Objective To investigate the effect of genetic alteration(homozygous deletion and point mutation)and expression of p16 gene and p16 protein on hilar cholangiocarcinoma(HCGC) . Methods Genetic alteration and expression of p16 protein were detected by polymerase chain reaction single strand comformation polymorphism (PCR-SSCP) and immunohistochemical method in 36 HCGC tissues. Results p16 gene revealed alteration in 21 of 36 HCGC tissues (58.3%),among which 8 had homozygous deletion and 13 had point mutation. In HCGC tissues, 8 revealed no p16 protein expression and 10 showed low level expression of p16 protein. Conclusions The alteration of p16 gene and abnormal expression of p16 protein are significantly correlated with the biological behavior and clinical staging of HCGC,and may be helpful to evalute the malignant degree of HCGC and the patients prognosis.

Objective To discuss the indications,technical skills and the therapeutic effects of percutaneous lumbar diskectomy(PLD) for the treatment of lumbar intervertebral disc herniation in patients over 70 years.Methods From August 2004 to July 2008,PLD was performed in 48 patients(aged 70-79) with lumbar intervertebral disc herniation.A total of 58 lumbar intervertebral disc herniations were detected,all of which were encapsulated intervertebral disc herniation.Fifty-two patients,who showed similar symptoms,signs and same imaging manifestations and were 70-81 years old,were randomly selected as control group to receive conservative treatment.Results Of 56 lumbar intervertebral disc herniations,54 were successfully punctured with a successful rate of 96.4%.All patients were followed up.The excellent rate and the effective rate at 6 months were 29.1% and 52.1% respectively for PLD group,while that were 19.2% and 36.5% respectively for control group.The excellent rate and the effective rate at 12 months were 25.0% and 47.9% respectively for PLD group,while that were 17.3% and 32.7% respectively for control group.At both 6 and 12 months after the treatment,the therapeutic effects of PLD group were significantly better than that of control group,the difference were statistically significant(?2=7.45,P

Objective To summarize the clinical characteristics of and therapeutic approaches to deep venous thrombosis(DVT)caused by pelvic tumors,in the fact that some patients with pelvic tumors may present DVT as the first sign of the tumor. Methods The clinical data of 36 patients admitted between January 1997 and April 2009 suffering from pelvic tumor induced DVT were analvzed retrospectively.Result In all of these 36 patients,the occurrence of limb sweUing wag chronic and progressive with insidious onset.Regular DVT treatment Was given to 25 cases yielding no effect before the cause Was revealed.Ultrasound and CT were used for detection of the pelvic tumor.and compression of the iliac vein by the tumor was detected in an the cases.Pelvic tumor resection with iliac vein ligation was done in 29 cases(5 cases had iliac artery reconstruction with prothesis graft),in the remaining cases the pelvictumors were left untreated. Elastic stocking compression and venotropie preparations. microcirculation-improving agents were routinely applied in all the pafients.All the cases got improvement with different degrees.Conclusion DVT Call be a precursor of pelvic tumors.A thorough consideration of this posibility Is important when limb swelling Was chronic and progressive,or no improvement was observed after regular DVT treatment.Surgical resection of the pelvic tumors and conservative therapy of the involved limb is the therapeutic principle.

Objective To observe the clinical efficacy of drilling and drainage combined with atorvastatin calcium tablets in treatment of chronic subdural hematoma (CSDH).Methods Totally,46 patients with CSDH,admitted to and received therapy in our hospital from January 2014 to January 2017,were selected for this research.These patients were divided into control group (n=16) and experimental group (n=30) according to therapeutic schemes.The patients from the control group underwent drilling and drainage.Besides that,the patients from the experimental group were given atorvastatin calcium tablets additionally,20 mg/d×2 months.Two months after that,the curative efficacy,hematoma volume before and after operation,pneumocephalus volume one week after operation,duration of tube drainage,length of hospital stay,China stroke scale (CSS) scores,activities of daily life-Barthel index scale (ADL-BI) and visual analog scale (VAS) score were compared between the patients from the two groups.Results Two months after treatment,patients from the experimental group had significantly decreased hematoma volume as compared with those from the control group (P＜0.05).The hematoma volume in both groups 2 months after treatment was significantly decreased as compared with that before treatment (P＜0.05).The pneumocephalus volume,indwelling time of drainage tube,and hospital stays in the experimental group were significantly shorter/lower than those in the control group (P＜0.05).The CSS scores and VAS scores in the experimental group 2 months after treatment were significantly lower than those in the control group (P＜0.05).The ADL-BI scores in the experimental group 2 months after treatment were significantly higher than those in the control group (P＜0.05).The ADL-BI scores in both groups 2 months after treatment was significantly increased as compared with those before treatment (P＜0.05).Conclusion As compared with simple use of drilling and drainage,drilling and drainage combined with atorvastatin calcium tablets can help hematoma absorption,decrease incidence of pneumocephalu,and improve prognosis effectively.