Objective To study the value of laparoscopic cholecystectomy (LC) for treating gallbladder benign diseases in aged patients. Methods Laparoscopy cholecystectomy (3-port or 4-port) was performed in 2335 senile patients with gallbladder benign diseases from December 1992 to May 2005. Results Five patients were found as having the Mirizzi syndrome and were given a subtotal cholecystectomy. In 18 patients with a frozen Callot’s triangle, the anterior wall of the gallbladder was resected and the mucous membrane on the posterior wall was electrocauterized. LC was completed smoothly in the remaining 2312 patients. No conversions to open surgery were needed. The operation time was 8~55 min (mean, 19 min), and the intraoperative blood loss was 1~ 50 ml (mean, 8 ml). An abdominal drainage tube was placed in 213 patients, including double-cannula lavage in 56 patients. The length of hospital stay was 4~16 d (mean, 6 d). Follow-up examinations for 10 days ~13 years in 1859 patients showed no biliary stenosis, gallbladder pouch, or residual stones. Conclusions Laparoscopic cholecystectomy is safe and feasible in aged patients, being the first choice of operative method. Proper perioperative management, careful prevention co-morbidities, and control of operation time as short as possible are important for senile patients.

Objective To investigate the effect of somatostatin on pancreatic blood flow and pancreatic function on the patients with acute pancreatitis.Methods 120 patients with acute pancreatitis from March 2015 to March 2017 were collected, and were randomly divided into the observation group and the control group.The control group were given routine treatment, at the basis of this, the observation group were given somatostatin.octreotide 0.6 mg was dripped into intravenous continuously, and was reducted to 0.3 mg, continuous treatment for 7 d.The changes of blood flow and the curative effect of pancreas were compared between the two groups before and after treatment.Results The total effective rate was 96.67%(58/60)in the treatment group and 80.00%(48/60)in the control group.The total effective rate in the observation group was significantly higher than that in the control group, the difference was statistically significant (P<0.05).There was no significant difference in blood flow(BF), blood volume(BV)and capillary surface permeability(PS)between the two groups before treatment.1 and 7 days after treatment, BF, BV in the observation group were higher than those in the control group, the levels of PS were significantly lower than that in the control group, the differences were statistically significant(P<0.05).Before treatment, the differences of(CP), insulin(INS), glucagon(GLU), serum lipase(LIP), amylase(AMY)and trypsinogen-2(TPS)were measured in the two groups were not statistically significant.1 and 7 days after treatment, CP and INS in the observation group were significantly higher than those in the control group, and GLU, LIP, AMY and TPS-2 were significantly lower than those in the control group, the differences between the two groups was statistically significant (P<0.05).Conclusion It has a protective effect on pancreatic blood flow and function which somatostatin was used in the treatment of the patients with acute pancreatitis, it can improve the overall state of pancreas, and has significant therapeutic effect.

Central Nervous System ; pathology ; Humans ; Lymphoproliferative Disorders ; pathology ; Transplantation ; adverse effects

Objective To explore the indications and attention points in one-stage thyroidectomy and bilateral neck dissection for thyroid carcinoma.Methods The clinical and pathological data of 68 thyroid carcinoma patients treated with one-stage thyroidectomy and bilateral neck dissection from Jan 1990 to Dec 2005 were reviewed retrospectively.Results There was no operative death in this series.Of the 68 patients,60 had bilateral and 4 had unilateral positive lymph nodes;4 had negative lymph nodes.The metastatic rate of patients who had unilateral thyroid cancer with contralateral cervical enlarged lymph nodes,bilateral thyroid cancer with unilateral cervical lymph nodes and isthmus cancer with lymph nodes was 100%(7/7),90%(9/10) and 66.67%(4/6) respectively.Postoperative complications include 7 cases of facial and flap edema,2 headache,5 postoperative hoarseness,7 temporary hypoparathyroidism,1 permanent hypoparathyroidism,1 left chylus fistula,and 3 unilateral accessory nerve injury.Conclusions The patients with unilateral thyroid cancer and enlarged contralateral neck lymph nodes,with bilateral thyroid cancer and unilateral cervical lymph nodes,and with isthmus cancer and enlarged lymph nodes are high-risk patient of bilateral neck metastasis,and should be treated with one stage thyroidectomy and bilateral cervical lymph node dissection.The procedure is safe,no serious postoperative complications occurred,and the survival rate and life quality can be improved.

Objective To investigate the expression of long chain non-coding(lnc) RNA LOC285194 in breast cancer tissue and paracancerous tissue and its clinical significance.Methods Forty-two samples of paraffin embedded breast cancer tissue and 16 samples of paraffin embedded paracancerous tissue were selected.The expression of lncRNA LOC285194 in these tissue were detected by using quantitative real-time polymerase chain reaction(PCR).Then its correlation with clinicopathological features was analyzed.Results The expression level of lncRNA LOC285194 in breast cancer tissue was significantly lower that in the paracancerous tissue (P＜0.01);the level of lncRNA LOC285194 in human epidermal growth factor receptor-2(HER2)overexpression tissues was up-regulated compared with HER2 negative breast cancer tissue(P =0.013),there was a positive correlation between them(r=0.385,P=0.012).Conclusion lncRNA LOC285194 may play the role of cancer suppressor gene and may be involved in the generation of breast cancer by HER2 association,which may become a target gene of breast cancer treatment.

SAαt2,6 and SAα2,3 linked sialic acid molecules on epithelial cell membrane served as receptors for influenza virus, which axe specifically recognized by human and avian influenza viruses, respectively. The distribution of these two species of sialic acids in human respiratory tract from different anatomical sites and different age groups was investigated. The results showed that SAα2,3Gal species was prevalent in respiratory bronchiole and lung alveolar epithelium, but was infiequent in trachea, bronchus and bronchiole. On the contrary, the SAα2,6Gal species was more common in the trachea and bronchus and to a lesser degree in the alveolar epithelium. When compared the expression levels of SAα2,6Gal and α2,3Gal in the respiratory tract among different age groups, no significant difference was found. In the ex vivo H5N1 virus infection study, alveolus epithelium were found to be more susceptible to avian influenza than trachea and bronchus epithelial cells. These results suggest that the human respiratory tract, to some extent, is permissive for avian influenza viruses. The currently-observed limited human to human transmission of H5N1 virus may be associated with the different abundance of SAα2,3Gal linkages in human upper respiratory tract among individuals.

Objective:To establish the model of rats with UC by 2,4,6 trinitrobenzene sulfonic acid ( TNBS)/ethanol to understand the changes of IL-17,IL-23,TGF-β1,IFN-γin pathogenesis of ulcerative colitis (UC) and the impacts of mesalazine,mont-morillonite powder and clostridium on that.Methods:85 rats were divided randomly into 6 groups including the model ,mesalazine, montmorillonite,clostridium,mesalazine combined with montmorillonite powder group (15 rats per group ) and an additional control group of 10 normal rats.TNBS/ethanol was used to establish the model of rats with UC.The dosage of model, mesalazine, montmorillonite powder ,clostridium and mesalazine combined with montmorillonite powder were converted by surface area of rat and given to the rats by gastric-tube daily.All rats were executed at the 12th day of the molding and treatment ,and the blood and colon samples were collected.The content of IL-17,IL-23,TGF-β1,IFN-γwas measured in the blood by the ELISA method.The different changes of the four cytokines were compared separately.Results: ( 1 ) TNBS/ethanol was used to establish the model of rats with UC.The obvious inflammation can be observed on distal colon of rats by pathologic sections of HE stained .(2) The levels of plasma IL-17,IL-23 and IFN-γin the model,mesalazine,montmorillonite,clostridium and mesalazine combined with montmorillonite powder group were higher than ones in the control gruop (P<0.05),meanwhile,the levels of plasma TGF-β1 are lower (P<0.05).3.Comparing with the model group,the levels of plasma IL-17,IL-23 and IFN-γin the mesalazine,montmorillonite,clostridium and mesalazine combined with montmorillonite powder group were lower , and the levels of TGF-β1 were higer.The differences have statistic significative ( P<0.05).(4)Comparing the efficacy of treatment among mesalazine ,montmorillonite powder,clostridium and mesalazine combined with montmorillonite powder ,mesalazine and mesalazine combined with montmorillonite powder gets the best results ( P<0.05 ).The efficacy between montmorillonite powder and clostridium is similar.Conclusion:(1) TNBS/ethanol can be used to establish the model of rats with UC and can be successfully approved by the measurement of symptoms and pathologic investigation .(2)The IL-17,IL-23 and IFN-γare very active higher in the blood of rats with experimental ulcerative colitis induced by TNBS /ethanol, and have a positive correlation with inflammation.The TGF-β1 is in decrease in the blood of rats with colitis , and has a Negative Correlation with inflammation.(3)Mesalazine,montmorillonite powder,clostridium and mesalazine combined with montmorillonite powder may renovate the damage of inflammatory tissues of rats with experimental ulcerative colitis , and relieve the symptom of inflammation by reducing exudation of proinflammatory cytokines IL-17, IL-23 and immune regulatory cytokines IFN-γby producing the exudation of proinflammatory cytokines TGF-β1 to be good for recovery of UC.

Objective: To elucidate clinical characteristics and build a prognostic nomogram for patients with vulvar cancer. Methods: The study population was drawn from the Surveillance, Epidemiology, and End Results (SEER) database. Patients were randomly assigned to training and validation sets. Cox proportional hazards model and competing risk model were used to identify the prognostic parameters of overall survival (OS) and cancer-specific survival (CSS) to construct a nomogram. The nomogram was assessed by concordance index (C-index), area under the curve (AUC), calibration plot, and decision curve analysis (DCA). Results: A total of 20,716 patients were included in epidemiological analysis, of whom 7,025 patients were selected in survival analysis, including 4,215 and 2,810 in training and validation sets, respectively. The multivariate Cox model showed that the predictors for OS were age, marital status, histopathology, differentiation and tumor node metastasis (TNM) stages, whether to undergo surgery and chemotherapy. However, the predictors for CSS were age, race, differentiation and TNM stages, whether to undergo surgery and radiation. The C-index for OS and CSS in the training set were 0.76 and 0.80. The AUC in the training set for 1-, 3- and 5-year OS and CSS were 0.84, 0.81, 0.80 and 0.88, 0.85, 0.83, respectively, which was similar in the validation set. The calibration curves showed good agreement between prediction and actual observations. DCA revealed that the nomogram had a better discrimination than TNM stages. Conclusions The nomogram showed accurate prognostic prediction in OS and CSS for vulvar cancer, which could provide guidance to clinical practice.