Objective To explore the application value of the guide-wire for selective biliary cannulation of proximal biliary obstruction.Methods A total of 344 patients with proximal biliary obstruction were treated by endosocopic retrograde cholangio-pancreatography.Various guide-wire skills,were applied to pass through the stricture of bile duct,so as to reach the target bile duct,and analyzed for their therapeutic effects.Results Selective biliary cannulation of proximal biliary obstruction was completed in 336 patients,after successful cholangiography for therapeutic operation.The overall success rate was 97.67％.There was no procedure-related complications,such as hemobilia or perforation.Conclusion The guide-wire for selective biliary cannulation of proximal biliary obstruction not only improves the success rate of therapeutic endoscopy but also reduces the procedure time and the incidence of complications.

Objective To study the relationship of pit pattern in the progress of colorectal and the expression of PCNA and survivin in pit pattern. Methods Chromoendoscopy observation results were recorded according to the pit pattern classification proposed by Kudo. These results were divided into 6 groups according to the pit pattern and the results of histophathology. Expression of PCNA and surviving mRNA was detected by RT-PCR. Statistical analysis was performed using χ2 test , Fisher's exact test or Spearman rank correlation with SPSS 12.0 software package. Results In 6 groups classified according to the pit patterns, the expression rate of PCNA mRNA in type Ⅰ, Ⅱ, Ⅲ L, Ⅳ, V 1 and VN were 0% (0/13), 12.5% (1/8), 38.9% (7/18), 66.7% (12/18), 75.0% (3/4) and 100.0% (9/9), the expression rate of survivin mRNA in type Ⅰ,Ⅱ, Ⅲ L, Ⅳ, V 1 and V N were 0%, (0/13), 12.5% (1/8), 22.2% (4/18), 44.4% (8/18), 50.0% (2/4) and 77.8% (7/9), respectively. Conclusions The expression of survivin and PCNA mRNA had positive correlation in the coloree-tal lesions classified whether by the pit patterns or histophathology. Study of the two genes simultaneously could complement each other and reflect the biological characteristics of colorectal cancer more accurately.

Objective To evaluate the endoscopic precut sphincterotomy for malignant biliary obstruction. Methods Endoscopic precut sphincterotomy was performed in different ways for 46 patients with malignant biliary obstruction and difficult biliary cannulation according to the anatomic structure of the papilla and cannulation. Ways of precut were summarized and complications were analyzed. Results Precut sphincterotomy was performed with bow-like knife in 4 patients, with needle-knife in 24, with trans-pancreatic sphincterotomy in 12 and with combined ways in 6. The procedure succeeded in 35 cases (76. 1%, 35/46). Post-procedure complications included bleeding in 3 patients, pancreatitis in 1, hyper-amylasemia in 2and cholangitis in 1. No perforation was found. Conclusion Endoscopic precut sphincterotomy is not only able to improve the therapeutic endoscopy achievement rate in patients with malignant biliary obstruction, but also to lower the incidence of complications if used adequately.

PURPOSE: To report the use of multiband accelerated echo-planar imaging (EPI) for resting-state functional MRI (rs-fMRI) to achieve rapid high temporal resolution at 3T compared to conventional EPI. MATERIALS AND METHODS: rs-fMRI data were acquired from 20 healthy right-handed volunteers by using three methods: conventional single-band gradient-echo EPI acquisition (Data 1), multiband gradient-echo EPI acquisition with 240 volumes (Data 2) and 480 volumes (Data 3). Temporal signal-to-noise ratio (tSNR) maps were obtained by dividing the mean of the time course of each voxel by its temporal standard deviation. The resting-state sensorimotor network (SMN) and default mode network (DMN) were estimated using independent component analysis (ICA) and a seed-based method. One-way analysis of variance (ANOVA) was performed between the tSNR map, SMN, and DMN from the three data sets for between-group analysis. P < 0.05 with a family-wise error (FWE) correction for multiple comparisons was considered statistically significant. RESULTS: One-way ANOVA and post-hoc two-sample t-tests showed that the tSNR was higher in Data 1 than Data 2 and 3 in white matter structures such as the striatum and medial and superior longitudinal fasciculus. One-way ANOVA revealed no differences in SMN or DMN across the three data sets. CONCLUSION: Within the adapted metrics estimated under specific imaging conditions employed in this study, multiband accelerated EPI, which substantially reduced scan times, provides the same quality image of functional connectivity as rs-fMRI by using conventional EPI at 3T. Under employed imaging conditions, this technique shows strong potential for clinical acceptance and translation of rs-fMRI protocols with potential advantages in spatial and/or temporal resolution. However, further study is warranted to evaluate whether the current findings can be generalized in diverse settings.
Dataset ; Echo-Planar Imaging* ; Magnetic Resonance Imaging* ; Methods ; Signal-To-Noise Ratio ; Volunteers ; White Matter

Objective: To study the oxidative damage of di- (2-ethylhexyl) phthalate (DEHP) on MCF-7 cells, and to investigate the effects of 3β-hydroxysteroid dehydrogenase (3β-HSD) gene silence or overexpression on DEHP-induced oxidative damage. Methods: MCF-7 cells, 3β-HSD gene silencing cells and 3β-HSD gene overexpression cells were treated with different doses of DEHP (0,0.05,0.1,0.2,0.4,0.8 mmol/L) for 24h, then intracellular oxidative damage index such as MDA, SOD, GSH, GSH-PX were detected, DNA repair gene hOGG1, hMTH1 mRNA expression were tested by Q-PCR, hOGG1, hMTH1 protein expression were detected by western blot. Results: After MCF-7 cells were treated by DEHP, MDA levels increased; SOD activity, GSH content, GSH-PX activity decreased, hOGG1 and hMTH1 mRNA expression levels increased, hOGG1 and hMTH1 protein expression levels increased, the differences were statistically significant when compared with control (P<0.05 or P<0.01) . In 3β-HSD gene silencing cells which were treated by DEHP, when compared with the same dose group of MCF-7 cells, MDA content increased, SOD activity, GSH content, GSH-PX activity decreased, hOGG1 and hMTH1 mRNA expression levels decreased, hOGG1 and hMTH1 protein expression levels decreased, the difference were statistically significant (P<0.05 or P<0.01) . In 3β-HSD gene overexpression cells which were treated by DEHP, when compared with the same dose group of MCF-7 cells, MDA content decreased; SOD activity, GSH content, GSH-PX activity increased, of hOGG1 and hMTH1 mRNA expression levels increased, hOGG1 and hMTH1 protein expression levels increased, the difference were statistically significant (P<0.05 or P<0.01) . Conclusion DEHP could cause oxidative damage in MCF-7 cells, induce the changes of related genes and proteins, 3β-HSD plays an antioxidant role in the process of DEHP ox-idative damage.

Objective: To study the effect of particulate matter 2.5 (PM_2.5) on oncogene expression in human bronchial epithelial (HBE) cells. Methods: HBE cells were selected as the study subjects, and PM_2.5 treatment group (10 μg/ml and 50 μg/ml) , negative control group and positive control group (10 μmol/L Cr⁶⁺) were set. CCK8 assay was used to test the IC₅₀ value of PM_2.5. HBE cells were treated with PM_2.5 for 24 h at 10 μg/ml and 50 μg/ml, additionally, cells were treated with blank as negative control, 10 μmol/L Cr⁶⁺ as a positive control for 24 h. After the treatment, mRNA expression of oncogenes including c-myc, c-fos, k-ras and p53 were detected by fluorescent quantitative RT-PCR, the protein expression of oncogenes were detected with western blot. Results: The IC₅₀ value of PM_2.5 in HBE cells is 70.12 μg/ml. The qRT-PCR data showed that compared with the control group, the expression level of c-myc gene increased by respectively 500.1%、780.7%、305.3% after exposure to 10、50 μg/ml PM_2.5 and positive control group; c-fos gene increased respectively 34.0%、76.7%、131.3% after exposure to 10、50 μg/ml PM_2.5 and positive control group; k-ras gene increased respectively 50.3%、107.0%、49.7% after exposure to 10、50 μg/ml PM_2.5 and positive control group; p53 gene decreased by 28.3%、28.7%、59.7% after exposure to 10、50 μg/ml PM_2.5 and positive control group. The western blot results showed that compared with the control group, c-myc protein increased respectively 29.7%、77.3% after exposure to 50 μg/ml PM_2.5 and positive control group; c-fos protein increased respectively 200.3%、137.0% after exposure to 50 μg/ml PM_2.5 and positive control group; k-ras protein increased respectively 106.3%、130.3%、116.7% after exposure to 10、50 μg/ml PM_2.5 and positive control group; p53 protein decreased by 43.7%、53.3%、52.1% after exposure to 10、50 μg/ml PM_2.5 and positive control group. Conclusion PM_2.5 could promote the expression of oncogenes in HBE cells, the carcinogenicity of haze might be related to promotion of oncogenes expression induced by PM_2.5.

Objective: To construct 3β-HSD gene shRNA lentivirus interference vecto, then transfect into human MCF-7 cells, and construct cell line with 3β-HSD gene silencing, finally to study the effects of 3β-HSD on apoptosis induced by di- (2-ethylhexyl) phthalate (DEHP) . Methods: According to the mRNA sequence of 3β-HSD gene provided by GenBank, three interference sequences were designed and connected to PLVX-shRNA2-puro after annealing. The recombinant lentivirus vector was transfected into 293FT cells, the virus supernatants were collected and infected with MCF-7 cells. After puromycin screening, MCF-7 cells with 3β-HSD gene silencing were constructed. The cells with 3β-HSD gene silencing were identified by real-time quantitative PCR and western blot. Then the 3β-HSD gene silencing cells and MCF-7 cells were treated at various doses of DEHP for 24 hours to detect the gene expression and protein expression of apoptosis genes including Bax, Caspase-3 and Caspase-8. Results: The interference sequence of 3β-HSD gene inserted into lentivirus vector PLVX-shRNA2-puro is consistent with the designed sequence. 3β-HSD gene expression level in MCF-7 cells with 3β-HSD gene silencing was 77% lower than than that of control MCF-7 cells. 3β-HSD protein level in MCF-7 cells with 3β-HSD gene silencing was 74% lower than that of control MCF-7 cells. After DEHP treatment in MCF-7 cells with 3β-HSD gene silencing and control MCF-7 cells, qRT-PCR results showed that Bax gene expression levels increased by 28%-54%, Caspase-3 gene increased by 13%-49%, Caspase-8 gene increased by 21%-70% in MCF-7 cells when compared with the control group. Additionally, in the 3β-HSD gene silencing cells, Bax gene expression level decreased by 11%-28%, Caspase-3 gene expression decreased by 12%-23%, Caspase-8 gene expression decreased by 11%-34%, compared with the same treatment group of MCF-7 cells. Western blot results showed that Bax protein expression level increased by 28%-61%, Caspase-3 protein expression level increased by 40%-48%, Caspase-8 protein increased by 31%-84% in MCF-7 cells when compared with the control group. In 3β-HSD gene silencing cells, Bax protein expression level increased by 11%-27%, Caspase-3 protein increased by 21%-40%, Caspase-8 protein increased by 12%-25%, compared with the same treatment group of MCF-7 cells. Conclusion The stable 3β-HSD gene silencing cell line are successfully constructed in this study. DEHP can induce increased expression of apoptotic gene and protein. Silencing of 3β-HSD gene can inhibit the activation of apoptotic gene by DEHP in a certain degree.

Objective : To explore the correlation between serum fibroblast growth factor⁃23 (FGF23) concentration and heart failure and all⁃cause death in patients with end⁃stage renal disease (ESRD) . Methods : The prospective cohort study design was used in the present study. The ESRD patients who were admitted to the department of nephropathy in the Hospital and without heart failure symptoms were recruited in this study. The data of patients was collected through baseline questionnaires , physical examinations , echocardiography , and laboratory examinations. The serum FGF23 levels were measured by enzyme⁃linked immunosorbent assay (ELISA) . The follow⁃up time was 2 years. The onset of heart failure (ACC/AHA stage C ⁃D) and all⁃cause death were composite endpoint events. The Cox proportional risk model was used to explore the risk factors of outcome events. Through subgroup analyses and interaction analyses , further exploration was conducted to determine whether there was heterogeneity in the association between FGF23 and outcome events in different subgroups. Results : Ultimately , 107 ESRD patients were included in this study , with an average age of (52. 00 ± 12. 51) years. There were 39 males (36. 45% ) , and the median follow⁃up time was 23 months (21 , 25 months) . There were 32 (29. 9% ) outcome events , of which 22 (20. 6% ) onset of heart failure and 10 (9. 3% ) all⁃cause of deaths. The results of this study showed that the concentration of FGF23 in the outcome event group was significantly higher than that in the non⁃event group [(4. 40 ± 1. 16) pmol/ml vs (3. 85 ± 0. 82) pmol/ml ,P < 0. 05] . The Cox proportional risk model showed that the elevated FGF23 was associated with increased risk of the composite endpoint events in ESRD patients (HR = 1. 730 , 95% CI: 1. 164 - 2. 570 , P = 0. 007 ) . Subgroup analyses showed that there was an interactive effect between FGF23 levels and gender on the risk of cardiovascular outcome events. Especially in male ESRD patients , the increased FGF23 level was correlated with a higher risk of cardiovascular events (P⁃interaction < 0. 05) . Conclusion Elevated serum FGF23 is an independent risk factor for the onset of heart failure and all⁃cause of mortality in ESRD patients , especially in male patients.

Objective : To employ the EQ-5D-5L questionnaire to evaluate HRQOL in patients on peritoneal dialysis ( PD) and investigate the related risk factors to provide suggestions for improving quality of life． Methods : PD patients who were followed up regularly in the department of nephrology were recruited in this study． Demographic characteristics and laboratory data were collected．Exercise capacity was assessed by the 6-MWT．PHQ-9 was con- ducted to screen depression status．The EQ-5D-5L questionnaire was used to evaluate HRQOL．Multivariate linear regression analysis was used to examine the potential influencing factors of EQ-5D-5L health utility value. Results : The highest health utility value of EQ-5D-5L was 1 point，while the lowest was －0. 01 points．The mean EQ-5D-5L score was (0. 92 ± 0. 15 ) ． The multivariate linear regression analyses showed that increased bilirubin level ( β = - 0. 009，P = 0. 018 ) ，increased CRP level ( β = －0. 005 ，P ＜0. 001 ) ，and increased PHQ-9 score ( β = - 0. 008，P = 0. 014) were negatively correlated with the EQ-5D-5L health utility value．Increased 6-MWD ( β = 0. 005，P = 0. 018) was positively correlated with the EQ-5D-5L health utility value． Conclusion The bilirubin and CRP levels，depression status，and exercise capacity are considered the main factors influencing HRQOL in PD patients.