Cholangiocarcinoma is a highly malignant tumor which originates from bile duct epithelial cells, and its invasion and metastasis is an important factor affecting the prognosis of patients and the main causes of the high mortality.Epithelial-mesenchymal transition is a reversible biological process of transition from epithelial phenotype to stromal cell phenotype, which is closely related to tumor invasion and metastasis.The microRNA is an endogenous non-coding RNA with a sequence of 20~25 nucleotides, which participates in the occurrence and development of tumor, especially in the progress of tumor invasion and metastasis by complementary base pairing with the 3'-untranslated region (3'-UTR) of the target gene at the post-transcriptional level.Herein, we present the mechanism of microRNA regulating epithelial-mesenchymal transition and its effect on the invasion and metastasis of cholangiocarcinoma.

The astrocyte reaction to cerebral trauma was reviewed in this paper,which included the study model,detection technique,as well as the astrocyte changes in the morphology and metabolism.It was also prospected to their significance in medicolegal expertise.

Objective:To explore the effect of early exercise rehabilitation in patients with acute myocardial infarction (AMI).Methods:A total of 64 AMI patients with stable vital signs were randomly divided into early exercise reha-bilitation group (n=32)and routine rehabilitation group (n=32)according to number table method.Early exercise rehabilitation group received early exercise rehabilitation guidance by rehabilitation therapists on first day after on-set,while routine rehabilitation group received exercise rehabilitation guidance by rehabilitation therapists of same qualification after one-week absolute bed rest.Besides,the two groups received same therapy and nursing.Incidence of major adverse cardiovascular events (MACE:re-infarction,death,severe arrhythmias,angina pectoris after in-farction and heart failure),hospitalization days and condktion of life self-care ability were observed,compared and analyzed between two groups.Results:Before discharge,there were no significant difference in MACE incidence rate (40.63% vs.43.75%)and percentages of patients with life self-care ability (100% vs.96.88%)between early exercise rehabilitation group and routine rehabilitation group,P >0.05,but length of hospital stay in early rehabili-tation group [(9.23±1.45)d]was significantly shorter than that of routine rehabilitation group [(15.03±2.53) d],P <0.01. Conclusion:Early exercise rehabilitation training can shorten length of hospital stay and is safe in pa-tients with acute myocardial infarction.

To reduce and avoid the contradiction caused by the right of privacy in nursing practice, the author analyzed problems of patients'privacy in nursing: distance between nursing staffs cognition and practice; doctors' opinion is different from nurses'; the contradiction between privacy and informed consent; problems of privacy relate to bed side teaching; new contents brougth out by science development. Aiming at the problems, the author puts forward corresponding countermeasures: to enhance the study of law; to balance the right to privacy and informed consent; to respect patients'privacy, strengthen communication with patients; and to understand new contents about ethics.

OBJECTIVE:To study the pharmacokinetics and relative bioavailability of two kinds of preparations of valaciclovir hydrochloride.METHODS:This was a randomized two-way cross-over study.A total of 18 healthy volunteers were randomly assigned to receive single oral dose of test valaciclovir tablets(trial group) or reference valaciclovir tablets(control group),with the plasma aciclovir concentrations determined by HPLC,the pharmacokinetics parameters calculated and the relative bioavailability evaluated using 3p97 program.RESULTS:The main pharmacokinetic parameters test and reference valaciclovir hydrochloride tablets were as follows:AUC0～ 24:(12.85? 4.32) vs.(12.19? 4.63) ?g? h? mL-1;AUC0～ ∞:(14.65? 5.75) vs.(13.27? 5.03) ?g? h? mL-1;Cmax:(3.55? 0.92) vs.(3.71? 0.97) ?g? mL-1;tmax:(1.44? 0.43) h vs.(1.33? 0.37) h;t1/2:(6.23? 2.81) h and(4.55? 1.84) h.The relative bioavailability of the test valaciclovir tablets were(111.01? 23.52) %.CONCLUSION:The reference valaciclovir tablets and the test valaciclovir tablets were bioequivalent.

0.05) . CONCLUSION: Gatifloxacin has no significant influence on pharmacokinetics of the hepatic injury model group as compared with the normal group.

Objective To explore therapeutic effect and side effect of oral indomethacin for treating patent ductus arteriosus(PDA)in full-term infants.Methods Forty-one full-term infants confirmed PDA by echocardiographically,who were admitted to the neonatal intensive care unit of our hospital from Jan.2004 to Dec.2007,were randomly divided into experimental group(21 cases)and control group(20 cases).Three oral doses of indomethacin [0.2 mg/(kg?time),at an interval of 12 hours] were administered in experimental group,while nothing in control group.Hepatorenal function and blood routine were measured in both groups in 2 days before and after treatment.Urine output and level of serum blood sugar were measured,and abdominal distension,vomiting,bloating,and bleeding were recorded during treatment.Color Doppler echocardiographic examination was performed,heart murmur was stethoscopied,and the rate of ductal closure was recorded at 5 to 7 days after treatment.The infants were followed up at out-patient department at 6 to 12 months after treatment,color Doppler echocardiographic examination was performed,and ductal closure condition was recorded.Results Hepatorenal function and blood routine were normal in experimental group in 2 days before and after treatment.Except that a little gastrointestinal bleeding occurred in one case of experimental group after the second dose of indomethacin,other adverse reactions were not observed during treatment.The ductus was closed in 16 infants in experimental group,the rate of ductal closure was 76.19%,while the ductus was closed naturally in 5 infants in control group,the rate of ductal closure was 25.0% at 5 to 7 days after treatment.There was significant difference in the rate of ductal closure between the experimental and control groups(?2=10.74 P

Objective To investigate the frequency of autoimmune encephalitis (AE) in limbic encephalitis (LE) syndrome and compare its clinical features with viral encephalitis.Methods Patients diagnosed with LE syndrome who admitted to Huashan Hospital between December 2015 and June 2016 were enrolled and screened for autoantibodies associated with AE (anti-N-methyl-D-aspartate receptor, anti-α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor, anti-gamma-amino-butyric acid B-receptor, anti-leucine-rich glioma inactivated 1 and anti-contactin-associated protein-like 2 antibodies) in cerebrospinal fluid (CSF) and serum. Their clinical features and auxiliary examinations were also collected and analyzed retrospectively. Results Fifty-four patients were diagnosed with LE syndrome, including 35 males and 19 females. The age of these patients was (38.98±17.29) (15-75) years. Twenty patients (37.0%) were identified as AE, 17 patients (31.5%) as viral encephalitis. Other cases included three (5.5%) with neurosyphilis, one (1.9%) with glioma and 13 (24.1%) of unknown cause. Young patients(15-29 years old)and patients older than 45 years accounted for 46.0% (17/37) and 37.8% (14/37) of all AE and viral encephalitis cases respectively. Patients with AE had longer disease progression time than patients with viral encephalitis ((22.45±11.62) d vs (6.24±2.95) d, t=6.015, P<0.01).Emergency hospitalization of patients with AE was less frequent than that of patients with viral encephalitis (3/20 vs 12/17, P=0.001). Patients with AE were less common to present with fever at disease onset than patients with viral encephalitis (8/20 vs 15/17, P=0.006). Seizures as the first neurological symptom were less common in AE than in viral encephalitis (2/20 vs 8/17, P=0.023). White blood cell counts in CSF were less frequently elevated in AE than in viral encephalitis (7/17 vs 12/15, P=0.036). The differences of age, gender, disease severity as well as abnormal rates of brain MRI, electroencephalogram and CSF protein were not statistically significant between the two groups. Tumors were discovered in 6 (6/19) patients with AE. Conclusions The frequency of AE in LE syndrome is not low. It is worthwhile to screen for autoantibodies associated with AE in patients diagnosed with LE syndrome. AE and viral encephalitis have their own characteristics, which could offer help in differential diagnosis between them and application of effective treatment.

Neural stem cell (NSC) has self-renewal and differentiation potential.It can orderly differentiate into neurons,astrocytes and oligodendrocytes in the development of central nervous system.NSC differentiation was commonly regulated by a variety of factors,including cytokines,transcription factors and epigenetic factors.Epigenetic regulation is a heritable gene expression without changing the DNA sequence.Histone modification is an important regulation mode in epigenetic modifications,which is essential in the transcription process.It also plays a critical role in the development of central nervous system.This article briefly reviews the histone methylation and demethylafion in the regulation of NSC differentiation.

Type 1 diabetes mellitus(T1DM) is a chronic autoimmune disease.Prospective studies carried out in T1 DM pre-diabetic relatives have shown that the process of β-cell degeneration can take place before the disease manifests itself clinically.Scholars have made several breakthroughs in immune therapy for T1 DM.This paper will make a review of the latest progress in the antigen-specific,antibody-based,cell-based,and other immunotherapies of T1DM.