Objective To compare the effect of percutaneous intraluminal radiofrequency ablation ( RFA ) combined with biliary stenting and that of percutaneous transhepatic puncture combined with biliary stenting .Methods A total of 56 patients with unresectable malignant obstructive jaundice were reviewed retrospectively .Among them, 25 patients had received percutaneous intraluminal RFA combined with biliary stenting ( RFA group) while another 31 patients had been simultaneously selected for the simple biliary stent implantation ( stent group ) .The changes of the serum total bilirubin ( TB) and direct bilirubin ( DB) before and after 7-14 days of treatment , surgical complications , stent median patency and the median survival were observed.Follow-up information was obtained through telephone reviews or check-up records. Results The technical success rate was 100%.No procedure-related peritonitis or perforation occurred .There were respectively 3 cases with cholangeitis in RFA group and 3 in stent group.All the cases was controlled by effective clinical treatment.There was obvious statistically significant difference after treatment in TB and DB in the two groups (P<0.01, P<0.01).TB and DB fell by (149.05 ±110.71) and (96.93 ±69.12)μmol/L after 7-14 days in RFA group vs (151.40 ±94.47) and (94.21 ±67.36)μmol/L in stent group.The changes of the two groups were of no statistical significances .The stent patenmedian time was 122 ( 9 -550 ) and 157 ( 16 -510 ) d, while the median survival was 125(9-550) and 163 ( 16 -520 ) d.The difference was of no statistical significance .Conclusion Percutaneous intraluminal RFA combined with biliary stenting and percutaneous transhepatic puncture combined with biliary stenting are both safe and feasible therapeutic options for unresectable malignant obstructive jaundice .There is no statistically significant diffference between the two groups in the recent and long-term curative effects .

Objective: To investigate the personal wellbeing index (PWI) among elderly aged 55 and above from the elderly day care centers in Macao, Hong Kong and Guangzhou, and associated factors. Methods: We used convenient sampling to select participants from 16 elderly day care centers in Macao, Hong Kong and Guangzhou. Inclusion criteria were: females aged 55 or above, males 60 or above, the participants who were conscious and clearly understood the questionnaire. Informed consent form was signed by the participants. A total of 324 elderly participated in the study: 90 from Macao, 100 from Hong Kong, and 134 from Guangzhou. Close-end questionnaire was used to collect demographic information and PWI inventory (Cantonese version) was used to assess the PWI scores. Comparison in the PWI scores difference was conducted. Multiple regression method was used to analyze factors associated with PWI. Results: The PWI was 7.3±1.9 (Macao: 7.7±1.9, Hong Kong: 7.2±1.7, Guangzhou: 7.0±1.9) (F=3.32, P=0.037). The multiple regression analysis showed that comparing to those who did exercised 3 times or less, or single/devoiced/separated, or had no education, the elderly who did exercised 4 times or more per week or married/widowed, or received education in primary school or above had higher PWI scores. The beta values (95%CI) were 0.82 (95% CI: 0.31-1.34), 1.03 (95% CI: 0.12-1.94), 0.51 (95% CI: 0.04-0.99) respectively. Conclusion The elderly participants aged 55 or above who went to elderly day care centers in three cities had higher PWI score generally. Marital status, participate in sufficient physical activity and advanced education level were significant related to PWI.

Objective To investigate the correlation between decoy receptor (DcR) 1,DcR2,osteoprotegerin (OPG) gene polymorphisms and susceptibility of Crohn's disease (CD) in Han population in Zhejiang province.Methods From April 2008 to July 2017,at the Department of Gastroenterology of The Second Affiliated Hospital of Wenzhou Medical University,The First Affiliated Hospital of Wenzhou Medical University,Central Hospital of Wenzhou and Renmin Hospital of Wenzhou,285 patients diagnosed as having CD were enrolled,and during the same period 572 healthy individuals who received health checkup at the Second Affiliated Hospital of Wenzhou Medical University were collected as healthy control.The single nucleotide polymorphism (SNP) of DcR1 (rs12549481),DcR2 (rs1133782) and OPG (rs3102735) were examined by SNaPshot technique.An unconditional logistic regression analysis was performed to analyze the differences in each SNP mutation alleles and genotype frequencies between CD group and control group.Furthermore,their correlation with clinicopathological features of CD and the efficacy of corticosteroid and infliximab was also evaluated.Results The frequencies of mutant allele A and genotype GA + AA of DcR2 (rs1133782) of CD group were 11.93％ (68/570) and 22.81％ (65/285),respectively,which were higher than those of healthy control group (8.22％,94/1 144;and 15.91％,91/572;odds ratio (OR) =1.513,95％ confidence interval (CI) 1.088 to 2.104,P =0.013;OR =1.562,95％ CI 1.094 to 2.230,P =0.014).However there was no statistically significant difference in the mutant allele and genotype frequencies of DcR1 (rs12549481) and OPG (rs3102735) between two groups (all P ＞ 0.05).The frequencies of mutant allele C and genotype TC + CC of DcR1 (rs12549481) in patients with stricturing CD were 13.89％ (25/180)and 27.78％ (25/90),respectively,which were lower than those of patients with non-stricturing,non-penetrating CD (27.68％,62/224 and 48.21％,54/112),and the differences were statistically significant (OR =0.421,95％ CI 0.252 to 0.705,P =0.001;OR =0.413,95％ CI 0.229 to 0.747,P =0.003).Besides,the frequencies of mutant allele A and genotypes GA + AA of DcR2 in patients with penetrating CD were 7.23％ (12/166) and 13.25％ (11/83),which were lower than those of patients with non-stricturing,non-penetrating CD (15.62％,35/224 and 30.36％,34/112),and the differences were statistically significant (OR =0.407,95％ CI 0.205 to 0.809,P =0.009;OR =0.350,95％ CI 0.165 to 0.743,P =0.005).In addition,there was no statistically significant difference in the frequencies of mutant allele and genotypes of OPG (rs3102735) among subtypes of CD with different features (all P ＞ 0.012 5).Moreover,the DcR1 (rs12549481),DcR2 (rs1133782) and OPG (rs3102735) polymorphisms were not correlated with the efficacy of corticosteroid and infliximab (all P ＞ 0.05).Conclusions DcR1 (rs12549481) mutation may be correlated with stricturing CD.DcR2 (rs1133782) mutation may be correlated with CD,especially with penetrating CD.However,the gene polymorphism of OPG (rs3102735) is not correlated with the risk of CD susceptibility.And the above gene SNP may be independent of the efficacy of corticosteroid and infliximab.

Objective To investigate the mechanism of cellular senescence in ischemia reperfusion injury (IRI)-induced acute kidney injury (AKI) that leads to chronic kidney disease (CKD) in elderly mice.Methods An acute kidney injury model was established in C57B1/6 male mice at ages 8-10 weeks (young group) or 20-24 months (old group) by bilateral IRI.The animals were randomly divided into 4 groups as follows:Young-Sham (n=8),Old-Sham (n=8),Young-IRI (n=8),and Old-IRI groups (n=8).All mice were weighted,and their blood was collected from the tail vein at days 1,3,and 7 after surgery.The mice were killed on day 14 after surgery,and their kidneys were harvested for further analysis.Serum was used for the creatinine test.The changes of the renal tissue morphology and pathology were assessed using hematoxylin-eosin staining and sirius red staining.Immunofluorescence staining of collagen Ⅰ,F4/80,phosphor-histone H3 (p-HH3),and Ki67 were performed to determine the stage of the collagen deposit,macrophage filtration,and cell cycle G2/M arrest.The collagen Ⅰ expression was analyzed using western blot.The expression levels of TNF-α,IL-6,TGF-β,and collagen Ⅰ were determined using real-time PCR.Results Compared with that in the sham group,the serum creatinine levels in both Young-IRI and Old-IR1 groups were obviously increased.The Young-IRI group recovered completely on day 7.The Old-IRI group had higher creatinine levels than the Young-IRI group at each time point.Morphology and pathology analyses revealed that acute injury was repaired in the Young-IRI group,but slight inflammatory cell filtration and collagen deposition were observed in the Old-Sham and Old-IRI groups,respectively.Immunofluorescence staining revealed some F4/80-positive macrophage filtration,collagen Ⅰ deposition,and p-HH3 and Ki67 double-positive nuclear tubular epithelial cells in the Old-Sham group,but considerably more positive results were found in the Old-IRI group.Western blot analysis revealed that collagen Ⅰ expression level was higher in the Old-IRI group than in the Young-IRI group (P ＜ 0.01) and in the Old-Sham group than in the Young-Sham group (P ＜ 0.05).Real-time PCR demonstrated that the mRNA expression levels of cytokines and fibrosis markers,including of TNF-α,IL-6,TGF-β,and collagen Ⅰ,in the Old-Sham and Old-IRI groups were increased as compared with those in the Young-Sham and Young-IRI groups (P ＜ 0.05).Conclusions The levels of kidney inflammation,fibrosis,and cell-cycle arrest are lower in the old mice.After IRI injury,a sustained and ongoing inflammatory reaction is involved and more cells are arrested in the cell cycle G2/M,which inhibit renal repair and promote fibrosis progression.