Objective To analyze the clinical features of intrahepatic biliary cystadenoma and cystadenocarcinoma.Methods Sixteen patients from Dec.2008 to Dec.2013 were retrospectively reviewed to investigate their clinical manifestations,image features,treatment and prognosis.Results Intrahepatic biliary systadenoma and occured occurred primarily in middle-aged women with no typical clinical manifestations.Image examination is the key method in diagnosis.Surgery is the only method to cure the disease.The procedure depends on its location,and its prognosis is related to complete surgical resection.Conclusion Intrahepatic biliary cystadenoma and cystadeno-carcinoma is a rare tumor occuring mostly in middle-aged women.Image examination is the key method in diagnosis.Complete surgical resection contributes to its better prognosis.

Objective To set up a new real-time quantitative PCR method for the detection of minimal residual disease in chronic myeloid leukemia patients, and to assess the bcr/abl fusion gene expression in chronic myeloid leukemia patients before and after treatment with imatinib mesylate by real-time quantitative PCR method. Methods The bcr/abl fusion gene expression in 30 patients with bcr/abl-positive chronic myeloid leukemia was analyzed by using real-time quantitative reverse transcription PCR (RQ-PCR) method. The patients treated with imatinib in a dose of 400mg/d for 1 year and 2 years were also examined (8 cases for each). In 19 new patients the same study was also conducted. Results The real time quantitative PCR method could detect 10 copies in the test. The average bcr/abl expression levels in new patients or patients who had been treated with imatinib for 1 year and 2 years were 68.18%?26.67%, 0.16%?0.15% and 0.04%?0.02%, respectively. The average logarithm reduction values after treatment were 2.82 in the first year and 3.36 in the second year. In 25% of patients (4/16) negative FISH results could not be obtained, but it was much lower than that of before imatinib-treatment. When FISH became negative, RQ-PCR showed positive results. Conclusions RQ-PCR is a more sensitive technique in the detection of bcr/abl fusion gene than the FISH. It is an important way to monitor the tumor cell during the treatment with imatinib mesylate in chronic myeloid leukemia patients.

Oxytocin ( OT ) is a cyclic neuropeptide containing nine amino acids residues, in addition to the traditional roles of uterine contraction and lactation, it also plays important roles in the central nervous system and other peripheral organs, such as improving schizophrenia, autism - related psychiatric and psy-chological symptoms. Oxytocin exhibits its physiological func-tions by binding to its receptor (oxytocin receptor,OTR). Cur-
rently researchers are manipulating OT system by developing new OTR ligand ( agonists and antagonists ) , hoping to prevent and treat OTR related diseases. This paper reviews the latest devel-opment of OTR agonists, antagonists and its physiological roles in central nerve system and peripheral organs.

AIM:To determine the effects and mechanisms of interleukin-22 (IL-22) on the fibroblast-like sy-noviocytes ( FLSs) from rheumatoid arthritis ( RA) patients.METHODS:RA-FLSs were cultured by tissue culture meth-od.RA-FLSs were incubated with different concentrations of IL-22 (0,1,10,100μg/L) for 24 h, 48 h and 72 h.The cell viability was examined by CCK-8 assay.IL-22 at concentration of 10 μg/L was used to stimulate RA-FLSs for 24 h, and the change of cell cycle distribution was identified by flow cytometry.The effects of IL-22 at concentrations of 0, 1, 10, 100μg/L and/or STA-21 (a STAT3 inhibitor at concentrations of 0, 25, 50μmol/L) on the protein levels of Bcl-2 and p-STAT3 in the RA-FLSs were determined by Western blot.RESULTS:Compared with control group, stimulation of rhIL-22 at different concentrations for 24 h, 48 h and 72 h, the cells viabilityof RA-FLSs were obviously increased ( P<0.05 ) . After co-cultured with 10 μg/L rhIL-22 for 24 h, the percentages of RA-FLSs were obviously increased in the G2/M+S phase and decreased in the G0/G1 phase.At the same time, rhIL-22 increased, but STA-21 decreased the protein levels of Bcl-2 but p-STAT3 in the RA-FLSs obviously (P<0.05).Treatment with STAT3 inhibitor STA-21 reversed the effect of IL-22-induced Bcl-2 upregulation in the RA-FLSs ( P<0.01 ) .CONCLUSION: STAT3 is critical in the process of IL-22-induced Bcl-2 upregulation in RA-FLSs, indicating that IL-22 may play a role in the apoptosis of RA-FLSs.

Objective To investigate the feasibility,safety and clinical efficacy of three-port laparoscopic sleeve gastrectomy (TLSG).Methods The retrospective cross-sectional study was conducted.The clinical data of 104 obese patients who were admitted to the Beijing Friendship Hospital of Capital Medical University between September 2016 and March 2017 were collected.TLSG was performed to all the 104 patients by the same surgical team.The surgical situations,conversion situations (port-site increased or conversion to open surgery),operation time,volume of intraoperative blood loss,surgery-related complications,duration of postoperative hospital stay and follow-up situations were observed.Patients were followed up by Wechat,telephone interview and inpatient examination once at month 3,6,9 and 12 postoperatively and once every year after 1 year postoperatively up to April 2017.Follow-up included weight-loss efficacy and postoperative long-term complications.Measurement data with normal distribution were represented as x±s or average (range).Results All the 104 patients underwent successful TLSG,without port-site increased or conversion to open surgery.Operation time and volume of intraoperative blood loss were (121±25)minutes and (9±6)mL,respectively.There was no severe intraoperative collateral damage.All the 104 patients with complications were cured by symptomatic treatment,including 1 with port-site infection,1 with peritoneal effusions causing secondary infection,3 with improper eating-induced acute delayed gastric emptying,6 with fat liquefaction around port-site and 9 with delay healing of port-site.There was no occurrence of severe complications,such as gastrointestinal bleeding,intra-abdominal bleeding and gastrostoma.Duration of postoperative hospital stay was (2.4±0.8)days.Eighty-two patients were followed up for 3 months (range,3-6 months),including 59 with 3-month follow-up,23 with 6-month follow-up and 22 with under 3-month follow-up.During the follow-up,there was no port-site hernia.Excess weight loss (EWL) was 37％± 11％ in 59 patients with 3-month follow-up and 45％± 13％ in 23 patients with 6-month follow-up.Of 59 patients with 3-month follow-up,14 patients with diabetes mellitus stopped taking antidiabetic drugs,10 of 14 patients had complete remission (CR) of hemoglobin Alc (HbAlc) and 4 of 14 patients had partial remission (PR) of HbAlc.Of 23 patients with 6-month follow-up,6 patients with diabetes mellitus had CR of HbAlc.Of 18 patients with obstructive sleep apnea hypopnea syndrome (OSAHS),4 had 3-month follow-up,including 3 with CR and 1 was improved to mild OSAHS.Other 14 patients were not evaluated due to inadequate follow-up time.Conclusion TLSG for obese patients with specific indications cannot increase operation time and risk,meanwhile,it can reduce port-site,with a good cosmetic effect.

Objective:To investigate the expression and clinical significance of Nusap1 in hepatical carcinoma. Methods:The expression of Nusap1 protein in 61 specimens of hepatical carcinoma was examined by immunohistochemistry. Based on the levels of Nusap1 expression, the 61 specimens were divided into a high Nusap1 expression group and a low Nusap1 expression group. The correlation between Nusap1 expression with clinicopathologic features and prognosis of hepatical carcinoma was analyzed. Results:TherateofhighNusap1expressionwas54.1%inhepaticalcarcinoma.TherateofhighNusap1 expression was 21.3%in noncarcinoma, with signiifcant difference between the 2 groups (P<0.01).Nusap1 overexpression had signiifcant correlation with histological differentiation, tumor size, liver cirrhosis,lymphaticmetastasis,tumorthrombiandearlyrecurrence(P<0.05),butnotwithsex,age,AFP level,tumornumber,TNMclassificationandtumorencapsulation(P>0.05).Survivalanalysissuggested thatthe6monthand12monthnoncarcinomasurvivalratewassignificantlylowerinthehighNusap1 expression group [33.3%(11/33), 17.9%(5/33)] than that in the low Nusap1 expression group [89.3%(25/28), 53.6%(15/28);P<0.005]. Conclusion:Nusap1 is overexpressed in hepatical carcinoma and is a valuable prognostic factor for hepatical carcinoma.

Purpose To evaluate renal function recovery state with color Doppler ultrasound before and after ultrasonic pneumatic ballistic lithotripsy under percutaneous nephrolithotomy. Materials and Methods 79 patients with 81 kidneys with upper urinary tract stones underwent ultrasonic pneumatic ballistic lithotripsy under percutaneous nephrolithotomy, renal parenchymal thickness, renal collecting system separation degree and renal arterial resistance index (RI) were measured with color Doppler ultrasound before and after the operation, subjects were divided into renal dysfunction group (both preoperative and postoperative GFR <20 ml/min, the difference <20 ml/min), renal function significantly improved group (postoperative GFR greater than preoperative, the difference>20 ml/min), renal function significantly impaired group (postoperative GFR less than preoperative GFR, the difference>20 ml/min) and no significant improvement group (both preoperative and postoperative GFR were >20 ml/min, the difference <20 ml/min) according to the preoperative and postoperative glomerular filtration rate (GFR) difference. Renal parenchymal thickness, renal collecting system separation degree and renal artery RI of each group were compared, and their correlation with GFR was analyzed. Results Statistically significant differences (F=129.750, 110.953, 45.411, 18.530, 18.904, 12.565, 27.291, 24.263; P<0.05) were detected in all the four groups between preoperative and postoperative renal parenchymal thickness, renal collecting system separation degree, interlobar renal artery (IRA) and main renal artery (MRA) RI. There was a significant positive correlation (r=0.916, P<0.05) between renal parenchymal thickness and pre-and post-lithotripsy GFR, and a significant negative correlation (r=-0.886,-0.903,-0.923;P<0.05) between renal collecting system separation degree, IRA and MRA RI with pre-and post-lithotripsy GFR. The sensitivity and specificity were 93.4%and 97.3%, respectively when taking renal parenchymal thickness<0.32 cm, renal collecting system separation degree >4.27 cm, IRA RI and MRA RI>0.8 as diagnostic standard for kidney dysfunction; and the sensitivity and specificity were 87.4% and 85.7%respectively when taking IRA RI<0.72 as diagnostic standard for renal function improvement. Conclusion Renal parenchymal thickness <0.32 cm, renal collecting system separation degree >4.27 cm, IRA and MRA RI >0.8, and IRA RI <0.72 can be regarded as clinical reference standard for renal function prognosis of kidney dysfunction and hypo-functional before conducting ultrasonic pneumatic ballistic lithotripsy under percutaneous nephrolithotomy.

Objective:To investigate the association of Subclinical Carotid AtheroSclerosis (SCAS) and prediabetes or Diabetes Mellitus (DM)in the healthy people.Methods:From September 2018 to June 2019, participants who underwent physical examination in the Health Management Center of Beijing Tiantan Hospitial were enrolled consecutively. The baseline characters were collected prospectively. Carotid Ultrasound was evaluated by radiologists according to the standard operating protocol. Univariable analysis and multivariable logistic analysis were used to estimate the association of prediabetes or DM with SCAS.Results:Totally 401 participants were eligible and enrolled. The mean age was (52.2±10.4) years and 43.7% (252/401) of them were females. The prevalence of DM and SCAS were 16.4% (66/401) and 48.9% (196/401) respectively. In the univariate analysis, elder age (≥60 years old) ( OR=5.93, 95% CI: 3.86-9.09, P<0.001), hypertension ( OR=2.76, 95% CI: 1.84-4.15, P<0.01), prediabetes( OR=1.67, 95% CI: 1.08-2.58, P<0.05) and DM ( OR=3.60, 95% CI: 1.97-6.58, P<0.01), cigarettes smoking ( OR=2.64, 95% CI: 1.82-3.81, P<0.001), lower HDLlevel<1.04 mmol/L ( OR=1.58, 95% CI: 1.04-2.42, P<0.001) and hyperhomocysteinemia (≥15 μmol/L)( OR=1.69, 95% CI: 1.17-4.04, P<0.01) were associated with higher prevalence of SCAS. On the contrary, female sex ( OR=0.53, 95% CI: 0.39-0.74, P<0.001) was associated with lower prevalence of SCAS. In the multivariable logistic analysis, elder age(≥60 years old) ( OR=6.04, 95% CI: 3.13-11.7, P<0.01), hypertension ( OR=2.14, 95% CI: 1.13-3.87, P<0.05), cigarettes smoking ( OR=2.19, 95% CI: 1.21-3.98, P<0.05) and DM ( OR=2.32, 95% CI: 1.16-4.67, P<0.05) were associated with SCAS independently. The association between prediabetes and SCAS was not statistically significant. Conclusions:DM is independently associated with SCAS in neurological healthy people, while prediabetes tended to increase the risk of SCAS.

Objective To explore the influence factors of cirrhosis complicated with upper gastrointestinal bleeding,and to guide the clinical treatment of patients with cirrhosis and prevent upper gastrointestinal bleeding.Methods One hundred and seventy-five cases patients with cirrhosis and upper gastrointestinal bleeding were treated in the Infectious Disease Hospital of Tangshan and the Affiliated Hospital of North China University of Science and Technology from July 2013 to July 2015 as the case group.One hundred and eighty-two patients with cirrhosis and no upper gastrointestinal bleeding at the same period in hospital as the control group.A face to face questionnaire was used to fill in the questionnaire.Results Multifactor conditional Logistic regression analysis showed that onset season (OR =4.185,95％ CI:1.874-8.354),non steroidal drugs (OR =6.215,95％ CI:2.681-15.532),drinking (OR =5.481,95％ CI:3.205-11.225),portal vein highpressure gastropathy(OR =7.658,95％ CI:3.227-14.714),diameter of portal vein (OR =8.901,95％ CI:1.218-9.026),liver function classification (OR =13.124,95 ％ CI:2.107-15.228) and esophageal varices (OR =11.021,95％ CI:2.181-13.487) were related with patients with liver cirrhosis complicated with upper digestive tract hemorrhage.Conclusion The onset season,nonsteroidal anti-inflammatory drugs,drinking,portal hypertensive gastropathy,portal vein diameter,liver function classification and esophageal varices are the risk fators of liver cirrhosis complicated with upper digestive tract hemorrhage factors.

Objective To investigate the function of triggering receptor expresses on myeloid cells receptor-1 (TREM-1) in lymphocyte differentiation and regulation of Aspergillus infected immunosuppressed rats.Methods Cyclophosphamide (CTX) was intraperitoneally injected and Fumigatus spore suspension was inhaled by percutaneous tracheostomy to establish the immunosuppressive invasive pulmonary aspergillosis (IPA) rat model.After 24 h, 48 h, 72 h and 96 h inoculation, rats were sacrificed.Lung tissue specimens, bronchoalveolar lavage fluid (BALF) , and plasma samples were collected.Plasma and BALF sTREM-1, plasma T cell-specific transcription factor (T-box expressed in T cells, T-bet) and eomesodermin(Eomes) were detected by ELISA.Biopsy specimens of lung tissue were used for periodic acid-schiff (PAS) staining and culture.Results The mortality rate of immunosuppressed rats after Aspergillus inhalation for 96 h was as high as 54.4％.Biopsy of lung tissue suggested acute inflammatory cell infiltration, interstitial lung congestion, alveolar structural damage, and visible Aspergillus hyphae in alveoli.Compared with normal control group[(110.50 ± 7.70)ng/L], plasma sTREM-1 in study groups were significantly increased [IPA : (146.77 ± 10.41) ng/L;CXT + IPA at 24 h : (226.00 ± 11.88) ng/L;CTX + IPA at 48 h : (200.77 ± 10.63) ng/L;P ＜ 0.05], so were T-bet levels [IPA : (561.17 ± 7.23) μg/L;CXT + IPA at 24 h : (647.00 ± 33.03) μg/L;CTX + IPA at 48 h : (619.23 ± 87.44) μg/L;control group : (340.03 ± 26.32) μg/L;respectively, P ＜0.05].However, plasma Eomes levels in IPA group, CTX + IPA at 24 h and 48 h were significantly lower compared with that in normal controls [IPA : (7.96 ± 0.65) ng/L;CXT + IPA at 24 h : (3.97 ± 0.35) ng/L;CTX + IPA at 48 h : (4.00 ± 0.74) ng/L;control group : (8.38 ± 0.51) ng/L;respectively,P ＜0.001].Compared with those in CTX + IPA vaccination after 24 h and 48 h, plasma sTREM-1 [(106.67 ±7.64)ng/L;(133.27 ± 32.79) ng/L] and T-bet [(299.64±63.07)μg/L;(398.02 ± 109.22) μg/L] in CTX + IPA at 72 h and 96 h inoculation were significantly lower (P ＜ 0.001).While Eomes [(8.38 ± 0.54) ng/L;(8.40 ± 0.70) ng/L] raised significantly higher (P ＜ 0.001).Compared with the control group, sTREM-1 levels in BALF of IPA + CTX 24 h, 48 h, 72 h, and 96 h groups were consistently high (P ＜ 0.05).Pearson correlation analysis showed that sTREM-1 and T-bet had a significant positive correlation (r =0.91, P ＜ 0.001), yet Eomes was negatively correlated with them (r =-0.788, P ＜ 0.001).Conclusions sTREM-1 in rat plasma and BALF appears highly expressed in immune compromised Aspergillus infected rat model.Plasma sTREM-1 is closely correlated with T-bet and Eomes levels, which suggests that TREM-1 may be involved in lymphocytic regulation and differentiation during fungal infection.