0.05);The expression of Survivin in hilar cholangiocarcinoma was closely statistically related with the expressions of PTEN and nm23.Conclusion:The expression of Survivin in hilar cholangiocarcinoma is significantly higher than that in tissues near carcinoma,suggesting its correlation with tumor;Survivin plays an important role in the oncogenesis and metastasis of hilar cholangiocarcinoma;Survivin is statistically related with PTEN and nm23 and detected together may helpful for diagnosis and prognosis of hilar cholangiocarcinoma.

Objective:To retrospectively analyze the clinical features of intestinal tract metastatic tumors of ovarian cancer,and estimate the feasibility of resection and its relation to prognosis.Methods:64 patients with ovarian cancer associated with intestinal tract metastasis were brought into this clinical analysis.The extent of intestinal tract involvement was evaluated preoperatively.Cytoreduction was defined as the residual lesion less than 1 cm3,at the same time pelvic and paraaortic lymphadenectomy and/or biopsy were implied.Intestinal surgery included tumor stripping surgery and/or intestinal repair,intestinal resection or colostomy.Regular chemotherapy was administrated,postoperative complications as well as prognosis were evaluated.Results:54 cases (84.8%) had rectum/sigmoid colon metastasis,metatsis in other parts of colon were 26 cases,small intestinal metastasis were 18 cases,infiltration of serosal and superficial muscular layer were 47 cases,17 cases had deep muscular layer and mucosal infiltration.Epithelial cancer which had invaded intestinal mucosa were 4 cases (7.7%) ,no invading to intestinal mucosa was detected in germnoma.All the 64 patients were recepted surgical treatment,including tumor stripping surgery in 44 cases,intestinal resection in 20 cases,sigmoidal and rectal resection in 14 cases,and colonost omy in 6 cases.The optical cytoreduction was[FK(WB00018。142mmZQ1mm]achieved in 56 cases (87.5%),and post-chemotherpy regression rate was 58.9%,but the post-chemotherpy regression rate was only 12.5% in 8 patients who got partial resection;regular chemotherapy was finished in 49 cases,and the regression rate was 65.3%,but the regression rate was only 15.4% in those who couldn’t finish regular chemotherapy.Postoperative morbidity was 26.6%,and two patients died of postoperative peritonitis.Conclusion:Intestinal tract is the common metastatic site of ovarian cancer,tumor stripping and intestinal resection are not only feasible but also prerequisite for optimal cytoreduction,postoperative regular chemotherapy can improve prognosis of ovarian cancer.

Objective:To explore the general pattern of lymph node metastasis and its effect on prognosis in early gastric cancer.Methods:The clinicopathological and follow-up data of early gastric cancer cases from 1990.6~2000.6 were retrospectively analyzed.Results:The tumor size and depth of invasion were related to lymph node metastasis in early gastric cancer.The 5-year survival rate of patients with node-positive early gastric cancer was significantly lower than those of patients with node-negative,72.4% and 92.5% respectively.The 5-year survival rate of patients with ≥4 metastatic lymph nodes was significantly lower than those of patients with 1~3 metastatic lymph nodes,50.0% and 84.2% respectively.Conclusion:Lymph node metastasis is the independent prognostic factor.Postoperative therapy should be recommended for the patients with ≥4 metastatic lymph nodes.

Objective: To investigate the protective effects and the mechanism of the preconditioning with hypertonic saline against warm hepatic ischemia-reperfusion (I-R) injury. Methods: Sixty patients who underwent partial liver resection were randomly assigned to 3 groups (n =20): group 1 without Pringle maneuver(NPR); group 2 with Pringle maneuver (PR), and group 3 with 7.5% hypertonic saline 4ml/kg preconditioning (HS) 5 minutes before Pringle maneuver for resection and in group 2 , 4ml/kg normal saline were given. Blood samples were obtained at 3, 15, and 30 minutes before and after liver resection, and 2, 24, and 48 hours following resection of the liver for polymorphonuclear leukocytes (PMN) count and serum alanine transminase levels test. In addition, small pieces of liver tissue were cut from remaining liver before resection and 30 minutes after resection to determine MPO concentrations. Results: Following partial liver resection via NPR, no changes in the concentration of circulating PMN and liver MPO concentrations were observed. But in the PR and HS group PMN counts significantly decreased and liver MPO concentrations significantly increased. Serum ALT levels increased in all groups significantly 24 and 48 hours after resection. All of these changes were most pronounced in the PR group and significantly reduced by hypertonic saline. Conclusion: Preconditioning with 7.5% hypertonic saline can protect liver from warm ischemia reperfusion injury and the possible mechanism was the inhibition of PMN accumulation in the liver.

Objective To investigate the effect of antisense oligodeoxynueleotide targeting sur-vivin (survivin ASODN) on hilar cholangioearcinoma cell line FRH-0201 depressing the expression of survivin. Methods Survivin ASODN was transfected into hilar eholangiocarcinoma cell line FRH-0201by liposome. Morphologieal changes were observed by inverted phase contrast microscope. RT-PCR and Western blot methods were performed to detect the expressions of survivin mRNA and protein re-spectively. The changes in cell apoptosis were detected by flow cytometry. Results The expression of survivin mRNA and protein was significantly decreased in survivin ASODN group than that in the con-trol group(mRNA: 0.51-t-0. 03 vs 0. 82-t-0.02,P%0. 05～protein: 1.82-t-0.16 vs 3. 08--t-_0. 27, P-Q 0.05). The morphologieal apoptotic changes were observed and the apoptosis rate was increased (11.50+1.49% vs 0.39-+-0.08～, P%0.05). Conclusion Survivin AS()DN can induce hilar cholan-gioeareinoma cell line FRH-0201 into apoptosis by decreasing the expression of survivin.

Objective:To introduce the method of laparoscopy combined with endoscopy in the treatment of gastroenterological surgery,and to evaluate the efficacy and safety of endoscopic lesion localization.Methods:A retrospective study was designed to analyze the data gathered at Qilu Hospital of Shandong University from April 2003 to June 2008,in which there were 48 operations performed by laparoscopy combined with endoscopy,including 28 gastrectomies and 20 colectomies.Results:All the 48 operations were accomplished successfully without conversion.All the lesions were located accurately with no intraoperative complications related to endoscopy.There were no postoperative complications like anastomosis leakage,incisional or intraabdominal infection.Conclusions:The combination of laparoscopy with endoscopy can raise the accuracy of lesion localization and decrease the possibility of laparotomy.

0.05). The correlation between the expressions of Survivin and C-myc was significant (P

Objective To explore the clinical value of laparoscopy in the treatment of pancreatic diseases.Methods Twelve patients with pancreatic diseases received laparoscopic surgery.Among which 9 patients with cystic diseases,4 cases underwent laparoscopic spleen-preserving distal pancreatectomy,2 cases received distal pancreatectomy and splenectomy,and 3 cases underwent pancreatic cystectomy.Laparoscopic insulinoma enucleation was performed for 2 patients who suffered from insulinoma.Besides,a patient suffered from pancreatic carcinoma recurrence received left thoracoscopic splanchnicectomy.Results All the operations were accomplished successfully,including 8 total laparoscopic surgery and 4 laparoscopic assisted surgery.The average operative time was 225 min(range 100-420 min),and the average volume of blood loss was 80 ml(range 2-150 ml).Pancreatic fistula was observed in 1 patient which was cured by conservative therapy.The postoperative average hospital stay was 7.2 d(range 5-13 d).The patient with recurrent pancreatic carcinoma survived for 6 months after operation and the pain-killing effect was satisfactory.With a follow-up of 10-36 months for other patients,the surgical effects were ideal and no recurrence occurred.Conclusion With the advantages of less trauma,less pain,fast recovery,and low morbidity rate,laparoscopic surgery is an effective and safe method for the treatment of pancreatic diseases,and thus may be widely used in the clinical settings in the future.

Objective:To investigate the changes and the adjusting effects of brain-gut peptides (BGP) on immunologic function in the rats before and after relief of biliary obstruction.Methods:One hundred Wistar rats were randomly divided into five groups,including sham common bile duct ligation group (group A),common bile duct ligation group (group B),sham relief of biliary obstruction + normal saline group (group C) ,relief of biliary obstruction + normal saline group (group D) and relief of biliary obstruction + Sandostatin (group E).At 1d,7d after the operation of each group,the changes of plasma vasoactive intestional peptide (VIP),substance P(SP),serum interleukin-2(IL-2) and serum T-lymphocytic subsets (CD4 +,CD8 +)were determinded by radioimmunoassay and flowcytometry .Results:Plasma VIP and SP were increased in group B compared with group A(P

Objective:To detect the expression of IL-17A、IL-10 and IFN-? in patients wth different forms of inflammatory bowel disease(IBD) during clinical remission phase and investigate their role in the onset and treatment of IBD.Methods:Tissue samples were obtained from patients with ulcerative colitis(UC,n=46),Crohn's disease(CD,n=12),and normal colorectal tissues(n=20).IL-17A expression was evaluated by a standard immunohistochemical procedure.Serum IL-17A、 IL-10 and IFN-? levels were determined by ELISA.Results:IL-17A expression was not detected in samples from normal colonic mucosa but was present in the mucosa of IBD.The level of IL-17A significantly increased in IBD patients while it was not detected in the sera of normal individuals.The level of IL-10 in patients with Crohn's disease was significantly higher than that in patients with ulcerative colitis and control group(P