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.

Objective To investigate the different expression of various subtypes of human leukocyte antigen-G(HLA-G)in placenta of patients complicated with severe pre-eclampsia.Methods Ten placental samples from early-onset severe pre-eclamptic pregnancies and ten from late-onset severe preeclamptic pregnancies were collected as study group; ten placental samples from preterm pregnancies and ten from normal pregnancies were collected as control group.The levels of HLA-G protein in the four groups were measured by western blot and immunohistochemistry.Results(1)HLA-G1 protein decreased significantly in both the early-onset(2.4 ± 0.6 versus 2.9 ± 1.1,P ＜ 0.05)and the late-onset pre-eclampsia groups (3.5 ± 2.1 versus 4.2 ± 2.4,P ＜ 0.05).(2)HLA-G5 protein increased in the late-onset pre-eclampsia groups(1.8 ± 1.1 versus 1.1 ± 0.9,P ＜ 0.05); the increase in the early-onset pre-eclampsia group is not obvious(1.6 ± 0.9 versus 1.4 ± 0.7,P ＞ 0.05).(3)The level of HLA-G1 protein in placenta from patients complicated with premature labor is lower(2.9 ± 1.1 versus 4.2 ± 2.4,P ＜ 0.05); HLA-G5 protein does not change significantly(1.4 ± 0.7 versus 1.1 ± 0.9,P ＞ 0.05).(4)HLA-G1 and G5 proteins mainly express in the placenta extravillous cytotrophoblast cells.There is also a high level of expression around the blood vessels and in the extraembryonic mesoderm.Conclusions(1)HLA-G1 decreased significantly in both the early-onset and late-onset pre-eclamptic patients.(2)HLA-G5 increased in both the early-onset and late-onset pre-eclamptic patients,and the increase in the late-onset pre-eclamptic patients is obvious.(3)In late pregnancy,the level of HLA-G1 is lower in patients complicated with premature labor,this may be the result of its earlier pregnancy week; HLA-G5 does not change significantly.(4)HLA-G1 and G5 mainly express in the placenta extravillous cytotrophoblast cells.

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 investigate Bcl-2 and Bax gene expression in acute myelogenous Leukemia and the relationship between Bcl-2/Bax ratio and drug resistance.Method:Expression of Bcl-2、Bax was detected by immunohistochemical method while drug resistance of AML was detected by cell culture and MTT assay.Results:A high expression of Bcl-2 and a low expression of Bax were detected in AML,respectively,and the ratio between Bcl-2 and Bax was significantly higher than that in normal control (P＜0.01). The ratio in those who are resistant to chemotherapy was significantly higher than that in those sensitive to chemotherapy (P＜0.05).The responsiveness to chemotherapy of those with a high ratio was poorer than thos with a low ratio (P＜0.05).Conclusion:The alteration of Bcl-2 and Bax played certain role in the development of drug resistance in AML,the test of Bcl-2/Bax ratio may have great significance in choice of chemotherapeutic agents and also provide important information for outcome prediction.

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.

32 cases of children small cerebral abscess di-agnosed with CT scaning are reported. The maxi-mum diameter of the enhancement area was 2. 2cm. 29 cases did not give a history of infection. In30 cases, Epileptic seizures were usually the Initialand main symptoms, but local neurological signswere usually absent. All of the cases were treatedby antibiotic therapy. The duration of the therapyin most childhood patients was 2～3 months exceptthree who were over 3 months.