Carcinoma of gallbladder is the most frequently encountered malignancy of the biliary system. Early diagnosis is very difficult and the tumour resection rate is low,and the prognosis of carcinoma of gallbladder is very poor. With the increasingly widespread acceptance of laparoscopic cholecystectomy (LC),the number of cases of unsuspected gallbladder carcinoma (UGC) has increased. However,management of UGC is a difficult issue in the absence of established guidelines. High age and history of stones are the risk factors for gallbladder carcinoma and they are related to UGC. Surgical handling and pneumoperitoneum play an important role in the metastasis. The surgical approach used for cholecystectomy would not seem to influence the outcome in patients with UGC. The tumour stage is the most important prognostic factor. To understand UGC better, we review its clinical characteristics,investigation,prognosis and especially the recent advances in the diagnosis and treatment of this disease.

Objective To investigate the constituents in Lysimachia congestiflora.Methods The constituents were isolated by the silica gel column chromatography,and their structures were identified by spectroscopy methods.Results ?-Stigmasterol(1),quercetin(2),myricetin 3′-methyl ether(3),syringetin-3-O-?-L-arabinofuranosid(4),ardicrenin(5) and ardisiacrispin A(6) were isolated and identified.Conclusion Six compounds have been isolated from Lysimachia congestiflora,and ardicrenin(5) is isolated from this species for the first time.

Objective To explore the changing rule of schistosomiasis endemic situation in Gaoyou City,so as to provide the evidences for schistosomiasis control in lake and marshland regions. Methods The endemic data of schistosomiasis of Gaoy?ou City from 1970 to 2009 were collected to analyze the endemic patterns of schistosomiasis in different control stages compre?hensively. Results In the first years of infection control stage(1970-1975),transmission control stage(1976-1994)and transmission interruption stage(1995-2009),the prevalence rates of schistosomiasis were 4.20%,0.80%and 0 in human and 3.00%,0.51%and 0 in cattle respectively. In 1984,the positive rate of crowd stool tests fell to 0.04%,which was reduced by 99.05%compared with that in 1970. From 1970 to 1980,the positive rates of stool tests of people and livestock were positively correlated significantly(r=0.67,P<0.05). After 1985,no local infection patients or cattle were found. No schistosome infect?ed Oncomelania hupensis snails were found from 1970 to 2009. Conclusion The comprehensive control measures have been insisted in Gaoyou City in different prevention and control stages. Although the snail situation is undulate,the prevalence of schistosomiasis steadily declines and the interruption of transmission has achieved.

Objective:To explore the expression of B7-1,B7-2 and B7-H1 on tumor-infiltrating dendritic cells(TIDC) and on splenic dendritic cells(SDC),and to investigate TIDC-mediated and SDC-mediated T-cell function after blocking B7-H1 expression in these dendritic cells.Methods: The TIDCs and SDCs were isolated from tumor-bearing mice using anti-mouse CD11c magnetic beads.The expression of B7-1,B7-2 and B7-H1 on TIDC and SDC was analyzed using flow cytometer.T cells were co-cultured with TIDCs or SDCs for the mixed lymphocyte reaction(MLR),and monoclonal antibodies to B7-H1 or the isotype control antibodies were added to the MLR cultures.T-cell proliferation was assessed using XTT method and the secretion of IL-10 was detected using ELISA.Results: B7-1 and B7-2 positive TIDCs were significantly less than SDCs(P0.05).T-cell proliferation stimulated by TIDCs was weaker than that stimulated by SDCs;T cells produced more IL-10 after TIDCs stimulation than after SDCs stimulation(P

Objective To investigate the role of vascular endothelial growth factor (VEGF)in the pathogenesis of bronchial asthma and chronic obstructive pulmonary disease (COPD). Methods Thirty patients with stable bronchial asthma (asthma group), 28 patients with stable COPD (COPD group), and 24 healthy subjects (control group) were studied. Lung function, inflammatory cell differentials in sputum and the level of VEGF in induced sputum were determined by induced sputum method and ELISA method respectively. Results The levels of eosinophils in induced sputum in asthma group were 0.9 (0.4-1.4) × 109/L, significantly higher than those in COPD greup[0.1 (0-0.2)×109/L], and control group[0.0(0-0.1) × 109/L] (P < 0.05). The levels of neutrophils in COPD group were 2.3 (1.8-2.8) × 109/L, significantly higher than those in asthma group [1.1 (0.2-1.9) × 109/L], and control group [1.0(0.8-1.2) × 109/L] (P < 0.05). The levels of VEGF in asthma group, COPD group and control group were (2.3 ± 0.5), (0.3 ± 0.1), (0.9 ± 0.2) μg/L, respectively, and significant difference was showed between each group (P < 0.05). The VEGF level in induced sputum was positively correlated with the number of eosinophils in induced sputum in asthma group (γ = 0.62,P < 0.05), and was negatively correlated with FEV<,1>% (γ =-0.56, P < 0.05). The VEGF level in induced sputum was positively correlated with FEV1% in COPD group (γ = 0.43, P < 0.05), and was not correlated with the number of neutrophils in induced sputum (γ = 0.21, P > 0.05). Conclusions The concentration of VEGF in induced sputum increases in patients with bronchial asthma. VEGF may take part in the airway inflammatory development of asthma. The concentration of VEGF in induced sputum decreases in patients with COPD. VEGF may take part in the incidence of COPD.

ObjectiveTo evaluate the feasibility and safety of endoscopic intraductal radiofrequency ablation (RFA) for unresectable malignant biliary strictures.MethodsA total of 12 patients with malignant biliary obstructions,who were unsuitable for surgical resection,were prospectively selected for this study.During ERCP,when successful biliary cannulation achieved,a bipolar radiofrequency probe was introduced into bile duct over a guidewire.RFA was given to the tumor lesion under fluoroscopy,followed by stent placement.The patients were closely observed and followed up after the procedure.ResultsSuccessful RFA was achieved in all patients before stents insertion ( plastic and metal stents in 6 respectively,additional pancreatic stents were given to 3).Mild complications of cholangitis and pancreatitis occurred in 1 patient respectively,which were cured with short-term management.Jaundice was promptly controlled in 7 patients (58.3％ ).During the mean follow-up duration of 3.4 (range 0.5-5.5) months,one patient died of cardiocerebral accident and others survived without obvious disconffort.The 1- month and 3- month stent patency was 100％ (12/12) and 80％ (8/10),respectively.ConclusionIt is technically feasible and safe to perform endoscopic intraductal RFA for the palliation of biliary malignancies.The short-term outcome is satisfying,however,long-term result and the better therapeutic schedule need further evaluation.

Objective To investigate the effects of sperm DNA fragmentation (SDF)and sperm morphology on the fertilization and embryo development in ICSI.Methods SDF and sperm morphology were detected in the meanwhile of taking eggs in 1 45 ICSI treatment cycle.On the basis of SDF index (DFI)divided into group A (DFI≤30%)and group B (DFI >30%).According to the normal sperm morphology divided into group C (NMSR≥4%), group D (1 %≤NMSR <4%),group E (NMSR <1 %).According to the sperm DFI and NMSR divided into group F (DFI≤30% and NMSR≥4%)and group G (DFI >30% and NMSR <4%).Statistically analyzed ICSI outcome of research group:fertilization rate,embryo utilization rate,good quality embryo rate,implantation rate and clinical pregnancy rate.Results (1 )The normal fertilization rate,embryos utilization rate,good quality embryo rate,implan-tation rate in group A were significantly higher than those in group B (χ2 =6.96,8.95,5.49,3.92,all P <0.05), but clinical pregnancy rate had no significant difference (χ2 =1 .08,P >0.05).(2)The normal fertilization rate was statistically significant in group C,group D,group E (χ2 =34.5,65.8,11 .8,all P <0.05),but there were no significant differences in embryo utilization rate,good quality embryo rate,implantation rate and clinical pregnancy rate (P >0.05).(3 )The normal fertilization rate,embryo utilization rate,good quality embryo rate,implantation rate and clinical pregnancy rate in group F were significantly higher than those in group G,and normal fertilization rate,embryos utilization rate,good quality embryo rate had statistically significant differences (χ2 =37.5,1 1 .0,4.3,all P <0.05). Conclusion Sperm abnormal morphology has negative effect on fertilization,and the high DNA fragments have negative effects on fertilization and embryo development.

AIM: To study the expression of telomerase inhibitor Pinx1 in acute leukemia cells and during the differentiation of acute promyelocytic leukemia cells, and to realize its effect on telomerase activity. METHODS: Realtime quantitative PCR with fluorescence probe hybridization was used to measure the expression of Pinx1 and hTERT mRNA in acute leukemia cells and during differentiation of NB4 cells induced by ATRA. The correlations between Pinx1 and hTERT expression were also analyzed. RESULTS: Pinx1 mRNA expression in acute leukemia samples (0.00312, 5.42?10 -4-0.024) was significantly higher than that in normal bone marrow mononuclear cells (7.89?10 -4, 0-0.00863, P

Objective To evaluate the safety and efficacy of a newly designed anti-reflux metallic stent (ARMS) for malignant extra-hepatic biliary obstruction. Methods A total of 23 patients with unresectable biliary malignancy in the middle or lower part of common bile duct underwent endoscopic retrograde cholangiopancreatography (ERCP) and ARMs placement. The success rate, early complications, stent patency and patients' survival were recorded. Results The ARMSs were successfully placed in all patients and no procedure-related complication was recorded. The average operation time was similar to that of self-expanding metallic stents (SEMs). In 22 patients completing the follow-up, the total serum bilirubin dropped to normal within one month in 20. ARMs dysfunction occurred in 6, including tumor in-growth in 1, overgrowth in 2, and stent dislodgement in 3. Other patients were free of biliary symptoms until death or at the end of follow-up. The average stent patency of ARMs was 14 months. Patency rates at 3, 6, and 12 months were 95%, 74% and 56%, respectively. The mean patient survival was 7. 9 months ( 1-14 months).Postoperative survival rates at 3,6 and 12 months were 91.0%, 81.3% and 17. 2%, respectively. Conclusion Endoscopic placement of novel ARMs in patients with extra-hepatic biliary tumors is feasible,safe and effective.

Objective To explore the relationship between tumor necrosis factor (TNF) gene polymorphisms in donors and recipients and the incidence and severity of acute graft-versus-host diseases (aGVHD) after unrelated allogeneic hematopoietic stem cell transplantation (alIo-HSCT). Methods Single nucleotide polymorphisms (SNPs) of TNFα-238 (G/A), TNFα-857 (C/T), TNFα-863 (C/A), TNFα-1031 (T/C), TNFβ + 252 (A/G) were analyzed by Multiplex SNaPshot analysis in 76 pairs of donors and recipients. Results Transplantation involving donors with TNFα-857 CC genotype resulted in a higher incidence of grade Ⅱ-Ⅳ aGVHD than donors with CT genotype (91.3% vs 8. 7% , P =0. 039). In the 23 patients with grade Ⅱ-Ⅳ aGVHD, no patients had TNFβ +252 AA genotype, 19 (82.6%) had GA genotype and 4 (17.4%) had GG genotype. There was a significant difference in the distribution pattern of the TNFβ +252 (AA, GA and GG) genotypes in these patients (P =0.03). There was no significant association of TNFα-238 (G/A), TNFα-863 (C/A) and TNFα-1031 (T/C) polymorphisms with the risk of aGVHD. Conclusion These results suggest donor TNFα-857 CC genotype is related to a higher incidence of grade Ⅱ -Ⅳ aGVHD, and patients with TNFβ +252 AA genotype have protection against the risk of grade Ⅱ -Ⅳ aGVHD.