Objective:To investigate the effect of rapamycin on cell growth and migration of gallbladder cancer GBC-SD cells, and to discuss its potential in clinical therapy of gallbladder cancer. Methods: Proliferation of GBC-SD cells treated with different concentrations of rapamycin (12.5, 25, and 50 mmol/L) was examined by MTT assay. Cell cycle distribu-tion and apoptosis of GBC-SD cells treated with different concentrations of rapamycin were determined by flow cytometry. Migration ability of GBC-SD cells was assessed by Transwell assay. The expression of mTOR (mammalian target of rapam-ycin) and its phosphorylation in GBC-SD cells were examined by Western blotting assay. Results: Rapamycin significant-ly inhibited the phosphorylation of roTOR, but had no influence on the expression of roTOR in GBC-SD cells. Rapamycin significantly inhibited the growth of GBC-SD cells in a dose-dependent manner (P < 0.01). Raparnycin induced apoptosis of GBC-SD cells and arrested them at the G_1/S phase. Furthermore, rapamycin also significantly suppressed migration of GBC-SD cells as showed by Transwell assay (P < 0.01). Conclusion: Rapamycin can remarkably inhibit the growth and migration of gallbladder cancer cells, probably by inhibition of p-roTOR pathway, induction of apoptosis and cell cycle ar-rest of gallbladder cancer cells.

Three cases of Good's syndrome with pulmonary lesions in our hospital from June 1,2010 to June 1,2013 were retrospective analyzed and relevant literatures were reviewed.Clinical manifestation,characteristics of pulmonary lesions,diagnosis and treatment were summarized.Abnormality of lymphocyte subpopulation to varying degrees in peripheral blood was detected in all 3 cases.However none showed hypogammaglobulinemia.If thymoma patients developed recurrent respiratory infections,Good's syndrome should be considered.Pulmonary manifestations of Good's syndrome have lesions similar to those of diffuse panbronchiolitis or interstitial lung disease.Early screening of immune competency and treatment for immunodeficiency may improve prognosis.

Hilar cholangiocarcinoma (HCCA) is the most common type of cholangiocarcinoma, with in sidious onset and a high degree of malignancy, and there are often lymph node metastasis and vascular invasion. R 0 resection by surgery is still the main treatment for cure. This article reviews the hot issues and their related advances in surgical treatment of hilar cholangiocarcinoma, including preoperative evaluation, surgical treatment and systematic treatment.

Objective:To evaluate the relationship between postoperative delirium and preoperative modified frailty index (mFI) score in elderly patients undergoing colorectal cancer surgery.Methods:The medical records of elderly patients of either sex, aged 65-90 yr, with primary tumor, without radiotherapy and chemotherapy before operation, with the expected operating time ≥ 2 h, undergoing colorectal cancer surgery under general anesthesia, were collected.The patients′ preoperative frailty was assessed using mFI scale.Primary outcome was the incidence of delirium within 7 days after operation, and delirium was assessed using Confusion Assessment Method.The preoperative baseline characteristics, BI score, mFI score and Mini-Mental State Examination were recorded; anesthesia-related information, surgery-related information, intraoperative adverse events, total volume of intraoperative fluid infused, blood loss, and urine output were recorded.The patients were divided into delirium group (D group) and non-delirium group (N group) according to whether delirium occurred or not, and logistic regression analysis was used to screen the risk factors for postoperative delirium in elderly patients with colorectal cancer.Results:A total of 370 patients were enrolled in this study, and the incidence of delirium was 10.8%.There were significant differences in age, ASA grading ratio, mFI score, anesthetic time and total volume of intraoperative fluid infused between group N and group D ( P<0.05). The results of multivariate logistic regression analysis showed that increased age and mFI were independent risk factors for the occurrence of postoperative delirium ( P<0.05). Conclusions:Increased mFI score and age are independent risk factors for postoperative delirium in elderly patients undergoing colorectal cancer.