Cholangiocarcinoma is a type of malignant tumor with high destruction.Due to its low diagnostic rate and high fatality rate,the operation is the unique therapeutic methods for the radical cure.However,the diagnosis and treatment for the disease were always in the phase of progression,so currently,the radical therapeutic rate is quite low,while the recurrence rate of the operation is extremely high.If the correlated mechanism of perineural invasion of cholangiocarcinoma could be understood,then interrupted its perineural invasion in the early period,that could greatly enhance the prognosis of cholangiocarcinoma patients.This article systematically reviews the progress of cholangiocarcinoma neural invasion related molecules and possible mechanism.

This paper discusses non-contact detection technologies in medical service. With the progress of science and technology, non-contact detection technologies for life parameters, based on microwave technology, infrared technology, laser technology and so on, will be more and more important in the development of digital medical equipment.

As the indexes of reflecting whole blood coagulation and fibrinolytic capacity, thrombelas-tography are being increasingly used in the fields of guiding intraoperative blood transfusion, hypercoagulable state monitoring and correction, treatment of trauma patients, and clotting mechanism research. This article reviews the clinical application value and limitation of thrombelastography in patients with ischemic cerebrovascular disease.

Objective To investigate the anticancer efficacy of dihydromyricetin (DMY)in gastric cancer cells SGC7901. Methods The DMY was puritied using RP-HPLC was almost 98%.The cell viability was assessed by CCK-8 Assay.The cell ap-optosis was assessed by flow cytometry.Using ultrasonic extraction with neutral water and reversed-phase high-performance liquid chromatography,DMY was purified from rattan tea.Results By using RP-HPLC,the purified DMY is almost 99%.DMY inhibi-ted the growth of tumor cells in the low concentration(≤ 1 mmol)with a dose-dependent manner(P <0.05 ).Further study on DMY showed that it induced apoptosis in SGC7901 cell line with a dose-dependent manner.Conclusion DMY is a potential thera-peutic agent for gastric cancer.

Objective To discusses the clinical features of early inflammatory bowel obstruction (EPIS-BO) after abdominal surgery,and analyze diagnosis and treatment. Methods The clinical data of 48 patients with early inflammatory bowel obstruction after abdominal surgery were analyzed retrospectively from July 2005 to July 2015. Results 45 patients were recovered after non-operative treatment including gastrointestinal decompression , total parenteral nutrition (TPN),antibiotics,glucocorticoid and somatostatin. The average time of treatment was 17.45 days. The other 3 patients underwent laparotomy respectively on 16,19 and 20 days after conservative treat-ment.Two cases were turned to intestinal fistula after operation ,and one of them died after reoperation because of severe abdominal infection 9 days later. Conclusion Conservative treatment should be regarded as the first choice for EPISBO in clinical practice due to less complications and better effect than operative treatment.

Objective To evaluate the clinical efficacy and safety of methotrexate(MTX) plus low dose glucocorticoid in the treatment of rheumatoid arthritis (RA) from thetarget control point of view.Methods Patients diagnosed as RA according to American College of Rheumatology(ACR)/European League against Rheumatism (EULAR) 2010 classification criteria were enrolled.All of the patients were prescribed with 15 mg/week MTX,5 mg/week folic acid and prednisone (not exceeding 10 mg/day) orally.At week 0,4,12,disease activity and clinical efficacy were recorded.Co-primary assessment criterion was disease activityscore (DAS28)-based on C-reactive protein (CRP).Secondary assessment criteria included EULAR response criteria,ACR response criteria,simplified disease activity index(SDAI),clinical disease activity index(CDAI).The tolerability and toxicity of MTX was recorded at week 4,12.All patients were evaluated for the occurrence of adverse drug reactions associated with prednisone at week 12.Results A total of 76 patients were enrolled in the study.At week 4 and 12,68 and 65 patients completed regular follow-up respectively.At week 12,there were 30(46.2％),9(13.8％),26(40.0％) patients who met DAS28-CRP remission,low disease activity,middle and high disease activity criterion respectively.Three of nine patients who grouped in low disease activity after therapy were early or intermediate patients and didn't reach the target.Thus 36 (55.4％) patients met the standard of target control.The percentage of patients who met the criteria of EULAR good response,the ACR criteria for 20％ improvement (ACR20),the ACR criteria for 50％ improvement (ACR50),the ACR criteria for 70％ improvement (ACR70) were 29.2％,75.4％,69.2％,64.6％,respectively.The proportion of patients meeting the standard of treat to target using SDAI and CDAI were 76.9％,58.5％ respectively.The rate of liver injury,abdominal pain,abdominal distention and acid reflux,nausea were 11.8％,4.4％,4.4％,2.9％ respectively at week 4.At week 12,4.6％ of patients reported abdominal distention.There was only one patient (1.5％) each who complained of abdominal pain,nausea,loss of hair,varicella zoster virus infection and pulmonary infection at week 12.No serious adverse event was observed during the study.Conclusions Based on the view of target control,drug efficacy and safety,MTX plus low dose prednisone is still a useful therapeutic regimen for RA at present.

Objective: To assess the relationships between nutritional risks, nutritional support, and doctors' knowledge related to nutritional risks. Methods: 217 pre-operative patients and 41 doctors in the same general surgical wards were surveyed by using NRS2002 and self-developed questionnaires in a Beijing hospital. Results: The overall prevalence of pre-operative nutritional risks was 15.7%. Patients with gastrointestinal and/or malignant diseases had higher risks than others(P values were both less than 0.001). The nutritional support rates were 14.7% among patients with nutritional risks, and 2.2% among those without risks. The EN: PN ratio was 1∶ 2. A majority of doctors had misconceptions in nutritional risk screening and the effectiveness of nutritional supports. Their clinical practices were not consistent with their knowledge. Related trainings were required. Conclusions: Patients with gastrointestinal and/or malignant diseases have higher possibilities of nutritional risks. The nutritional supports rates are generally low. Doctors' knowledge related to nutritional risk screening is insufficient. More training opportunities are suggested to enhance the application of NRS2002 and appropriate nutritional supports.

Objective To explore the expression, as well as the proportion of subsets of the natural killer (NK) T cells in peripheral blood of patients with esophageal carcinoma before and after surgery, and provide ideas and experimental basis for immune treatment through tests. Methods Using CD3, CD56, CD4 and CD8 antibody to study the NKT cells and its subsets. Peripheral NKT cell subsets in 59 patients with esophageal carcinoma were analysed by flow cytometer. Results With the ratio of CD+3 CD+56 CD+8/CD+3 CD+56 CD+4 gradually increased, the proportion of phase Ⅲ- Ⅳ patients with esophageal carcinoma is gradually decreased between the groups. One-way ANOVA analysis showed that there were differences between the groups (P ＜0.05). The ratio of CD+3 CD+56 CD+8/CD+3 CD+56 CD+4 was in Non-linear related to CD+3 CD+56 CD+4NKT cells; CD+3 CD+56 CD+8; NKT cells were positively correlated with CD-3 CD+56 NK cells and negatively correlated with CD+3 T cells.Conclusion The ratio of CD+3 CD+56 CD+8/CD+3 CD+56 CD+4 may relate to tumor burden, and is helpful to determine the extent of disease in patients with esophageal carcinoma and prognosis.

Objective To evaluate the preoperative undernutrition, nutritional risks, and nutritional support in general surgical wards. Methods The nutritional risks of 217 new in-patients in general surgical wards in a Beijing-based hospital were assessed using nutrition risk screening 2002 ( NRS 2002 ) and the medical records were reviewed. Results The overall prevalence of preoperative undernutrition and nutritional risks was 7.4% and 14.7% respectively, most of which occurred in patients with gastrointestinal diseases and malignant diseases. Nutritional supports were provided to 18.8% of patients with undernutrition, 12.5% of patients with nutritional risks,3.0% of patients without undernutrition, and 2.7% of patients without nutritional risks. The enteral nutrition:The application of nutritional support should be further improved in general surgical wards.

Objective: To investigate the mortality trends and life loss due to pancreatic cancer death among residents in Suzhou City from 2006 to 2020, so as to provide insights into the management of pancreatic cancer. Methods : The data pertaining to the death of pancreatic cancer in Suzhou City from 2006 to 2020 were collected from the Jiangsu provincial mortality surveillance system. The crude mortality, standardized mortality, years of potential life lost ( YPL L), rate of YPLL ( YPLLR ), average years of life lost ( AYLL ) and annual percent change (APC) were calculated to analyze the changing trend in mortality and life loss due to pancreatic cancer. Results: The crude mortality of pancreatic cancer was 13.57/105 in Suzhou City from 2006 to 2020, appearing a tendency towards a rise ( P<0.05) with APC of 2.95%. The standardized mortality of pancreatic cancer was 6.39/105. The crude mortality of pancreatic cancer was 15.14/105 in men and 12.06/105 in women, which both showed a tendency towards a rise ( P<0.05 ) with APC of 3.18% and 2.73%. The crude mortality of pancreatic cancer appeared a tendency towards a decline in residents at ages of 30 to 45 years and 45 to 60 years ( P<0.05 ), with APC of -4.93% and -1.63%, and appeared a tendency towards a rise in residents at ages of 60 years and greater ( P<0.05 ), with APC of 0.53%. The YPLL and YPLLR of pancreatic cancer were 55 340 person-years and 0.06% in Suzhou City from 2006 to 2020, while the AYLL of pancreatic cancer was 9.81 years per person, which appeared a tendency towards a decline ( P<0.05 ), with APC of -2.35%. Conclusions The crude mortality of pancreatic cancer appeared a tendency towards a rise in Suzhou City from 2006 to 2020, and the AYLL showed a tendency towards a decline. Health education and screening of pancreatic cancer should be reinforced among men and the elderly.