Objective To explore the diagnostic values of bile cytology obtained in endoscopic retrograde cholangiopancreatography (ERCP) and blood tumor markers for malignant bile duct obstruction.Methods From August 2005 to April 2009, bile cytology and blood tumor markers measurement were performed in 47 cases with bile duct obstruction, in which 39 cases were confirmed to be malignant and 8 were benign. Results Malignant cells were found in bile from 26 of 39 malignant obstruction (66. 7% ), and serum CA19-9 was positive in 28 (71.8%). No malignant cells were detected in bile cytology from 8 cases with benign obstruction (with a specificity of 100% ) and serum CA19-9 was negative in 7 (87.5%). In 26 patients with cholangiocarcinoma, serum CA19-9 was positive in 18 (69. 2% ). For bile cytology and blood tumor markers test, sensitivity of parallel combination was 89. 7%, and the specificity of serial combination was 100. 0%. Conclusion Bile cytology testing during ERCP can provide the pathological evidence for malignant bile duct obstruction. The sensitivity is improved by combination tests of bile cytology and blood tumor markers.

Objective To explore the risk factors affected the timing of endoscopic examination in nonvariceal upper gastrointestinal bleeding (NVUGIB).Methods From January 2001 to December 2011 , 441 patients diagnosed as NVUGIB under endoscope were enrolled,and they were divided into the group receiving endoscopy within 24 hours (233 cases)and the group receiving endoscopy beyond 24 hours (208 cases).The demographic and clinical characteristics of the two groups were analyzed.Student′s t test was used for measurement data comparison and chi-square test for numerical data.Logistic regression analysis was used to analyze the multivariate factors which influenced the timing of endoscopy examination.Results The rates of complication in the group receiving endoscopy within 24 hours and the group receiving endoscopy beyond 24 hours were 9.0% (21/233)and 19.7% (41/208),and the difference was statistically significant (χ2 =10.411 ,P =0.001 ).The mean systolic blood pressure were (118 ±19 )and (122±19)mmHg (1 mmHg=0.133 kPa),respectively,and the difference was statistically significant (t=2.099,P = 0.036 ).On admission the mean hemoglobin were (98 ± 27 )and (93 ± 28 )g/L, respectively,and the difference was not statistically significant (t=1 .640,P =0.102).The mortality rate were 1 .3% (3/233 )and 5 .3% (11/208 ),respectively,and the difference was statistically significant (χ2 =5 .723,P =0.017).With multivariate Logistic regression,multivariate factors analysis indicated that complication was the main factor influenced the timing of endoscopy examination (OR =2.710,95 %CI :1 .502 to 4.899,P < 0.01).However,age,gender,systolic blood pressure,hemoglobin levels on admission,location of lesion and clinical symptoms were not related with timing of endoscopy examination (all P >0.05).Conclusion Complication is a risk factor in the timing delayed endoscopy.

To explore new agents of quinolone derivatives with high antibacterial activity, 7-(4-alkoxyimino-3-methyl-3-methylaminopiperidin-1-yl)quinolones were designed and synthesized, and their activity against gram-positive and gram-negative strains was tested in vitro. Sixteen target compounds were obtained. Their structures were established by 1H NMR, HRMS and X-ray crystallographic analysis. Compounds 14k and 14m-14o show good antibacterial activity against the tested five gram-positive strains and five gram-negative strains (MIC: 0.25-16 micromg x mL(-1)), of which the most active compound 14o is 8-fold more potent than levofloxacin against S. pneumoniae (MIC: 4 microg x mL(-1)), and comparable to levofloxacin against S. aureus, S. epidermidis, E. faecalis and E. coli (MIC: 0.25-1 microg x mL(-1)), but generally less potent than gemifloxacin.

Objective To evaluate the effectiveness and safety of a transanal drainage tube(TDT) for decompression of acute left-sided obstruction of colorectum.Methods Fifty-seven patients with acute left-sided colorectal obstruction were enrolled in this study from January 2010 to December 2014.The obstruction location, property, success rate of insertion, one-procedure rate and complication rate were analyzed.Results There were 53 cases of primary colorectal cancer,among which lesions were located in the transverse colon in 1 case, in descending colon in 10, in sigmoid colon in 24,and in rectum in 18.There were 4other cases, one sigmoid colonic metastases of pulmonary cancer, 1 adhesive colonic obstruction after ovary surgery, 1 cervical cancer involved with rectum with stricture and obstruction, and 1 descending colonic obstruction caused by Crohn's Disease.TDT was successfully inserted in 55 cases(96.5％) without complications,in which 43 cases of primary colorectal cancer finally underwent surgery.TDT indwelled from 0 to 22days, for an average of (8.7± 4.4)d.Hartmann operation was performed in 9 patients,6 of which underwent sufficient lymphnode dissection.Among the 43 patients, one-stage operation was performed in 34 (79.1％),of which 30 cases underwent sufficient lymph node dissection, without stoma leakage.And the rest of 13 cases refused surgery because of poor prognosis and financial problems.One patient with Crohn's Disease refused surgery after TDT insertion and was discharged after palliation of distention.Conclusion TDT is safe and effective in decompressing acute left-sided benign obstruction with high success rate and low expenditure, and can achieve preoperative colonic lavage in one-stage operation for acute left-sided colorectal malignant obstruction.

Objective:To study the effects of NS-398 on the expression of vascular endothelial growth factor (VEGF) in human tongue squamous cell carcinoma Tca8113 cells.Methods:Tca 8113 cells were exposed to the COX-2 inhibitor NS-398 at 150 ?mol/L for 48,72 and 96 h respectively,then cells were collected. VEGF expression was examined by RT-PCR and Western blot. Results:NS-398 inhibited VEGF mRNA and protein expression time-dependently in Tca8113 cells. Conclusion:NS-398 may inhibit VEGF expression in tongue squamous cell carcinoma.

Objective To observe the protection of human keratinocyte cell line, HaCaT cell, from UVA damage by resveratrol and its possible mechanism. Methods HaCaT cells were incubated with or without 0.01 mmol/L or 0.1 mmol/L resveratrol after exposure to 5 J/cm2 UVA irradiation. Unirradiated HaCaT cells-without the treatment with resveratrol served as the control. After another 24-hour culture, MTT assay was used to detect the proliferation of cells, RT-PCR and Western-blot to measure the iNOS mRNA and protein expression respectively, electron microscopic technique to observe the changes in cell ultrastructure. Results After irradiation with UVA of 5 J/cm2, the proliferation of HaCaT cells decreased with the absorbance at 490 nm descending from 0.889±0.083 to 0.542±0.004, while a significant increase was observed in the relative expression level of iNOS mRNA and protein in HaCaT cells (1.532±0.041 vs 0.009±0.003, 1.331 ±0.046 vs 0.003±0.001, both P < 0.05) with the presence of typical apoptotic cells. The treatment with 0.01 and 0.1 mmol/L resveratrol significantly promoted the proliferation of irradiated cells with the absorbance at 490 nm being 0.753±0.435 and 0.892±0.173 respectively, but inhibited the mRNA (0.853±0.038 vs 1.532±0.041, 0.392±0.033 vs 1.532±0.041, both P< 0.05) and protein expression level (0.809±0.018 vs 1.331±0.046, 0.412±0.026 vs 1.331±0.046, both P< 0.05) of iNOS in irradiated cells, and the resveratrol of 0.1 mmol/L was more effective than that ofO.01 mmol/L in all tested parameters (P< 0.05). Furthermore, no apoptofic cells or necrotic cells were observed in irradiated ceils incubated with resveratrol. Conclusion Resveratrol effectively protects HaCaT cells from UVA damage, which may be related to the inhibition of UVA-induced iNOS expression by resveratrol.

Objective To evaluate narrow?band imaging(NBI)for early esophageal cancer and pre?cancerous lesions. Methods A total of 170 patients ( 192 lesions) diagnosed as having superficial esophageal carcinoma and precancerous lesions by endoscopy were retrospectively analyzed. Clinical data of endoscopy, narrow?band imaging (NBI) and iodine chromoscopy were analyzed.Results The detection rates of early esophageal cancer were both 100?? 0% in NBI(13/ 13) and iodine staining (13/ 13), with no statisti?cally significant difference (P>0?? 05).The detection rate of high grade intraepithelial neoplasia in NBI and i?odine staining was 94?? 9% (94/ 99) and 100?? 0% (99/ 99) respectively with no statistically significant differ?ence (P>0?? 05); The detection rate of low grade intraepithelial neoplasia in iodine staining was 100?? 0%(80/ 80), significantly higher than that of NBI 78?? 8% (63/ 80) (P<0?? 01).Conclusion NBI and iodine staining endoscopy show better diagnostic value for early esophageal cancer and similar diagnostic value for high grade intraepithelial neoplasia in precancerous lesions. But for the low grade intraepithelial neoplasia, the diagnostic value of iodine staining endoscopy is better than that of NBI.

BACKGROUND:Currently, morphological observations of brain cavity after traumatic brain injury (TBI) via cadavers or animal specimen are difficult to obtain dynamic changes.
OBJECTIVE:To explore the application effect of MRI-based three-dimensional (3D) reconstruction for evaluating the prognosis of TBI.
METHODS:Five male Sprague-Dawley rats were enrol ed to establish TBI models by Electronic Cortical Contusion Injury (eCCI), and scanned by 3.0T MRI with Rat-coil to obtain the DICOM date of brain at 1 day, 1, 2 and 3 months after modeling. Brain cavities were 3-dimensional y reconstructed by Mimics16.0 software, and analyzed in the Meshmixer software.
RESULTS AND CONCLUSION:(1) The outline of reconstruction model image was clear, and could be observed and measured from different sides and perspectives. (2) The cavity volume and surface area at different time points after TBI showed significant differences between each other except that at 2 and 3 months (P<0.05). (3) The results of cavity change suggested that the cavity tended to be regular after 3 months of TBI. (4) In conclusion, 3D reconstruction software Mimics combining with model analysis software Meshmixer can conveniently and quickly obtain the cavity model, and provide an intuitive way for evaluating the dynamic variations of the brain cavity after TBI.

Objective To simulate the chemical microenvironment of traumatic brain injury (TBI) under mild hypothermia, and investigate the effect of such microenvironment on umbilical cord mesenchymal stem cells (UCMSCs) in vitro.Methods Eighteen SD rats were allocated to shamoperated group, TBI group and mild hypothermia group according to the random number table, with 6 rats per group.Rat models of TBI were made by electric cortical contusion impactor.After systemic mild hypothermia (33℃) for 4 h, brain tissue homogenate extracts were harvested.Polyacrylamide gels mimicking the elastic modulus of brain were manufactured.Human UCMSCs were isolated and cultured on the gels, added with brain tissue extracts from each group.After 24 h, the apoptosis level of UCMSCs was checked, and the medium was changed with normal one.Cell growth and morphological changes in each group were given dynamic observation.Seven days later, cell immunofluorescence was implemented, with the differentiation level of each group estimated.Results Apoptotic rate in TBI group was 73.47％,significantly higher than 10.42％ in sham-operated group (P ＜0.01).While the apoptotic rate was 28.57％ in mild hypothermia group, indicating mild hypothermia significantly reversed the apoptosis of cells in TBI group (P ＜ 0.01).Cell immunofluorescence demonstrated rate of neuronal differentiation of UCMSCs in sham-operated group, TBI group and mild hypothermia group was 16.48％, 2.59％ and 11.83％ respectively.Mild hypothermia resulted in significantly improved neuronal differentiation of UCMSCs after TBI (P ＜ 0.05).Conclusions More apoptosis and lower neuronal differentiation ability are observed in UCMSCs in the chemical microenvironment after TBI.However, mild hypothermia significantly reverses the elevation of apoptosis and restores the neuronal differentiation capacity of UCMSCs after TBI.

Intracranial infection is a common and serious complication of acute severe traumatic brain injury, with high mortality and disability rates, which significantly affects the prognosis. In recent years, with the widespread use of antibiotics, antibiotic-resistance rates of pathogens have risen year by year, and the choice of sensitive antibiotics is less and less, sometimes even in difficulties of no drugs available. This paper reviewed the treatment process of 1 case with intracranial infection caused by multi drug-resistant Klebsiella pneumonia after severe traumatic brain injury . The aim is to summarize the clinical experience.