AIM:To analyze the clinical significance of expression of human telomerase reverse transcriptase (hTERT) and mucin 4 (MUC4) mRNAs in peripheral blood of patients with pancreatic cancer. METHODS:Real-time fluorescence quantitative RT-PCR was applied to investigate the quantitative expression of hTERT and MUC4 mRNAs in peripheral blood of patients with pancreatic cancer and healthy controls. RESULTS:The expression levels of hTERT and MUC4 mRNAs in peripheral blood of patients with pancreatic cancer were significantly higher than those in normal controls (7.95 ± 5.46 vs 0.92 ± 1.07, P < 0.01; 38.25 ± 25.07 vs 4.37 ± 5.96, P < 0.05). The expression of both hTERT and MUC4 mRNAs was associated with lymph node metastasis, surrounding organ infiltration, distant metastasis, and TNM stage (hP = 0.036, 0.027, 0.019; M P = 0.041, 0.022, 0.017). CONCLUSION:Abnormal expression of hTERT and MUC4 mRNAs closely correlates with invasion and metastasis of pancreatic cancer, and hTERT and MUC4 mRNAs in peripheral blood cells might be useful markers for pancreatic caner.

Objective: To study the epidemiological features of Adult Congenital Biliary Dilatation and its diagnosis and treatment.Methods: Reports on adult congenital biliary dilatation published from 1990 to 2010 were retrieved from various databases,such as China National Knowledge Infrastructure(CNKI),VIP.The epidemiological features of adult congenital biliary dilatation and its diagnosis and treatment were analyzed.Results: A total of 5146 patients with adult congenital bil-iary dilatation were reported in China during the last 21 years.The average ages and accurate ages were reported in 4298 cases,the average age of them was 34.84 years,male and female ratio is about 1:2.55,43.44% of the cases were located in East China,68.38% of the patients had varying degrees of abdominal pain,25.22% of patients have fever or symptoms of high fever,32.46% of patients with varying degrees of jaundice,18.31% patients with palpable abdominal mass,with the typical triad of the performance of patients accounted for 15.98%.Todani type Ⅰ-type accounts for 79.81%,Ⅱ-type accounted for 4.34%,Ⅲ-type accounted for 1.17%,Ⅳ-type accounting for 11.78%,Ⅴ-type accounting for 2.48%.Surgical treatment as the main treatment,bile duct cyst excision and bile duct jejunum Roux-en-YKiss surgery,accounting for 71.63%;postoperative cholangitis symptoms,the rate was 12.24%;postoperative follow-up rate of 83.55%,the cure rate 86.84 %.Conclusion: Adult women with congenital bile duct dilatation occur,mainly in eastern China,Todani type Ⅰ-based,biliary-enteric cyst excision + Roux-en-Y anastomosis as the main procedure of treatment.

Objective: To investigate the epidemiological features,diagnosis and treatment of splenic inflammatory myofibroblastic tumor in China during the past 25 years.Methods: The clinical data of 64 patients diagnosed splenic inflammatory myofibroblastic tumor(Splenic inflammatory pseudotumor) published from 1985 to 2010 from various databases,including China National Knowledge Infrastructure(CNKI),VIP,and the epidemiological features,diagnosis and treatment of SIMT patients were retrospectively analyzed.Results: There were 64 patients,including 39 males and 25 females(1.56:1).And their age spread from 24 to 74 with an average of 49.2.Most of patients had not special symptoms,and were diagnosed through routine examinations such as type-B ultrasonic or CT scan.Epigastric pain,debilitation,low-grade fever and some other untypical symptoms might appear in some patients.A solitary splenic lesion might be seen during medical imageologcal examination.Histological types: hypocellular fibrous pattern(n=26),myxoid/vascular pattern(n=12),compact spindle cell pattern(n=5).Immunophenotypic findings show that the spindle cells were positive for Vimentin,SMA in most cases.For most patients,splenectomy were the mainly treatment,and there were no signs of relapse and metastasis after the operation.Conclusion: Splenic inflammatory myofibroblastic tumor is extremely rare in china,and there are not special clinical symptoms or signs.It can be identified by characteristics of medical imaging,histologic and immunophenotypic findings with other splenic lesions.But it is difficult to define its nature preoperatively.Splenectomy is the mainly treatment with a satisfactory prognosis.

患者男,41岁,因左侧鼻塞、涕中带血伴头痛3年余,于2009年10月9日入院.患者3年前无明显诱因出现左侧鼻塞,反复涕中带血及阵发性头痛,以左侧前额部为主,无恶心、呕吐,无发热、畏寒,未经治疗.后上述症状呈进行性加重而来我院就诊.专科检查:左侧鼻腔内可见较大淡红色肿物充满整个左侧总鼻道,鼻中隔明显受压右偏,肿物触之质脆,表面可见增生小血管,部分区域有少许坏死组织附着,清除后局部易渗血.鼻内镜检查见肿物与鼻中隔左侧面黏膜紧密相连,并挤压左侧中、下鼻甲,但与左侧中、下鼻甲无粘连.鼻窦CT扫描见左侧鼻腔内约3.5 cm ×3.3 cm ×3.0 cm软组织密度影,CT值约30 HU,边界清楚;鼻中隔受压明显右移,左侧额窦、筛窦及上颌窦呈阻塞性炎症表现,未见骨质破坏(图1).

AIM: To investigate the clinicopathologic features, diagnosis and treatment of bile duct adenoma. METHODS: The clinical data for 11 patients with pathologically confirmed bile duct adenoma at our hospital were retrospectively analyzed. RESULTS: This group of patients included 9 females and 2 males. Their age ranged from 25 to 75 years, with an average of 62.2 years. Abdominal pain, jaundice and fever were main clinical manifestations. Diagnosis must rely on histopathological examination. Radical resection of the tumor is the most important treatment owing to the high incidence of malignant transformation. Eight patients had papillary adenoma, and 3 had tubule-papillary adenoma. Six cases were associated with cancer, and four cases had vary- ing degrees of dysplasia. One patient underwent biopsy, and 10 patients underwent radical tumor resection. All patients showed no obvious signs of recurrence throughout the follow-up period. CONCLUSION: Bile duct adenoma has a high incidence of malignant transformation. It is difficult to diagnose before surgery and is easily misdiagnosed. Diagnosis must rely on histopathological examination. Surgical resection is an effective way to treat the disease with a good prognosis.

脾脏炎性肌纤维母细胞瘤(splenic inflammatory myofibroblastic tumor,SIMT)是一种少见的脾脏肿瘤,多发于中老年人,预后良好.我院2008年1月至2011年10月共收治SIMT患者5例,现报道如下.临床资料1.一般资料:本组患者男4例,女1例.年龄30～53岁,平均40.8岁.临床表现及病史:3例查体时B超发现脾占位性病变,另外2例表现为左上腹疼痛.病程最短1d,最长3个月。

【Objective】To study the epidemiological features of Adenomyomatosis of the Gallbladder and its diagnosis and treatment in China in the past 30 years.【Methods】Reports on Adenomyomatosis of the Gallbladder published from 1980 to 2010 were retrieved from various databases,such as China National Knowledge Infrastructure(CNKI)、VIP.The epidemiological features of Adenomyomatosis of the Gallbladder and its diagnosis and treatment made use of a systematic review method were analyzed.【Results】A total of 2 876 patients with Adenomyomatosis of the Gallbladder were reported in China during the last 30 years.The male to female ratio was approximately 0.70 ∶ 1.The average ages and accurate ages were reported in 1 248 cases,the average age of them was 46.14 years,mean age from 35 to 55 years old accounted 43.39% of the total number of cases.71% of the cases were located in East China and North China.Abdominal pain was the main clinical manifestation and clinical manifestation of abdominal pain was found in 27.68%% of the patients.50.04% of the cases that could be counted were limited,and 80.30% of these cases were in cholecystic fundus.Pure gallbladder resection was the main procedure for the treatment of Adenomyomatosis of the Gallbladder.【Conclusion】Adenomyomatosis of the Gallbladder were mainly found in young or middle aged female in East and North China,Pure gallbladder resection was the main procedure for the treatment of GBA.