Objective To discover the features of biliary obstruction in hepatocellular carcinoma (HCC) and evaluate the effectiveness of therapeutic ERCP in the management of such patients. Methods Two hundred and ninety two patients (male 234 and female 58) suffering from HCC with obstructive jaundice underwent 358 times of ERCPs between May 2000 and March 2003. The mean (SD) age and mean (SD) total serum bilirubin of these patients were 51. 9 ?10. 6 yrs and 232 ? 158?mol/L respectively. The profiles of cholangiographic changes were recorded. Two hundred and sixty cases received treatment under endosco-py. Then therapeutic techniques including sphinclerotomy and debris removal, naso-biliary drainage, plastic or metal stent placement or several procedures in combination were given to all patients except 32 cases in far advanced condition. The body temperature, amount of bile drained and changes in liver function test were observed within two weeks post-procedure and based on these data the therapeutic effectiveness was evaluated. Results According to the features of radiographic finding, five types of biliary obstruction were classified as: type Ⅰ - intrahepatic stricture or occlusion (5.9%); type Ⅱ - perihilar stricture or occlusion (19. 0% ) ; type Ⅲ - extrahepatic stricture or occlusion (18. 4% ) ; type Ⅳ - hilar intraductal tumor em-bolus (49. 4% ) ; and type Ⅴ - intraductal floating tumor debris (7. 3% ) . In 267 patients/times under follow-up, the symptomatic jaundice was improved in 82. 0% of the patients with significant reduction of serum bilirubin in 65. 5%. Conclusion ERCP plays an important role in both diagnosis and palliative management of the HCC patients with obstructive jaundice.

15 mm in length or the contractile segment distal to the union of the biliary and pancreatic ducts. When common bile duct appeared to join the main pancreatic duct, it was denoted as B-P type. While th e main pancreatic duct appeared to join the common bile duct, it was denoted as P-B type.Results Fifty-four patients had been proven to have gallbladde r carcinoma histopathologically. Seven of them (men 3, women 4) had APBDJ (P-B union 6, B-P union 1). The mean (SD) common channel was 21 0 mm ?11 2 mm in length (range 12 mm to 45 mm), among them there was one case with associated ear ly cystic dilation of bile duct. Three other patients had APBDJ: one was associ ated with a choledochal cyst and two with normal biliary trees. The overall prev alence of APBDJ was 0 9% (10/1082 cases). The incidence of APBDJ was significan tly higher in patients with gallbladder carcinoma (P

Objective To investigate the mechanism of the kidney injure in the newborn rats with endotoxemia.Methods Eighty Wistar rats aged 7 days were randomly divided into 2 groups:control group (intraperitoneal injection of saline of 0.1 ml;n = 40),lipopolysaccharide(LPS) group(intraperitoneal injection of LPS of 5 mg/kg;n =40).The rats in either group were killed at 1 h,4 h,8 h and 12 hours after intraperitoneal injection,respectively.The expressions of NF-κB and TGF-β1 in the kidney were detected by using the immunohistochemical assay.Renal ultrastructural changes was observed with a CM100 Philips electron microscope.Results The NF-κB in control group had no expression.NF-κB in LPS group mainly expressed in the renal tubular epithelial cell,increased at 1 h after test and peaked at 8 h,and slightly descended at 12 h.The expression of TGF-β1 in control group was slight,and had not show significant difference from control group at 1 h,4 h and 8 h,but significantly higher than that in control group at 12 h.In LPS group,newborn rat renal glomerular basement membrane was complete,part epithelial cell foot processes were fused and renal tubules epithelial cell mild mitochondria vacuolization was found at 4 h.Renal glomeruli epithelial cell foot processes obvious confluenced,quantities of mesangial cells mitochondria vacuole,and renal tubules epithelial cell mitochondria expanded to bubbles at 12 h.Conclusion The NF-κB involves in the pathogenesis of kidney damage induced by endotoxemia,but TGF-β1 may help to repair the damaged kidney,and may repress the production of NF-κB.

Objective To evaluate the effectiveness and safety of total pelvic floor reconstruction treating female pelvic organ prolapse with prolift system .Methods The effectiveness and complications 24 cases genital pro-lapse according to POP Q stages who underwent total pelvic floor reconstruction surgery with prolift system were retro -spectively reviewed.Results The mean operative time was (97.5 ±23.3) min.The average blood loss (68.5 ± 28.1)mL.The mean postoperative hospital′s day was (8.9 ±2.3)days.The symptoms of all patients with peivic floor prolapse disappeared .2 cases sufferd pain and mesh erosion ,1 case had buttock abscess during follow-up.All recov-ered after treatment .Conclusion The short-term curative of total pelvic floor reconstruction surgery with prolift sys-tem is good.These cases have some postoperative complication .Such operation mode should be selected comprehen-sively.

Objective To evaluate the pathophysiology of paraplegia during transarterial chemoembolization in liver cancer and investigate effective management and prevention for improving clinical situation and relieve major symptoms.Method 2758 patients accepted TACE procedure because of liver cancer(and/or combined with remote metastasis),demonstrated 4 cases suffering from paraplegia(3 males,1 female)since Mar.2003 to Feb.2005,with mean age of(51?14)years old,The operative records and the clinical features after chemoembolization were summarized in detail.Results The incidence of paraplegia was 0.145%,with major symptoms of dysesthesia and hypokinesise emerging within 4 hours after TACE,and most symptoms aggravating gradually within 24-48 hours untill paraplegia appeared,and then turned to stabilization about 5-7 days,with their body functions partial recovery in 2 months.Conclusion More attention should be paied to prevent ectopic embolization of spinal cord vessels originating from extrahepatic collateral arteries during TACE or TAE.

Objective To study the incidence rate and correlation of anomalous pancreaticobiliary ductal junction( APBDJ) for patients with biliogenic chronic pancreatitis (BCP). Methods From January 2000 to January 2012,the data of 1 373 patients who underwent ER-CP,MRCP or T-Tube cholangiography in which both biliary and pancreatic ducts in our hospital were analyzed retrospectively. Results Bil-iogenic chronic pancreatitis was found in 47 patients,of which 17 patients with APBDJ. The mean (SD) common channel was (19. 3±7. 2) mm in length ( range 11~40 mm) . Conclusion APBDJ may be the important reason of BCP among Chinese patients.

Objective To investigate the effects of 5-Aza-2'-deoxycytidine (5-Aza-dc),a methylation inhibitor,on the proliferation of androgen-sensitive prostate cancer line (LNCaP),and on its regulation of methylation on glutathione s transferaseP1 (GSTP1) and retinoic acid receptorβ2 (RARβ2) gene.Methods LNCaP cells were treated with 5-Aza-dc in different concentration,CCK8 method was used to detect the growth of LNCaP cells.The methylation of GSTP1 and RARβ2 gene in LNCaP cell was detected by nested methylation specific polymerase chain reaction (nMSP).Results The proliferation of LNCaP cells was inhibited after exposed to 5-Aza-dc.The methylation of GSTP1 and RARβ2 gene was changed from hypermethylation to demethylation by the 5-Aza-dc.These effects were dose-and time-dependent within certain concentration of 5-Aza-dc,but LNCaP cells grew better after 72 h than within 48 h when exposed to 5 Aza dc below 1.0 μmol/L.Also the methylation of GSTP1 and RARβ2 gene changed from hypermethylation to demethylation by the 5-Aza-dc was not different when exposed to 5-Aza-dc below 1.0 μmol/L within 72 h and 48 h.Conclusions 5-Aza-dc may effectively inhibit the growth of LNCaP cells and reverse the DNA methylation damage in some tumor suppressor genes,but the continuity and stability of low dose 5-Aza-dc is changeable.The study will provide a research basis for clinical treatment.

Objective:To investigate the effect and the mechanism of Apigenin on lipopolysaccharides ( LPS )-induced inflammatory mediators production in murine macrophages. Methods:The murine macrophage cell line RAW 264. 7 cells were cultured in vitro,and were treated with different concentration of Apigenin followed by LPS administration. Expression of heme oxygenase-1 ( HO-1),cyclooxygenase-2 (COX-2) and inducible nitric oxide synthase (iNOS),phosphorylation of p38 and IκB,nuclear translocation of Nrf2 were detected by Western blot. Production of Nitrite and nitrate ( NOx) was analyzed by colorimetric technique. Secretion of prosta-glandin E2 (PGE2) was detected by ELISA. Activation of NF-κB was measured by luciferase assay. Results: Western blot indicated that apigenin could induce RAW 264. 7 cells expression of HO-1, and pretreatment of SB203580, an inhibitor of p38 significantly inhibited apigenin induced HO-1 expression. In addition,Apigenin could also decrease the content of nuclear transcription factor Nrf2 in cytoplasm and increase its level in the nucleus. Silencing of Nrf2 by specific siRNA could inhibit apigenin-induced HO-1 expression. Furthermore,apigenin administration significantly inhibited LPS-induced NOx production and PGE2 secretion, COX-2 and iNOS expression,IκB phosphorylation and NF-κB activation,and transfection of HO-1 siRNA could reverse these actions. Conclusion:Apigenin inhibits LPS-induced inflammatory response through induction of HO-1 and inhibition of NF-κB in macrophages.

Objective To analyze the effect of different postoperative nutrition:enteral nutrition( EN) and parenteral nutrition( PN) in patients with colorectal cancer. Methods 84 patients with colorectal cancer were collected in this study from Jan. 2012 to Jan. 2014, and they were divided into the EN group (43 cases) and the PN group (41 cases). They were given EN or PN after operation. The nutritional parameters such as ALB, TF and PA were detected before surgery and 7 days after operation, Observe the adverse reaction, time of gastroin-testinal function recovery, infection and costs after operation. Results There was no statistical difference (P>0. 05) in the nutritional pa-rameters and rate of adverse reaction between the two groups. The rate of infection in EN group was lower than that in PN group(P<0. 01), and the time of gastrointestinal function recovery was shorter in EN group compared with that in PN group (P<0. 01). Conclusion EN is better in recovery of gastrointestinal function, and there is less complication compared to PN. EN have clinical application value for patients with gastrointestinal cancer.

OBJECTIVE To investigate the resistance rates of Gram negative bacilli and the distribution of ?-lactamases in hospital infections(HI) or community acquired infections(CAI) in Tongling.METHODS Antimicrobial(susceptibility)(test) was done on 356 strains of Gram negative bacilli isolated in Tongling from Oct 2003 to Sep 2004 by Kirby-Bauer method.The detection of ESBLs and AmpC ?-lactamases was performed by three-dimensional test,MBL by the double-disk synergy test.RESULTS Among total 356 strains of Gram negative bacilli,267 were with HI(53.9%) isolated from sputum of patients,89(34.8%) were(isolated) from CAI patients and urine.The antimicrobial susceptibility rates of Gram negative bacilli from CAI patients was significantly higher than that from HI patients,for Acinetobacter baumannii they were 1.5 to 3.0,for(Pseudomonas aeruginosa) were 1.2 to 1.6.No strains of Escherichia coli and Klebsiella pneumoniae were found resistant to imipenem.Among 356 Gram negative bacilli,77 strains hyperproducing ESBLs and AmpC ?-lactamases,the detection rate was 21.6%, 69 strains were isolated from HI patients,and 8 strains were from CAI patients.From strains resistant to imipenem had 13 strains detected MBL,the detection rate was 52.0%.All of them were isolated from HI patients.CONCLUSIONS The resistance of Gram negative(bacilli) is a serious problem in Tongling.The antimicrobial(susceptibility) rates of Gram negative bacilli from CAI patients are significantly higher than those from HI patients.Gram negative bacilli produce all kinds of(?-lactamases,) such as ESBLs,AmpC(?-lactamases) and MBL.