Objective To assess the optimal timing of laparoscopic cholecystectomy ( LC ) in mild acute gallstone pancreatitis ( mAGP) .Methods From May 1, 2012 to August 30, 2015, consecutive patients with mAGP were prospectively assessed.Each patient underwent abdominal computed tomography scan within 48 h after mAGP onset to assess the presence of peripancreatitc fluid collection, and Marshall score was used to assess if there was organ failure.Patients with neither peripancreatic fluid collection by CT ( classified as grade A, B or C based on the Balthazar CT grading system) nor organ failure by clinical data (Marshall score <2) were randomized according to simple randomization into early laparoscopic cholecystectomy ( ELC; LC performed within 7 days after a pancreatitis attack, without waiting for symptom resolution) or late laparoscopic cholecystectomy ( LLC; LC performed ≥7 days following an attack, with complete remission of AGP symptoms) group.The mean LC operation time, bleeding during LC, post-LC complications and lengths of hospital stay between the ELC group and LLC group were compered.Results The study enrolled 102 patients with mAGP.A total of 49 and 53 patients were assigned to ELC and LLC group, respectively.The mean LC operation time and lengths of hospital stay were significantly shorter in the ELC group than in the LLC group [(19.9 ±5.3) vs(31.1 ±8.4) min;(7.9 ±1.8) vs (16.8 ±5.3) d, P<0.05], while there were no significant difference on bleeding during LC and post-LC complications.Conclusions LC for patients with mAGP who had neither peripancreatic fluid collection nor organ failure within 7 days after the onset was safe and feasible.

Objective:In this study,we examined the HLA-DPB1 alleles in patients with tuberculosis,and health individuals attempt to investigate the association between the polymorphism of HLA-DPB1 gene and pulmonary tuberculosis in Han population in Shihezi area in Xinjiang uygur autonomous region of China.Methods:High-resolution typing of DPB1 was performed by the sequence-based typing ( SBT) method using the SBT-HLA-DPB1 generic DNA typing kit.Results:In the controls ,17 HLA-DPB1 alleles were ob-served,the HLA DPB1*0501 (28.1%) and HLA DPB1*0201(27.6%) frequency was significantly higher than other sites ,the first and second respectively.The frequency of HLA-DPB1* 0201 was observed significantly increased in patient group compared with control group ( P<0.05 );the frequency of HLA-DPB1* 0501 was observed significantly decreased in patient group compared with control group ( P<0.05 ).Conclusion: The gene frequencies of HLA-DPB1 in Xinjiang Shihezi Han population are roughly in consistence with other northern Chinese Han population;the HLA-DPB1*0201 may be the protective factor to pulmonary tuberculosis , and HLA-DPB1*0501 may be susceptible to pulmonary tuberculosis in Han population from the Xinjiang uygur autonomous region of China.

Objective To investigate the appropriate method in diagnosing precursor lesions of pancreatic cancer and its treatment. Methods From Jan. 2006 to Dec. 2007, 92 cases were operated for pancreatic neoplasms. Among them 7 cases had pancreatic precursors. The mucinous cystic neoplasm was found in 1 case, intraductal papillary mucinous neoplasm(IPMN) in 2 cases, endocrine tumor in 1 case and pancreatic intraepithelial neoplasia (PanIN) in 3 cases. CA19-9 level was tested by immunoflucence assay. All of the 7 patients were examined by CT. Endoscopic ultrasound(EUS) and endoscopic retrograde cholangio-pancreatography examinations were performed on 1 and 2 patients respectively. Results There was neither specific symptom related to these precursors nor any evidence of mass as revealed by CT or ultrasound. But dilatation and stricture of pancreatic duct were found in PanIN patients, and cystic dilatation of pancreatic duct in pancreatic head was present more in IPMN patients. For cystic neoplasms in pancreatic body and tail, they were commonly solid and isolated. CA19-9 level was slightly elevated in some patients but with no diagnostic value. Surgical resection was done with excellent result. Conclusion For the suspected pancreatic precursors, aggressive diagnostic approach and surgical resection will be the best option and can further prevent cancer development.

Objective: To investigate the causes and management of enteral feeding intolerance in patients with severe acute pancreatitis (SAP). Methods: The clinical data were retrospectively analyzed of 128 SAP patients who underwent enteral feeding treatment during the period from January 2006 to January 2008. Results: The rate of enteral feeding intolerance was significantly higher in the group of patients who didn' t use Flocare 800 pump, single-use enteral feeding tube and heater (10/50 or 20.0%) than that in the group of patients who used Flocare 800 pump, single-use enteral feeding tube and heater (5/78 or 6.4%). Conclusion: The possible risk factors of enteral feeding intolerance may be transfusional speed, temperature and concentration of nutritional fluid. Severity of acute pancreatitis is another important factor. Intestinal dysfunction should be noticed during the enteral nutritional support.

Objective To investigate the etiology of acute recurrent pancreatitis (ACP) and de-termine how to further enhance its level of treatment.Methods The clinical data of 33 patients with ACP treated in Ruijin Hospital from 2003 to 2007 were retrospectively analyzed.Results Of the 33 patients with an average age of 55 (22-86), 18 (55%) were male and 15 (45%) female.ACP occurred once in 26 patients, twice in 4 and 3 times in 3.The disease appeared whithin 1 year in 29 patients, 1-2 years in 2, 2-3 years in 1 and 3 years in 1 after being dischared from hospital.For its etiology, it was of biliary origin in 29 patients, hyperlipidemia in 1, pancreatic tumor in 1 and unknow reasons in 2.Twenty-four patients were treated with operation or endoscopy.Two patients died and the mortali-ty was 9.1%.Conclusion ACP is mainly due to biliary origin in China.Operative intervention at an appropriate opportunity can effectively reduce the recurrence of biliary-origin pancreatitis.

ObjectiveTo investigate the single nucleotide polymorphisms (SNPS) in the coding regions of the human ABCA2 gene and to determine the association of some of these SNPs with gallstone disease in a Chinese population. MethodsThe exons and part of the introns of the ABCA2 gene were sequenced using a fluorescent labeling automatic method in 24 patients with gallstone disease to identify and characterize the SNPs in a Chinese population. For SNPs in the exons, case-control studies were performed on patients and controls. ResultsTwelve SNPs were found within a 16911 bp region of the ABCA2 gene. Among them, two were in the exons, ten in the introns and five were novel SNPs. There was no significant difference in the SNPs genotype between the patients and the controis. ConclusionsThere is an important ethnic difference in the SNPs distribution of the human ABCA2 gene. The distribution of SNPs in the coding regions of the human ABCA2 gene is not significantly different between the patients and the controls.

Mycobacterium tuberculosis is the causative agent of tuberculosis(TB),which is still the leading cause of mortality from a single infectious disease worldwide.The development of novel anti-TB drugs and vaccines is severely hampered by the complicated and time-consuming genetic manipulation techniques for M.tuberculosis.Here,we harnessed an endogenous type Ⅲ-A CRISPR/Cas10 system of M.tuberculosis for efficient gene editing and RNA interference(RNAi).This simple and easy method only needs to transform a single mini-CRISPR array plasmid,thus avoiding the introduction of exogenous protein and minimizing proteotoxicity.We demonstrated that M.tuberculosis genes can be efficiently and specifically knocked in/out by this system as con-firmed by DNA high-throughput sequencing.This system was further applied to single-and multiple-gene RNAi.Moreover,we successfully performed genome-wide RNAi screening to identify M.tuberculosis genes regulating in vitro and intracellular growth.This system can be extensively used for exploring the functional genomics of M.tuberculosis and facilitate the development of novel anti-TB drugs and vaccines.