Clinicopathological characteristics and endoscopic treatment efficacy of de novo early colorectal cancer / 中华消化内镜杂志

Objective:To analyze the clinicopathological features of de novo early colorectal cancer and to evaluate the efficacy of endoscopic treatment.Methods:Patients with de novo early colorectal cancer who underwent endoscopic resection in Beijing Friendship Hospital, Capital Medical University from June 2020 to May 2022 were enrolled. The baseline data, endoscopic manifestations, treatment methods, postoperative pathological results and prognosis of the patients were collected retrospectively.Results:A total of 33 patients with de novo early colorectal cancer were enrolled with the age of 62.67 ± 8.62 years, and the male to female ratio was 7.25∶1. The long diameter of lesions was 0.96 ± 0.36 cm. The lesion morphology was mainly superficial phenotype (type 0-Ⅱ), accounting for 72.7% (24/33). Endoscopic submucosal dissection (ESD) was performed in 29 cases and endoscopic mucosal resection (EMR) was performed in 4 cases. Postoperative pathology showed that 11 cases (33.3%) were well differentiated tubular adenocarcinoma, of which the superficial submucosal layer was invaded in 2 cases. Twenty cases (60.6%) were moderately differentiated tubular adenocarcinoma, of which the superficial submucosa layer was invaded in 5 cases and the deep submucosa layer in 15 cases. Two cases (6.1%) were moderately-poorly differentiated tubular adenocarcinoma, where the deep submucosa layer was invaded in both. There was significant correlation between the depth of invasion and the degree of differentiation ( P<0.001), and moderately and moderately-poorly differentiated lesions were more likely to invade the deep submucosa layer. The en bloc resection rate was 100.0% (33/33), the complete resection rate was 97.0% (32/33), and the curative resection rate was 42.4% (14/33). Among the 19 patients who did not achieve curative resection, 13 patients received supplementary surgical treatment. No tumor residue or lymph node metastasis was found in the postoperative pathology. All patients were followed up for 3-25 months, and no signs of local recurrence or metastasis were found. Conclusion:Most de novo early colorectal cancers are superficial phenotype under endoscopy. The pathology is mainly moderately differentiated tubular adenocarcinoma. Endoscopic resection of de novo early colorectal cancer shows encouraging short-term efficacy.

New progress on the use of Dual Biologic Therapy for patients with Inflammatory Bowel Disease / 中国综合临床

At present, the incidence of inflammatory bowel disease in China is increasing. Although new biological agents continue to emerge, which induce a higher clinical remission rate in moderate and severe patients than traditional drugs and have much advantages in reducing the risk of surgery and changing the natural history, the remission rate of biological agents monotherapy is still not enough. In this context, dual biologic therapy is a viable strategy. Dual biologic therapy is mainly indicated for patients with inflammatory bowel disease that is refractory or complicated with extraintestinal manifestations.It is often used in combination with clinical practice according to the characteristics of drugs, showing relatively great efficacy and safety, but a series of key questions still need a high level of research evidence to explore.

Research progress in preventing delayed bleeding after gastric endoscopic submucosal dissection / 中国综合临床

Endoscopic submucosal dissection (ESD) is the common method for treatment of early gastric cancer. Compared with endoscopic mucosal resection (EMR), ESD can completely remove large lesions while ensuring negative margins as much as possible, which enables a more accurate pathological staging of tissue and reduces the risk of postoperative cancer recurrence. On the other hand, ESD generally results in larger ulcerations than EMR, which increases the likelihood of complications such as bleeding and perforation. Delayed bleeding is one of the main complications after gastric ESD. Delayed bleeding after ESD can cause hemorrhagic shock and even death, so we should take effective management strategies to prevent the occurrence of delayed bleeding after gastric ESD, such as the use of acid suppressive drugs, enough intraoperative hemostasis, lesion closure, and the use of lesion covering materials.

Diagnostic value of endoscopic ultrasound-guided fine-needle aspiration for pancreatic lesions with liver lesions / 中华消化内镜杂志

Clinical data of 5 patients with pancreatic and liver lesions who underwent endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) in the Department of Gastroenterology of Beijing Friendship Hospital from February to May 2020 were analyzed retrospectively. Pancreatic lesions were located in the head of pancreas in 3 cases, the neck of pancreas in 1 case and the body of pancreas in 1 case, with the maximum diameter of 3.2-4.6 cm. The histological and cytologic results of pancreas were all positive in 5 patients after 2-4 needles of aspiration. Three patients had single lesion in left lobe of liver, 1 had multiple lesions in left lobe of liver, and 1 had multiple lesions in left and right lobe of liver. The maximum diameter of liver lesions were 0.4-1.2 cm. After 1-3 needles of aspiration, the histological and (or) cytologic results of liver were positive in 4 of 5 patients, only 1 patient's cytologic result was negative. No associated complications were recorded. EUS-FNA for pancreatic and liver lesions is safe and effective.

Relationship between anesthesia factors and postoperative cognitive dysfunction in elderly patients with metabolic syndrome: propofol-based anesthesia versus sevoflurane-based anesthesia / 中华麻醉学杂志

Objective To compare the effects of propofol-based anesthesia versus sevoflurane-based anesthesia on postoperative cognitive dysfunction (POCD) in elderly patients with metabolic syndrome.Methods Ninety-four patients of both sexes,aged 65-80 yr,weighing 60-95 kg,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ,scheduled for elective orthopedic surgery or gastrointestinal surgery under general anesthesia,were assigned to either propofol-based anesthesia group (group P,n =47) or sevoflurane-based anesthesia group (group S,n =47) using a random number table.Anesthesia was maintained by Ⅳ infusion of propofol 4-6 mg · kg-1 · h-1 in group P and by inhalation of 1％-2％ sevoflurane in group S.The bispectral index value was maintained between 40-60 during surgery.Cognitive function was evaluated using the Mini-Mental State Examination,trial making test and Digit Span Tests Forward and Backward at 1 day before surgery and 3 and 7 days after surgery.The occurrence of POCD was recorded at 3 and 7 days after surgery.Results There were no significant differences in Mini-Mental State Examination scores,trial making test time,Digit Span Tests Forward and Backward scores or incidence of POCD between group S and group P (P＞0.05).Conclusion The effects of propofol-based anesthesia and sevoflurane-based anesthesia on POCD are comparable in elderly patients with metabolic syndrome.

Effects of high-flow nasal catheter and noninvasive mechanical ventilation on respiratory failure after thymectomy in patients with myasthenia gravis / 中国实用护理杂志

Objective To observe the reintubation rate of acute respiratory failure after thymectomy in patients with myasthenia gravis (MG) by two kinds of oxygen therapy (HFNC) and noninvasive mechanical ventilation. Methods Sixty-seven patients were treated with HFNC (observation group), and 80 patients were treated with noninvasive mechanical ventilation(control group). The baseline of the two groups was comparable. Results The rate of re-intubation and ICU stay time was 18.42%(14/76) , (5.35 ± 1.95) din control group and 7.50%(6/80), (3.42 ± 1.61) d in observation group. The difference was statistically significant (χ2=4.159,P =0.041;t =5.135,P=0.025).The respiratory rate、SpO2, PaO2, PaCO2 was (28.27 ± 4.32)beats/min, 0.9107 ± 0.0130, (86.43 ± 5.66)mmHg, (57.44 ± 5.73) mmHg in observation group and (24.84 ± 2.48) beats/min, 0.8867 ± 0.0309, (81.31 ± 2.85) mmHg, (65.38 ± 10.00) mmHg in control group. The difference was statistically significant (t =5.189-58.502,all P<0.01 or<0.05). Conclusion HFNC can improve the respiratory function of patients with myasthenia gravis after thymectomy, reduce the incidence of respiratory failure and re-intubation rate.

Effects of high-flow nasal catheter and noninvasive mechanical ventilation on respiratory failure after thymectomy in patients with myasthenia gravis / 中国实用护理杂志

Objective To observe the reintubation rate of acute respiratory failure after thymectomy in patients with myasthenia gravis (MG) by two kinds of oxygen therapy (HFNC) and noninvasive mechanical ventilation. Methods Sixty-seven patients were treated with HFNC (observation group), and 80 patients were treated with noninvasive mechanical ventilation(control group). The baseline of the two groups was comparable. Results The rate of re-intubation and ICU stay time was 18.42%(14/76) , (5.35 ± 1.95) din control group and 7.50%(6/80), (3.42 ± 1.61) d in observation group. The difference was statistically significant (χ2=4.159,P =0.041;t =5.135,P=0.025).The respiratory rate、SpO2, PaO2, PaCO2 was (28.27 ± 4.32)beats/min, 0.9107 ± 0.0130, (86.43 ± 5.66)mmHg, (57.44 ± 5.73) mmHg in observation group and (24.84 ± 2.48) beats/min, 0.8867 ± 0.0309, (81.31 ± 2.85) mmHg, (65.38 ± 10.00) mmHg in control group. The difference was statistically significant (t =5.189-58.502,all P<0.01 or<0.05). Conclusion HFNC can improve the respiratory function of patients with myasthenia gravis after thymectomy, reduce the incidence of respiratory failure and re-intubation rate.

Effect of Qingyi Lidan Granule on Serum Levels of HMGB1, HSP70, HSP27 and IL-8 of Patients with Severe Acute Pancreatitis / 现代生物医学进展

Objective:To study the effect of Qingyi Lidan Granule on the serum levels of high mobility group box 1 (HMGB 1),heat shock protein 70 (HSP70),heat shock protein 27 (HSP27) and interleukin-8 (IL-8) of patients with severe acute pancreatitis.Methods:From August 2015 to July 2016,84 patients with severe acute pancreatitis in our hospital were selected and randomly divided into the observation group and the control group according to random number,42 cases in each group.The control group was given routine treatment,and the observation group was treated by Qingyi Lidan Granule on the basis of control group.The recovery of blood amylase to normal time,white blood cell recovery to normal time,recovery of gastrointestinal function to normal time and relieving time of abdominal pain,serum levels of HMGB1,HSP70,HSP72 and IL-8 in both groups were observed and compared before and after treatment.Results:After treatment,the total clinical effective rate of observation group was significantly higher than that of the control group[92.86％ (39/42) vs 71.43％ (30/42)] (P＜0.05).The recovery of blood amylase to normal time,white blood cell recovery to normal time,recovery of gastrointestinal function to normal time and relieving time of abdominal pain in the observation group were significantly shorter than those of the control group (P ＜0.05).Before treatment,no significant difference was found in the serum levels of HMGB 1,HSP70,HSP72,IL-8 between groups (P＞0.05).After treatment,the serum levels ofHMGB1,HSP70,HSP72 and IL-8 in both groups were significantly lower than those before treatment (P＜0.05).The levels ofHMGB1,HSP70,HSP72 and IL-8 in the observation group were lower than those in the control group (P＜0.05).Conclusion:Qingyi Lidan Granule could effectively reduce the levels of serum HMGB 1,H SP70,HSP27 and IL-8 and enhance the clinical curative effect of patients with severe acute pancreatitis.

Effects of low temperature adjustable sodium dialysis combined astragalus injection in patients with chronic cardiac insufficiency uremia combined the clinical curative effect of dialysis related hypotension / 重庆医学

Objective To investigate the effects of low temperature adjustable sodium dialysis combined Astragalus injection in patients with chronic cardiac insufficiency uremia combined the clinical curative effect of dialysis related hypotension .Methods Fourty‐nine patients with uremia combined chronic cardiac insufficiency and suffered repeated dialysis hypotension were involved in this study ,and they were divided into treatment group(n=25) and control group(n=24) .Patients in the control group were treated with hemodialysis for low temperature (35 .5 ℃) ,and sodium curve dialysis ;patients in the treatment group were treated with the same method in that of control group ,and they were treated with astragalus injection 40 mL continuous intravenous drip .Then ob‐serve the blood pressure changes and treatment effect of the two groups of before and after treatment .Results Systolic pressure of the treatment group and the control group was (92 .6 ± 8 .4) and (89 .5 ± 9 .0) mm Hg ,and that of after treatment was (99 .9 ± 8 .0) and (94 .9 ± 9 .3) mm Hg respectively ,the difference before and after treatment in each group was significant (t=3 .147 , 2 .044 ,P<0 .05) ,and the difference of systolic pressure before and after treatment in each group was significant (t=2 .020 ,P<0 .05) .Before the treatment ,the left ventricular ejection fraction score of treatment group and control group was (45 .80 ± 3 .62)%and (46 .01 ± 3 .59)% ,and that of after treatment was (59 .05 ± 3 .15)% and (53 .85 ± 1 .60)% ,respectively ,and the difference be‐fore and after treatment was significant (t=13 .906 ,9 .847 ,P<0 .05) ,and the difference of the left ventricular ejection fraction score after treatment in the two groups was significant (t=7 .328 ,P<0 .05) .Conclusion For patients with uremia combined chronic car‐diac insufficiency and suffered repeated dialysis hypotension ,low temperature adjustable sodium dialysis can significantly reduce the incidence of hypotension in the process of dialysis .But combined huangqi injection in the treatment group could significantly in‐creased the left ventricular ejection fraction ,thus improve the left ventricular function in patients with dialysis .

Final test analysis and teaching reflection of clinical diagnostics / 中华医学教育探索杂志

Objective To evaluate the quality of the examination paper of the theory of Clinical Diagnostics,to explore and reflect on the teaching methods,so as to improve the quality of teaching.Methods Finals results of Clinical Diagnostics including 40 clinical undergraduates of Capital Medical University were analyzed.SPSS 20.0 was used to make analysis of the frequency,means statistics and normality of the examination paper.Kuder Richardson/Cmnbacha formula,percentage unification methods and so on were used to calculate confidence,validity,difficulty and degrees of distinction.Acquisition of relevant knowledge was assessed according to score distribution,while test paper quality was evaluated based on indicators including confidence,validity,difficulty and degrees of distinction.Results Test scores of 40 students were between 61 to 96 (83.64 ± 8.07).The degree of confidence (γ) for choice questions and subjective questions was 0.65 and 0.59 respectively;The validity (V) was 0.27;The overall difficulty (P) of the examination was 0.84;The degrees of distinction (D) were between 0.16 to 0.30.And the total points losing rate was 16.36％.Conclusion The examination is of medium difficulty and good degree of distinction,but the teaching strategies still need further adjustment in order to improve the students' ability of flexible application of the basic knowledge.

Role of spinal κ-opioid receptors in remifentanil-induced postoperative central sensitization in a rat model of incisional pain: by in vivo electrophysiology / 中华麻醉学杂志

Objective To evaluate the role of spinal κ-opioid receptors in remifentanil-induced postoperative central sensitization in a rat model of incisional pain by in vivo electrophysiology.Methods Sixty adult male Sprague-Dawley rats in which intrathecal catheters were successfully implanted,weighing 230-270 g,were divided into 5 groups (n=12 each) using a random number table:control group (group C),incisional pain group (group I),remifentanil group (group R),remifentanil plus incisional pain group (group R+I),and κ-opioid receptor agonist U50488H group (group U).A 1 cm longitudinal incision was made through skin,fascia and muscle of the plantar aspect of the right hind paw in isofiurane-anesthetized rats to establish the model of incisional pain.Remifentanil was intravenously infused for 1 h at a rate of 10 μg · kg 1 · min-1 in group R.In group R+I,remifentanil was intravenously infused for 1 h at a rate of 10 μg · kg-1 · min 1,and the model of incisional pain was established at the same time.In group U,U50488H 10 μg/10μl was injected intrathecally,30 min later remifentanil was intravenously infused for 1 h at a rate of 10 μg · kg-1 · min-1,and the model of incisional pain was established.Six rats in each group were randomly selected,the mechanical pain threshold (MPT) was measured in bilateral hind paws before implanting intrathecal catheter (T0),before operation (T1),and at 1 h,4 h and 1,2 and 3 clays after operation (T2-6).Six rats in each group were randomly selected to record the C fiber-evoked filed potentials in the spinal dorsal horn from 60 min before administration or operation to 180 min after administration or operation,the long-term potentiation (LTP) induced was also recorded,and the area under the curve (AUC) of C-fiber-evoked field potentials was calculated.Results No LTP was recorded in C,I and U groups,and the LTP was recorded in R and R+I groups.Compared with group C,the MPT in bilateral hind paws at T5,6 was significantly decreased in group R,the MPT in ipsilateral hind paws at T2 6 was decreased in group I,the MPT in ipsilateral hind paws at T2-6 and in contralateral hind paws at T5,6 was decreased in group R+I,the MPT in ipsilateral hind paws at T2-4 was decreased in group U,and the AUC of C-fiber-evoked field potentials was increased in R and R+I groups (P＜0.05).Compared with group Ⅰ,the MPT in ipsilateral hind paws at T4-6 and in contralateral hind paws at T5,6 was significantly decreased,and the AUC of C-fiber-evoked field potentials was increased in group R+I (P＜0.05).Compared with group R+ I,the MPT in ipsilateral hind paws at T2-6 and in contralateral hind paws at T5,6 was significantly increased,and the AUC of C-fiber-evoked field potentials was decreased in group U (P＜0.05).Conclusion The results of in vivo electrophysiology confirm that inhibition of spinal κ-opioid receptor function mav be involved in the mechanism by which remifentanil induces postoperative central sensitization in a rat model of incisional pain.

Evaluation of Glifeet in bowel preparation before colonoscopy / 中华消化内镜杂志

Objective To investigate the safety and effectiveness of Glifeet in bowel preparation before colonoscopy.Methods A prospective,single blind,randomized controlled trial of patients undergoing colonos-copy was conducted.A total of 67 inpatients were randomized to the control group,who received a low-residue and semiliquid diet (n =31)and the experimental group,who received Glifeet all day (n =36)before the proce-dure.All patients took polyethylene glycol electrolyte powder 1 000 ml at 7 pm on the day before colonoscopy and 2 000 ml at 8 am on the examination day.Bowel preparation quality was scored using the Boston Bowel Prepara-tion Scale (BBPS).Side effects were also observed.Results The time of the first bowel movement of the experi-mental group was significantly shorter [(77.43 ±54.21)min VS (149.35 ±118.15)min,P =0.002].An in-creased defecating frequency was observed in the experimental group,but there was no significant difference when compared with the control group (11.44 ±6.95 VS 8.74 ±3.58,P =0.055).Patient tolerance and acceptance did not differ.There was no significant difference in BBPS between the two groups.But the bowel preparation quality of the right colon was significantly better in the experimental group (2.56 ±0.50 VS 2.23 ±0.81,P =0.045). Conclusion Glifeet could meet the needs of basic energy in most patients for colonoscopy.Furthermore,Glifeet is well tolerated and can partially improve the quality of bowel preparation.

Effects of lead exposure on copper and copper transporters in choroid plexus of rats / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To investigate the effects of lead exposure on the copper concentration in the brain and serum and the expression of copper transporters in the choroid plexus among rats.</p><p><b>METHODS</b>Sixty specific pathogen-free Sprague-Dawley rats were randomly divided into a control group and three lead-exposed groups, with 8 mice in each group. The lead-exposed groups were orally administrated with 500 (low-dose group)), 1 000 (middle-dose group), and 2 000 mg/L (high-dose group) lead acetate in drinking water for eight weeks. And the rats in control group were given 2 000 mg/L sodium acetate in drinking water. The content of lead and copper in the serum, hippocampus, cortex, choroid plexus, bones, and cerebrospinal fluid (CSF) was determined by inductively coupled plasma-mass spectrometry (ICP-MS). Confocal and real-time PCR methods were applied to measure the expression of copper transporters including copper transporter 1 (Ctr1), antioxidant protein 1 (ATX1), and Cu ATPase (ATP7A).</p><p><b>RESULTS</b>Compared with the control group, the lead-exposed groups showed significantly higher lead concentrations in the serum, cortex, hippocampus, choroid plexus, CSF, and bones (P < 0.05) and significantly higher copper concentrations in the CSF, choroid plexus, serum, and hippocampus (P < 0.05). Confocal images showed that Ctr1 protein was expressed in the cytoplasm and cell membrane of choroid plexus in control group. However, Ctr1 migrated to CSF surface microvilli after lead exposure. Ctr1 fluorescence intensity gradually increased with increasing dose of lead, except that the middle-dose group had a higher Ctr1 fluorescence intensity than the high-dose group. In addition, the middle- and high-dose groups showed a lower ATX1 fluorescence intensity compared with the control group. Real-time PCR data indicated that the three lead-exposed groups showed significantly higher mRNA levels of Ctr1 and ATP7A compared with the control group (P < 0.05).</p><p><b>CONCLUSION</b>Copper homeostasis in the choroid plexus is affected by lead exposure to induce copper homeostasis disorders in brain tissue, which may be one of the mechanisms of lead neurotoxicity.</p>

Clinical study on the application of humanistic nursing for psychotic patients / 中国实用护理杂志

Objective To explore the application of humanistic nursing model in clinical nursing in psychotic patients. Methods 132 patients from January,2007 to January,2010 were retrospectively analyzed and randomly divided into the research group and the control group with 66 patients in each group.The control group was given routine nursing,the research group was given additional humanistic nursing based upon routine nursing.The nursing effect was compared between the two groups. Results The research group had apparent advantage in hospitalization time,satisfactory degree and treatment compliance comparing with the control group. Conclusions Humanistic nursing can wholly include the physiological,psychological,social,mental and culture factors of patients,so it can satisfy individual nursing care for psychotic patients.

Laparoscopic cholecystectomy plus exploration of the common bile duct in comparison with laparoscopiccholecystectomyandendoscopicsphincterotomyforsecondary choledocholithiasis / 中华普通外科杂志

ObjectiveTo compare the effects between laparoscopic cholecystectomy (LC) +laparoscopic common bile duct exploration(LCBDE) and endoscopic sphincterotomy(EST) + laparoscopic cholecystectomy( LC ) for secondary choledocholithiasis.MethodsThe clinical data of patients with secondary choledocholithiasis receiving LC + LCBDE or EST + LC from January 2008 to December 2009 were retrospectively compared. Parameters included operation time, postoperative complication, length of stay,cost of hospitalization. All patients received follow up of 1 year. Enumeration data was analyzed by chisquare test and measurement data was analyzed by t test.ResultsIn this study 87 patients received LC +LCBDE,76 patients received EST + LC.Patients in LC + LCBDE group had shorter hospital stay, less hospital charges and less complications. There was not difference in the procedure success rate and stone remanent rate between the two groups.ConclusionsLC + LCBDE could be used as the first choice for patients with gallstones and secondary choledocholithiasis.

Effects of enteral nutrition on intestinal permeability in patients with active ulcerative colitis / 中华临床营养杂志

ObjectiveTo explore the effects of enteral nutrition (EN) on intestinal permeability in patients with active ulcerative colitis (AUC). MethodsTwenty-four A UC patients were randomly divided into two groups:routine treatment group (n =11 ) and routine treatment plus EN group (n =13). Patients in routine treatment group were treated with mesalazine as well as low-residue diet, while patients in routine treatment plus EN group received mesalazine and short peptide EN for 14 days. The ratio of lactulose to mannitol in urine (L/M) before and after treatment was detected by high-performance liquid chromatography. ResultsThe L/M ratio was 0. 039 ± 0. 025 in routine treatment group and 0.072 ± 0.019 in routine treatment plus EN group (P =0.069). After 2 weeks of treatment, the L/M ratio of routine treatment plus EN group (0.038 ± 0.012 ) was significantly lower than the pretreatment level (P =0.043 ), while the L/M ratio of routine treatment group between before and after treatment had no significant difference (0.039 ± 0.025 vs. 0.032 ± 0.022, P =0.730). ConclusionEN can effectively improve the intestinal permeability in AUC patients.

Preparation and composition analysis of cod skin collagen protein / 中国海洋药物

Objective To explore how to increase the production and improve the quality of collagen protein from cod skin to offer reference for exploition and utilizing fisheries waste material accordingly.Methods The collagen protein from cod skin was extracted by pepsin methods primarily.Results and conclusion A comparison of the productions of collagen protein from different additions of pepsin,we suggested that the optimum addition of pepsin was 1%(w/w) and the optimum ratio between cod skin and solvent was 1∶10.

Matrix metalloproteinase-2 and tissue inhibitor of metalloproteinase-2 expression in hilar cholangiocarcinoma / 中国现代普通外科进展

Objective:To study the expression of matrix metalloproteinase-2 (MMP-2) and tissue inhibitor of metalloproteinase-2 (TIMP-2) in hilar cholangiocarcinoma.To discuss the relationship of MMP-2 and TIMP-2 expression with the metastasis and prognosis of hilar cholangiocarcinoma.Methods:Immunohistochemical S-P method was used in the examination of MMP-2 and TIMP-2 expression in 78 hilar cholangiocarcinoma.The relationships of MMP-2 and TIMP-2 expression with the pathological differentiation,metastasis and prognosis were analyzed.Results:The positive rate of MMP-2 expression was 72% ,and that of TIMP-2 was 76%.According to Ridit analysis,the degree of MMP-2 expression were correlated with the pathologic differentiation and lymph-node metastasis of hilar cholangiocarcinoma.The high expression of MMP-2 existed in the low pathologic differentiation and the high rate of lymph-node metastasis of hilar cholangiocarcinoma.The high expression of TIMP-2 existed in the high pathologic differentiation and the low rate of lymph node metastasis of hilar cholangiocarcinoma. MMP-2 and TIMP-2 expression had a significance correlation(r=0.708,P