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.

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.

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.

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.

The past few years have witnessed a rapid development in liver transplantation in China and great achievement has been made. This review introduces the recent focuses on liver transplantation in China, including scoring for end-stage hepatic disease and liver transplantation, liver transplantation for hepatocellular carcinomas, liver re-transplantation, expanding of the donor pool, and post-operative long-term follow-ups.

Objective To review the diagnosis and treatment of primary gallbladder carcinoma in patients older than 70 years.Method The clinical data of 48 patients older than 70 years with primary gallbladder carcinoma treated in our hospital from 2003 to 2010 were retrospectively analyzed.Results The preoperative diagnostic rate was 60.4％.Of 48 patients with primary gallbladder carcinoma,9 received cholecystectomy,18 radical resection,7 extended radical resection,8 palliative operation,while the remaining 6 received biopsy because of metastasis. The 3-year survival rate was 20.8％ and the 5-year survival rate was 8.3％.Conclusions Regular B-ultrasonography,CT-scan and MRI are suggested for elderly patients with chronic diseases of the gallbladder.Radical resection is recommended if clinically possible. Chinese traditional medicine given postoperatively improved the prognosis.

Objective To investigate the role of peripheral blood lymphocyte apoptosis through Fas/ Fas ligand pathway in the development of viral myocarditis. Methods Twenty-five viral myocarditis (VMC) and 25 healthy children were chosen for study. The apoptosis percentage in peripheral blood iymphocytes was quantitatively examined, flow cytometry with Annexin V/PI double parameter was used. And the expressions of Fas and Fasl protein in peripheral blood lymphocytes were analyzed with flow cytometry. Results The percentage of apoptosis in peripheral blood lymphocytes in children with VMC [(0. 6976 ± 0. 1109)%] was significantly higher than that of healthy children [(0. 1288 ± 0. 1069) %] (t = 18.459, P ＜ 0.001). Moreover, the apoptosis cell percentage showed a significant positive correlation with the serum levels of myocardium enzyme (creatine kinase-MB, lactate dehydrogenase, creatine kinase, hydroxybutyrate dehydrogenase)(r =0. 817 ,P ＜0. 01 ;r =0. 785 ,P ＜0.01 ;r =0. 726 ,P ＜0. 01 ;r =0. 712 ,P ＜0. 01). The expression of Fas and Fasl protein in VMC patients(2. 8804 ± 0. 3020,4. 4496 ± 0. 4836) were higher than those of health children(2. 1300 ±0. 6200,0. 1238 ±0. 0384) ,which had significant difference(t = 17. 321 ,P ＜0. 001 ;t' =44. 577, P ＜ 0. 001). The apoptosis percentage of peripheral blood lymphocytes in children with VMC showed a significant positive correlation with the Fas and Fasl protein expression in peripheral blood lymphocytes(r =0. 972, P ＜ 0. 01; r = 0. 958, P ＜ 0. 01). Conclusion Apoptosis percentage of peripheral blood lymphocytes increases among children with VMC, probably because immune response decreased or it is related with the degree of myocardium damaged. Fas and Fasl play an important role in apoptosis of peripheral blood lymphocytes in children with VMC.

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 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.