Curative resection can offer a better chance for long-term survival than any other therapeutic modalities for hilar cholangiocarcinoma.This review highlights recent improvements in hilar cholangiocarcinoma management,with special attention to the new staging system for hilar cholangiocarcinoma,the perioperative management and the accurate dissection approach to achieve more adequate tumor-free resection margin.Overall,the precise surgical strategy and appropriate surgical techniques may provide an increased chance to cure patients with hilar cholangiocarcinoma.

The Wnt signaling pathway,including the canonical and the non-canonical,is a conservative pathway which participates in organ development and tissue metabolism.The canonical Wnt pathway plays an important role in osteogenesis,bone formation and mineralization through the osteogenesis associated transcription factors.The canonical Wnt pathway also regulates osteogenic differentiation of the stem cells in the periodontal tissue and the regulative effect is influenced by the microenvironment.Understanding of the canonical Wnt pathway will contribute to the treatment of some related bone diseases.

OBJECTIVE:To explore the ways of development of drugstores in China.METHODS:To analysis the current situation of drugstores in China and to study the successful experience of developing drugstores in U.S.A.RESULTS & CONCLUSION:China's drugstores should develop a diversifying economy,implement chain-store operation and shape their own brand products.

Leptin,a peptide hormone synthesized and secreted primarily by adipose tissue,plays an important role in the regulation of body weight,metabolic and endocrine responses.It has emerged recently as a protective factor in multiple organ resistance to injury.We reviewed the protective effect of leptin and its possible mechanism.

Guided by the modern constructivism of the educational psychology theory,the author have carried out the teaching reformation on the students majoring in Applied Psychology in the past three years,and in combination with the characteristics and teaching requiement of each key course,explored many kinds of teaching mode such as the teaching mode of the scaffolding instruction in the operating experiments,of the random community practice,of the group supervision,of the problem-based anchored instruction and of the clinical situation etc.And the the preliminary effect has been got.

ObjectiveTo explore the expression of EZH2 and p53 protein in primary prostate cancer (Pca) and its clinical significance.Methods High-throughput tissue microarray technique and immunohistochemistry was used to detect the expression of EZH2 and p53 protein in 48 human prostate cancer specimens without a history of chemo-radiation therapy and 15 cases of benign prostate hyperplasic (BPH) tissues. The pathological characteristics and the relationship of the expression of EZH2 and p53 protein in primary prostate cancer was analyzed. ResultsImmunohistochemical results showed that the positive rates of EZH2 and p53 protein in prostate cancer were 87.50 ％ (42/48) and 33.33 ％ (16/48), respectively, which were significantly higher than that in BPH tissues[13.33 ％ (2/15) and 0 (0/15)](x2=26.429, x2=5.058,P ＜0.05). The expression of EZH2 and p53 protein was significantly related to Gleason score, TNM stage (P ＜0.05), but not to age and serum prostate-specific antigen (PSA) level (P ＞0.05). The positive expression in patients with Gleason＞6 was higher than that with Gleason≤6(P ＜0.05).The positive expression in patients with T3-T4 stage was higher than that with T1-T2 stage(P ＜0.05).Spearman rank correlation showed a significantly positive correlation between EZH2 and p53 protein (r=0.294, P ＜0.05). ConclusionEZH2 and p53 protein may participate in the pathogenesis of prostate cancer.The overexpression of EZH2 and p53 protein could become an index for the evaluation of the level of malignancy and progression of prostate cancer.Furthermore,combining detection of EZH2 and p53 protein may provide a new theoretical basis for the treatment of prostate cancer.

Objective To study the effects of Tongluo recipe on p38 mitogen-activated protrin kinase (p38 MAPK)- fibronectin(FN) signal pathway in the kidney of streptozotocin-induced diabetic rats, so as to explore the possible mechanism by which Toogluo recipe protects the kidney. Methods Male Sprague-Dawley(SD) rats were randomly divided into 3 groups(n = 7): control group (CON group), model group(DM group)and Toogluo recipe group(DM+TLR group). Rats in the DM group and DM+TLR groups were administered with streptozotocin (65 mg/kg) by intraperitoneal injection to induce diabetic model. Rats in DM + TLR group were also given 1g/(kg·d) of Toogluo recipe orally after successfully establishment of diabetic model, and rats in DM and CON groups were only given equivalent volume of ddH2O. The interference lasted for 12 weeks. Biochemical indices were obtained by automatic analyzer. Coomassie brilliant blue assay was used to measure the 24-hour urine protein. Kidney cortex was subjected to PAS staining. Western blotting analysis was used to detect the protein expression of total p38 MAPK (t-p38 MAPK), phosphorylated p38 MAPK (p-p38 MAPK), total cAMP response element-binding protein (t-CREB), phosphorylated CREB (p-CREB) and FN. Results Compared with CON group, the average left kidney mass/body mass (LKM/BM), blood glucose(BG), blood urea nitrogen(BUN), serum creatinine(Scr), 24-hour urine proteins(24 h UP) and urine protein/creatinine (UP/Ucr) were significantly increased in the DM group (P< 0.05); the average BM was significantly decreased(P<0.05); and the expression of p-p38 MAPK, p-CREB, FN was increased by 2.37, 2.21, and 2.03 folds, respectively (P< 0.05). Compared with DM group, the average LKM/BM, Scr, 24 h UP and UP/Ucr were significantly decreased (P<0.05) in DM+TLR group, and the expression of p-p38 MAPK, p-CREB, FN was significantly decreased(P< 0.05). Conclusion Tongluo recipe can protect the kidney in diabetic nephropathy rats, probably through inhibition of the p38 MAPK-FN pathway.

Objective To investigate the role of stem cell factor (SCF) and mast cells (MC) in the pathogenesis and progression of dermal lesions caused by chronic renal failure.Methods Thirty-six Wistar rats were randomly divided into model group (adenine lavage at a dose of 150 mg·kg-1·d-1) and control group (physiological saline lavage at equal volume).Six rats from each group were sacrificed respectively at week 4,8 and 12.The intensity of MC infiltration was examined by toluidine blue staining. The expression of SCF was detected by immunohistochemistry and real-time fluorescence quantitative PCR. Results Compared with control group,the intensity of MC and the expression of SCF were significantly higher in dermal tissue of model group (P＜0.O1,respectively),and they were increased with time.In the model group,the number of MC infiltration was positively correlated with both the protein expression of SCF (r=0.81,P＜O.01) and the level of SCF mRNA (r=0.65,P＜0.01). Conclusion The increased SCF and MC may participate in the pathogenesis and progression of dermal lesions caused by chronic renal failure.

Objective To present the preliminary clinical results of anterior thoracoscopic correction for thoracic idiopathic scoliosis and consider its ind ications. Methods Between June 2002 and May 2003, 8 female patients with a diagn osis of right thoracic idiopathic scoliosis were selected to undergo thoracoscop ic instrumentation, correction and fusion using Eclipse system. The average age at surgery was 14.8 years (ranged from 13 to 16 years). The average preoperative Cobb angle was 54? (ranged fom 40? to 72?). 5 had idiopathic thoracic curves of King type Ⅲ, 2 of King type Ⅱ, and 1 of King type Ⅴ. The Risser sign rang ed from (+++) to (++++). The bending films of the thoracic curves showed a flexi bility of 60%-75%. The thoracic sagittal profiles remained normal without obviou s kyphosis or lordosis. In all cases the rotation of the top vertebra of scolios is was of degree Ⅰ. The operative time, blood loss, postoperative drainage, the number of instrumented levels, curve correction and loss of correction were ana lyzed. Results The instrumented levels were from T5 to T12. The average number o f instrumented levels for each patient was 7.4. The operative time averaged 6 ho urs. The blood loss during surgery averaged 629 ml (ranged from 400 to 800 ml), with no blood transfusions being required, except in one case. The average posto perative drainage was 500 ml. The postoperative Cobb angle was 15? on average w ith curve correction of 74%. With an average follow-up period of 6.5 months (ran ged from 3 to 12 months), the loss of correction averaged 8.3%. No hardware comp lications occurred. Conclusion Compared to the open anterior and posterior surge ry, the thoracoscopic Eclipse instrumentation is a safe and an effective way to correct thoracic idiopathic scoliosis with similar short-term postoperative resu lts. However, challenging issues remain. These included long operative time, hig h technical requirement, relatively limited indication and large radiation expos ure. Again, further research is needed to study its long-term impact.

0.05). Conclusion Thoracoscopic anterior spinal release have comparable clinical results as conventional thoracotomic release for AIS patients.