Objective To compare the results between laparoscopic repair and surgical procedures in perforation of duodenal ulcer. Methods Fifteen p atients were operated on perforation of duodenal were by laparoscopic repair, an d thirty patients performed open repair or partial gastrectomy at the same peri od were chosen as control groups. Results The operating time in laparoscopic group and other two surgical groups were 59 min, 84 min and 204 min; postoperati ve requirement of analgesic was 7％(1/15), 73％(11/15) and 80％(12/15) in three groups respectively. The recovery time of gastrointestinal function was 25 h, 56 h, and 72 h. the mean time of hospitalization was 6 d, 8 d and 10 d. The differ ences among groups were significant (P

Objective To investigate the effect of postoperative anti-viral therapy using adefovir dipivoxil in recurrence of hepatocellular carcinoma HCC with HBV infection. Methods Sixty HCC patients with HBV infection were randomized into two groups:Group A (n=23) received hepatectomy only, and Group B (n=37) received hepatectomy and postoperative therapy using adefovir dipivoxil. The changes in liver func-tion, the suppression of HBV-DNA, HBeAg seroconversion rate, tumor recurrence rate and median survival in the two groups were observed and compared. Results In Group B, serum albumin, total bilirubin, AST and ALT were significantly improved compared with Group A (P < 0.05). Furthermore, the rate of 6-month and 1-year HBV-DNA suppression, the rate of 6-month and 1-year HBeAg seroconversion were significantly improved compared with Group A (P < 0.05). In Group A and Group B the tumor recurrence rate was 82. 6% (19/23) vs 78.4% (29/37) (P > 0.05), the recurrence time was 7.3 vs9.6 months (P > 0.05) and the median survival time was 17.4 vs 24.9 months (P < 0.01). Conclusion The results suggest that an-ti-viral therapy using adefovir dipivoxil postoperatively may improve the remnant liver function, suppress the HBV reaction, prolong the survival for patients with HCC with HBV infection.

Objective To investigate the effect of standardization regional lymphadenectomy in radical resection of ductal adenocareinoma in the pancreatic head.Methods On the basis of routine panereaticoduodenectomy(whipple proceduce),we performed the standardization regional lymphadenectomy,the emphasis of the procedure was the resection of wide nodes,particularly the mesenteric root lymph nodes(14abcd),the paraaortic lymph nodes(16a2b1),the hepatoduodenal ligament lymph nodes(12abpeh),hepatic artery(Group 8)and coeliacus lymph nodes(Group 9). Results Eleven patients underwent this procedure,there was no operative mortality,1 case occurred pancreatic fistula,the lymph nodes metastasis occurred in 7(63.6%)patients,the posterior pancreaticoduodenal lymph nodes(Groupl3)and superior mensenteric artery(Groupl4)was the predominant metastatic site of the tumor,the rate of the second site metastasis to lymph nodes was 57.1%.of the 11 cases follow-up 1 died. Conclusion The radical pancreaticoduodenectomy combined with wide resection of standardization regional lymph nodes is a safe and effective procedure of the treatment of adenocarcinoma of the head of the pancreas.but the long-term survivalrate must be valued objectively with many cases.

Objective To investigate kupffer cells (KCs) expressing indoleamine 2,3-dioxygenase(IDO)in the inhibition of allogeneic T-cell proliferation in vitro. Methods Real-time PCR was used to investigate the expression of IDO mRNA and FasL mRNA in KCs pretreated with or without IFNγ. High performance liquid chromatography was used to analyze the catabolism of tryptophan by IDO from KCs. Allogeneic T-cell response was used to confirm the inhibition of KCs in vitro. The proliferation of lymphocytes was detected using [3 H] thymidine incorporation. Cell cycle and lymphocyte apoptosis were evaluated by flow cytometric assay. Results Real-time PCR revealed IDO mRNA and FasL mRNA expression in KCs pretreated with IFN-γ. IDO catabolic effect was confirmed by a decrease in tryptophan and increase in kynurenine concentration. KCs expressing IDO and FasL from BABL/c mice acquire the ability to suppress the proliferation of T-cells from C57BL/6, which could be blocked by the addition of 1-methyl-tryptophan and anti-FasL antibody. The co-cultured T-cells with KCs expressing IDO and FasL could induce allogeneic T-cell apoptosis and exhibited cell-cycle arrest in G1. Conclusion In addition to the Fas/FasL pathway, IDO may also play an important role in KCs to inhibit allogeneic T-cell proliferation in vitro.

Objective To investigate the diagnosis and treatment of mucin-producing intrahepatic biliary tumor (MPIBT).Methods We retrospectively analyzed the clinical,radiologic,surgical and pathologic findings of 16 MPIBT cases from January 2004 to December 2011.Results There were six men and ten women,age ranged from 44 to 69 years (mean 60 years).Clinical presentation included jaundice with abdominal dull pain in 5 patients,acute cholangitis in 4 patients,painless jaundice in 2 patients,upper abdominal dull pain in 3 patients,no obvious symptoms in 1 patient,body weight loss more than 5 kg within 3 months in 5 patients.The most characteristic appearance of MPIBT on magnetic resonance cholangiopancreatography were asymmetry of intrahepatic bile duct dilatation and the dilatation in both extraand intrahepatic bile duct distal to the hepatic mass and not sudden interruption in extrahepatic bile duct.The primary tumor located in the left hepatic bile duct in 15 cases,in the right hepatic bile duct in one.13 MPIBT cases received hemihepatectomy and extrahepatic bile duct resection and Roux-en-Y anastomosis was done in 8 cases,3 received palliative biliary drainage.Pathologically 13 was papillary adenocarcinoma and 3 was papillary adenoma.The 1-,2-,3-year survival rates for the 16 MPIBT patients were 81％,66％,56％,respectively.Conclusions MPIBT had no specific clinical manifestations,MRCP might be an effective means for the diagnositic strategy and assessment of tumor extension before surgery,radical resection was the first choice of treatment,palliative biliary drainage could prolong the survival time.

The mosquito vector of filariasis malayi and its vectorial capacity was investigated In 5 endemic villages in Leshan Prefecture, Sichuan Province. The results showed that the man-biting rate, numan blood index and vectorial capacity of An. lesteri anthropophagus were 0.7, 5.1 and 10.63 times higher than those of An. sinensis. Besides, the natural infection by microfilaria in An, lesteri anthropophagus was also higher than that in An. sinensis by 5 times.From the above result, the authors concluded that An. lesteri anthropophagus was the main vector for transmitting filariasis malayi in the area under study.

OBJECTIVETo investigate the chemical constituents of Hypericum petiolulatum.

METHODThe chemical constituents were isolated and purified by column chromatography on silica gel, macroporous adsorbent resin, Sephadex LH-20, and preparative HPLC. Structures of the compounds were identified by NMR and MS spectroscopic methods.

RESULTNine lignans were obtained and their structures were elucidated as (-)-(2R, 3R)-1-O-feruloyl-8,8'-bisdihydrosiringenin (1), (-) -secoisolariciresinol 4-O-beta-D-glucopyrano-side (2), isolariciresinol-beta-4'-O-beta-D-glucopyranoside (3), 5-methoxy-9beta-xylopyra-nosyl-(+) -isolariciresinol (4), (+) -lyoniresinol 2alpha-O-beta-D-xylopyranoside (5), 5-methoxy-9-beta-xylopyranosyl-(-) -isolariciresinol (6), isolariciresinol 6a-O-beta-D-gluco-side (7), (+)-lyoniresinol 3alpha-O-beta-D-xylopyranoside (8) and 7-methoxy-5-benzofuranpropanol 4'-O-beta-D-glucopyranoside (9).

CONCLUSIONCoupound 1 was new and compounds 2-9 were obtained from the genus Hypericum for the first time.

Objective:To evaluate the risk factors on prognosis after resection of huge hepatocellular carcinoma.Methods:The clinical and followup data of 146 patients undergoing radical resection at Fujian Province Hospital from Jan 2012 to Dec 2017 was analyzed retrospectively.Results:Independent risk factors for tumor recurrence were neutrophil/lymphocyte ratio ≥2.49, serum alpha-fetoprotein ≥400 ng/ml, non-anatomical hepatectomy, ruptured huge hepatocellular carcinoma, multiple tumor and microvascular invasion and macrovascular invasion. These seven factors were used to develop a risk prediction model, in which 1-year recurrence-free rates in patients with low, middle, high risk group were 68.5%, 23.5%, and 0, respectively, and 3-year recurrence-free rates were 34.2%,15.3% and 0, respectively. Independent risk factors for tumor overall survival were neutrophil/lymphocyte ratio≥2.49, serum alpha-fetoprotein ≥400 ng/ml, HBV-DNA ≥2 000 IU/ml, multiple tumor, microvascular invasion, macrovascular invasion and hepatic capsule invasion. These seven factors were used to develop a risk prediction model, in which 1-year survival rates in patients with low, middle, high risk group were 94.7%, 74% and 40%, respectively, and 3-year survival rates were 68.4%,30.1%, and 5.7%, respectively.Conclusions:The recurrence rate of patients with huge hepatocellular carcinoma is high. Independent risk factors affecting prognosis were high neutrophil/lymphocyte ratio, high AFP level, high HBV-DNA, non-anatomical hepatectomy,ruptured,multiple tumor, microvascular and macrovascular invasion.

Objective To explore the impact of early use of renal replacement therapy on the prognosis of severe acute pancreati-tis patients .Methods 60 cases of patients with severe acute pancreatitis were chosen between September 2015 and June 2016 in De-partment of General Surgery in our hospital ,and were randomly divided into treatment group (n=30) and control group (n=30) with the method of number table .The patients in the control group were treated with conventional therapy ,treatment group was given the early use of renal replacement therapy (within 12 h after onset) .The scores of Acute Physiology and Chronic Health E-valuation Ⅱ (APACHE Ⅱ) ,partial pressure of oxygen (PaO2 ) ,oxygenation index (PaO2/FiO2 ) ,lactate (Lac) ,C-reactive protein (CRP) ,interleukin 1 (IL-1 ) ,and interleukin-6 (IL-6) levels before treatment ,12 h ,24 h ,48 h and 72 h after treatment were com-pared between two groups ,and the incidence of abdominal compartment syndrome (ACS) was compared as well .Results The difference of the indicators before treatment between two groups was not significant different (P>0 .05);the scores of APACHEⅡ ,PaO2 ,PaO2/FiO2 and Lac levels at 12 h ,24 h ,48 h and 72 h after treatment in treatment group were all lower than those in con-trol group ,and the difference was statistically significant (P<0 .05);CRP ,IL-1 and IL-6 levels at 24 h ,48 h and 72 h after treat-ment in treatment group were lower than those in control group ,and the difference was statistically significant (P<0 .05) .In the control group ,5 cases had ACS ,the incidence rate was 16 .7% ,and there was no case having ACS in treatment group and the differ-ence was statistically significant (P<0 .05) .Conclusion The early application of renal replacement therapy can effectively improve the physiological indexes of patients with severe acute pancreatitis ,inhibit the inflammatory response rapidly ,reduce damage to the abdominal organs ,and is worthy of promotion and application in clinical practice .

Objective:To identify and screen the differential methylation genes in patients with cholangiocarcinoma and to predict the prognosis of patients with CCA.Methods:Cholangiocarcinoma tissues and paracancerous tissues of 8 patients with cholangiocarcinoma in Fujian Provincial Hospital from October 2019 to May 2020 were selected for 850K methylation sequencing analysis to obtain differentially methylated genes. The 2018 genome-wide methylation data and clinical information of 36 patients with cholangiocarcinoma were download from The Cancer Genome Atlas (TCGA) database, the 2012 cholangiocarcinoma methylation data (GSE32879) were download from the Gene Expression Omnibus (GEO) database, and the 2018 TCGA database differential survival genomic data of overall survival (OS) and disease-free survival (DFS) of cholangiocarcinoma were download from the GEPIA2 database. The differentially methylated positions (DMP) and differentially methylated regions (DMR) results of 850K methylation sequencing analysis of submitted samples, methylated genes in TCGA and GEO databases, and cholangiocarcinoma survival genes of samples were jointly submitted for testing, multi-data set analysis was performed by the Sangerbox VENN tool, and common differentially methylated genes were obtained by intersection screening. The minimum P value method was used to determine the cut-off value of gene expression in Sangerbox, and the patients were divided into high and low expression groups of differentially methylated genes. The OS, DFS, disease-specific survival (DSS), disease-free interval (DFI) and progression-free interval (PFI) of cholangiocarcinoma patients were compared between the two groups. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed. Results:A total of 121 954 DMP were identified by 850K methylation sequencing of cholangiocarcinoma tissues and paracancerous tissues of 8 patients; a total of 1 399 differentially methylated genes were identified in DMR, and the common prognosis related genes glucosaminyl (N-acetyl) transferase 1 (GCNT1) and neurotrophic receptor tyrosine kinase 3 (NTRK3) were identified by intersection identification. The expression of GCNT1 in the cholangiocarcinoma tissues was higher than that in the paracancerous tissues, and the difference was statistically significant ( P = 0.040). The expression of NTRK3 in cholangiocarcinoma tissues was higher than that in the paracancerous tissues, but the difference was not statistically significant ( P = 0.790). The minimum P value method was used to predict the prognosis of patients with cholangiocarcinoma based on the combined expression of GCNT1 and NTRK3, and the order was based on the sum of the expression levels of the two genes. When 30% of the ranking was taken as the cut-off value, the difference in DFS between the high expression group and the low expression group in cholangiocarcinoma was the most significant ( P < 0.001); there was no significant difference in OS between the two groups ( P = 0.065). The results of GO functional analysis showed that GCNT1 was involved in protein glycosylation, macromolecule glycosylation, glycosylation, glycoprotein biosynthetic process, glycoprotein metabolic process, transferase activity and transferring glycosyl groups, protein O-linked glycosylation, O-glycan processing, etc., and NTRK3 was involved in neurotrophin signaling pathway, Ras signaling pathway, EGFR tyrosine kinase inhibitor resistance, ErbB signaling pathway, phospholipase D signaling pathway, central carbon metabolism in cancer, natural killer cell mediated cytotoxicity, etc. The results of KEGG analysis showed that GCNT1 was mainly associated with system functions such as mucin-type O-glycan biosynthesis and metabolic pathways, and NTRK3 was mainly associated with cell surface receptor pathways, intracellular signal transduction, positive regulation of stimulatory responses, transmembrane receptor protein tyrosine kinase signaling pathway, enzyme-linked receptor protein signaling pathway, MAPK signaling pathway cascade and regulation, protein phosphorylation signal transduction and other system functions. Conclusions:The expressions of differentially methylated genes GCTNT1 and NTRK3 in cholangiocarcinoma have certain predictive effects on the prognosis of patients with cholangiocarcinoma.