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Intrahepatic cholangiocarcinoma is a primary hepatic malignant tumor with high malignancy and poor prognosis. In addition to surgical resection, there are no clear studies showing that there are other effective treatments. In recent years, with the deepening of the research on the immune mechanism of various malignant tumors, immunotherapy has been gradually attached importance to various anti-solid tumor treatments, and has also become an important direction in the treatment of intrahepatic cholangiocarcinoma. The important role of tumor microenvironment in the immunotherapy of malignant tumors is gradually recognized. In this paper, the characteristics of immune microenvironment in intrahepatic cholangiocarcinoma has been summarized, and the application of immunotherapy in intrahepatic cholangiocarcinoma has been reviewed, with emphasis on the development of immune checkpoint inhibitors, cancer vaccines and adoptive cellular immunotherapy.
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Objective:To investigate the relationship between bone mineral density (BMD) of lumbar spine and abdominal adipose tissue in adult males.Methods:A total of 1 374 healthy male examinees in the Affiliated Hospital of Guizhou Medical University from June 2018 to September 2018 were retrospectively analyzed. The age ranged from 30 to 75 (50.9±0.30) years. Height, weight and waist circumference was measured and body mass index (BMI) was calculated. Quantitative CT (QCT) was used to measure the mean BMD value of L1 and L2. The abdominal subcutaneous fat area (SFA) and visceral fat area (VFA) at the level of L2 were measured as well. According to the BMD, the males were divided into three groups: normal group, osteopenic group and osteoporosis group. One-way ANOVA was applied to compare the age, BMI, VFA and SFA among three groups. LSD- t test was used for multiple comparisons, and Pearson correlation was used to analyze the correlation between age, BMI, VFA, SFA and lumbar BMD. Results:Totally 807 healthy males were in normal group, 451 in osteopenic group and 116 in osteoporosis group. There were significant differences in age, BMI and VFA among normal group, osteopenic group and osteoporosis group ( F=237.939, 5.788, 4.919, P<0.001, 0.003, 0.007). Age and VFA was higher in osteopenic group compared with normal group, and BMI was lower in osteopenic group compared with normal group. Age was higher in osteoporosis group compared with normal group, and the BMI was lower in osteoporosis group compared with normal group. The age was higher in osteoporosis group compared with osteopenic group. The above differences were statistically significant ( P<0.05). Although there was no statistical difference in VFA and SFA between osteopenic group and osteoporosis group, the VFA and SFA was higher in osteopenic group compared with osteoporosis group. BMD of male lumbar spine was negatively correlated with age ( r=-0.542, P<0.001), VFA( r=-0.104, P<0.001), and positively correlated with BMI ( r=0.109, P<0.001). After controlling for age and BMI, BMD was still negatively correlated with VFA ( r=-0.129, P<0.05). Conclusions:Males with abdominal obesity is more likely to manifest as low bone mass. The lumbar BMD is possibly negatively correlated with visceral adipose tissue in male.
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@#As one of the stimulus-response polymeric intelligent materials, shape memory polymers have been widely applied in biomedicine due to their better biocompatibility, higher controllability, stronger deformation restorability and biodegradability compared with shape memory alloys and shape memory ceramics. This review will introduce the structural principles of shape memory polymers and summarize their applications in the treatment of vascular diseases, especially in endovascular therapy. At the same time, the related technical problems and the future of shape memory polymers are prospected. With the continuous development of processing technology and materials, it can be predicted that shape memory polymers will be more widely used in the medical field.
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ObjectiveTo summarize the experience in laparoscopy combined with choledochoscopy and duodenoscopy in the treatment of gallstones complicated by intra- and extrahepatic bile duct stones, and to investigate its therapeutic effect. MethodsA total of 413 patients with gallstones complicated by intra- and extrahepatic bile duct stones who visited Meizhou People′s Hospital from March 2010 to March 2015 were enrolled, and according to the patients′ individual conditions, they were given laparoscopy combined with choledochoscopy and/or duodenoscopy. ResultsA total of 31 patients underwent laparoscopic cholecystectomy (LC)+laparoscopic transcystic common bile duct exploration (LTCBDE), and the success rate was 29.0% (9/31); 101 patients underwent LC+LTCBDE+T tube drainage, and the success rate was 93.1% (94/101); 96 patients underwent LC+laparoscopic common bile duct exploration (LCBDE)+choledochoscopic cholecystolithotomy+primary suture, and the success rate was 97.9% (94/96); 61 patients underwent LC+LCBDE+partial hepatectomy, and the success rate was 91.8% (56/61); 155 patients underwent endoscopic sphincterotomy (EST)+LC or LC+EST, and the success rate was 93.5% (145/155); 10 patients underwent laparoscopy+duodenoscopy+choledochoscopy (at the same time), and the success rate was 90%(9/10). Nineteen patients were converted to open surgery, and the overall success rate was 95.4％（394/413）. All the patients were cured, and there were no serious complications or deaths. ConclusionLaparoscopy combined with duodenoscopy and choledochoscopy is feasible, safe, and reliable in the treatment of gallstones complicated by intra- and extrahepatic bile duct stones.
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Objective To discuss method,operative characters and curative effect of total hip arthroplasty(THA)in treatment of acetabular fractures combined with ipsilateral femoral head or neck fractures.Methods One stage THA was done in seven patients with acetabular fractures combined with ipsilateral femoral head fracture(one patient)or femoral neck fractures(six patients)7-21 days after fractures.There were five males and two females,at age range of 41-65 years(average 50 years).According to AO classification,there were one patient with type A fracture,three with type B and three with type C.Of all,five patients received biological acetabular replacement after reduction and internal fixation of acetabular fracture and two received PMMA acetabular replacement with metal enforcement ring.All patients received biological femoral stem.Results Of all,six patients were followed up for from 2 years and 3 months to 6 years and 5 months(mean 3 years and 9 months),which showed heterotopic ossitlcation in one patient and dislocation in one who recovered after manipulative reduction.The Harris score was increased from mean prooperative 48 points to mean postoperative 91 points.X-ray found no loosening of prosthesis during follow-up.Conclusions THA can improve function of hip joint significantly,avoid further operation and lessen the burden of patients mentally and economically and hence is effective in treatment of acetabular fracture combined with ipsilateral femoral head or neck fractures.
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@#ObjectiveTo explore the mechanism of estrogen inhibiting osteoblast apoptosis induced with serum hungry.MethodsOsteoblasts of the second or third generation from newly born SD rats calvaria were divided randomly into three groups: control group,serum hungry group,serum hungry with estrogen group.Cells of each group were incubated for 1,2,3,5,7 or 14 d,and then were stained immunohistochemically.The rates of positive cells of each group were analyzed.ResultsThere was a little positive expression of Bax,Bcl2 and Fas in control group.The expression of Bax and Fas were significantly increased(P<0.05)in serum hungry group,peak time was 14 d,but the expression of Bcl-2 were not affected.Compared with that of serum hungry group,the expression of Bax and Fas significantly decreased(P<0.05) in serum hungry and estrogen group,peak time was still 14 d,while that of Bcl-2 increased(P<0.05).ConclusionSerum hungry can increase the expression of Bax and Fas in osteoblast,that can be inhibited by estrogen.Estrogen can also increase the expression of Bcl-2 in osteoblast.All of these may play a role in inhibiting osteoblast apoptosis induced with serum hungry.
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@#ObjectiveTo explore the effect of estrogen on osteoblast apoptosis induced by serum hungry in vitro.MethodsOsteoblasts of second or third generation from newly born SD rats calvaria were divided randomly into the control group, serum hungry group and serum hungry with estrogen group. Cells of each group were incubated for 24 h, 48 h, 72 h, 5 d, 7 d and 14 d, then labeled using TUNEL staining and examined for morphological characteristics of apoptotic cell under light microscopy after incubated for 72 h. The rates of apoptotic cells of each group were examined with flow cytometry.ResultsThe cells of the control group showed normal appears, the serum hungry group had many cells with purple and blue particles in nuclei, but serum hungry with estrogen group had less such cells. The rate of apoptotic cell significantly increased in serum hungry group and decreased in serum hungry with estrogen group compared with the control group examined with flow cytometry (P<0.05).ConclusionEstrogen can repress osteoblasts apoptosis of rats induced by serum hungry.