ObjectiveThe significance of intra or postoperative choledochoscopy in selecting propersurgery for biliary disorders was evaluated. MethodsThe clinical materials of 182 patients undergoingcholedochoscopy were reviewed.Results The rate of residual stones dropped from 35.2 to 9.7 percent in134 cases with choledocholithiasis.With the scopy residual stones were extracted in 12/13 patients , biliarymenbranous stenosis being dilated in 15/30 and the cause of malignant obstruction of lower common bile ductelucidated in 24 instances . Conclusion Intraoperative choledochoscopy is beneficial in the choice of ap-propriate operation for biliary disorders as well as in establishing correct diagnosis that is ambiguous beforesurgery.

Objective To explore the relevance of high density lipoprotein cholesterol (HDL-C) level and resistance of epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) in advanced non-small cell lung cancer (NSCLC).Methods In a total of 87 NSCLC patients harboring EGFR mutation treated with EGFR-TKI, the correlations of pre-treatment levels of soluble HDL-C between efficacy and resistance of EGFR-TKI were analyzed by Kaplan-Meier method and Cox proportional hazard model.Results Patients with normal HDL-C (≥0.94 mmol/L) had a better disease control rate (DCR) than those with low HDL-C (＜0.94 mmol/L) [94.5 ％ (52/55) vs 65.7 ％ (21/32), P ＜ 0.001].The results of univariate analysis showed that patients with normal HDL-C had longer progress free survival (PFS) (HR =0.27, 95 ％ CI 0.164-0.444, P ＜ 0.001).The results of multivariate Cox proportional hazard model analysis with sex, pathologic histology, smoking history and mutation type showed that only HDL-C group had a significant difference (P ＜ 0.001).The same results were showed when stratified by sex and smoking history (female: P ＜ 0.001, male: P =0.002;Smoker: P ＜ 0.001, non-smoker: P =0.014).Conclusion Normal pre-treatment serum levels of HDL-C are associated with a better outcome and longer progression-free survival in NSCLC patients treated with EGFR-TKI, which may be a predictive marker for a better response.

Objective To evaluate the association between C-reactive protein (CRP) blood levels and specific survival time of non-small cell lung cancer (NSCLC) patients treated with chemotherapy.Methods Data from 96 advanced (stage ⅢB/Ⅳ) NSCLC patients were analyzed.All patients were divided into two groups based on the enrolled time as follows the initial treatment group (48 cases) and retreatment group (48 cases).According to 0.6 mg/L and 7.3 mg/L of CRP which were the 1/3 and 2/3 of CRP concentrations,respectively,the 96 patients were divided into low,intermediate and high groups.Kaplan-Meier and Cox proportional-hazard models were used to evaluate the relationship between the CRP level and survival time.Results After adjusting for age,sex,smoking history,histological type and stage of lung cancer,a significant relationship between CRP and survival time was observed (P ＜ 0.05).Such significant differences of survival time were also observed in both of the adenocarcinoma (P ＜ 0.001) and squamous with poorly differentiated (P =0.032) subtypes.On stratification analysis by chemotherapy status,the circulating CRP level in retreatment group was correlated well with survival time (P ＜ 0.001).However,the influence of circulating CRP levels on survival time in initial group did not reach statistical significance (P =0.296).For all patients,the hazard ratio with high CRP levels for NSCLC-specific survival was 1.15 (95 ％ CI 0.82-1.61) compared with that of low CRP levels.The hazard ratio for the initial treatment group and retreatment group were 0.52 (95 ％ CI 0.16-1.74) and 1.77 (95 ％ CI 0.73-4.26),respectively.Patients with high circulating CRP level also responded poorly to chemotherapy.Conclusion A high level of circulating CRP is associated with an inferior response and survival outcome in NSCLC patients treated with chemotherapy.

[Objective] This paper focused on one sentence from Huangdi's Cannon of Classic, and explored its translation and deep meaning. [Method] The English translations and different scholars opinions were analyzed to explore the sentence meaning. [Result] The most suitable translation is deter-mined, and the healthy way of spring sleep time is getting up early in the morning, going to bed earlier than summer and later than winter. [Conclusion] Translation is based on understanding, and different understanding and translation can give different information to readers. The English versions can pro-mote the understanding of original Chinese meaning, and they are interacted.

Hypoxia, one major characteristic of malignant solid tumors, not only changes the biological characteristics of tumor cells, but also is the main cause of the failure for conventional chemotherapy and radiotherapy. This paper summarizes the implications of tumor hypoxia and the corresponding techniques,then we present the change in tumor biological characteristics induced by hypoxia. Next we analyze the cause of tumor resistance to chemotherapy and radiotherapy. And finally,We discuss the three antitumor strategies targeting hypoxia, which opens a new path to conquer cancer.[

Protein degradation is fundamental to cell viability,selective elimination of regulatory proteins in the cell is an effective mechanism for regulating vital cell processes.Rapid proteasomal protein degradation is key to activation of repression of many cellular processes,including cell-cycle progression and apoptosis.Bortezomib as a proteasome inhibitor has been approved by FDA for multiple myeloma treatment.This review summarizes current knowledge of the structure and function of the proteasome and its targets.In addition,preclinical findings obtained with Bortezomib are reviewed,and existing clinical data on Bortezomib are presented.

Objective To evaluate the efficacy of intravitreal injections of conbercept in choroidal neovascularization (CNV) secondary to pathologic myopia (PM).Methods A retrospective case series of 37 eyes of 37 patients affected with CNV secondary to PM treated by intravitreal injections of Conbercept.All the patients were examined with best-corrected visual acuity (BCVA) of Early Treatment Diabetic Retinopathy Study (ETDRS) chart,central macular thickness (CMT) of optical coherence tomography (OCT) at baseline.The initial average letters of ETDRS BCVA was 49.86±8.87,CMT was (306.38±31.01) μm.All eyes were treated with intravitreal Conbercept 0.05 ml (10 mg/ml).Follow up visits were performed monthly after injection.The mean follow-up time was 16.8 months.Injections were repeated according to the situation of BCVA,CMT,subretinal fluid and CNV leakage in follow-up.All eyes received an average of 4.8 injections.BCVA,CMT and ophthalmoscope examination were assessed monthly.The relationship of BCVA improvement and CMT reduction with the data at baseline and number of treatments were analyzed by Spearman Rho correlation respectively.Results During the 1,3,6 and 12 months after treatment,the mean BCVA were all improved with statistically significant difference (t=17.629,P＜0.01).At 12 months,15 eyes (45.9％) had improvement of 15 letters or more,32 eyes (86.5％) had improvement of 5 letters or more,and 1 eye (2.7％) had decreased more than 5 letters.During the 1,3,6 and 12 months after treatment,the mean CMT were all decreased with statistically significant difference (F=43.726,P＜0.01).At 12 months,the retinal fluid of 34 eyes (91.9％) were absorbed completely;33 eyes (89.2％) had angiographic closure at that time.There was no significant relevance between BCVA improvement and sex,age and course of the disease (P＞0.05),but a significant negative correlation was found between the BCVA improvement and BCVA at baseline,injection times (P＜0.05).There was no significant relevance between CMT reduction and sex,age,course of the disease and injection times (P＞0.05),but a significant positive correlation was found between CMT reduction and CMT at baseline (P＜0.05).There were no systemic or ocular serious side effects during the follow up.Conclusions Intravitreal injections of Conbercept showed BCVA improvement and CMT reduction.It appeared to be effective and safe for choroidal neovascularization secondary to pathologic myopia.Intravitreal Conbercept for CNV secondary to PM showed BCVA improvement,CMT reduction and safety.

Objective To understand the quality of malaria blood examinations in township?level hospitals,so as to provide the evidence for continuing the malaria blood examinations in the stage of post?malaria elimination. Methods A total of 64 township hospitals were investigated and 640 negative malaria blood slides were scored individually according to 10 indicators inMalaria Elimination Technical Schemein 2013 and 2014. The single and multiple indicators were calculated,and the work of blood examinations and situation of technicians were investigated. The data of malaria blood examinations and patient discovery in township hospitals of Nantong City were collected and analyzedduring the period of 2011-2014. Results Forthe single indi?cator,29.5%of the thick blood films did not reach the standard,and 35.8%of thin blood films did not reach the standard. For the multiple indicators,blood slides with more than 4 indicators below the standard(poor quality)accounted for 32.5%. From ma?laria blood examinations and malaria situation,the number of slides was 194 635 during the period of 2011-2014,and there were no local vivax malaria casesin 4consecutive years from 2011 to 2014,andlocal malaria has been effectively controlled in Nantong City. For health facilities where malaria patients initially presented,the township and village level accounted for 16.3%,and county and higher level accounted for 83.7%. Conclusions The quality of malaria blood examinations in township level hospitals of Nantong City is not high and the microscopic examination has a relatively low efficiency in the discovery of ma?laria cases. A new model for malaria blood examinations needs to be further explored.

Objective To evaluate the roles of proton magnetic resonance spectroscopy(1H-MRS) and the volume of the hippocampus(HCV) measured by MRI in the diagnosis and the differential diagnosis of mild cognitive impairment (MCI) and mild Alzheimer disease (AD).Methods HCV and 1H-MRS were performed in the bilateral hippocampus and the bilateral medial temporal lobes(MTLS) in 30 cases with MCI,30 cases mild with AD and 30 healthy persons in age and sex-matched with controls by using volume analysis software and stimulates echo acquisition mode(STEAM). The ratios of NAA/Cr,Cho/Cr,MI/Cr,NAA/MI and HCV were compared among these groups.The contributions of HCV and 1H-MRS in diagnosis of MCI and AD was compared.Correlation coefficients were calculated for Mini Mental State Examination (MMSE) scores and HCV or the ratios of NAA/Cr,Cho/Cr,MI/Cr and NAA/MI in the MCI group and the mild AD group.Results Patients with mild AD showed significant reduction of HCV and NAA/Cr and NAA/MI ratios in the bilateral HCVand MTLS,and significant MI/Cr increase in the bilateral MTLS relative to control subjects. Patients with MCI demonstrates significant reduction of NAA/Cr in the left MTL , significant reduction of the bilateral HCV and NAA/MI ratio and significant MI/Cr increase in the bilateral HCV and MTLS relative to control subjects. Patients with mild AD showed statistical differences of MI/Cr and NAA/MI ratios in the left MTL relative to patients with MCI . Patients with mild AD showed no significant differences of HCV and NAA/Cr relative to patients with MCI .The Cho/Cr ratios among three groups showed no significant differences. HCV yielded the volume with the sensitivity 50% and specificity 83.33% in the diagnosis of MCI . 1H-MRS yielded the ratios with 43.33% in sensitivity and 81.25% in specificity in the di- agnosis of MCI.The combination of HCV and 1H-MRS yielded the volume and ratios with sensitivity of 73.33% and specificity of 84.62% in the diagnosis of MCI. HCV yielded the volume with sensitivity of 73.33% and specificity of 88% in the diagnosis of mild AD.1H-MRS yielded the ratios with sensitivity of 70% and specificity of 87.5% in the diagnosis of mild AD.The combination of HCV and 1H-MRS yielded the volume and ratios with sensitivity of 83.33% and specificity of 86.21% in the diagnosis of mild AD. HCV yielded the volume with the sensitivity of 50% and specificity of 62.5% in the differential diagnosis of MCI and mild AD.1H-MRS yielded the ratios with sensitivity of 56.67% and specificity of 65.38% in the differential diagnosis of MCI and mild AD.The combination of HCV and 1H-MRS yielded the volume and ratios with sensitivity of 66.67% and specificity of 64.52% in the differential diagnosis of MCI and mild AD. Patients with mild AD and MCI showed significant correlation between MMSE and the bilateral HCV ,NAA/Cr ratio. Patients with mild AD showed significant correlation between MMSE and right NAA/MI ratio .Patients with mild AD and MCI showed significant correlation between HCV and NAA/Cr ratio. Conclusion The combination of HCV and 1H-MRS are the best choice in the diagnosis and the differential diagnosis of MCI and mild AD.

Aim To observe the modulation of adenosine triphosphate (ATP) on motility of isolated gastric smooth muscle from rat.Methods Longitudinal and circular muscle strips of rat gastric body and antrum were prepared, and the effects of ATP (0.1, 1,10,100 ?mol?L~-1 and 1 mmol?L~-1 ) on the motility of the strips were investigated. Results ATP induced a small relaxation followed by an obvious spasm in longi- tudinal muscle strips of the gastric body; when tone was raised by KCl, ATP induced a larger relaxation followed by a smaller spasm.ATP only produced contraction in circular muscle strips of the gastric body.Low concentration of ATP inhibited the contractile amplitude of the antral longitudinal strips, at the same time increased the frequency of the contraction apparently; when tone was raised by KCl, ATP produced a concentration-related relaxation.Low concentration of ATP firstly enhanced and then inhibited contractile amplitude of antral circular musle strips, while high concentration of ATP fully inhibited the motility. Conclusion We firstly reported the obvious effects of ATP on longitudinal and circular strips of rat gastric body and antrum. The effects of ATP on the four preparations were different from each other, suggesting that ATP plays an important modulatory role on motility of gastric smooth muscle of rats.