Pancreatic cancer has the characteristics of high malignancy, early dissemination within the pancreas,extrapancreatic nerve plexus invasion, lymph node metastasis and vascular invasion. The 5-year survival rate of pancreatic cancer patients was under 5% even for those who had undergone surgical resection. Based on the review of the literatures including 42 pancreatic cancer patients who survived for 5-20 years after the operation, we concluded that curative resection of pancreatic cancer was still a reliable means in achieving long-term survival; factors influencing the results of resection of pancreatic cancer were lymph nodes involvement, poor differentiated tumor, extrapancreatic nerve plexus invasion, tumor size, residual tumor, curative resection and adjuvant chemotherapy; early diagnosis, aggressive surgery for patients with indications of resection, appropriate surgical procedure and postoperative adjuvant chemotherapy are essential factors to ensure a long term survival of patients with pancreatic cancer.

Four patients with injuries of bile ducts caused by abdominal trauma were reported. The injured sites were as follows: surpaduodenal common bile duct (CBD) in 1 case, intrapancreatic CBD in 1 case, right hepatic duct concomitant with common hepatic duct in 2 cases. Definite treatment, cholangiojejunostomy Roux-en-Y were not performed until 3 weeks, 6 and 16 months after injury respectively in 3 cases because of deferred diagnosis. Biliary peritonitis and fistula were main signs for the injury of bile ducts, bile ducts were repaired with gailbladder wall. The result proved to be satisfactory.

Objective To illustrate the relationship between the temporary alteration of renal functions of rats with obstructive jaundice due to ischemia reperfusion injury(RI) and lipid peroxidation and the expression of heat shock protein 70 in rat kidney. Methods Wistar rats were divided into 4 groups of sham operation group(S group), sham operation and renal RI group(SRI group), common bile duct ligation group(J group), common bile duct ligation and renal RI group(JRI group). One week after bile duct ligation, rat bilateral renal arteries were transiently occluded for 10 minutes. The variations of renal function were observed at different time phases after renal reperfusion. Simultaneously, the expression of heat shock protein 70 in kidney was evaluated by immunohistochemistry. Results In JRI group, endogenous creatinine clearance rate(Ccr) decreased progressively along with the prolongation of the duration of reperfusion. In J and JRI groups, the level of malondealdehyde(MDA) in renal tissue increased but superoxide dismutase(SOD) decreased. In JRI group, the expression of heat shock protein 70 reached its peak at the 4th hour after reperfusion and began to decrease at the 12 th hour and became lowest at the 24 th hour. No expression of HSP70 was found in other groups. Conclusion The sensitivity of rat kidneys with obstructive jaundice to ischemia reperfusion injury is significantly elevated. Ischemia reperfusion injury, as well as lipid oxidative stress, may be involved in acute renal failure(ARF) after obstructive jaundice surgery. The expression of heat shock protein 70 is a protective response to RI.

Objective To evaluate the clinical and pathological features and treatment of primary hepatocellular carcinoma invading on to the bile duct.[WT5”HZ]Methods [WT5”BZ]39 cases of hepatocellular carcinoma of icteric type were collected in our hospital.[WT5”HZ]Results [WT5”BZ]The incidence was 6% in all hepatocellular carcinoma patients.Preoperative correct diagnosis was achieved in only 33% of the 39 cases.The positive diagnostic rate of B ultrasound and CT was 88% and 80%respectively,and 49% of cases suffered from intraportal thrombi concomitantly.[WT5”HZ]Conclusion [WT5”BZ]Preoperative correct diagnosis depends on image test,hepatectomy with biliary duct drainage is the mainstay for treatment.

Objective To investigate the clinical advantages of enteral nutrition (EN) for acute pancreatitis(AP)comparing with parenteral nutrition (PN) and its prospect. Methods Literatures using MESH Browser in Medline were collected and reviewed. Results Being of much higher cost and complications, total parenteral nutrition (TPN) ever regarded as most importantly for AP nutritional support, is now challenged by EN. Clinical evidence suggests enteral (jejunal) nutrition may diminish intestinal permeability to endotoxin and diminish bacterial translocation, thus reducing the cytokine drive to the generalized inflammatory response and preventing organ dysfunction, as well as achieving “pancreatic rest” equivalent to the TPN. Conclusion Early enteral nutrition should be used preferentially for patients with severe acute pancreatitis without paralytic ileus.

Objective To explore the lesion mechanism and the apoptosis related protein changes of kidney in rat suffered from obstructive jaundice. Methods Choledocho-ligation methods was used to create rat obstructive jaundice model. Six rats in the normal control group and thirty rats of experiment group were observed at day 1, 3, 6,10 and 14 after rat model establishment. HE staining for kidney pathological changes, TUNEL staining for cell apoptosis, SABC for apoptotic related proteins of survivin and bax, xanthine oxidase method for SOD activity and thiobarbiturate method for MAD content were carried out. Results Renal tubular epithelial cell necrosis, cell shedding and aggregation were the main pathological changes in the experiment group. In the experiment group, the apoptosis ratio increased significantly, and reached the peak of (25.2?2.8)% on postoperative day 14. The relative gray value of survivin in the experiment group decreased significantly and of bax increased significantly. The plasma SOD activity in the normal group was (193.6?23.5) U/L, but it in the experiment group decreased significantly. The plasma MDA content and the endotoxin level in the experiment group increased significantly. Conclusion Cell apoptosis is one of the lesion mechanisms of kidney in rats suffered from obstructive jaundice. The down-regulation of survivin and the up-regulation of bax may be the biological factor in the occurrence of apoptosis. The increasing of free radical and endotoxin are important factors in the kidney lesion.

Objective To investigate age-related changes of type Ⅰ and Ⅲ collagen in rat heart. Methods Twenty-one male Wistar rats were divided randomly into infanct,young and old group.Types Ⅰ and Ⅲ collagen expresson of different age hearts were studied by SP immunohistochemical methods. Results 1.Type Ⅰ and Ⅲ collagen all constitute thick fiber and fibril.The fibrils encircled every cardiac muscle and formed collagen net each other.The thick fibers being plaque were located among cardiac muscle groups.The content of type Ⅰ collagen was more than that of type Ⅲ.2.There were distinct expression difference of type Ⅰ and Ⅲ collagen in different aging rat hearts.The collagens distributed densely and evenly in infancy rat heart,and loosely and uniformly in young rat heart,and the contents were increased distinctly with heterogeneous distribution in old rat heart.The cardiac collagen was growing from infanct to old rat,and rapid progress of cardiac collagen was seen in young rat. 3.The content of collagen in right ventricle was more than that of left ventricle of infanct heart.The collagen in all parts of the heart is not of difference both in yound and old rat. Conclusion The contents of type Ⅰ collagen is more than that of type Ⅲ collagen.The two types collagen are increasing with growing.;

Objective　To explore the relationship between te lomerase activity and bile duct carcinoma and its significance in clinical diag nosis. Methods　Telomerase activities were examined in 23 cases of bile duct carcinoma, 5 cases of carcinoma adjacent tissues and 5 cases of nor mal bile duct tissues respectively with telomerase PCR-ELISA method. Results　Telomerase activity was detected in 18 of 23 cases (78.3%) of b ile duct carcinoma, and was not found in 5 cases of carcinoma adjacent tissues a nd 5 cases of normal bile duct tissues. The detection rate of telomerase activit y had no correlation with patients' age, sex, tumor site and size but significan tly correlated to metastasis of tumor (P<0.05). Conclusion　The level of telomerase activity was significantly higher in bile duct carcino ma and may be served as one of the clinical marker for malignant neoplasm becaus e of its spsecificity.

Objection To study the p21 WAF1 and p53 protein expression in patients with cholangiocarcinoma and its relation to the pathologic grading and metastasis of the tumor.[WT5”HZ] Methods Using immunohistochemical method, we examined p21 WAF1 and p53 protein expression in 48 cases of cholangiocarcinoma and 8 cases of biliary duct tissue with chronic inflammation.[WT5”HZ] Results The expression of p21 WAF1 and p53 was positive in 25% and 54% respectively of the cases with cholangiocarcinoma, and 88% and 0% respectively of the cases in normal bile duct tissue with chronic inflammation (all P

Objective To study the clinical features and treatment on hepatocellular carcinoma(HCC) with obstructive jaundice as primary symptom. Method We collected 39 cases of patients of HCC with obstructive jaundice as primary symptom in our hospital,the clinical features and treatments were studyed.Results The incidence of such patients was 6.3% in all HCC patients and all patients were operaed;the positive diagnostic rate of B ultrasonud and T was 88.2% and 80% respectively ,it was 48.7% in cases with intraportal thrombi.Conclutions Preperative correct diagnosis depends on image test,hepatectomy with biliary duct drainage is the mainstay for treatment .