Biliary-pancreatic-duodenal junction is a special region in the human body.It is difficult to diagnose and treat diseases in this region because of the complicated anatomy,the limitation of diagnosing methods,the variety of disease,the high risks of operation and the severity of complications. We should pay more attention to the pathophysiology aspects and the laboratory researches of diseases in this region.Proper diagnosis and combination of different diagnosing methods could improve the rate of early diagnosis and identify the characteristics of the disease. Individualized operation should be considered to deal with iatrogenic injury of biliary-pancreatic-duodenal junction according to different patients' condition.The principle of operation is to control damage firstly and to preserve the function of biliary-pancreatic-duodenal junction and the physiological passway of bile and pancreatic juice to the greatest extent.

ObjectiveTo evaluate the clinical efficacy and toxicity of the regimen of paclitaxel combined with gemcitabine for anthracycine-resistant metastatic breast cancer. MethodsThirty patients with anthracycine-resistant metastatic breast cancer were enrolled in the study: paclitaxel 135mg/m2 infusion on day 1; Gemcitabine 850mg/m2 infusion on day 1,8 ,and administered in three weeks cycle. The clinical efficacy was evaluated every two cycles. ResultsOf all thirty patients qualified for efficacy analysis and among them CR 3 cases( 10％ ) ,PR 11 cases (36.7 ％ ), SD 11 cases ( 36.7％ ), and PD 5 cases ( 16.7％ ), with an overall response rate of 46.7％. The median TTP and overall survival in those 30 patients was 7.1 and 15.6 months. The main toxicities with grade 3 and 4 were hypoleucocytosis in 10 patients(30.0％ ) ,thrombocytopenia in 4 patients( 13.3％ ). ConclusionThe regimen of paclitaxel combined with gemcitabine was effective,well-tolerated scheme in the anthracycine-resistant metastatic breast cancer.

Iatrogenic injury in choledocho-pancreatico-duodenal junction is usually difficult to discover in the course of operation because of its unique anatomical position. The injury can lead to postoperative chilis, fever, pain and swelling of the waist, which would easily be misdiagnosed as acute necrotizing pancreatitis. Controlling operations, such as bile and pancreatic juice separation, duodenal diverticularization, jejunal fistulation for enteral nutrition and abdominal drainage should be performed in dealing with the injury in choledocho-pancreatico-duodenal junction. Combined application of pyloric suture with absorbable thread and ligatian, gastric fistulation, ligation of the distal common bile duct and T-tube drainage is minimally invasive, and can fulfill a fully separation of bile and pancreatic juice and duodenal diverticularization. It will improve the possibility of secondary radical operation by ameliorating pyemia and general nutritional condition.

Objective To study the dinical value of serum soluble E-selectin(sE-selectin)and serum soluble P-selectin(sp-selectin)in patients with esophageal squamous cell carcinoma. MethodsThe sP-selectin and sP-selectin of the serum was measured by ELISA in 27 patients with viral encephalitis and 35 normal persons. ResultsIn patients with organ metastasissE-selectin and sP-selectin levels were significantly higher than normal(P＜0.01),In patients with organ metastasis,sE-selectin and sP-selectin levels increased more pronounced.No visceral metastasis in patients with esophageal cancer,postoperative serum sE-selectin and sP-selectin levels significantly decreased compared with the preoperative(P＜0.01),there are organ metastasis in patients with esophageal cancer sE-selectin and sP-selectin levels decreased not obvious. ConclusionsE-selectin and sP-selectin could be used as a new tumor detection of esophageal cancer targets,and has close relatimship with the incidence of esophageal cancer,development and metastasis.

Chromosome Aberrations ; Gene Fusion ; Genes, Tumor Suppressor ; Humans ; Oncogene Proteins, Fusion ; metabolism ; Oncogenes ; Pathology ; standards ; trends ; Soft Tissue Neoplasms ; genetics ; metabolism ; pathology

Actins ; metabolism ; Dermatofibrosarcoma ; classification ; pathology ; Desmin ; metabolism ; Head and Neck Neoplasms ; metabolism ; pathology ; Histiocytoma, Benign Fibrous ; classification ; metabolism ; pathology ; Histiocytoma, Malignant Fibrous ; classification ; metabolism ; pathology ; Humans ; Oncogene Proteins, Fusion ; metabolism ; Skin Neoplasms ; metabolism ; pathology ; Vimentin ; metabolism ; Xanthomatosis ; pathology

This study was aimed to further explore theory of small intestinal diseases and its principle of syndrome differentiation and treatment and lay the base for the clinical study, through the clinical research on the treatment of small intestinal diseases. Through the clinical survey among 584 patients, using Traditional Chinese Medicine (TCM) Clinical Multidimensional Relational Query System, which was established by the research on the clinical individual diagnosis and treatment evaluation system on the prevention and treatment of diseases, to conduct the multidimen-sional relational analysis on small intestinal diseases' disease-symptoms-syndromes-therapy-medicines-effects. Using data mining and statistical methods, such as WEKA, Business Objects, SPSS to mine and analyze the syn-dromes and symptoms. The results showed that commonly-used TCM methods on treatment of small intestinal dis-eases, therapeutic principles of main syndromes of small intestinal diseases were summarized. It was concluded that through scale-free network diagram analysis on the commonly-used treatment of small intestinal diseases, the main treatment methods included promotion the flow of qi, relieving pain, tonifying spleen, removing dampness, clearing away heat, mildly regulating cold and heat. And the treatment methods of dispersing cold, invigorating blood circula-tion and removing blood stasis, nourishing yin, moistening and loosening bowels, abductively dispersing food stagna-tion were also used. It corresponds with the results of clinical research.

Objective To evaluate the safety and effect of adefovir dipivoxil (ADV) on hepatitis B in HBeAgpositive patients.Methods 131 patients were divided into two groups randomly.Two groups were treated with ADV (10mg/d)and matrine (0.6g/d),respectively.The rate of HBV negative,the normalization rates of ALT,HBeAg loss and anfi-HBe seroconversion were evaluated respectively.Results After 12 weeks of treatment,the rate of HBV negative,the normalization rates of ALT,HBeAg loss and anti-HBe seroconversion of ADV were all significantly higher than those of matrine group(53.2％ vs 7.8％,36.0％ vs 8.7％,13.6％ vs 3.1％,6.2％ vs 0,respectively,x2 =56.32,23.18,all P ＜ 0.01).Conclusion The domestic ADV superior to matrine in HBeAg-positive patients.

Objective To study the relationship between HCV chronic infection and expression of CXC chemokines mRNA.Methods The levels of IL-8,IP-10 and Mig mRNA in peripheral blood mononuclear cells(PBMC) of chronic hepatitis C patients were detected by real-time quantitative polymerase chain reaction(RT-PCR) before,and 3,6 months after combined therapy of interferon-?(IFN-?) and Ribavirin.The rate of chemokine/GAPDH was regarded as the extreme level of chemokine.Results The mean level of HCV-RNA and expressive levels of IL-8,IP-10,Mig mRNA in peripheral blood of HCV chronic infection were 2.09?10~(6)copies/ml,and(1.243 7?0.071 2),(0.682 8?0.073 8),(0.668 3?0.075 4),with significant difference with those of normal controls(P0.05).Conclusion The expressions of IL-8,IP-10 and Mig mRNA in PBMC are high in patients with chronic hepatitis C,and associated with the replication level of HCV,and less associated with the gene type of HCV.IFN-? can effectively restrain the replication of HCV and down-regulate the levels of IL-8,IP-10 and Mig mRNA near to normal level in patients with chronic hepatitis C.IFN-? plays an important role in down-regulating inflammation response and controlling the development of the patients' condition.

Thyroidectomy provides rapid solution of hyperthyroidism and the goal of perioperative management is to make patient as close as possible to euthyroidism clinically and biochemically before surgery.It is recommended to target at the thyroid hormone synthetic,secretory,and peripheral pathway with concurrent treatment to correct any latent decompensation of normal homeostatic mechanisms.