Intrahepatic cholangiocarcinomas (ICCA) are primary intrahepatic malignancies originating from biliary epithelia.While both hepatocellular cancer and ICCA can present as mass lesions within the liver,these cancers are distinct in their morphology,etiology,pathology,natural history and response to therapy.There is a need for accurate and sensitive molecular markers for the diagnosis of ICCA.Recent advances in elucidating molecular and genetic characteristics of ICCA offer the potential of molecular-based diagnosis of ICCA.Specific genetic mutations of IDH1/2,BAP1,p53,and KRAS,FGFR gene fusions and alterations in microRNA have all been described in ICCA.Although there are no accurate serum or biliary biomarkers currently available for diagnosis of ICCA,several potential candidates have been identified.Knowledge of specific genetic or molecular abnormalities offers potential for individualized approaches for the treatment of patients with ICCA in the future.

[Objective] To explore the differentiation of Wei Qi Ying Xue on febrile disease,its treatment on external oculopathy of acute contagious conjunctivitis,which is failed in western medicine.[Method] Under the characteristics of the disease and the theory of differentiation of Wei Qi Ying Xue,its location is in Wei system,it should dispel with pungent and cool drugs to remove lung hotness,by applying revised normal pungent and cool prescription Yinqiao San;for disease in both Wei and Qi,it should use revised Yinqiao San and Baihu Tang to relieve exterior syndrome and clear hot toxin by pungent and cool drugs;if the location is in Qi system,it should take revised Baihu Tang and Dachengqi Tang to clear away heat and toxic material or by purgation;if it happens both in Qi and Ying(blood),take Qingying Tang and Xijiao Dihuang Tang to clear away heat and toxic material,cool and dispel blood;when the heat is removed and the fluid is injured,the bad heat is pondering,it should take Shashen Maidong Tang to clear away the remaining heat and produce fluid.[Result] It gets good result with correct differentiation.[Conclusion] As long as you have correct differentiation of signs,can the febrile disease theory in national medicine be applied in the treatment of external oculopathy flexibly.

Objective To study the excitability gastrointestinal hormone MTL and inhibitory gastrointestinal hormone SEC expression in the intestinal congestion and the effects of Salvia miltior-rhiza pretreatment at different time limits in 45min of rat hepatic ischemia-reperfusion to explore its possible mechanism and significance. Methods 80 rats were randomly divided into 4 groups: normal control group(CO group), sham-operated group(SO group), injury group(IR group), salvia miltior-rhiza pretreatment group(SM group). Non-invasive artery clamp was used to clip then slacken the he-patic pedicle to produce animal model of ischemia-reperfusion. The clamp time was 45 min. The rats in Salvia miltiorrhiza pretreatment group were injected 40 ml/kg saline with 6 g/kg Salvia Miltiorrhiza from caudal vein 30 min before clamping hepatic pedicle. While in the sham-operated group, the porta hepatis was dissected after laparotomy and hepatic pedicle not clamped. The upper jejunums at differ-ent reperfusion time phases (0 h, 3 h, 12 h, 24 h, 72 h) were made into specimens respectively, and then MTL and SEC immunohistochemical measurement were conducted. Results At 0 min of hepatic ischemia-reperfusion digestive tract congestion, the MTL expression of upper jejunum went down,SEC expression of upper jejunum went up. With the reperfusion time extending, the MTL expression also descended to minimum at 24 h, but SEC expression increased to reach the peak at 24 h. The ex-pression of these 2 hormones gradually returned to normal at 72h. The MTL expression of Salvia milt-iorrhiza pretreatment group was higher, SEC expression of SM group were lower than the IR group in each time phase of reperfusion. Conclusion The intestinal congestive injury caused by liver ischemia can down-regulate the excitability of gastrointestinal hormone MTL and up-regulate the gastrointesti-nal inhibitory gastrointestinal hormone SEC expression at reperfusion to inhibit gastrointestinal motili-ty. Salvia miltiorrhiza preconditioning can partly weaken the descending of jejunal MTL and increasing of the jejunal SEC expression, which may contribute to the early recovery of gastrointestinal motility.

Objective To study the changes of gastrointestinal hormones before and after hepatic ischemia reperfusion and the role of salvia miltiorrhiza pretreatment.Methods The clinical data of 32 patients with hepatic diseases who were admitted to the Wuhan General Hospital of Guangzhou Military Area of PLA from May 2010 to May 2012 were prospectively analyzed.Thirty-two patients with hepatic inflow occlusion were randomly divided into the ischemia reperfusion group (IR group,15 patients) and salvia miltiorrhiza pretreatment group (SM group,17 patients).Patients in the IR group and SM group received partial hepatectomy with hepatic inflow occlusion by Pringle maneuver for 15-20 minutes.Patients in the IR group and SM group were injected with normal saline and salvia miltiorrhiza (30 mL/d) by intravenous drip for 3 days before operation,respectively.Twelve patients with hepatic diseases who received open surgery without block of hepatic inflow occlusion were enrolled in the negative control group (SO group) and 5 healthy volunteers were enrolled in the normal control group (CO group).The changes of the motilin,cholecystokinin,vasoactive intestinal peptide and secretin of the 4 groups were recorded.All data were analyzed using the analysis of variance or LSD-t test.Results The level of motilin of the CO group was (347 ± 14)μg/L.The levels of motilin of the SO group,IR group,and SM group at postoperative 24,48 and 72 hours were (324 ± 13) μg/L,(345 ± 12)μg/L,(345 ± 13)μg/L,(307 ± 10)μg/L,(316 ±9)μg/L,(338 ±13) μg/L,(313 ± 7) μg/L,(337 ± 12) μg/L and (345 ± 12) μg/L,respectively.The level of motilin of the SO group at postoperative 24 hours was significantly lower than that of the CO group (t =5.25,P ＜ 0.05) ; the levels of motilin of the IR group at postoperative 24,48 and 72 hours were significantly lower than those of the SO group (t =10.05,8.09,2.07,P ＜0.05) ; the levels of motilin of the SM group at postoperative 24 and 48 hours were significantly lower than those of the SO group (t =9.83,2.28,P ＜ 0.05),while there was no significant difference in the level of motilin between the SM group and the SO group at postoperative 72 hours (t =0.36,P ＞0.05) ;the levels of motilin of the SM group at postoperative 24,48 and 72 hours were significantly higher than those of the IR group (t =3.80,7.10,2.35,P＜0.05).The levels of cholecystokinin of the CO group was (2.53±0.06)μg/L.The levels of cholecystokinin of the SO group,IR group and SM group at postoperative 24 hours were (3.28 ±0.09) μg/L,(2.52 ±0.09) μg/L,(2.54 ±0.16)μg/L,(4.34 ±0.21) μg/L,(3.63 ±0.31)μg/L,(3.25 ± 0.09) μg/L,(3.71 ±0.28)μg/L,(3.28±0.11)μg/L and (2.53 ±0.09)μg/L,respectively.The level of cholecystokinin of the SO group at postoperative 24 hours was significantly higher than that of the CO group (t =4.33,P ＜ 0.05) ; the levels of cholecystokinin of the IR group at postoperative 24,48and 72 hours were significantly higher than those of the SO group (t =9.32,5.37,2.16,P＜0.05) ; the levels of cholecystokinin of the SM group at postoperative 24 and 48 hours were significantly higher than those of the SO group (t =7.21,3.42,P ＜ 0.05),while there was no significant difference in the level of cholecystokinin between the SM group and the SO group at postoperative 72 hours (t =0.29,P ＞ 0.05) ; the levels of cholecystokinin of the SM group at postoperative 24,48 and 72 hours were significantly higher than those of the IR group (t =5.62,4.63,3.57,P ＜ 0.05).The level of vasoactive intestinal peptide of the CO group was (11.8 ±1.6) tμg/L.The levels of vasoactive intestinal peptide of the SO group,IR group,and SM group at postoperative 24,48 and 72 hours were (21.5 ± 3.8) μg/L,(12.2 ± 1.6) μg/L,(11.9 ± 1.7) μg,/L,(29.7 ± 4.1) μg/L,(22.9±4.2)μg/L,(18.8±2.8)μg/L,(22.4 ±4.1)μg/L,(16.4±2.3)μg/L and (12.1 ±1.6)μg/L,respectively.The level of vasoactive intestinal peptide of the SO group at postoperative 24 hours was significantly higher than that of the CO group (t =3.59,P ＜ 0.05) ; the levels of vasoactive intestinal peptide of the IR group at postoperative 24,48 and 72 hours were significantly higher than those of the SO group (t =6.35,3.22,2.36,P ＜ 0.05) ; the levels of vasoactive intestinal peptide of the SM group at postoperative 24 and 48 hours were significantly higher than those of the SO group (t =5.04,2.33,P ＜ 0.05),while there was no significant difference in the level of vasoactive intestinal peptide between the SM group and the SO group at postoperative 72 hours (t =0.18,P ＞ 0.05) ;the levels of vasoactive intestinal peptide of the SM group at postoperative 24,48and 72 hours were significantly lower than those of the IR group (t =4.27,3.87,2.45,P ＜ 0.05).The level of secretin of the CO group was (75 ± 5) μg/L.The levels of secretin of the SO group,IR group and SM group at postoperative 24,48 and 72 hours were (98 ± 6) μg/L,(76 ± 4) μg/L,(76 ± 4) μg/L,(129 ± 6) μg/L,(102 ±8) μg/L,(89 ± 6) μg/L,(104 ± 8) μg/L,(90 ± 6) μg/L and (74 ± 4) μg/L,respectively.The level of secretin of the SO group at postoperative 24 hours was significantly higher than that of the CO group (t =3.27,P ＜ 0.05) ;the levels of secretin of the IR group at postoperative 24,48 and 72 hours were significantly higher than those of the SO group (t =5.20,2.94,1.77,P ＜ 0.05) ; the level of secretin of SM group at postoperative 24 and 48 hours were significantly higher than those of the SO group (t =4.16,2.54,P＜0.05),while there was no significant difference in the level of secretin between the SM group and the SO group at postoperative 72 hours (t =0.23,P ＞ 0.05) ; the levels of secretin of the SM group at postoperative 24,48 and 72 hours were significantly lower than those of the IR group (t =5.13,4.32,2.87,P ＜ 0.05).Conclusions Gastrointestinal congestion caused by hepatic blocking leads to the decline of the expression of motilin,but the increase of the expression of cholecystokinin,vasoactive intestinal peptide,secretin.Salvia miltiorrhiza may improve micro-circulation,abate gastrointestinal adema,and influence the gastrointestinal hormone expression in an indirect way.

Objective To elucidate the antitumor activity of exopolysaccharide from Aphanothece halophytica(EPAH).Methods The in vivo inhibition of EPAH on growth of tumor was performed by inoculation of S_(180) sarcoma cells into ICR mice.While in vitro activity against tumor cells was assayed by the growth inhibition of cell lines of S_(180) sarcoma,Smcc7721,and HeLa.The effects of EPAH on immune function were evaluated by the influence on the thymus,spleen,and the number of lymphocytes in blood stream,the influence on proliferation of lymphocytes,the killing activity of NK cells,and the production of NO,IL-1?,and TNF-?. Results EPAH inhibited in vivo S_(180) sarcoma growth with the highest inhibi-(tory) rate of 66.79% and 47.93% in the test mice of pretreatment and simultaneous treatment,respectively.EPAH also displayed in vitro activity against the test cell lines with the highest inhibitory rate being more than 60% at a concentration of 100 ?g/mL.EPAH was found to affect the immune function in mice including increasing the weight of thymus,spleen,and the number of lymphocytes in the blood stream,accelerating the proliferation of lymphocytes,enhancing the killing activity of NK cells,and stimulating the production of NO,IL-1?,and TNF? by macrophages.Conclusion EPAH is an effective antitumor(agent.) It inhibites the tumor cells directly and hence the growth of tumor.Its antitumor activity is probably realized by increasing the weight of immune organs and the number of immunocytes as well as lymphocyte proliferation,enhancing the killing activity of NK cells,facilitating the production of NO and related(cytokines) in tumor-bearing mice.

Objective To investigate the specific pathogenesis of O-antigen polysaccharide(OPS) which is a subunit component of lipopolysaccharide(LPS) from enteroinvasive Escherichia coli. Methods The OPS was extracted and purified from Escherichia coli O29(enteroinvasive E.coli) strain. Effects of OPS, contrasted with the whole LPS molecule, were observed by in vitro experiments (HeLa cell culture) and in vivo experiments (rabbit ileal loop assay). Results It was revealed that the purified EIEC OPS alone cause cytopathic effect to HeLa cell, and that the OPS caused mucosal hemorrhage, but no fluid accumulation in ileal loop of rabbits. The scanning electron microscope and transmission electron microscope demonstrated the fine structures of cytopathic HeLa cell were damaged. Conclusion Escherichia coli O29 OPS might be one of the factors causing diarrhea and its mechanism was different from endotoxin reaction of LPS. Escherichia coli O29(pathogen) OPS showed a marked serious toxicity as compared with Escherichia coli HB101(nonpathogen) OPS.

At present,the fashions,methods and means of medical genetics teaching have fallen behind the development of the subject.Under the patterns of net-teaching,the construction of net-teaching database is an important tache to develop teaching favourably,improve the quality and efficiency of teaching fleetly.This paper introduces the process of constructing a net-teaching database for medical genetics,the applications and characters of the database in teaching.

Objective To compare the clinical efficacies of electroacupuncture plus rehabilitation training versus electroacupuncture alone in treating lumbar intervertebral disc herniation and evaluate the therapeutic effect of electroacupuncture plus rehabilitation training. Method Seventy-two patients with lumbar intervertebral disc herniation were randomly allocated to a treatment group of 36 cases and a control group of 36 cases. The control group received electroacupuncture at Huatuo jiaji(Ex-B2) points. In addition to electroacupuncture, the treatment group received lumbodorsal muscle stretch training according to the outcome (forward flexion and backward extension) obtained using the Turgunmed testing and evaluating system. Isokinetic muscle strength and the activity were measured and the ODI lumbago score and the VAS pain score were recorded before and after treatment. Result There were statistically significant differences in isokinetic muscle strength and the VAS pain score (P<0.01,P<0.05) but no in the activity and the ODI lumbago score (P>0.05) between the treatment and control groups. Conclusion Electroacupuncture plus rehabilitation training is more effective than electroacupuncture alone in improving isokinetic muscle strength and the VAS pain score in patients with lumbar intervertebral disc herniation.

Objective To simulate the mechanical environment of cells in vivo and study cellular signal transduction mechanisms. Methods A device was developed which could provide high cell yield, control the time, strain magnitude, direction and frequency of stretch, and applied 10% cyclic strain to cell culture substrate with stretch frequency at 1Hz. Results After being stretched, morphology and cytoskeleton of cells were altered. The major axis of cells and the alignment of stress fibers were vertical to the orientation of cyclic stretch. Conclusion This device provides versatile options for the study on the cellular responses of mechanical loading.

0.05),but for patients with mild disease,active angle reproduction