The expressions of Livin and Caspase-9 were detected by immunohistochemical technique in 60 duode-nal adenocarcinoma tissues and 30 adjacent normal tissue. The positive expression rate of Livin in duodenal adeno-carcinoma tissues was significantly higher than that of adjacent normal tissue,and the expression of Caspase-9 was lower than that of adjacent normal tissue ( P<0.01 ) . The expression of Livin was negatively correlated with the ex-pression of Caspase-9 ( P<0.01 ) . The expression of Livin and Caspase-9 was closely correlated with the progress of pathological changes, degree of development,lymph nods metastasis,and clinical stages,but not with sex,age and tumor size ( P>0.05 ) . Livin and Caspase-9 were associated with occurrence and development of duodenal adeno-carcinoma,and the expression of the above two were negatively correlated. Livin and Caspase-9 may be considered as reliable markers for clinical diagnosis,therapy efficacy and the prognosis of duodenal adenocarcinoma.

Objective To discussion the efficacy and safety of single channel and double chinese -made biliary stent in high biliary malignant hilar obstructive jaundice .Methods We reviewed the clinical data of 24 malignant hilar obstructive jaundice patients treated with single channel and double chinese -made biliary stent from October 2012 to December 2013 retrospectively.Of which 9 cases(study group)were used for single channel and double stenttreatment,and 15 cases(control group)were treated by the bilateral channel;We compared the number of intraoperative percutaneous puncture hepatic duct , radiation exposure doses , operation time , drainage effectiveness and complication rates in the two groups .Results The average number of percutaneous puncture hepatic duct in the study group was 1.44 ±0.53 times,which was significantly lower than the control group (3.73 ±0.70 times).The fluoroscopy time and radiation exposure dose of study group was 1152.22 ±335.61 s and 653.22 ±207.02 mGy,which was slightly less than the control group (1236.93 ±463.43 s and 727.00 ±348.52 mGy),the difference was not statistically significant (P=0.638;P=0.572).Liver function was tested after 4 W, the drainage effectiveness of study group and the control group were 88.9%(eight-nineths),86.7%(thirteen-fifteenths),the difference was not statistically significant .One case occurred bile leakage in the study group ,2 pa-tients with hemobilia in control group ,both groups showed no serious complication .Conclusion The single chan-nel and double chinese -made biliary stent to treat high biliary malignant hilar obstructive jaundice is minimally injured and effective ,which can be selectively applied to treat patients with hepatic hilum malignant obstructive jaundice .

Objective To compare of flexible ureteroscope holmium laser lithotripsy and percutaneous nephrolithotomy in treating renal stones of ≤2cm.Methods In this retrospective study,we compared 120 patients of renal pelvic stones of ≤2cm size treated with FURS(n=62)or PCNL(n=58).Factors such as operation time,hospitalization time,stone-free rate(SFR),drop in haemoglobin level,and complications were analyzed.Results The stone burden of the FURS group and PCNL group was(1.4±0.2)cm and(1.6±0.3)cm respectively.In FURS group,The operation time was(28±12)min with postoperatlve fever in 3 cases;he hospitalization time was(3.7±1.8)days.The decrease of hemoglobin was(0.18±0.06)g/L.No major complication was recorded.The SFR was 85.5%(53/62)one week postoperatively and 95.2%(59/62)one month postoperatively.In PCNL group,the operation time was (42±15)min with postoperative fever in 2 cases and bleeding in 2 case.The hospitalization time was 6.8±1.5 days.The decrease of hemoglobin was(14.30±3.50)g/L.The SFR was 91.4%(53/58)one week postoperatively and 96.6%(56/58)one month postoperatively.Conclusion For renal stones≤2cm,FURS has the advantages of shortening operation time,reducing blood transfusion requirements,decreasing postoperative complications with a farely SFR compared with PCNL.FURS is a good alternative.

Objective To explore the effect of ankle strategy stability limit training on balance and gait in recovering stroke patients with hemiplegia. Methods Forty recovering stroke patients were randomized into an intervention group and a control group.The patients in the intervention group were given ankle strategy stability limit training using visual feedback on the static long sets of a Smart Equitest Balance Master (SEBM) machine.Those in the control group practiced routine postural balance training using mirror visual feedback in parallel bars.Both groups of patients practiced balance and posture control for 30 minutes,once daily,6 days a week for two weeks. Both groups were also given routine therapy and other rehabilitation.The patients' balance function was evaluated using the Berg Balance Scale (BBS),and their gait was assessed using the walk across technique (WA). Results There was no significant difference between the two groups with regard to general information,BBS scores or WA results before treatment.After 2 weeks of treatment,BBS scores as well as the step length and pace in the WA improved significantly in both groups,but all improved significantly more in the intervention group.There was no significant difference in width of gait. Conclusion Ankle strategy stability limit training can enhance weight-bearing on stroke patients' affected foot as well as their balance and the symmetry of their steps.

OBJECTIVEIn order to explore the therapeutic effect of tongxinluo capsule (TXLC) on diabetic nephropathy, the influence on plasma endothelin (ET-1) level of the drug was observed.

METHODSAll the 63 patients enrolled were randomly divided into the treatment group and control group. They were all treated with low protein diabetic diet, oral administration of hypoglycemic or injection of insulin, calcium antagonist according to level of blood pressure and supportive symptomatic treatment. To the treated group, 2 capsules of TXLC were given additionally three times a day. The efficacy was evaluated after 8 weeks' treatment. The chief indices observed before and after treatment were endogenous creatinine clearance rate (CCr), urinary albumin excretion rate (UAER), urinary beta2-microglobulin (beta2-MG), fasting blood-glucose (FBG) and ET-1.

RESULTSBefore treatment, no significant difference was shown in all the tested indices between the treated group and the control group. After treatment, levels of CCr, UAER, beta2-MG, ET-1 and FBG significantly changed in the treated group, showing significant difference as compared with those before treatment (P < 0.05). Moreover, comparison of these indices in the two groups after treatment, excepting FBG, also showed statistical significance (P < 0.01).

CONCLUSIONTXLC shows obvious effect in reducing plasma ET-1 and UAER, it is definitely effective in repairing the renal tubular interstitial damage, and effectively delay the progress of diabetic nephropathy, improve the renal function, and is favorable to ameliorate hyperglycemia auxiliarily.

Albuminuria ; urine ; Capsules ; Diabetic Nephropathies ; drug therapy ; metabolism ; Drugs, Chinese Herbal ; therapeutic use ; Endothelin-1 ; blood ; Female ; Humans ; Male ; Phytotherapy

Background:Small intestinal bleeding is difficult to diagnose and treat because of its complex etiology and limit to examination method. Aims:To analyze the etiology,diagnosis,treatment and prognosis of small intestinal bleeding. Methods:The clinical data of 118 consecutive patients with small intestinal bleeding admitted from Oct. 2006 to Oct. 2016 at Daping Hospital,the Third Military Medical University were retrospectively analyzed. Results:Melena was the most common manifestation of small intestinal bleeding (41. 5％),followed by dark bloody stool,positive fecal occult blood test,hematochezia,and anemia with unknown cause. The major causes of bleeding were benign or malignant tumors (43. 2％),vascular lesions (28. 0％)and inflammatory lesions (15. 3％). Diagnosis was made by means of capsule endoscopy,colonoscopy,digital subtraction angiography (DSA),barium meal examination,multi-slice CT (MSCT)and CT enterography (CTE). Forty-one patients were treated by surgical operation,7 by selective arterial embolization,2 by endoscopic therapy,56 by conservative therapy,and all these patients achieved hemostasis. One patient died of massive hemorrhage and 11 were discharged with giving up of treatment. Conclusions:The leading cause of small intestinal bleeding is tumor,followed by vascular and inflammatory lesions. Capsule endoscopy is able to make definite diagnosis with high accuracy,and MSCT is the most widely used diagnostic approach. In addition to conventional treatment,surgical operation,interventional and endoscopic therapies also play important roles in treating small intestinal bleeding.

Objective To observe the effect of electrical stimulation of the pelvic floor muscles (PES) combined with acupuncture on urinary dysfunction in patients with spinal cord injury (SCI). Methods Sixty-two patients with SCI were randomly divided into a treatment group ( n =31 ) and a control group ( n =31 ).All subjects received routine bladder function training and a drinking water schedule for 8 weeks.In addition,the treatment group was given PES 30-40 min/d 6 times/week and acupuncture for 30 min/d,6 times/week for the 8 weeks.Residual volume of urine was evaluated using ultrasound and a daily voiding diary.Uurodynamic examinations and catheter extraction were used to assess the urinary function pre- and post-treatment. Results No significant difference was found between the two groups before treatment,but after 8 weeks of treatment the residual volume of urine detected by ultrasound and voiding frequency were significantly lower in the treatment group than in the control group.First desire to urinate and maximal urinary bladder capacities in the treatment group were also significant higher than in the control group.The efficacy of treatment was also sustained significantly longer in the treatment group. Conclusion PES combined with acupuncture therapy is more effective than routine bladder function training for SCI patients with urinary dysfunction.

Objective To evaluate the prognosis and immunotherapy response of patients with bladder cancer by constructing a risk-score model of cellular senescence-related signature (SRS), as well as to explore the clinical application value of SRS in bladder cancer. Methods Senescence genes were screened from TCGA-BLCA, and cellular SRS genes were screened according to LASSO regression. A bladder cancer risk-score model was constructed based on the SRS genes to analyze the survival difference and model-fit degree of TCGA-BLCA high- and low-risk groups. Univariable and multivariable Cox regression was used to analyze the prognostic risk factors of bladder cancer. Overall survival differences of high- and low-risk groups in GEO-BLCA database were verified, and variations in immunotherapy responses were analyzed in IMvigor210 databases. According to the result of β-gal chromogenic reaction in bladder cancer and normal paracancer tissues, the existence of cell senescence was determined. Results Eight marker genes were screened, and patients were divided into high- and low-risk groups according to the median risk score constructed by the marker genes. The 5-year survival rate of high risk group was lower than that of low risk group (training and validation sets P < 0.05). The area under the ROC curve of TCGA-BLCA in 1-, 3-, and 5-year were 0.657, 0.660, and 0.688, and those for GSE13507 were 0.665, 0.665, and 0.613, respectively. SRS risk score can be used as an independent risk factor for the prognosis of patients with bladder cancer. The SRS risk score in the response group was lower than that in the non-response group during bladder cancer immunotherapy (P < 0.05). The β-gal staining of bladder cancer tissue was positive, but the β-gal staining of adjacent normal tissue was negative. Conclusion Cell senescence occurs in bladder cancer tissues. SRS risk score can predict the clinical prognosis of patients with bladder cancer, and patients with low score can benefit from immunotherapy. SRS is a reliable biomarker for the prognosis and immunotherapy response of bladder cancer.

To investigate the osteogenesis characteristics of cultured rat mesenchymal stem cells (MSCs) under bone induction condition.

OBJECTIVETo compare the curative effects on stenosing tenovaginitis of flexor digitorum treated with acupuncture knife therapy and blocking therapy so as to explore the better method.

METHODSThree hundred and four cases were randomly divided into acupuncture knife therapy group (164 cases) and blocking therapy group (140 cases). In acupuncture knife therapy group, hooking and cutting were applied on the pressure points and scleromas with Ren's hooked acupuncture knife; routine blocking therapy was applied in blocking therapy group. The curative effects of both groups after 1-2 treatments and the recurrence after treatment in following 6 months were observed.

RESULTSThe curative rate was 98.2% (161/164)in acupuncture knife therapy group, superior to that of 65.7% (92/140) in blocking therapy group; the recurrence rate was 1.9% (3/161) in acupuncture knife therapy group, inferior to that of 37.0% (34/92) in blocking therapy group. The differences are significant between groups (both P < 0.01).

CONCLUSIONThe curative effect of stenosing tenovaginitis of flexor digitorum treated with acupuncture knife therapy is superior to that of blocking therapy, with low recurrence rate.

Acupuncture Therapy ; Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Tendon Entrapment ; therapy