Objective To explore the interventional method to treat biliary recurrent jaundice after T tube drainage in patients with malignant obstructive jaundice due to cholangiocarcinoma. Methods 7 bili ary metallic stents were placed in 7 patients with recurrent jaundice after T tube drainage in cholangiocarcinoma cases. Results Stent placement was once successful in all 7 cases with successful rate of 100%. For all cases, TBIL,ALT,GTP and AKP values 7 days postoperatively were significantly lower than that of preoperation together with subsidence of jaundice satisfactorily for 100% after the treatment.Conclusions Percutaneous placement of biliary metallic stents was effective economic, minimal invasive and safe for palliation of biliary recurrent jaundice after T tube drainage in cholangiocarcinoma induced obstructive jaundice.

Objective To analyze the clinical features,and prognosis of the interstitial lung disease (ILD) in patients with dermatomyositis (DM) and polymyositis (PM) by chest X-ray,chest high-resolution CT scan (HRCT) and pulmonary lung function.Methods Thirty-three patients hospitalized with DM/PM associated ILD were retrospectively analyzed.Results Thirty-three patients with ILD were confirmed by HRCT.Abnormal pulmonary function tests were available in 82% of patients.Clinical-imaging analysis revealed that the pathological features of ILD were non-specific interstitial pneumonia (NSIP,57%) and unusual interstitial pneumonia (UIP,25%).UIP types showed a poor prognosis and high mortality (70%).Conclusion This study shows that HRCT is more sensitive for the diagnosis of ILD than lung function tests and chest X-ray.Combined HRCT and chest X-ray with lung function tests and blood gas analysis have shown that the major pathological types of ILD are NSIP and UIP,in which UIP are associated with high mortality and poor prognosis.

0.05).After treatment,blood serum E2 level in group M was (74.18?22.32) pmol?L-1,whereas that in group D was (24.96?3.94)pmol?L-1,there was significant difference(P0.05).Conclusion Clinical symptoms of patients with recurrent endometriosis in two groups are improved.Serum E2 level in group M remains in the follicular phase,but group D declines to postmenopausal range.Mifepristone does not result in lack of estrogen,ovulation recovers rapidly after treatment in group M compared with group D.Mifepristone and danazol have not obvious impact on blood serum cortisol.

Objective To investigate the expressions of apoptosis stimulating protein of P53 (ASPP)family in colorectal carcinoma tissue and to explore their relationship with the clinicopathological characteristics of colorectal carcinoma,and to clarify the effect of ASPP family in the development of colorectal carcinoma.Methods 45 cases of colorectal carcinoma tissue and 20 cases of healthy controls were selected. Among 45 cases of colorectal carcinoma tissue, there were 1 1 cases of well differentiated colorectal carcinoma, 2 1 cases of moderately differentiated colorectal carcinoma,and 13 cases of poorly differentiated colorectal carcinoma;7 cases of T1 stage colorectal carcinoma,8 cases of T2 stage colorectal carcinoma,25 cases of T3 stage colorectal carcinoma,and 5 cases of T4 stage colorectal carcinoma;19 cases of N1 stage with lymph node metastasis,26 cases of N0 stage without lymph node metatasis.The expressions of ASPP1,ASPP2,and iASPP in 45 cases of colorectal carcinoma tissue and 20 cases of normal colon tissue were detected by immunohitochemistry SP method,and the correlations between the expressions of ASPP family and the pathologic typing,infiltrative depth,and lymph node metastasis of colorectal carcinoma were analyzed. Results ①The immunohitochemical staining results showed that the ASPP family members expressed in colorectal carcinoma tissue and normal colon tissue, and there were no significant differences in ASPP1 and ASPP2 positive rates between colorectal carcinoma tissue and normal colon tissue (P>0.05);the positive expression rate of iASPP in colon cancer tissue was higher than that in normal colon tissue (P<0.01).② The expression of ASPP1 in colon caner tissue had no correlation with the differentiation degree of tumor cells (rs=0.163,P>0.05);the expression of ASPP2 positive rate was decreased when the differentiation degree of tumor cells reduced,they had positive correlation (rs=0.454,P=0.002);the expression of iASPP in colon cancer tissue had no correlation with the differentiation degree of tumor cells (rs=-0.171,P>0.05).③ The expression of ASPP1 in colon caner tissue had no correlation with the infiltrative depth of tumor (rs=-0.268,P>0.05);the expression of ASPP2 positive rate was decreased when the tumor infiltrative depth increased,they had negative correlation (rs=-0.348,P<0.05);the expression of iASPP in colonic carcinoma caner tissue had no correlation with the infiltrative depth of tumor (rs=0.231,P>0.05).④The expressions of ASPP1,ASPP2, and iASPP in colon caner tissue had no correlation with lymph node metastasis (rs=0.089,rs=0.044,rs=0.210, P>0.05).Conclusion The expression levels of iASPP in colon cancer and normal colon tissues are different,it may be useful for the diagnosis, differential diagnosis and evaluation in benign and malignant colorectal diseases. The expression of iASPP is negatively correlated with the pathologic typing and neoplasm staging of colorectal carcinoma,it indicates that iASPP can be used as a indicator in judging the prognosis of colorectal carcinoma.

To study the value of lung ultrasound score (LUS) in assessing the clinical outcome of patients with ventilator-associated pneumonia (VAP).A total of 99 VAP patients were enrolled in a prospective study.All patients met the diagnostic criterion of VAP based on the 2013 guidelines and admitted into our ICU from Jun 2013 to Jun 2015.All parameters were recorded on the diagnostic day (day 1) and day 5,including LUS,clinical pulmonary infection score (CPIS),chest X ray (CXR),Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score,Sequential Organ Failure Assessment (SOFA) score,etc.According to the CPIS,patients were divided into 2 groups(CPIS less than 6 and more or equal to 6).CPIS and LUS were similar on day 1 between two groups (P ＞ 0.05).However,on day 5,significant differences of CPIS and LUS were found between groups with CPIS ＜ 6 and CPIS≥6 (P =0.019 and P ＜ 0.001 respectively).LUS decreased on day 5 in CPIS ＜ 6 group and increased in CPIS ≥6 group.In CPIS ＜ 6 group,there was a positive correlation between LUS and CPIS on day 1 (r =0.375,P =0.003) and day 5 (r =0.590,P ＜ 0.001).CPIS ≥6 groupshowed the same trend on day 1 (r =0.484,P =0.002) and day 5 (r =0.407,P =0.011).LUS can be used to dynamically evaluate the clinical outcome of VAP.

Objective·To eliminate the effects of intraperitoneal injection of transmembrane activator and calcium modulator and cyclophilin ligand interactor-Ig (TACI-Ig) on the opitc neuritis and the integrity of myelin sheath in mice.Methods·Twenty-four C57BL/6J mice were randomly divided into 4 groups,which were blank control group,saline control group,low-dose (0.4 mg/kg) TACI-Ig group and high-dose (4 mg/kg) TACI-Ig group,with 6 mice in each group.All groups were received intraperitoneal injection every other day.The saline control group received 0.2 mL saline injection in the same way,and the blank control group was not given any intervention.After 20 d of treatment,the eyeballs and optic nerve tissues were collected from each mouse under anaesthesia,embedded in paraffin and stained with hematoxylin-eosin (H-E) and Luxol fast blue (LFB),respectively.Results·H-E staining indicated that optic nerve fibers arranged closely both in blank and saline control groups and the staining of tissues was uniform.The optic nerve structure of low-dose TACI-Ig group was similar to blank and saline control groups,while in high-dose of TACI-Ig group,the infiltration of inflammatory cells was observed.The inflammatory cell infiltration scores were not significantly different in all groups (P=0.610 3).The retinal structures of all groups were clear and distinct to observe,and single ganglion cells arranged tightly with complete cell shape,visible nucleus and uniform distribution.There was no difference in the retina structure among 4 groups.LFB staining indicated that there was no significant loss of the optic nerve myelin in 4 groups by microscope observation (P=0.473 6).Conclusion·Low-dose (0.4 mg/kg) TACI-Ig injection wouldn't damage the normal structure of optic nerves and retinal ganglion cells,meanwhile high-dose (4 mg/kg) of TACI-Ig injection might cause minor infiltration of inflammatory cells into retina.

Objective To investigate the inhibitory effects of silencing expression ofEZH2 gene on the cell proliferation of human QBC939 cells and its mechanisms. Methods The targeting siRNA was designed and trans-fected into QBC939cells. The expressions of EZH2 mRNA and protein were detected by real-time qPCR and west-ern blotting,respectively. The ability of cellproliferationwas analyzed by MTT assay and plate clone formation assay. Cell apoptosis and cycle percentage weremeasured by flow cytometry. Cell senescence was assessed byβ-galactosi-dase dyeing.The expressions of H3K27me3,P14ARF,P16INK4a,P53,P21 and E2F1 proteinwere determined by West-ern blotting.Results Compared with the control group ,the expressions of mRNAand protein were significantly elevat-ed in experimental group. The ability of cellproliferation in the experiment group was significantly down regulated , which could also cause a rise of G1/S phase ,but not a marked variation of apoptosis rate. Silencing EZH2 would induce a obvious senescence phenotype in QBC939 cells. EZH2-siRNA transferredcould also down-regulate the expressions of H3K27me3 and E2F1 protein,while up-regulating the expressions of P14ARF,P16INK4a,P53 and P21 protein in QBC939 cells.Conclusions Silencing EZH2 could induce a significant inhibition on cell proliferation of QBC939 cells,the mechanism of which may be associated with the senescence pathway regulation.

Objective To establish a rapid method for detection of drug-resistance mutation in HBV, based on PCR-MALDI-TOF MS, and to explore the influential factors on this method. Methods One hundred blood serum samples, which were collected from chronic HBV patients with single drug-resistance or multiple drug-resistance of Lamivudin, Adefovi, Entecavir and Telbivudine, and 10 kinds of mutant HBV plasmids were analyzed using PCR-MALDI-TOF MS and confirmed by PCR-based sequencing. Results Of 100 samples detected, thirty-one samples were positive for drug-resistance and 69 samples were negative. The PCR-MALDI-TOF MS results of 94 samples were completely consistent with PCR-based sequencing. Six samples were inconsistent , of which three samples were positive by the two methods, but more mutation loci were detected by PCR-MALDI-TOF MS than sequencing. The consistent rate of two methods was 94%,detection sensitivity was up to 100 copies/μl, and the cut off value of detectable mutation level was 5%.Conclusion PCR-MALDI-TOF MS could be used for rapid and simple analysis of the drug resistance for the clinical application with features of high sensitivity and accuracy, high throughput and automation.

Objective To study the preoperative application value of the three-dimensional angiography in surgical strategy for the elderly patients with meningioma. Methods Forty-two elderly patients aged 60 years and over with meningioma were examined preoperatively with multi-slice spiral CT angiography(MSCTA) and (or) 3 dimensional contrast-enhancement MR angiography(3D CE-MRA)as simulation group.In three-dimensional post-processing workstation,the oppression and invasion degree of the intracranial important blood vessels,nervous running zone and sinus,as well as surgical risks were evaluated. 28 elderly patients without the above examination were as control group. The operation time, blood transfusions and postoperative complications were compared between the two groups. Results All 42 cases of simulation group completed reasonable surgical plan and approach.The incidence of postoperative complications were lower in simulation group than in control group (35.7％ vs.50.0％,P＞0.05),intra-operative blood transfusion were significantly decreased in simulation group as compared with control group [(5301.0± 150.6) ml vs.( 621.4±226.7)ml,t=2.01,P=0.049],operation time after three-dimensional simulation were reduced as compared with control group [(257.1 ±72.6) min vs.(307.5±88.2)min,t=2.61,P=0.011].Conclusions Application of three-dimensional angiography in elderly patients with meningioma to evaluate the operative risk may help make reasonable surgical strategy,thus reducing the surgical trauma and complications.

Objective To probe a simple, safe, and minimally invnsive method to treat ectopic pregnancy with preservation of the organs. Methods Superselective catheterization of uterine artery through cannulation of right femoral artery was achieved in 56 patients with ectopic pregnancy. Location of the lesions involved, feeding arteries, and active bleeding were observed on angiography. 150 mg of methylamine neopterin diluted in 100 ml of saline water was infused slowly into the target artery. Small gelatin spongy particles with size of 0.5 mm in diameter were used to embelize the uterine artery until its branches were totally obliterated. Follow-up was undertaken to observe the results of the treatment. Results Suporselective uterine arterial infusion and embolization were successfully performed in all 56 patients without any related complications. Active bleeding in the peritoneum in 33 cases ceased soon after embolization. The embryos in 13 patients were confirmed to have died by ultrasound two days after the procedure. Beta-HCG value dropped to below 5 U/L within two to twelve days. Hemorrhage in the peritoneum dissolved after seven days in all cases. Mixed mass disappeared after one month. Histerosalpingography was performed three months after the procedure in 19 patients and patent fallopians were demonstrated in 11 patients. Conclusions Superselective uterine arterial infusion and embolization is a minimally invasive procedure, which can be used to effectively treat ectopic pregnancy by disabling the ectopic embryo and embelizing leaking arteries with the advantages of preserving the fallopian tubes.