BACKGROUND:It generally thought that based on cholangiography,biliary tract stents implantation can achieve a same long-term therapeutic efficacy as resection,and obtain good clinical outcomes in treating hilar cholangiocarcinoma when combined with percutaneous portcatheter system.OBJECTIVE:To evaluate the clinical methods of double interventional therapy and the biocompatibility between stent and host in hilar cholangiocarcinoma following stant implantation.METHODS:The databases of MEDLINE,Cochrane library,CNKI and VIP were retrieved with deadline of August 2009.Medium survival time and jaundice decrease rate,complication rate as well as biocompatibility between stent and host were sewed as assessment index.Clinical studies addressing double interventional therapy for treating proximal bile duct cancer were included,and animal studies were excluded.A total of 156 literatures were obtained initially by computer,and 25 literatures were included in further analysis.RESULTS AND CONCLUSION:In vitro test showed that stents carrying antibiotic,silver,or Escherichia coil,which may prevent adhesion of bacteria,however,it obtained poor clinical results.Chitosan is a natural cationic polymer and possess good biocompatibility,antibiosis and biodegradability.For the compare of the therapeutic effectiveness among different surgical procedure,it found that the decrease of total bilirubin were more faster in the internal and external drainage group than the resection group,however,the difference had no statistically significance.According to the Kaplan-Meier survival analysis,the medium survival time of 7 patients in the resection group was 16 months.The 1,3,5 years survival rate were 57.1%(4/7),28.6%(2/7),14.3%(1/7),respectively.Among the double interventional therapy group,the medium survival time of 19 patients was 18 months,and the 1,3,5 years survival rate were 52.6%(10/19),27.8%(5/19),15.8%(3/19),respectively.The medium survival time was 12 months in 14 patients of the control group,with 1,3,5 years survival rate of 57.1%,28.6%,14.2%,respectively.The results demonstrated that biliary tract stents implantation combined with percutaneous portcatheter system can improve life quality and prolong survival time of patients with hilar cholangiocarcinoma.

BACKGROUND:Biliary stent restenosis is one of the main long-term complications following biliary stent restenosis implantation,which affects its application.OBJECTIVE:To evaluate the reasons for the biliary stent restenosis and to explore corresponding prevention methods.METHODS:A computer-based online search of MEDLINE,Cochrane library,CNKI and VIP between January 1989 and August 2009 was performed to search related articles with the key words of "biliary metal stent,reobstruction,and interventional therapy".Literatures related to biliary stent restenosis were selected,in the same field,the articles published lately or published by authoritative journals were preferred.A total of 171 articles were searched and 22 documents were included according to inclusion and exclusion criteria.RESULTS AND CONCLUSION:Tumor growth,gallstone formation and inflammatory hyperplasia are the main reasons for restenosis following biliary metal stent implantation.The interventional therapy is an effective way for the patients of stent restenosis.Simultaneously,the therapeutic efficacy and living quality of patients can be improved by noticing preoperative conditions,in-time detecting and controlling biliary infection,reducing complications as well as strengthening postoperative combined therapy.

Right ventricular (RV) function is very important for patients with respiratory and cardiovascular disorders resulting in RV impairments. Since RV has complex geometry of the chamber, it is difficult to accurately measure the RV volumetric parameters with conventional imaging modalities, especially those with dilated and abnormal RV. With the emergence and wide use of new noninvasive imaging modalities in accessing the cardiac anatomy and function, real-time three-dimensional echocardiography (RT3DE), multi-detector row computed tomography (MDCT) and new MRI sequences, noninvasive quantitative assessment of the RV function has attracted more and more worldwide attention.

Objective To study the role and mechanism of A2AR activation in tau hyperphosphorylation after brain injury.Methods SD rats were cultured with no specific pathogen level.SH-SY5Y was cultured.The rats were treated with CGS21680 solution and DMSO and SH-SY5Y respectively.The CGS21680 solution and sb216763, H-89, or Only add ZM241385, the control group plus DMSO, compared with each group tau hyperphosphorylation.Results The phosphorylation level of tau protein in SH-SY5Y cells was significantly higher than that in the control group (P<0.05).The phosphorylation level of tau protein in the primary hippocampal neurons of rats was significantly higher than that of the control group (P<0.05).The levels of tau protein phosphorylation in group 2 and group 3 were significantly higher than those in control group (P<0.05).The expression of tau in group 4 and group 5 was statistically significant (P<0.05)There was no significant difference in phosphorylation level between the two groups.Conclusion A2AR activation can activate kinase A and GSK-3β after brain injury, leading to tau hyperphosphorylation.

Diffuse lower-grade glioma is a diversified group of infiltrative brain tumors comprising WHO grades II and III astrocytomas, oligodendrogliomas, and mixed oligoastrocytomas. These tumors exhibit a wide range of clinical heterogeneity;thus, histopathological classification does not adequately predict clinical outcomes. In recent years, a number of molecular markers closely related to the clini-cal features and prognosis of gliomas have been discovered. These molecular markers include isocitrate dehydrogenase (IDH) muta-tion, chromosome 1p/19q codeletion, ATRX mutation, TERT promoter mutation, and MGMT promoter methylation. Furthermore, nu-merous studies focusing on the integrated molecular classification of diffuse lower-grade gliomas combined with these molecular markers have been conducted. Results indicate that integrated molecular pathological classification can improve the diagnostic and prognostic accuracy and facilitate therapeutic formulation. This paper reviews the research progress on integrated molecular classifica-tion of diffuse lower-grade gliomas.

Objective To detect the expression of MSI2 protein and mRNA in pancreatic ductal adenocarcinoma (PDAC) tissue,and investigate the correlation between the expression of MSI2 protein and the clinicopathological parameters.Methods The expression of MSI2 protein in 61 PDAC specimens and paired adjacent non-cancerous pancreatic tissues were detected by immunohistochemistry.Western blot and quantitative real-time PCR (QRT-PCR) were used to examine the expression of MSI2 protein and mRNA level in 10 PDAC specimens and adjacent non-cancerous pancreatic tissues.Then the relationship between MSI2 expression in cancerous tissues and clinicopathological parameters was analyzed.Results In 61 patients with PDAC,the expression rate of MSI2 protein was higher in cancerous tissues (63.9％) compared with that in paired non-cancerous pancreatic tissues (41.0％),and the difference between the two groups was statistically significant (t =2.809,P =0.007).The expression levels of MSI2 protein in 10 fresh PDAC specimens and adjacent non-cancerous pancreatic tissues were 0.748 ± 0.195 and 0.420 ± 0.171,and the expression level of MSI2 mRNA in PDAC specimens was as 2.507 ± 2.981 times as much of adjacent non-cancerous pancreatic tissues,and the difference between the two groups was statistically significant (t =3.689,P=0.005;t =2.660,P =0.026).The expression of MSI2 in cancerous tissues was only positively associated with the size of the tumor (x2 =5.096,P =0.024),but it was not associated with other parameters.The median survival of patients with high MSI2 expression was 321 d,and it was 730 d for patients with low MSI2 expression,and the median survival of patients with high MSI2 expression was significantly shorter than that of low MSI2 expression (x2 =6.706,P =0.010).Conclusions The expression MSI2 is up-regulated in PDAC and related to the tumor size.The patients with high expression of MSI2 protein have poor prognosis.

The blood supply of metatarsuses and pha-langeals in 30 cases of fetuses and infants was ob-served by microangiographic methods. The resultsdemonstrated that diaphyses and cartilages of bothends of metatarsuses and phalangeals gradually in-creased in the fetal period and appeared nourishingartery and cartilage canal. Both ends of metatar-suses and phalangeals gradually decrea.ed in the. infant period and cartilage canals gradually disap-peared also. These implied that the appearance ofcartilage canals was related to the size of cartilageblocks. Cartilage Canals were temporary bloodsystem of fetal cartilage. Characteristics of bloodsupply of metatarsuses and phalangeals: 1. Asym-metrical distribution of blood supply on metatar-suses and phalangeal, that is the blood supply ofepiphyseal end is richer than one of non--epiphy-seal end, is adapted with the difference of growthability at both ends. 2. There is distribution ofcartilage canals at the epiphyseal end of the distalphalanx, and it is adapted with having growth a-bility at the proximal end. These show that bloodsupply of metatarsuses and phalangeals is closelyrelated to their growth and development.

Objective To study the effects of glycyrrhizin on cerebral mitochondrial ATPase and membrane fluidity and malondialdehyde (MDA) and water content and brain function after cardiac arrest and resuscitation.Methods Eighteen dogs weighing 10-14 kg were randomly divided into 3 groups ( n = 6 each) : group A control; group B cardiac arrest and resuscitation and group C glycyrrhizin + cardiac arrest and resuscitation. The animals were anesthetized with fentanyl, intubated and mechanically ventilated and PaCO2 was maintained within normal range. The chest was opened. In group B and C cardiac arrest was produced by clamping of ascending aorta and coronary perfusion with hyperkalemic cardioplegic solution and maintained for 18 min and resuscitated by direct cardiac massage, adrenaline and defibrillation. The animals were observed for 8 h after spontaneous cardiac rhythm resumed. In group C glycyrrhizin injectio 40 ml?kg-1 was infused over 8 h as soon as spontaneous cardiac rhythm resumed. Brain function was evaluated according to Pittsburgh Brain stem score (PBSS). The animals were then killed and their brains removed for determination of (1) mitochondrial membrane fluidity and Na+-K+-ATPase and Mg2+ -ATPase activity and (2) brain MDA and water content.Results The mitochondrial membrane viscosity and cerebral MDA and water content were significantly higher and ATPase activity was significantly lower in group B (cardiac arrest) than in group A (control) . Brain function was also impaired by global cerebral ischemia-reperfusion (I/R) in group B. In group C glycyrrhizin infusion significantly attenuated the deleterious effects of cerebral I/R by reducing mitochondrial membrane viscosity and cerebral MDA and water content and increasing ATPase activity. Glycyrrhizin infusion also improved brain function.Conclusion Glycyrrhizin can ameliorate the deleterious effects of global cerebral I/R induced by cardiac arrest.

Objective To observe the clinical therapeutic effects of BaDuanJin exercise on patients with scapulohumeral periarthritis.Methods 72 patients were randomly divided into therapeutic group and control group,with 36 cases in each group.The patients in control group were treated with electroacupuncture and those in therapeutic group were treated with electroacupuncture and BaDuanJin exercise for 4 weeks.Pain degree(VAS)and shoulder ROM(Melle Scores)were evaluated before therapy,2 weeks and 4 weeks after therapy.The patients were followed up for 3 months.Results The VAS scores and Melle scores of both groups after therapy(both at two weeks and four weeks)showed significant difference than those before thempy.The scores after 4 weeks therapy were better than those of 2 weeks therapy.The effects of therapeutic group after 3 months showed better result than controls,but without statistical difference(P>0.05).Conclusion BaDuanJin,as a mild exercise had favorable therapeutic effccts on patients with scapulohumeral periarthritis.

Objective To study the effects of selective mild cerebral hypothermia on endogenous anti-injury mechanism in brain tissue after cardiac arrest and resuscitation. Methods Fifteen healthy mongrel dogs of both sexes were anesthetized and intubated. Cardiac arrest was induced by potassium cardioplegia and cross-clamping of aorta, vena cava superior and inferior and azygos vein and maintained for 18min. The animals were randomly divided into 3 groups: group A, in which no cardiac arrest was induced, served as control ( n = 4) ; in group B animals received routine cerebral resuscitation ( n = 5) ; in group C animals received selective mild cerebral hypothermia (34℃?0.5℃) and routine cerebral resuscitation ( n = 6) . After successful resuscitation, the animals were observed for 8 hours. At the end of the experiment the parietal cerebral cortex was removed for determination of MDA, GSH, LA, FFA content and activities of SOD(T-SOD, Mn-SOD, Cu-ZnSOD) and GSH-Px. Results FFA and LA content of brain tissue in group B was significantly higher than those in group A (P