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.

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.

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 evaluate the effect of -477C/T single nucleotide polymorphism (SNP) in promoter region of ABCA1 gene on plasma levels of high density lipoprotein cholesterol (HDL-C) and coronary artery disease (CAD). Methods -477C/T genotypes in promoter region of ABCA1 gene were assessed in 96 CAD patients and 100 healthy individuals with polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), and distribution of the -477C/T genotypes was compared between CAD group and healthy group, and also between patients with different CAD clinical manifestations. The clinical indexes associated with CAD were also compared among the three genotypes. Results The distributive frequency of CC, CT, or TT genotype of CAD group and healthy group was different from one another, and the proportion of the TT genotype or the T allele was obviously higher in CAD group than in healthy group (P

0.05). Conclusion The genotypes of ABCA1 R1587K polymorphism were associated closely with the plasma levels of HDL-C. The HDL-C levels of K allele carriers were remarkably lower. However, there was no significant association of the ABCA1 R1587K polymorphism and the susceptibility to CAD.

This study compared the efficacy of non-penetrating trabecular surgery and trabeculectomy for the treatment of open angle glaucoma. We searched the Cochrane Library, PUBMED (1966 to 2009), Embase (1980 to 2009) and CMB-disk (1979 to 2009) for the randomized clinical trials (RCT) concerning the two treatment strategies. The reports, including the papers listed in bibliographies, were evaluated against a set of quality criteria and the RCTs that satisfied the criteria were selected and subjected to Meta analysis by employing the Cochrane Collaboration's RevMan 4.5 software package. A total of nine RCTs were included in the study. The analyses of the reports showed that, 12 months after surgery, there was significant difference in the reduction of interocular pressure (IOP) between non-penetrating trabecular surgery and trabeculectomy (Z=6.05 P<0.00001). There also existed statistically significant difference in the reduction of IOP at the censored time between the two procedures (Z=4.92, P<0.00001). Difference in the success rate was also found between the two surgeries (Z=3.82, P=0.0001). It is concluded that, compared with the non-penetrating trabeculectomy, the traditional trabeculectomy could reduce IOP more and had higher success rate while the non-penetrating trabecular surgery is associated with lower postoperative complications.

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 evaluate the effects of preoperative continued dual antiplatelet therapy (DAPT) with aspirin and clopidogrel on early outcomes in patients underwent off-pump coronary artery bypass grafting (OPCABG). Methods A single-center study was conducted. The 279 unstable angina patients underwent first-time isolated OPCABG at our institution from January 2015 to May 2016 were divided into DAPT group (preoperative aspirin 100 mg/d and clopidogrel 75 mg/d were given until the time of surgery, n=148) and control group (stopped DAPT for 5 days before surgery, n=131). The total chest-tube output, blood-product transfusion requirements, re-exploration rate for bleeding, major adverse cardiac events (MACE) and other in-hospital outcomes were collected and compared between the two groups. Results There were no significant differences in demographic and preoperative clinical characteristics between the two groups. The total chest-tube drainage volume and perioperative transfusion requirements (rate and volume) including red blood cell, fresh plasma and platelets were statistically higher in the continued DAPT group than those of control group (P < 0.05). There were no significant differences in hemostatic re-exploration rate, length of operation, postoperative nonfatal myocardial infarction, ICU stay, ventilation time and duration of postoperative hospitalization between the two groups. Stroke and other severe outside chest bleeding and all-cause mortality were not observed in both groups during the postoperative period and prior to discharge. Conclusion Preoperative continued DAPT is associated with the increased chest-tube drainage and higher blood-product transfusion requirements but it does not increase the dection rate of thoracotomy because of bleeding. This antiplatelet strategy does not alter other investigated outcomes in primary isolated OPCABG patients. The preoperative DAPT may be able to be safely continued in patients referred for primary isolated OPCABG.

Objective To research an ultrasound imaging workstation based on DICOM so as to construct a patient-centered effective digital hospital.Methods Several interfaces of ultrasound imaging workstation based on DICOM were showed and their advantages and disadvantages were analyzed.Ultrasound imaging workstation based on DICOM was also compared with that based on video capture card.Results DICOM-based ultrasound imaging workstation gained advantages over the one based on video capture card in availability,resolution and management.Conclusion The workstation may contribute to enhancing clinical efficiency,promoting digital hospital and regional medical image sharing,and thus is worthy popularizing practically.