Role of miRNA in the development and progression of cholangiocarcinoma / 临床肝胆病杂志

Cholangiocarcinoma is the most common malignant tumor of the biliary tract, with a relatively high mortality rate and an incidence rate increasing year by year. Due to atypical symptoms in the early stage and complex anatomical location, it is often difficult for patients with cholangiocarcinoma to be diagnosed in the early stage, and therefore, they often miss the optimal treatment period and tend to have poor prognosis. In recent years, studies have shown that miRNAs play a key role in the pathophysiological process of the development and progression of cholangiocarcinoma. This article reviews the regulatory role of miRNAs in the development, invasion, metastasis, drug resistance, and tumor microenvironment of cholangiocarcinoma and introduces the latest advances in exosome miRNA and cholangiocarcinoma, so as to provide potential treatment strategies for cholangiocarcinoma.

Catheter aspiration alone or combined with thrombolysis in the treatment of superior mesenteric artery embolism / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the efficacy of catheter aspiration or combined with thrombolysis in the treatment of superior mesenteric artery embolism(SMAE).</p><p><b>METHODS</b>Clinical and imaging data of 25 SMAE patients who underwent catheter aspiration or combined with urokinase thrombolysis in the First People's Hospital and the Second People's Hospital of Changzhou from January 2005 to July 2013 were retrospectively analyzed.</p><p><b>RESULTS</b>Twenty patients were confirmed as SMA trunk embolism and 5 as SMA branch artery embolism. The embolic SMA trunks were completely recannulated by catheter aspiration in the above 20 cases, but small emboli embolized distal branch artery in 6 cases. These 6 patients plus above 5 patients with branch artery embolism received catheter aspiration combined with thrombolytic therapy. Among these 11 patients, complete open, partial open and non-open of branch arteries were found in 5, 3, 3 cases respectively, while collateral circulation increased significantly in non-open patients. During the follow-up period of (4.1±2.2) months, clinical symptom relief and digestive function recovery were observed in 24 cases. Only one case underwent bowel resection because of intestinal necrosis 24 hours after treatment and developed short bowel syndrome.</p><p><b>CONCLUSION</b>Catheter aspiration or combined with thrombolysis is a safe and effective method in treating SMAE.</p>

Applied value of muitislice CT in selecting living donor kidneys and excision methods / 中华器官移植杂志

Objective To evaluate the applied value of multislice CT (MSCT) in the selection of living donor kidneys and excision methods.Methods Ninety living renal donors underwent MSCT assessment.The nonenhanced,arterial,venous and excretory phase examinations were performed.Using maximum intensity projection and volume rendering techniques for vascular imaging,two blinded radiologists independently analyzed and evaluated all MSCT images.According to the CT reconstructive images,radiologists and physicians selected the left renal or the right renal donors,and chose laparoscopic or open live donor nephrectomy.Results On the 90 cases of donors,78 donors underwent nephrectomy in the left kidney.Seventy-one left kidney donors having no significant variation received the routine laparoscopic live donor nephrectomy.Seven left kidney donors on both sides had relatively obvious anatomical variations such as accessory renal artery,multi-branch renal vein and renal vein in the back of the abdominal aorta,and they were subjected to the left kidney open donor nephre.ctomy.Other 12 donors having significant variation in the left kidney were given nephrectomy in the right kidney,and all of them received hand-assisted laparoscopic live donor nephrectomy.All intraoperative records of urine collection system and renal vascular anatomy were consistent with the preoperative evaluation of MSCT,and the accuracy was 100 ％.Two imaging experts in the evaluation of renal artery,renal vein and urine collection system showed good consistency.Nephrectomy was successfully performed on 90 cases of donors,and.postoperative recipients had no renal vein thrombosis and other vascular complications.Conclusion MSCT can provide accurate and valuable information for the selection of living donor kidneys and excision methods as a “one-stop” technique for the preoperative evaluation of living renal donors.