Bullous pemphigoid antibodies can recognize two autoantigens-BPAG1 (220 000-240 000 ) and BPAG2 (160 000 -180 000). With two specific primers, we successfully amplified a 588bp cDNA fragment of 160 000 BP antigen from human keratinocyte cDNA library in this paper. The result confirmed that lip antigens were synthesized by keratinocyte at a molecular level. This cDNA fragment could not be amplified with epidermal DNA Templets. We suggest that BP antigen gene may be separated by some introns. We will prepare cDNA probes and recombinant antigens using PCR product in order to elicit autoimmunity mechanism of BP.

Chronic pancreatitis (CP) is a chronic inflammatory and fibrotic disease of the pancreas caused by a variety of causes. The basic treatment principle of CP is to remove the etiology, control the symptoms, improve the pancreatic secretory function and prevent the complications. At present, more and more studies have been conducted on CP treatment strategies. The step-up approach and the surgery first approach are both effective strategies for CP treatment. In clinical practice, endoscopic intervention can be the preferred treatment for pancreatic pseudocyst, pancreatic duct stone, and biliary stenosis. Partington operation is the first choice for dilated main pancreatic duct patients without pancreatic head lesion. Patients with pancreatic head lesions should be intervened with the Beger or Frey operation. For patients without main pancreatic duct dilatation, pancreatectomy should be performed according to the specific lesion location. The total pancreatectomy is advisable for patients with total pancreatic inflammatory disease or multiple lesions of pancreas. Surgeons should follow the individualized and multidisciplinary treatment concepts and strategies in choosing surgical procedures, especially for the control of surgical indications, timing and methods. The authors comprehensively analyze the research progress at home and abroad, elaborate the endoscopic treatment and surgical intervention strategies of CP in order to further optimize the overall efficacy of CP.

In order to study the relationship of keratin 5 gene and Weber-Cockayne epidermolysis bullosa simplex (WC-EBS), we use polymerase chain reaction (PCR) amplification combined with single strand conformation polymorphism (SSCP) methods and DNA sequenceing to detect the point mutation of keratin 5 in a family of WC-EBS. The results showed that there is a G→T substitution at the third base pair of codon 327, which caused methionine changed into isoleucine. This abnormality of keratin structure makes the normal assembly of tonofilaments impossible. Furthermore, the above change resulted in blister formation and epidermolysis clinically. This indicates that PCR-SSCP is useful for the gene and prenatal diagnosis of genodermatoses and also provides the basis of theroies for gene therapy.

Objective To study the gene mutation in a pedigree with Dowling-Meara type epidermolysis bullosa simplex (DM-EBS). Methods Using the immuno-histochemistory, electron microscopy, PCR-HA and DNA sequencing. Results The cytolysis was observed throughout the lower basal layer, tonofilaments were decreased; using PCR-HA, the K14 gene mutation was detected. By DNA sequencing, we found gene mutation in this pedigree: K14 1A domain: N123R. Conclusion There is K14 1A domain gene mutation in this DM-EBS pedigree.

Objective To summarize the diagnostic and therapeutic experience on chronic pancreatitis characterized by a pancreatic mass. Methods The clinical data of 28 cases of chronic pancreatitis with mass undergoing surgical operations were retrospectively analyzed in our hospital from June1999 to June 2009. Results Among the 28 cases, 19 were diagnosed as carcinoma, 9 cases were diagnosed as chronic pancreatitis respectively before operation. Needle aspiration biopsy and/or postoperative pathology identified chronic pancreatitis in all cases. The symptom included abdominal pain (22 cases),jaundice (15 cases), and obstruction of duodenum (4 cases). Pancreaticoduodenectomy was performed in 17 cases, choledochojejunostomy performed in 3 cases, pancreatojejunostomy performed in 1 case.Duodenum-preserving resection was performed in 4 cases, and resection of body and tail of the pancreas were performed in 3 cases. There was no operative death. Postoperative complications included pancreatic leakage (2 cases), severe gastroplegia (2 cases) and stress peptic ulcer with massive bleeding ( 1 case). All patients got follow-up ranging from 6 months to 5 years. Recurrence of abdominal pain developed in 7 cases after 2 years. Canceration of pancreatic mass was found respectively in 8 months, 1 year after operation in one each cases. Conclusion Preoperative differential diagnosis of chronic pancreas and pancreatic tumor was difficult. Although needle aspiration biopsy is the effective method for diagnosis, there may be still a possibility of missed diagnosis/misdiagnosis.

Objective To explore the clinical features and perioperative treatment effects of colorectal cancer in elderly patients.Methods Retrospective analysis of clinical data especially focusing on perioperative treatment from 104 elderly patients with coloreetal cancer were performed.Results A total of 99 patients (95.2%) were cured or improved at discharge.Perioperative pulmonary infection occurred in 13 cases (12.5%), of whom 6 cases (5.8%) suffered from respiratory failure.Lower extremity deep venous thrombosis occurred in 3 cases (2.9%), incision infection in 6 cases (5.8%), wound dehiscence in 2 cases (1.9%), intestinal fistula in 1 case (1.0%) and gastroparesis in 1 case (1.0%).About 5 cases (4.8%) died from multiple organ failure.Conclusions Old age is not a contraindication in surgical treatment for colorectal cancer.Paying attention to accurate and timely treatment in perioperative peroid can reduce postoperative complications and improve patients' quality of life.

For patients with malignant pancreatic cancer combined with vascular invasion,radical pancreaticoduodenectomy with vascular resection and anastomosis is the treatment of choice.Because this procedure is difficult to manage and with high risks,it is a great challenge to surgeons.A 50-year old patient with pancreatic head cancer whose portal vein and superior mesenteric vein were involved received radical pancreaticoduodenectomy in the Second Affiliated Hospital of Harbin Medical University.In the surgery,the tumor and its surrounding tissues were dissected,and then the portal vein and splenic vein were reconstructed.The patient was discharged at the 10th day after the surgery with favorable prognosis.

Objective To analyze the screening results of yon Willebrand factor among patients before blood transfusion in Ruijin Hospital and discuss von Willebrand factor in ABO blood group and the relationship between age and gender,refine the classification of vWF antigen and activity by reference factors.Methods The von Willebrand factor among 247 cases of patients before blood transfusion in Ruijin Hospital with no clinical manifestations of abnormal blood clots and routine coagulation as laboratory tests for normal surgical patients.The vWF:Ag and vWF:Act were measured by immune turbidimetric method and ABO blood group was identified by blood type serology.Furthermore,the differences between A,B,O,AB different blood groups,sex and high (≥40 years) and low age group (＜40 years) were compared by statistical methods.Results The levels of vWF:Ag in different blood groups were as follows:A blood type:98.5-142.00,B blood type:97.90-160.30,O blood type:82.13-125.45,A B blood type:103.00-135.80.The levels of vWF:Act in different blood groups were as follows:A blood type:76-130.14,B blood type:78.06-144.3,O blood type:60.89-116.11,AB blood type:88.99-124.09.O blood type vWF:Ag and vWF:Act were lower significantly (P＜0.05) than non-O blood type,the difference was.Besides,young vWF:Ag and vWF:Act were lower significantly than in the elderly.There was no significant difference in vWF:Ag and vWF:Act levels between male and female groups.At last,the reference range of four groups of vWF activity (antigen) was obtained.Conclusion Plasma vWF antigen and activity levels were significantly affected by ABO blood type and age,and the refined reference range established for these influencing factors was beneficial for more detailed diagnosis of VWD and predicting vWF levels associated with bleeding and thrombosis risk.

AIM: To evaluate the effects of hyperthermic peritoneal chemiotherapy (HPC) on cardiovascular system. METHODS: Twenty-six patients whose age was 31 to 75 receiving gastric cancer radical resection followed by HPC were involved in this trial. All hemodynamic parameters were recorded during whole procedures. RESULTS: The blood temperature(T) increased significantly during HPC; cardiac index increased immediately when HPC began( P

Objective To determine the peripheral dose ( PD) of a Trilogy accelerator under different conditions and the feasibility of PD measurement using the semiconductor diode ionization chamber. Methods In a solid water phantom, a CC13 air?filled ionization chamber and a semiconductor diode ionization chamber were used for PD measurements with different distances (13 measurement locations within 1?31 cm) , depth ( 3, 5, 15 cm) , field sizes ( 10, 20, 30 cm) , wedge ( W15, W45, VW15, VW45) , and beam energy (6, 18 MV). The relationship of PD with PDleakage and PDscat er was determined by removing the scatter phantom. Simulating the patients with cervical cancer undergoing radiotherapy, a CIRS phantom received volumetric modulated arc therapy ( VMAT) , step?shoot intensity?modulated radiotherapy ( IMRT) , and sliding?window IMRT to measure PDs of the breast, thyroid, and lens. All the data were normalized to the isocenter. Results PD was gradually reduced with the increase in distance ( 13?41% at 1 cm from the edge to 0?25% at 31 cm from the edge) . With a fixed distance from the edge of the radiation field, there was no significant difference in PD between different depths. A radiation field with a size of 30 cm had a PD about two?fold higher than that with a size of 10 cm. PD increased with the increase in the physical wedge angle and increased by 1% compared with the open field;PD decreased with the increase in the virtual wedge angle and decreased by 2?3% compared with the open field. PD decayed from 13?35% at 1 cm to 0?23% at 31 cm under 6 MV X?ray and from 11?06% at 1 cm to 0?20% at 31 cm under 18 MV X?ray. Dscat er was dominant in the regions close to the edge of radiation field and decreased from 62?45% at 1 cm to 5?71% at 25 cm. In all measurements under 6 MV X?ray, the maximum proportion difference between CC13 ionization chamber and diode ionization chamber was less than 1%. PDs of the breast, thyroid, and lens were 6?72, 2?90, and 2?37 mGy in VMAT mode, 7?39, 4?05, and 2?48 mGy in step?shoot IMRT mode, and 9?17, 4?61, and 3?21 mGy in sliding?window IMRT mode, respectively. Conclusions For the measurement of PDs, the CC13 air?filled ionization chamber and semiconductor diode ionization chamber have good consistency and feasibility under 6 MV X?ray. In clinical practice, the understanding of the relationship of PD with different radiation conditions helps to reduce the doses to organs at risk. Shielding and protective techniques can further reduce dose deposition.