Objective To explore the management of unsuspected gallbladder carcinoma (UGC) discovered during laparoscopic cholecystectomy (LC). Methods From January 2000 to May 2007, 15 560 cases of LC were performed in our hospital, UGC was discovered in 28 of the cases. Clinical data of the 28 patients were analyzed retrospectively. Results Among the 28 cases of UGC, 12 were discovered intraoperatively, and 16 were diagnosed postoperatively.Radical cholecystectomy was performed on the 12 cases who were detected during the operation,and 5 of the 16 patients who were diagnosed after the operation.LC was carried out in the remaining 11 cases. Postoperative pathological examination showed TNM stageⅠin 3 cases, stageⅡin 23, and stage Ⅲ in 2. The patients were followed up for 7-66 months with a mean of 22 months. During the period, 19 patients died. The 1-, 3-, and 5-year survival rate of the 17 patients who received radical cholecystectomy were 76.5% (13/17), 23.5% (4/17), and 11.8% (2/17), respectively. Whereas, in the 11 patients who underwent LC, the 1-year survival rate was 45.4%; moreover, none of the 11 survived for more than 2 years. Conclusions For high-risk population, attention should be paid to UGC during operation. Most of the UGCs discovered during LC are early-stage carcinomas, which should be treated with standard radical cholecystectomy, but not LC.

Objective To discuss how to improve judgement and technique for avoiding bile duct injury during laparoscopic cholecystectomy(LC).Methods The clinical data of 39 860 patients treated by LC between October 1992 and October 2005 were analyzed retrospectively.Bile duct injury occured in 46 patients.Results Bile duct repair and T-tube drainage was performed in 26 patients and bile duct end-to-end anastomosis and T-tube drainage was performed in 4 patients,with the T-tube indwelling time for 3~12 months.The Roux-en-Y cholangiojejunostomy was conducted in 11 patients,the ligation of accessory hepatic duct was conducted in 5 pauients,the re-operation for bile duct stenosis in 4 patients,and the re-operation for stenosis after cholangiojejunostomy,in 2 patients.Conclusions Intensive anatomic knowledge and skillful surgical performance can avoid or minimize the incidence of bile duct injury.Early detection and active repair of the bile duct injury for preventing acute inflammation is the most important measure to avoid repeated operations.

Objective To investigate the clinical significance of YMDD mutation during Lamivudine therapy on chronic hepatitis B.Methods Fluorometric analysis PCR, ELISA were used to estimate the YMDD mutation, HBVDNA quantative level and HBeAg for HBV of 72 cases with chronic hepatitis B before therapy (0 month), and after Lamivudine therapy for 9,12,18 months.Results The YMDD mutation was not observed in these cases before Lamivudine therapy. The mutation was found in 8 cases (11.1%), 17 cases (23.6%) and 28 cases (38.9%) at 9, 12, 18 month for therapy. The YMDD mutation rate rose with the therapy time lasting (P＜0.05). Moreover, the YmDD mutation rate in the patients with HBVDNA quantity higher than 108 copies/ml was significantly higher than that in the patients with HBVDNA quantity lower than 108 copies/ml (P＜0.005). The YMDD variation rate in patients with HBeAg positive and in patients with HBeAg negative showed no significant difference (P＞0.05). The HBeAg negative conversion rate was significantly higher in non-mutation group than that in mutation group (P＜0.05).Conclusion The serum virus quantity may be regard as an early estimate indication of the development of YMDD mutation during Lamivudine therapy.

OBJECTIVE:To make clear the antimicrobials used for inpatients in our hospital from September 1999 to March 2000 METHODS:We sampled the records of discharged patients at the ratio of 1/3 of sickbeds in our hospital,and filled in "the questionnaire of antimicrobials used in clinical department" item by item,finally,we carried out comprehensive analysis RESU_LTS:More than half was administration of single and basic antimicrobial Combined use of antimicrobials for severe and mixed infections was rational The rate of using antimicrobials was high(79 64%),especially in preventing perioperative infections,reached nearly 100% The starting-point was high in choice of drug and the newly-developed,special and expensive drugs occupied the front place in order of consumption Combined use of drugs was unduly prevalent Most of treatment depended on experience The rate of bacterial drug resistance test was only performed in 10% of patients CONCLUSION:Rational use of drugs is the main trend,however,the measure directed against existing problem should be worked out

A series of andrographolide derivatives with the structure of 12-N-substituted-14-deoxyandrographolide were synthesized from the parent compound andrographolide.Their antitumor activities were preliminarily evaluated on various cancer cell lines and compound 4d stood out due to its potent growth inhibitory effect in comparison with andrographolide.Compound 4d also demonstrated significant antitumor effect on human hepatoma HepG2cells in vitro and on sarcoma 180 (S180) and hepatoma 22(H22)-bearing mice in vivo.Then,the apoptosis induced by compound 4d in HepG2cells was detected by Annexin V/PI double staining assay.Further mechanic study showed that the expression of p53 and Bax was significantly elevated and that of Bcl-2was downregulated in 4d-treated HepG2cells.Collectively,these data suggested that compound 4d had remarkable antitumor effect both in vitro and in vivo and could effectively induce apoptosis via a p53-dependent pathway in HepG2 cells,thus deserving further investigation.

Objective To discuss about the relationship between the occurrence of the uterine cervix cancer and the risk factors.MethodsAmong the patients we collected,92 patients were diagnosed to have the cervical cancer,63 patients were diagnosed as CINⅢ (the cervical intraepithelial neoplasia,CIN),and 252 patients belonged to the control group.All patients had not been cured before.We used the questionnaire to investigate them about the dietary habit and other information.Through using different statistical Methods ,we explored the relationship between the cervical cancer and the potential factors.ResultsWe found out that many factors contributed to the happening of the cervical cancer,such as gynecopathy(χ2=19.31,P＜0.01),the first time of the menses(F＝11.62,P＜0.01),the first time of the sex life(F＝25.76,P＜0.01),the first time of the parturition (F＝28.02,P＜0.01),the times of the pregnancy and the parturition(F1＝13.98,P1＜0.01;F2＝4.78,P2＜0.01),the culture degree(χ2＝10.70,P＜0.05),the infection of HPV(χ2＝179.95,P＜0.01),the level of the folic acid (F＝3.39,P＜0.05) and so on.The result of the logistic regression analysis showed that keeping the habit of drinking tea(OR＝0.321,β＝-1.136,P＜0.05),paying attention to the sanitation of the sex life(OR＝0.387,β＝-0.950,P＜0.05),putting off the first time of the sex life(OR＝0.551,β＝-0.596,P＜0.05),and the higher level of the folic acid (OR＝0.502,β＝-0.688,P＜0.05) were the protective factors tothe occurrence of the uterine cervix cancer.Meanwhile,the infection of the HPV(OR＝27.215,β＝3.304,P＜0.01),many times of the parturition(OR＝1.846,β＝0.613,P＜0.05) and the passive smoking (OR＝1.673,β＝0.515,P＜0.05) were the risk factors.ConclusionsWith the higher level of the folic acid,the less possibility you will get the cervical cancer.There exists many measures to prevent the happening of the cervical cancer,like keeping the healthy sex life,keeping far away from the passive smoking,not to give birth too early or too many and preventing being infected the HPV.What's more,having the good habit of drinking tea and paying attention to the supplement of the folic acid and Vitamin B12 may be the effective method to prevent the occurrence of the cervical cancer.

Objective Using 7.0 T diffusion tensor imaging(DTI) to study myocardial fibers character in isolated rats heart in aspect of water molecular diffusion, myocardial mechanics and microstructure. Methods Fixed male rats heart (n=10) underwent DTI and the myocardial structures were quantitatively measured by Diffusion Toolkit and Matlab. The characteristic of myocardial fibers arrangement was observed and FA values and ADC values of myocardial fibers, myocardial fibers density and length, mean helix angle of left ventricular were calculated as well. Mean helix angle of anterior wall, ventricular septum, lateral wall and posterior wall of epicardium and endocardium were compared by using one?way ANOVA. Results The SD rats' myocardial fibers appeared in compact and inerratic distribution from epicardium to endocardium. Compared with HE staining, regular direction and arrangement in fibers were showed in myocardial fibers tracer map and tensor map in papillary muscle plane. Quantitative analysis showed that ADC value of SD rats' myocardial fibers was (9.6 ± 3.6) × 10-4 mm2/s, FA value was 0.80 ± 0.04, myocardial fibers density was (981±24) tracks/mm3 and myocardial fibers length was (6.18±1.71)mm. Mean helix angle of left ventricular epicardium to endocardium ranged from-81.37° to 0° and then gradually change to 82.83° . There were no significant differences in mean helix angle of anterior wall, ventricular septum, lateral wall and posterior wall of epicardium and endocardium, respectively (F=2.25, 0.40, P>0.05). Conclusions This study shows that DTI is an effective method to quantitatively measure the characteristics of myocardial fibers. This study provides useful information for further study of myocardial fibers in heart disease models.

We obtained recombinant ferritin from Dermatophagoides f arinae ,and analyzed the characterization of the pro‐tein .A pair of primers was designed according to the known sequence of ferritin gene .The live mites identified and cultured lo‐cally were picked and the total RNA was extracted .The ferritin gene fragment was amplified by RT‐PCR ,and cloned into pET32a vector ,and then transferred into E .coli Top10 .The target gene obtained from the recombinant plasmid by digestion with Bam HⅠand Hind Ⅲ was connected to the prokaryotic expression vector pET‐32a .The expressed recombinant plasmid containing ferritin gene was constructed by cloning target gene into pET‐32a and transferred into E .coli Bl21 (DE3) .The ex‐pressed recombinant protein was analyzed by SDS‐PAGE ,and was purified by immobilized metal ion affinity chromatography (IMAC) .The ferritin expressed by dust mite was analyzed by the method of bioinformatics .The recombinant plasmid pET32a‐ferritin was constructed .SDS‐PAGE showed a correct molecular weight of the recombinant ferritin protein .After purification by affinity chromatography ,the protein showed only one strip on SDS‐PAGE gel .SDS‐PAGE showed a band at 20 kD .Dust mite ferritin contains 8 serine kinase ,7 threonine kinase ,7 tyrosine kinase ,and 0 histidine kinase phosphorylation sites .Hy‐drophilic region is larger than the hydrophobic region and it is an unstable protein .In conclusion ,the ferritin gene has been cloned and expressed .The purified ferritin has high purity . The study provides a basis for further study of composition and physicochemical properties of house dust mite allergen .

Objective To establish and optimize three-cube FRET assay in living cells and analyze subunit assembling of iGluR receptors. Methods Taking HEK293 cells cotransfed with pECFP and pEYFP as negative control, and those transfected with pECFP-YFP as positive control,different calculation methods using fluorescence microscopy were compared. Results These calculation methods were all suitable for FRET measurement in the system. but the measurement results were affected by the ratio of Donor/Acceptor (D/A) in some degree,and different calculation methods have different optimized conditions. FRET measurement using FR value showed subunit specific assembly of iGluR subtypes.Conclusion There are different optimized conditions for these different calculation methods in the three-cube FRET measurement system,and a further evidence is provided for subunit specific assembling of iGluR subtypes from the FRET assay.

Objective To investigate the relationships among clinical features, endoscopic characteristics and pathologic epithelial types of Barrett esophagus. Methods Magnification chromoendoscopy ( MCE) was performed in 2506 patients with gastroesophageal reflux disease ( GERD) and 106 patients with Barrett esophagus in our hospital during Feb,2003 -Feb,2004 were analyzed. The clinical features, endoscopic characteristics, pathologic epithelial types and their relationships were analyzed. Results The symptoms of gastro esophageal reflux disease ( GERD) were the main presentation of Barrett esophagus but 27 (25. 5% ) cases without such presentation. Four types of mueosal patterns, dot pattern, ridge or villous pattern and irregular/distorted pattern. were noted within the columnar mucosa using high magnification endos-copy: There were three epithelial types within the columnar lined esophagus: intestinal metaplasia (IM ) , cardiac and fundie types. Three epithelial types were noted in the methylene blue staining areas; ridged/vil-lous pattern and irregular/distorted pattern, all of them were in epithelial types of intestinal metaplasia. Conclusion Magnification chromoendoscopy helps to identify areas with IM, and having important significance in diagnosis and clinical follow up of Barrett esophagus.