Objective To investigate the clinicopathological and immunohistochemical expression in 8 cases with synchronous occurrence of digestive tract cancer and GIST. Methods Clinical and pathologic data of 8 out of 70 cases of GIST coexisted with gastrointestinal cancer were recorded, and immunohistochemical stain ( Envision method) was used to detect the expressions of CD117, CD34 ,Vimenlin etc. Results In 8 cases of GIST (4 benign, 3 borderline, 1 malignant) coexisted with GI carcinoma, of which 6 cases featured the simultaneous occurrence of GIST and adenocarcinomas (5 cases in slomach and 1 case in colon) , whereas the other 2 cases associated with squamus cell carcinoma of esophagus. In 4 cases, tumors arose from the same organ, in the other 4 cases they developed from different sites of digestive tract. In all of the cases two kinds of neoplasms were developed in different areas without any connection, preoperative endoscopy and biopsy showed adenocarcinomas and squamous cell carcinoma, but histologic and clinical diagnosis of coexisted tumors were not achieved in any case. All GIST expressed Vimentin and CD34; 7 cases expressed CD117; 2 cases were focally positive for S-100 protein and 1 each for SMA and Desmin. Conclusion The simultaneous occurrence of epithelial tumor and GIST in digestive tract is not less than that usually expected, in clinical practice we should pay much attention on the diagnosis of this entity. Endoscopic biopsy conjugated with profound inspection during operation and pathological examination of specimen postoperatively can improve the possibility of early diagnosis.

The latest reports showed that kidney secrets a new type protein:renalase,a novel flavin adenine dinucleotide-dependent(FAD-dependent)amine oxidase which is secreted into the blood by the kidney and regulates heart function and blood pressure by metabolizing catecholamines.Kidney disease is associated with cardiovascular disease,so people pay more and more attentions to renalase.This article will introduce the structure and mechanism of renalase,and propose its future.

Objective To study the risk factors of patients with atherosclerotic renal artery stenosis (ARAS) and the relation with renal function.Methods The renal function of 64 ARAS patients was measured and compared with 36 healthy controls.Results Compared with the healthy controls, the incidence rates of morbilities of coronary artery disease, more than single-vessel, peripheral vascular disease, renal inadequacy increased significantly ( P<0.05), and the age, pulse pressure, levels of blood urea nitrogen (BUN), serum creatinine (SCr) were significantly higher ( P<0.01) in ARAS patients.Conclusion The elder, coronary artery disease, more than single-vessel, large pulse pressure, peripheral vascular disease and renal inadequacy are risk factors for ARAS. Severe renal artery stenosis may lead to renal inadequacy.

Dietary fiber contents in 34 common foods perchased in Beijing markets have been determined with detergent method, including neutral detergent fiber, acid detergent fiber, cellulose, hemicellulose and lignin. On dry basis, the dietary fiber contents of vegetables varied with kinds of food: the dietary fiber contents were higher in tender stems, leaves, stalks and flowers; lower in starchy tubers and roots; medium in non-starchy tubers and roots. The propotions of dietary fiber components were different in various categories of foods. Cellulose was the major component in vegetables and legumes, but in most cereals, hemicellulose content was higher than cellulose. All foods had the lowest lignin content with the exception of garlic bolt.

Objective To study the expression of PIWIL1, PIWIL3 and PIWIL4 in human colon cancer and its clinical significance. Methods We collected cancerous tissues and its adjacent tissues of 106 patients with colon cancer, two tissue microarrays were constructed, with 62 and 150 points respectively. We studied the expression of PIWIL1, PIWIL3 and PIWIL4 through immunohistochemistry. Results The expression of PIWIL1, PIWIL3 and PIWIL4 were significantly higher in cancerous tissues than those in adjacent tissues (P＜0. 01). In cancerous tissues and its adjacent tissues, postive correlation were seen among PIWIL1, PIWIL3 and PIWIL4 expression (P＜0. 01). PIWIL1 expression was significant higher in low differentiation group than that in high differentiation group (t =- 2. 840, P＜0.01 ). PIWIL3 expression was higher in high clinical stage than that in low clinical stage (F= 3. 112, P＜0.05). The expression of PIWIL3 and PIWIL4 were significantly higher in patients with colon cancer with distant metastasis than those without distant metastasis (t= -3. 349, P＜0.01 ; t = - 2. 168, P＜0. 05). PIWIL3 and PIWIL4 expression were correlated with occurring of colon cancer (P＜0. 01). Conclusions The expressions of PIWIL1,PIWIL3 and PIWIL4 in colon cancer were correlated with the differentiation, clinical stage and distant metastasis of colon cancer. PIWIL3 and PIWIL4 expression were two independent related factors of occurring of colon cancer, which would be furtherly investigated to be served as novel markers for early diagnosis and promising molecular targets for colon cancer therapy.

Objective To delineate the utility and results of intraoperative transesophageal echocardiography (TEE) in the evaluation of patients undergoing robot-assisted cardiac surgery. Methods Intraoperative TEE was performed in 193 patients undergoing robot-assisted procedures in cardiac surgery over a period of 4 years. (1) Before CPB, a comprehensive TEE was performed to document the lesions and their precise localization. ( 2 ) During establishment of peripheral CPB, a arterial cannula was placed percutaneously into the right internal jugular vein and passed into the superior vena cava; a venous cannula was inserted into the right common femoral vein and passing it into the inferior vena cava with its tip just inferior to the inferior vena cava-right atrium junction; a arterial perfusion cannula was passed into the ascending aorta with its tip approximately 3 cm from the aortic valve under TEE guidance. (3) After weaning from CPB, TEE was performed to evaluate the efficiency of the procedure. Results (1) The concordance with surgical findings concerning the lesions and precise localization was 100% and 98. 8% among all the patients, respectively. (2) All cannulae were located in the correct position. (3) TEE confirmed successful procedures with no concomitant complication in all the patients. Conclusion Intraoperative TEE is a valuable adjunct in the assessment of robot-assisted cardiac surgery.

Objective To investigate the short-term clinical outcome of one-level degenerative diseases for a single surgeon during his initial phase of performing a minimally invasive surgery oblique lumbar interbody fusion (OLIF) on the basis of perioperative parameters and follow-up data.Methods A prospective analysis of 49 consecutive patients that underwent a OLIF between November 2014 and March 2016 by corresponding author was performed.Only those patients that were single level,index surgeries were included.Every patient had a diagnosis of degenerative lumbar diseases including lumbar spondylolisthesis (25 cases),discogenic low back pain (14 cases) or segmental instability (10 cases).Patients underwent an indirect decompression and fusion using an expandable tubular retractor and single intervertebral cage with bilateral percutaneous pedicle screw fixation.49 patients were divided into the A group (the first 24 patients) and the B group (25 patients after the initial 24 patients).The following data were compared between the two groups:surgical time for Skin-Skin (minutes),estimated blood loss (ml),radiograph exposure time (seconds),the clinical and radiographic results,and intra-/postoperative complications.All intraoperative parameters only included the measurement and findings related with the OLIF procedure.The short-term clinical outcome of single level degenerative lumbar diseases treated by OLIF was assessed on the basis of follow-up data.The learning curve was measured using a logarithmic curve-fit regression analysis.Results Average operative time was significantly longer in the A group 47.1±10.6 min compared with the B group 37.2± 10.0 min.In comparison with the B group,the A group had significantly more X-ray exposure time (25.3±6.1 s versus 17.1±6.9 s).The operative and X-ray exposure time gradually decreased as the series progressed,and an asymptote was reached after about 20 cases.There was no statistically significant difference in intraoperative blood loss between the A group (28.1± 18.2) ml and the B group 24.4± 10.9 ml.The most observed complication was donor site pain (11 cases,45.8％),followed by thigh numbness/pain (5 cases,20.8％) and psoas/quadriceps weakness (2cases,8.3％),paralytic ileus (one case,4.2％) and sympathetic nerve injury (one case,4.2％) in the A group.Donor site pain occurred in four patients (16.0％),thigh numbness/ pain in three patients (12.0％),psoas/quadrieeps weakness in one patient (4.0％) and sympathetic nerve injury in one patient (4.0％) in the B group.All complications were transient and resolved within 3 months.The incidence of complications excluding donor site pain in the early period (A group) and the later period (B group) was 37.5％ and 20.0％,respectively,although there were no significant differences in perioperative complications between both groups.Forty nine patients were followed up for more than 1 year,and the average follow-up period was 18.5±3.9 months.The back pain VAS and ODI scores decreased respectively from 6.4±2.3 before surgery to 1.5±0.9 in final follow-up and from 37.1 ±9.4 before surgery to 11.8±3.9 in the last follow-up time.Total fusion rate was 89.8％ (44/49 cases)in final follow-up.Radiographic evaluation showed similar bony fusion in the A group (22 of 24 cases) with the B group (22 of 25 cases) in the last follow-up time.Conclusion Single level degenerative lumbar diseases can safely and effectively be treated by using OLIF with a good short-term clinical outcome.The procedure presents a learning curve to the practicing spine surgeon with regards to operative time,X-ray exposure time and intra-/postoperative complications.Intraoperative parameters improved with understanding the minimally invasive technique.Close attention to details can minimize complications that may be associated with the learning curve.

BACKGROUND:Ankle fracture combined with deltoid ligament injury can disorders the anatomical structure of ankle joint. Improper treatment can cause more serious complication, such as walking disorders.
OBJECTIVE:To evaluate the clinical effect of anchor repair plus open reduction internal fixation in the treatment of ankle fracture combined with deltoid ligament injury.
METHODS:Thirty-five patients with ankle fracture combined with deltoid ligament injury were selected from the Department of Orthopedics, the Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University between May 2009 and January 2011, including 24 males and 11 females, and al the patients were treated with anchor repair plus open reduction internal fixation. The age of the patients was 22-61 years, averaged 35.7 years, and al the patients were closed injury without other fractures. The treatment time was 2-10 days, average 4.6 days. According to Lauge-Hansen classification, 26 patients had supination-eversion ankle fracture and nine patients had pronation-eversion. According to Danis-Weber classification, 26 patients were C type and nine patients were B type. After al the three patients were treated with anchor repair, the treatment effect of anchor repair was evaluated through assessing the improvement of clinical symptoms and signs, as wel as the imaging examination of repair and healing.
RESULTS AND CONCLUSION:Al the 35 patients were fol owed-up for 9-26 months, average 13.8 months. Al the patients got Ⅰ stage healing without complications of infection and screw loosening. Fol ow-up X-ray film showed al the 35 patients with ankle fracture achieved bone union, the healing time was 10-21 weeks, average 13.6 weeks. Modified Baird-Jackson score system showed excel ent in 11 cases, good in nine cases, average in four cases, poor in one case, and the excel ent and good rate was 85.7%. At 6 months after internal fixation, the stress X-ray film examination showed the mal eolus gap of the affect side was (3.49±0.36) mm, the mal eolus gap of the healthy side was (3.37±0.41) mm, and there was no significant difference (P>0.05). The results indicate anchor in the repair of deltoid ligament injury during the treatment of ankle fracture with open reduction internal fixation can achieve satisfactory therapeutic effect.

Objective To investigate the influence on biological characteristics in human pancreatic cancer cells after beding transfected by two anti-carcinoma miRNAs at the same time.Methods Pancreatic cancer cells PANC1,SW1990 and normal pancreatic cells AR42J were transfected by miR-34a and(or) miR-let7 by liposome.Cells transfected with negative control miRNA (miR-NC) and untransfected were as controls.The expression of miR-34a and miR-let7 were detected by real-time fluorescent quantitative RT-PCR.The cell proliferation was detected by MTT test and the migration and invasion were evaluated by transwell assay.The apoptosis rate was measured by flow cytometric analysis.Results After being transfected with miRNAs,the expression of miR-34a and miR-let7 in double transfection group (miR-34a and miR-let7 were transfected at the same time),miR-34a transfection group,miR-let7 transfection group was significantly up-regulated than those in miRNA-NC transfection group and untransfected group in PANC1 cells,SW1990 cells and AR42J cells,repectively.The difference which was statistically significant (P ＜0.05)indicating that cells were successfully transfected.The cell proliferation in double transfection group of PANC1 cells and SW1990 cells were (0.665 ± 0.01,0.6375 ± 0.03),which were significantly inhibited compared with (0.974 ± 0.03,0.971 ±0.05) in miR-NC group and (0.8875 ±0.05,0.8625 ±0.06) in miR-let7 group.The difference was statistically significant(P ＜ 0.05).The cell proliferation activity in double transfection group was lower than those in miR-34a group (0.795 ±0.06,0.7925 ±0.06),but did not have statistically significant difference.There was no significant change in AR42J cells.Cell invasion assay showed that the number of PANC1 cells permeating substrate membrane in miR34a group (103.7 ± 3.28) and miR-let7 group (100.7 ± 1.76) were significantly fewer than miR-NC group (231.3 ±2.6) and untransfected group (153.7 ±2.6).The number of cells permeating substrate membrane in double transfection group(61.67 ± 3.18)was fewer than miR-34a group and miR-let7 group,respectively.The difference was statistically significant (P ＜ 0.01).The migration test had consistent results with invasion test.The changes of invasion and migration in SW1990 cells were similar to those in PANC1 cells.The apoptosis rate of PANC1 cells in miR-34a group,miR-let7 group,double transfection group,miR-NC group and untransfected group was (16.66 ± 1.27) ％,(15.46 ± 0.33) ％,(23.35 ± 1.80) ％,(9.33 ± 0.31) ％ and (8.83 ± 0.36) ％ respectively.Single transfection group had higher apoptosis rate than miR-NC group and untransfected group (P ＜0.05).Double transfection group had a significantly higher apoptosis rate than miR-let7 group (P ＜ 0.05),while there was no significant difference between double transfection group and miR-34a group.Conclusions The cell proliferation,invasion and migration in double miRNAs transfected pancreatic cancer cells were significantly down-regulated compared with those in single miRNA transfected cells,while apoptosis rate in double miRNAs transfection group was higher than single miRNA transfection group.Thus,the combination of two anti-cancer miRNAs may exert a more significant synergistic antitumor effect.

Objective To evaluate the effect of metabolic syndrome(MS)on prognosis of patients with cardiovascular diseases(CVD).Methods The data of 143 CVD patients including the age,waistline,blood pressure,body mass index(BMI),coronary arteriongraphy,ultrasound and blood glucoset,total cholesterol(TC),triglycerides(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),uric acid(UA),creatinine(Cr)were analyzed to detect the incidence of MS,the position and degree of coronary atherosclerosis,organ functional failure(OFF)and ventricular remodelling in the MS patients and those without MS.Results Of 143 CVD patients,72 cases(50.35%)were diagnosed with MS,and UA,Cr,waistline,systolic blood pressure(SBP),diastolic blood pressure(DBP),blood sugar,TG,body mass index(BMI),MS index,HDL-C,left ventricular end-systolic diameter(LVESD),ejection fraction(EF),left atrial dimension(LAD),interventricular septum thickness(IVST),posterior wall thickness(PWT),left ventricular mass(LVM),left ventricular mass index(LVMI),myocardial infraction(MI),stroke,cardia insufficiency,the position and degree of coronary atherosclerosis had difference between the patients with MS and without MS(P<0.05).Conclusion MS is a condition characterized by clustering of CVD risk factors.MS not only increases the incidence of CVD and OFF in the patients,but also effects the prognosis.