Objective To evaluate the influence different of operation opportunity on clinical effects of laparoscopic cholecystectomy in the treatment of patients with acute gallstone pancreatitis.Methods A retrospective analysis was made on 93 patients with acute gallstone pancreatitis,laparoscopic cholecystectomy was performed in all patients.And the patients were divided into research group(early:within 48 h)and control group(delay:over 8 to 12 weeks)by operation opportunity.The operation index,biochemical index,quality of life,recurrence and complication occurrence between the two group were compared.Results There were no significant differences in the amount of blood loss and operation time between the two groups(t=0.332,0.486,all P>0.05).The hospital stay of the research group was lower than that of the control group[(11.43±2.65)d vs.(20.51±3.42)d],the difference was statistically significant(t=14.245,P<0.05).7 d after operation,the biochemical indicators of the two groups were all decreased,and had significant differences compared with 1 d after operation(t=17.184,35.209,12.018,7.452,16.045,36.124,12.337,7.038,all P<0.05).But there was no significant difference in biochemical index between the two groups at 7 d and 1 d after operation(t=0.431,0.663,0.664,1.118,0.085,0.156,0.283,0.262,all P>0.05).The life quality of the two groups were greatly improved after treatment,and had significant difference compared with before treatment(t=5.017,7.028,6.124,3.095,6.023,6.995,6.184,3.128,all P<0.05).There were no significant differences in the incidence rates of recurrence and complications(4.44% vs 2.08%,6.67% vs.10.42%)between the two groups(x2=0.412,0.081,all P>0.05).Conclusion Early laparoscopic cholecystectomy can shorten the length of stay in patients with acute gallstone pancreatitis ,and with good clinical effects and safety.

Focal adhesion kinase(FAK),the non-receptor tyrosine kinase,has been implicated in regulating a number of fundamental biological signal transudation pathways that control cell proliferation,survival,adhesion,motility.Many researches have reported that FAK highly expressed in many cancers and involved in the process of cancer development,such as initial,progress,metastasis,multi-drug resistance of cancer.FAK has been the hotpot in cancer research,and it will be a new target in cancer therapy.

0\^05). The negative rate of DIGFA in healthy people was 100%(40/40). The cross reaction rate in 20 cysticercosis cases and 25 schistosomiasis cases were 5%(1/20) and 4%(1/25), respectively. Both coincidence rates comparing DIGFA with dot\|ELISA were 90\^9%(50/55). Conclusion DIGFA is as sensitive and specific as the dot\|ELISA,and has the advantages of simplicity and without specific equipment.

Objective To investigate the correlation between the walking function status and the quality of bowel preparation for colonoscopy in the elderly patients. Methods Two hundreds elderly (over 70 years) patients undergoing colonoscopy were selected. The walking function status was evaluated by the ability of daily living scale (Schonberg index), and the patients were divided into normal walking group (114 cases) and difficulty walking group (86 cases). Patients in the 2 groups accepted the unified intestinal preparation programs and education guidance. The patients′ compliances to preparation instructions were observed. The causes of non-compliance were investigated. The quality of bowel preparation was assessed using the Boston bowel preparation scale (BBPS). The correlation between walking function status and compliance or quality of bowel preparation was analyzed with the Spearman rank correlation test. Results The proportion of failing to completely take the intestinal cleanser was lower in the difficulty walking group than that in the normal walking group: 53.5% (46/86) vs. 26.3%(30/114), and there was statistical difference (χ2=15.362, P<0.05). The reasons for failing to completely take the intestinal cleanser in the difficulty walking group were as follows: unconvenient of frequently walking to the restroom to defecate (39 cases) , forgetting (4 cases) and adverse reactions (3 cases). The good proportion of bowel preparation compliance and sufficient rate of bowel preparation in difficulty walking group were significantly lower than that in normal walking group: 41.9% (36/86) vs. 65.8%(75/114) and 55.8% (48/86) vs. 72.8% (83/114), and there were statistical differences (χ2 = 11.365 and 6.264, P<0.01 or<0.05). There was no significant difference between 2 groups in the constituent ratio of strictly implementing the bowel preparation program (P>0.05). The correlation analysis result showed that the walking function status was positively correlated with compliance and quality of bowel preparation in the elderly patients (r=0.238 and 0.177, P<0.05). Conclusions The walking function status is correlated to the quality of bowel preparation in elderly patients undergoing colonoscopy. Difficulty walking may indicate the poor compliance and poor colonoscopy preparation in the aged.

Objective To study the genetic variation of two mitochondrial DNA molecules (CO1 and Cytb gene) of Oncomelania hupensis isolated from different areas. Methods Snails were collected from Jingxi of Guangxi,Yueyang of Hunan and Eryuan of Yunnan. Genomic DNA was extracted from the snails,Co1 and Cytb gene fragments were amplified by PCR,then purified and sequenced. Sequences of each isolates were edited by using Clustal W(1.82) software,and the nucleotide composition,transition and transversion were accounted by using MEGA(3.1) software. The genetic distances were computed with Kimura method and phylogenetic trees were constructed with UPGMA and MP method respectively. Results CO1 and Cytb gene fragments were about 700 bp and 600 bp(including 2 primers) respectively. A total of 106 mutation spots (15.9%) were tested in CO1 homological nucleotides,and 165 mutation spots (28.5%) were tested in Cytb homological nucleotides. The distance matrix between Guangxi isolate and Hunan isolate was 0.051 and 0.031 for CO1 gene and Cytb gene respectively;while that between Guangxi and Yunnan isolates was 0.158 and 0.405 respectively. Phylogenetic trees constructed by UPGMA and MP took on the similar topo-structure:isolates of Guangxi and Hunan clustered into one group,while the Yunnan isolate exhibited as another group. Conclusion Oncomelania hupensis in Guangxi,Hunan and Yunnan are of relatively rich polymorphism in CO1 and Cytb genes in general.

Objective To compare the efficacy of the emergency ESWL within 24 hours after the onset of renal colic and elective ESWL at 5 - 7 days after the onset of renal colic in the treatment for ureteral stones.Method From January 2008 to October 2009, 365 patients in the Second Hospital of Nanchang, with ureteral stones were admitted to our department for renal colic. They underwent emergency ESWL or elective ESWL with HK. ESWL- 108 energy electromagnetic shock wave lithotripter. Success rate of fragmentation, stone-free rate after 2 weeks of operation, pain recurrence rate, and complications were evaluated. The data were analyzed using SPSS 15.0. Results The success rate of fragmentation and the stone-free rate after 2 weeks of emergency ESWL were 96.76% and96.21%, respectively, which were higher than those (88.33% and 87.22%, respectively) of elective ESWL ( P ＜ 0. 05). The postoperative pain recurrence rate of emergency ESWL ( 4.32 % ) was lower than that (9.44%) of elective ESWL ( P ＜0.05). There was no difference of total complications between emergency ESWL (3.24%) and elective ESWL (2.78%) group (P ＞0.05). Conclusions Emergency ESWL is superior to selective ESWL and is the safe and effective method for the management of ureteral stones.

Objective To investigate the expression and clinicopathological significance of metastasis-associated 1 (MTA1), matrix metalloproteinase-9 (MMP-9) and vascular endothelial growth factor-C (VEGF-C) in a gastric adenocarcinoma.Methods The expressions of MTA1, MMP-9, and VEGF-C were detected with immunohistochemical method in 120 cases of gastric adenocarcinoma tissues and 30 cases of normal gastric tissues.Results The positive percentage of MTA1, MMP-9, and VEGF-C proteins in gastric adenocarcinomas was 76.7％ , 71.7％ , and 64.2％ , respectively, which was significantly higher than that (33.3％, 36.7％, and 30.0％) in normal gastric mucosa tissues (P ＜0.05).The expressions of MTA1, MMP-9, and VEGF-C were significantly higher in gastric carcinoma invasion serous membrane, lymph node metastasis, clinical Ⅲ ～ than that in non-invasion serous membrane, non-lymph node metastasis, and clinical Ⅰ ～ Ⅱ (P ＜ 0.05).The expression of MTA1 had significantly positive correlation with that of MMP-9 (P ＜ 0.05) and VEGF-C (P ＜ 0.05) in gastric adenocarcinomas.Conclusions The expressions of MTA1, MMP-9, and VEGF-C were higher in gastric adenocarcinomas than normal gastric mucosa tissues.They may play an important role in the invasion and metastasis of gastric carcinomas.MTA1 may promote infiltration, invasion, and lymph node metastasis of gastric carcinoma through regulation of the expressions of MMP-9 and VEGF-C.The combined detection of MTA1, MMP-9, and VEGF-C expressions has important value to judge the grade malignance of gastric adenocarcinomas.

The hydroa vacciniforme -like lymphoma is clinically manifested by rash ,fever,hepatospleno-megaly and lymphadenectasis .Pathological character showed that lymphocytes infiltrated into dermis and there were some heterocysts.Immunohistochemistory showed that Bcl -6,Bcl -2,CD3,CD8,TIA,CD4,granzyme, EBER were positive,CD56,CD20 all tested negative.The rearrangement of TCR of bone marrow cell was positive . The hydroa vacciniforme-like lymphoma is uncommon clinically ,and it is easy to misdiagnosed .The effect of tra-ditional therapy is poor ,while the allogeneic hematopoietic stem cell transplantation followed by lymphocyte and donor-derived EBV-specific cytotoxic T -lymphocyte immunotherapy is effective ,which may offer an curable therapy for HVLL.

Objective To investigate spiral CT,PET/CT and clinical manifestations in non-HIV infectious penicilliposis marneffei lung disease, to improve diagnostic level of this disease.Methods Imaging manifestations of 6 cases of non-HIV infectious penicilliposis marneffei confirmed by bronchofiberscope lung biopsy and/or pus culture were analyzed retrospectively All cases underwent chest CT,two had brain MRI,and two had PET/CT scan before treatment.Imaging appearances were observed and combined with clinical dates and literatures.Results Unilateral lung lesion was detected in 1 case,bilateral lungs lesions in 5 cases.Multiple patchy consolidation,stripe shadow in bilateral lungs or right lung were found in 3 cases, multiple nodes in 2 cases, mass with nodes in 1 case.Among 6 cases, 2 had septa interlobulare thickness,1 had tracheal fistula,2 had pericardium and pleura involvement,4 had bone destruction,1 had the brainand liver involvement.6 cases showed multiple lymphadenectasis,amalgamation and necrosis in bilateral hilar,mediastinaand the neck.2 had abdominal cavity and or retroperitoneal lymphadenectasis.On PET/CT,2 cases showed high uptake,and the range of SUV value were 1.4-13.9.Initial misdiagnosis by imaging was found in 5 cases.6 patients recovered after anti fungus treatment.Conclusion Imaging appearances of non-HIV infectious penicilliposis marneffei mainly reveals as multiple patchy consolidation,nodes and mass in bilateral lungs, all accompany with lymphadenectasis, many with bone destruction,lack of specificity, which needs lesion biopsy and pus culture to make confirmed diagnosis.

Objective To investigate the effects of 2-methoxyestradiol (2-ME) on the proliferation and apoptosis of a mouse malignant melanoma cell line B16,and to explore their mechanism.Methods B16 cells were cultured in vitro,and divided into a negative control group receiving no treatment and several intervention groups treated with 2-ME at final concentrations of 5,10,20,40 mmol/L,respectively.After different durations of treatment,inverted phase-contrast microscopy was conducted to observe the morphologic change of B16 cells,sulforhodamine B (SRB) assay to evaluate proliferative activity and to draw growth curve of B16 cells according to the absorbance value at 490 nm,flow cytometry to detect cell cycle and apoptosis,and reverse transcription PCR and real-time PCR were performed to measure the expressions of the apoptosis-inducing gene gadd45b and proto-oncogene c-myc.Results As repeated measures analysis of variance showed,there were significant differences in the inhibitory effect on B16 cell proliferation among different concentrations (5,10,20,40 mmol/L) and different treatment durations (24,48,72 hours) of 2-ME (F =1170.94,1843.04,respectively,both P ＜ 0.01),and there was a significant interaction effect between these concentrations and treatment durations (F =272.79,P ＜ 0.01).After 48-hour treatment with 2-ME at 10,20 and 40 mmol/L,the apoptosis rate of B16 cells was increased to (4.13 ± 1.12)％,(11.25 ± 2.380)％ and (19.46 ± 2.9)％ respectively,compared to (0.23 ± 0.5)％ in the negative control group (all P＜ 0.01); the proportion of B16 cells in G0/G1 phase was increased to (59.5 ± 5.6)％,(63.4 ± 8.2)％ and (70.8 ± 4.4)％ respectively,compared to (44.1 ± 3.4)％ in the negative control group.There was a significant difference in the proportion of B16 cells in G0/G1 phase among the negative control group and intervention groups (F =13.56,P ＜ 0.05).Moreover,the mRNA expression of gadd45b was significantly enhanced after 24-hour treatment with 2-ME at concentrations of 20 and 40 mmol/L (both P＜ 0.01),while that of c-myc was significantly weakened after treatment with 2-ME at 10,20 and 40 mmol/L (all ＜ 0.05) compared with the negative control group.Conclusion 2-ME can inhibit the proliferation of B16 cells in vitro,upregulate the expression of gadd45b gene and downregulate the expression of C-myc gene.