Intraductal papillary neoplasm of the bile duct (IPNB) is a variant of bile duct tumors characterized by papillary growth within the dilated bile duct lumen and secretion with a large amount of mucins.IPNB is an intraductal papillary cancer of the bile duct or a preinvasive lesion classified by the 2010 World Health Organization (WHO) classification.Although the specific etiology and pathogenesis are unclear,IPNB is known to two major risk factors:hepatoliathiasis and clonorchiasis.The clinical manifestations of IPNB include intermittent abdominal pain,acute cholangitis and obstructive jaundice.Results of laboratory test show abnormal liver function resulting from obstruction of bile duct,but it's not specific.The most common imaging findings for IPNB are bile duct dilatation and intraductal masses.Computed tomography,magnetic resonance image and cholangiography are usually performed to access tumor location and extension.According to morphology of the tumor epithelial cells,IPNB are classified into the pancreticbiliary,intestinal,gastric and oncocytic types.The surgical resection is a major treatment of IPNB.In principle,IPNB should be resected in a manner similar to that employed for other types of intrahepatic cholangiocarcinomas and extrabepatic bile duct carcinomas.The type of surgical procedure for IPNB depends upon tumor location and extension.Although several investigations have been conducted for illuminating molecular genetic changes during the development and progression of IPNB,the specific mechanism is still not clear,and further study is needed.

Objective　To explore the correlation between the expression of p33/ING1 and the clinicopathological features in patients with colorectal cancer, and to understand the possible mechanism of p33/ING1 in the oncogenesis of colorectal neoplasms. Methods　All samples of normal mucosa and cancer tissues from 52 patients with colorectal cancer were detected for their expression levels of p33/ING1 by RT-PCR. Results　A significant decrease in p33/ING1 mRNA expression was found in 30 out of 52(57.7%) colorectal cancer tissues. The results also showed that repression of p33/ING1 expression markedly related to both the Duke's stage and metastasis. Conclusion　Down-regulation of p33/ING1 may play an important role in the oncogenesis and development of colorectal carcinoma.

Objective To explore the relationship between the stromal angiogenesis and growth of the large intestinal carcinoma. Methods The vascular quantitative parameters(, , Sv, TA/BA) of the distal and proximal ends of the carcinoma, the center of the carcinoma, and the intestinal mucosa of distal and proximal ends of carcinoma were analyzed with computerized image. Differentiation degree of tumor cell was observed microscopically. Results Of the 48 cases studied, significant differences( P

Objective To provide the theoretic basis for the clearance of the metastatic lymph nodes in radical operation of colorectal carcinoma(CRC) by means of exploring the relationship between mass size of both tumor and lymph nodes and the rate of lymph node metastasis. Methods A total of 702 lymph nodes from 57 cases of CRC radical operations were divided into 5 groups and each of the lymph nodes was examined. The size of lymph nodes, Dukes' phases, the pathological types of CRC and their metastasis rate were analyzed. Results ① High metastasis rate was found at Dukes' C and D phases of CRC, being 29.93% and 48.12%, respectively. ② The metastasis rates of mucous adenocarcinoma and signet ring cell carcinoma were the highest of all pathological types, being 59 52% and 59.26%, respectively. ③ Metastasis rate of lymph nodes was not correlated with the mass size of tumor, but correlated with Dukes' phase. Conclusion ① Metastasis rate of lymph nodes increases with the growth and infiltration of tumor. ② Metastasis rates of mucous adenocarcinoma and signet ring cell carcinoma are higher than those of well and mid differentiated carcinomas. ③ Metastasis may be suggested for lymph node of CRC more than 5 mm in diameter during operation. However, clearance of lymph node of CRC less than 5 mm in diameter needs further study.

Objective To study the mental experience of nurses from outpatient department in dealing with patient's complaints.Method Using convenient sampling method,15 nurses from 5 sections of the outpatient department were chosen as interviewees,with the interviews on their mental experience in handling the complaints from outpatients.Result The issues from the interviews included:part of the patients were unable to complain accurately,part of the nurses were ineffective and therefore inactive in handling the complaints;some of the nurses were poor at employing communication skills and some others were incapable of specifying the complaints or asking for assistance.Conclusions Complaint handling is part of the nurses' job in the outpatient service.The nurses should take the initiative to improve their ability in complaint handling,so as to handle the complaints in a positive and effective way and improve patient's satisfaction.

ObjectiveTo study the expression of ING1 mRNA and its mutation status in human colorectal cancer. MethodsSamples of normal mucosa and cancer tissues from 52 patients with colorectal cancer were detected for their expression of ING1mRNA with RT PCR, and screened for its mutation with PCR SSCP. The expression of p53 protein was detected with immunohistochemical staining.ResultsThe impaired expression of ING1mRNA in colorectal cancer was associated with an advanced Dukes′ stage and metastasis of lymph nodes ( P ≤ 0 01). The expression of ING1mRNA positively correlated to that of p53 protein ( P ≤0 01). And a infrequent mutation of ING1 was also observed. Conclusion Our results suggest that ING1 contributes to the tumorigenesis and progression of colorectal cancer through down regulating its expression rather than through mutation.

BACKGROUND: Overexpression of cancer suppressor gene ING1 may cause apoptosis of many kinds of cancer cells and results in cell cycle arrest in G1 stage. ING1 is involved in p53 signaling pathway and regulates the activity of p53 as a transcription-activating factor.OBJECTIVE: To explore the association of ING1 gene expression and mutation with the clinicpathological features of colorectal cancer.DESIGN: A controlled observation of the pathological samples.SETTING: Department of General Surgery, Southwest Hospital, Third Military Medical University of Chinese PLA.PARTICIPANTS: Totally 52 fresh colorectal cancer samples were obtained from patients hospitalized in the Southwest Hospital, Third Military Medical University of Chinese PLA from October 1998 to October 1999. Normal mucosal tissues were also collected 10 cm from the margin of the tumor during the operation. The patients included 29 male and 23 female patients with an average age of 50.28 years.METHODS: ING1mRNA and protein expressions were detected in the 52 colorectal cancer tissue samples. The ING1 gene mutation was detected by analyzing single-stranded DNA polymorphism. The expression of p53 protein in the colorectal cancer tissue was detected immunohistochemically.tion-single-strand conformation polymorphism.was obviously decreased in comparison with that in the normal mucosa(0. 626 ±0. 382 vs 1. 166 ±0. 245, P ＜ 0. 001) . The expression of ING1 in the tumor tissue of patients with lymphatic metastasis was significantly lower than that in the tumor tissues from patients without lymphatic metastasis (0. 393 ±0. 243 vs 0. 960 ±0. 299, P ＜0.01). The expression of p53 protein was positively correlated with ING1 mRNA expression( P ＜ 0.01). Only one of the 52 samples was positive for ING1 gene mutation.CONCLUSION: ING1 gene may participate in the occurrence and progression of colorectal cancer and its decreased expression inhibits the action of tumor suppressor genes. The decrement in ING1 mRNA and protein expression without gene mutation indicates that ING1 participates in the pathogenesis of colorectal cancer in a manner quite different from that of the classic tumor suppressor genes.

Objective To summarize the clinical experiences in partial splenectomy for the treatment of splenic injuries Methods The indications, surgical procedures and surgical outcomes of a total of 105 cases undergoing partial splenectomy for splenic injuries in Southwest Hospital in the past 16 years were analyzed retrospectively Results Sixty seven cases(63 8%) suffered from isolated splenic injury According to splenic injury scale, grade Ⅰ (13, 11 4%), grade Ⅱ (56, 53 3%), gradeⅢ (28, 26 7%) and grade Ⅳ(8, 7 6%) were found in 105 cases of splenic injuries Surgical procedures included segmental splenectomy in 41 cases, hemi splenectomy in 35 cases, subtotal splenectomy in 29 cases and autotransplantation of splenic tissue in 21 cases of splenic injury in children There was no in hospital death in all cases Severe complications of subdiaphragmatic fluid collection and infection occurred in 3 cases, but the patients were cured by conservative treatment Conclusion Partial splenectomy is a safe and reasonable choice for selected patients with splenic injury

The biological role of hydrogen molecule has been misunderstood in some cases.Recent studies have indicated that hydrogen molecule is a promising selective antioxidant and has prominent therapeutic effects on many disorders.This paper reviews the recent progress on medical application of hydrogen molecule and proposes the possible research directions.

Objective To investigate the anti-gastric cancer effects of dendritic cells tumor vaccine loaded with heat shock protein gp96 polypeptide complex. Methods Con A sepharose affinity chromatography and mono Q ion exchange chromatography were applied to purify gp96 polypeptide complex from gastric cancer tissues and DC was loaded with gp96 polypeptide complex to prepare tumor DC vaccine. Fluorescence-activated cell sorter (FACS) was used to detect surface molecules expression of dendritic cells. Enzyme-linked immunosorbent assay ( ELISA) was used to detect IL-10 and interferon-? (IFN-?) of the supernatant secreted by activated T lymphocytes and 51Cr release test was performed to evaluate the gp96 peptide specific CTL response. Results DCs derived from patient's peripheral blood mononuclear cells loaded with gp96 polypeptide complex had high express surface molecule of GD1? (79. 3 ?4. 1)% , CD80 (84. 3 ? 2. 4) % , CD83 (85. 7 ? 3. 2) % and HLA-DR( 83.4 ? 2. 9) %. The effector T lymphocytes induced by DCs vaccine loaded with gp96 polypeptide complex had rised killing effect to primary culture gastric tumourcells(58.47?10. 71)% when compared with SGC 7901 cells(23. 98 ?4. 16)%. The level of IFN-? (2875 ? 177.66 pg/ml) significantly increased and that of IL-10 (36 ? 6.72 pg/ml) decreased. Conclusion Autologous heat shock protein gp96 polypeptide complex/DC vaccine induces strong peptide complex specific CTL response with high specificity.