Biliary stent has been utilized in the patients of benign and malignant biliary strictures and biliary fistula who are unsuitable or unwilling to operate.Its short-term curative effect is distinct,while the long-term effect is relatively poor,because the long-term application is affected by stent blocking and biliary ducts restenosis.Therefore,the research and development of new biliary stents,such as biodegradable stent and covered stent,are the main trend of the current development,which will be of profound significance for the biliary tract disease.

Adult ; Enhancer of Zeste Homolog 2 Protein ; Female ; Humans ; Leukemia, Myeloid, Acute ; genetics ; Male ; MicroRNAs ; genetics ; Polycomb Repressive Complex 2 ; genetics

Cancer cell exfoliation,invasion and entry into circulation system is the early event with metastasis,which provide the possibility to formation of clinical metastase.Further research about the circulating cancer cells can help us to understand the mechanism of metastasis and offer the scientific proof against anti-metastasis.The detection of circulating tumor cells and clinical significance were reviewed.

Objective To evaluate the efficacy and safety of a levonorgestrel-releasing intrauterine system(LNG-IUS)for the treatment of dysmenorrhea associated with adenomyosis.Methods We recruited 48 women with moderate or severe dysmenorrhea associated with adenomyosis.All women were inserted of LNG-IUS into their uterine cavity from days 5-7 of their periods and maintained for 12 months.We compared the visual analogue scale(VAS)scores and verbal rating scale(VRS)scores of their dysmenorrhea and dyspareunia at baseline and 12 monthes follow-up.Results Forty-four women completed the study. There were significant differences between mean VAS and VRS scores changes of dysmenorrhea and dyspareunia at baseline and 12 monthes follow-up,those of dysmenorrhea dropping from 75?13 to 11?11 and 2.3?0.4 to 0.4?0.3,those of dyspareunia dropping from 54?19 to 4?4 and from 1.6?0.8 to 0.2?0.2 respectively.Overall 29 women(66%)were very satisfied or satisfied with the one-year treatment. Conclusion Insertion of LNG-IUS alleviates moderate or severe dysmenorrhea associated with adenomyosis remarkably.

BackgroundThe effects of extremely low frequency electromagnetic fields (ELF-EMFs) on public health have attracted wide attentions.The association of the thermal effect of ELF-EMFs with cancer and ocular tissue damage has been of concern.However,the pathological changes of scleral tissue after exposure to ELF-EMFs as well as the relationship between these changes and myopia are still poorly understood.ObjectiveThe present study was to investigate the molecular pathological changes of human fetal scleral fibroblasts (HFSFs) after exposure to ELF-EMFs in vitro and to explore the possible mechanism in the occurrence and development of myopia.MethodsHFSFs were cultured and passaged and then exposed to 50 Hz electromagnetic fields,and HFSFs that did not receive the irradiation of ELF-EMFs were used as the control group.The expression of collagen type Ⅰ (COL1A1 ) mRNA and matrix metalloproteinase-2 (MMP-2) mRNA in cultured HFSFs were detected by real-time qualitative polymerase chain reaction (real-time PCR) under different magnetic field intensites (0,0.1,0.2,0.5,1.0 mT) and different exposure time (0,6,12,24,36,48 hours).Cell proliferation assay of HFSFs was detected by the cell counting kit 8 ( CCK8 ) assay.The expression levels of COL1 A1 and MMP-2 proteins in HFSFs were further confirmed by immunofluorescence staining.Results The expression of COL1A1 mRNA was significantly down-regulated under the exposure of 0.2 mT ELF-EMFs for 6 hours,in comparison with the control group;moreover,it decreased in parallel with the increased of flux density (0.099±0.008 vs.0.050±0.004) (P =0.009 ).The expression of MMP-2mRNA was up-regulated conspicuously after exposure to 0.1 mT ELF-EMFs for 24 hours,and it increased with exposure time in comparison with the control group ( 0.009 ±0.001 vs.0.018±0.003 ) ( P =0.038 ).Proliferation of HFSFs (A450) was inhibited following the exposure to 0.2 mT ELF-EMFs for 24 hours in comparison with the control group (P =0.009 ).The expression of COL1 A1 in the experimental group was decreased,compared with the control group,but the expression of MMP-2 was increased.ConclusionsELF-EMFs inhibit the proliferation of HFSFs and expression of COL1 A1 in HFSFs,which might be one of the reasons for the development of myopia.

Objective To explore a technical modification by transperineal Da- W anorectoplasty (Da WARP) on treating low, intermediate anorectal anomalies(AA) and to evaluate the results of long - term follow up. Methods Forty six cases of AA underwent a Da-W ARP,which involved preservation of the rectal end of the fistula and invagination of the perineal skin flap through the neoanus.The clinical records were reviewed and analyzed retrospectively. Results The median follow - up period was 7 years and 2 months. All of them achieved a good fecal continence exception of 1 patient with intermediate AA and associated anomaly,had fair result. Conclusions The Da - WARP is relatively simple and practical methods for surgical treatment of low, intermediate AA, with good long - term results.

Objective To explore atechnical modification bytransperineal Da-Wanorectoplasty(Da-WARP) ontreatinglow,intermedi-ate anorectal anomalies(AA) andto evaluate the results of long-termfollowup.Methods Forty-six cases of AAunderwent a Da-WARP,whichinvolved preservation of the rectal end of the fistula andinvagination of the perineal skinflapthroughthe neoanus.The clinical records werereviewed and analyzedretrospectively.Results The medianfollow-up period was 7 years and 2 months.All of themachieved a goodfecal conti-nence exception of 1 patient withintermediate AAand associated anomaly,hadfair result.Conclusions The Da-WARPis relativelysimple andpractical methods for surgical treatment of low,intermediate AA,with goodlong-termresults.

Objective To explore a technical modification by transperineal Da-W anorectoplasty(Da-W ARP) on treating low,intermediate anorectal anomalies(AA) and to evaluate the results of long-term follow up.Methods Forty-six cases of AA underwent a Da-W ARP,which involved preservation of the rectal end of the fistula and invagination of the perineal skin flap through the neoanus.The clinical records were reviewed and analyzed retrospectively.Results The median follow-up period was 7 years and 2 months.All of them achieved a good fecal continence exception of 1 patient with intermediate AA and associated anomaly,had fair result.Conclusions The Da-W ARP is relatively simple and practical methods for surgical treatment of low,intermediate AA,with good long-term results.

OBJECTIVETo investigate the clinical effect of chronic myelocytic leukemia (CML) patients treated with imatinib (IM) and interferon (IFN)-α.

METHODSOne hundred and fifty five CML patients at chronic phase were included in the study. All patients were divided into two groups according to treatment regimen: IM + IFN group and IM group. Complete cytogenetic response (CCyR) rate, major molecular response (MMR) rate, complete molecular response (CMR) rate, overall survival (OS) and progression free survival (PFS) were observed and compared in both groups.

RESULTSThe CCyR rate was higher in the IM + IFN group than that in the IM group at 6 months (60.6% vs 41.6%, P < 0.05), but no difference was observed later on. The MMR + CMR rate was higher in the IM + IFN group than that in the IM group at 6 months and 12 months (71.2% vs 34.8%, 77.3% vs 52.8%, respectively, P < 0.05), but no difference after that. After stratification according to Sokal risk, the CCyR rate of low- and intermediate-risk patients was higher in the IM + IFN group than that in the IM group at 6 months (77.8% vs 52.6%, 75.0% vs 46.7%, P < 0.05), but not from 12 months on; the MMR + CMR rate of low- and intermediate-risk patients was higher in the IM + IFN group than that in the IM group at 6 months and 12 months (85.2% vs 36.8%, 90.0% vs 36.7%, P < 0.05; 88.9% vs 57.9%, 90.0% vs 56.7%, P < 0.05), but not from 24 months on. There was no significant difference in high-risk patients. OS in IM and IM + IFN group at 6, 12, 24 and 36 months was 100%, 100%, 96.8% and 90.0%, and 100%, 100%, 97.9% and 93.1%, respectively. PFS in IM and IM + IFN group at 6, 12, 24 and 36 months was 97.8%, 95.5%, 91.9% and 85.5%, and 98.5%, 95.5%, 91.5% and 86.2%, respectively. There was no significant difference in OS (u = 0.427, P = 0.514) or PFS (u = 0.556, P = 0.456). The side effects in both groups included pancytopenia, edema, weight gain, ostalgia, rash and muscle spasm. In addition, patients in the IM + IFN group suffered from flu-like symptoms, impaired liver function, abnormal thyroid function and extremity sensory disturbance. It seemed that grade III or IV pancytopenia occurred more commonly in the patients in the IM + IFN group, however, there was no statistically significance.

CONCLUSIONSThe response to IM + IFN is more rapid than that to IM alone, especially for the low- and intermediate-risk patients. It seems no benefit of the addition of IFN to treatment of high-risk patients. During the period of 36 months, survival rate in the IM + IFN group is not higher than that in IM group, and it is possible to increase the side effects of pharmaceutical drugs.

Adult ; Aged ; Benzamides ; therapeutic use ; Drug Therapy, Combination ; Female ; Humans ; Imatinib Mesylate ; Interferon-alpha ; therapeutic use ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; drug therapy ; Male ; Middle Aged ; Piperazines ; therapeutic use ; Pyrimidines ; therapeutic use ; Retrospective Studies ; Treatment Outcome ; Young Adult

Objective Toinvestigate the role of dynamic dispersion of electrical recovery in ventricular fibrillation maintenance mechanism.Method Thirty-seren male Yorkshire pigs weighing (23?2.5) kg at 3 months age were randomly divided into Sham-operated group and myocardial infarction group in which the first branch of left anterior descending coronary artery of animals was hgated.After 4 weeks,according to VF occurrence by programmed electrical simulation,the myocardial infarction hearts were divided into two groups, twelve hearts in VF (+) group or six hearts in VF (-) group;and the normal hearts were divided into two groups,five hearts in VF (+) group or ten hearts in VF (-) group.Action potential duration (APD) of subendocardial,subepicardial and mid-layer myocardium of left ventricular anterior wall were recorded simultaneously.The relationship between APD and diastolic interval was quantified as an electrical restitution curve.A Student's-test was used to specify differences between groups.Results At the fourth week after coronary artery ligation,eighteen myocardial infarction hearts and fifteen normal hearts were investigated.When investigating transmural dispersion of reporlarization (TDR) of left ventricle,there was no difference between VF (+) group and VF (-) group [ (20.43?7.01) ms vs (22.32?7.53) ms,P=0.45],although there was statistically significant between normal hearts and myocardial infarction hearts [ (15.66?4.45) ms vs (25.72?6.70) ms,P =0.001].The percentage of APD restitution slope exceed 1 and APD restitution slope maximum were high in the VF (+) group with myocardial infarction hearts and in the VF (+) group with normal hearts, lower in the the VF (-) with normal hearts and lowest in the the VF (-) group with myocardial infarction hearts.Conclusion Dynamic APD restitution properties may play an important role in the ventricular fibrillation maintenance mechanism.The APD restitution slope and not static TDR have prognostic value regarding ventricular fibrillation events.The hearts with the steepest of APD restitution curves has the greatest liability of ventricular fibrillation to happen.