Objective To explore the relationships between cholangiocarcinoma and clonorochiasis or hepatolithiasis,and to compare their MRI features.Methods The MRI features in 37 patients with cholangiocarcinoma confirmed by surgery and pathology were retrospectively analyzed,including clonorchiasis with cholangiocarcinoma in 21 (group A)and hepatolithiasis with this tumor in 16 (group B).The analyzed parameters included the location,size,shape,signal intensity and enhancement pattern of the tumor and the characteristics of bile duct dilatation.Results In group A,the tumors were located in the right lobe in 12 (57.2%),left lobe in 4 (19%),and porta hepatic in 5 (23.8%).In group B,those were located in the right lobe in 3 (18.7%),left lobe in 9 (56.3%),and porta hepatic in 4 (25%).There was a significant difference in the left/right lobe between two groups (P<0.05),however,no significant difference was found in porta hepatic (P>0.05).The MRI showed the tumors with low signal on T1 WI and high or heterogeneous signal on T2 WI,and with peripheral enhancement in early stage and delayed centric enhancement in 34 patients.Diffuse saccular dilatations of terminal intrahepatic bile ducts were showed in 1 6 (7 6 .2%)in group A and 1 (6 .2%)in group B,meanwhile the dilatations of bile ducts within tumors were showed in 2 (9.5%)in group A and 13 (81.3%)in group B,exhibiting significant differences between the two groups (P<0.05).Conclusion Clonorochiasis and hepatolithiasis are related with the cholangiocarcinoma.No differences in MRI features of cholangiocarcinoma are found between the two groups,however significant differences in location and the features of bile duct dilatation are observed.

Acquired Hyperostosis Syndrome ; therapy ; Combined Modality Therapy ; Humans ; Integrative Medicine ; Male ; Middle Aged

Objective To systematically review the effect of team-based learning (TBL) versus the traditional lecture-based learning (LBL) teaching model on basic medical courses in undergraduate medical education. Methods The CNKI, VIP and Wanfang medical databases were electronically searched to retrieve randomized controlled trial studies on TBL applied in undergraduate basic medi-cal courses up to June 2014. In these studies TBL teaching model was used in experiment group with LBL teaching model as control group and course grades were adopted to evaluate the effect of learn-ing. Literature screening, data extraction, and quality assessment were performed in strict accordance with the inclusion and exclusion criteria, and then data were analyzed using RevMan 5.3 software. Results This Meta-analysis examined 12 studies, all of them with low quality at C level. Meta analysis shows that the score of the course of TBL teaching is better than the traditional LBL teaching, and the difference is statistically significant [weighed mean difference (WMD): 9.33, 95%CI (5.67, 13.00), P=0.000]. Conclusion Compared with the LBL teaching, the application of TBL teaching in medical undergraduate basic medical courses has the promotion effect, but need more rigorously randomized controlled trials to verify.

BACKGROUND: The problem of the high rate of acute restenosis at an early and advanced stage has been a hot spot, while the stent with paclitaxel (poly-L-lactide, PLLA/polyglycolic acid, PGA) degradable material will resolve it. OBJECTIVE: To seek an ideal biologic degradable material used in biologic degradable stent. DESIGN, TIME AND SETTING: The comparative cytological study was performed at the Laboratory of Toxicology, Institute of Public Health, Jilin University (Key Laboratory of Radiobiology of Ministry of Public Health of China, Key Laboratory of Toxicology of Jilin Province) from July 2003 to July 2005. MATERIALS: Paclitaxel degradable material (PLLA/PGA) (PLLA:PGA= 9: l ) were offered by Changchun Applied Chemistry Institute of Chinese Academy of Science). Human umbilical arterial smooth muscle cells (SMCs) were purchased from Boster, Wuhan, China. METHODS: The sixth passage of SMCs were digested by 0.25% Trypsin under ambient temperature for 3 minutes, incubated in 10 mL 10% ox serum BMEM, and made into SMC suspension. The materials kept in hypothermal disinfectant Co60 were heated to 37 ℃ by waterbath after surface treatment, and then placed in a 6-well culture plate. SMC suspension was added into the middle of the materials. The density of cells was about 5×106/cm2. Cell suspension diffused around the materials gradually. At last, 10% ox serum BMEM culture solution was added into it, and cultivated in a 5% CO2 incubator at 37 ℃. The growth of cells in and surrounding the materials was observed by inverted microscope everyday. MAIN OUCOME MEASURES: The materials were obtained after culture for 3, 6, 12, 19, 26, 34 days and vacuum dehydration, and were weighed. The weight loss of materials was compared before and after culture. The average degradable rate of materials was calculated.RESULTS: Degradable material had no influence on the development of SMCs. The average degradation rate ex vivo was 0.45% per day. CONCLUSION: PLLA/PGA with good cellular compatibility could be applied to intravascular stents.

Fifty adult lower limbs were studied macromicroscopically to reveal the extrinsic blood vessels of the menisci of the knee joint. It was found that the menisci were supplied from 2 sources, the genicular branches (except the superior lateral genicular branch) of the popliteal artery, and the descending branch of the descending genicular artery. A pair of additional genicular branches with independent stems from the popliteal artery, named as the posterior medial and the posterior lateral genicular arteries by the authors, constantly supplied the posterior part of both the menisci. The arterial branches formed a circular anastomotic arch around the menisci with small branches springing from the arch and getting into the menisci. The arterial arch communicated with the femoral and the popliteal arteries and became an important stem of a reentry channol in cases of popliteal artery occlusion.

Objective To explore clinical features of bloody ascites.Methods 45 cases of bloody ascites were analyzed as for their clinical characteristics,laboratory examinations, X-ray and endoscope.Results Of 45 cases , 28 cases were males and 17 females with average age of 44 5 years old, 34 cases were malignant tumors,11 cases were non-malignant tumors .Conclusion The incidence of bloody ascites is much high in the malignant tumors,non-malignant ascites is also commonly found in the tuberculous peritonitis.

Objective To observe the difference of FKBP-12 expression level between in Alzheimer's disease model mice's brains and in control mice's brains.Methods Taking the Senescence Accelerated Mouse imported from Japan(SAM-P/8)as the Alzheimer's disease model mouse,and SAM-R/1 mouse as control,observe the distribution difference of FKBP-12 between in Alzheimer's disease model mice's brains and in control mice's brains both in mRNA level and in protein level with the methods of RT-PCR and immunohistochemistry staining.The mice were divided into four groups of 4,6,8,10 months old.Results There was no distribution difference of FKBP-12 between in Alzheimer's disease model mice's brains and in control mice's brains both in mRNA level and in protein level.Conclusion FKBP-12 probably has no relativity with the accelerated aging process of the Alzheimer's disease model mice imported from Japan.

Objective To investigate clinical characteristics and outcomes of twin pregnancies complicated with growth discordance.Methods Five hundred and seventy-six twin pregnancies who delivered between January 1,2000 and July 31,2012 in Peking University First Hospital were retrospectively analyzed.Cases with twin-twin transfusion syndrome had been excluded.Fetal weight was estimated by abdominal circumference and femur length; neonatal birth weight was recorded.The weight difference between two babies was divided by the weight of the bigger one to obtain the differential ratio.Twin pregnancy complicated with growth discordance was diagnosed if the ratio was equal or greater than 25％ (discordance group,n=68),and growth concordance was diagnosed if the ratio was less than 25％ (concordance group,n=508).The incidence of twin pregnancies complicated with growth discordance was analyzed.The incidence of maternal complications,premature delivery,perinatal death and neonatal complications were compared between the two groups.Chisquare test and t test were used for statistical analysis.Results The incidence of twin pregnancies complicated with growth discordance was 11.8％ (68/576).The incidence of growth discordance in monochorionic twins was higher than that in dichorionic twins [17.6％ (40/227) vs 8.0％ (28/349),x2=11.40,P＜0.05].The gestational age at delivery in the discordance group was earlier than that in the concordance group [(35.6±4.1) weeks vs (36.6±3.2) weeks,t=-1.66,P＜0.05],and the incidence of premature delivery in the discordance group was higher than that in the concordance group [58.8％ (40/68) vs 47.6％ (242/508),x2=3.85,P＜0.05].The perinatal mortality in discordance group was higher than that in the concordance group [9.6％ (13/136) vs 4.7％ (48/1 016),x2=5.84,P＜0.05].Among babies in discordance group,the incidence of intracranial lesion in monochorionic twins was higher than that in dichorionic twins [20.9％ (14/67) vs 6.8％ (3/44),x2=4.06,P＜0.05].Conclusions Twin pregnancies with growth discordance are prone to adverse pregnancy outcomes.Prenatal care should be strengthened and fetal condition should be assessed timely.It is suggested that neonates should undergo overall checkup and long-term follow-up.

Objective To study the effect and the mechanism of sibelium on apoptosis and transcription of bcl 2 clan and interleukin 1? converting enzyme(ICE) gene in limbic system after rats' middle cerebral artery occlusion(MCAO).Methods MCAO model was made, and determined the dynamic changes on the cell counts of apoptosis, bcl 2 clan and ICE gene positive transcription in temple ortex, hippocampus and hypothalamus in the controls of normal saline,sibelium 50 ?g intervenient group and sibelium 100 ?g intervenient group during rats MCAO or reperfusion.Results The apoptosis counts of every times in sibelium 100?g intervenient group was significant lower than another two groups( P 0.05).The bcl 2 gene positive transcription cell counts at every times in sibelium 100?g intervenient group were significant higher than another two gruops( P

Objective To evaluate the second generation micro-endoscopic discectomy (MED) system in the treatment of lumbar disc herniation. Methods Eighty-five patients with single or double level lumbar disc herniation were treated with MED under epidural anesthesia from May 2000 to October 2001.Single disc herniation was in 72 cases, double disc herniation in 13 cases; lateral recess stenosis in 15 cases. Results The average following-up period was 14 months and the successful therapeutic results achieved 92 9%(79/85). the patients were allowed to walk 3 d and discharged 3～5 d after operation. The length of incision was only 1.6 cm. Conclusions MED has short-term satisfactory therapeutic efficacy in the treatment of lumbar disc herniation. The suitable indication and precise technique are the key for the operation.