Primary intrahepatic cholangiocarcinoma (ICC) is the second frequent malignant tumor in adult liver,and appears an increasing tendency worldwide.Gross type is frequently mass-forming and a tubular adenocarcinoma is shown as the typical histopathological appearance.Surgical resection is the only curative treatment,and liver transplantation is selected for the patients with early ICC.Rediofrequency ablation,transcatheter arterial chemoembolization or molecular targeted therapies should be considered in the treatment of the unresectable or recurrent patients.

Objective To explore predictive value of baseline red cell distribution width (RDW) determined in a routine blood count for severity of chronic heart failure (CHF) and mortality during hospitalization.Methods The study group comprised 135 patients hospitalized in the our hospital with CHF in the Ⅱ ～ Ⅳ class according to New York Heart Association (NYHA).The control group included 44 patients in class Ⅰ.Hematological and biochemical parameters were obtained and compared among groups.Receiver operator characteristic (ROC) curves were used for assessing predictive values.Results RDW increased significantly in class Ⅲ and Ⅳ compared to class Ⅰ [(14.3 ±2.3)％ and (14.3 ± 1.7)％ vs (12.9 ±0.8)％,P ＜0.01].Areas under ROCs (AUCs) of RDW,N-terminal prohormone brain natriuretic peptide (NT-proBNP) for class Ⅳ HF was 0.817 and 0.840,respectively.RDW was significantly elevated in mortality group compared to survival group [(15.8 ± 1.8)％ vs (13.7 ± 1.7) ％,P ＜ 0.01],predictive value of RDW was lower than that of NT-proBNP but was comparable to white blood cell (WBC),neutrophil (NEU),lymphocyte (L),and neutrophil/lymphocyte ratio (N/L) for mortality during hospitalization with AUCs (0.837,0.939,0.858,0.891,0.885,and 0.885,respectively).RDW and NT-proBNP showed low predictive values for repeated admission (≥3).RDW was an independent risk factor for mortality (OR =2.531,95％ CI:1.371 ～4.671).Conclusions RDW increased significantly in class Ⅲ and Ⅳ patients and death group.The predictive value of RDW is comparable to NT-proBNP for class Ⅳ and lower than that of NT-proBNP for mortality.Elevated RDW is an independent risk factor for mortality.

Objective To investigate the effect of spinal cord ischemia/reperfusion injury on hindlimb dysfunction in rabbits.Methods Twenty-eight health adult rabbits were distributed into normal control group (n =4) and model group (n =24) according to the random number table.The modelof spinal cord ischemia/reperfusion injury was established by selective occlusion of lumbar arteries.The model group were submitted to ischemia for 30 min (Group Ⅰ),60 min (Group Ⅱ) and 90 min (Group Ⅲ) before the reperfusion with 8 rabbits each.Jacobs score,Reuters score and Rivlin inclined plane test were used to evaluate the hindlimb function in each Group at days 1,3 and 7 after reperfusion.Changes in nerve conduction function in each group were observed using the cortical somatosensory evoked potential (CSEP).Results At days 1,3 and 7,the paraplegia rates in group Ⅰ were 50％,38％ and 38％ respectively,in Group Ⅱ were 75％,88％ and 100％,and in Group Ⅲ were all 100％.Paraplegia rate differed significantly among the three groups at 1 d and 3 d (P ＜ 0.01).Paraplegia rate differed significantly in Groups Ⅱ and Ⅲ when compared to that in Group Ⅰ at 7 d (P ＜ 0.01),but there was no significant difference between Groups Ⅱ and Ⅲ (P ＞ 0.05).With the prolongation of reperfusion,the Reuters score in Group Ⅰ dropped but not differed from that in control group (P ＞ 0.05);the Reuters score in Groups Ⅱ and Ⅲ increased and differed from that the control group (P ＜0.01),but the difference between Groups Ⅱ and Ⅲ was insignificant (P ＞ 0.05).Critical angle and obstacle rate of the inclined plane in control group were (68.4 ± 3.0)° and 0％.One day after reperfusion,critical angles of the inclined plane in Groups Ⅰ,Ⅱ and Ⅲ were (58.8 ± 4.1) °,(38.5 ± 2.8) ° and (29.8 ± 1.8) °,and the obstacle rates were (14.5 ± 0.9) ％,(43.6 ± 2.4) ％ and (56.0 ± 2.9) ％.There were significant differences compared to control group (P ＜ 0.01).Slight decrease in critical angle of the inclined plane but a minor increase in the obstacle rate was detected in Groups Ⅱ and Ⅲ at 3 d and 7 d after reperfusion,and the differences were significant compared to control group (P ＜ 0.01).Three days after reperfusion,critical angle of the inclined plane raised and obstacle rate of the inclined plate fell in group Ⅰ,not significantly different from these in control group (P ＞ 0.05).Latencies of CSEP N1 and P1 waves in Group Ⅱ [(33.1 ± 1.8) ms and (58.6 ± 4.0) ms] were longer than these in control group [(23.7±0.5)msand (48.1±4.1)ms]andgroup Ⅰ [(26.2±0.7)ms and (50.2±4.2)ms] (P＜ 0.01) 7 days after reperfusion,but the differences between control group and Group Ⅰ were insignificant (P ＞ 0.05).While the CSEP wave disappeared in Group Ⅲ.Conclusions Severity of spinal cord inschemia/reperfusion injury is related to the duration of ischemia.Hindlimb dysfunction caused by ischemia/reperfusion injury is characterized mainly by spastic paraplegia.

Objective To analyze the genotype of varicella-zoster virus (VZV) strains isolated from patients with chickenpox or zoster and to differentiate them from Oka vaccine strain by molecular analysis. Methods In the present study, single nucleotide polymorphisms(SNP) based VZV genotypes were analyzed in 19 VZV isolates using the polymerase chain reaction and restriction fragment length polymorphisms analysis of DNA fragments of the open reading frames 38, 54, 62, and the 1t5 repeat region. Results The genotypes of 19 VZV isolates including two different groups with 52.7% of Pst Ⅰ+ Bgl Ⅰ+ R5A and 47.3% of Pst Ⅰ+ Bgl Ⅰ+ R5B, which is very different from those found in North America, Europe and Japan. All the Chinese isolates are wild-type strains with ORF62 Sma Ⅰ-. No Oka vaccine strains were revealed among the isolates. Conclusion Chinese VZV strains reported in this study showed different molecular characteristics from those circulating in Europe, North America and Japan. The SNPs in ORF62 and ORF38 may be used to distinguish VZV wild-type strains and vaccine strain in clinical isolates in China.

β2-Microglobulin is a small molecule protein, consisting of a polypeptide chain.Previous studies have confirmed that serum β2-microglobulin is a biomarker that reflects early renal function injury, and renal function injury is closely correlated with ischemic stroke.Studies in recent years have shown that the level of serum β2-microglobulin increases significantly in patients with ischemic stroke.Thus, it can be used as a biomarker for the risk of ischemic stroke.

Objective To construct the eukaryotic expression vector for IL-37 fused with the enhanced green fluorescent protein (EGFP) and express the fusion protein IL-37-EGFP in 293T cells. Methods The IL-37 and EGFP gene were amplified by PCR, respectively. Then the gene fragments of IL-37 and EGFP were in-serted into the pcDNA3.1 vector to construct the recombinant eukaryotic expression vector pcDNA3.1/IL-37-EGFP. The pcDNA3.1/IL-37-EGFP recombinant expression vector was identified by enzymatic digestion , DNA sequencing, PCR identification. Then the recombinant plasmid pcDNA3.1/IL-37-EGFP was used to transfect 293T cells , the expression of EGFP in 293T cells was detected by fluorescence microscope , the expression of IL-37 in 293T cells was detected by RT-PCR and Western blot. Results The results of enzymatic digestion and DNA sequencing showed that the fusion gene of IL-37 and EGFP linked with (G4S)3 was cloned correctly into pcDNA3.1 vector. The green fluorescence was observed in 293T cells transfected with pcDNA3.1/IL-37-EGFP by fluorescence microscope. RT-PCR and Western blot showed that the expression with high level of IL-37 mRNA and IL-37 protein in 293T cells transfected with pcDNA3.1/IL-37-EGFP , respectively. Conclusion The recom-binant eukaryotic expression vector for IL-37 fused with EGFP, pcDNA3.1/IL-37-EGFP, was constructed suc-cessfully and expressed effectively in 293T cells.

Objective To evaluate the effects of percutaneous cholecystostomy (PCT) for the treatment of acute cholecystitis (AC) in poor-risk patients.Methods A retrospective clinical analysis was undertaken in poor-risk AC patients receiving PCT or emergency cholecystectomy (CCY) from April 2007 to December 2012.The success rate,complications,hospital stay and mortality,and readmission rate were compared between PCT and CCY groups.Results Of the 51 poor-risk acute cholecystitis patients,25 underwent PCT drainages and 26 received emergency CCY at an average age of 75 and 74 years respectively.The average intensive care unit length of stay was 13 days in PCT group and 5 days in CCY group (t =5.175,P =0.001).The mean hospital length of stay in PCT patients (21.3 days) was longer than that in CCY patients (9.8 days) (t =3.213,P =0.002).However,there was no significant difference in the overall hospital mortality,complications and successful rate between the two groups.No recurrence was observed in 19 out of 25 PCT cases after removing PCT catheter.The remaining six patients were readmitted for recurrent AC.Three of them were conservatively treated,while another 3 patients had PCT drainage anew and one of the three underwent delayed CCY 4 weeks after PCT replacement.The overall successful rate of PCT treatment was 76％.Conclusions Compared with emergency CCY,PCT has similar treatment effects in the successful rate of surgical management,morbidity,and overall hospital mortality although it is associated with longer hospital stays and higher readmission rate,which indicated that PCT is a convenient,safe and effective treatment option for poor-risk AC patients.

To investigate the influence factors and effects of metal or dissolving microneedles on the formation and healing of skin microchannels, the pencil-shaped or conical stainless steel microneedles with different lengths, tip to tip space and base area, and the pencil-shaped dissolving microneedles with different tip to tip space were used. The microneedles were applied to the skin of epilatory mice and rats, and the effects of various microneedle parameters, application parameters, and animals on the microchannels were explored by the transepidermal water loss (TEWL) and methylene blue staining. Visually observe the skin local irritation caused by the microneedles. The animal experiments were approved by the Animal Experiments Welfare and Ethical Committee of Zhejiang University of Technology. The application time of the microneedle should be maintained at 30 s or more. When the insertion forces were 2, 4, 8 N, and the TEWL initial values of the formed microchannels were 12.9, 33.0, 40.4 g·m^-2·h^-1, respectively. When the length of metal microneedle were 400, 600, 800 μm, and the TEWL initial values of the formed microchannels were 37.1, 40.4, 49.5 g·m^-2·h^-1, respectively. When the tip to tip space of metal microneedle were 400, 600, 800 μm, and the TEWL initial values of the formed microchannels were 33.2, 40.4, 55.8 g·m^-2·h^-1, respectively. When the base area of metal microneedle were 0.16, 0.35, 0.62 cm², and the TEWL initial values of the formed microchannels were 35.1, 40.4, 67.1 g·m^-2·h^-1, respectively. The effects of conical and pencil-shaped microneedles are similar. When the tip to tip space of pencil shaped dissolving microneedle were 400, 600, 800 μm, and the TEWL initial values of the formed microchannels were 49.8, 60.5, 70.5 g·m^-2·h^-1, respectively. The TEWL baseline values of animal skins of different genders and series are different, but the tendency of microchannels formation and closure is similar. Visual inspection revealed that the slight erythema caused by the microneedles subsided within 24 h. Microneedles of different parameters have different effects on microchannels. The microchannels closed within 24 or 48 h, and the skin local irritation caused by microneedle was mild.

Objective To evaluate of the clinical efficacy and side-effect of 595nm tunable pulsed dye laser in treatment of children heamangioma of skin. Methods A retrospective study was conducted according to 76 children patients with heamangioma of skin (including 53 cases of nevus flammenus, 20 strawberry hemangioma and 3 cavernous hemangioma) treated with 595nm tunable pulsed dye laser. We evaluated the efficacy and side-effect of the treatment. Results The effectiveness rates were 83.2% and 86.63%, respectively, in nevus flammenus and strawberry hemangioma, but there were disappointed efficacy obtained in patients with cavernous hemangioma treated with 595nm tunable pulsed dye laser. There was 7.9% of the side-effect rate in the children with heamangioma of skin treated by 595 nm tunable pulsed dye laser. Conclusion There is satisfactory clinical efficacy and lower side-effect for children hemangioma treated by 595nm tunable pulsed dye laser.

Objective:To investigate the clinical efficacy of Zhang's acupoint pressure therapy plus electroacupuncture (EA) in treating post-traumatic knee osteoarthritis.Methods:A total of 98 eligible patients with post-traumatic knee osteoarthritis were divided into group A and B by the random number table, 49 cases in each group. Group A was intervened by Zhang's acupoint pressure therapy plus EA; group B was given medicinal fumigation. The clinical efficacies of the two groups were compared.Results:The markedly effective rate of group A was significantly higher than that of group B.Conclusion:Zhang's acupoint pressure therapy plus EA can produce a satisfactory clinical efficacy in treating post-traumatic knee osteoarthritis, and is worth promotion.