ObjectiveTo evaluate the diagnostic and therapeutic methods for hilar cholangiocarcinoma(HCC). Methods In 20 HCC patients serum CA19 9, CA242, CEA were determined preoperatively. A total of 57 HCC patients underwent surgery. Postoperatively 89% (51/57) patients were followed up. Results The sensitivity and specificity of CA19 9 for preoperative diagnosis were 78% and 90%, respectively. 47%(27/57) patients underwent radical resection with 1, 3 year survival rates of 96% and 32%. ConclusionThe results showed that CA19 9 is helpful for the diagnosis of hilar cholangiocarcinoma. Radical resection is effective for prolonging the long term survival in patients with HCC.

Over the past years efforts have been made by the government to improve the management of clinical laboratories.The government activities such as networking of quality assurance, development and implementation of clinical laboratory standards, and establishment of external quality control mechanisms have facilitated the improvement of clinical laboratory quality.Further definition and integration of clinical laboratory services, introduction of clinical laboratory pathologists and consultation and establishment of a permission mechanism are needed for improving the effectiveness of clinical laboratory services.Government regulations will continue to play an essential role in the clinical improvement process.

ObjectiveTo summarize the intraoperative nursing of patients undergoing aparoscopic adjustable gastric banding placation to reduce weight and improve the efficiency of operative cooperation.Method The clinical data on the intraoperative nursing of 9 patients undergoing laparoscopic adjustable gastric banding placation were retrospectively reviewed and analyzed.Result All patients lived through the successful operations and the postoperative rehabilitation were in good condition without postoperative complications and sequelae.Conclusion Full preoperative operation,familiarity with the operative procedures,close cooperation with surgeons are key to smooth performance of the operation and assurance of patient’s safety.

Objective To find out the detection level of the blood routine test in clinical laboratories of basic medical institutions in Hefei ,and to analyze the results of inter‐laboratory comparison among township health centers and community health service cen‐ters in Hefei and explore the main factors .Methods Forty‐three township health centers and community health service centers were randomly selected to conduct field investigations and take blood routine test inter‐laboratory comparison .Results Both 41 .9% of the passing rate and the average score 72 .37 points in Inter‐laboratory comparisons were significantly lower than the An‐hui province clinical inspection center(94 .1% and 95 .97 points) ,the differences were statistically significant(P<0 .05);Comparing to the results of the Anhui province clinical inspection center ,there was statistically significant difference on parameter(WBC ,RBC , Hb ,HCT ,PLT) average pass rate of blood routine test(P<0 .05);the personnel primary education was low ,18 .80% of the staff in clinical laboratories were not professionals ;most of blood analyzers were domestic and 53 .49% of all instruments had been used for more than 5 years;the overall laboratory quality management level was low .Conclusion The blood routine test detection level in clinical laboratories of basic medical institutions in Hefei was far below than that of secondary and tertiary medical institutions .The daily laboratory internal quality control should be strengthened and the quality management system should be improved gradually .

Objective To evaluate the clinical effect of ultrasound-guided percutaneous transhepatic cholangial drainage (PTCD) combined with endoscopic retrograde cholangio-pancreatography (ERCP) in treating malignant obstructive jaundice, and to discuss its technical points. Methods A total of ten cases with malignant biliary obstruction were enrolled in this study. After the failure of ERCP treatment, the patients had to be treated with ultrasound-guided PTCD immediately. The guide-wire was inserted into the duodenum through intrahepatic bile duct and common bile duct to connect with ERCP, which was followed by the biliary stent implantation or the removal of physical factors causing obstruction. The clinical results were analyzed. Results Technical success was obtained in all 10 cases. In the patients who underwent a successful guide-wire docking with ERCP the postoperative serum bilirubin was significantly decreased. The main complications were fever, elevation of amylase and transient bloody bile. Conclusion With the help of docking technique the combination use of ultrasound-guided PTCD and ERCP is a new tentative treatment for malignant obstructive jaundice after the failure of initial ERCP treatment. This technique carries promising value in clinical practice as it can significantly increase the success rate of ERCP.

Objective To determine activity concentrations of natural and artificial radionuclides in the surface soils in Huhhot city,measure environmental radiation level,and evaluate risks to residents health.Methods Radionuclides in 48 surface soil samples were determined by means of the high purity germanium γ spectrometer;environmental radiation level was measured using an environment γ dose rate meter;comparison was made of average activity concentrations in soils between domestically and globally;and the radiation dose to the local residents was estimated by using the methods recommended by UNSCEAR and reported in the related literatures.Results The average values for specific activity of 238U,232Th,226 Ra,40K and137 Cs in the surface soil samples in Huhhot city were (29.29 ± 12.95),(39.33±4.34),(29.77 ±3.21),(650.49 ±62.21) and (1.62 ± 1.53) Bq/kg,respectively;the measured air absorbed dose rate was (86.32 ± 11.92) nGy/h;the annual effective dose to local residents from outdoor γ radiation was 79.27 μSv/year.Conclusions The specific activities of radionulcides in soils and the environmental radiation in surface soil in Huhhot city were at a normal background level,with low risks to health of the local residents.

Objectives To investigate the risk factors of acute renal injury (acute kidney injury) in patients with acute left heart failure.Methods Clinical data of 188 patients with acute left heart failure who were admitted to our hospital were retrospectively analyzed.Logistic regression analysis was used to assess the risk factors for AKI.Results Among 188 patients with acute left heart failure,incidence of acute kidney injury was 33.51％.Univariate and Multivariable logistic regression analyses showed that the independent predictors of acute kidney injury were lower baseline eGFR (OR=4.294,P ＜ 0.001) and anemia (OR=3.573,P=0.006).Conclusions The incidence of acute left heart failure complicated with AKI was high.Basic state of renal function and anemia were the independent risk factors for AKI.

Thyroid hormones are known to influence the activities of sympathetic nerve by modifying the P-adrenoceptor numbers in several peripheral organs. In order to find out whether similar changes exist in central nervous system ( CNS ) , the changes of ?-adrenergic re-cetors in mouse brain during experimental hyperthyroidism and the effects of some Yin Tonice( Rehmannia ) on that were investigated by method of radioligand binding. The results were as follows: 1 . The maximum Binding capacity (Bmax ) value of hyperthyroid mouse brain was 29% higher than the control's. No significant difference in KD value between the control and hyperthyroid animals was found . 2. By administration of rehmannia, the Bmax of hyperthyroid mouse was reduced to control value.

Objective:To investigate the predictive value of preoperative and postoperative serum tumor markers, namely, carcinoem-bryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), and CA72-4, in the diagnosis of gastric cancer recurrence at different stag-es. Methods:Analysis was performed in 564 patients who underwent curative resection for gastric cancer between January 2002 and March 2007, received no chemotherapy at our hospital, and received complete follow-up according to the schedule determined pro-spectively. The values of CEA, CA19-9, and CA72-4 were evaluated before and after surgery. Results:In the pTNM-Ⅰ and pTNM-Ⅱ stage groups, patients with positive preoperative serum CEA, CA19-9, and CA72-4 levels showed recurrence rates of 50.0%, 24.1%, and 22.6%, respectively. Similarly, the recurrence rates of patients with positive postoperative serum CEA, CA72-4, and CA19-9 levels were 42.9%, 21.7%, and 14.3%, respectively. Multivariate analysis showed that the positive preoperative serum CEA level could be an inde-pendent factor of recurrence. In the pTNM-Ⅲ stage group, the recurrence rates of patients with positive preoperative serum CEA, CA19-9, and CA72-4 levels were 50.0%, 55.2%, and 47.6%, respectively. The recurrence rates of patients with positive postoperative se-rum CEA, CA19-9, and CA72-4 levels were 75.0%, 66.7%, and 66.7%, respectively. Multivariate analysis showed that high postoperative serum CA72-4 levels could be an independent factor of gastric cancer recurrence. Conclusion:Serum tumor markers exhibited differ-ent predictive values in different pTNM stages. Preoperative CEA level could be used to predict recurrence in patients with pTNM-Ⅰ and pTNM-Ⅱ stages of gastric cancer. Moreover, postoperative CA72-4 level could be used to predict recurrence in patients with pTNM-Ⅲ stage gastric cancer.

Objective To investigate the expressions of miR-143 and miR-145 in gastric cancer tissues and their biological functions. Methods A set of gastric cancer metastasis-related miRNAs was screened by comparing the miRNA profiles between the primary gastric cancer and matched liver metastasis. Among these miRNAs, expressions of miR-143 and miR-145 were further validated. The influence on metastasis was analyzed by transwell assay. Results Expressions of miR-143 and miR-145 down-regulated significantly in gastric cancer tissues compared to adjacent normal tissues (miR-143, 0.028 ±0.005 vs. 0.052 ±0.014, P=0.058; miR-145, 0.922 ±0.135 vs. 1.722 ±0.285, P=0.007), and decreased significantly in the metastatic lesion compared with the primary lesion (miR-143, 0.059±0.025 vs. 0.182±0.045, P=0.021; miR-145, 0.164±0.076 vs. 0.594±0.283, P=0.042). Expressions of miR-143 and miR-145 were significantly correlated (r=0.400, P=0.000), and they synergistically inhibited gastric cancer cell migration. Conclusion miR-143 and miR-145 may take part in the progression of gastric cancer metastasis, and they may have synergetic effects.