Objective To investigate the surgical techniques of laparoscopic procedures in the management of stones straddling between the cystic duct and the common bile duct. Methods Clinical data of 19 cases of stones straddling between the cystic duct and the common bile duct treated by laparoscopic cholecystectomy (LC) from January 2001 to June 2003 were retrospectively reviewed. Results The operations were completed by opening the gallbladder ampulla and/or the cystic duct in all the patients. The stones were 0 4~0 6 cm in diameter (mean,0 5 cm).The drainage was removed 48 hours ofter the surgery.The patients were discharged from hospital 3~5 days postoperatively.Follow-up checkups in the 19 cases for 2~24 months (mean,10 months) found no residual stones. Conclusions Thorough exposure of the union of the cystic duct with the common bile duct and the opening of the cystic duct to expel the stones is the best way to manage stones straddling between the cystic duct and the common bile duct under laparoscope, and also the most effective method to prevent postoperative residual stones.

This study evaluated the biological stability and cytotoxicity of rabbit thoracic aorta cross-linked by dye-mediated photooxidation in vivo environment of blood flow. Rabbits, whose allogenic thoracic aorta was cross-linked by dye-mediated photooxidation (DMP, n=6) and glutaraldehyde (GA, n=6), were in the DMP group and GA group, respectively; rabbits, whose homogenic abdominal aorta was orthotopic transplanted (OT, n=6), were in the OT group. Then the donor arteries were transplanted into the position of the abdominal arteries of rabbits. After operation, the animals were fed for 1 month, then each of graft arteries was removed for observation. Biological stability was evaluated through histological analysis under optical microscope. Cytotoxicity was evaluated through ratio of coverage of endothelial cell (ES) under scanning-electron microscope. The results showed that no statistically significant difference was noted between DMP group and OT group (P>0.05); however, there was a significant difference between DMP group and GA group (P<0.01). The stability index in DMP group was much higher than that in GA group. There was a statistically significant difference between DMP group and GA group (P<0.01). Ratio was much higher in DMP group than in GA group. In conclusion, the arteries cross-linked by dye-mediated photooxidation treatment appeared to have higher biological stability and lower cytotoxicity in rabbit allogenic transplation model.
Animals ; Aorta, Abdominal ; transplantation ; Aorta, Thoracic ; cytology ; drug effects ; surgery ; Bioprosthesis ; Blood Vessel Prosthesis ; Coloring Agents ; chemistry ; Cross-Linking Reagents ; Endothelial Cells ; cytology ; Female ; Male ; Oxidants, Photochemical ; pharmacology ; Oxidation-Reduction ; Photochemistry ; Rabbits ; Random Allocation

This study was aimed to analyze the volatile constituents from flower, stem tip and seed of Cucurbita moschata Duch.(Miben). The volatiles were analyzed by head-space solid micro-extraction, coupled with GC-MS and Kovats indices for the first time . The results showed that 22 compounds were identified from the flower , 20 from the stem tip and 21 from the seed of the C. moschata (Miben). The total essential constituents from each part were 91 . 89%, 89 . 24% and 96 . 26%, respectively . A total of 10 compounds in the flower and stem tip were mutual. And 3 compounds in the flower, stem tip and seed were mutual. It was concluded that the β-bourbonene (17.57%) and heneicosane (11.90%) were the highest components of the total essential constituents of the flower of C. moschata (Miben). Decanal (28.77%) was the highest components of the stem tip and hexadecanoic acid ethyl ester (29.12%), 2,3-butanediol (16.90%) and linoleic acid ethyl ester (16.52%) were the highest compo-nents of seed of C. moschata (Miben).

Medical research institutions in Shanghai have been developing in at a slow pace because of problems such as out of date institution structures, unreasonable resource allocation and distribution,shortage of research resources, insufficient creativity, and unfocused effort and investment. Hence reform is the only way out. This research discussed the possible strategies for development and proposed some suggestions on the institution categorization, structure change, allocation of resource and overall arrangement.

Background and purpose:The effective rate of ifrst-line chemotherapy for advanced lung cancer is 30%-40%. The purpose of this study was to evaluate the efifcacy and adverse effects of pemetrexed combined with carboplatin or cisplatin in the treatment of patients with advanced non-squamous non-small cell lung cancer (NSCLC). Methods:One hundrend and twenty-one patients with advanced non-squamous NSCLC were enrolled in this study and all of these patients had been conifrmed with pathology or cytology. Among the 121 cases, 60 cases were male and 61 were female, the median age was 59 years, adnenocarcinoma in 113 patients and large cell carcinoma in 8 patients. Combination regimen: patients received pemetrexed 500 mg/m2 on day 1 and carboplatin 300 mg/m2 or cisplatin 70 mg/m2 on day 1 by intravenous infusion, administrated every 3 weeks for 2 to 6 cycles. All patients who received 2 or more cycles could be evaluated. Disease control rate (DCR) was the primary end point; secondary end points included progression-free survival (PFS), 1-year survival rate and safety.Results:There was 1 case with complete response (CR), 44 cases achieved partial response (PR), 50 had stable disease (SD) and 26 cases had progressive disease (PD) in the overall cases. ORR and DCR were 37.2% (45/121) and 78.5% (95/121), respectively. The median PFS time was 5.2 months and 1-year survival rate was 59.0%. In pemetrexed combined with carboplatin group, the ORR and DCRwere 38.3% (23/60) and 78.3% (47/60), respectively; The median PFS was 5.1 months (95%CI: 3.8-6.4 month) and 1-year survival rate was 55.2%. The patients treated with pemetrexed plus cisplatin, the ORR and DCR were 36.1% (22/61) and 78.7% (48/61), respectively. Median PFS was 6.2 months (95%CI: 4.3-8.1 month) and 1-year survival rate was 62.5%. There were no statistical differences between carboplatin/pemetrexed and cisplatin/pemetrexed for both ORR, DCR, PFS and 1-year survival rate (P>0.05). The major adverse effects were leukopenia, neutropenia, fatigue and gastrointestinal reaction.Conclusion:Pemetrexed plus platinum chemotherapy could be considered as the ifrst-line treatment option for advanced non-squamous NSCLC patients. Pemetrexed combined with carboplatin/ cisplatin regimen has efifcacy with mild toxicity and better tolerability.

Health service is an important part of the integrated development of the Yangtze River Delta. Taking the cooperation practice between Shanghai Tenth People′s Hospital and Suzhou Yinshanhu Hospital as an example, this article introduced the multi-agent cooperation mode of the loose medical alliance including the government, urban hospitals and cross provincial grassroots medical institutions. Among them, the local government provided policy, fund guarantee and guidance, the urban hospital exported management ideas, medicine talents and technologies, and the primary hospital conducted dual training by inviting in and going out to achieve double growth. Through the high gap cooperation between tertiary hospital and primary hospital, Yinshanhu hospital had been comprehensively developed. The loose medical alliance with multi subject coordination and cross region could give full play to the advantages of the loose healthcare alliance mode, achieve multi-win, and have reference significance for promoting the regional integration of medical and health services in the Yangtze River Delta.

Objective To explore the clinicopathological and immunohistochemical features of nephrogenic adenoma(NA).Methods Clinical data of NA patients diagnosed in the Department of Pathology,Zhongshan Hospital,Fudan University from July 2016 to October 2022 were collected and analyzed to explore their clinicopathological features.Results A total of 13 NA cases were enrolled.There were 11 males and 2 females.Organs involved:ureter(n=7),bladder(n=5),bladder and ureter(n=1),renal pelvis(n=2).NA patients performed as ureteral stenosis(6/7),rough bladder wall(3/5),and renal pelvis polyp(2/2).The typical microscopical features of NA were tubular(13/13)and papillary(4/13)structures,covered with cuboidal or columnar epithelium(13/13),or a mixed hobnail-spike eosinophilic epithelium(12/13);the interstitium was loose,containing varied amounts of vasculature and inflammatory cells(13/13).Immunohistochemistry revealed specific expressions of CK7,PAX-8,CK19 and CK8.Conclusions NA is a rare neoplasm of the urinary system with unique histological features.NA has the risk of misdiagnosis and over-treatment,and the potential of recurrence and malignant conversion.The diagnosis of NA depends on pathology,and the immunohistochemistry can be helpful for its pathological diagnosis.

Tumor-specific neoantigens have attracted much attention since they can be used as biomarkers to predict therapeutic effects of immune checkpoint blockade therapy and as potential targets for cancer immunotherapy. In this study, we developed a comprehensive tumor-specific neoantigen database (TSNAdb v1.0), based on pan-cancer immunogenomic analyses of somatic mutation data and human leukocyte antigen (HLA) allele information for 16 tumor types with 7748 tumor samples from The Cancer Genome Atlas (TCGA) and The Cancer Immunome Atlas (TCIA). We predicted binding affinities between mutant/wild-type peptides and HLA class I molecules by NetMHCpan v2.8/v4.0, and presented detailed information of 3,707,562/1,146,961 potential neoantigens generated by somatic mutations of all tumor samples. Moreover, we employed recurrent mutations in combination with highly frequent HLA alleles to predict potential shared neoantigens across tumor patients, which would facilitate the discovery of putative targets for neoantigen-based cancer immunotherapy. TSNAdb is freely available at http://biopharm.zju.edu.cn/tsnadb.
Antigens, Neoplasm ; metabolism ; Data Analysis ; Databases, Genetic ; Humans ; Immunotherapy ; Mutation ; genetics ; Neoplasms ; genetics ; immunology ; Tumor Suppressor Protein p53 ; genetics ; Urinary Bladder Neoplasms ; genetics