Objective To investigate the indication and value of metallic stent in the management of patients with malignant obstructive jaundice(OJ). Method The clinical data of 15 patients with malignant OJ treated in our hospital were analysed retrospectively. All the 15 patients were treated with metallic stent including cholangiocarcinoma in 8 cases, carcinoma of gallbladder in 3 cases, pancreatic carcinoma in 2 cases, porta hepatis metastasis of gastric carcinoma after radical gastrectomy in 2 cases. Result All the patients' jaundice disappeared 11-38 days after the stent placement. No severe complications or death occurred in this series. One patient had cholimia 5 days after the stent placement, which was cured by non-operative method. All cases were followed up periodically, the survival time was 30-384 days(averag 180.5 days). Conclusions Installing stent of Titanium-Nickel metallic alloy for the patient with unresectable malignant OJ is an ideal palliative therapy which is simple and less discomfortable.and less complications.The effect of reducing jaundice is satisfactory. This method may offer a new alternative method in the management of malignant OJ.

OBJECTIVETo detect the somatic mutations in peritoneal mesothelioma with whole genome sequencing technique.

METHODSSurgically resected cancer and pericancerous tissue samples from one patient with peritoneal mesothelioma were obtained. The whole genome sequences of tumor tissue and pericancerous tissue were examined by the second generation sequencing technique and compared with reference sequences from human genome database.

RESULTSThere were 639 717 single nucleotide variations (Single Nucleotide Variation SNV) found in both tumor and pericancerous tissue cells; while 20 302 SNVs were unique for tumor cells and 2 185 SNVs unique for pericancerous tissue, but still 223 SNVs found in cancer and pericancerous tissue were differed from those in human genome database.

CONCLUSIONThe preliminary results indicate that merely comparing the gene sequences of cancer and pericancerous tissue samples in an individual with the human genome reference sequence can not accurately locate all somatic mutations in pathological cells. For those individualized diseases caused by random somatic mutations, it is suggested to sequence the whole genome at birth or at least to reserve a DNA sample at early age for both research and clinical needs.

Aged ; DNA Mutational Analysis ; Female ; Humans ; Mesothelioma ; genetics ; Mutation ; Peritoneal Neoplasms ; genetics ; Polymorphism, Single Nucleotide

Objective To explore the ultrasound characteristics of intraductal papillary mucinous neoplasm of the bile duct( IPM N-B) and evaluate its diagnostic value . Methods Seventeen cases of IPM N-B were diagnosed by ultrasonic examination and confirmed by surgery and pathology . The ultrasound findings and distribution of color Doppler flow signals were observed and analyzed in comparison with the surgical and pathological results . Results Ultrasound revealed the characteristics of IPMN-B:① Bile duct mural nodules that looked like papillary or polypoid were observed; ② Asymmetry bile duct dilatation ,namely obvious dilatation in the lesion intrahepatic bile duct ,but only mild dilatation in the normal intrahepatic bile duct ;③Typical lesions showed mucus in bile duct along bile duct wall without acoustic shadow or move . High frequency ultrasound revealed that mucus in bile duct could float that looked like gelatin when operator vibrated probe in those superficial lesions . This is reliable characteristics of IPMN-B by ultrasound . Conclusions Ultrasound is of high value in the diagnosis of IPMN-B .