Objectives:The time of Carotid intervention for recently symptomatic,severe carotid stenosis which cause a transient ischemic attack or minor stroke is still a controversial issue.Early studies showed that carotid endarterectomy (CEA) caused a high risk if performed within days follow an acute ischemic stroke.However,The National Stroke Strategy posted by UK Department of Health advocated that this situation should be regarded as an emergency procedure,and carotid intervention should ideally be performed within 48 hours.We designed this study to discuss the effect of urgent CEA on operative risk and benefit.Methods: we analyze 12 urgent CEA with primary closure performed during 1996 to 1998.All 12 patients were underwent CEA within 2 weeks,and 2 of them within 2 days.Operative risks and overall benefit from surgery were discussed in relation to the time from the last symptomatic event to CEA.Results: 2 urgent CEA performed in 2 days are recovery uneventful.1 of 12 patients,who underwent urgent CEA within 2 weeks,occurred restenosis after 3 months follow up.No 30-day perioperative recurrent TIA,stroke and death.Conclusions:CEA performed within 2 weeks is feasible and reliable procedure in preventing recurrent TIA and stroke after presenting manifestations.The future aim is to perform CEA within 48 hours after TIA or stroke symptoms.

Objective:To investigate the number of CD+68 cells in hepatocellular carcinoma (HCC),paraneoplastic tissues,cirrhosis tissues and normal liver tissues and their clinical significance.Methods:Surgical specimens from 60 cases of HCC,62 cases of cirrhosis and 23 cases of normal liver were investigated by immunohistochemical staining of CD+68with streptavidin-horseradish peroxidase detective system.Results:(1)The order of the mean number of CD+68cells in the tissues from the highest to the lowest was:paraneoplastic,cirrhosis,normal liver and HCC tissues(P〈0.01);(2)The number of CD+68cells in the tissues decreased successively with the decrease of HCC differentiation (P〈0.05);(3)There was no relationship between the number of CD+68cells in HCC and its clinical TNM stage;(4)The number of CD+68cells in the cases with metastasis within 15 months was significantly lower than that without metastasis (P〈0.05).Conclusion:The number of CD+68cells might be an important marker to estimate the immune status and a useful factor to predict the prognosis of HCC patients.

Objeetive:To study the expression of cell adhesion molecules on the lymphatic endothelial cells In the rectum cancer and peritumoral lymph nodes as well as their relationship with the diffusion of cancer cellS. Methods: In this Study the immunhistochemistry method was employed to observe the expression of CEA, ICAM-1 and CD31 on rectum cancer lymphatic endo-thelial cells. Results :The results demonstrated that CEA and lCAM-1 were highly expressed on the lynphatio endothelial cells in the peritumoral rectum tissues and lymph nodes. It was, howev-er,negative in normal lymphatic endothelial cells. CD31 was expressed on both lymphatic endothe-Ilal cells in the periturmral rectum tissues and lymph nodes and vessel endothelial cells of the normal human. Conelusion: The study suggests that there are relationships between the dis-semination of cancer cells and excession of CEA, lCAM-1 and CD31 in lymphatic endothelial cells.The CAE and ICAM-1 seem to induce stable adhesion between oancer cells and endothelial cells.

Objective: Gallbladder polyps are frequently discovered in the past decade. Ifthe polyps are oenign,without concomitant stone and the gallbladder has a good function, it is not an absolutely indication for cholecystectomy. For this reason percutaneous endoscopio polypectomy of the gallbladden polyps were developed and applied. Methods: Among those who underwent peroutaneous endosoopic polypectomy of the gallbladder, 85 patients with gallblaeder polyps were studied. Under the epidural anesthesia, cholecystoscope was introduced into the gallbladder. The polyps were coagulated by self-made miorowave ceagulator and then resected for histopathelogical evaluation. The preserved gallbladders were followed up to evaluate the effioacy of this minimally invasive therapy. Results: All precedures were eventful with mean operation time of 1h to 1. 5h. Sixty seven patients were followed-up for a mean of 5.5 yeah (2～9 years) and showed all patients to be symptom free and in 64 cases the gallbladder function was found to be well preserved without recurrence of polyps and occurrenca of gallstones on ultraSound. Conclusion: The procedure reposed is a reliable, simple,effective and minimally invasive technique to remove gallbledder polyps and to preserve gallbladder function for the patients who have the benign gallbladder polyps.

Objective:To investigate the changes of radiosensitivity and growth features of the surviving progeny from the irradiated bile duct cancer cells.Methods:To cultivate human bile duct cancer cell and the progeny of irradiated bile duct cancer,population doubling time(PDT),plating efficiency(PE),radiosensitivity index SF2 and the detection of bile duct cancer cell lines.Results:The PDT of bile duct cancer was (120.0?2.8)hrs,PE(14.0?0.6)%,SF2 0.62?0.05.The PDT of the irradiated bile duct cancer cells was(152.8?11.2) hrs (t=3.124,P

Objective:To compare the clinical effects of different reconstructive alimentary canal for total gastrectomy.Methods: The patients were divided into P loop/Roux-en-Y and Distal antiperistaltic jejunal reservoir group.The nutritional status of these two groups was investigated.Results:The differences of body weight,hemoglobin,total albumin and albumin afer operation one year in P loop group were(52.5?3.8)kg,(98.0?6)g/L,(52.0?2)g/L,(28.0?3g)/L;meanwhile those in Distal group were(59.2?4.8)kg,(121.0?5)g/L,(62.0?4)g/L,(35.4?2)g/L.These differences between two groups were significant(P

Objective: To investigate the clinical results of permanent implantation of radioactive 125 I seeds in treatment of advanced pancreatic adenocarcinoma.Methods:Eight patients with advanced pancreatic adenocarcinoma were treated with 125 I implantation from May 2002 to December 2002 and the data was retrospectively analyzed.Results: The mean number of 125 I seeds implanted was 22.8 with minimum of 19 to maximum of 38 each. The matched peripheral dose was 65 Gy.The postoperative courses were uneventful and no bone marrow suppression was recorded.The preoperative efractory abdominal and back pain in 2 patients were relieved completely (2/2).The postoperative CT scan which were done in four cases showed that tumor disappeared completely in 2 cases,were well locally controlled in 1 and slightly controlled in one.No acute pancreatitis and pancreatic leakage were encountered in all patients.Conclusion: The implantation of radioactive 125 I was effective in local control of the tumor and pain relief and is a safe alternative for the treatment of unresectable pancreatic adenocarcinoma.

Objective:To explore the expressions of the nuclear factor-?B(NF-?B),C- myc and ICAM-1 in human colon and rectal cancer and the relationship between NF-?B and the occurrence,the metastasis of human colon and rectal cancer.The clinical significance was analyzed.Methods:Fifty human colon and rectal cancer cases ,16 colon and rectal adenomas,9 carcinomatous change of colon and rectal adenoma and 8 normal colon were studied,the expressions of NF-? Bp65,C- myc and ICAM-1 in them were examined by immunohistochemical method.Results:NF-?Bp65,C- myc were strongly expressed in the colon and rectal cancer and carcinomatous change of colon and rectal adenomas than those in colon and retal adenoma;C- myc could not express in normal colon;NF-? Bp65 and C- myc were significantly positive correlation with colon and rectal cancer;NF-?Bp65,ICAM-1 were strongly expressed in the colon and rectal cancer which had metastasis than those had no metastasis,and they had striking positive correlation with colon and rectal cancer which had metastasis.ConclusionTo control the transcription of C- myc and ICAM-1,NF-?B plays an important action in the occurrence and metastasis of colon and rectal cancer.It will become a new target of treatment of colon and rectal cancer.

Objective:To investigate the effects of c-fos antisence olioneucleotide on the intimal proliferation of autogrfted veins with antisence technology.Methods:The external jugule veins were grafted into common carotid arteries in 20 rabbits and were divided into test group and control group randomly.The anastomosis and transplanted vein were coated with c-fos antisence olioneucleotide glue gel in the test group,while the contral group were merely coated with glue gel.The autografted veins were removed and measured by means of pathology and immunohistochemistry two weeks later.Results:The results show that the thickness of the venous intima,the degree of the vascular stricture,the expression of PCNA and the numbers of vascular smooth muscle cell were decreased in test group.Conclusion:The results suggest the c-fos antisence olioneucleotide can inhibit the intimal proliferation of the autografted veins.It is a prospective and idea genetic prophylactic therapy to intimal hyperplasia.

Objective:To detect the expression of 5-LOX and observe its inhibitory effect in humane pancreatic cancer cell.Methods:5-LOX mRNA and protein expression were analyzed by RT-PCR and immunocytochemical staining as well as images analyzing system,and the effect of MK886 was tested.Results:MK886 effectively down-regulated the expression of 5-LOX mRNA.Immunocytochemical staining and images analysis confirmed that the expression 5-LOX protein in cell treated with MK886 was lower than untreated control cell.Conclusion:Inhibitor of 5-LOX can effectively prevent the target mRNA into protein product,thus block or weaken the expression of 5-LOX.