Objective To systematically evaluate the safety and effectiveness of interventional uterine artery embolization (UAE) in treating symptomatic uterine fibroids by comparing it with surgical therapy. Methods Computer retrieval of the Cochrane Library, PubMed, EMbase, Web of Science, China National Knowledge Internet (CNKI), Wanfang data, etc. was conducted. The retrieval time was from the inception to July 2014. The academic papers that were related to the randomly controlled test (RCT) of UAE and surgical treatment for symptomatic uterine fibroids were collected, and the reference literatures were also searched for. Two reviewers screened the literatures according to the inclusion and exclusion criteria, the useful data were extracted and the qualities were evaluated. Meta-analysis was performed by using RevMan 5.2 software. Results A total of 6 RCTs were finally obtained, including 732 patients in total. Meta-analysis indicated that both the hospitalization time and recovery time in UAE group were shorter than those in surgery group. No significant differences in health -related quality of life, patient’s satisfaction, intra -operation complications, the recurrence rate and main complications within one year existed between UAE group and surgery group; while the differences in the incidence of minor complications within one year and the need of further intervention rate during 2 -5 years were statistically significant, the occurrence of these minor complications in UAE group being higher than that in the surgery group. The pregnancy rate and live-birth rate in UAE group were significantly lower than those in the surgery group. Conclusion Compared with surgery, UAE has many advantages, such as technically-safe, excellent therapeutic effect, simply-manipulated, easy-nursing, mini-invasive, quick-recovery and easily-accepted by patient, etc. although there is risk of receiving intervention treatment again. The influence of UAE on the fertility, the influence of different embolic agents on the therapeutic effect of UAE, and the effectiveness of UAE for multiple uterine fibroids need to be further studied.

Objective To investigate the efficacy of integrated traditional Chinese medicine (TCM) with Western medicine in treatment of diarrhea type irritable bowel syndrome (IBS-D) and its effect on serum inflammatory cytokine levels.Methods One hundred and sixty four IBS-D patients treated in Guangfu Hospital from July 2013 to August 2015 were randomly divided into study group and control group with 82 cases in each group.All patients received oral Saccharomyces boulardii 1.0 b.i.d, while patients in study group received additional Shuganjianpi decoction b.i.d for 4 weeks.The clinical efficacy was observed, serum IL-10, IFN-γ and TNF-α levels were measured in 2 groups.Results After treatment, the total score of clinical symptoms in study group was lower than that of control group [(5.71±1.41) vs.(11.70±2.88) points,t=16.707, P<0.01].Serum levels of IFN-γ, TNF-α in study group decreased significantly after treatment [IFN-γ (2.88±1.38) ng/L vs.(1.00±0.44) ng/L, t=11.609, P<0.01;TNF-α (41.26±5.29) ng/L vs.(24.13±3.27) ng/L,t=24.636, P<0.01], IL-10 significantly increased [(142.23±21.58) ng/L vs.(170.23±33.45) ng/L,t=6.291,P<0.01].The overall effective rate of study group was higher than that of control group, [87.50% (70/80) vs.68.75% (55/80), x2=8.228, P<0.01].After treatment, the quality of life scores in both groups were improved;but the improvement of diet, spirit, mood and sleep scores in study group were better than those in control group [(240±69) vs.(193±60), t=4.579, (316±74) vs.(230 ± 69), t=7.603, (297±62) vs.(228±59), t=7.211;(284±62) vs.(230±54), t=5.874, all P<0.01].Conclusion The efficacy of integrated traditional Chinese medicine with Western medicine in treatment of IBS-D is significantly better than that of Western medicine alone, which may be associated with its regulatory effect on the serum inflammatory cytokine levels.

Objective To sum up operative experience and prevention of complications while resecting the hepatic hilar tumor. Methods 14 cases with hepatic hilar tumor were analyzed in respect of operative method,complications, experience and prevention of complications. Results Some peri-operative complications happened. such as massive hemorrhage in 2 cases,billiary fistula in 1 case,hepatic failure in 1 case and tumor remained at resection edge in 1 case. No patients died during the operation. Conclusion The resection of hepatic hilar tumor is very difficult and risky,safety of surgery can be improved by paying attention to pre-operative evaluation and preparation,as well as carefulness during operation.

Objective To investigate the effects of bone morphogenetic protein-7 ( BMP7 ) on insulin signaling transduction in C2C12 myotubes and HepG2 hepatocytes, and the underlying mechanisms were studied preliminarily.Methods The C2C12 myotubes and HepG2 cells were treated with BMP7 at different concentrations.The insulin signal transduction was analyzed by Western blot.Meanwhile, total RNA was extracted and quantitative PCR was employed for detecting the effects of BMP7 on gene expressions of effectors involved in insulin signal pathway.Furthermore, JNK signal pathway was also measured.Results The protein levels of p-IR, p-Akt and p-GSK3β, as well as glucose uptake, were significantly stimulated by insulin in the C2C12 myotubes and HepG2 cells.However, these stimulations induced by insulin were largely attenuated by BMP7.The mRNA levels of Akt1, Igf1r, Insr, and Irs1 were not altered by the treatment of BMP7.The JNK signal pathway was activated by a 5-min exposure of BMP7 in the HepG2 cells, and this activation was gradually reduced along with the treating time.Conclusion BMP7 attenuates the insulin signal transduction in the HepG2 cells and C2C12 myotubes, and this attenuation effect may be through JNK activation.

Objective To provide anatomical basis for preventing paresthesia that appear in the lateral thoracic wall ,the arm‐pit and the inside of the upper arm during axillary lymph node dissection for breast cancer .Methods The intercostobrachial nerve (ICBN) and its contiguous relationship were observed ,besides the origin ,ramus and branch were measured and recorded by anato‐mizing 30 adult embalmed cadavers (60 sides) .Results Three intercostals nerve (50 sides) and the ICBN (29 sides) were the mainly nerves in lateral thoracic wall ,the medical brachial cutaneous nerve(MBCN) was not observed .Three intercostals nerve , ICBN(42 sides)and MBCN(44 sides) were found in armpit ,but mainly was intercostobrachial nerve (42 sides) .ICBN and the MB‐CN equally distributed in the dorsal and medical of the upper arm ,but the three intercostals nerve was not observed .81 .7% (49 sides) of intercostal nerve and all of the brachial plexus presenced filament .They existenced blood vessel accompanied when the ICBN pierced the chest wall (63 .3% ,38 sides) .Conclusion Identify and intactly preserve the ICBN and relevant nerves and their filament during axillary lymph node dissection of the breast cancer may benefit to prevent paresthesia .

Objective To construct and express a prokaryotic expression vector carrying the gene of FimH 1-156 that comprises human lysosome membrane protein 2 P41-49 gene ,and to express and purify the fusion protein .Methods FimH1-156 gene was cloned from plasmid pPKL241 by PCR ,and inserted into vector pET-28a(+ ) to obtain prokaryotic expression plasmid pET-28a-FimH . After transforming Escherichia coli BL21(DE3) with pET-28a-FimH ,fusion protein FimH1-156 was expressed under induction .The target fusion protein was purified ,and its antigenicity was detected through Western blot .Results The expressed recombinant pro-tein was purified ,the expression of protein was the highest when IPTG was 1 mmol/L and 4h after induction ,it was expressed as include body form ,and the expressed protein was identified to react with monoclonal antibodies 6 × His by Western blotting .Conclu-sion We cloned FimH1-156 fusion protein expressed genes successfully ,constructed prokaryotic expression vector ,and won the in-clusion body purification of FimH1-156 fusion protein .

Ichthyosis refers to a group of skin diseases characterized by abnormal keratinization of the epidermis,resulting in dryness,roughness and scale of the skin.A girl with ichthyosis,who presented with skin ulcers and infection of the right dorsal foot,was admitted to our department.An autologous razor-thin skin grafting procedure was performed to repair the skin ulcers after debridement and vacuum sealing drain.After 8 months of follow-up,both the donor and recipient site healed well and there were no newly formed ulcers or infections.Although the skin quality of ichthyosis is poor,the lesion area can still be used as donor or recipient cite.

Objective To explore the application value of dipstick dye immuno-assay (DDIA) for screening the schistosomiasis chemotherapy targets in the low endemic areas of Xiaogan City.Methods The residents aged 6-65 years in a village in the low endemic areas of schistosomiasis of Xiaogan City were selected and tested by the methods of fecal examination,DDIA,indirect hemagghitination (IHA),enzyme linked immunosorbent assay (ELISA) and inquiry,and the results of fecal examination were determined as the gold standard.Results The Youden' s indices of IHA,DDIA,ELISA and inquiry were 0.74,0.72,0.62 and 0.30,respectively,and the consistency rates of them were 93.38%,91.99%,81.53% and 70.03%,respectively.It took 16.70,4.95,4.12,5.63 and 2.44 Yuan screening one patient with the fecal examination,IHA,DDIA,ELISA and inquiry,respectively.Conclusion The validity of DDIA with simple operation and low cost for screening the schistosomiasis chemotherapy targets is satisfying,and the method is suitable for large scale screening in low endemic areas.

The 8th Japan-China Hepato-Pancreato-Biliary Symposium was held in Tokyo,Japan from 22nd to 23rd November 2018.The meeting was convened coincidently with the 80th Annual Congress of Japanese Surgical Association,which attracted the participation of Chinese and Japanese hepatobiliary and pancreatic surgeons.The symposium aimed to explore the latest achievements and clinical issues of diagnosis and treatment for hepato-pancreato-biliary diseases.In this article,authors reviewed the up-to-date research information in order to share the experience,achievements and new information in the field of hepatobiliary and pancreatic diseases with colleagues.

Objective : To investigate the role of early inhibition of Toll⁃like receptor 4 (TLR4) in regulating hippampal neuroimmune responseto adolescent ratsafter neonatal hypoxic⁃ischemic brain damage(HIBD) . Methods: Postnatal day 7 rats were randomized into controlgroup , hypoxic ischemia (HI) group , and HI + TAK⁃242( the specific inhibitor of TLR4)(TAK⁃242) group. The expression of TLR4 in rat hippocampus was detected by immunohistochemistry at 3 days after HI. Immunofluorescence were used to determine the number of Iba⁃1 + , GFAP + , CD161 + , MPO + and CD3 + cells in the hippocampus at 21 days after HI. Immunohistochemistry was used to detect ICAM⁃1 and C3a expression in the hippocampal CA1 region ; and Western blot was used to detect tumor necrosis factor interleukin IL⁃1β , TNF⁃α and IL⁃10 expression. Results : Compared with control group , significantly raised TLR4 expression was observed in the left hippocampal CA1 , CA3 and DG regions(P < 0. 01 or P < 0. 05) , while the expression in the TAK⁃242 group lowered compared to the HI group (P < 0. 05) . The number of GFAP + cells in the CA1 area of the hippocampus in the TAK⁃242 group of neonatal rats decreased compared to which in the HI group at 21 days after HI(P < 0. 05) , but the number of CD3 + T lymphocytes in the hippocampal CA1 area of new born rats in the HI group increased compared to which in the Control group (P < 0. 05) , but the difference between TAK⁃242 and the Control group was not statistically significant. The number of Iba⁃1 + cells , MPO + cells , CD161 + cells , the expression of ICAM⁃1 and C3a in hippocampal CA1 region , and the expression of TNF⁃α , IL⁃1β and IL⁃10 in hippocampus of rats were not different among groups at 21 days after HIBD. Conclusion Early inhibition of TLR4 may ameliorate adolescent neuroimmune disorders by reducing the increase of hippocampal astrocytesafter neonatal HIBD.