Cholestasis refers to damage of bile formation or flow at the level of hepatocytes and/or bile duct cells,resulting in the inability of bile to excrete normally into the duodenum and deposit in the liver.Excessive bile acids and bilirubin cause liver cell damage and hepatic fibrosis until liver failure.Therefore,the specific mechanism for the occurrence and development of cholestasis is of great significance for the treatment of the disease and the prognosis of the patient.

Objective To investigate the effect of 620 nm red light on chondrogenic differentiation in rat precartilaginous stem cells (PSCs). Methods Rats' PSCs were isolated and purified using magnetically activated cell sorting and cultured in vitro.The PSCs were exposed once to 620 nm wavelength red light from a light-emitting diode (LED) with an irradiation energy of 0.5 J/cm2,1 J/cm2,2 J/cm2 or 4 J/cm2.Any effect was confirmed by Alcian blue staining,immunohistochemistry and observing histomorphological changes under a light microscope,as well as detection using a reverse transcription polymerase chain reaction (RT-PCR). Results After being induced for 14 d,the PSCs exhibited polygonal and round shapes. Alcian blue and type Ⅱ collagen immunohistoehemistry staining showed positive results,but the control group had no significant change.RT-PCR showed that the mRNA expression of Sox9 and type Ⅱ collagen increased significantly compared with the control group. Conclusion Low energy 620 nm red light can enhance chondrogenic differentiation in PSCs significantly.

Objective To investigate the hemodynamics of increasing portal venous pressure(PVP) in hepatocellular carcinoma patients complicated with hepatic arterioportal vein fistulas (HAPVF)and the diagnosis and therapy of intractable upper gastrointestinal hemorrhage caused by HAPVF.Methods One hundred and fifteen cases of hepatocellular carcinoma with upper gastrointestinal hemorrhage were checked by hepatic arteriography and were treated through orifices embolization in cases with severe HAPCF by coils and/or ethanol. Results Twenty-six out of 31 patients suffering intractable upper gastrointestinal hemorrhage have severe HAPVF(the main stem of portal veins are visible).However,there are only 15 patients with light HAPVF among the 84 patients who have mild upper gastrointestinal hemorrhage (the main stem of portal veins are invisible).After the embolization,all of the 26 patients who have severe HAPVF stopped bleeding.Among them,the main stem of hepatic arteries are occluded in 2 patients. Conclusion The existence of severe HAPVF should be taken into consideration when intractable upper gastrointestinal hemorrhage occurs in hepatocellular carcinoma patients,and it can be diagnosed through hepatic artery DSA.Orifice embolization is the most effective method for such kind of hemorrhage.

Objective To explore the effects of examine ways reform for nursing health education course.Methods We used the different examine ways for nursing health education course for nursing students enrolling in 2007 and 2008.A self-designed questionnaire was used to investigate the effects of the examine ways reform among nursing students.Results The evaluation of students about the new examine ways are obviously superior to those before reform,the difference was statistically significant (P ＜ 0.05 ).The scores of the students of Grade 2007 was ( 78.63 ± 4.36 ),the scores of Grade 2008 was ( 86.19 ± 4.42 ),the difference was wtatistically significant (t =16.91,P ＜ 0.01 ).Conclusions The new examine ways can improve nursing students' study interesting and initiative,exercise the comprehensive ability,develop team spirit,relieve their pressure and so on.

Intrahepatic cholangiocarcinoma (ICC) is a liver malignant tumor, and its incidence is second only to hepatocellular carcinoma, accounting for 5%-30% of patients with primary liver cancer. Usually it is characterized by insidious attack, high degree of malignancy, postoperative recurrence, and being asymptomatic at the early stage, most patients have developed into the advanced stage when the diagnosis is confirmed. Thus, early laboratory examinations and imaging judgments are particularly important, providing opportunities for early radical resection of patients. The purpose of this paper is to review and update the medical literature to provide new ideas for diagnosis and treatment of ICC.

Targeted drug delivery can significantly increase the concentration of the drug in treatment site, and decrease the dosage of drugs, cost of treatment and the drug's adverse effects on the body. So targeted drug delivery is the hotspot of recent studies. This paper reviews the development of targeted drug delivery research in recent years, including three areas: passive targeting, active targeting, and physical and chemical targeting.
Animals ; Antibodies ; metabolism ; Drug Carriers ; Drug Delivery Systems ; methods ; trends ; Emulsions ; Humans ; Liposomes ; Magnetics ; Microspheres ; Nanoparticles ; Pharmaceutical Preparations ; administration & dosage ; Photosensitizing Agents ; pharmacology ; Prodrugs ; Receptors, Cell Surface ; metabolism

Objective To compare the curative effect of open and minimally invasive treatment of acute closed achilles tendon rupture with 5 years followed-up study.Methods From September,2010 to January,2012,28 patients with acute closed Achilles tendon rupture in our hospital were followed up for 5 years.There were 21 males and 7 females.Minimally invasive percutaneous suture in 11 cases;open suture in the treatment of 17 cases.The patients were followed up at 6 months,1 year,2 years,3 years,4 years,and 5 years after AOFAS and ATRS score.Results The follow-up time ranged from 60 to 72 months.All incisions healed by first intention and no incision related complications occurred.2 groups of patients with ATRS score at 6 months after operation:the open group was 81.23±3.99,minimally invasive percutaneous group of 88.27±4.27,the difference between the two groups was statistically significantly.After 1 year,there was no significant difference in the scores between the two groups.Two groups of patients with AOFAS score at 6 months after operation:the open group was 69.00±6.23,minimally invasive percutaneous group of 79.27±4.83,the difference between the two groups was statistically significantly.At one year after operation,the open group was 85.53±3.38,and the minimally invasive group was more than 89.90±3.38.The difference between the two groups was statistically significantly.After 2 years,there was no significant difference in the scores between the two groups.Conclusion There is no significant difference between the 2 years after surgery in the treatment of acute closed Achilles tendon rupture or open surger.

Objective To observe skin test results of tetanus antitoxin prepared by different solvents.Methods Patients who needed injecting tetanus antitoxin as required by trauma were randomly divided into two groups, Group A and Group B, respectively. Group A was administered with tetanus antitoxin prepared by water for injection, while Group B with tetanus antitoxin prepared by saline. Skin test results were observed, the incidence of positive skin test results and self-inductance of pain intensity were compared.Results The incidence of positive skin test results in Group A was significantly higher than that in Group B (34.19% vs 17.50%,χ2=8.631,P<0.01), and the self-inductance of pain intensity were also greater than that in Group B. Patients with positive skin test results (40 patients) in Group A, were later injected tetanus antitoxin prepared by saline, 42.50% of them (17 patients) shown negative skin test results.Conclusions There might be a high false positive rate by using tetanus antitoxin prepared by water for injection; therefore tetanus antitoxin prepared by saline is recommended, for it could decrease the false positive rate, reduce unnecessary desensitization injections, alleviate patients' pain and improve nurses' work efficiency.

OBJECTIVETo identify potential mutation responsible for synpolydactyly (SPD) in a large Chinese kindred and to offer genetic counseling and prenatal diagnosis for the members of the family.

METHODSAll family members were examined clinically, and blood samples were obtained for linkage analysis and mutation screening. Ultrasound examinations were conducted at 16-21 weeks. Amniotic fluid sample was obtained by ultrasound-guided amniocentesis at 18 weeks of gestation.

RESULTSA large kindred affected with SPD was identified and characterized. With two short tandem repeat (STR) markers (D2S1238 and D2S1245) flanking the HOXD13 gene, the disease was mapped to 2q31. A heterozygous 27 bp expansion within the imperfect GCN triplet-repeat of exon 1, c. 184_210dup, was identified. The mutation resulted in a gain of 9 alanine residues between the 14th and 15th alanine of the normal 15-amino-acid-long polyalanine tract. On ultrasound examination, all fingers and toes of the fetus appeared to be normal. Linkage analysis and mutation detection confirmed that the fetus did not inherit the mutant allele from his affected mother.

CONCLUSIONHOXD13 gene mutation was responsible for the SPD phenotype in this family. Accurate prenatal diagnosis of SPD was achieved with combined ultrasound and molecular analysis.

Adolescent ; Adult ; Base Sequence ; China ; DNA Mutational Analysis ; Female ; Fingers ; abnormalities ; Genetic Linkage ; Homeodomain Proteins ; genetics ; Humans ; Male ; Middle Aged ; Pedigree ; Pregnancy ; Syndactyly ; diagnosis ; genetics ; Toes ; abnormalities ; Transcription Factors ; genetics ; Ultrasonography, Prenatal ; Young Adult

Objective: To evaluate the effectiveness of therapeutic massage (tuina) for treating knee osteoarthritis (KOA). Methods: Six English and Chinese databases, including Chinese National Knowledge Infrastructure (CNKI), Wanfang Academic Journal Full-text Database (Wanfang), Chongqing VIP Database (CQVIP), China Biology Medicine Disc (CBM), Cochrane Library and PubMed databases, were independently searched to identify appropriate randomized controlled trials (RCTs) studying therapeutic massage for KOA compared to oral non-steroidal anti-inflammatory drugs (NSAIDs) alone. The main outcome measures were total effectiveness and the Western Ontario and McMaster Universities osteoarthritis index (WOMAC) score. Results: A total of 8 RCTs were included and they were of average quality. The results showed that therapeutic massage was more effective than NSAIDs comparing total effectiveness [risk ratio (RR)=1.14, 95％ confidence interval (CI) (1.07, 1.21), P<0.0001]; compared with NSAIDs, therapeutic massage produced more significant improvements in pain [mean difference (MD)=-2.06, 95％CI (-2.75, -1.36), P<0.00001], stiffness intensity [MD=-0.90, 95％CI (-1.05, -0.75), P<0.00001] and joint function [MD=-12.48, 95％CI (-13.91, -11.05), P<0.00001]. Conclusion: Therapeutic massage was more effective than oral NSAIDs in treating KOA. In relieving pain and stiffness and improving the function of knee joint, therapeutic massage was superior to NSAIDs.