Objective To evaluate the feasibility and clinical application of two stents insertion via single tract for treatment of hepatic hilar cholangiocarcinoma. Methods Eighteen patients with hepatic hilar cholangiocarcinoma who had left and right bile duct obstruction were treated with stents insertion via right bile duct puncturing routeway. These two stents were implanted between right and left bile duct, and between right bile duct and common bile duct. Results Eighteen patients obtained successful two stents placement by right bile duct puncturing tract and succeeded with internal drainage for all bilialy tree jaundice subsided distinctly. Conclusions The technique of two stents insertion via single tract could predigest interventional drainage procedure of high bile duct obstruction ,reduce operation trauma, shorten handling time and possese promising application value.

Autophagy is the process through which cells utilize lysosomal hydrolases to degrade cytoplasmic misfolded proteins and damaged organelles. This process allows cells to reuse degradation products and degrade harmful substances to maintain intracellu-lar stability. The autophagy level is low at the normal cell state. Cells under unfavorable conditions activate autophagy to eliminate ad-verse factors. An increasing number of studies have shown that autophagy plays important roles in tumorigenesis, tumor progression, metastasis, relapse, and drug resistance. However, the detailed mechanisms remain unclear. This review summarizes the expression of gastric cancer cell-related autophagy genes and the mechanism by which autophagy promotes gastric cancer cell death. Autophagy has an important application prospect in treating gastric cancer.

The database design of multi-focal visual electric-physiological examining system is introduced in this paper.Microsoft Access 97 is used to design the database.VC++ can append,query or delete records of the database through DAO interface.It reflects such advantages that the database is easy to be managed and convenient to be queried.The design pattern can be transplanted to other medical devices' design.

Objective To observe the effects of enriched environment on cognitive function in mice with sepsis-associated encephalopathy and to study the neuron PAS domain protein 4 (NPAS4)/brain deprive neurotrophic factor (BDNF)related mechanisms.Methods Sixty adult male mice were divided randomly into three groups:sham operation with standard environment group (group SS,n =12),cecal ligation and puncture with standard environment group (group CS,n =24),cecal ligation and puncture with enriched environment group (group CE,n =24).All mice were reared in standard environment or enriched environment for 28 days.The fear condition test was conducted on day 29 af-ter operation in mice.The change of NPAS4 and BDNF,the density of dendritic spine were detected by western blot or golgi staining.Results Compared with group SS,the context freezing time, NPAS4 and BDNF expression and the density of dendritic spine in hippocampus decreased significantly in group CS (P < 0.05).Compared with group CS,the context freezing time,NPAS4 and BDNF expression and the density of dendritic spine in hippocampus increased significantly in group CE (P <0.05).No significant difference was observed in the conditional freezing time among three groups.Conclusion Enriched environment can obviously improve cognitive function impairment induced by sepsis-associated encephalopathy,which may be related with up-regulated expression of NPAS4/BDNF,and promoted synaptic plasticity.

Objective Chronic diseases are recognized as a major health problem in the 21st century.This project was to assess the effects of self-awareness health management service on optimization of life-style of community residents so as to effectively control the occurrence and development of chronic diseases.Method A survey of health information,an evaluation of health status,health intervention were conducted among 231 people aged between 29-65 years in a community for a half year,and the health management was effectively assessed of them.38 subjects with chronic diseases were subjected to diet friends used and exercise quantitative management model.Results The way of life of the 231 people has been optimized,and in the 38 patients with chronic diseases who had adopted the management mode of friends six months later their average body weight dropped by 1.3 kg,body mass index dropped by 0.5,and waist circumference reduced by 1.8 cm(P<0.05).Conclusion It is feasible to conduct health management in residents of communities,especially in patients with chronic diseases,which COnforms to the basic principles and requirements of prevention and treatment of chronic diseases advocated by WHO.

Objective To observe changes of hippocampal levels of pro-inflammatory cytokines in rats with neuropathic pain-induced depression, and to explore the relationship between hippocampal levels of pro-inflammatory cytokines and severity of depression.Methods Twenty-eight adult male rats were randomly divided into two groups: group sham (n=14) and spared nerve injury (group SNI) (n=14).Mechanical withdrawal thresholds (MWT) were measured 1 day before and 7, 14 and 21 days after operation.Sucrose preference test and forced swim test were tested 1-3 days before and 21-23 days after operation.After test, hippocampus was collected.The hippocampal levels of interleukin (IL)-1β, IL-6 and tumor necrosis factor-α (TNF-α) were measured by ELISA.Correlational relationships between hippocampal levels of pro-inflammatory cytokines and sucrose preference were evaluated.Results Compared with group sham, MWT was decreased 7, 14, 21 days after operation (P<0.001).Group SNI displayed decreased sucrose preference 21 days after operation (P<0.01) and increased immobility time in FST 23 days after operation (P<0.05).The levels of IL-6 and TNF-α were increased in hippocampus (P<0.05 or P<0.01).No significant difference was observed in IL-1β.The hippocampal levels of IL-1β (r2=0.60,P<0.01), IL-6 (r2=0.55,P<0.01) and TNF-α(r2=0.60,P<0.01) were negatively correlated with sucrose preference.Conclusion The hippocampal levels of pro-inflammatory cytokines IL-6 and TNF-α are increased in rats with depression induced by neuropathic pain, and the levels of hippocampal pro-inflammatory cytokines are negatively correlated with the severity of depression.

Objective:The characteristics of lymph node metastasis were investigated to guide the range of lymph node dissection during the radical operation of distal gastric cancer. Methods:The clinical data of 773 patients with distal gastric cancer who under-went radical distal subtotal gastrectomy at the Tianjin Medical University Cancer Institute and Hospital between February 2010 and September 2014 were reviewed and analyzed to infer the potential clinical mechanisms of lymph node metastasis. Results:Among the included patients, 423 (54.72%) had lymph node metastasis. The proportion of metastasis in the patients from the highest to the lowest rate was observed in group NO. 6, 3, 4sb, and 5 lymph nodes. The metastasis rates of the N1 lymph nodes from the highest to the low-est were observed in group NO. 3, 6, 5, and 4d lymph nodes, whereas those of the N2 lymph nodes occurred in group NO. 8a, 7, and 1 lymph nodes. Group NO. 8a lymph node with skipped metastasis was observed in 50.68%of the patients. Conclusion:During radical distal gastric cancer surgery, attention should be given to the possibility of metastasis in group NO. 8a lymph node. Appropriate exten-sion of the lymph node dissection should be conducted when necessary.

Objective:To explore mechanism of long non-coding RNA maternally expressed gene 8(LncRNA MEG8)mediates immune escape in colorectal cancer(CRC)cells by regulating MICA/B via targeting miR-15a-5p.Methods:RT-qPCR and Western blot were used to detect expressions of MEG8,miR-15a-5p,MICA,MICB,NKG2D protein in CRC tissue and cell lines;dual luciferase experiment was used to verify regulatory relationship of MEG8 on miR-15a-5p;NC,MEG8,miR-NC and miR-15a-5p were respectively or co-transfected into SW480 and SW620 cells by liposome transfection,and recorded as NC group,MEG8 group,MEG8+miR-NC group,MEG8+miR-15a-5p group;NK cells were cocultured with SW480 and SW620 cells respectively;ELISA was used to detect TNF-α and IFN-γ levels in coculture medium;CCK-8,EdU staining,Transwell assay were used to detect cell prolifera-tion,migration and invasion ability;RT-qPCR and Western blot were used to detect MEG8,miR-15a-5p,MICA,MICB,NKG2D protein levels in cells.Results:Compared with adjacent cancer tissues or normal colon epithelial cells,MEG8,MICA,MICB,NKG2D mRNA and protein levels in CRC tissues and cell lines were decreased,while miR-15a-5p level was increased(P<0.05).MEG8 targeting regulated miR-15a-5p.In cocultivation system,compared with NC group,MICA,MICB,NKG2D protein levels,TNF-α,IFN-γ levels in cocultured supernatant in MEG8 group were significantly increased,after 1 d,2 d,and 3 d of cell culture,OD value,EdU positive rate,number of migrating and invading cells were significantly decreased(P<0.05);overexpression of miR-15a-5p could partially reverse effects of overexpression of MEG8 on MICA,MICB,NKG2D,TNF-α,IFN-γ levels in cells,prolifera-tion,invasion and metastasis ability(P<0.05).Conclusion:MEG8 promotes NK cell activity and inhibits CRC cell immune escape by regulating MICA and MICB expressions via targeting miR-15a-5p.

Objective To observe the effect of enriched environment (EE) on the pain threshold and depression like behavior in mice with chronic constriction injury (CCI) and the underly ing mechanism.Methods Sixty C57/BL6 mice were equally randomized into five groups:sham operation group (group Sham),CCI+standard environment(SE) group (group CS),CCI+EE group (group CE),CCI+EE+temozolomide group (group CET),CCI+EE+lipopolysaccharide group (group CEL).The paw withdraw threshold (PWT),paw withdraw latency,forced swim test (FST)and sucrose preference test (SPT) were evaluated,after the operation,meanwhile the hippocampal bromodeoxyuridine (Brdu),ki67 and doublecortin (ICX) positive cells,tumor necrosis factor-α (TNF-α) and interleukin-1β(IL-1β) were determined.Results Compared with group Sham,the PWT,PWL,sucrose consumption and Brdu,Ki67,DCX positive cells were significantly decreased,the immobility time and levels of TNF-α and IL-1β were obviously increased in group CS (P＜0.05).Compared with group CE,the PWT,PWL,sucrose consumption and Brdu,Ki67,DCX positive cells were significantly decreased in groups CS and CEL.The immobility time was obviously increased in groups CS,CET and CEL,moreover,the levels of TNF-α and IL-1β were significantly increased in groups CS and CEL (P＜0.05).Conclusion EE can improve the neuropathic pain,depression-like behavior and neural regeneration in mice with CCI.The inhibition of neural regeneration can block EE-induced improvement of depression-like behavior,but does not affect the pain threshold in mice with CCI.The augmentation of central inflammation can attenuate EE-induced improvement of pain threshold and depression-like behavior in mice with CCI.

Objective To investigate the effect of magnetic resonance diffusion tensor imaging(DTI)combined with Buyang Huanwu decoction on limb rehabilitation of patients with spontaneous hypertensive cerebral hemorrhage in basal ganglia.Methods A total of 68 patients with spontaneous hypertensive intracerebral hemorrhage in basal from March 2022 to March 2023 were selected from the department of neurosurgery of the First People's Hospital of Huzhou as research object.According to the random number table method,the patients were divided into control group(30 cases)and experimental group(38 cases).The control group was diagnosed with hypertensive intracerebral hemorrhage and received conventional therapy,and the experimental group was treated with DTI combined with Buyang Huanwu decoction.After 4 weeks of treatment,the overall treatment effect of the two groups was compared,and the differences of Fugl-Meyer assessment(FMA),National Institutes of Health Stroke Scale(NIHSS),Berg balance scale(BBS),and modified Barthel index(MBI)scores were compared.Results The overall therapeutic effect of experimental group was significantly higher than that of control group[86.8%(33/38)vs.56.7%(17/30),P<0.05].After 4 weeks of treatment,FMA,BBS and MBI scores were significantly increased in both groups,NIHSS scores were significantly decreased in both groups,and the improvement degree of the experimental group was significantly better than that of the control group(FMA score:74.21±9.07 vs.66.73±12.76,NIHSS score:15.16±3.73 vs.20.27±6.15,MBI score:69.29±14.68 vs.60.63±19.10,BBS score:43.55±4.30 vs.36.90±3.86,all P<0.05).Conclusion DTI combined with Buyang Huanwu decoction can improve the motor function of the limbs of patients in the basal ganglia area and enhance their ability to perform activities of daily living.