Gallbladder cancer is a disease associated with high mortality. Improvement of early diagnosis is of great significance to prolong the survival. Risk factors for gallbladder cancer include gallstones, cholelithiasis, anomalous pancreaticobiliary junction, focal mucosal microcalcifications, and et al.Advances in endoscopic ultrasonography, magnetic resonance cholangiopancreatogram and helical computed tomography have enhanced preoperative diagnosis of gallbladder cancer. Understanding the characteristics of gallbladder cancer with the help of multiple imaging modalities can facilitate accurate diagnosis and may also help in sorting patients to undergo extended resection or an alternative therapy. Resection is currently the most effective and only potentially curative treatment for gallbladder cancer.However, owing to its non-specific symptoms, gallbladder cancer patients often suffer from late diagnosis, and few patients are suitable for surgery. Other treatment strategies such as chemotherapy, radiotherapy, percutaneous biliary drainage, palliative surgery are used in patients with advanced gallbladder cancer.For jaundiced gallbladder cancer patients, preoperative biliary drainage is still under debate. Since biliary inflammation adversely affects the prognosis of gallbladder cancer patients,antibiotics with high concentration in bile is recommended for selected patients. Palliative treatment and molecular target therapy are promising for patients with inoperable gallbladder cancer.

Complicated bile duct injury greatly affects quality of patients' life and even threatens their life safety because it is difficult to be recognized and reconstructed,also with the poor surgical effect.Regarding to the surgical timing of complicated bile duct injury,it still have a big controversy.Here we would discuss the timing of surgeries for bile duct injury.We consider that it should be reconstructed when it is recognized during operation,even converted to laparotomy for laparoscopic surgeries.About postoperative cases,we think that it should be operated to explore damage range and reconstruct for those cases found within 48 hours and without obvious infection.However,reconstruction should be performed after 6 weeks for those found after 48 hours or with biliary duct infection.

Effects of melatonin ( MT ) and supernatants from cultured pineal glands stimulated by 10 ?mol/L isoproterenol (ISO) for 0, 30, 60, 120 min on interleukin I ( IL-1 ) production by peritoneal macrophage ( PM? ) in rats were studied. Theses results showed that LPS-induced IL-1 production by PM? was enhanced by in vitro treatment with MT (0.1~1 ?mol/L ) , but IL-1 production was not influenced by MT without LPS. LPS-induced IL-1 production by PM? was enhanced in various degree by the supernatants, action of supernatants for 60min was best. The data is suggested that LPS-activated M?s may be one of target cells for MT.

Effects of supernatants from cultured rat pineal glands on ConA and LPS induced proliferative responses of splenocytes in mice, ConA induced interleukin 2 (IL-2) production of splenocytes in rats were studied. These results showed that ConA and LPS induced proliferative responses of splenocytes were enhanced by supernatants from cultured rat pineal glands stimulated with 10 ?mol/L isoproterenol (ISO) for 60 min (Dilution. 1 : 45 ) , ConA induced IL-2 production of splenocytes in rats was also enhanced by the supernatants (Dilution: 1 : 135 ) .

Effects of melatonin ( MT) on Con A or LPS-induced prolifera-tive responses of splenocytes in mice and Con A induced interleukin 2 ( IL-2 ) production of splenocytes in rats were studied. The results showed that Con A and LPS induced proliferative responses of splenocytes were enhanced by in vitro treatment with MT (0.01~1?mol/L and 0.01~10?mol/L, reinduced-pectively ) . ConA IL-2 production of splenocytes were also enhanced by in vitro treatment with MT (1~10?mol/L), but MT has no effects oa above functions of splenocytes without activating by ConA or LPS. These data suggested that mitogen activated lymphocytes might be one of the target cells for MT.

0.05).In the elderly group,every complication rates of LR were lower than those of OR(P

Humans ; Salivary Gland Neoplasms ; therapy

Translational medicine is a new concept in China.It sets up a bridge between basic research and clinical work,and aims to transfer the basic study results to clinical practice as soon as possible.It is necessary for a surgeon to master the research idea of translational medicine in order to be expert in science and technique.Many unsolved clinical problems could be found in routine work,which is an advantage for translational medicine research.How to raise questions in routine clinical work and get these questions resolved in laboratory,and then apply the results to clinical work is a demand for surgeons nowadays.In this article,the research idea of translational medicine is introduced based on an example of the research on the relationship between rapamycin and hepatocellular carcinoma.

Objective This paper aimed to evaluate the effect of preoperative embolization on the intraoperative blood loss of sacrum chordoma.Methods forty patients involved with the spinal chordoma were retrospectively analyzed in this study.The preoperative embolization group consisted of 16 sacrum chordoma patients were embolizationed by gelatin sponge particles (10 male and6 female)age from 35 to 71 years old,(mean 57.9 years) ; and the control group consisted of 4 sacrum chordoma patients (3 male and 1 female),age from 43 to 61 years old(mean 51.8 years).analyzed the predictive value of preoperative embolization in correlation with the intraoperative blood loss.Results The mean blood loss (2025.0 ±818.5)ml of sacrum chordoma in the preoperative embolization group was insignificantly than that (1950.0 ± 802.1) ml in the control group,(P ＞ 0.05).Conclusion The study shows that the preoperative feeding artery embolization of the spinal tumor has no significant effect on the intraoperative blood loss in the surgical excision of the sacrum chordoma.

Objective To explore the protection of the facial-acoustic nerve during microsurgery for acoustic neuroma via the suboccipital retrosigmoid approach. Methods The clinical data of 25 cases with acoustic neurinoma treated by the suboccipital retrosigmoid approach were retrospectively analyzed. Results Total removal was achieved in 22 patients and subtotal in 3 patients. 20 with Cochlear nerve anatomic preservation at 2 weeks after surgery and 3 patients with effective hearing and 13 patients lost effective hearing but retained measurable hearing and 9 patients completely lost hearing( the New Hannover Classification V grade). The facial nerve was preserved anatomically in 18,H-B Grade I ～ IV in 15,Grade V ～ VI in 10. There were not cerebrospinal fluid leakage, intracranial infection and death in all cases. Conclusion When operating,the relation between the tumor and the important structure surrounding could should be understood fully. Then removed the tumor piece by piece with microsurgical techniques. That the effective way to keep the facial nerve and its function being protected,and could improve the prognosis of the operation.