Cholangiocarcinoma is the second most common malignant tumor after primary hepatic cancer.Despite advances in diagnostic techniques during the past decade, cholangiocarcinoma is usually encountered at an advanced stage. In this review, we describe the classification, diagnosis, and management of cholan-giocarcinoma with obstructive jaundice.

Objective To explore changes humoral immune factors and MDA in DEACMP patients.Methods 40 cases with carbon monoxide poisoning delayed brain were selected to be experiment group.40 cases of healthy people were selected to be control group.IL-2,IL-6,IL-10 and MDA were before and after treatment.Results IL-2,IL-6 of the experiment group were lower,IL-10,MDA were higher than the control group before treatment (P<0.05),both of IL-2,IL-6,IL-10 and MDA were recovery after the treatment (P<0.05).IL-6 of the experiment before treatment was significantly correlated with MMSE score(r =0.34,P <0.05).More severe cognitive impairment, the higher the level of concentration of IL-6(P<0.05). Conclusion The immune inflammatory cytokines and MDA play an important role in acute carbon monoxide poisoning delayed encephalopathy pathogenesis.Detection of the levels for judging the severity of the patient’s condition and prognosis has important significance.

New developments appear in digestive tract anastmosis with better understanding to its healing process and the adoption of new techniques, such as single-layer anastomosis, combined suturing and me-chanical anastomosis. These issues are reviewed in this article.

In the state of the stress,macrophage apoptosis is increased,function of secretion disordered and the ability of antigen-presenting redused,so the defense system is significantly reduced.This is one rea-son of complications including infection,sepsis,systemic inflammatory response syndrome and multiple or-gan failure.But mild heat stress may promote the immunological function of splenic macrophage.

Objective To investigate the clinical significance of soluble Mer receptor tyrosine kinase (sMerTK) in patients of systemic lupus erythematosus.Methods sMerTK was detected in the serum of 101 SLE patients,96 disease controls and 62 healthy controls (HC) by sandwich enzyme-linked immunosorbent assay (ELISA).The relationships between the serum levels of sMerTK and clinical manifestations,laboratory parameters,disease activity were investigated in SLE patients.Comparisons between groups were tested by t-test and x2 test,Correlation of parameters were analyzed by Spearman method.Results sMerTK levels in SLE patients [(10.6±6.0) ng/ml] was significantly higher than disease controls [(4.4±2.0) ng/ml] (t=9.704,P＜0.01) and healthy controls [(2.8±2.5) ng/ml] (t=11.505,P＜0.01).The concentrations in SLE patients were independent of gender,age and disease duration.The levels of sMerTK were negatively correlated with white blood cell (r=-0.236,P=0.017),hemaglobin(r=-0.354,P＜0.01),platelet values (r=-0.310,P=0.002).Compared with the patients without lupus nephritis (LN)[(9±6) ng/ml],patients with LN had higher concentrations in serum [(11±6) ng/ml],and the difference was statistically significant (t =2.071,P=0.041).In addition,sMerTK levels were also correlated with 24 h-urinary protein level (r=0.293,P=0.013),serum creatinine (r=0.250,P=0.035) and e-GFR (r=-0.201,P=0.045).Furthermore this study indicated that sMerTK was negatively correlated with C3 (r=-0.447,P＜0.01) and C4 (r=-0.357,P＜0.01)level,but positively correlated with anti-dsDNA antibody titers (r=0.360,P＜0.01),anti nucleosome antibody (AnuA) (r=0.264,P=0.016) and SLEDAI (r=0.473,P＜0.01).Conclusion sMerTK level is increased in SLE patients.The concentration may associate with hematology changes and lupus nephritis.It may be an indicator of disease activity.

Objective To explore the expression and clinical significance of soluble Axl and Tyro3 receptor tyrosine kinase in systemic lupus erythematosus (SLE).Methods Sandwich enzyme linked immunosorbent assay (ELISA) was used to detect sAxlTK and sTyro3TK in the serum of 140 SLE patients,150 disease controls and 100 healthy controls (HC).The relationships between the serum levels of sAxlTK/sTyro3TK and clinical manifestations,laboratory parameters,disease activity were analyzed in SLE patients.Analysis of variance,Dunnett's t-test,chi-square test and spearman's test were used for statistical analysis.Results The concentrations of sAxlTK [(56±18) ng/ml] and sTyro3TK [(3.9±1.6) ng/ml] were both elevated in serum of SLE patients,which were significantly higher than disease controls [sAxlTK:(41±17) ng/ml;sTyro3TK:(2.6± 1.2) ng/ml] and healthy controls [sAxlTK:(37±10) ng/ml;sTyro3TK:(2.1±0.7) ng/ml].The SLE sAxlTK levels were negatively correlated with lymphocyte count (r=-0.266,P=0.002),hemoglobin (r=-0.480,P＜0.01),platelet count (r=-0.374,P＜0.01),albumin (r=-0.465,P＜0.01),estimated glomerular filtration rate (eGFR,r=-0.230,P=0.006),complement C3 (r=-0.399,P＜0.01) and complement C4 (r=-0.374,P＜0.01).However,the levels of sAxlTK in SLE patients were positively correlated with D-dimer (r=0.371,P＜0.01),creatinine (r=0.278,P＜0.01),24-hour urinary protein quantification (r=0.383,P＜0.01),erythrocyte sedimentation rate (r=0.422,P＜0.01),titre of anti-nuclear antibodies (r=0.271,P=0.002),anti-dsDNA antibody (r=0.299,P＜0.01),anti-nucleosome antibody (r=0.263,P=0.013) and anti-cardiolipin antibody (r=0.309,P＜0.01).In addition,the levels of serum sAxlTK in SLE patients showed positive correlation with the scores of SLEDAI (r=0.307,P＜0.01).Comparisons of sAxlTK levels between patients with high and low disease activity demonstrated a higher level of sAxlTK in the former [(64±17) ng/ml vs (52±16) ng/ml;t=-3.939,P＜0.01].Conclusion The levels of sAxlTK and sTyro3TK are elevated in the serum of SLE patients.The concentration of sAxlTK is correlated with autoantibodies production,hematological and renal involvement in SLE,which may be a serolgical marker for disease activity.

AIM: To investigate the role of mild heat stress towards the immunological function of splenic macrophages and significance of BiP protein expression. METHODS: Primary cultured splenic macrophages were prepared and placed in 41 ℃ thermostat for thermal stress and restored to 37 ℃ after an hour. Heat stressed macrophages were separated into groups at time points of 0 min, 30 min, 60 min, 120 min and 180 min, and their BiP mRNA and BiP protein expressions were detected. At the same time, the phagocytic function, cytotoxicity and chemotaxis of the macrophages were detected. RESULTS: After heat stress, the expressions of BiP mRNA and BiP protein in splenic macrophages remarkably increased, and reached to peak after 30-60 min, still remained higher than control group after 120 min and restored to normal level after 180 min. At the same time, mild heat stress enhanced the phagocytotic, cytotoxicity and chemotactic activities of splenic macrophages, and reached to peak after 60 min then gradually decreased. CONCLUSION: The expression of BiP protein is enhanced after mild heat stress, synchronous changes happen both in BiP protein expression and cellular function. There is close relation between BiP protein expression and increased functions of splenic macrophages induced by mild heat stress.

Objective To study the influences by a Cyelin-dependent kinase inhibitor Roscovitine on cell cycle in mitotic hepatoma carcinoma cell SMMC-7721. Methods Microscope,MTT, flow cytometry and R-T PCR were used to observe the effects of Roscovitine on morphology, proliferation, cell cycle, apoptosis and the mRNA expression of CDK2, Caspase-3, bcl-2 in SMMC-7721 cells. Results Roscovitine inhibited the proliferation of SMMC-7721 cells in dosage and time dependent manner and induced apoptosis. Flow cytometry showed the ratio of G0, G1 increased. R-T PCR showed that the expression of bcl-2 reduced, Caspase-3 increased. Conclusion Reseovitine can inhibit the growth, proliferation, block the cell cycle at G0/G1 and promotes apoptosis of mitotic SMMC-7721 cells, and the mechanism of apoptosis is dependent on the activity of bcl-2 and Caspase-3.

Objective To evaluate the value and the expression of Axl receptor tyrosine kinase (AxlTK) in renal pathology of lupus nephritis (LN) patients. Methods The expression of AxlTK were detected in 29 LN and 10 primary nephritic syndrome (NS) patients using immunohistochemistry in renal tissue. The correlations between the levels of AxlTK on glomeruli and clinical manifestations, laboratory parameters, disease activity, and renal pathology in LN patients were investigated. T test and single factor analysis of variance were used tp compare between groups, and Pearson or Spearman test was used for correlation analysis. Results AxlTK was extensively expressed on surface of mesangial cells, endothelial cells in glomeruli. There was more expression of AxlTK on mesangial cells in LN patients [(7.0 ±2.2)×10-2] than that in primary NS patients [(3.1 ±1.2) ×10-2] (t=5.382, P<0.01). The expression of AxlTK in the glomeruli of LN patients with oral ulcers is higher than that in patients without of ulcers (t=2.259, P=0.032), and it was positively correlated with the anti-nucleosome antibody (AnuA) level in patients (r=0.488, P=0.017). The expression of AxlTK on glomeruli were higher in class Ⅳ and classⅢ of LN patients than that of class Ⅴ, but there was no statistically significant difference between them (P>0.05). Conclusion The expression of Axl TK in glomerular is significantly increased in glomeruli in LN patients. The expression level of AxlTK on glomeruli is correlated with the occurrence of oral ulcers and AnuA. The level of AxlTK expression is related to pathological categories of kidney in LN patients. The results of this study suggest that AxlTK might participate in the pathogenesis of LN.

BACKGROUND:Studies have shown that percutaneous vertebroplasty is a better method to repair osteoporotic vertebral compression fractures, but there are stil less specific schemes of transpedicular approach. Whether unipedicular or bipedicular approach is preferred is stil controversial. OBJECTIVE:To compare the clinical efficacy of percutaneous verterbroplastyviaunipedicular and bipedicular approach on osteoporotic vertebral compression fractures. METHODS:Totaly 118 patients with osteoporotic vertebral compression fractures who had been admitted at the Department of Orthopedics, the First People's Hospital of Kashi from June 2010 to June 2013 and folowed up over 1 year were enroled and randomly divided into unipedicular and bipedicular groups, with 59 in each group. These two groups were compared in terms of bone cement volume, bone cement leakage, kyphosis correction, vertebral height restoration, visual analog scale score, Oswestry disability index, activity of daily living scale score, SF-36 score, and postoperative complications. RESULTS AND CONCLUSION: The cement leakage rate was lower in the unipedicular group (34%) than the bipedicular group (37.3%), but there was no significant difference (P=0.701 > 0.05). The kyphosis correction and scoliosis correction had no statistical significance between the two groups (P > 0.05). The mean vertebral height was improved significantly in both two groups at 1 year after operation (P < 0.05), but there was no difference between the two groups before and after operation (P > 0.05). There were also no significant differences between the two groups in terms of visual analog scale score, Oswestry disability index, activity of daily living scale score, SF-36 score before and after operation, but these indexes were al improved significantly in each group at 1 year after operation than before operation (P < 0.05). The bone cement amount of the unipedicular group was lower than that of the bipedicular group (P=0.001 < 0.05), and the operation time was also shorter in the unipedicular group than the bipedicular group (P=0.000 < 0.05). No serious complications occurred in the two groups. These findings indicate that percutaneous verterbroplasty via unipedicular and bipedicular approach has good analgesic and repair outcomes in patients with osteoporotic vertebral compression fractures, and the unipedicular approach is better than the bipedicular approach in the folowing aspects: less bone cement volume, lower cement leakage and shorter operation time.