Objective To analyze the factors influencing the prognosis of patients with bile duct carcinoma after resection. Methods The clinical data of 120 patients with bile duct carcinoma receiving resection in our hospital from 1980 to 2004 were collected retrospectively and clinicopathologic factors that might influence survival were analysed. A multiple factor analysis was performed through Cox proportional hazard model. Results The overall 1-year, 3-year and 5-year survival rates were 71.7%, 32.5% and 19.2% respectively. The single factor analysis showed that the major significant factors influencing survival of these patients were histological type of the lesions, lymph node metastasis, pancreatic infiltration, duodenal infiltration, resected surgical margin, perineural infiltration, peripheral vascular infiltration and depth of tumor infiltration (P

Objective: To investigate the inhibitory effect of ethanol extract of Forsythia suspensa root (FSEER) on growth of esophageal cancer cells in nude mice. Methods: The inhibitory effect of FSEER on growth of esophageal cancer cell lines including TE-1, TE-13, Yes-2 and Eca-109 was measured by MTT method. The xenograft tumor models of TE-13 cells in nude mice were established and divided into two groups: treatment group [treated with FSEER (50 mg/kg)] and the control group (treated with equal volume of normal saline). Then the growth of xenograft tumors in nude mice was observed and their sizes and weights were measured. The apoptosis of tumor tissues in nude mice was deteced by TUNEL staining analysis. The expressions of Bcl-2 and Bax in tumor tissues were detected by immunohistochemical method. Morphological changes of lung and liver tissues in nude mice were observed by hematoxylin-eosin staining. Results: FSEER had obvious inhibitory effect on the growth of esophageal cancer cells in vitro (P < 0.01). Moreover, the growth of TE-13 cells was inhibited by FSEER in the dose-and timedependent manner (P < 0.01). The average volume and weight of tumor tissues in nude mice of FSEER treatment group were significantly smaller and lower, respectively, as compared with those of the control group (P < 0.05). Comparing to the control group, the number of apoptotic cells in FSEER treatment group was significantly increased (P < 0.05), while the expression level of Bcl-2 was decreased (P < 0.05), but Bax expression level was increased (P < 0.05). No obvious morphological changes were found in liver and lung tissues in FSEER treatment group and the control group. Conclusion: FSEER has inhibitory effect on the growth of xenograft tumor of esophageal cancer cells in nude mice, which may be related to inducing apoptosis.

Objective To increase the awareness of thyroid diseases through observing the relationship between ultrasound indications of thyroid and thyroid disease,and to enhance the understanding of thyroid disease through outpatient data.Methods Two hundred women aged 25 to 50 with thyroid imaging data were selected from the Department of Ultrasonography,the First Affiliated Hospital of Harbin Medical University.Seven indications including age,body weight,thyroid volume,the number of nodules,nodule size,nature of nodules and thyroid disease were recorded.Thyroid cases were divided into four groups based on their sonographic changes of color Doppler ultrasound:normal group (136 cases):sonographic changes of thyroid were approximately normal ; mild degree group (9 cases):consisting of patients with mild thyroid disease,diffused thyroid enlargement or combined cystic nodules; moderate degree group (38 cases):consisting of patients with moderate thyroid disease,hyperthyroidism or hypothyroidism; severe degree group (17 cases):consisting of patients with severe thyroid disease,thyroiditis and/or with hemorrhage and calcification.Data were analyzed using the method of clinical case observation and SPSS 16.0.Results We found that in mild degree group the discriminant coefficients of thyroid volume,the nature of thyroid nodules and nodule size were 0.085,0.169 and 0.695; but in sever degree group the corresponding values were 0.158,0.344 and 0.484,respectively,and the difference between the two groups was statistically significant (x2 =43.3,df =18,P ＜ 0.01).Conclusions The nature,size and area of thyroid nodules are closely related to the progression of thyroid disease.The color Doppler ultrasound data of outpatients as a part of hospital statistics have important theoretical and practical value.

OBJECTIVE To study the prevalence,fungal species,therapy and prevention of invasive fungal infections in our Affiliated Hospital.METHODS From Jan 2004 to Dec 2005,all patients with positive results for fungal culture of blood and sterile fluid were reviewed retrospectively.The in vitro activity of antifungal agents against fungal isolates was determined.RESULTS Eighty-eight positive patients were collected in this analysis based on the diagnosis of invasive fungal infection in our hospital for two years,from them the majority were diagnosed as candidal infections(n=72,81.8%),the others were Cryptococcus neoformans(n=8,9.1%),Aspergillus(n=5,5.7%) and other different fungal infections.The most common was C.albicans(n=48,66.7%),C.glabrata(n=12,16.7%),and C.tropicalis(n=8,11.1%),C.parapsilosis and C.krusei were both the same results(n=2,2.8%).CONCLUSIONS Infections caused by Candida are the most common invasive fungal ones in our hospital,and C.albicans is the most common one.Fluconazole remains effective for treament of candidal infections,especially those caused by C.albicans.

OBJECTIVE To investigate the antibiotic resistance status in clinical strains of Staphylococcus aureus (SAU) in Xiangfan and provide scientific evidence for reasonable use of antibiotics. METHODS Retrospective review was performed to analyzed the specimen source and the clinical distribution of 359 strains of SAU. BioMerieux Vitek 32 was used to identify the species of bacteria. Antibiotic susceptibility test was performed by K-B method and drug-resistance results were read according to CLSI2006. RESULTS Isolating rate of methicillin resistant S. aureus (MRSA) arrived at 54.9%. The results of susceptibility test showed that SAU had been resistant to the diverse antibiotics in different degree. The drug sensitivity rate of glycopeptide antibiotics and linezolid were all 100%. CONCLUSIONS The different grade hospitals should practically perform the management of antibiotics to postpone the resistance development and control outbreak and prevalence of nosocomial infections.

The pharmaceutical microbiological examination in medical institutions is an important method to ensure the safety of preparations.It is of great significance to popularize the techniques of drug microbiological examination in primary medical institutions.This article started with the purpose, plan and training contents of the microbiological examination training program, which combined with theory teaching and practical operation, two-phase practical teaching, group teaching and collective teaching and guided students to design and plan experiments to carry out the teaching work,and then explored the ways and improving measures of the pharmaceutical microbiological examination training for hospital pharmacists, which could provide reference for the training and teaching of hospital pharmaceutical microbiological examination.

Objective:To investigate the immune response after injecting polysaccharide nucleic acid of Bacillus Calmette-Guerin(BCG-PSN)under the mucous membrane of bladder in rabbits and to search for the most suitable dose of BCG-PSN.Methods:The rabbits were randomly divided into 5 groups:high dose(0.35 mg/ml)BCG-PSN group,mid- dle dose(0.175 mg/ml)BCG-PSN group,low dose(0.0875 mg/ml)BCG-PSN group,BCG(0.35 mg/ml)control group and BCG-PSN(0.35 mg/ml)intra-bladder perfusion control group.T lymphocyte subsets(CD4~+,CD8~+)in the peripheral blood were determined by flow cytometry before and 1 week,2 weeks,1 month and 3 months after the treatment; the levels of IL-2,TNF-?,and IFN-?of peripheral blood were determined by enzyme-linked immunosorbent assay;H-E and Masson staining was used for the pathological examination of the bladder.Results:(1)BCG-PSN injection increased the number of CD4~+ and CD8~+ T lymphocytes in a time- and dose-dependent manner,with the peak numbers appeared 2 weeks after BCG-PSN injection;the numbers restored to the normal levels 3 months after BCG-PSN injection.BCG control group had a similar changing pattern to the BCG-PSN injection group.The number of CD4~+ T cells BCG-PSN perfusion group was significantly lower than that in the high-dose BCG-PSN injection group(P

Objective To investigate the effects of low frequency repetitive transcranial magnetic stimulation (rTMS) on motor function and excitability of motor cortex in Parkinson's disease (PD) patients and to study the mechanism of PD from the electrophysiology. Methods Twenty-eight patients with PD received 1 Hz rTMS therapy for 15 d. Thirty normal volunteers were enrolled as controls. Unified Parkinson's Disease Rating Scale (UPDRS) and motor evoked potential (MEP) were adopted as assessment indicators. The excitability of motor cortex was assessed by rest motor threshold (RMT), central motor conduction time (CMCT) and the amplitude of MEP. Results The initial RMTs and CMCTs of PD patients were significantly lower than those of the controls, but MEP amplitudes were not significantly different. After rTMS treatment, motor function of PD patients improved, RMTs increased and CMCTs prolonged. Conclusion In PD patients, motor function disorder and increased motor cortical excitability were observed. Low frequency rTMS may inhibit these changes to some extent.

Objective To investigate the hepatic expression of sterol regulatory element binding protein (SREBP)-1c in patients with non-alcoholic fatty liver disease (NAFLD) and its significance.Methods Twenty patients with NAFLD were included,and 20 age/sex matched asymptomatic HBV carriers (ASC) without steatosis evidenced by liver biopsy were used as control in the same time scale.Hepatic SREBP1c was detected using SP method of immunohistochemistry.An automatic biochemical analyzer (Hitachi 7060) was used to measure serum levels of lipids (TG,CHO),fasting blood glucose (FBG) and liver enzymes (AST,A LT,and GGT),and electrochemiluminescence was used to determine fasting insulin (FINS).Results Compared with the control group,NAFLD patients showed diffusely hepatic steatosis and a significantly higher expression of hepatic SREBP1c (P ＜ 0.05).Consistently,serum levels of ALT,AST,TG,CHO,FSG and FINS all increased than those of control group (P ＜ 0.05).Conclusions Hepatic expression of SREBP1c increased significantly in patients with NAFLD,and this over expression may be involve in fatty degeneration of the livers in human.

Objective To investigate the safety and clinical effect of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) in the treatment of hepatocellular carcinoma (HCC) with cirrhosis.Methods The retrospective cohort study was adopted.The clinical data of 5 patients with primary HCC with cirrhosis who underwent ALPPS at the First Bethune Hospital of Jilin University between October 2014 and August 2015 were collected.The surgical plan was determined according to preoperative liver function and liver functional reserve.The patients underwent portal vein (PV) ligation and liver partition in the first staged surgery.The second staged surgery was performed when growing future live remnant (FLR) came up to the standard of safe section by rescan of computed tomography (CT) at 10,14,18 days after the first staged surgery,and hemihepatectomy and hepatic segmentectomy were applied to patients.(1) The intraoperative situations were observed,including the severity of liver cirrhosis,first staged surgery time,volume of intraoperative blood loss and FLR in the first staged surgery,interval time of surgery,growth rate of liver volume,ratio of FLR and standard liver volume (SLV),time and volume of intraoperative blood loss in the second staged surgery.(2) Pre-and postoperative biochemical indicators in the first and second staged surgeries were detected,including total bilirubin (TBil) and alanine phosphatase (ALT).(3) Postoperative situations were observed,including occurrence of complications,results of pathological examination and duration of hospital stay.(4) The follow-up using telephone reservation and outpatient examination was performed to detect tumors recurrence and metastasis and survival of patients by imaging examination and tumor marker test up to November 2015.Count data were represented as mean (range).Results (1) Intraoperative situations:of 5 patients,there were 1 patient with F3 of liver cirrhosis and 4 with F4 of liver cirrhosis.One patient was complicated with lots of peritoneal effusion,followed by acute renal failure,and didn't receive the second staged surgery.Four patients underwent successful ALPPS.The first staged surgery of 5 patients:average operation time,volume of intraoperative blood loss,FLR,interval time of surgery,growth rate of liver volume,ratio of FLR and SLV were 282 minutes (range,240-320 minutes),500 mL (range,300-700 mL),457 em3(range,338-697 cm3),15 days (range,14-18 days),58％ (range,46％-67％) and 42％ (range,32％-44％),respectively.Average operation time and volume of intraoperative blood loss in second staged surgery were 220 minutes (range,200-260 minutes) and 412 mL (range,300-600 mL).(2) Pre-and post-operative biochemical indicators:levels of TBil and ALT of 5 patients from pre-operation to postoperative day 12 in the first staged surgery were from 4.9-30.4 μmol/L to 9.8-56.1 μmol/L and from 12.9-156.1 U/L to 46.3-207.3 U/L,respectively.Levels of TBil and ALT of 4 patients from pre-operation to postoperative day 10 in the second staged surgery were from 10.1-21.2μmol/L to 6.9-38.0 μmol/L and from 30.8-55.5 U/L to 19.8-72.8 U/L,respectively.(3) Postoperative situations:there were no perioperative death and postoperative complications of liver failure and intraperitoneal infection.One patient complicated with bile leakage was cured by non-operative treatment for 30 days.Results of pathological examination:5 patients were confirmed as Ⅱ-Ⅲ stage HCC,and 4 tumors had vascular tumor thrombi and negative resection margin with tumor size of 8-13 cm.Duration of hospital stay of 5 patients was 36 days (range,28-48 days).(4) Results of follow-up:4 patients undergoing successful ALPPS were followed up for 4-12 months.One patient was emerged with a new lesion of 2 cm in left half liver at postoperative month 7,level of AFP of which was 512 μg/L before the first staged surgery reduced to normal level at postoperative month 2,and then the patient received transcatheter arterial chemoembolization (TACE) and radio frequency ablation (RFA) treatments without tumor recurrence up to postoperative month 12.No tumor recurrence and new lesions in liver were detected in other 3 patients by abdominal enhanced scan of CT,with a normal level of AFP.Conclusion ALPPS is safe and feasible for HCC with cirrhosis,with a satisfactory short-term outcome.