Adolescent ; Adult ; Female ; Histiocytic Necrotizing Lymphadenitis ; diagnosis ; therapy ; Humans ; Lymph Nodes ; Male ; Middle Aged ; Neck ; Young Adult

Objective To investigate the prognostic factors of hilar cholangiocarcinoma. Methods The clinical data of 204 patients with hilar cholangiocarcinoma who were admitted to The First Affiliated Hospital of China Medical University from January 1996 to May 2007 were retrospectively analyzed. The survival rate was calculated using the Kaplan-Meier method and Log-rank test. Seventeen factors that may have influenced prognosis were analyzed by univariate analysis. Factors that were statistically significant were further analyzed by the Cox regression model. Results The median survival times of patients who received radical resection, palliative resec-tion, bile duct exploration and catheter drainage, exploratory laparotomy, and liver transplantation were 37, 18, 11,5 and 25 months, respectively, and there was a significant difference between the 5 groups (χ2 = 58. 300, P < 0. 05). The prognostic factors included tumor size, portal vein or hepatic artery invasion, local invasion, resection margin, tumor grading, lymph node metastasis and surgical procedure (χ2 =6. 541, 8. 159, 5. 837, 4. 365, 13.748, 5.346, 9.472, P <0.05). Multivariate analysis demonstrated that surgical procedure and tumor grading were independent prognostic factors (6=0.287, 0. 320, P <0.05). Conclusions Radical resection is the most important prognostic factor of hilar cholangiocarcinoma. Appropriate perioperative care can improve the survival rate.

Objective To investigate the surgical effect of hilar cholangiocarcinoma and its impact on prognosis. Method The clinical data of 204 hilar cholangiocarcinoma admitted into the First Hospital of China Medical University were retrospectively analyzed. According to the Bismuth-corlette type, type Ⅰ was 18 cases, type Ⅱ 40 cases, type Ⅲ-a 30 cases, type Ⅲ-b 53 cases, type Ⅳ 57 cases. The other 6 cases was not typed. Color Doppler ultrasound, CT, MRCP were used to determine the Bismuth-Corlette type before the surgery. Based on preoperative image diagnosis the correct diagnosis rate was 53. 7%, 76. 4%, 100% for ultrasound, CT and MRCP respectively. Ninety-two cases underwent tumor resection, including radical resection (R0) in 55 cases, and palliative resection (R1, R2) in 37 cases. Ninety-eight cases underwent exploration and biliary drainage, 6 cases did laparotomy only, 2 cases received liver transplantation. The survival rate (P < 0. 001) is statistically different between patients receiving tumor resection and those not. Radical resection and palliative resection group are also statistically different in survival rates (P < 0. 05). Cox multivariate analysis shows that operation pattern, histological differentiation are two independent prognostic factors. Conclusion Surgery is the main method to treat hilar cholangiocarcinoma and radical resection could achieve the best effect. Reasonable perioperative treatment could reduce the complications and mortality.

Objective To study parameters influencing the prognosis of patients with gallbladder carcinoma.Methods A retrospective clinical analysis was conducted in 96 cases of gallbladder carcinoma treated in this hospital between 1993 and 2003.Results The overall 5-year survival rate of the patients was 6.32%.The 1-, 3-, and 5-year survival rates following radical resection for gallbladder carcinoma were 78.36%, 48.54%, and 23.87%, respectively.The survival rate was remarkably higher in the radical resection group than in others.Multivariate analysis revealed that depth of infiltration of the tumor and surgical procedure were markedly associated with prognosis.Conclusion Early diagnosis and radical resection are still the mainstay for long-term survival of the patients with gallbladder carcinoma.Appropriate perioperative care can improve survival rate.

Objective To evaluate the use of spiral enteroscopy in diagnosis and treatment of smallbowel diseases.Methods The data of 8 patients who underwent spiral enteroscopy from July to September 2009 were retrospectively studied.The variables including maximal insertion depth,total procedure time,complications,and outcome were evaluated.Results The average maximal depth of intubation was 2.2 m beyond the Ligament of Triez (0-3.6 m beyond Ligament of Triez),with a mean procedure time at 41 min (25 to 77 min).Small bowel Crohn's disease was diagnosed in 2 cases with biopsy suggesting active inflammation and granular formation.Small intestinal tumor was detected in 1 patient with pathological finding of high grade dysplasia.Jejunal ulcer was detected in 1 patient.Multiple polyps were found in 1 patient after jejunal anastomosis,which were then treated with endoscopic argon plasma coagulation (APC).No abnormalities were found in 3 other patients.No complications occurred during and after the procedure.The maneuver of spiral enteroscopy and APC were same as that of balloon enteroscopy.Conclusion Spiral enteroscopy is simple and convenient to operate,which is of great potential in clinical use.

lem and direct necessary intervention to improve the completion rate of whole small intestine examination.

Objective To evaluate the clinical effect of capsule endoscopy(CE)followed by a directed double-balloon enteroscopy(DBE)in diagnosis of patients with suspected small bowel disease.Methods Two hundred and ninety-nine consecutive patients with obscure gastrointestinal bleeding or other various indications for CE examination were analyzed.DBE was recommended after negative or indeterminate evaluation on CE.The diagnostic and follow-up data were collected and analyzed.Resails A total of 296 patients completed CE examination.Of whorn,138(46.6%)cases had positive findings,68(23.0%)cases were suspected for small bowel disease and 90(30.4%)cases had negative finding,Those who were suspected(45 cases)and negative(7 cases)for CE examination were performed DBE examination and small bowel lesions were found in 31 cases and 1 case,respectively.The false-negative diagnosis was probably made by DBE in 8 patients,whereas no false-positive case was found by DBE.The false-negative diagnosis was probably made by CE in 2 patients,whereas 8 false-positive cases were found by CE.With the results of CE examination,lesions were found by only one-side procedure of DBE in 90.3%(28/31)of patients.The results that followed up for median 17 months indicated that 93.5% of patients with positive findings by DBE were received optimal therapy.Both CE and DBE procedures were well tolerated and no severe complications occurred.Conclusions The detection rate of sinall bowel lesions with CE was high,whereas the indetermination of CE findings was also significant.Majority of suspected findings by CE may be further confirmed by DBE.The strategy that start with CE and followed by DBE may increase diagnostic yield in patients with suspected small bowel disease and improve the prognosis.

Objective To assess the effect of suppression of insulin-like growth factor-1 receptor (IGF1R)in HO8910PM cell line by small interference RNA(siRNA).Methods Transfection of siRNA using liporectamine 2000 was conducted to silence IGF1R gene expression,the expression levels of IGF1R mRNA and protein were evaluated,and the effects on the cell cycles at 48 hours of transfection were assessed by real-time PCR,western blot and flow cytometry(FCM)assay respectively.The cell growth was detected by cell counting kit-8(CCK-8)at 24,48,72,96 hours of transfection.After 24 hours of transfection,the cells were cuhured with difierent concentrations of cisplatin(DDP)for 24 hours,the cell growth inhibition rate Was evaluated by CCK-8.Following incubation with 10μg/ml DDP for 24 hours after 24 hours of transfection,the apoptosis cells and the protein expression level of apoptosis-related gene,B cell leukemia/lymphoma 2(Bcl-2),were identified by FCM and western blot respectively.Resuits (1)Expression levels of IGF1R mRNA and protein were markedly decreased respectively at 48 hours of transfection IGF1R siRNA.(2)Suppression of IGF1R accompanied the reduction of cell growth at 48,72,96 hours of transfection with IGF1R siRNA,absorbance were 1.71±0.13,2.32±0.23,2.79±0.28 respectively (P＜0.01).(3)IGF1R siRNA induces arrest of G2 phase,the G2 phase rate of cells were 24.37%(P＜0.05).(4)Following treatment with 2.5,5,10,20μg/ml DDP for 24 hours after 24 hours of transfection,the cell growth inhibition rates were(25.94±0.08)%,(40.25±0.05)%,(59.48±0.03)%and(74.18±0.08)%respectively(P＜0.01).(5)Treatment with 10μg/ml DDP for 24 hours after 24 hours of transfection,induces 17.95%of cells apoptosis(P＜0.05),and decreases Bcl-2 protein level.Conclusion RNA interference of IGF1R gene induces the IGF1R silence in HO8910PM cell line significantly,inhibits cell growth in vitro, arrests the G2 phase, and enhances the chemosensitization to DDP.

BACKGROUND:Bone marrow mesenchymal stem cells(MSCs)are a kind of adult stem cells with multi-potential differentiation property.At present,it has served as cell carrier for the treatment of Parkinson's disease.OBJECTIVE:To construct pDsRed-C1-CDNF eukaryotic expression vector and induce its expression in rat MSCs.METHODS:CDNF gene was amplified from mouse tissues using RT-PCR,and sequence with Xho I,BamHI restriction enzyme cutting site.The CDNF gene was inserted into the eukaryotic expression vector pDsRed-C1 encoding red fluorescent protein gene.The plasmid pDsRed-C1-CDNF was constructed and transfected into rat bone marrow MSCs.RESULES AND CONCLUSION:The pDsRed-C1-CDNF recombinant plasmid was confirmed by double digestion of Xho I and BamHI restriction enzyme or single digestion of BamHI,and PCR sequence.Results show that the recombinant pDsRed-C1-CDNF eukaryotic expression vector was successfully constructed.

BACKGROUND: PEX gene can interfere with the invasion acts of malignant glioma. Bone marrow mesenchymal stem cells (MSCs) are a new type of targeted cell vector on cancer therapy. OBJECTIVE: To construct MSCs stably expressing PEX gene.METHODS: PEX eukaryotic expression vector was constructed by molecular cloning, and identified the recombinant plasmid pcDNA3.1(+)-PEX by restriction endonuclease digestion and sequencing. After transfected with MSCs, the eukaryotic expression vector expression in MSCs was verified by immunocytochemical method. The MSCs stably expressing PEX was established by G418 selection, and then was detected by using reverse transcriptase-polymerase chain reaction.RESULTS AND CONCLUSION: The MSCs stably expressing PEX gene is successfully established, in which PEX gene is highly expressed at both gene level and protein level.