Objective To systematically assess the values of B-ultrasound(US),computed tomography(CT),magnetic resonance cholangiopancreatography(MRCP)and endoscopic retrograde cholangiopancreatography(ERCP)in diagnosing cholangiocarcinoma(CCA).Methods All published literatures on bile duct cancer were collected from the literature databases of PubMed,Medline,Embase,CNKI and Wanfang.Then the patients with bile duct cancer suspected by US,CT,MRCP and ERCP were performed the systematic review.The evaluation indicators included sensitivity and specificity.The summary receiver operating characteristic(SROC)curve was adopted to obtain the area under the curve(AUC)and Q values.The diagnostic values of 4 kinds of method were analyzed.Results Forty-four articles were included,involving 4 364 patients.The pooled sensitivities of US,CT and MRCP were 0.75,0.82 and 0.85 respectively,the specificities were 0.72,0.80 and 0.87 respectively(sensitivity and specificity of ERCP cytology and image were 0.62,0.98;0.88,0.84),the Q values were 0.690 8,0.787 8 and 0.841 7(0.846 1,0.833 2 in ERCP cytology and image).Conclusion The accuracy of CT,MRCP and ERCP for diagnosing bile duct cancer is similar and higher than that of US,which is an effective assisted examination method when compared with US.The pooled specificity of ERCP cytology is obviously higher than that of other examination method and has high clinical diagnostic value in the patients with highly suspected bile duct malignant tumor.

Taking Science Citation Index Expanded (SCI-Expanded) as information source,and using methods of bibliometric analysis,Chinese Medicine international co-authored articles which published from 1998 to 2010 were statistically analyzed on publish year,document growth,active fields,etc.,aiming to look for status and trends in International Collaboration of the Traditional Chinese Medicine,and to be a reference for researchers.

AIM: To investigate the effect of silymarin on homocysteine-induced cell viability and apoptosis in human umbilical vein endothelial cells (HUVECs). METHODS: Cell viability was analyzed by using MTT and LDH assay. Apoptotic cells were detected by using DNA fragmentation and flow cytometric analysis. The level of intracellular reactive oxygen species (ROS) and the potential of mitochondrial membrane were determined by flow cytometric assay. The activity of caspase-3, -6 and -9 were measured with microplate spectrofluorometer. Protein levels were examined by Western blotting. RESULTS: Treatment of cultured HUVECs with HCY for 48 h induced a significant decrease in cell viability, and the percentage of apoptosis increased to 76.8%. The level of intracellular ROS and activity of caspase-3, -6 and -9 enhanced, and the red/green ratios of mitochondrial membrane decreased. However, simultaneous treatment with silymarin exhibited cytoprotective effects, reduced formation of the DNA ladder, prevented the levels of Bax and Bcl-2 proteins and the accumulation of ROS as well as caspase-3, -6 and -9 activation, reconverted the potential of mitochondrial membrane, and the percentage of apoptosis/necrosis was significantly decreased to 12.7% in a dose-dependent manner. CONCLUSION: These results demonstrate that silymarin has the protective capacity to antagonize HCY-induced apoptosis in HUVECs. The antiapoptotic action of silymarin may be partially dependent on an anti-oxidative stress effects, inhibition of caspases activity, and maintenance of mitochondria function.

Network pharmacology is an emerging discipline based on the Disease-Gene-Drug multilevel network. And it has been used to forecast the drug targets and improve the efficiency of drug discovery. Its research ideas are similar to the overall efficacy of traditional Chinese medicine (TCM), which attracts more and more medical re-searchers to look for the joint point of TCM and network pharmacology. A series of approaches on disease-related genes, predicting the information of target and active ingredients of TCM emerge. In this paper, the network pharma-cology research tools, databases and their applications were summarized and introduced. This paper also proposed scientific strategies to separate active ingredients of TCM using network pharmacology, so as to improve the efficiency and speed of finding active ingredients of TCM.

The UK Ebola-countering Operation in Sierra Leone from September 2014 to November 2015 called Operation Gritrock and its countermeasures were briefly introduced , such as the national strategy , aero-maritime deployment , self medical support , base-oriented training and international cooperation .A comparative analysis was made of operations of the same type between the UK and China in terms of mission-orientation, command and control , deployment timeline , past experience, deployment routes, logistics and assistance effects.Four implications for China′s military function construction in future international disaster relief operations were also summarized at the strategic , operational and tactical levels .

Objective:To compare the efficacy between arthroscopy-assisted reduction and internal fixation (ARIF) versus open reduction and internal fixation (ORIF) in the treatment of tibial plateau fractures.Methods:A retrospective analysis was done of the 75 patients with tibial plateau fracture who had been treated by ARIF or ORIF at Department of Orthopaedics, Union Hospital Affiliated to Tongji Medical Collage from January 2016 to August 2018. They were 58 men and 17 women, aged from 20 to 54 years (average, 47 years). The left side was affected in 42 cases and the right side in 33. By the Schatzker classification, there were 23 cases of type Ⅰ, 49 cases of type Ⅱ and 3 cases of type Ⅲ. Of them, 40 were treated by ARIF and 35 by ORIF. The 2 groups were compared in terms of operation time, incision length, intraoperative blood loss, hospital stay, postoperative complications and the Hospital for Special Surgery (HSS) scores 12 months after operation.Results:There was no statistically significant difference between the 2 groups in the preoperative general data, showing the 2 groups were comparable ( P>0.05). The patients were followed up for 12 to 15 months (average, 13.5 months) after operation. The wounds in the 75 patients healed at one stage with no complications like neurovascular lesions. All the fractures healed within 6 months after operation. Compared with the ORIF group, the ARIF group had significantly longer operation time (58.3 min ± 4.2 min versus 48.4 min ± 5.2 min), a significantly shorter incision (4.3 cm ± 0.9 cm versus 6.2 cm ± 0.8 cm), and significantly less intraoperative blood loss (60.8 mL ± 4.5 mL versus 72.8 mL ± 6.5 mL) ( P<0.05). There was no significant difference between the 2 groups in hospital stay (5.1 d ± 0.6 d versus 5.5 d ± 1.6 d) ( P>0.05). Fifteen patients in the ARIF group and 5 in the ORIF group were complicated with soft tissue injury, showing a statistically significant difference ( P<0.05). The excellent and good rate by HSS scores was 100% (40/40) for the ARIF group and 85% (34/40) for the ORIF group, showing no significant difference ( P>0.05). Conclusions:In the treatment of tibial plateau fractures of Schatzker types Ⅰ-Ⅲ, both ARIF and ORIF may result in good efficacy. However, ARIF can evaluate and treat the complicated soft tissue injuries to the knee joint more precisely, showing advantages of shorter operation time, a smaller incision and less blood loss.

Aim To study the effect of proteasome inhibitor MG132 on expression of Caspase-3 and UPP associated genes in the apoptosis of human hepatocelluar cancer cells.Methods HepG2 cells were treated with MG132 (2,5,10 ?mol?L -1) for 24 h. The apoptotic cells were determined with flow cytometric analysis. The levels of E1, E2, E3 and Caspase-3 mRNA expression were detected with RT-PCR. Caspase-3 protein expression was detected with immunohistochemistry. Results The results showed that the increase of the degree of HepG2 cell apoptosis was concentrationly dependent. RT-PCR showed that E1, E2 and E3 gene expressions were decreased in the treatment group. MG132 down-regulated the gene expression of E1, E2, E3 and up-regulated the gene/protein expression of Caspase-3. Conclusion Proteasome inhibitor MG132 may induce HepG2 cells apoptosis by inhibitting UPP activity,up-regulating the gene/protein expression of Caspase-3.

Objective To investigate the distribution and drug resistance of pathogens in elderly patients with gastric cancer complicated with diabetes mellitus.Methods 367 elderly patients with gastric cancer and diabetes mellitus were selected from the hospital from March 2010 to March 2017.The samples were isolated and cultured.The Gram positive bacteria were tested by GN201,the Gram negative bacteria susceptibility test was carried out by GP,and the drug susceptibility test was carried out by disk diffusion method.Results There were 68 cases of postoperative infection in gastric cancer patients with diabetes mellitus,and 79 strains were isolated and cultured.Among the gram negative bacteria,Escherichia coli,Klebsiella pneumoniae and Pseudomonas aeruginosa were the main pathogens.Among the Gram positive bacteria,Staphylococcus aureus and Staphylococcus epidermidis were the main pathogens.The main Gram negative bacteria,Escherichia coli to ceftazidime with levofloxacin resistance rates were 93.33% and 80.00%;Klebsiella pneumoniae had a higher drug resistance rate for cefoperazone and ciprofloxacin,76.92% and 69.23% respectively;a relatively high rate of Pseudomonas aeruginosa resistant to levofloxacin was 80.00%.Among the gram positive bacteria,the re-sistance rates of Staphylococcus aureus to penicillin and erythromycin were relatively high,respectively 91. 67% and 83.33%.Staphylococcus epidermidis had relatively high resistance rates to penicillin and erythromy-cin,100.00% and 77.78% respectively.Conclusion Gastric cancer complicated by diabetes mellitus elderly patients with postoperative infection of pathogenic bacteria distribution is given priority to with Gram-negative bacteria was the most common in,Pseudomonas aeruginosa,the main pathogenic bacteria of Escherichia coli to ceftazidime with levofloxacin resistant rate of Klebsiella pneumoniae was higher on cefoperazone and ciproflox-acin resistant Pseudomonas aeruginosa,the resistance rate of Pseudomonas aeruginosa to levofloxacin is high, and it is important to apply antibiotics rationally according to drug sensitivity test.

Objective:To analyze the correlation between the monitor units and pass rate of plan dose verification in the volumetric intensity modulated arc therapy (VMAT) plan.Methods:VMAT plans for 20 patients with nasopharyngeal carcinoma (NPC) and 30 patients with cervical cancer who underwent radiotherapy at Liuzhou Workers' Hospital from January to October 2020 were retrospectively chosen. The Detector 1500 array and Octavius 4D phantom from German PTW company were used for dose measurement. The pass rates of dose verification of relevant plans were analyzed under the conditions of 3%/2 mm and 2%/2 mm. The correlation between the monitor units and pass rate of plan dose verification in VMAT plans was assessed by Pearson's bivariate correlation analysis.Results:Under the condition of 3%/2 mm, the correlation coefficients between the monitor units and gamma pass rate were -0.873 ( P<0.001), -0.800 ( P<0.001), -0.781 ( P<0.001), -0.493 ( P=0.006) for NPC_1Arc, NPC_2Arc, NPC_1Arc+NPC_2Arc and Cervix_2Arc, respectively. Under the condition of 2%/2 mm, the correlation coefficients between the monitor units and gamma pass rate were -0.842 ( P<0.001), -0.770 ( P<0.001), -0.748 ( P<0.001) and -0.531 ( P=0.003) for NPC_1Arc, NPC_2Arc, NPC_1Arc+NPC_2Arc and Cervix_2Arc, respectively. Conclusion:Significant negative correlation can be observed between the monitor units and plan dose verification pass rate in VMAT plan.

This study explores the application effect of the case-based teaching method based on Xuexitong learning platform in the online teaching of Digestive System, and analyzes the learner's emotional experience, learning behavior, and learning effect in the case-based online teaching. The results of the study show that the case-based online teaching model based on Xuexitong learning platform improves students' online learning interest, and the students have good emotional experience, high learning enthusiasm, good classroom interaction, enhanced self-learning ability before and after class, and good learning effect. In addition, precise teaching can be used for individual students who are not enthusiastic about online learning.