Objective To improve the rate of early diagnosis and prolong the survival of patients with gallbladder carcinoma.Method Clinical data of 111 cases of primary carcinoma of the gallbladder undergoing surgery from Jan 2002 to Dec 2010 were analyzed retrospectively.Result The preoperative diagnositic rate was 61.3％.Among the 111 cases of primary carcinoma of the gallbladder,22 patients received simple cholecystectomy,47 patients received radical resection,18 patients received extended radical resection,12 patients received palliative operation while the other 12 patients only got biopsy due to widespread intraabdominal metastasis.The 3 years survival rate of the patients was 29.7％ (33/111) while the 5 years survival rate was 9.9％ ( 11/111 ).Conclusions B-ultrasonography and CT are the mainstay for the diagnosis of primary carcinoma of the gallbladder.For those suspected of having the carcinoma,an exploration is recommended.

Assessment of librarian training effect plays an important role in librarian training, but studies on librar-ian training effect in academic library are few. A rational librarian training effect assessment criteria system was thus constructed by using Delphi method and hierarchy analysis method in order to help librarian training in aca-demic library.

Objective To explore the relationship between plasm level of vascular endothelial growth factor (VEGF) and children Anaphylactoid purpura(AP).Methods The concentrations of VEGF in serum were detected with enzyme-linked immunosorhent assay in twenty four children with AP,twenty four children with APN in acute phase and twenty four healthy children.Results The concentrations of VEGF in patients with APN in acute phase,AP and normal control was (244.56±51.12)μg/L,(155.71±50.48)μg/L and (54.91±40.07)μg/L,respectively.Plasma levels of VEGF in children with APN and AP were significantly higher than those in normal control,statistically significant difference was observed (F=95.789,P=0.000＜0.01).Conclusion The concentrations of VEGF in serum increases markedly in acute phase of AP,those in APN is higher than in AP.It indicated that VEGF involved in the occurrence and development of AP vaseulitis,and may reflect the extent of pathogenetic condition.

Scoring methods used in bidding directly affects the bidding results,it is thus of great importance for the scoring methods used in acquisition of Chinese books to assure the academic level of books bought by college and university libraries and improve the efficacy of funds for acquisition of books.A scientific,rational,standardized and practical comprehensive evaluation method for bidding of acquisition of Chinese books was established by analyzing the application of comprehensive evaluation method in 14 college and university libraries of Shandong Province in order to provide reference for bidding of acquisition of Chinese books in college and university libraries.

Objective To discuss morphology and biomechanics of the sacrum fractures so as to provide scientific basis for corresponding clinical treatment. Methods A total of 10 fresh pelvis specimens were collected for dynamic impact test and static destruction test, in the former one of which, the dynamic parameters were measured to make sure the dynamic characters of the fractures. Meanwhile, the fractures of the sacrum wing, the sacral foramina and the sacrum edge were made decalcification, slice of paraffin wax and staining (Masson, Mallory, HE) in order to make a cytological observation of the tissue. Results (1) The form of sacrum fracture or acetabulum fracture, crista iliaceis fracture was relevant to the impact energy. Low impact energy usually caused fractures of the ilium, acetabulum or sacroiliac crest. High impact energy resulted in following three kinds of fractures, just as the classification of Denis: sacral ala fractures belonged to typeⅠfractures, sacral hiatus fractures to type Ⅱ fractures and central vertebral canal fractures to type Ⅲ fractures. All three types of fractures might involve lateral or bilateral nerve roots. (2) There was a significant mechanic difference in regard of the mechanism of both dynamic destruction and static destruction of pelvis, ie, not only the limit pressure differed but also the former increased rapidly with the higher rate of the strain. The clash energy beyond 25 J would beget the cleft fractures of the sacrum via sacrum hiatus and even involve the nerve roots. The clash energy under 20 J usually resulted in fractures of the ilium and the sacrum. The clash energy between 20 J and 25 J more easily caused type Ⅰ fractures. While fracture of the ilium and the acetabulum would happen most in static destruction. (3) The cross section of the sacrum was cracked and the bone board of Haversian system is brittle, as led to separation of bone board and malposition of a few cross bone boards. Conclusions Under dynamic state, the sacrum fractures mostly belong to type Ⅰ and type Ⅱ (Denis classification of sacral fractures), usually involving the nerve roots. The sacrum fracture is relevant to the microstructure, the distribution of the bone trabecula, the osseous lacuna and the Haversian system of the sacrum. The fractures of the ilium and the acetabulum more frquently appear in static state, with slight wound of peripheral tissues.

Objective To investigate the value of laparoscopy combined with choledochoscopy in treatment of cholecystolithiasis complicated with choledocholithiasis.Methods Clinical data of 168 patients with cholecystolithiasis and choledocholithiasis treated in our haspital from June 2005 to June 2009 were analysed.Ninety patients were randomly selected and treated by laparoscopic cholecystectomy combined with choledocholithotomy and T-tube drainage (group A),the other 78 patients,as control group,underwent routine cholecystectomy and choledocholithotomy plus T-tube drainage by laparotomy (group B).Results The hospital stay and the mean time to passage of flatus in group A was much shorter than that in group B (P0.05).Conclusions Laparoscopic cholecystectomy combined with choledocholithotomy and T-tube drainage for cholecystolithiasis and choledocholithiasis is a microtrauma management with advantages of quick recovery and shorter hospital stay,that makes it superior to the open operation.

Objective: To study the influence of vascular endothelial growth factor(VEGF) expression on angiogenesis,the relationship of VEGF expression and microvessel density (MVD) with invasion and metastasis of colorectal carcinoma.Methods: Sixty-one samples of colorectal carcinoma tissues were examined for VEGF expression by SABC immunohistochemical method and for the CD34 endothelial antigen by SP immunohistochemical method to highlight the new growth microvessels,the MVD of tumor was calculated.Results: The positive expression rate of VEGF was 49.2% and the mean of MVD was 28.7?12.9 (range from 6 to 55) in colorectal carcinoma tissues.The positive expression rate of VEGF and MVD were significantly correlated with the depth of invasion,lymph node metastasis,liver metastasis and Dukes’s stage(P29) was significantly higher than that in group of lower MVD.MVD in group of VEGF positive expression was significantly higher than that in negative expression group (P

Objective To study the influence of vascular endothelial growth factor (VEGF) expression and microvessel density (MVD) on invasion and metastasis of human colorectal carcinoma. Methods VEGF expression was detected by SABC immunohistochemical method and the new growth microvessels were highlighted by SP immunohistochemical staining of CD34 endothelial antigen in 61 colorected carcinoma tissues, and the MVD of tumor tissues was calculated. Results The positive expression rate of VEGF was 49 2% and the average MVD was 28 7?12 9 in colorectal carcinoma tissues. The VEGF expression and MVD in colorectal carcinoma tissues were significantly associated with the depth of invasion, lymph node metastasis, liver metastasis and Dukes' stage (P

Objective To investigate the effect of binding pancreaticojejunostomy (BPJ) on the prevention of the pancreatic leakage after pancreaticoduodenectomy(PD). Methods The clinical data of 108 patients who underwent PD, including 26 cases of BPJ since 2001 and 82 cases of other type of pancreaticojejunostomy from 1993 to 2000,were retrospectively analyzed. Results The frequency of pancreatic leakage in this series was 13.9%. No pancreatic leakage occurred in BPJ group, whereas the frequency of pancreatic leakage in end-to-end invaginated pancreaticojejunostomy group and duct-to-mucosa pancreaticojejunostomy group was 24.6%(14/57) and 4.0%(1/25),respectively. The frequency of pancreatic leakage in BPJ group was significantly lower than that in end-to-end invaginated pancreaticojejunostomy group(P0.05). Conclusion BPJ may be effective in the prevention of the pancreatic leakage after PD.