Effects of orlistat on the viability of human gallbladder cancer cells / 中华消化外科杂志

Objective:To investigate the effects of orlistat on the viability of human gall-bladder cancer (GBC) cells.Methods:The experimental study was conducted. The human GBC NOZ cells with high expression of FSAN was screened out through in vitro cultivating human GBC-SD, SGC-996 and NOZ cells. The cell proliferation assay, clone formation assay and protein detection experiment were used to analysis of the effects of orlistat on the viability of human GBC cells. Cell grouping: NOZ cells cultured with medium were set as the control group, cultured with medium + 10 μmol/L orlistat were set as the low-dose orlistat group, cultured with medium + 100 μmol/L orlistat were set as the high-dose orlistat group, respectively. Observation indicators: (1) expression of FASN protein in human GBC cells; (2) effects of orlistat on the proliferation of human GBC NOZ cells; (3) effects of orlistat on apoptosis of human GBC NOZ cells. Measurement data with normal distribution were represented as Mean± SD, the ANOVA test was used for comparison between groups and the least significant difference method was used for pairwise comparison. Results:(1) Expression of FASN protein in human GBC cells. Results of western blot showed that the relative expression of FASN protein in human GBC NOZ, GBC-SD and SGC-996 cells was 0.57±0.06, 0.12±0.04 and 0.10±0.02, respectively, showing a significant difference among them ( F=115.67, P<0.05). There were significant differences between the NOZ cells and the GBC-SD or the SGC-996 cells ( P<0.05), and there was no significant difference between the GBC-SD cells and the SGC-996 cells ( P>0.05). (2) Effects of orlistat on the proliferation of human GBC NOZ cells. ① Results of cell proliferation assay showed that the absorbance value of NOZ cells was 2.34±0.12, 1.57±0.08 and 1.07±0.13 in the control group, low-dose orlistat group and high-dose orlistat group, respectively, showing a significant difference among them ( F=205.88, P<0.05). ② Results of clone formation assay showed that the number of NOZ cells clones was 257±23, 153±11 and 83±11 in the control group, low-dose orlistat group and high-dose orlistat group, respectively, showing a significant difference among them ( F=92.64, P<0.05). ③Results of western blot showed that the relative expression of Cyclin-D1 protein of NOZ cells was 2.31±0.10, 1.52±0.05 and 1.23±0.11 in the control group, low-dose orlistat group and high-dose orlistat group, respectively, showing a significant difference among them ( F=120.73, P<0.05). The relative expression of CDK-4 protein of NOZ cells was 1.58±0.04, 1.21±0.02 and 1.19±0.04 in the control group, low-dose orlistat group and high-dose orlistat group, respectively, showing a signifi-cant difference among them ( F=110.45, P<0.05). (3) Effects of orlistat on apoptosis of human GBC NOZ cells. Results of western blot showed that the relative expression of Bcl-2 protein of NOZ cells was 1.07±0.03, 0.36±0.03 and 0.15±0.02 in the control group, low-dose orlistat group and high-dose orlistat group, respectively, showing a significant difference among them ( F=1 242.93, P<0.05). The relative expression of Bax protein of NOZ cells was 0.51±0.03, 0.38±0.05 and 1.38±0.04 in the control group, low-dose orlistat group and high-dose orlistat group, respectively, showing a signifi-cant difference among them ( F=583.51, P<0.05). Conclusion:Orlistat can inhibit the growth of human GBC NOZ cells and promote their apoptosis.

Chemical constituents from leaves of Jatropha curcas / 中草药·英文版

OBJECTIVE@#To investigate the chemical constituents from the leaves of Jatropha curcas and evaluate their inhibition on lipopolysaccharide (LPS)-activated BV-2 microglia cells.@*METHODS@#The n-BuOH extract of the leaves of J. curcas was isolated by macroporous adsorption resin, silica gel, ODS, column chromatography and semi-preparative HPLC. The structures of the compounds were identified by MS, NMR, ECD, and other spectroscopic methods. In addition, anti-neuroinflammatory effects of isolated compounds were evaluated by measuring the production of nitric oxide (NO) in over-activated BV-2 cells.@*RESULTS@#Seventeen compounds, including (7R,8S)-crataegifin A-4-O-β-D-glucopyranoside ( 1), (8R,8'R)-arctigenin ( 2), arctigenin-4'-O-β-D-glucopyranoside ( 3), (-)-syringaresinol ( 4), syringaresinol-4'-O-β-D-glucopyranoside ( 5), (-)-pinoresinol ( 6), pinoresinol-4'-O-β-D-glucopyranoside ( 7), buddlenol D ( 8), (2R,3R)-dihydroquercetin ( 9), (2S,3S)-epicatechin ( 10), (2R,3S)-catechin ( 11), isovitexin ( 12), naringenin-7-O-β-D-glucopyranoside ( 13), chamaejasmin ( 14), neochamaejasmin B ( 15), isoneochamaejasmin A ( 16), and tomentin-5-O-β-D-glucopyranoside ( 17) were isolated and identified. Compounds 2, 4 and 8 significantly inhibited the release of NO in BV-2 microglia activated by LPS, with IC50 values of 18.34, 29.33 and 26.30 μmol/L, respectively.@*CONCLUSION@#Compound 1 is a novel compound, and compounds 2, 3, 8, 14- 17 are isolated from Jatropha genus for the first time. In addition, the lignans significantly inhibited NO release and the inhibitory activity was decreased after glycosylation.

Synthesis, evaluation and proteomic analysis of PROTAC based on parthenolide / 药学学报

As a natural product with a long history of medicinal use, parthenolide has aroused great interest of chemists and biologists. Existing studies have shown that it has anti-inflammatory, antitumor and other pharmacological activities, and also revealed its action on NF-κB signaling pathway, DNMT1 enzyme and Wnt/β-catenin signaling pathway. But its biological targets remain to be elucidated systematically. Proteolysis Targeting Chimeras (PROTAC) provides a new strategy for target discovery of natural products, which can be used to explore the panorama of protein changes in cells through proteomic investigation, so as to analyze their potential targets. Based on this idea, current study designed and synthesized 20 parthenolide-derived degraders. After measured their antitumor activity in vitro, selected compounds were carried out the proteomic experiment. Finally, 139 down-regulated differentially expressed proteins were identified and the discovery of parthenolide interacting protein was preliminarily explored.

Application of online teaching in the teaching of medical imaging diagnostics / 中华医学教育探索杂志

Objective:To explore the application and effectiveness of online teaching in the teaching of medical imaging diagnostics.Methods:A total of 134 undergraduate students of Medical Imaging Technology Department of Chongqing Medical University in Batch 2016 and Batch 2017 were selected as the research objects. They were divided into control group and experimental group with 67 students in each group. The experimental group adopted the online teaching mode based on Xuexitong and Tencent Meeting learning platforms; while the control group adopted the traditional teaching mode. The final grades of two groups were compared, and self-made questionnaires were anonymously investigated, so as to realize the evaluation of online teaching effects. SPSS 21.0 was used for rank sum test.Results:The qualification rate of final results in the experimental group and control group were respectively 80.6% (54/67) and 64.2% (43/67). The qualification rate of final results in the experimental group students was significantly better than that of the control group ( P<0.05). A total of 134 survey questionnaires were distributed and all recovered. The survey questionnaires showed that experimental group was superior to the control group in self-learning ability, analyzing and solving problems ability, communication skills, interest and enthusiasm in learning ( P<0.05). Conclusion:The online teaching is conducive to improving the qualification rate of final results, self-learning ability, analyzing and solving problems ability, communication skills, interest and enthusiasm in learning for the teaching of medical imaging diagnostics, which has good teaching effects and qualities and is of great promotion significance.

Post-infectious cough of different syndromes treated by traditional Chinese medicines: A review / 中草药·英文版

The application of traditional Chinese medicines (TCMs) has a history of more than 2000 years, which have the characteristics of multi-component, multi-target, and high safety. Post-infectious cough (PIC) is a respiratory disease with high incidence. It belongs to subacute cough and accounts for as much as 40%–50%. Cough is the main clinical manifestation of PIC. PIC seriously affects people's life quality because of complex etiology, long-term course of disease, treatment difficulties and other characteristics. Western medicines are based on the principle of symptomatic treatment, so they are often difficult to control PIC fundamentally. These factors could due to that PIC is prolonged and unable to heal repeatedly. TCMs have obvious advantages in treating PIC, with accurate curative effects, less side effects and adverse reactions and are effective in improving PIC-related symptoms and indicators, enhancing patients' life quality and reducing pain. TCMs, guided by holistic concept and syndrome differentiation, advocate determine treatment on the basis of pattern types, and have remarkable clinical treatment effects. As for TCMs etiology, pathogenesis and syndrome types of PIC, TCM scholars have not yet reached a unified standard. However, most of them think that wind pathogen can cause PIC alone, or it can be combined with other evils, which might be the main mechanism of PIC. This paper discusses the advantages and limitations of TCMs in PIC treatment from etiology, pathogenesis, distribution of syndrome types and treatment of TCMs. This article focuses on the treatment methods and pharmacodynamic material basis of wind pathogen, providing ideas in treating PIC of TCMs clinically and innovative drug development.

Effect of extracellular vesicles derived from adipose on hippocampal neuronal damage in mice with a high-fat diet / 中国药理学通报

Aim To investigate the effect of extracellular vesicles secreted by adipose tissue of mice on hippocampal neurons and cognitive behavior of mice with a high-fat diet.Methods Twenty C57BL/6J male mice were randomly divided into normal diet(ND)group(n=10)and high-fat diet(HFD)group(n=10), fed for 28 weeks.The weight of mice was recorded weekly.The level of fasting blood glucose, insulin and the insulin resistance index(HOMA-IR)of mice were tested at week 27.At week 28, the learning and memory abilities of mice were assessed by the Morris water maze.The morphological differences in adipose tissue were observed by HE staining, and the extracellular vesicles secreted from adipose tissue were quantified by TEM and NTA.Extracellular vesicles derived from adipose tissue labeled with PKH 67 were injected into normal mice via the tail vein, and after 30 h, the uptake of extracellular vesicles was detected in the hippocampal slice.The primary hippocampal neurons were treated with extracellular vesicles with the same amount of protein, and the effects of them on neuronal morphology and cell viability were observed.Results Compared with ND group, mice in HFD group were significantly heavier, with hyperglycemia, hyperinsulinemia and higher insulin resistance index.In the Morris water maze test, the HFD group showed a longer escape latency and less swimming time in the target zone.The volume of adipocytes and the amount of extracellular vesicles secreted from them significantly increased in HFD group.Extracellular vesicles secreted by adipose tissue could be internalized by both the primary hippocampal neurons and the hippocampal neurons in the normal mice.Compared with ND group, extracellular vesicles secreted by adipose tissue of the HFD group significantly reduced the length of primary hippocampal neuronal dendrites, the number of primary and secondary dendrites, and the cell viability of neuron cells.Conclusion Long-term high-fat diet could damage the hippocampal neurons by affecting the extracellular vesicles derived from adipose tissue.

Advances in the role of natural products in human gene expression / 中国天然药物

Natural products (NPs), especially those from traditional herbal medicines, can evidently modulate human gene expression at multiple levels, leading to a wide diversity of bioactivities. Although numerous bio-functions of NPs for human body have been found, there is little understanding about how NPs achieve it, as less attention was drawn to the definite mechnism by which NPs regulate gene expression. Furthermore, based on the rapidly advancing knowledge of mechanisms for gene regulation in recent years, newly-understood mechanisms, such as post-transcriptional regulation, are found to be involved in NP-elicited bio-effects, providing a new perspective on understanding the role of NPs in gene expression. Therefore, in the current review, we summarize the function of NPs in gene expression from the perspectives of transcriptional, post-transcriptional, and post-translational regulation, which will reinforce the understanding of NP-induced effects in gene expression and facilitate the exploration of more NPs with potential therapeutic effects.

Standardized diagnosis and treatment process of gallbladder disease and technical details / 中华消化外科杂志

Based on current diagnosis and treatment of gallbladder disease, the occur-rence of incidental gallbladder cancer is partly caused by the irregular clinical diagnosis and treatment process of gallbladder disease, which leads to the failure to make the diagnosis of gallbladder cancer in time, carry out the correct preoperative and intraoperative staging, and cause R 1 or R 2 resection. The authors summarize standardized diagnosis and treatment process of gallbladder disease and technical details. In clinical practice, the concept of incidental gallbladder cancer should be discarded, and various gallbladder diseases should be taken as a whole. A more standardized diagnosis and treatment process should be established to improve the diagnostic accuracy of gallbladder cancer and achieve radical resection, which eventually improve survival of patients.

Discussions on the diagnosis-treatment of focal intrahepatic bile duct strictures based on its pathological characteristics / 中华肝胆外科杂志

Focal intrahepatic strictures (FIHS) refers to local strictures or stenosis of the intrahepatic bile duct induced by various factors. FIHS is easily leading to misdiagnosis and miss diagnosis. At present, most of the techniques or examinations for making position as well as qualitative diagnosis of FIHS have poor sensitivity. Paying more attention to the medical history and combined applications of various inspection methods might help to improve the diagnostic level of FIHS. In terms of treatment, we suggested for patients with suspected malignant strictures or those who were failure of medical treatment, dilation, drainage and pathological diagnosis of FIHS could be conducted by endoscopy before determining the indications and procedures of surgery based on a new anatomy classification system of FIHS.

Dihydrophenanthrenes from medicinal plants of Orchidaceae: A review / 中草药·英文版

The plants of Orchidaceae are widely distributed in the world, 47 species of which have been used as folk medicines with a long history. The tubers and stems of them exhibit diverse efficacy, including clearing heat and resolving toxin, moistening lung and relieving cough and promoting blood circulation. Since dihydrophenanthrenes were responsible for the medical purposes, the characteristic skeletons, pharmacological effects and clinical applications of dihydrophenanthrenes were summarized in this review, so as to provide a theoretical basis for the comprehensive study, development and application of DPs from medicinal plants of Orchidaceae.

Effect of anesthetic factors on Th cell balance and outcome after hepatectomy: improved effect of epidural block combined with general anesthesia / 中华麻醉学杂志

Objective:To evaluate the effect of epidural block combined with general anesthesia on T helper (Th) cell balance and outcome after hepatectomy.Method:Seventy patients aged 18-64 yr, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, undergoing hepatectomy in our hospital, were randomly assigned into combined epidural-general anesthesia group (E+ G group, n=35) and general anesthesia group (G group, n=35). The consumption of anesthetics during operation and analgesics after operation was recorded.Blood samples were obtained on the morning of the operation day (T 0) and morning of 2nd and 3rd days after operation (T 1, 2). The concentrations of interferon (IFN)-γ, interleukin-4 (IL-4), IL-17, IL-10 and transforming growth factor (TGF)-β 1 were determined by enzyme-linked immunosorbent assay.The ratio of IFN-γ/IL-4 was calculated.The patients were followed up for 3 yr after operation, and the survival and tumor-free survival were recorded.Multivariate COX proportional hazards model was used for multivariate analysis of the factors associated with survival and tumor-free survival. Results:Sixty-one patients were finally included in this study, including 31 patients in E+ G group and 30 patients in G group.Compared with G group, the consumption of fentanyl, sevoflurane and postoperative morphine was significantly decreased, the plasma concentrations of IFN-γ and IL-4 at T 1 and IL-17 and TGF-β 1 at T 2 were decreased, the ratio of IFN-γ/ IL-4 was increased, and the overall survival rate and tumor-free survival rate were increased in E+ G group ( P<0.05). The results of multivariate COX proportional hazards model analysis showed that vascular invasion was a risk factor for tumor-free survival and overall survival ( P<0.05), and anesthesia method was not a risk factor for tumor-free survival ( P>0.05). Conclusion:Compared with general anesthesia alone, epidural block combined with general anesthesia is more helpful in maintaining the balance of Th cells and in improving the outcome of hepatectomy.

Advances in pharmacotherapy for post-transplant diabetes mellitus / 解放军医学杂志

Post-transplant diabetes mellitus (PTDM) often occurs after solid organ transplantation, and treatment of PTDM is different from that of type 2 diabetes mellitus, the current research in this field is increasing gradually. The present paper summarizes the characteristics of blood glucose change in PTDM, risk assessment, the safety of hypoglycemic drugs, and the effect of immunosuppressive drugs on blood glucose in PTDM patients, and focuses on the efficacy and safety of new hypoglycemic drugs in PTDM patients, as well as the clinical research evidence such as the type of immunosuppressant used and the formula of administration has been summarized, so as to select a more optimized PTDM treatment options.

Comprehensive treatment based on oncology principles should also be emphasized for treating gallbladder cancer / 中华外科杂志

Gallbladder carcinoma(GBC) is one of the most malignant cancers of the digestive system with very poor prognosis due to its histopathological features of easy invasion to the liver, early lymph node metastasis and nerve infiltration, which result in low resection rate. It has been confirmed that radical surgery only makes sense to relatively early GBC in improving prognosis of patients. Therefore, based on recognition of biological characteristics of GBC and the theories of oncology, efforts should be focused on developing various adjuvant treatment methods for treating GBC including chemotherapy, radiotherapy, targeted therapy and immunotherapy.

Influence of oxidative/antioxidative biomarkers and inflammatory cytokines on rats after sub-acute orally administration of titanium dioxide nanoparticles / 北京大学学报(医学版)

OBJECTIVE@#To evaluate the sub-acute oral effect of titanium dioxide (TiO2) nanoparticles on the oxidation/antioxidation biomarkers and inflammatory cytokines in blood, liver, intestine, and colon in rats.@*METHODS@#Twenty four 4-week-old clean-grade Sprague Dawley (SD) rats were randomly devided into 4 groups by body weight (n=6, control, low, middle, and high), in which the rats were orally exposed to TiO2 nanoparticles at doses of 0, 2, 10 and 50 mg/kg body weight/day for 28 consecutive days separately. Food intake, body weight and abnormal behaviors during the experiment were recorded. The rats were euthanized on the 29th day. The blood was collected via abdominal aortic method and centrifuged to collect the serum. Tissues from liver, intestine and colon were collected and homogenated. Then enzyme-linked immunosorbent assay (ELISA) and microwell plate methods were used to detect oxidation/antioxidation biomarkers including superoxide dismutase (SOD), glutathione (GSH), glutathione peroxidase (GSH-Px), total mercapto (T-SH), glutathione disulfide (GSSG), malomdialdehvde (MDA) and inflammatory cytokines including interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) in the serum, liver, intestine and colon in the rats.@*RESULTS@#Compared with the control group, no significant differences in body weight, food intake and organ coefficients were observed in all the three groups after TiO2 gavage. No significant changes in GSH, GSH-Px, T-SH, and IL-6 were observed. Compared with the control group, significant increase of SOD activity in serum in high dose group, signi-ficant increase of GSSG concentration in intestine in middle and high dose group and significant increase of MDA concentration in liver in low and high dose group were observed. Compared with the control group, a significant increase of TNF-α in liver in middle and high dose group was observed.@*CONCLUSION@#TiO2 nanoparticle can increase antioxidant enzymes activities in blood, increase oxidative biomarkers in liver and intestine, increase inflammatory cytokines in liver in rats after a 28-day sub-acute orally administration. Among blood, liver, intestine, and colon, liver is most sensitive to the toxicity induced by TiO2 nanoparticles, followed by intestine, blood, and colon in sequence.

Effects of titanium dioxide nanoparticles on fecal metabolome in rats after oral administration for 90 days / 北京大学学报(医学版)

OBJECTIVE@#To explore the effects and related mechanisms of oral exposure titanium dioxide nanoparticles (TiO2 NPs) for 90 days on the intestinal and the gut microbiota of rats, through fecal metabolomics.@*METHODS@#Twelve 4-week-old clean-grade Sprague Dawley (SD) rats were randomly de-vided into 2 groups by body weight, treated with TiO2 NPs at dose of 0 or 50 mg/kg body weight everyday respectively for 90 days. The solution of each infection was freshly prepared and shocked fully by ultrasonic. Characterization of the particle size, crystal form, purity, and specific surface area of TiO2 NPs was conducted. And the fresh feces of the rats were collected on the 90th day. After lyophilized and hydrophilic phase extraction, ultra performance liquid chromatography-Q-exactive orbitrap-high-resolution mass spectrometry system (UPLC-QEMS) was utilized for non-targeted determination of fecal meta-bolites. The metabolites were identified and labeled through Compound Discoverer 3.0 software, and used for subsequent metabolomics analysis. Bioinformatics analysis was carried out including unsupervised principal component analysis and supervised orthogonal projection to latent structure discriminant analysis for the differential metabolites between the two groups. The differential metabolites were followed-up for Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis.@*RESULTS@#Compared with the control group, the body weight of the rats was significantly reduced (P<0.05) in the treatment group. A total of 22 metabolites in fecal metabolomics showed significant changes. Among them, xanthine, 1-methyladenine, 3-hydroxypyridine, methionine sulfoxide, pyridoxine, 1,5-isoquinolinediol, N-acetylornithine, N-acetyl-D-galactosamine, L-citrulline, L-methionine, leucine, DL-tryptophan, L-ornithine, 4-methyl-5-thiazoleethanol, and L-glutamic acid totaled 15 metabolites increased significantly. N-acetylhistamine, D-pipecolinic acid, imidazolelactic acid, L-valine, 2,3,4,6-tetramethylpyrazine, caprolactam, and histamine totaled 7 metabolites decreased significantly. N-acetylhistamine, L-valine and methionine sulfoxide were changed more than 16 times. Analysis of KEGG pathway revealed that the two metabolic pathways arginine biosynthesis and aminoacyl-tRNA biosynthesis were significantly changed (false discover rate < 0.05, pathway impact > 0.1).@*CONCLUSION@#Oral exposure to TiO2 NPs for 90 days could disrupt the metabolism of the intestine and gut microbiota, causing significant changes in metabolites and metabolic pathways which were related to inflammatory response, oxidative stress, glucose homeostasis, blood system and amino acid homeostasis in rat feces. It is suggested that the toxic effect of TiO2 NPs on rats may be closely related to intestinal and gut microbiota metabolism.

Progresses of cardiovascular MR in diagnosis of myocardial inflammation: Based on "Expert Recommendation of 2018 Update of CMR Criteria for Non-ischemic Myocardial Inflammation" / 中国医学影像技术

The Consensus on Magnetic Resonance Imaging of Myocarditis, published in 2009, has played an important role in diagnosis of myocarditis. Cardiovascular MR (CMR) is expected to further improve diagnostic accuracy of myocarditis with the development of MR software and hardware, especially the introduction of T1 mapping, T2 mapping technology based on absolute quantitative myocardial tissue characteristics. Based on an expert recommendation (Expert Recommendation of 2018 Update of CMR Criteria for Non-ischemic myocardial inflammation) based on the new MR technology (mainly T1 mapping, T2 mapping) published in JACC main issue, the research progresses of CMR in diagnosis of myocarditis were reviewed in this article.

Preparation of folate-targeted phase-transition nanoparticles carrying bismuth sulfide and application in CT/ultrasound imaging in vitro / 中国介入影像与治疗学

Objective To prepare folate-targeted phase-transition nanoparticles carrying bismuth sulfide (FBS-PFH-NPs), in order to use for targeting performance and CT/ultrasound (US) imaging in vitro. Methods Rotary evaporator and probe-type sonication methods were used to prepare FBS-PFH-NPs. Basic characteristics of FBS-PFH-NPs were detected using several analytical methods. The targeting performance of FBS-PFH-NPs was verified through incubation with cervical cancer Hela cells in vitro. The echo intensity and temperature variation of FBS-PFH-NPs were observed after irradiating with HIFU using different acoustic powers (60, 90, 120, 150 and 180 W), respectively. The effects of FBS-PFH-NPs with different Bi2S3 concentrations (1.0, 2.0, 3.0, 4.0 and 5.0 mg/ml) for enhancing CT/US imaging were investigated. Results FBS-PFH-NPs were prepared with diameter (458.50±69.22)nm, which showed regular spherical morphology and uniform size under microscope. Bi2S3 nanoparticles randomly distributed in the lipid shell, and the concentration of Bi2S3 was 1.0 mg/ml. A mass of FBS-PFH-NPs was bond to Hela cells. The phase-transition of FBS-PFH-NPs occurred after irradiation with HIFU. The echo intensities and temperature of FBS-PFH-NPs gradually enhanced with increased HIFU powers (F=110.09, 440.69, both P<0.01). The echo intensities and CT value of FBS-PFH-NPs gradually enhanced with increased Bi2S3 concentrations (F=146.14, 16.74, both P<0.01). Conclusion FBS-PFH-NPs can not only target to Hela cell specifically, but also be applied in CT/US dual-modal imaging in vitro.

History, current situation and bottleneck of the diagnosis and treatment system of hepatic hilar cholangiocarcinoma in Japan / 中华外科杂志

Hilar cholangiocarcinoma is one of the most difficult malignant tumors to treat in the biliary system. In Japan, 5-year survival rate of the disease has increased from 32.5% to 67.1% during the past 30 years. The impressive progress reflects the solid efforts in preoperative endoscopic diagnosis, innovation in surgery such as PTPE as well as hepato-pancreatoduodenectomy and perioperative treatment including replacement of the bile and synbiotic treatment, which have finally formed a set of standardized diagnosis and treatment systems. The present review intends to report the history, current status and remaining bottlenecks of the diagnosis and treatment system of hilar cholangiocarcinoma in Japan as follows.

Comparison of alveolar bone changes in maxillary anterior area secondary to different kinds of retraction method of anterior teeth: a cone-beam computed tomography study / 上海交通大学学报（医学版）

Objective • Using cone-beam computed tomography (CBCT) to compare alveolar bone changes in maxillary anterior area secondary to maxillary incisor retraction adjunct with tip (R&Tp) and retraction adjunct with torque (R&Tq) movements. Methods • Forty teenagers with Angle's class Ⅱ division 1 malocclusion who had completed orthodontic treatment met the inclusion criteria and were selected, and all of their 160 maxillary incisors were classified into two categories, namely R&Tp group and R&Tq group, according to their actual retraction pattern. Pre- and post-treatment CBCT images and 3D measurement software were used to measure and analyze tooth retraction and alveolar bone height and thickness changes within each group and to compare treatment changes of teeth and alveolar bone between two groups. Results • Anterior teeth in each group were intensively retracted and uprighted, with a longer retraction distance of incisal edge and a greater retraction angle of teeth in R&Tp group than in R&Tq group (both P=0.000). Alveolar bone thickness was significantly decreased at L3 and P1 in R&Tp group (both P<0.05), while it was significantly decreased at P1 and P2 in R&Tq group (both P<0.05). Total alveolar bone thickness decreased at T1 in R&Tp group (P=0.000) and at all levels in R&Tq group (all P=0.000). Finally, alveolar ridge height in two groups dropped both in the buccal (both P=0.000) and palatal (both P=0.000) sides, with a more prominent extent in the palatal side, and ridge height dropped most in palatal side of the teeth in R&Tq group. Conclusion • The buccal root apex area and the palatal alveolar ridge area of alveolar bone in the R&Tp group and the cervical and middle area of incisor root in palatal side of alveolar bone in the R&Tq group are high-risk areas for alveolar bone resorption when anterior teeth in teenagers with Angle's class Ⅱ division 1 malocclusion are intended to have en masse retraction.

Problems and reflections on the diagnosis and treatment of gallbladder cancer / 中华外科杂志

Although more and more attention has been paid on the diagnosis and treatment of gallbladder cancer, the patients′ survival were still unsatisfied.Increasing the early diagnosis rate, the raise of awareness and treatment of unexpected gallbladder cancer, performing radical surgery for early stage patients and utilizing comprehensive treatment with adjuvant therapy for aggressive T2 or higher stage cases were the key points to improve patients′ prognosis of gallbladder cancer.