Objective To discuss the clinical application of individualized strategy of endoscopic retrograde cholangiopancreatography (ERCP) in the treatment of bile duct stenosis after liver transplantation (LT).Methods Fifty-two patients,including 40 men and 12 women,aged 54.3 ± 9.1 years old,who suffered from bile duct stenosis and accepted 88 times of ERCP from June 2014 to May 2016 in our department were investigated.The procedures,clinical features and biochemical criteria were analyzed retrospectively.Results According to the treating occasions and clinical symptoms,single plastic stent,dilatation combined with single plastic stent,and dilatation combined with multiple plastic stents were chosen to use.ERCP in 8 patients out of 52 patients failed technically,and the therapeutic efficacy was 82.7％.The treatment duration was 8.2 ± 2.9 months.The recurrence rate was 4.7％ (2 cases) during the follow-up period.The most common complications were postERCP pancreatitis (2.3％) and cholangitis (3.4％),which would be cured by conservative treatment in most cases.Conclusion ERCP,as an effective and safe method,could be used as the first choice or bridge treatment for bile duct stricture after LT.We recommend individualization strategy,including step by step mode and different combinations of PTC or endoscopic procedures,in order to improve clinical efficacy of all kinds of stricture.

Objective To observe long-term follow-up results of in-stent restenosis by digital subtraction angiography(DSA) method after angioplasty and stenting with the Gateway-Wingspan stenting system in middle cerebral artery(MCA).Methods Consecutive patients with ischemic stroke and Wingspan stent placement were enrolled into our study.The proportion of in-stent restenosis and ischemic stroke associated with restenosis were evaluated by DSA after 6 and 12 months of stent placement.Results 30 patients with stenosis/occlusion of MCA underwent Wingspan Stent successfully.All of the patients finished follow-up except two patients(6.7％ ) who died in the first three months after stenting.At the sixth months follow-up,in-stent restenosis was observed in 7 patients( 23.3％ ) with average (69.0 ± 9.8 )％ in-stent restenosis degree.However,no additional in-stent restenosis was found at the twelfth month,two patients among the 7 with in-tent restenosis were suffered with artery occlusion in stent.Conclusion In-stent restenosis after Wingspan stenting in middle cerebral artery was more common during the first six months,and 85.7％ with ischemic stroke.It was worthy of paying attention to prevent in-stent restenosis at the first six months after stenting.

Objective To observe the clinical effect of applying responsibility holistic nursing to patients treated with double cannula irrigation drainage. Methods Seventy cases with severe acute pancreatitis were selected and divided in-to two groups randomly. The control group received conventional nursing ,and the observation group received responsi-bility holistic nursing. The standing time of drainage tube,drainage effect,length of stay and complications of two groups were recorded. And the nursing satisfaction of patients or family member was evaluated. Results The patients operative time,postoperative irrigation and drainage time and hospital stay were (49.57±5.82) min,(10.10±1.04) d and (29.14±3.52) d, significantly shorter than the control group, the cure rate was 97.44% of observation group, signifi-cantly higher than the control group;in the observation group catheter complication rate was 41.03%, significantly low-er than the control group;observation care patients and their families who were very satisfied and satisfied respectively 53.85%and 92.31%, significantly more than those in the control group. These differences were all statistically signifi-cant (P <0.05). Conclusion Applying double cannula washing drainage to the patients treated with double cannula washing drainage not only can reduce the treatment time and improve the treatment effect , but also can reduce the in-cidence rate of adverse reactions and improve the satisfaction degree of patients. So the nursing mode has great signifi-cance in clinical application.

OBJECTIVES: To explore the expression of autophagy related genes 5 (ATG5) and cyclin E in coronary heart disease (CHD) and its clinical significance. METHODS: From April 2018 to August 2018, 80 patients diagnosed with CHD in the Second Xiangya Hospital, Central South University were selected as an observation group, and another 80 healthy subjects were selected as a control group. The expression of ATG5 and cyclin E mRNA in nucleate cells and the plasma protein in the 2 groups were detected and analyzed. The model of macrophage-derived foam cells induced by oxidized low density lipoprotein (ox-LDL) was used to simulate atherosclerosis. The proliferation of macrophage- derived foam cells and the protein levels of ATG5 and cyclin E induced by ox-LDL at different concentrations were examined. RESULTS: Compared with the control group, the levels of ATG5 mRNA and protein in the blood in the observation group were decreased, and the cyclin E mRNA and protein levels were increased, there were statistically difference (both <0.05). Receiver operating characteristic (ROC) curve showed that the area under curve (AUC) of ATG5 mRNA, cyclin E mRNA, ATG5 protein and cyclin E protein were 0.739, 0.780, 0.671 and 0.807, respectively. Pearson analysis showed that the ATG5 mRNA was negatively correlated with the cyclin E mRNA (=-0.734, <0.05),while the plasma ATG5 protein was negatively correlated with the plasma cyclin E protein (=-0.746, <0.05). Macrophage-derived foam cell model induced by ox-LDL showed that the proliferation of foam cells and the expression levels of cyclin E protein were increased in a concentration and time-dependent manner, and the expression levels of ATG5 protein were decreased in a concentration-dependent manner. CONCLUSIONS The levels of ATG5 mRNA and protein are lowly expressed while the levels of cyclin E mRNA and protein are highly expressed in the patients with CHD.The ATG5 protein levels are lowly expressed in ox-LDL-treated macrophage-derived foam cells while the cyclin E protein levels are highly expressed in ox-LDL-treated macrophage-derived foam cells. Based on these observations, we conclude that ATG5 inhibits the degradation of the cyclin E and promotes the proliferation of macrophages, involving in the occurrence and development of CHD.
Autophagy ; Autophagy-Related Protein 5 ; Coronary Disease ; Cyclin E ; Foam Cells ; Humans ; Lipoproteins, LDL

Objective: To determine the changed expression levels, biological roles and underlying mechanism of LncSox4 in non-small cell lung cancer (NSCLC), providing novel biomarkers for NSCLC diagnosis and therapy. Methods: QRT-PCR was used to detect the expression of LncSox4 in the tumor tissues of NSCLC patients. Colony formation, cell growth curve, Transwell migration and invasion assays were used to determine the effects of LncSox4 knockdown on A549 cell function, respectively. Flow cytometry was used to determine the effects of LncSox4 on the progression of A549 cell cycle. QRT-PCR and western blot were used to explore the expressions of genes and proteins in epithelial-mesenchymal transition (EMT). Results: The expression of LncSox4 was upregulated significantly in carcinoma tissues of NSCLC compared to the para-carcinoma tissues (t=7.109，P＜0.01). The growth rate of A549 cells slowed down in LncSox4 knockdown group and the number of formed cell colonies was less than that in control group(P＜0.01). LncSox4 knockdown reduced the migration and invasion abilities of A549 cells (P＜0.01) and induced cell cycle arrest at G1 phase(P＜0.01). LncSox4 knockdown downregulated the protein expressions of Cyclin D1, c-Myc, N-cadherin, and Vimentin, while upregulated the expression of E-cadherin in A549 cells. LncSox4 knockdown also decreased the expressions of EMT-related transcription factors including snail, slug and twist. Conclusion The high expression of LncSox4 in NSCLC may promote malignant progression of NSCLC by enhancing cell proliferation, migration and invasion, suggesting that it should be a promising target for diagnosis and therapy of NSCLC.

Objective: To investigate the expression change, biological role and action mechanism of long non-coding RNA (lncRNA) LINC00978 in non-small cell lung cancer (NSCLC). Methods: The expression levels of LINC00978 in tumor tissues and serum samples of NSCLC patients were detected by the qRT-PCR. The effects of knockdown and overexpression of LINC00978 on the biological function of A549 cells were determined by the CCK-8, colony formation, Transwell migration and invasion assays. The action mechanisms of LINC00978 in NSCLC were investigated by the flow cytometry, qRT-PCR and western blot, respectively. Results: The expression levels of LINC00978 in the tissues ( t =2.465, P ＜0.05) and serum samples ( t =8.781, P ＜0.01) of NSCLC patients increased. The knockdown of LINC00978 inhibited the proliferation, migration and invasion of A549 cells ( P ＜0.01) and induced cell cycle arrest at G1 phase and apoptosis of A549 cells ( P ＜0.01). The knockdown of LINC00978 downregulated the expression of Cyclin D1 and Bcl-2 , and upregulated the expression of Bax ( P ＜0.05). In addition, the knockdown of LINC00978 inhibited the expression of N-cadherin, Vimentin, Snail, Slug and Twist, and promoted the expression of E-cadherin ( P ＜0.05). The overexpression of LINC00978 had the opposite effect. Conclusion LINC00978 is highly expressed in NSCLC and can promote the occurrence and progression of NSCLC, which may serve as a potential target for the diagnosis and therapy of NSCLC.

Neurogenesis decline in hippocampal dentate gyrus (DG) participates in stress-induced depressive-like behaviors, but the underlying mechanism remains poorly understood. Here, we observed low-expression of NOD-like receptor family pyrin domain containing 6 (NLRP6) in hippocampus of stress-stimulated mice, being consistent with high corticosterone level. NLRP6 was found to be abundantly expressed in neural stem cells (NSCs) of DG. Both Nlrp6 knockout (Nlrp6^-/-) and NSC-conditional Nlrp6 knockout (Nlrp6CKO) mice were susceptible to stress, being more likely to develop depressive-like behaviors. Interestingly, NLRP6 was required for NSC proliferation in sustaining hippocampal neurogenesis and reinforcing stress resilience during growing up. Nlrp6 deficiency promoted esophageal cancer-related gene 4 (ECRG4) expression and caused mitochondrial dysfunction. Corticosterone as a stress factor significantly down-regulated NLRP6 expression, damaged mitochondrial function and suppressed cell proliferation in NSCs, which were blocked by Nlrp6 overexpression. ECRG4 knockdown reversed corticosterone-induced NSC mitochondrial function and cell proliferation disorders. Pioglitazone, a well-known clinical drug, up-regulated NLRP6 expression to inhibit ECRG4 expression in its protection against corticosterone-induced NSC mitochondrial dysfunction and proliferation restriction. In conclusion, this study demonstrates that NLRP6 is essential to maintain mitochondrial homeostasis and proliferation in NSCs, and identifies NLRP6 as a promising therapeutic target for hippocampal neurogenesis decline linked to depression.