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Objective To summarize the clinical and pathological characteristics of primary gallbladder carcinoma, analyze factors such as surgical procedures, tumor stages that associated with prognosis, and standardize the diagnosis and treatment strategy for primary gallbladder carcinoma.Methods From January 1986 to October 2009, 197 patients of primary gallbladder carcinoma were treated in Peking Union Medical College Hospital (PUMCH). A retrospective study was performed basing on clinical data of these patients, statistical analysis carried out using SPSS version 13.0, Kaplan-Meier estimate employed for the survival analysis and Log-rank test for the group comparisons. Results One hundred and ninety-seven patients were enrolled (73 male and 124 female) with the mean age of 64.4±1.1years. Abdominal pain (77.3%) , obstructive jaundice (33.6%) and fever (19.5%) were the main symptoms of primary gallbladder carcinoma, with accompanying cholecystolithiasis in 99 cases. B-mode ultrasonic examination and CT scan were important for preoperative diagnosis. Nevin stages and surgical modalities were independent prognosis factors. For stage Ⅰ and Ⅱ patients the survival terms were not different between those receiving radical cholecystectomy and simple cholecystectomy. However, for stage Ⅲ, Ⅳ and Ⅴ patients the survival terms were of statistically different between those in radical cholecystectomy group and simple cholecystectomy group. Conclusions For stage Ⅰ and Ⅱ patients, simple cholecystectomy is a good surgical procedure. For those at more advanced stages, radical cholecystectomy is the choice of therapy, while simple cholecystectomy also improves the prognosis compared with laparotomy only.

Objective To summarize the clinical and pathological characteristics of incidental gallbladder carcinoma,analyze the factors such as surgical procedures,tumor stages that associated with prognosis,and standardize the diagnosis and treatment strategy of incidental gallbladder carcinoma. Methods Between January 1991 and October 2009,27 incidental gallbladder carcinoma patients were treated in Peking Union Medical College Hospital (PUMCH).A retrospective study was performed based on the clinical data of these patients to evaluate the methods of diagnosis,curative treatment and prognosis. Results Twenty-seven patients were collected (8 male and 19 female) with the mean age of (68.3 ± 1.9)years.Abdominal pain,obstructive jaundice and fever were the main symptoms of incidental gallbladder carcinoma.All the 27 cases underwent open cholecystectomy based on preoperative tentative diagnosis of benign disease,and carcinoma of gallbladder was confirmed by postoperative pathology.In this group(9 lowdifferentiation,9 moderate-differentiation,4 high-differentiation and 5-carcinogenesis from adenoma).Two cases were on the stage of Nevin Ⅰ,5 on Nevin Ⅱ,8 on Nevin Ⅲ,5 on Nevin Ⅳ and 7 on Nevin Ⅴ.The survival terms were of statistic significance between the radical cholecystectomy groups and simple cholecystectomy groups(x2 =4.450,P=0.035); The prognosis of patients on stages Ⅰ、Ⅱ are better than those who are on stages Ⅲ、Ⅳ、Ⅴ (x2 = 6.825,P = 0.014). Conclusion The clinical manifestations of incidental gallbladder carcinoma are diverse,which usually lead to misdiagnosis.Frozen section examination during operation is key to diagnose incidental gallbladder carcinoma.Surgical operation is the first choice of therapy,offering much better prognosis than those received simple cholecystectomy.

Objective To investigate the diagnosis and treatment strategy of primary sclerosing cholangitis (PSC). Methods From January 1991 to August 2009, 31 patients with PSC were treated at the Peking Union Medical College Hospital. A retrospective study was performed based on the clinical data of these patients to evaluate the methods of diagnosis, curative treatment and prognosis. Results Obstructive jaundice, fever and abdominal pain were the main symptoms of PSC, which accounted for 90% (28/31) , 65% (20/31) and 52% (16/31) , respectively. Thirty patients presented with an elevation of alkaline phosphatase. The positive rate of autoantibody was 45% (14/31). The positive expression of serum tumor markers of 15 patients was elevated, and 13 of the 15 patients had an elevated expression of CA19-9 (84-5000 U/mL). The diagnostic accuracies of B-mode ultrasound, computed tomography, magnetic resonance cholangiopancreatography, and endoscopic retrograde cholangiopancreatography (ERCP) were 3/28, 2/24, 2/18, 18/25, respectively. Nineteen patients received drug therapy and only one patient had no obvious discomfort after the treatment. Twelve patients received surgical treat-ment and the prognosis of two patients who underwent liver transplantation was good. Eleven patients received endoscopic treatment, only one patient had no obvious discomfort and the condition of the remaining 10 patients was alleviated after treatment. Conclusions PSC is usually characterized by an elevated expression of CA19-9. ERCP has a high diagnostic accuracy. Conventional treatments can only relieve the symptoms, whereas liver transplantation has a favorable long-term efficacy.

Objective To observe the effect of a repeated-sprint training on the speed-endurance of basketball players in a hypoxia environment.Methods Sixteen basketball players were divided into a hypoxiagroup and a normoxia group which had 8 persons each group.The 2 groups separatelyhad a repeated-sprint training with anaerobic power bicycles in a simulatedhypoxic environment at the altitude of 3000 meters and a normoxia environment for 4 weeks(twice a week).Before and after the training,the two groups of subjects had a shuttle run testing and a Wingateanaerobic powertestingin a normoxia environment.Then their blood were collected and measured the blood lactate level at the point-intime of after the shuttle run,3 min later,5 min later,7 min later,and 9 min later.Recorded the result of the shuttle run,the relative average power of the Wingateanaerobic powertesting,and carried on a statistic analysis of the data.Results Comparing with the performance of the shuttle run before the training,the performance of the 2 groups was improved obviously after the four-week-long training (P＜0.05).But there was no significant difference between the 2 groups(P＞0.05).The rate of blood lacticacid clearance in the hypoxia group was higher than that in the normoxia group,and there was a significant difference at 7 min (P＜0.01).The relative average power of the hypoxia group had a significant improvement(P＜0.05),while the normoxia group had no significant change(P＞0.05).There was no significant difference of the relative average power between the two groups.Conclusion Repeatedsprint training can improve basketball players' speed-endurance.Repeated-sprint training in a hypoxic environment can effectively improve basketball players' ability of reducing blood lactate in their body,and the improvement of this aerobic ability can help athletes to have a better performance in competitions.

Objective To explore the change of sexual life quality and its influencing factors of premenopausal breast cancer patients.Methods 94 premenopausal breast cancer patients were included. Changes in Sexual Functioning Questionnaire short-form (CSFQ-14) was used and part of its items was changed. Their sexual life was evaluated before and after treatment by using depth interview and anonymous methods. Results 94 cases received face-to-face communication and study. 88 (93.6%) questionnaires were received, in which 81 (92.1%) questionnaires were effective. Their sexual life quality and sexual satisfaction significantly decreased and there was significant difference in the CSFQ-14 score (P<0.001) before and after treatment. The ratio of bad, worse, and worst sexual life were 39.5%, 29.6%, and 14.8% respectively after treatment. 65.4% of the patients had no sexual activity. The reasons included medical related factors, fear of cancer metastasis and recurrence, physical discomfort, poorer body image, partner sexual attitudes changed, life stress, common psychological problems, traditional ideas and so on. Conclusion Sexual dysfunction was obvious and sexual life quality significantly decreased in premenopausal breast cancer patients after treatment. Patients' physical and mental damage, the change of body image and spouse's attitude are significant influencing factors. It is necessary to give sexual rehabilitation guidance to patients and their spouses.

Objective To evaluate the role of tumor budding in the prognostic value of intrahepatic cholangiocarcinoma(ICC) after radical resection.Methods The clinicopathological data of patients undergoing radical resection for intrahepatic cholangiocarcinoma between 2011 and 2016 were retrospectively analyzed.The number of tumor budding was counted in a ×200 microscopic field (0.785mm2).Based on receiver operation curve (ROC),the number of tumor budding ≥ 15 was defined as high-grade group,and ＜ 15 was low-grade group.Multivariate analysis were performed on predictors of the tumor.Results Low-grade group was observed in 32 cases and high-grade group in 50.High-grade group appeared to develop tumors with higher CA199,poor differentiation,larger tumor diameter,advanced stage and high risks of lymphnode metastasis (respectively x2 =5.470,4.359,5.101,4.696,5.960,all P ＜ 0.05).Univariate analysis showed that tumor budding,CA199,differentiation,tumor diameter,T classification and lymphnode metastasis were related to the overall survival of patients with ICC (respectively x2 =11.704,4.876,5.056,5.152,8.442,16.725,all P ＜ 0.05).On multivariable analysis,high-grade group was a significant independent predictor of worse OS (HR =2.707 95％ CI 1.558-4.705,P ＜ 0.001).Conclusions High-grade tumor budding is an important negative prognostic factor for ICC.