Objective To observe the clinical efficacy of three types of drainage in the treatment of malignant obstructive jaundice.Methods 84 patients with malignant obstructive jaundice were selected,40 cases were treated with bridge drainage,24 cases were undergone percutaneous transhepatic cholangial drainage(PTCD) and 20 cases were treated with Roux-En-Y anastomosis.The changes of total bilirubin and direct bilirubin were detected 1,3,7 and 14 days after operation.Results The total bilirubin and direct bilirubin after 1,3,7 and 14 days had significantly decreased compared with pre-treatment(P ＜0.05),the decline rates in bridge drainage group were faster than the other two groups (P ＜ 0.05).Conclusion The three types of drainage for treating malignant obstructive jaundice have exact effect,and the bridge drainage can reduce the bilirubin to lower levels more quickly than the other two methods.

Objective:To design a software to read and display CT and RT structure and draw a new contour without treatment planning system (TPS).Methods: In order to display the contour information drawn by doctors, the first step was to match CT images and RT structure then the same screen rendering of CT and RT structures could be applied. In order to add contour in RT structure obtaining the coordinates interactively, connecting coordinate points were the essential steps. Then a unique identity was given in the area of that contour to ensure its unique results. Results: The software successfully read and displayed CT and RT structures and drew a new contour without TPS.Conclusion: In this study, the software establishes a basis to improve the precision of the radiotherapy dose.

Apoptosis ; Fatty Liver, Alcoholic ; Humans ; Lipid Metabolism

Endocrine Disruptors ; Environmental Exposure ; adverse effects ; Environmental Pollutants ; Humans ; Obesity ; epidemiology

Objective To observe the effect of lycopene on myocardial interstitial fibrosis and to explore the possible mechanisms involved.Methods Sprague-Dawley rat myocardial infarction (MI) model was established by left anterior descending coronary artery ligation.Established MI model rats received lycopene or saline.After 28 days,myocardial fibrosis was observed by Masson staining.The expressions of Ⅰ type collagen,matvix metalloproteina-ses-9 (MMP-9) and matrix metall opeptidaseg(MAPKs) protein were detected in the peri-infarcted zone by Western blotting.Results In MI group,collagen volume fraction (CVF) was increased and the protein expressions of collagen Ⅰ,P-p38 and MMP-9 were increased in the peri-infarcted zone as compared with the sham group [CVF:(21.68±4.63)％ vs.(8.21±2.17)％; collagen Ⅰ:(1.58±0.22) vs.(0.97±0.09); P-p38:(1.93±0.44) vs.(0.85±0.21); MMP-9:(4.85±0.47) vs.(1.03±0.59); all P＜0.05].Lycopene attenuated the increments of myocardial infarction-induced collagen Ⅰ,p38MAPK and MMP-9 expressions [collagen Ⅰ:(1.24 ± 0.24) vs.(1.58± 0.22) ; P-p38:(0.85 ± 0.21) vs.(1.93 ±0.44); MMP9:(1.77±0.28) vs.(4.85±0.47); all P＜0.05],and decreased the collagen volume fraction in the peri-infarcted zone [CVF:(15.17±2.56)％ vs.(21.68±4.63)％,P＜0.05] as compared with the MI group.Conclusions Lycopene may improve ventricular remodeling after MI by inhibiting p38MAPK signaling pathway and MMP-9 expression.

ObjectiveTo evaluate the therapeutic effect of gastroesophageal devasculariztion on cirrhotic portal hypertensive bleeding.MethodsClinical data of 85 cirrhotic patients with portal hypertentsive bleeding undergoing gastroesophageal devascularization were retrospectively analyzed. Results The following-up rate was 78％. The 1-yr,3-yr and 5-yr survival rate was 95％, 88％and 82％respectively.There was significant difference in survival time after devascularization between patients of Child-Pugh A and Child-Pugh B.For the whole group the 1-yr,3-yr and 5-yr recurrent bleeding rate was 6％,16％ and 28％ and postoperative hepatic encephalopathy was 7％.ALT,AST and ALB recovered to pre-operative level on post-operative day 7.ConclusionsGastroesophageal devascularization was an effective therapy in treating portal hypertensive variceal bleeding.Liver function remains a significant factor influencing long term survival.

Objective To summarize clinical experience on the diagnosis and management of pancreatic regional portal hypertension. Methods The clinical manifestations,diagnostic methods and therapeutic modalities of 40 cases of pancreatic regional portal hypertension were analyzed retrospectively.Results Male:female =26: 14.The average age was (40 ± 10)yrs.Among these patients,16 patients (40％) were accompanied by upper gastrointestinal bleeding and 20 patients (50％) by hypersplenism.There were 16 patients (40％) suffering from benign lesions and 6 patients (15％) from malignancy at pancreatic body and tail respectively,and 8 patients(20％ ) from severe necrotic pancreatitis accompanying pseudocyst and 10 patients (25％) from chronic pancreatitis. The average splenic venous pressure was (28.4±4.2) cm H2O(P ＜0.01 ).The average diameter and speed of splenic vein bloodflow by Doppler examination was ( 1.3 ± 0.2 ) cm ( P ＜ 0.01 ) and ( 9.3 ± 0.5 ) cm/s ( P ＜ 0.05 ).The follow-up rate was 100％.Splenectomy was effective for controlling gastrointestinal bleeding. Conclusions It is not difficult to diagnose pancreatic regional portal hypertension based on findings of US,CT and endoscopic examination,together with its clinical features. Therapy should be aimed at both regional portal hypertension and underlying diseases.

ObjectiveTo investigate the effect of endoscopic retrograde cholangiopancreatography(ERCP)combined with laparoscopic resection (LC) in the treatment of patients with cholecystic stone.Methods100 patients with cholecystic stone were randomly divided into observation group and control group.The patients in the control group (50 cases) received traditional open surgery,and the patients in observation group(50 cases) were given ERCP combined with LC.The effects of two groups were observed.ResultsThe operative time was (49.2 ± 8.5 ) min and intraoperative blood loss was(54.0 ± 12.2 )ml in the observation group.The operative time was (80.2 ± 15.7 )min and intraoperative blood loss was ( 114.5 ± 27.5 ) ml in control group.There were statistically significant differences between two groups(P ＜0.05 ).The hospital stay time and postoperative infection rate of the observation group was significantly lower than that of the control group ( all P ＜ 0.05 ).ConclusionIt was a safe and effective method to treat patients with cholecystic stone by ERCP combined with LC,which had the advantages of less trauma,faster recovery,less hospitalization time and could reduce the financial burden on patients,thereby it was worthy of clinical application.

ObjectiveTo systematically evaluate the therapeutic effect of gastroesophageal devascularization( GD),portasystemic shunt( PSS),devascularization plus portasystemic shunt ( GD + PSS) for the treatment of 4250 cirrhotic portal hypertension cases reported in Chinese literature. MethodsThe literatures about the effect of gastroesophageal devascularization,portasystemic shunt,devascularization plus portasystemic shunt on portal hypertension were collected from Wanfang databases, China National Knowledge Infrastructure(CNKI) from 1980 to 2011.RevMan 4.2 and SPSS 13.0 were used for data analysis. ResultsIn this study 17 reports were enrolled into the meta-analysis.The results of the mta-analysis showed that long term survival rate in the group of GD plus PSS was higher than that in group of GD [OR=1.73,95％CI (1.23,2.44),P ＜0.01].That in group of PSS was similar with the group of GD [ OR =0.87,95 ％ CI (0.63,1.20),P =0.40 ].That of group GD plus PSS was similar with the group of PSS [ OR =1.73,95％ CI (0.95,3.13),P =0.07 ].For recurrent variceal bleeding rate,that in group of PSS was lower than that in the group of GD[ OR =0.46,95％ CI (0.35,0.61 ),P ＜0.01 ].That in the group of GD plus PSS was lower than that in the group of GD [ OR =0.25,95％ CI (0.18,0.35),P ＜ 0.01 ].The group of GD plus PSS was similar to that of group of PSS [ OR =0.72,95％ CI ( 0.40,1.29 ),P =0.27 ].Encephalopathy rate was higher in the group of PSS than the group of GD [ OR =3.57,95％ CI (2.43,5.23 ),P ＜0.01 ].That in group of GD plus PSS was lower than that in the group of PSS[ OR =0.37,95％ CI (0.20,0.69),P ＜0.01 ],while that in GD plus PSS was similar to the group of GD[ OR =1.58,95％ CI (1.02,2.43),P =0.04 ].ConclusionsThe only significant factor influencing the long term result in Chinese patients with portal hypertension is preoperative liver function.The three types of operation have different benefits and disadvantages.

High mobility group protein A1 ( HMGA1 ) are members of a superfamily of non-histone chromatin proteins,which exist widely in eukaryotic nuclei and are mainly involved in transcriptional regulation of gene expression.Recent researches show that almost all human malignant tumors have abnormal expression of HMGA1,which may have an important role in the development of cancer,but the exact mechanism is not clear yet.In cancer research,transfection system which constructed on the basis of HMGA1 will have potential value,and also could shed some light on the treatment of cancer.