Hilar cholangiocarcinoma is the most common types of cholangiocarcinoma,it is difficult to perform operation owing to its anatomic characterstics.Currently,radical resection is the most important prognostic factors of hilar cholangiocarcinoma.In addition,lymph node metastasis and biomarkers such as CA19-9,hepatocyte growth factor receptor,interleukin-8,and so on,are also closely related to the prognosis of hilar cholangiocarcinoma.This paper will review the relevant researches of China and abroad to summarize important prognostic factors of hilar cholangiocarcinoma above-mentioned.

Objective To investigate the characteristics and clinical application value of anti-double stranded DNA antibody de-tected by Crithidia indirect immunofluorescence assay method and enzyme linked immunosorbent assay method.Methods Eighty-five patients with systemic lupus erythematosus,20 disease controls and 75 healthy controls were selected.The serum anti-double stranded DNA antibody was detected simultaneously by the methods of Crithidia indirect immunofluorescence assay and enzyme linked immunosorbent assay and their diagnostic efficacies for detection were compared.Results For each method the positive rate in the systemic lupus erythematosus group was significantly higher than that in the disease control group and healthy control group. The difference had statistical significance (P <0.05).The positive rates of Crithidia indirect immunofluorescence assay and enzyme linked immunosorbent assay in the systemic lupus erythematosus group were 72.94% and 88.24% respectively,and the positive predictive value of enzyme linked immunosorbent assay is lower(P <0.05).Meanwhile the anti-double stranded DNA antibody con-centrations detected by enzyme linked immunosorbent assay method showed statistically significant difference among the active sys-temic lupus erythematosus group,the stable systemic lupus erythematosus group and the control group (P <0.05 )and presented linear trend.Conclusion Using Crithidia indirect immunofluorescence assay method to detect anti-double stranded DNA antibody for the systemic lupus erythematosus group has high specificity and is helpful for the diagnosis of systemic lupus erythematosus. Enzyme linked immunosorbent assay can be used to detect anti-double stranded DNA antibody concentration quantitatively,which is linearly related with systemic lupus erythematosus activity and the method is of high sensitivity,which can effectively screen the pa-tients with systemic lupus erythematosus.

Female ; Hepatitis C ; complications ; drug therapy ; Humans ; Interferon-alpha ; therapeutic use ; Interferons ; therapeutic use ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; complications ; drug therapy ; virology ; Middle Aged ; Polyethylene Glycols ; therapeutic use ; Recombinant Proteins ; therapeutic use ; Treatment Outcome

Education, Nursing, Continuing ; General Surgery ; education ; Humans ; Physicians

Rheumatoid arthritis is a common and potentially devastating condition which did not have good treatment options until recently. Pharmacological treatment should not just comprise antiinflammatory agents and corticosteroids. The current therapeutic approach is to start a disease modifying agent early in the illness to prevent eventual joint damage. Older disease modifying anti-rheumatic drugs (DMARDs) include methotrexate, sulphasalazine and hydroxychloroquine. Newer ones such as leflunomide and cyclosporine are also used. A recent advance in the management of rheumatoid arthritis is the use of biological agents which block certain key molecules involved in the pathogenesis of the illness. They include tumour necrosis factor (TNF)- blocking agents such as infliximab, etanercept and adalimumab, the anti-CD 20 agent rituximab and CTLA-4 Ig abatacept. Other agents which are in development include anti-IL6 tocilizumab, anti-CD22 and anti-lymphostat B. In this review, the efficacy and side effects of these agents, their impact on current clinical practice and future trends are discussed.
Abatacept ; Antibodies, Monoclonal ; therapeutic use ; Antibodies, Monoclonal, Humanized ; Antirheumatic Agents ; therapeutic use ; Arthritis, Rheumatoid ; immunology ; therapy ; Drug Therapy, Combination ; Humans ; Immunoconjugates ; therapeutic use ; Immunologic Factors ; adverse effects ; therapeutic use ; Immunosuppressive Agents ; therapeutic use ; Methotrexate ; therapeutic use ; Remission Induction ; Tumor Necrosis Factor-alpha ; antagonists & inhibitors

ObjectiveTo investigate changes of sex hormone levels and sexual function in male patients after liver transplantation.MethodsBlood samples were taken from 69 male patients receiving liver transplantation pretransplantation and postoperative 3rd,7th,14th day,1st and 3rd month respectively.Serum estradiol and testosterone were measured by radioimmunoassay.Serum sex hormone binding globulin was measured by ELISA.Sixty-nine discharged adult male liver transplant recipients ( age ranging 24 -45 years) with a normally functioning allograft for at least 6 months were questioned on their pre-and post-operativesexualfunction compared with 23adulthealthy controls.ResultsPretransplantation serum estradiol and sex hormone binding globulin were significantly higher (87.56±31.21 vs.26.00 ±9.12,u=9.30,P＜0.0001,134.50±30.68 vs.51.04 ±12.05,u=12.69,P ＜ 0.0001,respectively),and testosterone was lower than normal controls (2.02 ± 1.28 vs.4.82 ± 1.48,u =-8.73,P ＜0.0001 ) and levels were correlated with MELD scores (r =0.80,P ＜0.0001,r =-0.77,P ＜0.0001,r =0.72,P ＜0.0001,respectively).Sex hormone levels were back to normal on postoperative 2nd week (serum estradiol) or 1st month (serum testosterone and sex hormone binding globulin).Compared with pretransplant status,sexual function improved significantly when evaluated on postoperative 6th month.ConclusionsLevels of serum sex hormone were correlated with MELD scores before liver transplant.After liver transplant,estradiol was back to normal level on postoperative 2nd week,testosterone and sex hormone binding globulin back to normal level on postoperative 1 st month.Sexual function significantly improves after liver transplantation.

Expression and regulation of the P-glycoprotein (P-gp) is associated with the development of multidrug resistance in cancer.Cancer cells are exposed in endogenous damages from its own micro-environments and inflicted stimulated damages.These harmful micro-environments could trigger cellular stress response and regulated the expression of P-gp through various activated signal transduction pathways.Researches of the cellular endogenous micro-environments and exogenous stimulation damages on the expression and regulation of P-gp would have important significance for exploring the multidrug resistance of cancer cell.

The microRNA let-7 family,functioning as a tumor suppressor,has emerged as a regulator of stem cell differentiation and tumor repression.The RNA-binding protein lin28 is a stem cell pluripotency factor,which contributes to the maintenance of stem cell characteristics and promoting cell malignant transformation.lin28 can block the maturity of let-7 by combining with the precursors of let-7 family miRNAs,which is itself able to repress lin28 by binding to the 3'-UTR of lin28 transcripts,thus forming a feedback loop.The double-negative feedback loop comprising lin28 and let-7 is involved in several biological processes such as differentiation of stem cell,tumorigenesis,invasion and metastasis,drug resistance and relapse,which couldbe a potential target for cancer therapy.

Objective To explore the related risk factors for neuropathic pain in diabetic rats.Methods Female Wistar rats of clean grade were divided into three groups :Non diabetic standard diet (NdStd) group (n=10) ,diabetic high fat diet and pain (DbHFP) group (n=10) ,and diabetic high fat diet and no pain (DbHFNP) group (n=10).Body weight ,blood glucose ,TG ,TC ,HDL‐C ,LDL‐C and 50%pain threshold were measured regularly to assess the relationship between blood lipids and pain. Results Non‐conditional logistic regression analysis showed that pain threshold was negatively correlated with TG , LDL‐C and blood glucose(P<0.05) ,and positively correlated with HDL‐C (P<0.05). And there was no association between TC and body weight (P> 0.05). Conclusion Pain threshold of diabetic rats was negatively correlated with TG ,LDL‐C and blood glucose ,and positively correlated with HDL‐C.

Objective To investigate the predictive value of trauma index on the prognosis in pa-tients with traumatic spinal cord injury.Methods Enrolled 168 cases of patients with traumatic spinal cord injury,the traumatic index score and the American Spinal Injury Association (ASIA)grade were as-sessed on admission,then followed up for 6 months,the Spearman correlation analysis was performed to a-nalysis the relationship between trauma index and ASIA grade,and Receiver operating curve (ROC)anal-ysis was used to evaluate the relationship between trauma index and prognosis.Results There was a sig-nificant negative correlation between trauma index score and ASIA grade(r =-0.68,P <0.01).A total of 157 cases (93.5%)completed follow-up,the trauma index score had a good predictive value on the traumatic death in these patients,it's sensitivity was 71.4%,specificity was 76.1%,the best cut-off point was 25 points(P <0.01 );Compared with the low score group (<25 points),the high group (≥25 points)showed a lower ASIA grade and higher mortality,the differences were statistically significant (P <0.01).Conclusion The trauma index score was related with the spinal cord injury,and it is a predictive factor of poor prognosis in patients with traumatic spinal cord injury.