Hilar cholangiocarcinoma is a rare tumor with a poor prognosis.Due to advances in preoperative imaging and enhanced comprehension of tumor biological behavior,surgical management of hilar cholangiocarcinoma has evolved since its original description.Currently,it has been accepted that complete surgical resection provides the only possibility for cure or long-term survival,however,the surgical management of hilar cholangiocarcinoma is extremely challenging because of its anatomical location and vascular proximity.In order to achieve complete resection, several surgical approaches have been investigated and evaluated regarding major hepatic resection,lymph node dissection,vascular resection,extended resection and liver transplantation,however,there are still many disputations. Furthermore,many surgical technical difficulties exist in biliary reconstruction after resection owing to anatomical problems.Focusing on the disputes and problems mentioned above,we herein review and discuss surgical strategies in managing hilar cholangiocarcinoma.

Background and purpose: Ovarian cancer is the common gynecological cancer, and the drug resistance of anti-tumor drug was one of major reasons for therapy failure, some studies considered that there is a closed relationship between Gankyrin and drug resistance. In this study, we investigated the effects and mechanisms of Gankyrin silencing on reversing the cisplatin resistance of ovarian cancer drug-resistant SKOV3/DDP cell line. Methods:The expression of Gankyrin in SKOV3 and SKOV3/DDP cells was measured by real-time PCR assay, MTS assay was employed to determine the effect of Gankyrin on SKOV3/DDP sensitivity to cisplatin, apoptosis rate and intracellular concentration of rhodamine-123 (Rh-123) were determined by lfow cytometry, the expression of multi-drugs resistant protein MDR1, Caspase-3/8, Survivin and Bcl-2 were determined by Western blot and real-time PCR. The phosphorylation of AKT and expression of p53, NF-κB and PTEN were analyzed by Western blot assay. Results:The expression of Gankyrin was increased in SKOV3/DDP cells, Gankyrin silencing was able to increase the cisplatin sensitivity of SKOV3/DDP. Before and after gene silencing, the reverse folds (RF) to cisplatin were 1.81 and 2.45, respectively, the intracellular levels of Rh-123 were 1.73 and 2.42 fold, the apoptosis rates were 2.23 and 4.23 fold,the expressions of MDR1, Survivin and Bcl-2 were downregulated, the mRNA expressions of MDR1 were 62.8%and 21.6%, the mRNA expressions of Survivin were 24.5%and 10.3%, the mRNA expressions of Bcl-2 were 47.5%and 18.4%, the levels of Caspase-3/8, p53 and PTEN were elevated, phosphorylation of AKT and expression of NF-kB were downregulated compared with control group. Conclusion:Gankyrin silencing was able to reverse the cisplatin resistance of SKOV3/DDP cells by inhibiting the drug eflfux and promoting cell apoptosis, the PTEN/AKT/NF-κB/p53 may be the key pathway.

Objective To investigate the relationship between polymorphism of the estrogen receptor(ER) gene and bone mineral density(BMD), and bone metabolism in Chinese postmenopausal healthy women. Methods In 246 postmenopausal healthy women, aged 44-78 years (average 61 years), BMD of lumbar spine and femoral neck, Ward and trochanteric areas were measured by dual energy X ray absorptiometry. Biochemical indexes(serum Ca, P, ALP, PTH, CT)were measured and PvuⅡ and XbaⅠ restriction fragment length polymorphism(RFLP) of ER were analysed by polymerase chain reaction restriction fragment length polymorphism(PCR RFLP). The relationship between polymorphism of the ER gene and BMD, and bone metabolism were evaluated. The RFLP was represented as Pp(PvuⅡ) and Xx(XbaI). Results In the PPxx genotype, Z score values of BMD were significantly lower than those in other genotypes. Conclusion RFLP of ER gene associated with BMD in postmenopausal healthy women and this might explain the cause of postmenopausal osteoporosis in Chinese women.

Objective:To compare efficacy of percutaneous vertebroplasty (PVP) with radiotherapy and radiotherapy alone for bone me-tastasis pain. Methods:A total of 247 bone metastasis patients with pain were analyzed. The radiotherapy group comprised 158 cases, whereas the combination group comprised 89 cases. We mainly observed the effect of pain treatment, behavioral states, and im-proved emotional condition. The side effects and complications were also investigated. Daily medicine consumption of background pain treatment was observed between the two groups. Analysis was done by SPSS 17.0 statistical software. Numerical variables were analyzed using t test and comparisons between groups used chi-square test. Results:The VAS scores of radiotherapy group decreased from 8.12±1.45 to 3.06±1.68 after treatment (P<0.05), and combination group VAS scores from 8.46±1.73 to 2.45±1.47 (P<0.05). The time to pain relief following PVP and radiotherapy were 1.63±0.81 and 8.56±2.87 days, respectively (P<0.001). The breakthrough pain frequency was 4.56 ± 1.98 times/day, which decreased to 1.57 ± 0.98 times/day after PVP (P<0.05). By contrast, the breakthrough pain frequency was 4.73±2.24 times/day before treatment, which decreased to 3.56±1.56 times/day after radiotherapy. No serious compli-cations were observed in the two groups. The depression and anxiety mood in the combination group improved after treatment. Daily medicine consumption in radiotherapy group increased after therapy. However, daily medicine consumption in combination group was reduced after therapy. Conclusion:PVP with radiotherapy can effectively relieve bone metastasis pain and improve patients' quality of life and it is worthy of promotion in clinical practice.

Objective To observe the effect of PM2.5 on the secretion of NO, ET-1 and the proliferation of rat vascular smooth muscle cell(VSMC) in vitro.Methods VSMCs were treated with PM2.5 collected from urban area of Zhanjiang,at the doses of 10,20,50,100 and 200 ?g/ml.After 24 hours of treatment, the levels of NO and ET-1 in the VSMCs were detected by nitrate reductase method and radioimmunoassay respectively, the proliferation of VSMCs was detected by MTT.Results At the concentrations of 10-200 ?g/ml, with PM2.5 increased, the level of NO in VSMCs decreased from(43.53 ?3.46)?mol/L to(29.28?2.28)?mol/L(F=18.89,P

Objective:To investigate the clinical efficacy of Neurotropin combined with oxycodone hydrochloride in moderating the severe pain in neuropathic cancer pain (NCP) patients. Methods: NCP patients who received drug therapy with a visual analog scale (VAS) score of>4 were randomly divided into the placebo combined oxycodone group (group A) and Neurotropin combined oxy-codone group (group B). The VAS score, pain relief rate, frequency of pain outbreaks, average dose of oxycodone per day, and adverse drug reactions between the two groups were compared. Results:The VAS scores in groups A and B both had significant reduction after treatment (P<0.05), whereas the VAS score in group B after 14 days of treatment decreased more significantly than that in group A (P=0.03). The pain relief rate in group B patients 14 days after treatment was significantly higher than that in group A (P<0.001). The out-break pain in groups A and B 7 and 14 days after treatment significantly decreased, whereas the outbreak pain in group B was signifi-cantly lower than that in group A (P values were 0.07 and 0.07, respectively). The average dose of oxycodone per day in group B 14 days after treatment was lower than that in group A (P<0.001). Adverse reactions, such as nausea and vomiting, in group B were signifi-cantly less than those in group A (P<0.05). Conclusion:Neurotropin combined with oxycodone can effectively lower the NCP, average dose of oxycodone per day, and adverse reactions.

A new type of testing system used for antithrombotic pressure circulatory equipment has been developed, which realized a new method for the calibration of pressure sensor. Multi-path control and acquisition functions are achieved by this method based on human-computer interaction testing system. The precision of pressure sensor is ob tained by polynomial fitting for each test point using linear interpolation method. The result showed that the precision test of pressure sensor could be realized easily and efficiently, using the developed testing system, and the parameters of pressure sensor could be calibrated effectively, so that it could be accurately used in the antithrombotic pressure circulatory equipment. The developed testing system has a prosperous future in the aspects of promotion and application.
Algorithms ; Calibration ; Equipment Design ; Humans ; Monitoring, Physiologic ; instrumentation ; Pressure ; Thrombosis ; diagnosis

Objective To determine the values and variation tendency of a disintegrin and metalloprotease 12-S(ADAM12-S)of early pregnancy, and discuss the value of ADAM12-S to the ectopic pregnancy in the first trimester.Methods 150 early pregnancy cases (from the 5th to 10th week of pregnancy)were selected in Huanggang Women &Children's Healthcare Hospital.There were 102 cases of normal pregnancy,48 cases of ectopic pregnancy.The AutoDELFIA immunoassay platform was used to measure the value of ADAM12-S in the serum.Results Of the 102 normal pregnancies, the values of ADAM12-S in 5th-10th week of pregnancy linearly increase with gestationalage.The correlation coefficient was 0.9217 (P<0.05).While the values of ADAM12-S in the ectopic pregnancy group were significantly lower than the normal pregnancy group and not linearly increased with gestationalage.The correlation coefficient was 0.2817.There was statistically significant difference between the two groups (P<0.05).Conclusion The values of ADAM12-S is stable in the first trimester of normal pregnancy,while it is much more lower in abnormal pregnancy.ADAM12-S has great significance in the diagnosis of ectopic pregnancy of the first trimester.

Objective To investigate the protective effects of aspirin on hypoxic brain neural cells of rat and the effects of extracellular calcium on the neuroprotective effect of aspirin. Methods The hypoxic cell model was established by adding Na_2S_2O_4 to the calcium or calcium free medium. Cultured primary cortical neurons of rat were pretreated with ASA in vitro. The change of intracellular free calcium and neuroglobin (NGB) were observed and analyzed by laser scanning confocal microscope. Results The expression level of [Ca~(2+)] i and NGB increased significantly in the chemical hypoxia group ( P < 0. 05 ). ASA can attenuate the increase of [ Ca~(2+) ] i and NGB in the hypoxic group and calcium-free hypoxia group(P <0. 05). Conclusion Aspirin can inhibit calcium overload and the hypoxia-induced expression of NGB, so protect rat brain cells against hypoxia.

Objective To investigate the effects of interferon-γ (IFN-γ) on interleukin-10 (IL-10) and mononuclear macrophages in a mouse model of gallbladder cancer.Methods Mouse models of gallbladder cancer were constructed by inoculating the human gallbladder cancer cell line GBC-SD subcutaneously in 20 BALB/C mice,and then all the mice were randomly divided into the IFN-γ group and the control group (10 mice in each group).Murine recombinant IFN-γ (0.1 mL,1 × 105 kU/L,diluted with normal saline) was injected into the tumors in the IFN-γgroup,and normal saline was injected into the tumors in the control group.The expression of IL-10 was detected by ELISA,and the numbers of CD14 + cells (mononuclear macrophages),CD64 + cells (M1 macrophages) and CD206+ cells (M2 macrophages) were counted by the immunohistochemistry.All data were analyzed using the Student's t test.Results The mouse models of gallbladder cancer were successfully constructed 1 week later.Nine mice survived in the IFN-γ group,and 7 mice survived in the control group.The tumor weight was (518 ± 138)mg in the IFN-γ group and (669 ± 128)mg in the control group,with a significant difference between the 2 groups (t =2.240,P ＞ 0.05).The volume of the tumor was (456 ± 172)mm3 in the IFN-γ group and (505 ± 146)mm3 in the control group,with no significant difference between the 2 groups (t =1.503,P ＞ 0.05).The concentration of IL-10 was (58 ± 16) μg/g in the IFN-γgroup,which was significantly lower than (102 ± 45) μg/g in the control group (t =2.796,P ＜ 0.05).The number of mononuclear macrophages was 81 ± 16 in the IFN-γ group,which was significantly greater than 50 ± 21 in the control group; the number of M1 macrophages was 66 ± 12 in the IFN-γ group,which was significantly greater than 9 ± 4 in the control group ; the number of M2 macrophages was 15 ± 4 in the IFN-γgroup,which was significantly lower than 40 ± 14 in the control group (t =3.214,13.127,6.914,P ＜ 0.05).Conclusions IFN-γ could decrease the concentration of IL-10 in the tumor microenvironment,and it could induce the mononuclear macrophage to infiltrate into the stroma of the gallbladder cancer cells,and most of the monocytes and macrophages were differentiate to M1 macrophages.Gallbladder neoplasms; Interleukin-10; Interferon-γ; Mononuclear macrophages