Objective To investigate the effects of cholecystokinin (CCK) on diabetes mellitus with cholecystolithiasis. Methods Relevant literatures of recent years were reviewed. Results CCK exists widely in human body.On the one hand, CCK enhances cholecystolithiasis by causing diabetes. On the other hand, its pathological changes can also lead to cholecystolithiasis. Besides, it is possibility that the CCK-related gene abnormality is the common cause of diabetes and cholecystolithiasis. Conclusion CCK plays an important role in diabetes mellitus complicated with cholecystolithiasis. However, there is much yet to be known about CCK.

Objective To study the expression of CCR4 in gallbladder carcinoma tissues,and to determine its relationship with clinical pathological factors and its influence on prognosis of gallbladder cancer.Methods The expressions of CCR4 in gallbladder carcinoma tissues,and chronic cholecystitis gallbladder mucosal tissues were detected using immune histochemical methods and they were analyzed together with the clinical records.Survival analysis was used to compare the expressions of CCR4 between the positive group and the negative group.Multiple factors analysis was carried out using the Cox regression model.Correlation between the expressions of CCR4 in gallbladder tissues and the clinical pathologic factors was done using the Chi-square test.Results CCR4 is expressed tan-yellow in gallbladder cell cytoplasm and/or cell membrane.The expression of CCR4 protein in the gallbladder carcinoma was obviously higher than in the chronic cholecystitis gallbladder epithelial tissues (P ＜ 0.05).A high expression of CCR4 was not correlated with patients' age,gender,pathological classification,distant metastasis and nerve/lymphatic invasion factors.It was,however correlated with tumor lymph node metastasis (P ＜ 0.05) and histological grading (P ＜ 0.05).Kaplan Meier survival analysis showed the postoperative survival between the CCR4 positive group and the negative group were significant different (P ＜0.05).On multiple factors analysis,CCR4 expression level was an independent risk factor of survival of patients after gallbladder surgery.Conclusions The chemokine receptor CCR4 expressed in gallbladder carcinoma.Its level of expression correlated with lymph node metastasis and histological grading.It was an independent risk factor of survival in patients with gallbladder carcinoma after surgery.As it was associated with invasion and metastasis of gallbladder carcinoma,antitumor treatment targeting CCR4 is expected to become a novel treatment of gallbladder carcinoma.

Objective To discuss the remedy and clinical effect of traumatic splentic rupture.Methods Clinical data of 32 cases of traumatic splentic rupture were retrospective analyzed.Results No dead cases,6 cases were cured by conservative treatment,18 cases were explored by laparoscope,and 14 cases remained spleen,4 cases were converted to traditionary splenectomy.Traditionary splenectomy was done on 8 cases directly.Conclusions Ⅰ,Ⅱ grade of traumatic splentic rupture may choose conservation treatment or remain spleen by laparoscope operation.Splenectomy should be done on Ⅲ,Ⅳ grade of traumatic splentic rupture in time.

Purpose To investigate the effects of chemotactic factor CCR4 on the abi1ity of pro1iferation,ce11 cyc1e,invasion,and mi-gration of human ga11b1adder cancer ce11. Methods Western b1ot was used to detect the expression 1eve1 of CCR4 in ga11b1adder carci-noma ce11s. Ga11b1adder carcinoma ce11s was infected by means of s1ow virus,the CCR4 gene si1encing was conducted using siRNA-CCR4 interference techno1ogy. Ga11b1adder carcinoma ce11s GBC-SD were divided into three groups( GBC-SD,GBC-SD/CCR4-RNAi and GBC-SD/contro1). CCL17,a 1igand of CCR4,was used to act on these three groups of ce11s. CCK8 method was used to detect the ce11 pro1iferation abi1ity of three groups. F1ow cytometry was used to test ce11 cyc1e. Tanswe11 assay was app1ied to detect ce11 migration and invasion abi1ity. Western b1ot was performed to detect the expression of its corresponding 1igands CCL17 and CCL22 proteins. Re-sults CCR4 gene si1ence did not inf1uence ce11 cyc1e and pro1iferation of ga11b1adder ce11 GBC-SD,but can significant1y inhibit GBC-SD ce11 invasion and movement abi1ity,CCR4 gene si1ence had no inf1uence on the expression of CCL17 and CCL22 gene in tumor ce11s. Conclusion Ga11b1adder carcinoma ce11s GBC-SD express chemokine receptor CCR4,chemokine receptor CCR4 can promote the invasion and metastasis of GBC-SD ce11s.

ObjectiveTo evaluate the influence of electrotome on permanent and temporary cardiac pacemaker in laparoscopic cholecystectomy ( LC),and the application of cardiac pacemaker to the cases of cholecystolithiasis combined with bradyarrhythmia.MethodsClinical data of 215 patients with permanent or temporary cardiac pacemaker who underwent were studied for the preoperative and postoperative variation of pacemaker function,and for the influence of electricity coagulation during the operation on cardiac pacemaker function.ResultsLC was successfully completed in all 215 patients.The function of cardiac pacemaker was not obviously interfered during the operation,and the parameters of cardiac pacemaker did not remarkably change after the operation.ConclusionCardiac pacemaker is slightly interfered when electrotome and electrocoagulation were used in LC; LC is feasible and safe for patients with bradyarrhythmia by placement of cardiac pacemaker.

Objective To investigate the excretion probability,clinical characteristics of gallstones with small common bile duct stone.Methods The clinical data of 216 patients were analyzed retrospectively.The relevant clinical characteristics of small common bile duct stone's excretion were analyzed.x2 and Pearson correlation coefficient were used to analyze correlation between small common bile duct stone's excretion and relevant clinical characteristics,multiple logistic regression analysis was performed to identify these excretion related factors.Results Univariate analysis showed that patients of age less than 50 years,female sex,abdominal pain relieved and liver function recovered rapidly in 3 days of treatment,normal or slightly dilated diameter of common bile duct,single or multiple stones located in one place,stones completely located in the common bile duct or completely within the sphincter were more likely to be discharged.Multivariate analysis indicated that rapid relief of abdominal pain,rapid recovery of liver function,single or multiple stones located in one place were independently correlated with small common bile duct stone's excretion.Conclusion Small stones in common bile duct have a high probability of spontaneous removal in patients with gallstones and small common bile duct stone.