Objective To explore the method and the effect of combined use of laparoscopy and open surgery in the treatment of primary gallbladder cancer. Methods Pathological frozen-section examinations were carried out in all cases suspected of gallbladder cancer during laparoscopic cholecystectomy (LC). Patients in Ⅰ～Ⅱ Nevin stage received surgical removal of loose connective tissue at hepatic portal and gallbladder bed under laparoscope, while patients in stage Ⅲ or above underwent conversions to open operations of radical or extended radical resections. Results Out of the 34 cases of gallbladder cancer receiving LC, conversions to open surgery were required in 6 cases, open operations were performed after laparoscopic operation in 7 cases, and 1 patient refused further treatment. Except for 1 case of port-site cancer implantation below the xiphoid process, no other severe intra- or post- operative complications occurred. Follow-up revealed a 5-year survival rate of 80% (12/15) (survival range, 2～8 years) in 15 cases of laparoscopic surgery, and a survival duration of 8 months～4 years in 8 cases of open surgery. Conclusions Combined use of laparoscopy and open surgery in the management of variable stages of primary gallbladder cancer is effective.

Objective To investigate the biological characteritics of adult animal hepatocytes induced by phenobarbital sodium(PBS) in vivo,and to study the potential value of biological artificial liver of effective hepatocytes.Methods 12 adult male mice,are yandomly divided in to preinducing group and controll group.The preinducing group are intraperitoneally injected PBS per day,45mg/kg for 7 times in total;the controll ware injected NS.after that,we detected the blood serum TP,BUN,CHOL,HDLC.And the same amount of isolative hepatocytes was developed after being developed 48h;MTT was used to investigate the proliferation of hepatocytes after being developed 24h;chromosome was investigated to observe the cell division;and the survival deadline and morphology was also investigated.Results The TP had remarkable difference between the two groups(t=2.678,P

Objective To evaluate the diagnostic value of MSCT in the differentiation of thymic epithelial tumours (TET)with the maximum diameter equal or less than 3 cm.Methods A retrospective analysis of pathological and imaging data of 56 patients with pathologically confirmed TET with the maximum diameter equal or less than 3 cm was performed.According to the 2004 WHO classification,56 TETs were classified as low-risk thymomas(types A/AB/B1),high-risk thymomas (types B2/B3)and thymic carcinomas (type C).The CT manifestations of TET in each group,including shape of tumor,tumor edge (smooth or spiculate protuberance), presence of small nodule around tumor,enhancement degree,pleura invasion and fat space around tumor,were analyzed retrospectively.The differences in the CT manifestations among three types were compared using chi-square test.If the sample number was too small, Fisher 's exact test was used.Results Compared with high-risk thymomas (23 cases)and thymic carcinomas (6 cases),regular round shape was more often observed in low-risk thymomas (27 cases)(χ2 =73,P <0.001;χ2 =116,P <0.001)and the mediastinum-lung interface was more likely to bulge (χ2 = 3.41,P =0.046;χ2 =7.39,P =0.01).Blurred edge,spiculate protuberance and pleural invasion and so on were significantly more common in high-risk thymomas and thymic carcinomas (P <0.001)and they were the most common in thymic carcinomas (χ2 =11.5,P =0.009).There was a significant difference between type B2 thymomas and thymic carcinomas (χ2 =31.52, P <0.001),however there was no significant difference between type B3 thymomas and thymic carcinomas (χ2 =6.96,P =0.07). Conclusion MSCT can accurately show the shape of tumor,tumor edge,presence of small nodule around tumor,enhancement degree,pleura invasion,which can predict the histologic type of thymomas and also can provide information for preoperative diagnosis and prognosis evaluation.

Objective: To identify the phenotypes, antibodies and explore the molecular mechanisms of a patient who carries antibodies to RBC high-frequency antigens and his family members. Methods: The antibody identification test was performed for the proband by serological methods, and targeted NGS was subsequently used to detect mutations that occurred in blood group genes. Blood samples were collected from the proband and his family members. Sanger sequencing was used to verify the mutation of the XK gene. The expression of Kell blood group antigens was detected by serological methods and flow cytometry. K cells were used to detect the antibody specificity of the proband. The morphology of red blood cells was detected by the scanning electron microscopy. The serum creatine kinase levels of the proband and his family members were analyzed by colorimetric methods. Results: The results of the antibody identification test suggested that the proband might have antibodies to high-frequency antigens. NGS results suggested a homozygous mutation (c. 107G>A) in exon 1 of the XK gene in the proband, resulting in a truncated XK protein. The Sanger sequencing results of the proband were consistent with the NGS results, and the mutation was not found in other family members. The expression of Kell blood group antigens of the proband was not found by serological methods and flow cytometry. The results of the antibody specificity test showed that the proband had anti-Km antibodies. Spike-like changes were identified on red blood cells, and serum creatine kinase level was elevated in the proband. Conclusion: In this study, the McLeod phenotype caused by homozygous mutation (c. 107G>A) of XK gene was identified in Chinese individuals for the first time by the phenotype and molecular mechanism studies. The results of genotyping and phenotyping suggested that the McLeod phenotype caused by the mutation was compatible with the phenotypes of McLeod and K .