the team of Christopher McGuigan. ProTides are aryloxyphosphoramidates (or aryloxyphosphonamidates) which contain a phosphorus atom combined with an amino acid ester and an aryloxy group. These prodrugs can efficiently cross the cell membrane and escape from the first rate-limiting step of phosphorylation, which afford effective solutions to the drawbacks of current nucleoside analogues. At present, ProTide technology has been extensively applied in the field of antiviral research. It has been successful in providing a number of approved drugs and clinical candidates, such as sofosbuvir and so much more, highlighting the promising future in drug discovery. This review summarizes the brief history and characteristics of ProTide technology, as well as its application in the exploration of antiviral drugs.

Objective To observe the pathologic features on cardiac allograft and to test archived endomyocardial biopsy specimens for antibody-mediated rejection specific marker-C4d deposition and its characteristics by using immunoperoxidase (IP) techniques. Methods From January 2003 to December 2007,10 recipients underwent orthotopic cardiac transplantation and 17 specimens of endomyocardial biopsy were obtained either for a protocol basis (generally at 1 st month,3rd month,1st year and 2nd year post-transplant) and on immediate clinical indications.All specimens of endomyocardial biopsy were collected for histopathological examination and C4d immunohistochemical staining,simultaneously. All pathological diagnoses were done according to 2004 International Society for Heart and Lung Transplantation (ISHLT) recommendation working formulation and AMR Schema,and C4d staining intensity were graded and recorded as 0 to 3 +.Results Except 1 specimen unqualified,all 16 consecutive specimens of endomyocardial biopsy were qualified.There were 4 cases of acute T cell-mediated rejection (all graded 1 ),2 cases of Quilty lesion,and 7 cases of antibody-mediated rejection,who were documented according to ISHLT Schema and C4d deposition.Meanwhile,there were 6 cases showing evidence of antibody-mediated rejection without concurrent acute cellular rejection and only one case concordant with acute T cell-mediated rejection.One case of antibody-mediated rejection died 20 months posttransplantation due to combined transplant coronary artery disease (TCAD). The C4d in the cardiac allograft was deposited in microvasculature diffusively.Conclusion Antibody-mediated rejection is an important clinical entity following orthotopic heart transplantation and is difficult to diagnosis except to perform endomyoeardial biopsy.Immunoperoxidase staining for C4d is a sensitive and specific technique for detecting one marker of antibody-mediated rejection.

Objective To compare the clinical effect and safety of peroral endoscopic myotomy (POEM) with surgical therapy in treatment of esophageal achalasia. Methods 78 patients diagnosed as esophageal achalasia from January 2012 to October 2014 were enrolled in the study and divided into POME group and Heller group. There were 42 patients in POEM group and 36 patients in Heller group. The clinical symptom remission rate, LES resting pressure, Eckardt scores, complication rate, length of hospital stay and the hospitalization expenses were analyzed between the two groups. Results The patients in POEM group and Heller group both got clinical remissions after the treatment. There was no statistical difference in the rate of complication occurrence, Eckardt scores and LES resting pressure between the two groups. Patients in POEM group had shorter operation time, hospital stay and less expenses compared with the Heller group. Conclusions Compared with Heller group, the POEM group has the similar curative effect in treatment of esophageal achalasia. The POEM as a minimally invasive surgery has the advantages of less pain and trauma, shorter hospital stay, well tolerated and low cost. Therefore, the POEM is worth to be popularized and applied in treating esophageal achalasia.

Objective To analyze the clinical characteristics and outcomes of angiographically confirmed drug-eluting stent thrombosis (ST). Methods All the angiographically confirmed ST was enrolled in the study from March 2005 to March 2009. Clinical data, angiographic outcomes, procedures of PCI, and anti-platelet treatment of ST were retrospectively collected. Results Total 20 cases of ST included 18 cases (90.0%) of sirolimus and derives eluting stents and 2 cases (10.0%) of paclitaxel eluting stent. Ten (50.0%) stent thromboses were subacute, 1 (5.0%) were late, and 9 (45.0%) were very late. ST reoccurred in 3 cases and occurred simultaneously in two arteries in 1 case. All the cases presented with ST-segment elevation myocardial infarction (STEMI). ST occurred in 16 cases after emergency PCI and 4 cases after selective PCI. Nine late stent thrombosis occurred after clopidogrel cessation. Long stents (stent length ≥ 30 mm) were implanted in 12 cases (60.0%), of which overlap stents were implanted in 8 cases (40.0%).Balloon angioplasty was used in 16 cases (80.0%). The 2 patients died from STEMI during hospitalization and 1 patient accepted coronary artery bypass graft for repetitive ST. Conclusions Angiographically confirmed ST appears rarely, but most frequent ST presents with STEMI. ST is related with long stent implantation and emergency PCI. Balloon angioplasty is frequently used for ST. Some patients have the risk of multiple arteries and repetitive ST.