Intrahepatic cholangiocarcinoma (ICC) has a poor prognosis. Surgical treatment combined with adjuvant therapy including chemotherapy, radiotherapy, molecular targeted drug therapy, local liver damage therapy, interventional therapy, antiviral therapy can have complementary effects to prevent its recurrence after surgery. We will review the latest advances in surgery and adjuvant therapy for ICC, and provide new ideas for the comprehensive treatment and clinical research of ICC.

Objective: To evaluate Chinese clinical practice guideline/consensus for digestive diseases published in the past five years in order to recommend the high-quality guidelines and help with the promotion and implementation of them. Methods: From January 2013 to June 2018, the officially published Chinese practice guideline/consensus for digestive diseases were selected. The inclusion and exclusion criteria of the guideline/consensus was evaluated by "Evaluation Criteria for Chinese Clinical Practice Guidelines 2017(AGREE-China 2017)" . The guideline/consensus were independently scored by three evaluators and then calculated the average value. Descriptive analysis methods were used to analyze the Chinese clinical practice guideline/consensus for digestive diseases. Those with the total score more than 40.0 points were included in the recommended list. Results: A total of 119 officially published clinical practice guideline/consensus of digestive diseases were retrieved, and 74 clinical practice guideline/consensus for digestive diseases were included in the evaluation. Among them, 18 (24.3%, 18/74) scored over 60.0 points, 31 (41.9%, 31/74) scored between 40.0 and 59.9 points. Finally 48 guideline or consesus were selected for the recommended list 19 cases of esophagus and gastrointestinal diseases, 18 cases of liver diseases, five cases of biliary and pancreafic diseases, and six cases of digestive endoscopy. The three guideline/consensus with the high scores (> 80.0 points) were The Fifth Chinese National Consensus Report on the Maragement of Helicobacter pylori Infection, Consensus on the Diagnosis and Treatmeat of Cholestatic Liver Disease (2015) and Guidelines for the Prevention and Treatment of Chroaic Hepatitis B (2015 Update). The higher the score of the guideline/consensus, the more scientific and rigorous the method, and the clearer the evaluation of evidence grade and the description of the formation of recommendations. Compared with international standards of guideline/consensus development, there are still some problems in Chinese guidelines or consensus such as no explanation of retrieval strategy, no basis of evidence classification and no description of the formation process from evidence to recommendation. Conclusions The quality of Chinese clinical practice guideline/consensus for digestive diseases has been improved year by year. However the scientific aspects need to be further improved. AGREE-China which demonstrates good validity, realiability and practicability is easy and clear to use.

Objective To explore the significance of GBA gene mutation and gene detection in diagnosis of Gaucher disease. Method The clinical data and genetic testing results of 3 probands from 3 unrelated Gaucher families and their family members were analyzed. Results A compound heterozygous mutation of c.907C>A and c.1448T>C was found in the proband of the first family, which was inherited from parents respectively. Another complex heterozygous mutation of c.1174delC and c.1226A>G was found in the proband of second family, which was inherited from parents respectively, and the variant c.1174delC was a new mutation, which has not been reported in the literature according to the search by HGMD. The homozygous nucleotide variation of c.1342G>C and heterozygous nucleotide variation of c.1263_1317del was found in the proband of the third family and the c.1263_1317del heterozygous mutation was inherited from father. Conclusion The mutation of GBA gene was the cause of Gaucher disease in these 3 families and Gaucher disease can be diagnosed by molecular genetics in clinic.

Objective To observe the dynamic changes of the power parameters of each frequency band of electroencephalography during the postoperative sedation process of traumatic brain injuries (TBI) to evaluate the values of EEG power in assessing sedation depth.Methods A retrospective case series study was conducted on the clinical postoperative data of 42 patients with TBI from February 2017 to January 2018.There were 22 males and 20 females,aged (39.8 ± 5.3)years (range,25-66 years).Before the sedation,the Glasgow Coma Scale (GCS) was (9.2 ± 2.3)points,ranging from 8 to 12 points.Before the administration of dexmedetomidine (Dex) and 10,30,60,90 minutes after the medication,the body temperature,respiration,heart rate,oxygen saturation (SpO2),and mean arterial pressure (MAP) were recorded and evaluated by Ricker sedation agitation score (SAS).At the same time,the EEG power value changes of four frequency bands (α,β,θ,and δ) were recorded constantly.Correlation analysis was performed between the changing power values and corresponding SAS.Results (1) During sedation,the body temperature,respiration,heart rate,SpO2 and MAP did not show significant fluctuation along with the decrease of SAS (P ＞ 0.01).(2) Before and after Dex sedation,the electroencephalography power value of the delta band was negatively correlated with SAS,with the correlation coefficient absolute value between 0.85 and 0.88 (P ＜ 0.01).The highest absolute value of the correlation coefficient was that of the left frontal and of the right frontal region (0.88,P ＜0.01).The absolute value of the correlation coefficient between (θ + δ)/(α + β) and SAS was between 0.75 and 0.85 (P ＜ 0.01).(3) The fast wave power (α and β band) in each brain area before sedation increased to varied degrees after the sedation,but it decreased along with the falling SAS.The absolute value of correlation coefficient between the electroencephalography power value in α and β band ranged from 0.29 to 0.48 (P ＜ 0.01),indicating weak correlation.There was no significant correlation between the EEG values in the θ band and SAS (P ＞ 0.01).Conclusions The electroencephalography power values of the δ band of each brain region are negatively correlated with SAS and can objectively reflect the dynamic changes of the sedation depth.The absolute values of correlation coefficient between bilateral frontal δ band power and SAS can serve as a better guide for clinical sedation.

Chinese president Xi Jinping made clear at the National Health and Wellness Conference that health is the prerequisite for people's all-around development and a precondition for the sustainable development of China. Oral health is an indispensable component of overall health in humans. However, the long neglect of oral health in overall health agendas has made oral diseases an increasing concern. With this perspective, we described the global challenges of oral diseases, with an emphasis on the challenges faced by China. We also described and analyzed the recently released health policies of the Chinese government, which aim to guide mid-term and long-term oral health promotion in China. More importantly, we called for specific actions to fulfill the larger goal of oral health for the nation. The implementation of primordial prevention efforts against oral diseases, the integration of oral health into the promotion of overall health, and the management of oral diseases in conjunction with other chronic non-communicable diseases with shared risk factors were highly recommended. In addition, we suggested the reform of standard clinical residency training, the development of domestic manufacturing of dental equipment and materials, the revitalization traditional Chinese medicine for the prevention and treatment of oral diseases, and integration of oral health promotion into the Belt and Road Initiative. We look forward to seeing a joint effort from all aspects of the society to fulfill the goal of Healthy China 2030 and ensure the oral health of the nation.
China ; Health Policy ; Humans ; National Health Programs ; Oral Health

The vegetative state is a complex condition with unclear mechanisms and limited diagnostic, prognostic, and therapeutic methods. In this study, we aimed to explore the proteomic profile of tears from patients in a traumatic vegetative state and identify potential diagnostic markers using tears-a body fluid that can be collected non-invasively. Using iTRAQ quantitative proteomic technology, in the discovery phase, tear samples collected from 16 patients in a traumatic vegetative state and 16 normal individuals were analyzed. Among 1080 identified tear proteins, 57 were upregulated and 15 were downregulated in the patients compared to the controls. Bioinformatics analysis revealed that the differentially-expressed proteins were mainly involved in the wound response and immune response signaling pathways. Furthermore, we verified the levels of 7 differentially-expressed proteins in tears from 50 traumatic vegetative state patients and 50 normal controls (including the samples used in the discovery phase) using ELISA. The results showed that this 7-protein panel had a high discrimination ability for traumatic vegetative state (area under the curve = 0.999). In summary, the altered tear proteomic profile identified in this study provides a basis for potential tear protein markers for diagnosis and prognosis of the traumatic vegetative state and also provides novel insights into the mechanisms of traumatic vegetative state.
Adult ; Aged ; Aged, 80 and over ; Biomarkers ; metabolism ; Chromatography, Liquid ; Enzyme-Linked Immunosorbent Assay ; Eye Proteins ; metabolism ; Female ; Humans ; Male ; Mass Spectrometry ; Middle Aged ; Persistent Vegetative State ; metabolism ; Proteome ; Proteomics ; ROC Curve ; Tears ; metabolism ; Young Adult

BACKGROUND: Inert biomaterials such as metal usually hold poor biocompatibility and weak bonding force, which is against the effect of dental or bone implants. Therefore, how to improve their biocompatibility has become the research hotspot.OBJECTIVE: To prepare collagen-coated titanium alloy (Ti6Al4V), and to assess its biocompatibility.METHODS: Ti6Al4V served as the matrix, the 3-amino propyl triethoxy silane (KH550) as the crosslinking agent, and the three-dimensional printed titanium alloy coated by collagen type Ⅰ and Ⅱ was prepared,respectively. The coated materials were co-cultured with mouse preosteoblasts MC-3T3-E1 to evaluate its biocompatibility. The effect of different kinds of collagen on the cell differentiation was compared by differential recognition of surface proteins.RESULTS AND CONCLUSION: When the N content on the titanium alloy surface (Φ10 cm) was 8.41%, the cladding quantity of collagen type Ⅰ and Ⅱ was 0.81 and 0.77 mg, respectively. Compared with the bare titanium alloy, the cell adhered well and distributed extensively on the coated titanium alloy,which showed strong viability and fast proliferation.The cells cultured on collagen type Ⅰ coated materials expressed the proteins associated with matrix synthesis, and those on collagen type Ⅱ coated materials expressed the proteins associated with mineralization. These results clarify that the collagen coating can improve the biocompatibility of titanium alloy, and different types of collagens act on different functional proteins.

Objective To discuss the protective effects ofGuiqi YiyuanOintment on damages caused by heavy ion radiation induced bystander effects; To explore the possible mechanism.Methods Totally 42 Wistar male rats were randomly divided into blank control group, pure radiation group andGuiqi Yiyuan Ointment group. TheGuiqi Yiyuan Ointment group was givenGuiqi Yiyuan Ointment by gavage for two weeks in advance. Later the right lungs of the rats in the pure radiation group andGuiqi Yiyuan Ointment group were radiated once by 2 Gy12C6+, while the blank control group received no radiation. 6, 12, 24 h after radiation all groups of rats were executed. Peripheral hemogram and the levels of IL-6, TGF-β1 and IL-1β in serum of the rats were examined. The changes of lung tissue pathology morphology in the rats were observed by HE staining.Results Compared with the blank control group, the contents of IL-6, TGF-β1 and IL-1β in serum of the pure radiation group increased obviously at 12 h after radiation (P<0.01), and the amount of leukocyte, erythrocyte, blood platelet and hemoglobin distinctly declined at 12 h after radiation (P<0.01); HE staining showed that the alveolar wall was thickened at 24 h after radiation, and there were exudate and inflammatory cell infiltration in the alveolar cavity. Compare with the pure radiation group at 12 h after radiation, the levels of IL-6, TGF-β1 and IL-1β inGuiqi Yiyuan Ointment group decreased significantly at 12 h after radiation (P<0.01). Indexes of blood routine significantly increased (P<0.01), and the pathological changes of lung tissue in rats improved (P<0.01). ConclusionGuiqi Yiyuan Ointment can protect damages caused by heavy ion radiation induced bystander effects.

Objective To investigate the effect of electroacupuncture (EA) pretreatment on neurological function, and the expression of Toll-like receptor 4 (TLR4) and nuclear factorκB (NF-κB) protein in ischemic penumbra after cerebral ischemia-reperfusion (CIR) injury. Methods A total of 36 male Sprague-Dawley rats were randomly divided into sham group (n=12), model group (n=12) and EA group (n=12). The later two groups were occluded their right middle cerebral arteries for two hours and reperfused. The EA group was pretreated with EA at Baihui (GV20) for two weeks before modeling. They were assessed with modified Neurological Severity Scores (mNSS), the injury in ischemic brain was detected with HE staining, and the expression of TLR4 and NF-κB protein in ischemic penumbra were detected with Western blotting, 24 hours after reperfusion. Results The score of mNSS decreased (P<0.05), the injury of brain tissue ameliorated, and the expression of TLR4 and NF-κB decreased in ischemic penumbra (P<0.05) in EA group compared with those in the model group. Conclu-sion EA pretreatment can reduce the injury and improve the neurological function in rats after CIR by down-regulating the expression of TLR4 and NF-κB protein in ischemic penumbra.

Objective:To evaluate the translucency,opalescence and fluorescence reflection of 6 light-cured resin composites. Methods:Disks of 6 resin composites including Filtek Supreme XT-YT(XT),Filtek Supreme XT-A3B(3M),Clearfil Majesty-A3 (MJ),Gradia Direct-A3(GC),Venus-A3(VE)and Charisma Diamond-A3(CA)were prepared in the diameter of 9 mm with the thickness 2.0 mm.PR-650 spectral scanning colorimeter was used to measure and caculate translucency parameters(TP),opal-escence parameter(OP)and fluorescence reflection(FL)and to draw the fluorescence reflection curves.Results:Except XT and MJ,TP value of other resin composites were in the range of natural tooth.Only OP value of XT was in the range of natural tooth en-amel.FL value of XT was close to that of natural tooth dentin.Fluorescent peak wavelength of GC,MJ,VE and CA were in the range of natural tooth,but fluorescent peak height was higher than that of natual tooth.TP was positively correlated with OP(r =0.85,P <0.05).There was no statistic correlation between TP and FL,between OP and FL.Conclusion:The 6 resin composites can simulate optical property of natual tooth,but the opalescence of resin composites is defective.