Bile Duct Neoplasms ; pathology ; surgery ; Bile Ducts, Intrahepatic ; Cholangiocarcinoma ; pathology ; surgery ; Humans

Glypican-3 (GPC3) is an oncofetal protein anchored on the plasma membrane and highly expressed in hepatocellular carcinoma (HCC).GPC3 could he used as a biomarker for the diagnosis of HCC and the serum levels of GPC3 in liver cancer patients has a significant role for their prognosis.Moreover, GPC3 in HCC cells is immunoreactive, rendering it a suitable target for the treatment of HCC.Nowadays, several clinical trials targeting GPC3 for HCC therapy have already been conducted: new anti- GPC3 antibodies are generated; the clinical trials about its combination administration with other targeted medicines are being in progress; (tP(3-targeted TRAB, GPC3 vaccines and GPC3-based chimeric antigen receptor T-cells (CAR-T) therapy are under investigation.In this review, we briefly discuss the structure of GPC3, its role in HCC pathogenesis and summarize the recent development in the clinical application of GPC3.We firmly believe that GPC3 would be a promising target for HCC therapy.And further studies focusing on GPC3 should provide us more solid evidence.

Acupuncture Therapy ; Humans ; Huntington Disease ; physiopathology ; therapy ; Male ; Middle Aged ; Motor Activity

Objective To study retrospectively the effects of low-dose glucocorticoids in outcomeof septic shock.Method The present stray was carried out by analysis of septic shock patients treated with norepinephrine or dopamine.A total of 46 patients with a confirmed diagnosis of septic shock admitted from January 2000 to October 2006 were divided into two groups:(1)ghcocorticoids treatment group(n=22),treated with glucocorticoids in addition to conventional treatment from November 2002 to October 2006;(2)conlrol group(n =24),only treated with routine treatment from January 2000 to October 2002.The differences in outcome were compared between the two groups.Results The duration of of vasopressor support was significantly shorter in treatment group com0~ed with control group.The percentage of shock reversal at 7 days was higher in treatment group than that in control group(72.73%vs.41.67%,P=0.034).Furthermore,a reduction in C-reactive protein(CRP)indicated inhibition of inflammatory response due to the effect of glucocorticoids in treatment group within 48-72 hours from admission to ICU(20.05±4.06 mg/dl vs.23.55±4.93 mg/dl,P=0.015).Therefore,APACHE Ⅱ score on 3rd day was significantly lower in treatment group than that in control group(16.76±4.87 vs.21.45±4.02,P=0.001).However,there were no statistical signifieances in the duration of mechanical ventilation,the length of ICU stay,the incidence of multiple organ dysfunction syndrome(MODS)and hospital-mortality between the two groups(P＞0.05).Conclusions Tmatmeut with low-dose gheocorticoids could effectively accelerate the recovery from refractory septic shock and the early withdrawal of vasopressor.It seems to be associated with the reduced production of CRP,suggesting the effects of low-dose glucocorticoids on both stabilization of hemodynamics and inhibition of inflammatory response.The beneficial effects of low-dose steroids regimens on long-term outconm of patients with septic shock have not determined.

Acrocephalosyndactylia ; diagnosis ; genetics ; therapy ; Female ; Humans ; Infant

Objective To verify the reference interval for D-dimer assay and analyze the influence of age and gender on the ref-erence interval.Methods Inclusion criteria for reference individuals were established.60 healthy males and 63 females were enrolled and divided to three groups by age,including 20 to 39 years old group (20 males and 20 females),40 to 59 years old group (20 males and 23 females)and above 60 years old group (20 males and 20 females).Blood samples were drawn in cit-rate sodium anticoagulated tubes and D-dimer concentration was determined by three different coagulation analyzers using o-riginal reagents.According to CLSI guideline C-28-A3,the reference interval for each measurement system from reagent manufacturer was verified and the difference of D-dimer concentration between different age-group and sex-group was ana-lyzed using non-parameters tests.Results All reference intervals were verified for people under age 40,while one reference interval cannot be verified for people from 40 to 59 years old as same as one for people above 60 years old.D-dimer concen-tration increased with age and there was significantly different between 20~39 years old group and 40~59 years old group or above 60 years old group(P<0.05).There was only a significant difference between sex-group for people under age 60(P<0.05).Conclusion D-dimer concentration was associated with age and sex.For people under age 40,the reference inter-val from reagent manufacture can be verified and directly used in laboratory,while for people above age 60,the reference in-terval from reagent manufacture cannot be verified.The cause should be investigated and a new reference interval should be established separately when necessary.

AIM: To discuss the clinical applications of methods to localize nasal cut ends and the effects of Z-plasty in the surgeries for lower eyelid longitudinal laceration combined with lower lacrimal canaliculi disruption.
METHODS: From September, 2010 to October, 2013, a total of 37 patients ( 37 eyes ) with lower eyelid longitudinal laceration combined with lower lacrimal canaliculi disruption were operated for anastomosis of lacrimal canaliculi disruption and suture of lower eyelid longitudinal. Different methods to search for the nasal cut ends of lacerated lacrimal canaliculi, such as “under a microscope directly”, “guided by probing needle” and“pigtail curved probe”. Then, to repair lower eyelid longitudinal laceration with Z-plasty transposition flaps. Follow up was 3mo~2a after operation.
RESULTS: All nasal cut ends could be found successfully on 37 patients;Lacrimal duct unobstructed in 31 patients (83. 8%), improved in 5 patients (13. 5%), invalid in 1 patient (2. 7%),the overall successful rate was 97. 3%; the eyelids repair was satisfactory, small scars, the appearance and function was normal.
CONCLUSION: The nasal cut ends can be found successfully by “directly under a microscope”, “guided by probing needle” and“pigtail curved probe”;the effect of silicone drainage tube used as lacrimal canaliculi bracket is satisfactory; most patients gained excellent recovery for both appearance and function after Z-plasty.

AIM: To compare the effectiveness of botulinus toxin of type A and complete resection of the periorbital muscle on idiopathic blepharospasm.
● METHODS: Patients with idiopathic blepharospasm and having undergone either of two procedures from Dec. 2010 to Jun. 2015 were selected ( 60 patients ) . Among them, group A (30 patients, 60 eyes) underwent botulinus toxin of type A, group B (30 patients, 60 eyes) underwent complete resection of the periorbital muscle.
●RESULTS: ln group A, the patients with complete response, obvious response, partial response, and no response were 36(60. 0%), 20(33. 3%), 2(3. 3%) and 2 (3. 3%) cases respectively. ln group B, the patients with complete response, obvious response, partial response, and no response were 16(26. 7%), 24(40. 0), 12(20. 0%) and 8 ( 13. 3%) cases respectively. The difference was statistically significant ( Z = - 2. 968, P = 0. 003 ). The relapse rate of group A and group B were 93. 3% and 20. 0% after 6mo, the difference was statistically significant (χ2=32. 851, P<0. 001).
●CONCLUSION: The botulinus toxin injection of type A is effective for idiopathic blepharospasm. But recurrence rate is high after 6mo. Complete resection of the periorbital muscle have long-term efficacy for idiopathic blepharospasm. It′s a supplementary therapy after idiopathic blepharospasm recurrence.

Objective To understand the changes and possible mechanism of the blood brain barrier(BBB) permeability induced by tumor necrosis factor(TNF-?) in vitro.Methods BBB model was established by coculturing allogenic brain microvessel end othelial cell(BMEC) and astrocyte(AS).The BBB model was divided randomly into normal control group,TNF-? group and Y-27632 pretreatment group.The changes of BBB permeability were evaluated by Gamma radioim muno assay counter.Results The Gamma radioimmuno assay indicated that the marker,~(125)I-BSA,across the BBB model in vitro was significantly increased after TNF-? treatment compared with control group,Y-27632 pretreatmen could prevent the permeability of BBB induced by TNF-?(P

25 mmHg) had no response to conservative management, and,therefore,had to be decompressed by invasive procedure,including 6 patients performed by decompression laparotomy,2 patients by laparoscopic decompression and 5 patients by ultrasound/computed tomography location and needle paracentesis drainage.These 13 ACS patients had obvious amelioration in physiological variables (hemodynamic,respiratory and tissue perfusion) after 24 hour post-decompression (P