Objective To evaluate the effect of surgical treatment for primary hepatocellular carcinoma(HCC) with bile duct thrombi(BDT).Methods Eleven cases were diagnosed as HCC with BDT by B ultrasound,CT,MRCP or ERCP.Hepatectomy and choledochotomy were performed,resecting the primary tumor and cleaning the BDT completely,followed with TACE.Results No patients died during operation.The survival time of 9 patients who received hepatectomy and BDT clearance ranged from 3 to 38(average 18.5) months,and that of the other two patients received TACE and BDT clearance survived 6 and 11 months respectively.Conclusion Accurate diagnosis and radical hepatectomy with complete BDT clearance are effective treatment for HCC with BDT.

BACKGROUND:Induction of osteoblasts differentiating into osteocytes is a hot spot in tissue engineering;however, the regulatory mechanism underlying differentiation has not been ful y elucidated. MicroRNA, as an endogenous smal RNA molecule, can regulate post-transcriptional gene expression by binding to the 3’ nontranslated region of the target gene mRNA, which also has been found to play an important regulatory role in osteocyte differentiation. OBJECTIVE:To study the regulation of miR-155 on osteoblast differentiation and the underlying mechanism. METHODS:The mouse osteoblast cel lines MC3T3-E1 were selected and induced by mouse bone morphogenetic protein-2 (BMP2, 200 ng/mL) and then the miR-155 mRNA expression was determined by quantitative real-time PCR at 1, 3, 7 and 14 days. MC3T3-E1 cel s were divided into control, BMP2, miR-155 and miR-155 inhibitor groups, fol owed by cultured withα-MEM medium, BMP2, miR-155 and miR-155 inhibitor, respectively, for 2 weeks. RESULTS AND CONCLUSION:After induction using BMP2, miR-155 expression was downregulated in a time dependent manner. The staining intensity of alizarin red in the BMP2 group was significantly higher than that of the control group, and the activity of alkaline phosphatase and mRNA expression were also significantly higher than those in the control group (P<0.01). The staining intensity of alizarin red, activity of alkaline phosphatase and mRNA expression in the miR-155 group were significantly lower than those in the control group (P<0.01), while al above measurements were reversed significantly by miR-155 inhibitor (P<0.05). miR-155 could bind to the 3’ untranslated region of SMAD5 mRNA and significantly downregulated the expressions of SMAD5 protein and mRNA in MC3T3-E1 cel s (P<0.01). These results show that miR-155 can inhibit MC3T3-E1osteogenic differentiation by downregulating SMAD5 expression.

Objective To construct the recombinant plasmid containing human filaggrin gene,purify and identify the immunoreactivity of the recombinant protein,and establish the indirect ELISA to detect AFA for diagnosis of RA.Methods The constructed plasmids were transformed into E. Coli Rosettagami(DE3).This fusion protein was purified by NAT chromatography.ELISA coated with the fusion protein Was established to detect the AFA in serum of patients,which included 114 cases of RA,56 cases of SLE,32 cases of OA and 40 cases of normal controls. The correlation between the results of AFA and anti-CCP in RA group were compared. Results 321 bp fragment of filaggrin gene was amplified and the recombinant expression vector pET-28a( + )-filaggrin was constructed. The sequence of filaggrin gene was the same as the sequence reported in the literatures. The Rosetta-gami (DE3) strains of E. Coli with recombinant vector showed high level of filaggrin protein after induction. The SDS-PAGE showed that the plasmid expressed the filaggrin fusion protein with molecule weight of 14 000 Da. The expression protein could be purified by Ni-NAT with activity. The absorbance value of AFA in RA group was 0.473 ±0. 248 while they were 0. 160 0. 088, 0. 121±0. 070, 0.050 0. ±018 in SLE, OA and normal groups respectively. There were significant differences of absorbance values of AFA between RA and SLE, OA, control group (t = 12.004, 14. 464, 18.078, P<0. 01, respectively). The positivities of anti-filaggrin in RA, SLE and OA were 48.2%, 5.4% and 3. 1% respectively. The positivities of AFA were significantly different between RA, OA and normal control groups (x~2 = 67. 088, P < 0. 01). There was positive correlation of results between AFA and anti-CCP antibody (r = 0.42, P < 0. 05 ) . The consistency rate of results between AFA and anti-CCP was 70. 1%. Anti-CCP was negative in 10 out of 114 patients with AFA positive. AFA can be used to diagnose RA with sensitivity of 48. 2% , specificity of 96.9% , positive predictive value of 93. 2% and negative predictive values of 67. 9% . Conclusions The purified human filaggrin fusion protein is successfully purified. The indirect ELISA method based on the recombinant protein shows good sensitivity and specificity. Joint detection with AFA and anti-CCP can improve the positive rate of detection.

Purpose/Significance To explore the teaching mode of Python language programming based on case-driven in medical u-niversities and colleges,so as to cultivate the computational thinking ability of medical students and the ability to solve practical medical is-sues using computer programming ideas.Method/Process Detailed analysis is finished on the problems existing in the implementation of Python language programming course in medical universities and colleges.The content is innovated and the new teaching method based on cases is proposed.Taking the development of a text mining information system as an example,the process of teaching are elaborated in de-tail.Result/Conclusion The restructuring of the content and the reform of teaching mode improve the computational thinking ability of med-ical students and promote their ability to use computer technology to analyze and solve medical related issues.

Objective: To explore the changes in ribosomal DNA copy number in peripheral blood among patients with pneumoconiosis and its influencing factors, so as to provide insights into prevention and treatment of pneumoconiosis. Methods: Eighty-eight patients with pneumoconiosis who visited a designated hospital and 71 community residents with no history of pneumoconiosis or dust exposure were selected as the pneumoconiosis group and control group, and age, smoking history, drinking history and cumulative years of exposure to dust were collected through questionnaire surveys. The copy number of 45S rDNA and 5S rDNA was detected using real-time fluorescence quantitative PCR, and the differences between the two groups were compared. Factors affecting the copy number of 45S rDNA and 5S rDNA were identified by a multiple linear regression model. Results: The pneumoconiosis group had a median age of 56.00 (interquartile range, 15.25) and a mean cumulative dust exposure duration of (12.40±8.08) years, with 56.82% smoking and 62.50% drinking. The control group had a median age of 64.00 (interquartile range, 37.00) years, with 32.39% smoking and 26.76% drinking. The median copy number of 45S rDNA in the pneumoconiosis group was 1.29 (interquartile range, 0.59), which was lower than 2.10 (interquartile range, 1.88) in the control group; the median copy number of 5S rDNA in the pneumoconiosis group was 5.33 (interquartile range, 0.85), which was higher than 4.66 (1.34) in the control group (both P<0.05). Multiple linear regression analysis identified age (β=-0.034) and pneumoconiosis (β=-1.595) as factors affecting 45S rDNA copy number, age (β=-0.013) as a factor affecting 5S rDNA copy number, and age (β=0.018) as a factor affecting 5S rDNA copy number in the pneumoconiosis group (all P<0.05). Conclusions Compared with community residents with no history of pneumoconiosis or dust exposure, the copy number of 45S rDNA in peripheral blood among patients with pneumoconiosis is reduced and the copy number of 5S rDNA is increased.

Objective? To explore the effects of self-designed facial muscle exercise in facial paralysis nursing among patients after acoustic neurinoma surgery. Methods? From May 2018 to February 2019, we selected 90 cerebellopontine angle (CPA) patients after acoustic neurinoma surgery of the Cancer Ward of Neurosurgery Department at a Class Ⅲ Grade A hospital in Beijing. All of the patients were randomly divided into experimental group (n=50) and control group (n=40). Control group carried out routine facial paralysis management. On the basis of routine nursing, experimental group implemented the self-designed facial muscle exercise directed by researchers from 10:00 to 11:00 in the morning and from 16:00 to 17:00 in the afternoon. The grades of facial paralysis after facial paralysis were assessed with the House-Brackmann facial nerve grading system, and statistical analysis was used to the recovery effects of facial paralysis and anxiety of patients between two groups. Results? A total of 30 days after surgery, the total effective rate of experimental group was higher than that of control group with a statistical difference (P＜ 0.01). A total of 90 days after surgery, the total effective rate of experimental group was 96.0% higher than that (55.0%) of control group with a statistical difference (P＜ 0.01). There was no statistical difference in the scores of Self-Anxiety Scale (SAS) of patients between two groups before intervention (P＞ 0.05). The scores of SAS of experimental group were lower than those of control group 7, 30 and 90 days after surgery with statistical differences (P＜0.01). Conclusions? The self-designed facial muscle exercise can promote the recovery of facial paralysis after acoustic neurinoma surgery and improve anxiety of patients.

Purpose To quantitatively evaluate the ability of advanced virtual monoenergetic technique (monoplus) in improving the display of pulmonary arteries with dual-source CT dual-energy pulmonary angiography.Materials and Methods Thirty patients whose CT values in pulmonary artery and its branches were lower than 300 HU in mixed images while image quality was poor in distal branches were enrolled in this study.All these patients underwent dual-source dual-energy (100/Sn140 kVp) CT pulmonary angiography (CTPA) with small amount of contrast medium (30 ml) from September 2016 to December 2016.Non-linear blending images were assigned in group A,100 kVp images from one tube were assigned in group B,and optimized monoenergetic images with low keV monoplus (40+,50+,60+ keV) were assigned in group C,D and E,respectively.CT and SD values of segmental,subsegmental and distal branches were measured,and signal noise ratio (SNR) and contrast noise ratio (CNR) were calculated.Results Among all the 5 groups,CT values of pulmonary artery in group C,D and E were significantly higher than in group A and B (P＜0.05).SNR values of segmental artery in group C were significantly higher than those in group A (P＜0.05).SNR values of subsegmental artery in group C and D were significantly higher than those in group A (P＜0.05).SNR values of segmental and subsegmental pulmonary artery in group C,D and E were all significantly higher than those in group B (P＜0.05).The SNR values of distal branches in group C,D and E were not significantly different from those in group A (P＞0.05),but were significantly higher than those in group B (P＜0.05).CNR values in group C,D and E were not significantly different from those in group A (P＞0.05),but were significantly higher than those in group B (P＜0.05).Conclusion Combined with dual-source dual-energy CT pulmonary angiography,low keV monoplus images can effectively increase CT values of pulmonary artery and clearly display the distal branches.Meanwhile,the image quality is comparable with non-linear blending images,better than that of low tube voltage (100 kVp) images.

Diabetes mellitus is a metabolic disease characterized by chronic hyperglycemia caused by absolute or relative insufficiency of insulin secretion. As the disease progresses， patients begin to suffer from diabetic nephropathy， diabetic cardiomyopathy， non-alcoholic fatty liver disease or other complications， which increase the burden on the patients. Moreover， the number of patients is increasing， which brings a heavy burden to the society. Ferroptosis is a new type of programmed cell death which has attracted wide attention in recent years. It refers to the cell death caused by the excessive accumulation of lipid peroxide under the overload of iron ions. Studies have discovered that ferroptosis exists in diabetes mellitus and its complications. Inhibiting ferroptosis can greatly slow down the occurrence and progression of diabetes mellitus and its complications. Chinese medicine， the unique medical treasure in China， acts in a multi-pathway， multi-target manner and is praised for the cheap price， low toxicity， and mild side effects. It has been widely used in the treatment of diabetes mellitus and its complications and has demonstrated definite therapeutic effects， bringing the good news for the majority of patients. The regulation of ferroptosis by Chinese medicine may be a new direction for the treatment of diabetes mellitus and its complications in the future. This paper briefly describes the mechanism of ferroptosis， explores the relationship of ferroptosis with diabetes mellitus and its complications， summarizes the research status of Chinese medicine interventions， and puts forward suggestions， aiming to provide a reference for further research on the treatment of diabetes mellitus and its complications with Chinese medicine.

ObjectiveTo observe the effect of Hedysari Radix polysaccharide （HRP） on the Janus kinase 2 （JAK2）/signal transducer and activator of transcription protein 3 （STAT3） signaling pathway in diabetic nephropathy db/db mice. MethodFifty db/db mice were randomly divided into model group， irbesartan group （irbesartan suspension， 22.75 mg·kg^-1）， and high-， medium-， and low-dose HRP groups （HRP suspension， 200， 100， 50 mg·kg^-1） according to the body weight， with 10 mice in each group. Another 10 C57BL/6 mice were assigned to the normal group. The mice were treated with corresponding drugs by gavage， while those in the normal group and the model group received distilled water at 5 mL·kg^-1. The mice in the six groups were administered once a day by gavage for 12 consecutive weeks. The uric acid （UA）， triglycerides （TG）， and total cholesterol （TC） were detected. Periodic acid-Schiff （PAS） staining and Masson staining were used to observe the pathological changes in kidney tissues. Western blot and Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） were used to detect the protein and mRNA expression levels of JAK2， STAT3， suppressor of cytokine signaling 3 （SOCS3）， and tumor necrosis factor-α （TNF-α） in the kidney. ResultAfter 12 weeks of treatment， compared with the normal group， the model group showed significant pathological ultrastructural changes in kidney tissues and increased UA， TG， and TC levels （P<0.01）. Compared with the model group， the high- and medium-dose HRP groups and the irbesartan group showed improvement in pathological ultrastructure of kidney tissues and reduced UA， TG， and TC levels （P<0.05， P<0.01）. Compared with the normal group， the model group showed a decrease in SOCS3 protein and mRNA expression levels and an increase in JAK2， STAT3， and TNF-α protein and mRNA expression levels （P<0.01）. Compared with the model group， the high- and medium-dose HRP groups and the irbesartan group showed an increase in SOCS3 protein and mRNA expression levels and a decrease in JAK2， STAT3， and TNF-α protein and mRNA expression levels （P<0.05， P<0.01）. ConclusionHRP can alleviate renal damage in diabetic nephropathy to a certain extent， and its mechanism may be related to the inhibition of the activation of the JAK2/STAT3 signaling pathway.

Diabetic nephropathy （DN）， as one of the common chronic microvascular complications of diabetes， has become the main cause of renal failure in end-stage renal disease in China， increasing the risks of renal dialysis and kidney transplantation in diabetes patients. It is the leading cause of death in people with diabetes. The latest research on DN has focused on the gene level. microRNAs （miRNAs） are a family of endogenous accessible short-chain non-coding RNA molecules. By acting on a particular target， they activate or inhibit its mediated signaling pathways and related molecules， playing an important role in the occurrence and development of DN. They have become microeconomic factors for the prevention and treatment of DN. Traditional Chinese medicine （TCM） has a long history in the diagnosis and treatment of DN and has unique advantages such as significant curative effect and few side effects. A large number of studies have proved that TCM can target miRNA to affect multiple signaling pathways， participate in the regulation of inflammatory response， pyroptosis， mesenchymal transdifferentiation， and other pathological changes， and delay the further development of DN. Therefore， this study discusses the biogenesis mechanism of miRNA and its action mechanism in disease-related signaling pathways based on TCM diagnosis and treatment approaches from the perspective of miRNA， and summarizes the effect of TCM targeting miRNA on the disease-related signaling pathways and on DN. Thus， this study is expected to provide a theoretical reference for exploring the progress of TCM intervention in DN from the perspective of genes.