Neuroendocrine tumors of the gallbladder(GB-NET) are rare, and it lacks early clinical manifestations and has no specific tumor markers, it is difficult to distinguish GB-NET from gallbladder adenocarcinoma. The diagnosis of GB-NET is based on histopathology of the tumor and the assessment of proliferation fraction, which makes it difficult to achieve early diagnosis. GB-NET has a high degree of malignancy, 32.39% of patients have liver metastases at diagnosis, and 51.60% of patients have lymph node metastases, the median survival time is 9 to 10 months.There are currently no specific guidelines or consensus for the treatment of GB-NET. The treatment strategies are choosen mainly by the principles of gallbladder adenocarcinoma. We reviews the clinical and basic researches of GB-NET and case reports from China and across the world, as well as the data from SEER database, and we discuss the research progress on the classification, clinicopathological features, diagnosis, treatment advances and the prognosis.

Objective To study effects of GDNF and HSV GDNF on apoptosis of spinal cord motoneurons after scratch injury in vitro. Methods In the period of culture cell,motor neurons were periodically observed and counted.Scratch injury was executed on culturing 12th day,in the same time,cultured neurons were divided into 4 groups,and each group was given corresponding medium(medium serum free control group,serum group,HSV GDNF group,GDNF group).On the 4th and 7th day after scratch injury,TUNEL staining was respectively performed,and the number and the mean densities of apoptotic motoneurons were observed. Results The number of living motoneurons was in inverse proportion to time of scratch injury in each group.The number of apoptotic motoneurons from control group,HSV GDNF group to GDNF group was successively decreased as well as the mean densities of apoptotic motoneurons on the 4th and 7th day after scratch injury.Furthermore,the effects of groups with serum were no better than those of medium serum free groups,in the same time,difference was not obviously in HSV GDNF group and GDNF group. Conclusion GDNF and HSV GDNF can decrease apoptosis of injured motoneurons in vitro .It suggests that GDNF and HSV GDNF might play an important role in the growth and development of motor neurons.

Objectives The purpose of this study was to investigate the characteristics of the aged patients with cholelithiasis and summarize the clinical application experiences.Methods A retrospective analysis was performed on aged patients with cholelithiasis treated by laparoscopic operation between Apr.2012 and Apr.2015.Studies which provided outcome data on aged patients, subjected to laparoscopic operation were considered.Mortality, morbidity, cardiac and pulmonary complications were the outcome measures of treatment effect.Results Twenty-seven patients had cholecystolithiasis, of whom laparoscopic cholecystectomy was successfully performed in twenty-six cases and one case was changed to transabdominal operation.Among the fifty-four patients with suspected or confirmed biliary calculi, laparoscopic cholecystectomy + laparoscopic transcystic common bile duct exploration was successfully performed in forty-two cases and one case was changed to transabdominal operation.Six cases changed to cholecystectomy because of the diameter of the bile duct.Five patients who already had laparoscopic cholecystectomy received Ⅰ stage suturing of bile duct after the removal of the stones.Bile leak occurred in one case and pancreatitis occurred in three cases.Pneumonia occurred in three cases and one case was transmitted to the infection ward for further treatment.No severe procedure-related complication occurred.There was no significant difference in mortality, morbidity, cardiac and pulmonary complications.Conclusions Laparoscopic operation was acceptable for aged patients.Proper peri-operative management was essential to reduce the complications.

Objective:To study the effect of PRR13 expression and the sensitivity of colorectal cancer cells to oxaliplatin, as well as the effect of PRR13 expression on the apoptosis rate of colorectal cancer cells under the action of oxaliplatin. Methods:Two colorectal cancer cell lines(SW620, SW480) were screened from the colorectal cancer cell lines commonly used by ATCC. Lentiviral vectors were used for cell transfection to construct a PRR13-silent colorectal cancer cell model. MTT oxaliplatin drug sensitivity experiments were conducted and compared. In this study, a colorectal cell model stably transfected with shRNA lentivirus containing the silenced PRR13 sequence was defined as the silent group, and a colorectal cell model stably transfected with empty vector of lentivirus was defined as the control group. After silencing the PRR13, the colorectal cancer cells changed the IC 50 of oxaliplatin, and then used a double staining flow cytometry apoptosis experiment to compare the expression of PRR13 and the rate of apoptosis of colorectal cancer cells under the action of oxaliplatin relationship. The measurement data were expressed as mean±standard deviation ( Mean± SD), and the comparison between groups used independent sample t test. The count data were expressed as percentage (%), and the comparison between groups used chi-square test. Results:The IC 50 of the same cell model decreased significantly with time. At the same time point, the IC 50 of the silent group was significantly lower than that of the control group. In the same cell model with the same concentration, the apoptosis rate of the silent group was significantly higher than that of the control group (SW620 silent group 22.5% vs SW620 control group 11.35%, SW480 silent group 13.63% vs SW480 control group 4.59%), the ratio of viable cells was significantly lower than that of the control cell model (SW620 silent group 76.0% vs SW620 control group 87.2%, SW480 silent group 74.5% vs SW480 control group 89.3%). Conclusion:Silencing the PRR13 can reduce the sensitivity of cells to oxaliplatin and reduce the drug resistance of oxaliplatin and the effect of treatment is more significant.

Objective To identify the genetic cause of a case of congenital hypotrichosis by a nextgeneration sequencing technology.Methods A 9-year and 3-month-old girl presented with few villous hairs at birth,which grew slowly.Skin examination showed sparse,thin,soft,woolly and light-yellow hairs,small amount of hairs on the top of the head and a less amount of hairs around the head,hairline recession and broadened forehead.No abnormality was found by ophthalmic examination.No similar aberrant phenotype was observed in the patient's parents or her younger sister.Her parents were non-consanguineous marriage.Peripheral venous blood samples were obtained from the patient,her mother and younger sister.Genomic DNA was extracted and then analyzed by a next-generation sequencing technology.The suspected pathogenic mutations were validated by Sanger sequencing and subjected to bioinformatics analysis.Results Two mutations were identified in the CDH3 gene in the patient,including a c.1057G ＞ T (p.D353Y) heterozygous mutation in exon 5 and a c.1767delC (p.I589Ifs) heterozygous mutation in exon 10.They were both novel mutations,and their pathogenicity was predicted by softwares.Sanger sequencing indicated that the c.1057G ＞ T (p.D353Y) heterozygous mutation was inherited from the patient's mother,and gene transfer analysis revealed that the c.1767delC (p.I589Ifs) heterozygous mutation was inherited from the patient's father.Conclusion The c.1057G ＞ T (p.D353Y) and c.1767delC (p.I589Ifs)heterozygous mutations may cause hypotrichosis and juvenile macular dystrophy in the patient,so careful observation and comprehensive ophthalmic examination should be performed on time for early diagnosis and treatment of eye symptoms.

Objective:To analyze the research hotspots of self-management in patients with chronic obstructive pulmonary disease (COPD) at home and abroad.Methods:Related literature on self-management of COPD patients were searched in China National Knowledge Infrastructure and Web of Science databases, and the searched period was from January 1, 2013 to June 30, 2023. CiteSpace 5.8 software was used for keyword cluster analysis.Results:A total of 641 articles in Chinese and 1 192 in English were obtained. Domestic research hotspots about self-management of COPD patients mainly focused on health education, continuing care, rehabilitation care, etc. Foreign research hotspots about self-management of COPD patients mainly focused on mobile health, telemedicine and so on.Conclusions:This paper analyzes the research hotspots of self-management of COPD patients at home and abroad and provides reference for future research on self-management of COPD patients.

Objective:To retrieve, evaluate, and summarize the best domestic and international evidence on non-pharmacological management of sleep disorders in breast cancer patients undergoing chemotherapy, providing evidence-based guidance for healthcare professionals to conduct standardized assessment and management of sleep disorders in these patients.Methods:Clinical questions were translated into evidence-based questions using the PIPOST model. A systematic search of domestic and international databases and professional association websites was conducted for literature related to non-pharmacological management of sleep disorders in breast cancer patients undergoing chemotherapy, including clinical decisions, evidence summaries, guidelines, and systematic reviews. The search covered publications up to December 17, 2022. Two researchers trained in evidence-based nursing independently completed the quality assessment, evidence extraction, and summary of the included literature.Results:A total of 16 publications were included, comprising two clinical decisions, one evidence summary, five guidelines, six systematic reviews, and two randomized controlled studies. The best evidence was summarized from seven aspects: multidisciplinary collaboration, identification of risk factors, assessment and monitoring, referral, psychological behavioral interventions, exercise management, and complementary therapies, resulting in 25 key recommendations.Conclusions:This study summarizes the current best evidence for non-pharmacological management of sleep disorders in breast cancer patients undergoing chemotherapy. Healthcare professionals can follow these best evidence practices to standardize the assessment of patient sleep disorder symptoms and choose appropriate intervention plans based on clinical context and patient preferences, thereby improving patient sleep quality.

Objective To compare clinical outcomes between modified invagination pancreaticojejunostomyandmucosa (MIP) to mucosa duct pancreaticojejunostomy(MDP) in pancreaticoduodenectomy.Methods In Department of General Surgery,Beijing Friendship Hospital Capital Medical University,from Jan.2013 to Jan.2019,there were 222 cases performed pancreaticoduodenectomy,with MIP or MDP.According to the operation methods,by matching the sex and year decads,all patients were divided into MIP group (n =111) and MDP group (n =111).The incidence of pancreatic fistula in two groups was observed.The software of SPSS 20.0 was adopted for statistical analysis.Results There was no perioperative death in both groups.The mean operative time of MIP group was significant shorter than that of the MDP group [(212.8 ± 62.4) min vs (231.5 ±51.9) min,P =0.016].However,there were no significant differences in blood loss,blood transfusion,bowel fnnction recovery and liquid diet time.There was no grade C pancreatic fistula in MIP group,but 2 cases in MDP group.There were no significant differences in incidence and classification of pancreatic fistula between two groups.Conclusions There were no significant differences in clinical outcomes between MIP and MDP.The MIP is more easier to performed,so it is of certain spreading value.However,the further evidence need more prospective controlled study.

Objective To analysize the clinicopathologyic features of intraductal papillary neoplasm of the bile duct (IPNB),aiming to increase clinic reorganization of it.Methods Nine patients with IPNB were treated at Department of General Surgery,Beijing Friendship Hospital,Capital Medical University from April 2009 to March 2019,including 5 males and 4 females,aged from 53 to 72 years old.All patients' clinical characteristics,diagnostic methods,treatment and prognosis were retrospectively analyzed.All the patients were followed up from 1 to 119 months (medium 31 months).Results The pathologic diagnosis of all the 9 cases were obtained.Seven cases had occured recurrent abdominal painand fever and 2 cases presented painless jaundice.Five patients had single lesion (4 cases at the distal of common bile duct,1 cases at the hilum),whereas 4 cases had multiple lesions (2 cases diffuse lesionsin the biliary tree,2 cases multicentriclesionsin the common bile duct).Eight patients were underwent surgical procedure,including 7 cases of pancreticoduodenectomy and 1 cases radical resection of hilar cholangiocarcinoma.One patient with diffuse lesions was treated by chemotherapy after pathologic diagnosis was confirmed.One was died at 88 months after surgery,others were survival.Conclusions IPNB is a rear disease.The multicentric lesions have more chances to progress to invasive lesions.Different operative approaches should be chosen for different tumor sites and extents.

Objective To investigate the safety and effectiveness of anatomical partial splenectomy during liver transplantation in pediatric patients to prevent postoperative refractory hypersplenism.Methods From January 2015 to August 2018,7 pediatric patients with preoperative severe hypersplenism underwent anatomical subtotal splenectomy together with liver transplantation at our institution.Clinical informations,including operative time,intraoperative bleedinh,postoperative hospital stay,postoperative complications,platelet counts,leukocyte counts and the length and thickness of spleen determined by abdominal ultrasound,were collected retrospectively and statistically analyzed.Results The median total operation time was 495 min (320-768 min),the median intraoperative blood loss was 350 mL (300-1300 mL) and the median hospital stay was 19 days (14-55 days).Patients were followed up for 7.0-36.6 months (median 20.1 months).The length and thickness of spleen were reduced immediately from (18.89 ± 1.77) to (11.13 ± 2.28) cm (P＜0.001)and from (6.31 ± 0.53) to (4.97 ± 1.29) cm (P＜0.05),respectively.During the follow-up period of the first week,the mean platelet counts and leukocyte counts increased from (46.71 ± 18.91) × 109/L to (173.71 ± 73.15) × 109/L (P＜0.001) and from (1.59 ± 0.42) × 109/L to (11.12 ± 4.17) × 109/L (P＜0.001),respectively.During the one-year follow-up period,there was no residual splenic regrowth,and the peripheral blood cell counts remained normal.All patients survived to date with no procedure-related complications.Conclusions The anatomical subtotal splenectomy during liver transplantation in pediatric transplant recipients with preoperative severe splenomegaly and hypersplenism is a feasible option for the prevention of posttransplant refractory hypersplenism.