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.

Reforming the managerial system and the educational system of higher medical education is the requirement of the social development in the twenty-first century. The article expounds the fundamental characteristics of medical education including small scale, longer-duration program, and high expenditure. It emphasizes the significance of following the rule of medical education, and analyzes the important position of medical college and the relation of medical college to affiliated hospitals and other related colleges in the comprehensive university. Based on the requirement of the social development and the trend of higher medical education internationalization, it also analyzes the necessity of the adjustment on the medical educational system and the way of the adjustment.

Objective To investigate the changes of psychological state and family environment of the patients with neurosis (including depression and anxiety) in the process of treatment. Methods The Hamilton depression scale (HAMD), Hamilton anxiety scale(HAMA), self-rating depression scale(SDS), self-rating anxiety scale(SAS), family environment scale(FES), and family adaptability and cohesion scale(FACESⅡ-CV) were used to evaluate the changes of psychological state and family relationship in the process of treatment among patients with depression and anxiety hospitalized in general hospitals (n=45) and their family members (n=45). Results Before intervention, values of HAMD, HAMA, SDS and SAS in patients were higher than normal ones, and were in line with the corresponding diagnostic criteria. After psychological intervention and medication for 2 to 3 months, symptoms such as depression and anxiety were improved significantly, and values of the above scales were within normal ranges. Besides, there was also significant improvement in FES and FACESⅡ-CV after intervention among the patients. All the values of the family members were in the normal ranges before intervention, however, significantly positive changes were observed after intervention. Conclusion With the improvement in depression and anxiety after intervention among patients, the psychological pressure of family members is released, and family relationship is partially restored. The rehabilitation of patients plays an important role in the restoration of family function.

Objective To evaluate urodynamic diagnosis of intrinsic sphincter deficiency (ISD) in female stress urinary incontinence. Methods Leak-point pressures (LPP) and maximum urethra close pressures (MUCP) were detected in 30 patients with female stress urinary incontinence,among whom there were 11 cases with type Ⅲ,19 type Ⅱ/Ⅲ. Results Of type Ⅲ incontinence the LPP was less than 50 cmH 2O in 10 out of 11 and in 17 out of 19 type Ⅱ/Ⅲ incontinence the LPP 50～100 cmH 2O ( P

Objective To compare the protective effect of ischemic preconditioning(IP) and caspase inhibitor on ischemia reperfusion(IR) injury of the liver in rats,and to investigate the possible mechanism. Methods SD rats subjected to 60 or 120 minutes of 70% hepatic ischemia and 3 hours of reperfusion,respectively,then divided randomly into 6 groups: (1)Ischemia/ reperfusion group 1 (IR 1 group);(2)IR 2 group;(3)Ischemia preconditioning group 1(IP 1 group);(4)IP 2 group; (5)Caspase inhibitor treatment group1(T 1 group);(6)T 2 group.Serum levels of aspartate aminotransferase (AST) and alanine aminotransfernase (ALT),and liver Caspase-3 activity, hepatocytes apoptosis,and animal seven-day(7 d) survive rate were determined. Results Both ischemic preconditioning and Caspase inhibitor treatment could protect the liver against IR injury,and their protective effect in IP 1 group and T 1 group was equally at 3h reperfusion after 60min ischemia. At 3h reperfusion after 120min ischemia, the effect of inhibiting Caspase-3 activity and decreasing hepatocyte apoptosis in T 2 group were significantly superior to those in IP 2 group(P0.05). Conclusions Both IP and Caspase inhibitor treatment can protect the liver against IR injury in rats,and the protective effect is no significant difference between the two methods.However IP is more simple?safe and cheaper comparing with Caspase inhibitor treatment.

Objective To investigate the effect and mechanism of serotonin (5-HT) and secretin(SEC) on afferent discharge of vagus in rats. Methods Spontaneous afferent discharge of subdiaphragmatic vagus nerve was recorded in urethane anesthetized rats. The effects of 5-HT, 5-HT3 receptor antagonist and 5-HT+SEC on the discharge of subdiaphragmatic vagus nerve were investigated by intravenous injection of different dosage of 5-HT(3, 10, 30 ?g/kg), Granisetron (1 mg/kg) and 5-HT+SEC. Results Intravenous 5-HT caused obvious exciting effect on spontaneous afferent discharge of subdiaphragmatic vagus nerve. The 5-HT3 receptor antagonist significantly inhibited the effects of 5-HT. 5-HT+SEC could augment the effect of 5-HT on spontaneous discharge. Conclusion The exciting effect of 5-HT on afferent discharge of subdiaphragmatic vagus nerve is possibly mediated by 5-HT3 receptor related to vagus nerve afference. Secretin can augment the exciting effect of 5-HT on spontaneous discharge of vagus afferent nerve.

AIM: To establish the method of determining procyanidin B2 content in grape seed extract by HPLC. METHODS: The determination was carried out with ZORBAX SB-C_ 18 column. The mobile phase consisted of acetonitrile-2% acetate buffer under the gradient elution condition, detection wavelength was at 280nm. RESULTS: There was a good linear relationship between the peak area and concentration in the range of 1~30 ?g/mL for procyanidin B2. The average of procyanidin B2 (n=5) was 99.29% and RSD=1.64%, respectively. CONCLUSION: The method is simple, accurate, reproducible and can be used for assay of procyanidin B2.

Objective To discuss the clinical application of MSCT-guided BARD gun biopsy in diagnosing pulmonary lesions. Methods Under MSCT-guidance percutaneous transthoracic biopsy of lung with BARD gun was performed in 68 patients with pulmonary lesions. Results All the procedures were well performed with the technical successful rate of 100%. The final diagnosis was based on the pathological findings or clinical follow-up observation. The accuracy of the qualitative diagnosis was 94.1%. Of 68 patients, squamous cell carcinoma was found in 30, adenocarcinoma in 21, metastases in 7, inflammatory pseudotumor in 3, lung abscess in 2, and tuberculosis in one. The false-negative rate in making diagnosis was 5.9%. The complication occurrence was 8.8%. Conclusion BARD gun has the advantage of making coaxial- multipoint biopsy. With the help of MSCT-guidance and the full use of the operating advantage of BARD gun, this technique is safe and reliable, with higher accuracy and less complications.

Objective:To establish an HPLC method with a refractive index detector for the simultaneous determination of fructose and glucose in multiple electrolytes and invert sugar injections. Methods: A Waters XbridgeTM Amide(150 mm × 4. 6 mm,3. 5 μm) column was used with acetonitrile-water -triethylamine (75∶25∶0. 2) as the mobile phase, the column temperature was 40 ℃, the flow rate was 1. 0 ml·min-1 , the refractive index detector was used with the detector temperature of 40 ℃, and the injection volume was 50 μl. Results:A good linear relationship between the quantity of glucose or fructose and peak area was shown within the range of 99. 8-149. 7 μg(r=0. 999 7)for fructose and 100. 3-150. 4 μg(r=0. 999 2)for glucose, the average recovery of fructose and glucose was 99. 2% and 99. 5% with RSD of 0. 81% and 0. 84%(n=9), respectively. Conclusion: The method is fast and convenient with high specificity, good accuracy and promising separation, which can be used in the content determination of fructose and glucose in multiple electrolytes and invert sugar injections.