Objective To investigate the changes in the diagnostic and therapeutic methods for Lemmel′s syndrome over the past 20 years in China,and to provide experience for standardized diagnosis and treatment of this disease. Methods A retrospective analysis was performed for the clinical data of 23 patients with Lemmel′s syndrome who were diagnosed and treated in Tongji Hospital of Tongji University from Janu-ary 1998 to June 2017 and 384 patients with Lemmel′s syndrome reported in China during the same period of time(407 patients in total). According to the admission time,the patients were divided into groups A(139 patients admitted from 1998 to 2007)and B(268 patients admitted from 2008 to 2017). The patients′clinical features,diagnostic and therapeutic methods,and prognosis were recorded. The t-test was used for comparison of normally distributed continuous data between groups,and the Wilcoxon rank sum test was used for comparison of non-normally distributed continuous data between groups;the chi-square test was used for comparison of categorical data between groups. Results Compared with group A,group B had significantly higher age of onset(67.8 ± 17.8 vs 62.3 ± 12.3,t= -13.238,P= 0.019) and incidence rate of cholangitis(45.9% vs 32.4%,χ2=6.903,P=0.009). As for diagnostic methods,compared with group A,group B had a significantly higher proportion of patients who used multi-slice spiral CT(MSCT)(26.9% vs 8.6%,χ2=18.576,P<0.001), endoscopic ultrasonography(EUS)(15.7% vs 5.8%,χ2=8.352,P=0.004),magnetic resonance cholangiopancreatography(MRCP) (75.0% vs 33.1%,χ2=67.303,P<0.001),or endoscopic retrograde cholangiopancreatography(ERCP)(63.4% vs 36.7%,χ2=26.377,P<0.001),while the two groups had a similar false positive rate(22.8% vs 28.1%,χ2=1.385,P=0.239). As for therapeu-tic methods,compared with group A,group B had a significantly higher proportion of patients who underwent ERCP combined with conserva-tive pharmacotherapy and surgical operation(χ2=34.758,P<0.001). There was a significant difference in recurrence rate between endo-scopic surgery group and conservative pharmacotherapy group(χ2=40.211,P<0.001),as well as between surgical operation group and conservative pharmacotherapy group(χ2=26.785,P<0.001);there was no significant difference in recurrence rate between surgical oper-ation group and endoscopic surgery group(χ2=0.055,P=0.815),but endoscopic surgery had the advantages of minimal invasiveness, fast recovery,and low costs. Conclusion Age of onset of Lemmel′s syndrome is gradually increasing. MSCT,EUS,MRCP,and ERCP ap-plied alone or in combination are major diagnostic methods,and ERCP is the preferred therapeutic method for Lemmel′s syndrome.

Objective To investigate the expression of survivin variants and their relationship to each other as well as to clinic pathological factors in colorectal cancer.Methods survivin variant specific RT-PCR was developed to analysis their expression in 67 paired cancer and para-cancer tissues,and the expression of the wildtype survivin at the protein level was further verified by immunohistochemistry.Results All the cases tested expressed survivin mRNA,and immunohistochemistry obtained similar finding.The nonantiapoptostic survivin-2B was dominantly expressed in para-cancer tissues,whereas the antiapoptostic survivin-ΔEX3 was more frequently detected in cancer tissues.The expression of survivin-ΔEX3 mRNA was significantly associated with tumor metastasis.Conclusion The balance between antiapoptostic survivin iso-forms and nonantiapoptostic ones may play an important role in tumor genesis and tumor progression.

Objective To analyze the clinicopathological features of primary gastrointestinal lymphoma. Methods The biopsied or resected specimens from 42 cases of primary gastrointestinal lymphoma were examined clinicopathologically and immunohistochemically.Results The predominant type of primary gastrointestinal lymphoma was B cell lymphoma, among them the commonest was low-grade malignant mucosa-associated lymphoid tissue lymphoma. The clinical manifestations included the nonspecific gastrointestinal syndromes.Conclusion The morphologic and immunophenotypic characteristics of different kinds of gastrointestinal lymphoma were helpful to make correct diagnosis and differential diagnosis. Mucosa biopsy with pathological examination plays an important role in the early diagnosis, effectiveness observation and follow-up.