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.

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.

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.

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.

AIM: To investigate the phenomenon that miR-let-7d regulates the proliferation and invasion abilities of the lung cancer cells through nuclear receptor peroxisome proliferator-activated receptors γ (PPARγ).METHODS: The relation between PPARγ and microRNA was analyzed by bioinformatics.The plasmid reporter assay was used to verify that PPARγ was the target of miR-let-7d.The lung cancer cell line with low expression of PPARγ was selected from different lung cancer cell lines by Western blot.The regulatory role of miR-let-7d in the lung cancer cells was determined by dual luciferase labeling and Western blot.The effect of miR-let-7d on the proliferation ability of lung cancer cells was detected by colony formation assay, the effect of miR-let-7d on the invasive ability of lung cancer cells was detected by Transwell invasion assay.RESULTS: The results of bioinformatic analysis showed that miR-let-7d regulated the expression of PPARγ, and the 3'UTR of PPARγ contained 2 functional miR-let-7d binding sites, indicating that PPARγ is a direct target of miR-let-7d.miR-let-7d was able to directly regulate the expression of PPARγ at mRNA and protein levels.Transfection of miR-let-7d inhibitor promoted the proliferation and invasion abilities of lung cancer cells by increasing the expression of PPARγ.CONCLUSION: miR-let-7d increases the expression of tumor suppressor PPARγ to inhibit the proliferation and invasive abilities of lung cancer cells.

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 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

Objective To observe the bacterioflora of bile and it' s drugs sensitivity in patients with bile duct diseases to serve as a guidance in medication. Methods Bile of 156 cases of patients with biliary disease was collected and cultured respectively during endoscopic retrograde cholangiopancreatography (ER-CP) by deep cannulation and sucking out bile through the catheter. Forty eight blood samples among them were cultured simultaneously. Ten kinds of drug papers were used to investigate the bacterial sensitivity. The data were analysed statistically- Results Bacteria positive rate of these 156 bile samples was 62. 8% , including Gram - negative bacteria (81.6% ) and Gram - positive bacteria (18. 4% ). These bacteria consist of Pseudomonas aeruginosa (35. 1% ) , Escherichia coli(22. 8% ) , Streptococcus faecalis (16.7%) ,Entero bacilliaerogenes(7. 9% ) ,Klebsiella(7. 0% ) , Citrobacter(6. 1% ) ,Acinetobacler lwqffi(2. 6% ) and Staphylo-coccus aureus( 1. 7% ). The bacteria positive rate was only 4. 2% in the 48 blood samples. Drug sensitive rates of bacteria against 10 kinds of drugs were changed in recent years. The result indicated that the sensitive rates of bacteria were significantly higher in ciprofloxacin, fortum, cefoperazone, sulbactam + cefoperazone and cilastatin than those in ampicillin,azlocillin, cefazolin sodium, eefuroxime(P

Objective: To observe the influence on curative effect of aescine in curing Lumbar intervertebral disc prolapse(LIDP) before and after operation. Methods: 184 cases of patients with LIDP were divided into two groups. 96 cases in curative group began to be used 10mg of aescin by adding to infusion of iv drip bid 3 days before the operation, and contie for 6-8 days it. 88 cases in control group were only operated.Results: Curative group was superior to control group in lysis of pain, postoperative La feeling and improvement of muscle strength. The excellent and better rates in two groups are 72.91%, 91.67% and 43.18%, 85.22%. The excellent rate of curative group is higher than that of control group( P 0.05). There is no serious bad reaction of drug in curative group.Conclusion: Aescin used before and after operation is good to recovery of nervous function after LIDP operation.