Objective To explore the interventional methods to treat recurrent jaundice after palliative bilio intestinal anastomosis in patients with malignant obstructive jaundice due to cholangiocarcinoma. Methods Ten patients with recurrent jaundice after bilio intestinal anastomoasis were retrospectively evaluated. Nine of ten underwent PTCD with metallic stent placement, one underwent the inner outer draining catheter procedure. The patients were evalualed with comparison in regard to preoperative conditions, TBIL,ALT,GTP and AKP values.Results Stent placement was successful only once in all 10 cases with successful rate of 100%. TBIL,ALT,GTP and AKP values were significantly lower 7 days postoperative by than that preoperation. Subsidence of jaundice was satisfactory for 100% in all patients after the treatment. Conclusions Percutaneous placement of biliary metallic stents is a safety, simple, low complication method for managing recurrent jaundice after palliative bilio intestinal anastomosis for the terminal stage of malignant obstructive jaundice.

Objective:To evaluate the in vivo osteogenic activity of titanium implants with strontium loaded TiO 2 nanotubes (NTSr). Methods:The strontium loaded titanium nanotubes were formed on pure titanium implants through anodization and hydrothermal treatment, and the unmodified titanium (Control) and sheer TiO 2 nanotubes (NT) were set to be control groups and treatment group. Inductively coupled plasma mass spectrometry (ICP-MS) was used to evaluate the Sr release at 28 days. Field emission scanning electron microscopes (FE-SEM) was used to view the micro-topography, atomic force microscope was used to exam the surface roughness, and nano-indenter was used to evaluate the hardness of three groups ( n=3). Three groups of implant samples were inserted into the distal femoral metaphysis of New Zealand rabbits ( n=4 at each time point). After 4 weeks and 12 weeks, samples were harvested. Micro-CT scanning, immunofluorescent and histological examinations were carried out. Results:The strontium ions could be released slowly for at least 28 days [the Sr concentration at 28 Day was (2.6±1.5) ng/ml]. NTSr coating exhibited a nanoscale tube array (the diameter was about 70 nm), and the surface roughness of implant was increased with the nanobube coating [Control (34.8±5.3) nm, NT (66.2±4.3) nm, NTSr (85.7±10.6) nm, F=37.59, P<0.001]. The surface roughness (Ra) of NT and NTSr groups was higher than the control group ( P<0.05). Comparing to Control implants, NTSr implants exhibited a better osteogenic ability [the bone volume/total volume (BV/TV) value was Control (24.7±1.1)% vs. NTSr (37.7±1.9)% at 4 weeks ( P<0.05), and Control (40.7±0.9)% vs. NTSr (51.9±2.1)% at 12 weeks ( P<0.05)]. The fluorescent examination revealed that NTSr coating can also accelerated the generation of new bone tissue (bone tissue area% labelled by alizarin red at day 7 was Control (19.2±2.9)% vs. NT (35.4±3.7)% vs. NTSr (40.9±0.9)% ( F=42.74, P<0.01). The results in the NT and NTSr group were statistically higher than that in the control group ( P<0.05). Conclusions:The strontium loaded TiO 2 nanotubes can enhance new bone formation around titanium implants.

Objective To discuss the clinical value of interventional treatment for Klippel-Trenaunay syndrome complicated by spinal arteriovenous fistula and subarachnoid hemorrhage, and to report 1 patients with this disease who were successfully treated with interventional treatment. Methods One female children patient with clinically confirmed Klippel-Trenaunay syndrome complicated by spinal arteriovenous fistula and subarachnoid hemorrhage were enrolled in this study, who was underwent the embolization of arteriovenous fistula in the spinal. Results The interventional procedure was successfully accomplished in this case. The patient's clinical symptoms was disappeared gradually. No complications occurred. Conclusion For the treatment of Klippel-Trenaunay syndrome complicated by spinal arteriovenous fistula and subarachnoid hemorrhage, interventional management is minimally-invasive, safe and Reliable.

Registration of postoperative complications for surgical oncology including gastrointestinal cancer has received increasing attention with persistent researches on gastrointes-tinal tumor in China. The popularization of standardized gastric surgery and introduction of new technologies and concepts, including minimally invasive surgery, enhanced recovery after surgery, and neoadjuvant therapy, have promoted the conduction of clinical studies, e.g. the Chinese Laparoscopic Gastrointestinal Surgery Study Group series studies, on their safety, and further standardized the diagnosis and registration of postoperative complications as short-term study endpoints. Since then, for diagnosis and registration of complications in gastrointestinal surgery in China, the basis has evolved from clinical experience to clinical research. Since 2015, platforms such as China Gastrointestinal Cancer Surgical Union have been established to further promote the recording of real-world clinical data in more centers across the whole country. In recent years, the expert consensus on the diagnosis and registration of complications has been published sub-sequently and the prospective multicenter real-world complication registration study has been carried out. All of these efforts will facilitate medical centers especially the primary medical centers into the era of standardized diagnosis and registration of complications on a real-world basis.The authors review the standardized diagnosis and registration of surgical complications for gastrointes-tinal cancer in China, aiming to provide references to standardization of clinical practice of gastro-intestinal surgery.

Objective: To explore the activation of endoplasmic reticulum stress (ERS) in bone marrow mesenchymal stem cell (BMMSC) and its effect on osteogenic differentiation induced by micropit/nanotube topography (MNT), so as to provide guidance for the topography design of biomaterials. Methods: Four sample groups were fabricated: polishing control group (polished titanium, PT, no treatment), thapsigargin treatment (TG, 0.1 μmol/L TG treated for 9 h), MNT5 and MNT20 (anodized at 5 V and 20 V after acid etching). Scanning electron microscope (SEM) was used to observe the topography of Ti samples. The alkaline phosphatase (ALP) production, collagen secretion and extracellular matrix (ECM) mineralization of BMMSC (osteogenic induced for 7, 14 and 21 d) on Ti samples were detected to evaluate the osteogenic differentiation. After 12 h incubation, the shape and size of ER was examined using a transmission electron microscope (TEM), and ERS-related genes including immunoglobulin heavy chain binding protein (BiP), protein kinase RNA-like endoplasmic reticulum kinase (PERK) and activating transcription factor 4 (ATF4) were detected by quantitative real-time PCR (qRT-PCR). Results: After 7, 14 and 21 d of induction, the ALP production, collagen secretion and ECM mineralization in TG and MNT20 all significantly increased compared to PT (P<0.05). The cells grown on TG, MNT5 and MNT20 surfaces displayed gross distortions of the ER. Compared to PT, BiP, PERK, ATF4 mRNA expression in TG was respectively 1.87±0.10, 2.24±0.35, 1.85±0.14; BiP, ATF4 mRNA expression in MNT5 were respectively 1.27±0.09, 1.25±0.04; BiP, PERK, ATF4 mRNA expression in MNT20 were respectively 1.44±0.09, 2.40±0.60, 1.48±0.05 (P<0.05). Conclusions MNT triggered different degree of ERS, and the activated ERS may promote MNT-induced osteogenic differentiation.