Ductal strictures, recurrent cholangitis, liver atrophy or hepatic abscess, and ultimate cholangiocarcinoma are the major pathological entities of primary hepatolithiasis. Because of distinctive bile ductal lesion and hepatic tissue inflammation, liver resection indicated for hepatolithiasis should have different emphasis on perioperativer assessments and managements from hepatectomy for liver cnacer. Preoperative assessment should focus on the feasibility of precise hepatectomy for good long-term outcome. Percutaneous bile duct drainage is considered preferentially for patients with cholangitis. Attention should be paid to avoiding major blood loss, postoperative bile leakage and infectious biloma formation in surgical steps such as hepatic hilum dissection, liver parenchymal transection, bile duct exposure, bile duct stump closure and drainage of liver raw surface. The indication for biliary reconstruction should be based on the estimation of function of the Oddi sphincter. For residual hepatolithiasis, choledochoscopical trans-T tube stone withdraw should carried out 3 months postoperatively in prevention of laceration of T-tube fistula.

Background and purpose:Differentiation of tumor tissue is an important factor on determining the prognosis of gastric cancer. This study aimed to investigate the expression levels and clinical signiifcance of gender determining region Y-box 2 (SOX2) gene and octamer binding factor 4 (OCT4) gene in gastric cancer tissues varying different differentiation degrees. Methods: Sixty cases with gastric cancer were recruited in this study. The gastric cancer tissues and corresponding normal mucosa of the 60 cases were obtained. The mRNA and protein level of SOX2, OCT4 gene are evaluated by the quantitative real-time PCR (qRT-PCR), Western blot and immunohistochemistry, respectively. The relationship between the expression levels of SOX2, OCT4 gene and clinical pathological parameters were also analyzed in this study. Results:The expression of SOX2 in both mRNA and protein levels had no signiifcant difference between the well-differentiated gastric cancer tissues and normal gastric mucosa (mRNA levels:t=0.1033, P>0.05;protein levels:t=0.116, P>0.05). However, both the mRNA and protein expression of SOX2 in patients with well-differentiated gastric cancer tissues were signiifcant higher than not only in patients with moderately differentiated gastric carcinoma (mRNA levels: t=12.48, P<0.05; protein levels: t=22.78, P<0.05) but also in patients with than poorly differentiated gastric carcinoma (mRNA levels:t=17.56, P<0.05;protein levels:t=30.00, P<0.05). In contrast to SOX2, both the mRNA and protein expression of OCT4 in patients with well-differentiated gastric cancer tissues were signiifcant lower than not only in patients with moderately differentiated gastric carcinoma (mRNA levels:t=13.23, P<0.05; protein levels: t=25.56, P<0.05) but also in patients with poorly differentiated gastric carcinoma (mRNA levels: t=12.10, P<0.05; protein levels: t=69.48, P<0.05). There was no significance of OCT4 mRNA and protein expression between the well-differentiated gastric cancer tissues and normal gastric mucosa (mRNA levels:t=2.436, P>0.05;protein levels:t=1.064, P>0.05). Immunohistochemical study demonstrated that the positive rate of SOX2 in patients with well-differentiated gastric cancer tissues (10/21) were higher than in patients with not only moderately differentiated gastric carcinoma (7/20) but also poorly differentiated gastric carcinoma (2/19, P<0.05), while the positive rate of OCT4 in cases with well-differentiated gastric cancer tissues (2/21) were lower than in cases with not only moderately differentiated gastric carcinoma (6/20) but also the poorly differentiated gastric carcinoma (12/19, P<0.05). There was no correlation between the expression of SOX2, OCT4 in gastric cancer and gender or age (P>0.05). Nevertheless, the expression of SOX2, OCT4 were positive or negative correlated with the pathological staging, the degree of inifltration and lymph node metastasis (P<0.05). Conclusion:Decreased SOX2 expression and increased expression level of OCT4 can promote the formation, development and invasion of gastric cancer and they may become biomarkers or the diagnosis, treatment and prognosis evaluation in gastric carcinoma.

Objective To study the neuroprotective effect of fucoidan against 6-OHDA-induced damage on MN9D cell line and preliminarily explore its mechanism.Methods The MN9D cells were treated with different concentrations of 6-OHDA(12.5,25,50,100 and 200 μmol/L)for 24 h and with 50 μmol/L 6-OHDA for different time courses(6,12,24 and 48 h)as well.Based on the above experiment,the best concentration(50 μmol/L)of 6-OHDA and time course(24 h)were selected and the damaged model of MN9D cell line was induced accordingly.The MN9D cells were pretreated with 0.01,0.1 and 1.0 mg/mL fucoidan for 1 h,and then co-treated with 50 μmol/L 6-OHDA for 24 h.The viability of MN9D cells was detected by MTT assay;the LDH leakage was detected by bioassay;the level of intracellular xidative stress was observed by 2',7'-dichlorodihydrofluorescein diacetate assay.Results MTT metabolic value decreased following the increase of 6-OHDA concentration or the extension of processing time.Treatment with 50 μmol/L 6-OHDA for 24 h induced a significant decrease of MTT metabolic rate and an increase of LDH leakage rate in the MN9D cells.Pretreatment with 0.1 and 1.0 mg/mL fucoidan inhibited the death of 6-OHDA-induced cells,increased the MTT metabolic value and decreased the LDH leakage.Cell morphological changes were consistent with the biochemical experiments.Treatment with 50 μmol/L 6-OHDA for 8 h could significantly increased the generation of reactive oxygen species induced by 6-OHDA,while pretreatment with 1.0 mg/mL fucoidan for 1 h showed antagonism on that.Conclusion Fucoidan can protect MN9D cells from the death induced by 6-OHDA and the underlying mechanism may be involved in the antioxidant capacity of fucoidan.

OBJECTIVETo study the association between the single nucleotide polymorphisms (SNPs) in the high-temperature requirement A-1 (HTRA1) gene and rheumatoid arthritis (RA) in Chinese Han population.

METHODSFive SNPs in the HTRA1 gene (rs2014307, rs2248799, rs2300433, rs714816 and rs2268356) were genotyped by ABI Snapshot method in Han Chinese cohort composed of 344 patients with RA and 288 healthy controls. The serum rheumatoid factor (RF) and C-reactive protein (CRP) of the patients were determined by endpoint nephelometry method.

RESULTSGenotypes of all the five SNPs in the HTRA1 gene were not significantly different between the RA patients and controls (P> 0.05). Haplotypes generated by these five SNPs did not show significantly difference between the two groups either (P> 0.05). Serum RF levels in the RA patients had no significant difference among the genotypes for four SNPs (rs2014307, rs2248799, rs714816, and rs2268356) in the HTRA1 gene, while RF levels in the RA patients with genotypes AA+AG of the rs2300433 locus were significantly higher than that in genotype GG carriers (P< 0.05). Serum CRP levels in the RA patients had no significant difference among the genotypes for all the five SNPs.

CONCLUSIONAuthor's results suggested that although the five SNPs in the HTRA1 gene were not associated with RA in Chinese Han population, RF levels in the RA patients with genotypes AA and AG in the rs2300433 locus were significantly higher than the GG carriers. The HTRA1 role in RF regulation needs to be further investigated.

Aged ; Arthritis, Rheumatoid ; genetics ; Female ; Genetic Predisposition to Disease ; genetics ; Genotype ; Haplotypes ; High-Temperature Requirement A Serine Peptidase 1 ; Humans ; Male ; Middle Aged ; Polymerase Chain Reaction ; Polymorphism, Single Nucleotide ; genetics ; Serine Endopeptidases ; genetics

In the context of internationalization of education,the military graduate education concepts and models also come to change,and opportunities and challenges coexist.In this article,the challenges and problems of army medical college graduate education were mentioned and analyzed,and the exploration and attempt of graduate education in the process of international were summarized.

Objective To identify the association between gestational weight gain and birth weight over the past 9 years in Kunshan city,Jiangsu province,China.Methods This population-based study was conducted between 2001 to 2009.Data were retrieved from Perinatal Monitoring System of Maternal and Child Health Care Hospital of Kunshan.The study population consisted of 33 631 women and singleton live fetus.Gestational weight gain was defined as the total weight gain during the last and first prenatal care program and divided by the interval weeks.Results From 2001 to 2009,the average incidence of low birth weight was 1.86％,while the average incidence of macrosomia was a bit higher,fluctuating around 8.47％.On those underweight mothers,after adjustment for potential confounders,and stratified by the BMI levels,which were evaluated at the first prenatal care program,we found that weight gain in the 3rd and 4th intervals,could reduce the risk of low birth weight (less than 2500 g).With those mothers with normal-weight,weight gain in the 2 rid,3 rd and 4th intervals,would reduce the risk of low birth weight.Risks in the 4th quantile among underweight and normal-weight group were prevalence odds radio (POR) 95％CI:0.51 (0.32-0.80) and 0.58 (0.42-0.79),respectively.The risks showed a significant downward trend in underweight and normal- weight groups with increased gestational weight gain.As for macrosomia (≥4000 g),the risks increased (POR 95％CI) 4.69(2.82-7.81 ) in underweight,4.15 (3.43-5.03) in normal-weight,in overweight,3.64 (2.62-5.06) and 1.96 (1.48-2.60) in obese mothers with increased levels of gestational weight gain.Trend tests indicated that the risks of marcosomia increased in all levels of BMI,with the increase of gestational weight gain.Conclusion Findings from this population-based study suggested that gestational weight gain could reduce the risks of low birth weight among underweight and normal-weight groups,while increase the risks of macrosomia in all parturients,as compared with lowest levels of gestational weight gain.

OBJECTIVETo investigate the therapeutic effect of Baitouweng Decoction on dextran sodium sulphate (DSS)-induced ulcerative colitis in mice and explore its mechanism involving miR-19a.

METHODSForty female c57 mice were randomly allocated into 4 equal groups, namely the normal control group, model group (treated with 3.5% DSS solution), treatment group (treated with DSS+Baitouweng Decoction), and positive control group (treated with DSS+5-ASA). Ulcerative colitis was induced in the mice by feeding them with 3.5% DSS in drinking water, and the mice in the control group were given water only. The disease activity index (DAI) of the mice in each group was recorded daily. Seven days later, the mice were sacrificed for histological examination of the intestines using HE staining; the expression of miR-19a mRNA in the intestines was detected using RT-qPCR.

RESULTSCompared with the control group, the model group showed significantly increased DAI and histological scores, and administration of Baitouweng Decoction significantly lowered the DAI and histological scores of the DSS-treated mice. The expression of miR-19a was lowered following DSS treatment, and Baitouweng Decoction treatment caused an increased miR-19a expression in DSS-treated mice.

CONCLUSIONBaitouweng Decoction has therapeutic effects on DSS-induced ulcerative colitis in mice, and this effect is probably mediated by enhancement of miR-19a expression in the intestines.

Animals ; Colitis, Ulcerative ; drug therapy ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Female ; Intestines ; metabolism ; Mice ; Mice, Inbred C57BL ; MicroRNAs ; metabolism ; Phytotherapy

OBJECTIVETo study the optimum acupuncture treatment program and the mechanism for treatment of cerebral infarction.

METHODSSixty-three cases were randomly divided into 9 groups. The four factors, times of manipulation, the retaining time of the needle, acupuncture instrument and acupoints,and their corresponding three levels were adopted respectively in treatment of each group. Then nerve function defect score and insulin resistance were observed before and after treatment.

RESULTSThe acupoints, the times of manipulation and the retaining time of the needle have significant effects on nerve function defect and insulin resistance (P < 0.01 or P < 0.05), and the acupuncture instrument has a significant effect on insulin resistance (P < 0.01). The choice of acupoints was the most important factor for acupuncture treatment of cerebral infarction.

CONCLUSIONAcupuncture for regulating The Governor Vessel with twice manipulations and retaining the needle for 60 min is optimum treatment program for cerebral infarction. The good regulating effect of acupuncture on insulin resistance is one of the mechanisms of achieving the therapeutic results.

Acupuncture Points ; Acupuncture Therapy ; Cerebral Infarction ; Humans ; Insulin Resistance ; Needles

OBJECTIVE: To evaluate the value of super-elective transcatheter external carotid arterial embolization (TAE) in the treatment of intractable epistaxis. METHOD: Forty-six cases of intractable epistaxis were selected, TAE was performed in 36 cases and externa carotid artery ligation was elected in 10 cases. RESULT: The curing rate was 88.9% (32/36) in cases treated by TAE and was 40.0% (4/10) in cased treated by external carotid artery ligation, and the average hospital days of the former was 4.8 days, while the latter was 10 days. Recurrency were effectively stopped bleeding by all kinds of methods, and complications were rare. CONCLUSION Transcatheter external carotid arterial embolization is a simple, safe and effective treatment for the intractable epistaxis, which has more advantages than external carotid artery ligation, and comprehensive methods can effectively and thoroughly cure intractable epistaxis.
Adult ; Aged ; Carotid Artery, External ; Embolization, Therapeutic ; methods ; Epistaxis ; therapy ; Female ; Humans ; Male ; Middle Aged ; Treatment Outcome

To discuss the effects on early warning of measles, using the neural networks.Based on the available data through monthly and weekly reports on measles from January 1986 to August 2006 in Wuhan city. The modal was developed using the neural networks to predict and analyze the prevalence and incidence of measles. When the dynamic time series modal was established with back propagation(BP) networks consisting of two layers, if p was assigned as 9, the convergence speed was acceptable and the correlation coefficient was equal to 0.85. It was more acceptable for monthly forecasting the specific value, but better for weekly forecasting the classification under probabilistic neural networks (PNN). When data was big enough to serve the purpose, it seemed more feasible for early warning using the two-layer BP networks. However, when data was not enough, then PNN could be used for the purpose of prediction. This method seemed feasible to be used in the system for early warning.