Gallbladder cancer is a disease associated with high mortality. Improvement of early diagnosis is of great significance to prolong the survival. Risk factors for gallbladder cancer include gallstones, cholelithiasis, anomalous pancreaticobiliary junction, focal mucosal microcalcifications, and et al.Advances in endoscopic ultrasonography, magnetic resonance cholangiopancreatogram and helical computed tomography have enhanced preoperative diagnosis of gallbladder cancer. Understanding the characteristics of gallbladder cancer with the help of multiple imaging modalities can facilitate accurate diagnosis and may also help in sorting patients to undergo extended resection or an alternative therapy. Resection is currently the most effective and only potentially curative treatment for gallbladder cancer.However, owing to its non-specific symptoms, gallbladder cancer patients often suffer from late diagnosis, and few patients are suitable for surgery. Other treatment strategies such as chemotherapy, radiotherapy, percutaneous biliary drainage, palliative surgery are used in patients with advanced gallbladder cancer.For jaundiced gallbladder cancer patients, preoperative biliary drainage is still under debate. Since biliary inflammation adversely affects the prognosis of gallbladder cancer patients,antibiotics with high concentration in bile is recommended for selected patients. Palliative treatment and molecular target therapy are promising for patients with inoperable gallbladder cancer.

OBJECTIVE To investigate the application value of combined detection of fecal pathogens in infantile diarrhea.METHODS The Escherichia coli was detected by potato-dextrose agar(PDA) medium method and serum agglutination test was used to determine the serotype.The rotavirus,enteric adenovirus and Campylobacter jejuni were detected with latex agglutination test antigens.RESULTS Among the diarrhea children,the detection rate of rotavirus,C.jejuni to their,E.coli 1.5%,and adenovirus was 33.0%,7.2%,1.5% and 0.7%,respectively.The proportion of male and female detected positive was 1.6∶1.CONCLUSIONS The main etiologies of infantile infectious diarrhea are rotavirus and C.jejuni.The infection rate of E.coli and enteric adenovirus is lower.Therefore,combined detection of pathogens causing diarrhea is valuable to diagnose the infantile diarrhea.

Complicated bile duct injury greatly affects quality of patients' life and even threatens their life safety because it is difficult to be recognized and reconstructed,also with the poor surgical effect.Regarding to the surgical timing of complicated bile duct injury,it still have a big controversy.Here we would discuss the timing of surgeries for bile duct injury.We consider that it should be reconstructed when it is recognized during operation,even converted to laparotomy for laparoscopic surgeries.About postoperative cases,we think that it should be operated to explore damage range and reconstruct for those cases found within 48 hours and without obvious infection.However,reconstruction should be performed after 6 weeks for those found after 48 hours or with biliary duct infection.

110 g/m~2 in woman) were 94 subjects and non-LVH group 146 subjects.Results The average levels of 24-hour pulse pressure,day time pulse pressure,night time pulse pressure and AOD were significantly different between patients with LVH and without LVH(P

Objective To explore the clinicopathological features and safety of surgical treatment in aged patients with primary hepatocellular carcinoma (HCC). Methods The clinical data of 316 patients with HCC undergoing hepatectomy in our hospital from December 2005 to December 2008 were retrospectively analyzed. The patients were divided into an aged group (≥60 years,n= 72) and a non-aged group (＜60 years, n=244). The clinicopathological data and surgical outcomes were compared between the 2 groups. Results The aged group presented less hepatitis B surface antigen (HBsAg) positive rates and vascular invasion and a lower alpha-fetoprotein (AFP) value when compared with the non-aged group (P＜0.05). No significant differences were found in the extent of hepatectomy, operative duration, intraoperative blood loss, blood transfusion requirements, incidence of postoperative complication and mortality rate between the 2 groups (P＞0.05). Conclusion The aged patients with HCC were characterized by less HBsAg positive rate, vascular invasion and lower alphafetoprotein (AFP) value. Surgical resection for HCC in aged patients is safe. The attitude toward surgical treatment of aged patients with HCC should be active.

Objective To investigate T-cell receptor(TCR)ζchain gene expression level in peripheral blood T cells from patients with multiple myeloma(MM),thereby to estimate the feature of T cells activation status.Methods Real-time PCR with SYBR Green I technique Was used for detecting TCR ζchain expression level in peripheral blood mononuelear cells(PBMC)of 24 cages with MM and 24 normal individuals.β2-microglobulin(β2M)gene expression was used as an endogenous reference.Relative changes in TCRζchain expression level were analyzed by the 2-△α×100%method between patients with MM and normal individuals.Results Compared with normal individuals,TCRζchain gene expression was obviously down regulated in PBMC from patients with MM(P=0.019).The expression level of TCR ζchain gene is not significantly age-associated in MM patients[(1.83±1.72)%,(3.46±2.75)%](P=0.525).Conclusion This is the first description in the expression feature of TCRζchain gene in MM patients.TCRζchain expression Was decreased in most of MM patients,which might be related to celhar immunodeficiency.

The aim of surgical Chinese-English bilingual teaching is to improve medical students’ ability of foreign language and international intercommunication. Many methods are used to improve surgical Chinese-English bilingual teaching results,including understanding the importance,training persons qualified to teach,using and constructing English textbook,doing well examination,encouraging students to study and explore investigation of bilingual teaching.

Objective To investigate the early change of the function of hemostasis and coagulation as well as clinical significance in the full-term newborns recoveried from stifle.Methods To detect the platelet count (PLT),prothrombin time,fibrinogen and D-dimer in early stage of 50 newborns with different degrees of asphyxia recovreied from stifle,and compared with the control group.Results Compared with the control group,there were not obvious change in PLT in asphyxiated full-term newborns(P>0.05),and the differences of prothrombin time,D-dimer and fibrinogen were statistically significant(P<0.01),the more serious degree of asphyxia,the lower of the fibrinogen and higer of the D-dimer.Conclusions The function of hemostasis and coagulation can be changed in early stage of newborns recoveried from stifle.The detection of fibrinogen and D-dimer in early stage of newborns recovefied from stifle has important clinica significance.

Objective To evaluate the long-term efficacy of modified loop choledochojejunostomy (MLC). Methods The clinical data of 259 patients who had underwent choledochojejunostomy in First Affiliated Hospital of Sun Yat-Sen University from January 2000 to December 2006 were retrospectively analyzed. Of all the patients, 130 underwent MLC (MLC group) and 129 underwent Roux-en-Y choledochojejunostemy (RYC, RYC group). The changes in incidence of cholangitis and liver function between the 2 groups were compared. All the data were analyzed by t test, chi-square test or Fisher exact probability. Results The levels of alaninetransa-minase and alkaline phosphomonoesterase were (63±42) U/L and (147±147) U/L in MLC group, and (84±52)U/L and (256±201)U/L in RYC group, with statistical difference between the 2 groups (t=1.634, 1.655, P>0.05). The level of gamma-glutamyl transferase in MLC group was (116±91)U/L, which was signifieandy lower than (169±96)U/L in RYC group (t=2.461, P<0.05). Three patients (2.3%) in MLC group and 9 (7.0%) in RYC group suffered from acute cholangitis after operation, with no statistical difference in the incidence between the 2 groups (P>0.05). Of the 12 patients with acute cholangids, 1 in MLC group and 7 in RYC group were hospitalized, with statistical difference between the 2 groups (P<0.05). Conclusions The incidence of acute cholangitis in patients who underwent MLC is comparable to that of RYC. However, the procedure of MLC is simpler than RYC, and patients have milder symptom and lesser frequency of reflux cholangitis onset after MLC.

Objective To analyze the T- cell receptor excision DNA circles (TRECs) level and evaluate the thymic recent output nave T cells function in patients with acute promyelocytic leukemia (APL). Methods Quantitative detection of TRECs in DNA of peripheral blood mononuclear cells (PBMC) from 9 cases with APL were preformed by real- time PCR (TaqMan) analysis. The TRECs- number was related to the number of T- cells by determination of the number of CD-3 positive cells. 14 normal individuals served as controls. Results In comparison with normal individuals [ (4.10?3.65) copies/1000 PBMC and (6.36?5.28) copies/1000 CD+3 cells], a dramatic reduction of TRECs values in patients with APL [ (0.13?0.22) copies/1000 PBMC and (0.77?1.60) copies/1000 CD+3 cells] could be found (P =0.0004, P =0.0005). Conclusions This is, to our knowledge, the first description of TRECs level which was markedly reduced in APL patients.