Objective To investigate the feasibility and techniques of laparoscopic biliary re-operations. Methods Laparoscopic surgery was performed in 13 patients with bile duct stones who already had undergone biliary tract operations. Results Laparoscopic choledochotomy was successfully completed in 12 cases, while a conversion to open surgery was required in 1 case. The success rate of laparoscopic surgery was 92.3% (12/13). The operation time was (101～300) min, with a mean of 155 min. No intra- or post- operative complications occurred. Conclusions Laparoscopic biliary re-operations are feasible and experiences are needed to ensure the success of surgery.

Objective To investigate the correlation between gastric polyps and helicobacter pylori (Hp) infection .Methods 150 patients with gastric polyps(experimental group) and 150 patients with chronic gastritis(control group) from October 2011 to No-vember 2012 in Shapingba people′s hospital of Chongqing were enrolled in this study .The polyps biopsy in patients with gastric polyps and the mucosa in gastric antrum big and small bends ,and the anterior and posterior walls(about 2-5 cm from the pylorus) from both groups were detected for the pathological type ,inflammation degree and stained(modified Giemsa staining) for detection of the existence of Hp .Results In 150 patients with gastric polyps ,58% (87/150) of the cases were infected by Hp mainly in medi-um and low degree ,in which 39 .3% (59/150) of the infection located at polyps and 42% (63/150) of the infection occurred out of polyps .Pathological analysis for this group further demonstrated that the types of hyperplastic polyps ,fundic gland polyps ,inflam-matory polyp and adenomatous polyps accounted for 68 .0% (102 cases) ,20 .7% (31 cases) ,9 .3% (14 cases) and 2 .0% (3 cases) of total 150 gastric polyps cases ,of which 63 .7% (65/102) ,38 .7% (12/31) ,57 .1% (8/14) and 66 .7% (2/3) cases were infected by Hp ,respectively .Pathological analysis also indicated that ,among total 150 gastric polyps cases ,single polyps and multiple polyps types accounted for 62 .0% (93 cases) and 38 .0% (57 cases) .The polyps commonly existed at gastric fundus in which the incidence rate of the hyperplastic polyps type and the fundic gland polyps type were 94 .1% (96/102) and 87 .1% (27/31) ,respectively .The infection rate in hyperplastic polyps was markedly higher than that in fundic gland polyps (P<0 .05) ,and the infection of hyperplas-tic polyps was mainly medium and high degrees .In addition ,the inflammatory response in the hyperplastic polyps was higher ,ac-companied by the intestinal metaplasia and atrophy of gastric mucosa ,as compared with non-hyperplastic polyps .In the total 150 control cases ,52 .0% (78/150) patients were infected by Hp with mainly medium and high degree .Results indicated that there is no relationship between polyps occurring and Hp infection .Conclusion Compared to the chronic gastritis ,there is no positive associa-tion between gastric polyps and Hp infection .There is no remarkable difference for Hp infection rate and degree between the polyps and the non-polyps sites in the stomach .The infection rate and infection degree of hyperplastic polyps is significantly higher than that of fundic polyps .However ,the underlying mechanisms for the development of hyperplastic polyps have to be elucidated in the future .

Objective To construct Neuropilins-2 eukaryotic expression vector for RNA interference.Methods Recombinant targeting on gene NRP2 was designed and established with plasmid pGenSil-1 based on NRP2 cDNA equences of Genomes.Two pairs of oligonucleotides were synthesized according to the Tuschl and inserted into plasmid pGenSil-l to generate siRNA eukaryotic expression vector,DH5? strains were transformed,plasmid were extracted,and recombinant vectors were identified by the restriction map and the sequence analysis.The recombinant plasmid(pGenSil-NRP2) was transfected into the cultured LOVO cells.At 48 h after transfection,the whole cell protein was extracted,and the protein level was detected by Western blotting with mouse-anti-human NRP2 monoclonal antibody.Results Recombinant plasmids were completely coincided with the designs by the restriction map and the sequence analysis.pGenSil-NRP2 expression vector into LOVO cells down-regulated the protein level of NRP2 at 48 h after transfection.The recombinant eukaryotic expression vector were constructed successfully.Conclusion siRNA recombinant can be constructed successfully by RNAi technique for inhibiting NRP2 expression.

Pathology is a subject that studies the etiology,pathogenesis,pathological changes,progression and outcome of diseases.Pathology links the basic research and clinical practice and is an important part of translational medicine.In order to cultivate qualified pathological graduates with solid pathological theories and the abilities of proposing and addressing scientific hypotheses from pathological morphology changes,we employ modularized special training to divide the pathology training courses into morphology learning module,article searching and reading module,project design module,experiment operation module and scientific presentation module.The training contents among these modules are relatively independent but closely connected,and compose a strategy that aims to improve the scientific innovation ability of pathological graduates.

Objective:To investigate the clinicopathological features and prognosis of pleomorphic giant cell adenocarcinoma (PGCA) of the prostate, and to strengthen the understanding of this rare variant.Methods:From January 2009 to December 2019, 383 pathological samples of prostate adenocarcinoma with Gleason scores of 8-10 were selected from the First Affiliated Hospital, Army Medical University. PGCA was screened by reviewing the histomorphology of hematoxylin and eosin stained sections. Then the expression of prostate specific markers and mismatch repair (MMR) proteins of PGCA were detected by immunohistochemistry (IHC), and microsatellite instability (MSI) status was detected through polymerase chain reaction (PCR)-capillary electrophoresis. Meanwhile, the clinicopathological characteristics, diagnosis, treatment and prognosis of PGCA were summarized and analyzed along with those reported in the literature.Results:Three patients with PGCA of the prostate were 68, 63 and 71 years old respectively, and case 1 had a history of transurethral resection of the prostate and oral bicalutamide 3 months before surgery. All 3 patients underwent radical prostatectomy and received endocrine therapy, radiotherapy and/or chemotherapy, and died at 18, 23, and 10 months after surgery, respectively. Histologically, both the usual prostate adenocarcinoma with Gleason score of 9-10 and the pleomorphic giant cell component with anaplastic characteristics were observed in 3 tumors, and the latter accounted for 90%, 10%, and 20%, respectively. Immunohistochemical staining showed that both components expressed epithelial markers (CK, CK8/18) and prostate-specific markers (NKX3.1, PSA, P504S) to varying degrees, and the expression of MMR proteins (MSH2, MSH6, MLH1 and PMS2) were not defective. MSI was not detected in the usual prostate adenocarcinoma and pleomorphic giant cell components obtained by microdissection in 3 cases. Combined with 10 cases reported in the literature, there were totally 13 cases of PGCA for reviewing. The patients were 45-81 years old, the average age was 66 years old, and the median age was 66 years old. During the follow-up period of 3-36 months, 7 cases relapsed/metastasized, 6 cases died within 23 months after diagnosis, and 4 of which died within 1 year.Conclusions:PGCA is a newly recognized rare variant of prostate adenocarcinoma. At present, all cases are accompanied with high-grade usual prostate adenocarcinoma with Gleason score of 9-10, but it is different from the latter in pathological morphology and clinical manifestations, by presenting high invasiveness and poor prognosis. PGCA is not sensitive to conventional endocrine therapy, radiotherapy or chemotherapy. Accurate diagnosis of PGCA is helpful to judge the prognosis of patients and guide the treatment.

Objective To understand the mortality and potential life loss due to coronary heart disease (CHD) and stroke in Wujiang District, Suzhou from 2011 to 2022, and to provide strategies and basis for the prevention and treatment of CHD and stroke. Methods We collected the data of death cases due to CHD and stroke from the death monitoring system in Suzhou from 2011 to 2022. The mortality of CHD and stroke, potential years of life lost (potential years of life lost , PYLL), average years of life lost (average years of life lost , AYLL) and potential years of life lost rate (potential years of life lost rate , PYLLR) were calculated to analyze the development trend of death and disease burden of CHD and stroke. Results From 2011 to 2022, the crude mortality of CHD was 31.91/10 million, and that of stroke was 118.93/10 million. CHD and stroke mortality rates both showed an upward trend（P＜0.05, a statistically significant trend）. From 2011 to 2022, the mortality rate of CHD and stroke in Wujiang District increased rapidly with the increase of age. From 2011 to 2022, the disease burden caused by CHD totaled 11005 person-years, with PYLLR of 1.26% and AYLL of 12.34 years per person. The PYLL caused by stroke was 13 587.5 people-years, the PYLLR was 1.55%, and the AYLL was 8.93 years per person. PYLL, PYLLR and AYLL all decreased in women（P<0.05）, with no significant change in men（P>0.05）. Conclusion From 2011 to 2022, the mortality rate of CHD and stroke in Wujiang District appeared a tendency towards a rise, effective intervention and prevention measures should be taken among elderly and male residents.

Objective To understand the mortality and potential life loss due to coronary heart disease (CHD) and stroke in Wujiang District, Suzhou from 2011 to 2022, and to provide strategies and basis for the prevention and treatment of CHD and stroke. Methods We collected the data of death cases due to CHD and stroke from the death monitoring system in Suzhou from 2011 to 2022. The mortality of CHD and stroke, potential years of life lost (potential years of life lost , PYLL), average years of life lost (average years of life lost , AYLL) and potential years of life lost rate (potential years of life lost rate , PYLLR) were calculated to analyze the development trend of death and disease burden of CHD and stroke. Results From 2011 to 2022, the crude mortality of CHD was 31.91/10 million, and that of stroke was 118.93/10 million. CHD and stroke mortality rates both showed an upward trend（P＜0.05, a statistically significant trend）. From 2011 to 2022, the mortality rate of CHD and stroke in Wujiang District increased rapidly with the increase of age. From 2011 to 2022, the disease burden caused by CHD totaled 11005 person-years, with PYLLR of 1.26% and AYLL of 12.34 years per person. The PYLL caused by stroke was 13 587.5 people-years, the PYLLR was 1.55%, and the AYLL was 8.93 years per person. PYLL, PYLLR and AYLL all decreased in women（P<0.05）, with no significant change in men（P>0.05）. Conclusion From 2011 to 2022, the mortality rate of CHD and stroke in Wujiang District appeared a tendency towards a rise, effective intervention and prevention measures should be taken among elderly and male residents.