ObjectiveTo improve the diagnosis and treatment of duodenal carcinoma (DC).Methods A retrospective study was made on the diagnosis, treatment and prognosis of 45 duodenal carcinoma patients. Results The detection rate of DC by duodenoscopy was 95% (20/21), 96% (22/23) by hypotonic duodenography, 29% (13/45) by B ultrasound, 73% (19/26) by CT, and 80% (4/5) by MR. Forty four cases underwent surgery with resection rate of 53% (24/45), radical resection rate of 42% (19/45). The postoperative (radical resection) 1, 3, 5 year survival rate was 91%, 39%, and 26%, while the median survival time was 5 months in cases with unresectable tumor. Conclusions Duodenoscopy and hypotonic duodenography are ideal tools for the diagnosis of DC. For DC cases with obstructive jaundice, B ultrasound, CT and MR could show the obstructive portion and the metastasis.Radical resection is the mainstay for a long term survival.

Objective To design a novel efficient CEA vaccine of fission epitopes with the vehicle of HPV16L1,and construct the recombinant baculovirus in Bac-to-Bac baculovirus expression system.Methods The recombinant baculovirus expression vector pFastBac1-V was constructed.HPV16L1 and CEA-PADRE synthesis primers were inserted into bacmid in E.coli DH10Bac with the help of Tn7 transposition system.Then the recombinant baculovirus was got by infecting insect cell sf9.Results HPV16L1 and CEA-PADRE synthesis primers that were cloned to the baculovirus transfer vector pFastBac1 were assessed by restriction analysis and direct sequencing.The recombinant baculovirus of the novel vaccine had been constructed.After infected sf9,the correct fragment was amplified by PCR.Conclusion The baculovirus of CEA vaccine of fussion epitopes with the vehicle of HPV16L1 was constructed.

Objective To focus on the complication and manipulation of the ventricle-peritoneal(V-P) shunt operation.Methods The former clinical datas of the V-P operation were reviewed .Results Death rate was 13 percent,infect rate was 13 percent and re-operation rate was 18 percent.Conclusion The rate of the V-P operation complications is so high that avoiding the complications is important to improve success.

Objective To investigate the renoprotective effects of autologous transplantation of adipose-derived mesenchymal stem cells (ADMSCs) in diabetic rats. Methods Sprague-Dawley (SD) rats were injected intraperitoneally with 40 mg/kg streptozotocin (STZ) for 5 consecutive days to induce type 1 diabetes. Four weeks following STZ injection, eighteen SD rats were randomized into two groups: the diabetic group (n = 9) and the ADMSCs group (n = 9). Normal nondiaetic rats were set as the normal control (n = 9). Autologous ADMSCs were cultured and identified in vitro , which were intravenously injection to the ADMSCs group rats via the tail vein. At 8 weeks after transplantation, levels of blood glucose, insulin, serum urea nitrogen, serumcreatinine and urine protein were measured. Meanwhile the body weight and kidney weight were examined. Results Mesenchymal cell surface markers were expressed in the cultured ADMSCs. The ADMSCs could differentiate into the adipogenic and osteoblastic lineages. Both the diabetic group and the ADMSCs group rats had higher levels of blood glucose , urea nitrogen , serum creatinine , urine protein and higher ratio of the kidney weight/body weight than those in the normal control group (P < 0.05, respectively). Blood glucose, urea nitrogen and the ratio of kidney weight/body weight in the ADMSCs group rats were significantly decreased compared with the diabetic group (P < 0.05, respectively). The decreased insulin level was attenuated after transplantation of ADMSCs (P < 0.05). Besides, levels of serum creatinine and urine protein in the ADMSCs group were lower than those in the diabetic group with no significant difference. Conclusion Autologous transplantation of ADMSCs can improve metabolic disorder and relieves diabetic renal damage.

Objective To compare the sensitivity and specificity of interferon-gamma release assay(IGRA) in the Tibetan and Han patients with pulmonary tuberculosis(TB),and to investigate its clinical application value for screening Tibetan patients with pulmonary TB.Methods Sixty-four Tibetan cases of pulmonary TB,41 Tibetan cases of non-pulmonary TB,40 Han cases of pulmonary TB and 38 Han cases of non-pulmonary-TB in our hospital from April 2013 to April 2015 were selected and performed IGRA.T cells infected by mycobacterium tuberculosis were detected by ELISA.The difference between Tibetan abd Han nationalities was compared.The clinical value of IGRAfor screening Tibetan patients with pulmonary TB was evaluated by calculating the statistical indicators.Results The sensitivity,specificity,positive predictive value and negative predictive value of IGRA for diagnosing Tibetan pulmonary TB were 90.62%(58/64),80.49%(33/41),87.88%(58/66) and 84.62%(33/39) respectively,which for diagnosing Han patients with pulmonary TB were 92.50%(37/40),84.21%(32/38),86.05%(37/43) and 91.43%(32/35) respectively.The sensitivity and specificity of IGRA for diagnosing Tibetan and Han pulmonary TB had no statistical difference(χ2=0.005,P=0.944;χ2=0.018,P=0.893).Conclusion IGRA has high value for early diagnosis of Tibetan pulmonaty TB and is conducive to screening of early pulmonary TB.

Background and purpose: About 20 cases of BML have been reported in the literature,they occurred in females with history of uterus leiomyoma.BML appears as a histopathologic benign smooth muscle tumor located far from the uterus,often in the lungs.Firstly,it should be confirmed as originating from smooth muscle by immunohistochemistry,Secondly,its primary tumor should be confirmed as benign,with mucoid degenenation,it also should be distinguished from myxoid leiomyosacroma.Methods:We report a case of benign metastasizing leiomyoma,study its clinical,histopathologic and immunohistologic features,discuss the diagnosis and differential diagnosis and give a review of the related references.Results:The case occurred in a forty-two year old female who was found to have bilateral lung nodules after hysterectomy of her uterus leiomyoma six years ago.An open lung biopsy revealed the nodules to consist of proliferating smooth muscle cells with a histopathologic feature similar to her uterus leimyoma,consistent with the diagnosis of BML.Positive staining of estrogen and progesterone receptors was detected in both the uterus leiomyoma and the metastasizing lesions.No significant increase or enlargement of the lung nodules were found seven months after the operation with no therapy except taking Chinese traditional medicine.Conclusions:BML is a rare entity usually occurring in females with history of uterus leiomyoma.It appears as a histopathologic benign smooth muscle tumors distant from the uterus.It is hormone dependent and progresses slowly.

OBJECTIVE To investigate the distribution and resistance of clinical isolates to antimicrobial agents commonly used.Antimicrobial agents should be used rationally based on the results of susceptibility testing.METHODS The clinical isolates were identified with W/A-40 or VITEK-32.The results were analyzed by WHONET 5.3 software according to CLSI 2005.RESULTS A total of 2892 clinical isolates were collected in 2007.Gram-negative bacilli accounted for 68.2% and Gram-positive cocci accounted for 31.8%.The top eight pathogens were Pseudomonas aeruginosa,Escherichia coli,Klebsiella spp,Acinetobacter spp,coagulase-negative Staphylococcus,Enterobacter spp,Serratia spp and S.aureus.About 76.4% of S.aureus isolates were MRSA,81.6% of coagulase-negative Staphylococcus isolates were meticillin-resistant.Under 20.0% of Enterobacteriaceae strains were resistant to cefoperazone/sulbactam,imipenem and piperacillin/tazobactam.About 16.3% and 32.5% of P.aeruginosa isolates were resistant to cefoperazone/sulbactam and imipenem.CONCLUSIONS Gram-negative bacilli were dominant isolates in our hospital during 2007.P.aeruginosa is the most frequent pathogenwith severe antibiotic resistance.Enterobacteriaceae are susceptible to cefoperazone/sulbactam and imipenem.

Objective To investigate the clinical features,therapeutic approach and prognosis of focal nodular hyperplasia (FNH) of the liver. Methods Clinical data of 34 FNH patients confirmed by operation were analyzed retrospectively. Results Focal nodular hyperplasia of the liver was found mainly in males (67. 6% ) , Mean nodular size was significantly smaller in men than women. Most of the patients (64.7%) had no significant clinical symptoms. Tumor markers including CA19-9 and A-fetoprotein were within normal range. MRI is helpful to achieve a more accurate diagnosis of the disease, correct preoperative diagnosis rate was 54. 5%. All patients underwent liver resection with no recurrence within 17 - 134 months of follow up. Conclusions FHN of the liver is benign in entity. If a definite diagnosis can be obtained preoperatively, observation follow-up are recommended. Hepatectomy is indicated when there is a suspicion of malignancy.

Objective To investigate the clinical characteristics, diagnosis, treatment and prognosis of hepatic angiomyolipoma (HAML). Methods The clinical data of 14 patients with hepatic angiomyolipoma admitted in our hospital from 1989 to 2007 were analyzed retrospectively. Result There were 4 male patients and 10 female patients. Median age was 41 years old. The lesions located in right lobe in 8 patients, and in left lobe in 6 patients. B-US was taken in 12 patients before operation, and other examinations included CT in 8 patients, MRI in 7 patients and angiography in 2 patients. Five patients were diagnosed with HAML by imagine features. Fine needle biopsy was taken in 1 patient with no definite diagnosis. All patients underwent resection and got the histopathologic diagnosis with HAML. All specimens were HMB-45 positive. S-100 and SMA were tested in 7 and 6 patients respectively, and were positive in all those patients. All cases were followed up for 6 months to 18 years (median time was 3 years). 13 patients were still alive without recurrence and 1 patient died of postoperative DIC and heart failure. Conclusion There was marked female predominance in HAML. Imaging features are helpful for preoperative diagnosis of HAML, but correct diagnosis was achieved in only a fraction of patients. HMB-45 positive was definitive proof for histopathologic diagnosis of HAML. Hepatectomy was an effective treatment for HAML.

Objective To summarize the experience in the diagnosis and treatment for solidpseudopapillary tumors of the pancreas (SPTP). Method In this study, 27 cases of SPTP from September 2000 to June 2007 were retrospectively analyzed. Results The median age of these 27 cases was 26 years. There were 26 females and 1 male. Epigastric pain was complained in 16 cases, abdominal aponia mass in 11 cases. Tumour marker level was within normal range. Ultrasonic manifestation usually shows cystic and solid lesion without blood signal. Lesions were typical with high blood supply in enhanced CT scan, cystic and solid component confounding in it. MRI revealed low-middle signal in T1 and middle-high signal in T2. Pancreaticoduodenectomy was performed in 9 cases, pancreatic local excision and pancreaticojejunostomy were performed in 4 cases, pancreatic local excision was performed in 6 cases, Distal pancreatectomy and spleen resection were performed in 8 cases. Post-operative pathology shows local lesion in 12 cases, invading the pancreatic parenchyma in 14 cases and intravascular tumor thrombi and lymphnode metastasis in 1 case. All cases were followed up with an average period of 26.1 months. There was no recurrence nor metastasis. Conclusion Solid-pseudopapillary tumor of the pancreas has a low malignant potential, affecting primarily young women. It has no typical clinical appearance. Enhanced CT scanning has the relative characteristic imaging. Complete resection usually results in long-term survival.