Hilar cholangiocarcinoma (HCCA) is a type of bile duct cancer with insidious onset and poor prognosis. Surgical resection is the only potentially curative treatment. The selection of surgical approaches and prognosis assessment depend on different classification systems and preoperative imaging results. This article reviews the progress in classification systems, imaging modalities, biliary drainage techniques, postoperative adjuvant therapy, future liver remnant insufficiency treatment, liver transplantation and resection extent for HCCA.

Objective:To summarize the preliminary experience of percutaneous radiofrequency ablation(RFA) in the treatment of early breast cancer(the length of the lesion<15 mm) with negative sentinel lymph node(SLN), and to evaluate its feasibility and efficacy.Methods:From October 2016 to November 2019, 18 patients with early breast cancer(the length of the lesion<15 mm) treated in the First Affiliated Hospital of Zhengzhou University underwent FNAC of axillary SLN under the guidance of CEUS were enrolled. Patients with pathologically negative axillary SLN were treated with percutaneous RFA of breast cancer. The complete ablation rate and the relapse rate were evaluated. Intraoperative pain, postoperative complications and postoperative patient satisfaction were analyzed.Results:Eighteen patients underwent CEUS-guided FNAC of SLN, of which 1 case was positive and 17 cases were negative. Seventeen breast cancer lesions of the 17 negative patients underwent percutaneous RFA. The length of the lesions was 3.3-14.0 (8.2±3.9)mm, the complete ablation rate was 100%, the ablation time was 9-18 (12.8±2.7)min. During the follow-up of 9-46 months, no patient developed tumor progression. There were no serious complications related to RFA after operation. The patients′ satisfactory rate for postoperative appearance was 100%.Conclusions:RFA of early breast cancer(the length of the lesion<15 mm) with negative SLN is feasible and has the advantages of safety, minimal invasion and beauty.

Objective: To explore the clinical efficacy of S-1 single agent adjuvant chemotherapy for the patients undergoing radical resection of extrahepatic biliary carcinoma. Methods: The clinical data of 108 patients with extrahepatic biliary carcinoma receiving radical resection who were admitted from January 2014 to June 2017 were retrospectively analyzed. There were 62 males(57.4%)and 46 females(42.6%),with a median age of 59 years (range:26 to 79 years),10 cases(9.3%) in stage Ⅱ,85 cases(78.7%) in stage Ⅲ, and 13 cases (12.0%) in stage Ⅳ, 40 cases(37.0%) of hilar cholangiocarcinoma, 8 cases(7.4%) of middle cholangiocarcinoma, 25 cases (23.2%) of distal cholangiocarcinoma, 35 cases(32.4%) of gallbladder carcinoma.After radical resection of extrahepatic biliary carcinoma, 49 patients receiving S-1 single agent chemotherapy and 59 patients receiving non-special treatment were divided into the chemotherapy group and the operation group,respectively. All the dates of the patients were followed up and collected with the overall survival time,tumor-free survival time,1,2 and 3-year survival rate after operation,and the rate of major toxic reaction during chemotherapy of the chemotherapy group. Survival curve was drawn by the Kaplan-Meier method, and survival analysis was done using the Log-rank test. Results: There were no significant differences in the general date of two groups(sex, age, tumor size, tumor site, TNM stages, degree of differentiation). The median overall survival time and the median tumor-free survival time in the chemotherapy group were 27 months and 21 months,respectively,and in the operation group were 21 months and 17 months,respectively. There were differences between the two groups in the overall survival rates(χ²=3.967,P<0.05) and the 2 and 3-year survival rate(63.3%,36.6%;41.6%,20.4%;χ²=4.510,P<0.05;χ²=6.143,P<0.05),but the 1-year overall survival rate (83.4%,79.7%)was not statistically significant(χ²=0.286,P>0.05). There were no significant differences in the tumor-free survival time,1,2 and 3-year tumor-free survival rate(77.6%,41.4%,33.1%;62.7%,30.9%,21.2%)between the two groups(χ²=0.876,P>0.05;χ²=0.252,P>0.05;χ²=1.571,P>0.05;χ²=3.323,P>0.05,respectively). The main toxic reaction during chemotherapy were dyspepsia(28.6%, 14/49), anemia(26.5%, 13/49), and leukopenia(22.5%, 11/49), all of which were mild. Conclusion S-1 single agent chemotherapy after radical reseetion of extrahepatic biliary carcinoma could effectly improve the survival of patients and all of the main toxic reaction during chemotherapy were mild.

Objective To investigate the application value of choledochoscopy and imaging examination in the diagnosis and treatment of residual bile duct stones.Methods The retrospective descriptive study was conducted.The clinical data of 618 patients who underwent choledochoscopy and imaging examination after operation of hepatolithiasis in the First Affiliated Hospital of Zhengzhou University between April 2014 and September 2018 were collected,including 300 males and 318 females,aged from 19 to 89 years,with an average age of (58 ± 12)years.Observation indicators:(1) situations of residual bile duct stones diagnosed by choledochoscopy and imaging examination;(2) stone extraction situations of patients with hepatolithiasis.Measurement data with normal distribution were represented as Mean±SD,and measurement data with skewed distribution were described as M (range).Count data were represented as absolute number or percentage,and analyzed using the chi-square test or Fisher exact propability.Results (1) Situations of residual bile duct stones diagnosed by choledochoscopy and imaging examination:all the 618 patients underwent choledochoscopy,and 505 of them underwent the imaging examination before choledochoscopy.① Of patients undergoing single imaging examination,72 received ultrasonography,with false-negative rate of 29.17％ (21/72);37 received CT examination,with false-negative rate of 10.81％(4/37);33 received T-tube cholangiography,with false-negative rate of 39.39％ (13/33).② Of patients undergoing combined two imaging examinations,61 received ultrasonography + CT,with false-negative rate of 8.20％ (5/61);129 received ultrasonography + T-tube cholangiography,with false-negative rate of 12.40％ (16/129);52 received CT + T-tube cholangiography,with false-negative rate of 5.77％(3/52).③ There were 121 receiving ultrasound+CT+T-tube cholangiography,with false-negative rate of 7.44％ (9/121).There were statistically significant differences in the false-negative rates of combined two or three examinations of ultrasound + CT+ T-tube cholangiography and single imaging examination (x2=40.83,P＜0.05).The further analysis showed a statistically significant difference among the single imaging examination (x2=7.70,P＜0.05).There was no statistically significant difference among the combined two of imaging examinations (x2=2.10,P＞0.05).There were statistically significant differences in the combined three examinations of ultrasound +CT+T-tube cholangiography and ultrasound and T-tube cholangiography examination respectively (x2=16.23,21.62,P＜0.05).There was no statistically significant difference in the combined three of imaging examinations and CT examination and combination of CT+T-tube cholangiography respectively (P＞ 0.05).There was no statistically significant difference in the combined three of imaging examinations and combination of ultrasound+CT examinations and combination of ultrasound+T-tube cholangiography (x2=0.33,1.71,P＞0.05).Seventy-one patients without residual bile duct stone by preoperative imaging examination were detected residual bile duct stones by intraoperative choledochoscopy,and residual bile duct stones of 36,31 and 4 patients are respectively distributed around the distal common bile duct,small intrahepatic bile duct,left and right hepatic ducts,common hepatic duct and remaining common bile duct.(2) Stone extraction situations of patients with hepatolithiasis:of 618 patients,cases with 1,2,3,4,5,6,7,8,9 and 10 times of residual bile duct stones clearance were respectively 392,116,48,39,9,6,3,2,2 and 1.Residual bile duct stones clearance frequency of patients was an average of 1.73 times.There were 63.43％(392/618) and 96.28％(595/618) of patients had stone clearance with once and ≤ 4 times of stone extraction,respectively.Conclusion The negative results of preoperative imaging examinations cannot be as standards of bile duct stone clearance before choledochoscopy,and the best choice is to detect whether there are residual bile duct stones and remove the stones combined with choledochoscopy.

In this study, the mobilomes of nine teleost species were annotated by bioinformatics methods. Both of the mobilome size and constitute displayed a significant difference in 9 species of teleost fishes. The species of mobilome content ranking from high to low were zebrafish, medaka, tilapia, coelacanth, platyfish, cod, stickleback, tetradon and fugu. Mobilome content and genome size were positively correlated. The DNA transposons displayed higher diversity and larger variation in teleost (0.50% to 38.37%), was a major determinant of differences in teleost mobilomes, and hAT and Tc/Mariner superfamily were the major DNA transposons in teleost. RNA transposons also exhibited high diversity in teleost, LINE transposons accounted for 0.53% to 5.75% teleost genomic sequences, and 14 superfamilies were detected. L1, L2, RTE and Rex retrotransposons obtained significant amplification. While LTR displayed low amplification in most teleost with less than 2% of genome coverages, except in zebrafish and stickleback, where LTR reachs 5.58% and 2.51% of genome coverages respectively. And 6 LTR superfamilies (Copia, DIRS, ERV, Gypsy, Ngaro and Pao) were detected in the teleost, and Gypsy exhibits obvious amplication among them. While the SINE represents the weakest ampification types in teleost, only within zebrafish and coelacanth, it represents 3.28% and 5.64% of genome coverages, in the other 7 teleost, it occupies less than 1% of genomes, and tRNA, 5S and MIR families of SINE have a certain degree of amplification in some teleosts. This study shows that the teleost display high diversity and large variation of mobilome, there is a strong correlation with the size variations of genomes and mobilome contents in teleost, mobilome is an important factor in determining the teleost genome size.

Objective To explore the expression of calreticulin (CRT) in gallbladder cancer tissue and its effect on the biological behavior in gallbladder cancer GBC-SD cells.Methods Immunohistochemistry and RT-qPCR were applied to detect the expression of CRT.Small interfering RNA was transfected into gallbladder cancer GBC-SD cells and Western blotting were used to detect the expression of CRT.The proliferation was determined by using cell counting kit-8 (CCK-8) and clone assays.Flow cytometry were applied to detect the apoptosis and cell cycle.Migration was detected by wound healing and transwell assays,respectively.The expression of p-Akt and MMP-9 were detected by using Western blotting.Results Expression of CRT in gallbladder cancer tissues is higher than adjacent cancer tissues and chronic cholecystitis tissues(t =5.571,P ＜ 0.05).The relative growth rate in the siCRT-1,siCRT-2 experimental group for 24 hours,48 hourrs were 71.5％ ±6.3％,79.5％ ±2.7％;62.6％ ± 8.8％,55.6％ ±2.6％,respectively.The apoptosis rate in the blank group,the negative control group,siCRT-1 and siCRT-2 group were 3.0％ ± 1.8％,4.7％ ± 1.3％,13.6％ ± 1.0％,20.0％ ± 4.0％,respectively.Wound healing assays showed that the wound closure ratio in the blank group,negative control group,siCRT-1 and siCRT-2 group were(0.67 ±0.02),(0.58 ±0.02),(0.22 ±0.01),(0.37 ±0.04),respectively.Transwell experiments showed that the numbers of migration of GBC-SD cells in the blank group,negative control group,siCRT-1 and siCRT-2 group were (302 ± 11),(297 ± 15),(178 ± 10),(165 ± 12),respectively,compared with the blank group and the negative control group,the relative growth rate for 24 hours and 48 hours was significantly lower,the apoptosis rate was higher,the numbers of migration was lower (F =29.310,118.618,69.651,144.515,190.145,P ＜ 0.05).Compared with the blank group and the negative control group,the expression of p-Akt and MMP-9 decreased after down-regulating the expression of CRT.Conclusions The expression of CRT in gallbladder cancer tissue was higher.CRT downregulation mediated changes of biological behaviors in gallbladder cancer may be associated with p-Akt/MMP-9 signal pathway.

Objective To evaluate the clinical efficacy of acupuncture on sphenopalatine ganglion in the treatment of severe perennial allergic rhinitis (PAR) in a randomized controlled clinical trials. Methods A total of 81 patients with severe perennial allergic rhinitis were randomly divided into three groups: 27 in the observation group, 27 in the drug control group and 27 in the acupuncture control group. The patients in the observation group were treated with acupuncture on sphenopalatine ganglion; and the patients in the drug control group took Desloratadine; and the patient in the acupuncture control group were treated with acupuncture on Yintang (GV 29) and Yingxiang (LI 20). All the groups were treated for 4 weeks. The TNNS and VAS score system were tested before and after the treatment, and the nasal exhalation of nitric oxide (eNO) concentration level wa detected at baseline and each week's during treatments. Results After the treatment,the effective rate [80.8%(21/26)vs.64.0%(16/25),65.4%(17/26),x2=13.811]of the observation group was significantly higher than either the drug control group or the acupuncture control group (P<0.01). Compared to the score of the three group before treatment, the TNNS score was significantly lower (P<0.01) after the treatment. Compared with the drug control group, the level of eNO in nasal exhalation air (265.377 ± 36.475 ppb vs. 281.769 ±45.823 ppb vs. 295.231 ± 24.595 ppb, F=4.247) of the observation group and the acupuncture control group were significantly higher (P<0.05). Conclusions Acupuncture on the sphenopalatine ganglion can not reduce the eNO concentration level of nasal exhaled air in patients with perennial allergic rhinitis, but it can improve the symptoms of rhinitis. The clinical effect of acupuncture on the sphenopalatine ganglion was better than the desloratadine and acupuncture on GV 29 and LI 20.

Objective To investigate the role of RNA-binding protein La protein in the invasion and migration of cervical cancer cells.Methods RNAi technology was used to silence the La protein in HeLa cell,a cell line of cervical cancer,and then screened by G418.Finally the stably expressed HeLa-shLa cell line was constructed and then wound healing,Transwell,Western blot and gelatin zymography assay were performed. Results After La protein HeLa was silenced by RNAi,the invasion and migration capabilities of HeLa cells were decreased significantly compared with those of the controls.Meanwhile,SiRNA-mediated depletion of La reduced the expression of MMP-2 and increased the expression of TIMP-2.Meanwhile the activity of MMP-2 was reduced too.Conclusion RNA-binding protein La promotes the invasion and migration of cervical cancer cells,which may be related to regulating its matrix metalloproteinases and inhibitors.

ABSTRACT:Objective To investigate the anti-metastatic effect of allicin on glioma cell line U87 and related mechanisms.Methods In this study,we employed MTT assay to test the anti-proliferative effect of allicin. Transwell assay was used to test the anti-metastatic ability of allicin.Real-time PCR and Western blotting were employed to test the effect of allicin on the expressions of matrix metalloproteinase-2 (MMP-2 ) and matrix metalloproteinase-9 (MMP-9).Western blotting was employed to test the phosphorylated level of p38.Results Allicin could significantly inhibit the proliferation and invasion of U87 cells (concentration>8 μg/mL,P <0.05). Meanwhile allicin (concentration<8μg/mL)could inhibit the invasion of U87 cells.After treatment with allicin for 24 hours,the expressions of MMP-2 and MMP-9 were decreased significantly (P < 0.05 ).Moreover,allicin treatment decreased the phosphorylated level of p38 obviously (P < 0.05 ).Conclusion Allicin inhibits the invasion and migration of glioma cell line U87 by reducing the expressions of MMP-2 and MMP-9 via suppressing the activity of p38 signal pathway,suggesting that allicin is a potential therapeutic agent for glioma.

Objective To investigate the method of clinical diagnosis and treatment for urinary tract endometriosis (UTE).Methods The clinical data of 7 patients with UTE were analyzed retrospectively.Mean age was 36.5-year old.Two cases were diagnosed by taking cystoscopic biopsy tissue,the others were confirmed by intraoperative and postoperative pathology.Under the adjuvant treatment of endocrine,2 patients were performed partial cystectomy and ureteral resection and end-to-end anastomosis in 4 patients,1 patient undertook ureteric reimplantation.Results Among 7 patients,2 patients had endometrial ectopic bladder,4 patients had endometrial ectopic ureter,1 patient had endometrisis of bladder and urter.After operation,no leak and recurrence occurred 2-3 years of follow-up.Conclusions UTE is rarely seen and usually escape the attention of the physicians,endocrine therapy with surgical resection is the primary method.Choice of surgical approach should be based on a variety of factors lesion location,scope,depth,bilateral renal function,etc.