Objective To explore the relationship between anomalous pancreaticobiliary ductal junction(APBDJ) and gallbladder carcinoma. Methods The current related literatures were reviewed.Results APBDJ was associated with gallbladder carcinoma development. A proposed mechanism was free reflux of pancreatic juice into the gallbladder and molecular alterations of gallbladder epithelial cells.Conclusion APBDJ is a high risk factor for gallbladder carcinoma. Prophylactic cholecystectomy is recommended for patients with APBDJ.

Objective To review the recent studies regarding etiology and management of diarrhea after liver transplantation. Methods The current related literatures about the etiology and management of diarrhea after liver transplantation were reviewed. Results There were approximately 10.00% to 35.44% recipients developed diarrhea after liver transplantation. Other symptoms such as severe body fluid and electrolyte loss, discomfort, and increase blood level of immunosuppressive drug can be caused by diarrhea as well. Clostridium difficile, cytomegalovirus, rotavirus infection and immunosuppressant were main etiological factors. It is important to find out the inducement of diarrhea and work out the corresponding management and other supportive care on the basis of the etiology. Conclusion Diarrhea is a common complication of liver transplantation whose etiology is complex. Appropriate approaches may be helpful to decrease the risk of this complication.

Objective:To evaluate the expression of EGFR and gene nm23H1 and their relation to the tumor oncogenesis and progress of cholangiocarcinoma.Methods:SABC immunohistochemistry was used to detect the expression of EGFR and nm23H1 in cholangiocarcinoma and cholangitis tissue.Results:The positive rate of nm23H1 in cholangiocarcinoma was lower than cholangitis(P

Peroxisome proliferator-activated receptor(PPAR) belongs to the superfamily of nuclear hormone receptor.Three PPAR subtypes have been identified to date(PPAR?,PPAR? and PPAR?)and the relationship between PPAR? and tumor has drawn great attention.Current data showed that PPAR? agonists exert their antineoplastic effect through inhibiting cell growth and angiogenesis,inducing cell apoptosis and differentiation,and reducing tumor invasive ability.PPAR? agonists may be a promising tool for cancer chemotherapy.

Objective To investigate the protevtive effect and mechanism of early using selective digestive decontamination (SDD) on severe acute pancreatitis(SAP) in rats.Methods Sixty rats were randomly assigned into SAP group and SAP+SDD group after SAP model was set up.Rats in the SAP+SDD group underwent SDD immediately after the model was established and last for 3 days. The peripheral and portal vein serum endotoxin, tumor necrosis factor -a (TNF-a) and interleukin -1 (IL-1) at 24 hours, 48 hours, and 72 hours and the mortality, average living time and the degree of pancreatic necrosis were observed and compared in the 2 groups. Results The levels of peripheral and portal vein serum endotoxin, TNF-? , IL-1,and the mortalities in SAP+SDD group were significantly lower than those in SAP group(all P

Hepatic epithelioid hemangioendothelioma is a rare and low-grade malignant tumor of vascular origin.Clinical symptoms and laboratory findings are unspecific.The definitive diagnosis can only be made by histopathalogi-cal investigation The primary treatments of choice are radical hepatic resection or liver transplantation. The role of differ-ent adjuvant therapies for patients with hepatic epithelioid hemangioendothelioma remains to be determined.

Objective To investigate antimicrobial resistance of Acinetobacter baumannii (A.baumannii)causing hospital-acquired pneumonia (HAP),so as to guide rational use of antimicrobial agents and reduce antimicrobial re-sistant rate.Methods Clinical data of patients with A.baumannii HAP in a hospital between 2009 and 2012 were collected and analyzed retrospectively.Antimicrobial resistance data were summarized and analyzed statistically ac-cording to uniformed methods.Results A total of 284 patients developed A.baumannii HAP,patients mainly distributed in intensive care unit(45.07%),department of respiratory diseases(19.01%),neurosurgery (9.15%),and neurology (5.99%).The incidences of A.baumannii HAP,multidrug-resistant A.baumannii (MDR-AB)HAP,and extensively drug-resistant A.baumannii (XDR-AB)HAP increased year by year.The total resistant rates of A.baumannii to cef-operazone/sulbactam (9.51%)and minocycline(9.86%)were low,to levofloxacin(43.66%)and ciprofloxacin(45.42%) were relatively higher;resistant rates to imipenem and meropenem were 16.20%and 20.42% respectively.The resistant rates to meropenem,imipenem,cefoperazone/sulbactam,and ampicillin/sulbactam increased year by year (all P <0.05). Conclusion Antimicrobial resistance of A.baumannii is serious,it is essential to strengthen the monitoring of antimicrobial resistance of A.baumannii,and prevent the spread in hospital.

Objective: To explore the expression and significance of MMP-9 and TIMP-1 in gastric carcinoma.Methods: S-P immunohistochemical method was used to examine the expression of MMP-9 and TIMP-1 in 47 specimens of gastric carcinoma.Results: MMP-9 and TIMP-1 were expressed predominantaly in the peritumor stromal cells than tumor cells themselves.The expression level of MMP-9 and TIMP-1 correlated with lymph node metastasis (P0 05).Conclusion: The results suggests that MMP-9 and TIMP-1 might be important biological makers for determining the malignant behave of gastric carcinoma.

Objective To compare the vibrating perception threshold (VPT) between normal subjects and subjects with cervical spondylosis of nerve root type, and to observe the clinical efficacy of acupoint injection at Quyuan (SI13) in releasing pain in cervical spondylosis of nerve root type.Method Sixty-three patients with cervical spondylosis of nerve root type were recruited and randomized into a treatment group of 35 cases and a control group of 28 cases. The treatment group received acupoint injection at Quyuan, and the control group received acupoint injection at Jiaji (EX-B2) points. The short-form McGill Pain Questionnaire (MPQ) was adopted. From the questionnaire, the Pain Rating Index (PRI), sensory (S), affective (A), and total (T) pain rating indexes, Visual Analogue Scale (VAS), and Present Pain Index (PPI) were used to comprehensively evaluate the pain improvement and to quantify the therapeutic efficacy, and the VPT was also considered. The Clinical Assessment Scale for Cervical Spondylosis (CASCS) by West China Rehabilitation Center was also used to analyze the result in the treatment group.Result After the intervention, the MPQ and VAS scores in the treatment group were significantly lower than those in the control group (P<0.05). The total effective rate of the treatment group was significantly higher than that of the control group (P<0.05). Meanwhile, the VPT was improved after the treatment.Conclusion Acupoint injection at Quyuan can produce a more significant efficacy than at Jiaji (EX-B2) in treating cervical spondylosis of nerve root type.

Objective To evaluate the optimal surgical approach for huge liver neopiasms in the caudate lobe.Methods Thirty-three patients with huge liver neplasms（≥10cm) underwent caudate lobectomy at a single tertiary referral center between January 2001 and June 2007.The surgical out-comes of pateints who underwent isolated caudate lobectomy or caudate lobectomy combined with partial hepatectomy were compared.Result Fifteen（45.5％）of 33 patients underwent isolated total or partial caudate lobectomy（group A）,whereas 18（54.5％) had total or partial caudate lobectomy cellular carcinoma (HCC) (51.5％),followed by hemangioma(21.2％),intrahepatic cholangiocarcinoma(9.1％),angiomyolipoma(6.1％),hepatic adenoma (3％),focal nodular hyperplasia(3％),colorectal liver metastases(3％)and sarcoma(3％).The median diameter of the tumour was 12.3 (range,10.2-21)cm.Patients in group A had significantly longer operative time (280 minutes vs.170 minutes),longer length of hospital stay (17 days vs.12 days)and more blood loss(1250 ml vs.670 ml) than patients in group B.There was no perioperative death in the 2 groups of pateints.Complication rates in group A and group B were 26.7％ and 16.7％ respectively.There was no disease-related death in patients with benign lesions.The1-,3- and 5-year disease-free survivals of patients with malignant lesions in group A and group B were 25.9％,0％,0％and 74.3％,46.7％,31.2％,respectively.The 1-,3- and 5-year overrall survivals were 68.6％,19.7％,0％ and 100％,66.5％,41.8％,respecively.Conclusion The approach to caudate lobectomy depends on the size and location of the lesion and the liver functional reserve.For patients with sufficient liver functional reserve,caudate lobectomy combined with partial hepatectomy is preferred because it is technically less demanding.For patienls with marginal liver functional reserve,isolated caudate lobectomy is the only viable surgical option.