Gallbladder cancer is the most common malignant neoplasm in biliary system,with a high degrade of malignancy,invasion and metastasis.The prognosis is heartbreaking.Radical surgery is the only possible way for curing.The current understanding of China's doctors at all levels on radical surgery of gallbladder cancer is chaotic.Based on the latest version eighth TNM staging of the American Joint Committee on Cancer(AJCC)of gallbladder cancer,making a review of the literature,combined with the author's personal experience,we have interpreted the reasonable selection of hepatectomy of gallbladder cancer,in order to improve the doctors at all levels to regulate the understanding of hepatectomy and the prognosis of gallbladder cancer.

Objective To evaluate the clinical usefulness of manometry of esophgeal varices with endoscopic balloon technique. Methods The variceal pressure was measured by endoscopic balloon technique in 26 patients with portal hypertension, at the same time , laboratory parameters of liver function were determined. ResultsDetermination of variceal pressure was successful in 23/26 patients, while no side effects was observed. The intraobserver coefficient of variation was 7.18% ?2.64%,and there was a significant(P

[Objective]Extracellular signal-activated kinases(ERK),c-Jun N-terminal kinase(JNK) and P38 signal transduction pathway were three members of the MAPK family which mediated cellular proliferation,differentiation and apoptosis.The purpose of this study was to investigate the effects of ERK,JNK and P38 MAPK on pathogenesis and progression of human osteosarcoma.[Method]EnVisionTM immunohistochemical technique was used to detect the expressions of ERK,JNK and P38 protein among the 48 osteosarcoma and 25 osteoblastic benign tumor samples,and their differences were compared.[Result]The positive rates of ERK,JNK and P38 protein were 83.3%(40/48),72.9%(35/48) and 85.4%(41/48) respectively in 48 osteosarcoma,and 16.0%(4/25),12.0%(3/25) and 20.0%(5/25) in 14 osteoblastic benign tumor,the statistical analysis of the positive rates were performed using analysis of variance with P

Objective To investigate the diagnostic values of ultrasound in rheumatoid knee arthritis and the clinical significance of ultrasonic scoring system.Methods From July 2013 to December 2015,500 cases of patients with rheumatoid knee arthritis in two grade A class 3 hospitals of Lishui City were collected as the observation group and contemporaneous 500 healthy adults were collected as the control group.The knee joint synovial thickness,vascular detection rate in hyperplasia synovium,ultrasound score,rheumatoid arthritis disease activity score,erythrocyte sedimentation rate (ESR),C reactive protein (CRP),suprapatellar bursa effusion,infrapatellar bursa effusion,joint effusion,knee joint cartilage and bone surface were observed in the two groups.Results Compared with the control group,the observation group got a significant increase in knee joint synovial thickness [(0.50±0.19)cm vs.(0.13±0.05) cm,P=0.000)];depth of suprapatellar bursa fluid [(0.62±0.27)cm vs.(0.23±0.05) cm,P=0.000];depth of infrapatellar bursa fluid [(0.58±0.12)cm vs.(0.21±0.04) cm,P=0.000];joint fluid depth [(0.48±0.28)cm vs.(0.12±0.08) cm,P=0.000];ESR [(43.29±12.58)mm/h vs.(12.95±4.39) mm/h,P=0.000)];CRP level [(8.95±3.29)mg/L vs.(3.29±1.54) mg/L,P=0.000)];vascular detection rate in hyperplasia synovium (84.20% vs.13.00%,P=0.000).Moreover the ultrasound score was positively corrected with rheumatoid arthritis disease activity score,CRP level,ESR,suprapatellar bursa fluid depth,infrapatellar bursa fluid depth and joint fluid depth in the patients with rheumatoid arthritis (r=0.583,0.258,0.383,0.219,0.228,0.248;P<0.05).Conclusion Ultrasound has good diagnostic value in the patients with rheumatoid arthritis,and the ultrasonic scoring system can better reflect the severity of the disease.

With the strengthening of nuclear weapon development and the expanding of neutron application in economic area,the injury accidents of neutron radiation are happening from time to time.Neutron exposure,with high linear energy transfer,has high casualty rate,severe symptom and poor prognosis.In comparison with low-LET radiation damage,neutron irradiation induced injuries are more difficult to rescue.This review focused on the recent research progresses of radiation effects,intrinsic mechanisms and clinical prevention measures of neutron radiation,and to provide a theoretical clue for establishing an effective prevention protocol of neutron radiation damage.

Objective To explore the role of intravenous nutrition and enteral nutrition in the treatment of gastroplegia after gastrectomy. Methods The clinical data of 63 cases of gastroplegia after gastrectomy were retrospectively analyzed. Among the 63 cases, 30 were treated by gastrodynamic drugs and intravenous nutrition(intravenous nutrition group), and the other 33 cases were treated by gastrodynamic drugs and enteral nutrition(enteral nutrition group). Gastrointestinal decompression amount and recovery time of gastroplegia between the two groups were compared. Results Enteral nutrition group had a short recovery time of gastroplegia and less gastrointestinal decompression amount compared with intravenous nutrition group(P

In order to realize an individualized and specialized rehabilitation assessment of remoteness and intelligence, we set up a remote intelligent assessment system of upper limb movement function of post-stroke patients during rehabilitation. By using the remote rehabilitation training sensors and client data sampling software, we collected and uploaded the gesture data from a patient's forearm and upper arm during rehabilitation training to database of the server. Then a remote intelligent assessment system, which had been developed based on the extreme learning machine (ELM) algorithm and Brunnstrom stage assessment standard, was used to evaluate the gesture data. To evaluate the reliability of the proposed method, a group of 23 stroke patients, whose upper limb movement functions were in different recovery stages, and 4 healthy people, whose upper limb movement functions were normal, were recruited to finish the same training task. The results showed that, compared to that of the experienced rehabilitation expert who used the Brunnstrom stage standard table, the accuracy of the proposed remote Brunnstrom intelligent assessment system can reach a higher level, as 92.1%. The practical effects of surgery have proved that the proposed system could realize the intelligent assessment of upper limb movement function of post-stroke patients remotely, and it could also make the rehabilitation of the post-stroke patients at home or in a community care center possible.
Algorithms ; Arm ; physiopathology ; Artificial Intelligence ; Humans ; Movement ; Recovery of Function ; Reproducibility of Results ; Software ; Stroke Rehabilitation

Objective To evaluate the efficacy and safety of ultrasound elastography in the diagnosis of pros-tate cancer.Methods 83 patients with prostate cancer were selected and diagnosed by transrectal ultrasound elastog-raphy (TRTE)and transrectal ultrasound(TRUS).The surgical pathology of the patients was used as diagnosis basis, and the efficacy of the two methods was evaluated.Results There were 102 nodules of all the 83 patients,44 patients'surgical pathology were benign,a total of 49 nodules,39 cases were vicious,a total of 53 nodules.47 nodules were gland nodules,accounting for 46.08% and 55 nodules were outer gland nodules,accounting for 53.92% of all the 102 nodules.There were 54 focis,the TRTE detected 36 focis,the detection rate was 66.67%,and TRUS detected 24 focis,the detection rate was 44.44%.The sensitivity,specificity and accuracy rates of TRTE were 66.67%, 68.65% and 67.64%,which were higher than 44.44%,64.58% and 53.92% of TRUS,and the differences were statistically significant (χ2 =10.710,P <0.05;χ2 =3.879,P <0.05;χ2 =4.084,P <0.05).The differences of pathological findings and TRTE,TRUS findings of the benign and malignant prostate nodules were not statistically significant (P >0.05 ).Conclusion It has higher diagnostic sensitivity,specificity and diagnostic accuracy for ultrasound elastography in the diagnosis of prostate cancer,which can improve the clinical diagnostic performance and worthy of clinical application.

Purpose To explore the relationship between the mutations of epidermal growth factor receptor ( EGFR) and KRAS genes and clinicopathological characteristics in patients with non-small cell lung cancers (NSCLC). Methods Clinical samples from 431 NSCLC patients were obtained for EGFR and KRAS gene analysis. PCR based direct DNA sequencing was used to investigate mutations in exon 18-21 of EGFR gene and codon 12 and 13 of exon 2 of KRAS gene. Results The overall EGFR mutation rate of primary NSCLC was 53. 6% (231/431) in this study cohort and eight cases showed double EGFR mutations. Mutation rates in female and male were 65. 2% (122/187) and 46. 9% (98/209), respectively. The mutation rate was higher in patients with non-smokers and adeno-carcinoma and adenosquamous carcinoma subtypes than in their counterparts (P<0. 05), with the percentage of 57. 2% (124/216), 60. 3% (199/330), 42. 9% (6/14), respectively. In squamous cell carcinomas and other subtypes, EGFR mutation rates were 11. 6% (5/43) and 11. 1% (1/9), respectively. The EGFR mutation types included exon 18 point mutations (4. 0%, 9/227), exon 19 deletion mutations (4. 5%, 101/227), exon 20 insert or point mutations (9. 7%, 22/227) and exon 21 point mutations (41. 4%, 94/227). Activating mutations of KRAS gene were detected in 7. 8%(31/396) of NSCLC. Twenty-eight patients showed codon 12 mutations ( G>T, G>A, G>C) , and three patients had codon 13 mutations ( G>A, G>T) . Most of these mutations were G to T transversion (64. 5%, 20/31). Conclusion Polymerase chain reaction-direct sequencing is a reliable and effective method for the detection of the EGFR and KRAS gene mutation in NSCLC patients. The mutation rate of EGFR is higher in Chinese patients, especial-ly in non-smoking female patients with adenocarcinoma.

Objective To observe the diffusion characteristics and pathology changes with DTI in rabbit models with mild cerebral contusion and laceration (CCL). Methods Thirty rabbits were randomly selected and made into models of mild CCL by free fall, while other 10 rabbits were cut only in the skull as control. T2WI and DTI were performed 1, 3, 6, 12, 24, 48 and 72 h after the operation. DTI value of average diffusion coefficient (DCavg) and fractional anisotropy (FA) of mild CCL and its peripheral area were measured and compared. Histological examination was also performed. Results One hour after operation, CCL area showed high signal on T2WI, and no abnormal signal was found in the peripheral area, but both had abnormal color on DTI map. T2WI signal intensity in peripheral area of 22 rabbits (73.33%) increased gradually and had much abnormal color on T2WT map after 3 h. There was significant difference of FA and DCavg between CCL and the mirror region, the peripheral area and the mirror region (P<0.05). The value of FA decreased slightly since 12 h. More prominent tissue necrosis, edema and hemorrhage were found in CCL area than in the peripheral area with pathology examination. No abnormal manifestations of the brain were detected with both pathology and MR examination in the control rabbits. Conclusion DTI is sensitive for detecting mild CCL and can show it directly on color map, and thus may be used as a routine examination in the evaluation of mild CCL.