Primary intrahepatic cholangiocarcinoma (ICC) is the second frequent malignant tumor in adult liver,and appears an increasing tendency worldwide.Gross type is frequently mass-forming and a tubular adenocarcinoma is shown as the typical histopathological appearance.Surgical resection is the only curative treatment,and liver transplantation is selected for the patients with early ICC.Rediofrequency ablation,transcatheter arterial chemoembolization or molecular targeted therapies should be considered in the treatment of the unresectable or recurrent patients.

Objective To evaluate the effects of percutaneous cholecystostomy (PCT) for the treatment of acute cholecystitis (AC) in poor-risk patients.Methods A retrospective clinical analysis was undertaken in poor-risk AC patients receiving PCT or emergency cholecystectomy (CCY) from April 2007 to December 2012.The success rate,complications,hospital stay and mortality,and readmission rate were compared between PCT and CCY groups.Results Of the 51 poor-risk acute cholecystitis patients,25 underwent PCT drainages and 26 received emergency CCY at an average age of 75 and 74 years respectively.The average intensive care unit length of stay was 13 days in PCT group and 5 days in CCY group (t =5.175,P =0.001).The mean hospital length of stay in PCT patients (21.3 days) was longer than that in CCY patients (9.8 days) (t =3.213,P =0.002).However,there was no significant difference in the overall hospital mortality,complications and successful rate between the two groups.No recurrence was observed in 19 out of 25 PCT cases after removing PCT catheter.The remaining six patients were readmitted for recurrent AC.Three of them were conservatively treated,while another 3 patients had PCT drainage anew and one of the three underwent delayed CCY 4 weeks after PCT replacement.The overall successful rate of PCT treatment was 76％.Conclusions Compared with emergency CCY,PCT has similar treatment effects in the successful rate of surgical management,morbidity,and overall hospital mortality although it is associated with longer hospital stays and higher readmission rate,which indicated that PCT is a convenient,safe and effective treatment option for poor-risk AC patients.

Chinese peacekeeping medical team established a Level II Hospital on Liberia in 2004. Peacekeeping medical teams abide by varieties rules on medical service support and establish management and maintenance system of medical instrument. More than 95% medical equipment is still kept in good condition after four years and the routine rate of self-maintenance of small medical equipments can be reached 95%. All the medical equipment have passed the half-yearly verification of ORI by UN, the experience have great value for future similar missions.

Objective:To investigate the efficacy and safety of laparoscopic hepatectomy combined with microwave ablation in the treatment of hepatocellular carcinoma(HCC)in elderly patients.Methods:A total of 125 elderly patients with HCC were divided into the control group(n=73)and the observation group(n=52)according to the surgical method.The control group received laparoscopic hepatectomy and the observation group underwent microwave ablation during laparoscopic hepatectomy.The operation procedures, lymphocyte subsets and postoperative recurrence were compared between the two groups.Results:The bleeding volume, drainage tube removal time and hospitalization length were lower in the observation group than in the control group( t=6.370, 7.260 and 7.136, respectively, P<0.05). CD8 levels decreased with time in both groups( Ftime=43.716, P<0.05), and the decrease of CD8 in the observation group was greater than in the control group( Ftime×group=5.179, P<0.05). The overall level of CD8 was lower in the observation group than in the control group( Fgroup=3.792, P<0.05). The levels of CD3, CD4 and CD4/CD8 increased with time in both groups( Ftime=85.692, 62.534 and 37.589, all P<0.05), and the increases of CD3, CD4 and CD4/CD8 in the observation group were greater than in the control group( Ftime×group=5.213, 6.513 and 6.721, all P<0.05). The overall levels of CD3, CD4 and CD4/CD8 were higher in the observation group than in the control group( Fgroup=6.571, 4.538 and 5.363, all P<0.05). The 2-year survival rate was higher in the observation group than in the control group(41 cases or 78.8% vs.45 cases or 61.6%, χ2=4.186, P=0.041). The 1-year and 2-year relapse-free survival rates were higher in the observation group than in the control group(1-year: 44 cases or 84.6% vs.50 cases or 68.5%, χ2=4.233, P=0.041; 2-year: 37 cases or 71.1% vs.39 cases or 53.4%, χ2=4.005, P=0.045). Conclusions:Laparoscopic hepatectomy combined with microwave ablation can improve the systemic immunity and the immunity of the microenvironment at the site of the tumor, reduce recurrence, and has better clinical outcomes.

Objective:To investigate the effect of liraglutide(LRG) on high glucose-induced oxidative stress injury in(H9c2) cardiomyocytes and its underlying mechanisms.Methods:A high glucose treatment was applied to H9c2 cells for 24 hours to establish an in vitro model of myocardial cell injury. Different concentrations of liraglutide(10, 100, 1000 nmol/L) were administered for intervention. Cell viability was evaluated using the CCK-8 assay, and changes in cell morphology were observed under an inverted microscope. After 24 hours of liraglutide(100 nmol/L) intervention following high glucose treatment, the levels of lactate dehydrogenase(LDH), superoxide dismutase(SOD), and malondialdehyde(MDA) in the cell supernatant were measured. RT-PCR and Western blotting were used to detect the mRNA and protein levels of silent information regulator factor 1(SIRT1) and forkhead box protein O1(FOXO1). Western blotting was also used to assess the acetylation level of FOXO1 protein. Small interfering RNA(siRNA) technology was employed to silence SIRT1 in H9c2 cells to confirm its role in the study. Results:Compared to the control group, the high glucose group showed decreased cell viability, cell structure damage, increased levels of LDH and MDA in the cell supernatant, decreased SOD levels, aggravated oxidative stress, decreased SIRT1 expression, and increased acetylation level of FOXO1(all P<0.05). Compared to the high glucose group, liraglutide intervention resulted in increased cell viability, improved cardiac cell morphology, reduced oxidative stress levels, increased SIRT1 expression, and decreased acetylation level of FOXO1(all P<0.05). When SIRT1 was downregulated, the protective effects of liraglutide were weakened(all P<0.05). Conclusions:Liraglutide has a protective effect against high glucose-induced oxidative stress injury in H9c2 cells, which may be associated with the upregulation of SIRT1 expression.

Objective To investigate the effect of epidermal growth factor receptor 2 (ErbB2) expression on invasion ofglioma cells and its possible mechanism.Methods Glioma TJ905 cells were cultured in vitro; and ErbB2 shRNA and overexpression vectors were constructed and transfected into Glioma T J905 cells to down-regulate and up-regulate the ErbB2 expression levels; empty vector plasmid was also transfected into the TJ905 cells as control group.Invasive ability changes of T J905 cells were measured by Transwell assay,and the expression levels of matrix metalloprotease (MMP)-2 and MMP-9 were identified by Western blotting.Results As compared with the ErbB2,MMP-2 and MMP-9 protein expression levels in the control group (62.34±5.72,62.34±5.72 and 69.76±6.25),those in the ErbB2 shRNA group were significantly decreased (34.82±4.91,58.73±4.48 and 52.32±5.23),while those in the ErbB2 overexpression group were significantly increased (69.76±6.25,87.34±7.96 and 94.39±6.12),with significant differences (P＜0.05).The mean cells crossing Matrigel in the ErbB2 shRNA group (28.5 cells/field) were obviously decreased,and those in the ErbB2 overexpression group were increased (82 cells/field) as compared with those in the control group (70 cells/field),with significant differences (P＜0.05).Conclusion ErbB2 expression can affect the invasiveness ofglioma cells,which might be related to the expression changes of MMP-2 and MMP-9.