Objective To explore the application of plastic pancreatic stents and/or nasal biliary drainage for choledocholithiasis patients having DSBC during Endoscopic Retrograde Cholangiopancreatography (ERCP).Methods Retrospective analysis on clinical data of 57 ERCP cases aiming at choledocholithiasis patients having DSBC from January 2010 to December 2015 has been carried out. According to the guide wire cannulation in an operation, patients are divided into three groups, i.e. plastic pancreatic stents group, nasal biliary drainage group, and plastic pancreatic stents + nasal biliary drainage group, so as to observe the success rate of operation and the occurrence rate of postoperative complications, such as pancreatitis or hyperamylasemia, as well as to compare the differences between the three groups.Results Out of the 57 patients receiving ERCP, 13 patients are in the plastic pancreatic stents group, with two successful operations (15.4%), one case of hyperamylasemia (7.7%), two cases of postoperative pancreatitis (15.4%), one case of fever (7.7%) and one case of hemorrhage (7.7%); 20 patients are in the nasal biliary drainage group, with 20 successful operations (100.0%), no occurrence of hyperamylasemia or postoperative pancreatitis or other complications including hemorrhage and fever; 24 patients are in the plastic pancreatic stents + nasal biliary drainage group, with 19 ERCP operations succeeded at the first attempt (79.2%) and 5 ERCP operations succeeded at the second try (20.8%), as well as 4 cases of hyperamylasemia (16.7%), 2 cases of hemorrhage (8.3%) , no occurrence of fever cases and postoperative pancreatitis. In comparison between the three groups, the occurrence of postoperative pancreatitis and successful rate of operation show a significant difference.Conclusion By adopting plastic pancreatic stents and/or nasal biliary drainage for patients having a dififcult selective biliary cannulation during ERCP, the success rate of operation can be improved, and the occurrence of pancreatitis can also be reduced.

Radiofrequency ablation (RFA) is one of the most important methods for the treatment of liver cancer and has the advantages of small trauma,simple operation,and repeatability.However,for tumors in high-risk locations within 5 mm of the first and second branches of the hepatic portal vein,near the hepatic vein,the inferior vena cava,or the gallbladder,within 5 mm of the intestinal tract,under the Glisson's capsule,and in the diaphragm,RFA has the issues of a low complete ablation rate,a high local recurrence rate,and serious complications.This article introduces the complications of RFA for liver cancer in high-risk locations and their prevention and points out that with the promotion of individualized and standardized RFA,liver cancer in these high-risk locations is no longer a contradiction for RFA.

Aberrant promoter methylation in special genes such as tumor suppressor genes is early eventin carcinogenesis of lung cancer. Aberrant methylation, resulting in corresponding mRNA silence or overexpression , closely relates to carcinogenesis, development, treatment response and prognosis of lung cancer and it may become a potential biomarker. Methylation of special genes may provide evidences for individual treatment of lung cancers.

Adolescent ; Atrial Appendage ; Diagnostic Errors ; Female ; Humans ; Tachycardia, Ectopic Atrial ; diagnosis ; Tachycardia, Sinus ; diagnosis

Adenocarcinoma, Clear Cell ; pathology ; Aged ; Female ; Humans ; Kidney Neoplasms ; pathology ; Paranasal Sinus Neoplasms ; secondary

The aim of the eight year medical education program is to cultivate high-leveled and high qualified clinical and research personnel.Constructing forensic interest group for medical students of eight year program can not only cultivate the students' English learning,innovative thinking and practice ability,which is their Achilles heel but also combine eight year medical education with forensic science teaching reform.

OBJECTIVETo discuss the mechanism of gambogenic acid (GNA) in inducing the apoptosis of melanoma B16 cells.

METHODThe inhibitory effect of GNA on the proliferation of B16 cells was measured by the methyl thiazolyl tetrazolium (MTT) assay. The effect of GNA on B16 cells was detected by the Hoechst 33258 staining. The transmission electron microscopy was used to observe the ultra-structure changes of B16 cells. The changes in PI3K, p-PI3K, Akt, p-Akt, p-mTOR, PTEN proteins were detected by the Western blotting to discuss the molecular mechanism of GNA in inducing the apoptosis of B16 cells.

RESULTGNA showed a significant inhibitory effect in the growth and proliferation of melanoma B16 cells. The cell viability remarkably decreased with the increase of GNA concentration and the extension of the action time. The results of the Hoechst 33258 staining showed that cells processed with GNA demonstrated apparent apoptotic characteristics. Under the transmission electron microscope, B16 cells, after being treated with GNA, showed obvious morphological changes of apoptosis. The Western blot showed a time-dependent reduction in the p-PI3K and p-Akt protein expressions, with no change in p-PI3K and p-Akt protein expression quantities. The p-mTOR protein expression decreased with the extension of time, where as the PTEN protein expression showed a time-dependent increase.

CONCLUSIONGNA could inhibit the proliferation of melanoma B16 cells and induce their apoptosis within certain time and concentration ranges. Its mechanism in inducing the cell apoptosis may be related to PI3K/Akt/mTOR signaling pathways.

Animals ; Apoptosis ; drug effects ; Blotting, Western ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Cell Survival ; drug effects ; Dose-Response Relationship, Drug ; Melanoma ; metabolism ; pathology ; ultrastructure ; Mice ; Microscopy, Electron, Transmission ; Microscopy, Fluorescence ; PTEN Phosphohydrolase ; metabolism ; Phosphatidylinositol 3-Kinases ; metabolism ; Proto-Oncogene Proteins c-akt ; metabolism ; Signal Transduction ; drug effects ; TOR Serine-Threonine Kinases ; metabolism ; Terpenes ; pharmacology ; Xanthenes ; Xanthones ; pharmacology

Objective To investigate the effects of reactive oxygen species (ROS) inhibition on the down-regulation of adiponectin (ADPN) in mouse 3T3-L1 adipocytes by advanced glycation end-products (AGEs).Methods AGEs were prepared for incubating with cell.3T3-L1 preadipocytes were cultured in vitro and differentiated into mature adipocytes.Cell differentiation and lipid accumulation were determined by oil red O staining.After being intervened with AGEs,2',7'-dichlorofluorescein diacetate (DCFH-DA) was used as a reactive oxygen species (ROS) capture agent and the fluorescent intensity of 2',7 '-dichlorofluorescein (DCF) was detected by flow cytometry.Adiponectin expression under AGEs in 3T3-L1 adipocytes pretreated with N-acetyl-L-cysteine(NAC) or not was detected by real-time fluorescent PCR and ELISA.Results The level of ROS in 3T3-L1 adipocytes treated with AGEs was increased.mRNA and protein of ADPN were down-regulated.After inhibition with ROS,mRNA and protein expressions of ADPN injured by AGEs were ameliorated.Conclusion Exposure of 3T3-L1 adipocytes to AGEs induces oxidative stress in vitro,which decreases the expression of ADPN,and causes functional impairment of adipose cells and insulin resistance.

Objective To solve the problem of hospital Bureau class cost accounting system to manage the Branch class cost. Methods The system was optimized by extracting the raw data of localization, collecting income and expenditure account of flexible specialization, and setting subclass accounting ratio ways of rationalization. Results The optimization subsystem has been a fundamental change in cost accounting management and creates more effective. Conclusion According to the special requirement of sanatorium financial process, information system and cost accounting ways, the new system can be optimized in design and implementation method and achieve better effects during the implementation and operation.

Objective To observe and compare the curative effects of zoledronic acid (ZA) combined with radiotherapy and ZA combined with chemotherapy in the treatment of bone metastasis of non-small cell lung cancer (NSCLC). Methods Seventy-eight patients with NSCLC bone metastasis treated by radiotherapy or chemotherapy were taken in our hospital from January 2010 to June 2014, including 39 cases of ZA combined conventional fractionation radiotherapy (radiotherapy combined group), and 39 cases of ZA combined with chemotherapy (paclitaxel liposome + cisplatin) (chemotherapy combined group). Each group had 39 cases. WHO objective evaluation standard, efficacy evalulation of solid tumor metastasis and curative effect standard grading of pain, anticancer agent toxicity classification standard, Karnofsky standard were used for evaluating and analyzing the patients with primary lung tumor, bone metastasis, degree of pain, adverse reactions and functional status (once before and after the treatment). Results The efficiency rate of primary lung tumor, the efficiency rate of bone metastasis, the total effective rate of pain relief and the improvement rate of functional status (Karnofsky score increased by 10 points or more)in the radiotherapy combined group and chemotherapy combined group were 82.05 % (32/39) vs. 79.49 % (31/39), 48.72 % (19/39) vs. 51.28 %(20/39), 82.05 % (32/39) vs. 84.62 % (33/39), 66.67 % (26/39) vs. 71.79 % (28/39) respectively, and the differences were not statistically significant (the values of x2 were 0.224, 0.237, 0.195, 0.259 respectively, all P> 0.05); Although the two groups showed low-grade fever, bone marrow suppression, esophagitis, liver and kidney damage, gastrointestinal reactions and other adverse reactions, the adverse reactions of two groups were close to [28.21 % (11/39) vs. 30.77 % (12/39)] (x2 = 0.314, P> 0.05). Fortunately, these reactions were controlled well after symptomatic treatment. Conclusion ZA combined with radiotherapy or chemotherapy is a safe and effective way for bone metastasis of NSCLC, which should be taken based on the individual condition of the patients.