Objective To evaluate spiral CT diagnosis of gastrointestinal stromal tumors (GIST).Methods The CT findings and clinicopathological data of 32 GIST cases were retrospectively analyzed. Results Of the 32 GIST cases, 1 located in the esophagus, 22 in the stomach, 1 in the mesentery, 6 in the small intestine and 2 in the colon. There were 4 benign and 28 malignant cases. Expression of CD117 and CD34 was 75% and 81% respectively. The lesions were exogenous in 56% cases. The average size of the benign and malignant masses was 4. 75cm and 6.78cm respectively. Conclusions Spiral CT could provide important information for the diagnosis and localization of GIST, but the final diagnosis still relies on pathology.

1. 40 cadavers were dissected in order to observe the position and formation of the osteo-fibrous canal (384 canals) of the medial division of posterior ramus of lumbar nerves together with the occurrence of the articulo-accessory (process) ligament.2. The form of the external opening of the osteo-fibrous canal may be classified into three groups; nearly circular 35.1% (151); approximately ellipsoid 32.3% (124); crack detector 28.4% (109).3. The osteo-fibrous canal consists of four walls, bounded by mammillary process, accessory process, bony wall and superior articular process ligament respectively. According to the constitution of the anterior and posterior walls of the canal, it may be divided into three categories; osteo-aponeuroticoligamentous type 29.4% (113); osteo-membranous type 66.4% (255) and bony type 4.2% (16).4. The length and width of the superior articular process ligament were measured. The sexual difference of the lengths of L_(1～5) lumbar is significant.5. The sulcus between the superior articular process and the alar portion of the sacrum was observed and measured.6. The ligament on the posterior wall of the canal is nominated as the ligament of the superior articular process.7. Based on the anatomical structures thus studied, some clinical significances were discussed.

This article introduces how to use debate in clinical teaching and explains the organization,training,choosing the debate topics,making the rule and implementation of debate.Debate is advantageous to raise and enhance the medical students' abilities of study independent,clinical thought,consult,analysis and application literatures,oral expression,team cooperation and so on.

Objective To explore the correlation of chemosensitivity in vitro of anti-cancer drugs between peripheral blood lymphocytes and tumor cells in non-small cell lung cancer of elderly patients.Methods The MTT method was used to test the sensitivity of the peripheral blood lymphocyte and the tumor cells of 52 patients with nonsmall cell lung cancer to 13 kinds of anti-cancer drugs.Results The sensitivity test in eleven drugs include CDDP,CBP,LOHP,PTX,CTX,ICTX,THP,VP-16,GEM,VCR and NVB in the peripheral blood lymphocyte were associated with that in the tumor cells.But no dependablity in two drugs,ADM and HCPT.Conclusion The peripheral blood lymphocytes could be replace tumor cells to test the chemosensitivity of anti-cancer drugs in patients with non-small cell lung cancer.

1. 40 cadavers were dissected in order to observe the position, formation and morphology of the osteo-fibrous canal (400 canals) of the posterior rami of the lumbar spinal nerves.2. The average lengths of the osteo-fibrous canals for the posterior ramus of the lumbar nerves in both sexes are: L_1 4.88mm, L_2 4.71 mm, L_3 4.61 mm, L_4 4.57mm, L_5 4.39 mm.3. The average longitudinal diameter of the outlets of the osteo-fibrous canals of the posterior rami of the lumbar nerves in both sexes are: L_1 6.38mm, L_2 6.73 mm, L_3 6.34mm, L_4 5.75mm, L_5 2.61mm.The average transverse diameters of the outlets of the osteo-fibrous canals of the posterior rami of the lumbar nerves in both sexes are: L_1 2.69mm, L_2 2.66mm, L_3 2.68mm, L_4 3.14mm, L_5 2.06mm.4. The shapes of the outlets of the osteo-fibrous canals of the posterior rami of lumbar nerves may be classified into four types: nearly circular 64.75% (259 sides); approximately ellipsoid 30.25% (121 sides); nearly triangular 3.00% (12 sides); nearly oblate 2.00% (8 sides).5. 320 inter-transverse ligaments were observed and measured.6. There was always an iliolumbar ligament interposed between L_5 and S_1.7. Further more, the authors discussed the relationship between the morphology of the nerves and the osteo-fibrous canals in connection with the possible causes of low back pain.

Objective To probe the precision of the magnetic resonance spectroscopy (MRS)in assessing the fat content in the vertebral bone marrow and the changes at different vertebrae.Methods A total of 46 female volunteers were recruited in this study. After routine MRI examination,single voxel (SV)was chosen for the 1 H-MRS acquisition at L1 -L4 vertebral body.Thirty subjects were scanned twice to evaluate the precision of MRS.The fat fraction (FF%),unsaturation index (UI)and coefficients of variation (CV) were calculated by amplitude and area under the peak respectively.The changes of fat content in marrow at L1 -L4 vertebrae was further evaluated.Results The CV related to peak amplitude was 1.7% in quantification of vertebral FF%,while the CV related to peak area was 6.3%.In quantification of vertebral UI,the CV related to amplitude and area was 2.4% and 7.8% respectively.The FF% was ascended from L1 to L4,while UI of bone marrow declined.A significant correlation was observed between FF% and UI (r=-0.714,P <0.01).The correlation of FF% among L1 -L4 were also significantly observed (r =0.612 -0.923,P <0.01). Conclusion MRS at 3.0 T provides reliable measurement for marrow fat content with a good precision associated with amplitude. Meanwhile,there is a preferential increase in saturated lipids compared to unsaturated lipids from L1 to L4.There is a high correlation of FF%among L1-L4.MRS is a valuable tool for providing complementary information on osteoporosis research.

The article introduces the training of basic skill,renovating of the experiment contents,the diversifi cation and abundance in interest of experiment teaching methods of the students of medical laboratory speciality of higher profession.

Objective To study the metabolic change of proton magnetic resonance spectroscopy (1 H-MRS)in the visual cortex and optic radiation region of patients with diabetic retinopathy (DR).Methods 1H-MRS was performed in 20 patients with DR and 20 healthy volunteers on GE 1.5 T MR system respectively.Metabolic peaks of N-acetylasparte(NAA),creatine(Cr,in 3.02 and 3.94 ppm),choline-containing compounds(Cho)and myo-inositol(mI)were observed,and the ratios were analyzed by each other.Independent-samples t test was performed between two sets of data.Results In both visual cortex and optic radiation,the ratios of ml/Cr and mI/CrSee in DR group(0.664 ± 0.052 and 1.453±0.068 in visual cortex,0.717±0.074 and 1.484±0.114 in optic radiation)were significant higher than those in normal group(0.602±0.047 and 1.249±0.044 in visual cortex,0.679 ± 0.075 and 1.334±0.089 in optic radiation,P＜0.05).In DR group,the ratios of CrSec/Cr,Cho/Cr and NAA/Cr in visual cortex and optic radiation were 0.458±0.043 and 0.488±0.052,0.481±0.057 and 0.807±0.110,1.633±0.105 and 1.709±0.140 respectively.In control group.the ratios of those were 0.484±0.041 and0.502±0.056,0.471±0.065 and 0.786±0.109,1.625±0.098 and 1.716±0.135 respectively.The ratios of CrSec/Cr,Cho/Cr and NAA/Cr had no statistic difference between two groups(P＜0.05).Conclusion mI/CrSec is a typical change in the visual cortex and optic radiation region,1H-MRS as a noninvasive examination could provide biochemical and metabolic informations for diabetic patients.

Objective To assess the value of MRS in evaluating vertebral bone marrow. Methods A total of 152 female volunteers (mean age 58±14 years, ranged 30～80 years) were recruited in this study. All subjects underwent vertebral MRS examination after routine MRI examination (sagittal T_2WI, T_1WI and axial T_2WI). Single voxel (SV) was chosen for the 1H MRS acquisition at L_2～L_4 vertebral body with PRESS sequence. MRS parameters were measured by SAGE 7.0 software. Results The fat fraction (FF%) of vertebra ascend with aging;the water line width (LW) decrease with aging and there was not obvious tendency with lipid LW. Conclusion Vertebral MRS can be considered as a noninvasive examination added to routine spine MRI to demonstrate the changes of vertebral bone marrow.

BACKGROUND:For unstable intertrochanteric fracture repair, there are two views:extramedul ary fixation or intramedul ary fixation. Theoretical y, intramedul ary fixation is in line with the principles of minimal y invasive, more mechanical and biological advantages. However, evidence-based medicine and related studies have shown that compared with the extramedul ary fixation, intramedul ary fixation did not reflect the proper theoretical advantage. OBJECTIVE:To compare the biomechanical performance of two kinds of internal fixation systems:dynamic hip screw and Gamma nail which commonly used in repair of intertrochanteric fractures by finite element method, and to evaluate the advantages and disadvantages of dynamic hip screw and Gamma nail in treatment of unstable intertrochanteric fracture. METHODS:Three-dimensional finite element model of human femur unstable intertrochanteric fractures (31-A2;AO fracture classification), and the three-dimensional finite element models of dynamic hip screw and Gamma nail were established respectively, and were fixed according to the requirement of orthopedic surgery. The reference load which the joint bearing was at the peak time in adult step state period with the body mass of 700 N was stimulated. The stress distribution of bone, bone-internal fixation model, nail or screw, the strain and deformation of fracture location on the surface of the bone and bone-internal fixation model, the stress distribution along the femur and the loading transfer condition along the internal fixator and the like were analyzed. RESULTS AND CONCLUSION:Dynamic hip screw and Gamma nail have good sliding compression features which could make the continuous and dynamical y axial compression of the fractured section. Under the load conditions, the displacement value of dynamic hip screw was larger. In the treatment of unstable intertrochanteric fracture, Gamma nail was stronger than dynamic hip screw. Two kinds of internal fixations al make the bearing load of the proximal femur reduce. In the treatment of 31-A2 type unstable intertrochanteric fractures, we should choose dynamic hip screw for fixation if the femoral calcar was not seriously crushed, little defect or no defects and can immediately rebuild the stability of femoral calcar during operation, otherwise, stronger internal fixation, namely Gamma nail fixation should be chosen.