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Endoscopic retrograde cholangiopancreatography (ERCP) for extraction of common bile duct (CBD) stones in Billroth II anatomy patients is still a technical challenge and factors affecting stone extraction have not yet been clarified. This study aimed to analyze our experience and evaluate potential factors affecting CBD stone extraction. A retrospective analysis of CBD stones patients with a history of Billroth II gastrectomy, who underwent therapeutic ERCP for stone extraction at our center from August 1999 to December 2017, was conducted. The outcomes of ERCP and potential factors affecting stone extraction were examined. A total of 227 patients were enrolled, and 176 patients (77.5%) achieved technical success. The success rate of duodenal ampullary access and selective biliary cannulation was 84.1% (191/227) and 92.1% (176/191), respectively. The mean CBD diameter was 15 mm (range 6–35 mm), and the largest stone size was 13 mm (range 4–36 mm). CBD stones were ultimately removed in 137 patients (77.8%), and 105 patients (59.7%) for the first session. Mechanical lithotripsy was used in 17 patients (9.7%). The overall ERCP-related complication rate was 6.3% (11/176), including bleeding in 3 patients (1.7%) and mild pancreatitis in 6 patients (3.4%). The multivariate analysis indicated that CBD stone number ≥ 2 (OR 2.171; 95% CI 1.095–4.306; p = 0.027), and the largest CBD stone size ≥ 12 mm (OR 3.646; 95% CI 1.833–7.251; p

Endoscopic retrograde cholangiopancreatography (ERCP) for extraction of common bile duct (CBD) stones in Billroth II anatomy patients is still a technical challenge and factors affecting stone extraction have not yet been clarified. This study aimed to analyze our experience and evaluate potential factors affecting CBD stone extraction.A retrospective analysis of CBD stones patients with a history of Billroth II gastrectomy, who underwent therapeutic ERCP for stone extraction at our center from August 1999 to December 2017, was conducted. The outcomes of ERCP and potential factors affecting stone extraction were examined.A total of 227 patients were enrolled, and 176 patients (77.5%) achieved technical success. The success rate of duodenal ampullary access and selective biliary cannulation was 84.1% (191/227) and 92.1% (176/191), respectively. The mean CBD diameter was 15 mm (range 6-35 mm), and the largest stone size was 13 mm (range 4-36 mm). CBD stones were ultimately removed in 137 patients (77.8%), and 105 patients (59.7%) for the first session. Mechanical lithotripsy was used in 17 patients (9.7%). The overall ERCP-related complication rate was 6.3% (11/176), including bleeding in 3 patients (1.7%) and mild pancreatitis in 6 patients (3.4%). The multivariate analysis indicated that CBD stone number ≥ 2 (OR 2.171; 95% CI 1.095-4.306; p = 0.027), and the largest CBD stone size ≥ 12 mm (OR 3.646; 95% CI 1.833-7.251; p 0.001) were patient-related risk factors for failed stone removal; while the use of endoscopic papillary (large) balloon dilation (EPBD/EPLBD) (OR 0.291; 95% CI 0.147-0.576; p 0.001) was a procedure-related protective factor for successful stone extraction.ERCP is safe and effective for extraction of CBD stones in Billroth II anatomy patients. The number and the largest size of CBD stones, and the use of EPBD/EPLBD are predictive factors for CBD stone extraction.

MicroRNAs (miRNAs, miRs) are a class of non-coding single-stranded RNAs, which can negatively regulate gene expression at posttranscriptional levels by miRNA-mRNA interaction. It has been demonstrated that miRNAs play important roles in a variety of biological process, including cell proliferation, differentiation, apoptosis, and tumorigenesis. Recent studies have shown crucial roles of specific miRNAs in controlling oligodendrocyte (OL) differentiation and myelination. Dysregulation of miRNAs is a vital event in the pathogenesis of demyelinating diseases. Furthermore, new patents of miRNAs also provide new strategies for gene therapy and miR-drug development for demyelinating diseases, especially multiple sclerosis. In this review, we briefly introduce the roles of miRNAs in OL differentiation and in the pathogenesis of demyelinating diseases, with emphasis on the implication of miRNAs patents in disease diagnostic and therapeutic perspective and its related technologies and challenges in clinical application.

A Ln3+-doped (Yb3+, Tm3+ or Yb3+, Er3+ co-doped) NaYF4 nanoparticle/polystyrene hybrid fibrous membrane (HFM) was fabricated using an electrospinning technique. The HFM shows upconversion luminescence (UCL), flexibility, superhydrophobicity and processability. The UCL membrane can be used as a fluorescence sensor to detect bioinformation from a single water droplet (~10 μl). Based on the fluorescence resonance energy transfer, the detection limits of this sensor can reach 1 and 10 ppb for the biomolecule, avidin, and the dye molecule, Rhodamine B, respectively, which are superior to most of the fluorescence sensors reported in previous works. After the fluorescence detection, the target droplet was easily removed without residues on the UCL membrane surface due to its superhydrophobic property, which exhibits an excellent recyclability that cannot be achieved by traditional liquid-based detection systems.

Alzheimer's disease (AD) is the most common neurodegenerative disease and oligodendrocyte degeneration and white matter damage play a critical role in the pathogenesis of AD. FGF/FGF receptor signaling have been implicated in diverse cellular processes including cell apoptosis, survival, adhesion, migration, differentiation, and proliferation, as well as key regulators of the development of the central nervous system (including in axon guidance and synaptogenesis) via multiple signal pathways. It has been demonstrated that FGF infusion or gene transfer restores neurogenesis in subventricular zone and hippocampal functions in aged mice and mouse models of AD and has therapeutic implications for neurocognitive disorders. Besides, FGF receptor signaling in oligodendrocytes regulates myelin sheath thickness via Erk1/2 MAPK and PI3K/Akt/mTOR signaling, which sequentially regulates progression through distinct stages of oligodendrocyte differentiation. The effect could be effectively antagonized by the potent, selective tyrosine kinase inhibitor of FGF receptor activity. We therefore propose that modulation of FGF receptor signaling will suppress the development of oligodendrocyte degeneration and myelin breakdown or white matter damage in mouse models or patients of AD and improve or restore the pathological and clinical symptoms of cognitive decline, and FGF receptor signaling with its inhibitors and/or gene transfer would serve as an intervention and potential therapy for myelin breakdown and cognitive decline in AD.

MicroRNAs (miRNAs or miRs) are a class of endogenous small non-coding RNAs that consist of about 22 nucleotides and play critical roles in various biological processes, including cell proliferation, differentiation, apoptosis, and tumorigenesis. In recent years, some specific miRNA, such as miR-219, miR-138, miR-9, miR-23, and miR-19b were found to participate in the regulation of oligodendrocyte (OL) differentiation and myelin maintenance, as well as in the pathogenesis of demyelination-related diseases (e.g., multiple sclerosis, ischemic stroke, and leukodystrophy). These miRNAs control their target mRNA or regulate the protein levels of some signaling pathways, and participate in OL differentiation and the pathogenesis of demyelination-related diseases. During pathologic processes, the expression levels of specific miRNAs are dynamically altered. Therefore, miRNAs act as diagnostic and prognostic indicators of defects in OL differentiation and demyelination-related diseases, and they can provide potential targets for therapeutic drug development.