Objective To investigate the clinical effect of surgical treatment for hilar cholangio-carcinoma. Methods The clinical data of 89 patients with hilar cholangiocarcinoma surgically treated in our hospital were retrospectively analyzed. They were divided into 3 groups: radical resection(group A,n=23),palliative resection (group B,n=44) and external drainage operation (group C,n=22). Complications,operative mortality,survival rate and posttreatment quality of lire were compara-tively analyzed among the 3 groups. Results The rate of complications was significantly higher in group A than in group C (P<0.05). There was no marked difference in operative mortality between group A and group B (P>0.05). The 1-,2-and 3-year survival rates and scoring of quality of life were remarkably higher in group A than in other 2 groups (P<0. 001 and 0. 05). Conclusion Radical re-section of hilar cholangiocarcinoma can improve the long-term survival and significantly enhance quality of life of the patients after operation. For patients receiving unradical resection, palliative surgical man-agement can improve the long-term survival and enhance quality of life.

Objective To explore the relationship between depression and anxiety and peripheral blood cell counts ( white blood cell ( WBC) ,neutrophil ( NEU) ,lymphocyte ( LYM) ,red blood cell ( RBC) and hemoglobin ( HGB) ) of heroin?dependent patients receiving methadone maintenance treatment ( MMT) . Methods Two hundred and fifty?two MMT heroin addicts, who had received peripheral blood tests within the week prior to the study,were administered with a general information questionnaire,SDS and SAS. The results of blood tests of these patients were compared with those of 109 healthy people in physical examina?tion. Multiple linear regression was used to analyze associations between indicators of peripheral blood cell counts and depressive and anxiety symptoms. Results Compared with healthy controls,MMT patients had significantly higher proportions of elevated WBC(14.7%vs 3.7%),NEU(12.7% vs 2.8%) and LYM(9.9%vs 2.8%) counts (all P<0.05),and low RBC(10.3%vs 4.6%) counts and HGB(11.5%vs 4.6%) concentra?tion (both P<0.05). Multivariate linear regression analysis showed that blood cell counts of WBC ( β=0.261, P<0.01),NEU ( β=0.264, P<0.01),LYM ( β=0.196, P=0.003) and RBC ( β=-0.144, P=0.021) were independently associated with depression;and blood cell counts of WBC ( β=0.298, P<0.01) and LYM ( β=0.269, P<0.01) were independently associated with anxiety. Conclusion Improving the in?flammatory and malnutrition status may be helpful for reducing depressive and anxiety symptoms of MMT her?oin addicts.

AIM: Niflumic acid (NFA) is known as a kind of inhibitor of calcium-activated chloride channel. The inhibition and mechanism of NFA on the proliferation of airway smooth muscle cells (ASMCs) were investigated. METHODS: Using [ 3H]-TdR incorporation method, we examined the effect of NFA (at concentration of 10 and 50 ?mol/L) on the proliferation of primarily ASMCs from BALB/c mouse. With confocal laser scanning microscope the [Ca 2+ ]i in ASMCs exposed to histamine was observed, and the opposed effects of NFA and nifedipine on histamine were also checked. Finally the effect of NFA on expression of MAPK in ASMCs was examined by indirect immunofluorescent assay. RESULTS: Compared with control group, the proliferation of NFA group was reduced markedly with dependent concentration. Histamine significantly improved the [Ca 2+ ]i in ASMCs, but NFA and nifedipine showed the inhibition on the effect of histamine. NFA reduced the level of MAPK expression in ASMCs. CONCLUSION: It is demonstrated that NFA inhibits the proliferation of ASMCs by reducing [Ca 2+ ]i and the expression level of MAPK. [

Objective To evaluate the clinical significance of prostatic hypoechoic lesions on transrectal ultrasound (TRUS) for prostate cancer detection.Methods Four hundred and thirty-eight patients referred for biopsy of the prostate from August 1999 to August 2004. Every patient received 6-13 biopsy cores of the prostate. If a hypoechoic was identified, the biopsy was taken from this lesion. Correlation between hypo-echoic lesions, isoechoic areas and cancer detection for each core was performed. Results Among 438 patients, cancer was detected in 112(25.6%). Hypo-echoic lesions were seen in 75 (67%) patients with prostate cancer, the isoechoic were as in 37 (33%). A total of 3504 biopsy cores were obtained from 438 patients, and 636 biopsy cores were taken from hypoechoic lesions. Among 636 biopsy cores, 163 (25.6%) were cancer and 473(74.4%)were not. The cancer detective rate in patients with hypoechoic lesions (75/298, 25.2%) was similar to non-hypoechoic lesions (37/140, 26.4%) on TRUS. There was no statistically significant difference between them (P

Objective To investigate the clinical characteristics and surgical management of adult presacral tumors.Methods The clinical data of 24 patients with adult presacral tumors from 2007 to 2012 were retrospectively analysed.All patients were diagnosed by digital rectal examination and imaging examination before operation.Seventeen patients with via sacrococcygeal approach,4 patients with via abdominal approach,and 3 patients with via combined abdominal and sacrococcygeal approach.Results The incision of 22 patients primary healing.There were 2 patients with postoperative incision infections,after dressing change cure.No patients died during perioperative period.Twenty patients were followed up for 3-17 months,1 patient with via abdominal approach recurrenced,and was healed after a second surgical resection.Conclusions Digital rectal examination and imaging examination are the main methods for diagnosis of adult presacral tumors.Most adult presacral tumors can be resected through sacrococcygeal route.

Objective To investigate the life quality changes and influencing factors of acute coronary syn -drome after stent implantation .Methods 100 cases with acute coronary syndrome received stent implantation were selected .SF-36 life quality questionnaire was used to survey the patients′life quality before operation and 6 months af-ter operation,and the life quality changes and influence factors were analyzed .Results 6 months after operation,the physical activity ,mental health ,social activities ,physical pain ,physical function ,physical role ,energy and health score of the patients were higher than before operation (P<0.05).According to Logistic regression analysis ,female,type 2 diabetes,underwent percutaneous coronary intervention ,ST-T segment elevation myocardial infarction were the im-portant factors affecting patients′recovery(P<0.05).Conclusion 6 months after stent implantation,the life quality of the patients with acute coronary syndrome were improved obviously;the female and underwent percutaneous coro-nary intervention have positive influence on patients′recovery,while type 2 diabetes,ST-T segment elevation myocar-dial infarction affect patients′recovery in negative way .

Objective To explore the value of combined detection with MMP-9 and uPA in the progno-sis of pancreatic carcinoma. Methods By immunohistochemistry PV methods,the expression of MMP-9 and uPA was respectively studied in 63 surgical specimens of primary pancreatic carcinoma and the survival time of patients with pancreatic carcinoma was analysed. Results The expressions of MMP-9 and uPA were positively related(r=0. 573,P=0. 000). The expression of MMP-9 and uPA significantly correlated with differentiation (r= -0. 271,P=0. 032;r= -0. 333,P=0. 008),TNM stages(r= -0. 449,P=0. 000;r= -0. 430,P=0. 000)and lymph node metastasis(r=0. 329,P=0. 009;r=0. 400,P=0. 001),separately. The expression of MMP-9 had also a significant correlation with tumer size(r= -0. 297,P=0. 018)and distant metastasis(r=0. 320,P=0. 011). Univariate analysis identified that tumor size(χ2 =8. 766,P=0. 012),differentiation(χ2 =29. 050,P=0. 000),clinical stage(χ2 =24. 940,P=0. 000),distant metastasis(χ2 =12. 846,P=0. 000), lymph node metastasis(χ2 =15. 457,P=0. 000),MMP-9(χ2 =32. 700,P=0. 000)and uPA(χ2 =41. 495,P=0. 000)were significantly associated with prognosis. Kaplan-Meier survival analysis showed that 1-year survival rate of patients with MMP-9 ( -),uPA ( -)were significantly longer than that of the patients with MMP-9( ﹢),uPA( ﹢),respectively(χ2 =32. 700,P=0. 000;χ2 =41. 495,P=0. 000);1-year survival rate of patients with MMP-9( -)/uPA( -)was significantly longer than the others( Log-rank test,χ2 = 54. 892, P=0. 000). COX regression revealed that differentiation(RR=2. 315,P=0. 004),clinical stage(RR=1. 694, P=0. 002),MMP-9(RR=0. 165,P=0. 000)and uPA(RR=0. 244,P=0. 007)was independent prognostic factors in pancreatic carcinoma. Conclusion They may have a synergistic function in the the process of growth and invasion in pancreatic cancer between MMP-9 and uPA,and the posssible mechanism is that uPA activate degradation of MMP-9,which is not favorable to prognosis. Combined analysis of MMP-9 and uPA may lead to a more reliable prognostic estimation,as the beneficial supplement of the differentiation,and clinical stage to judge the prognosis of pancreatic cancer.

Objective To investigate the changes of fecal short-chain fatty acids (SCFA) and bile acid levels in patients with colon cancer.Methods Totally 189 patients with colon cancer (CC group),201 patients with adenomatous polyp (AP group),and 512 healthy patients (control group) who were confirmed by endoscopy were included in this study.The fecal SCFA and bile acid levels were measured by enzyme linked immunosorbent assay.Results The total bile acids,primary bile acids,and secondary bile acids were not significantly different among these three groups (P ＞ 0.05).The chenodeoxycholate level in the CC group [0.338 (0.101,0.416) mg/g] was significandy higher than that in AP group [0.241 (0.108,0.375) mg/g] and control group [0.248 (0.110,0.371) mg/g] (P=0.025,P=0.023),but was not significantly different between the AP groupand the control group (P ＞ 0.05).The deoxycholic acid level in CC group [0.375 (0.136,0.503) mg/g] and AP group [0.369 (0.113,0.494) mg/g] were significandy higher than that in control group [0.277 (0.115,0.412) mg/g] (P=0.026,P=0.024),and the difference between CC group and AP group was not statistically significant (P ＞ 0.05).The level of lithocholic acid in CC group [0.386 (0.147,0.507) mg/g] was significantly higher than those in the AP group [0.103 (0.012,0.238) mg/g] and control group [0.239 (0.081,0.405) rng/g] (P=0.011,P=0.027); also,its level in AP group was significantly lower than that in the control group (P =0.022).The levels of total short-chain fatty acids,acetic acid,propionic acid,and isovaleric acid were not significantly different among the control group,AP group,and CC group (P＞0.05).The levels of butyrate [0.105 (0.059,0.198) mg/g,0.090 (0.050,0.183) mg/g],isobutyl acid [0.036 (0.024,0.046) mg/g,0.025 (0.020,0.034) mg/g] in CC group and AP group were significantly higher than in the control group [0.081 (0.051,0.107) mg/g,0.021 (0.016,0.029) mg/g] (butyrate:P=0.026,P=0021; isobutyl acid:P=0.025,P=0.019),and the difference between CC group and AP group was statistically significant (butyrate:P =0.031; isobutyl acid:P =0.024).Conclusions Fetal chenodeoxycholic acid,lithocholic acid,butyric acid,and isobutyric acid may play a role in the developmem of colon cancer,while deoxycholic acid may also be implicated in both colon cancer and colon adenomas.No association is found between other SCFA and bile acids and colorectal cancer/adenoma.

Objective To assess the motion asynchrony of left ventricle(L V)wall in patients with chronic heart failure(CHF)by ultrasound two dimensional speckle-tracking imaging(2D-STI).Methods Thirty-seventy patients with CHF were divided into two groups:CHF1 group,22 with QRS≤120 ms;CHF2 group,15 with QRS ＞120 ms.Thirty healthy subjects(control group)were enrolled.2D-STI was applied to display and analyze the strain rate imaging on the three standard LV apical views and parasternal LV short-aix views,respectively.The time from the onset of QRS complexes to peak strain rate during systole(Tsrs)and early-diastole(Tsre)were measured from the longitudinal,radial and circumferential vector respectively(Tsrsl,Tsrel,Tsrsr.Tsrer,Tsrsc,Tsrec).The standard deviation of all above parameters(Tsrsl-SD.Tsrel-SD,Tsrsr SD,Tsrer-SD,Tsrsc-SI).Tsrec-SD)and the maximal temporal difference(Tsrsl-diff.Tsrel-diff,Tsrsr-diff,Tsrer-diff,Tsrsc-diff,Tsrec-diff)of 18 segments were calculated as indicator of dyssynchrony.Results The systolic dyssynehrony indices Tsrsl-SD,Tsrsl-diff,Tsrsr-SD,Tsrsr-diff,Tsrsc-SD Tsrsc-diff and diastolic dyssynchrony indices Tsrel-SD,Tsrel-diff,Tsrer-SD,Tsrer-diff,Tsrec-SD,Tsrec-diff were significantly higher in the CHF1 and CHF2 group than those in the control group(all P＜0.05).Compared with the values in the CHF1 group,the systolic indices of dyssynchrony and the radial and circumferential diastolic indicator of dyssynchrony in CHF2 group were longer(P＜0.05).Conclusions The longitudinal,radial and circumferential systolic and diastolic dyssynchrony of the LV were commonly existed in patients with CHF,regardless of QRS duration.2D-STI is a potientially useful tool to evaluate the systolic and diastolic synchrony of the LV wall motion in patients with CHF.

Objective To investigate the elasticity of the radial artery wall in type 2 diabetes mellitus (T2DM) patients with elastosonography. Methods A total of 37 patients with T2DM and 42 normal subjects were studied with elastosonography. The systolic diameter (Ds) and diastolic diameter (Dd) of the radial artery were measured, and the strain ratio of the blood in the radial artery to the wall of the radial artery was calculated. Results The strain ratio of the radial artery in T2DM group was significantly higher than that in normal group (P＜0.05). There was no significant difference in Ds and Dd of the radial artery between T2DM group and the control group (P＞0.05). Conclusion The early change of the radial artery wall elasticity in patients with T2DM can be assessed with elastosonography.