Purpose To explore the expression of Bmi-1, p14ARF and Mdm2 in colorectal carcinoma and to find out their association with clinicopathological features. Methods The expression of Bmi-1, p14ARF and Mdm2 was detected by immunohistochemistry in 125 cases of colorectal carcinoma and 20 cases of normal colorectal tissues. Results ( 1 ) The positive rates of Bmi-1 and Mdm2 were 56. 8% and 62. 4% in colorectal carcinoma, respectively, which were much higher than that in normal colorectal tissues (20. 0% and 15. 0%). The positive rates of p14ARF was 47. 2% in colorectal carcinoma, which was much lower than that 75. 0% in normal colorec-tal tissues ( P<0. 05 ) . ( 2 ) The expression of Bmi-1 was significantly correlated with serosal invasion, lymph node metastasis and Dukes stage. The expression of p14ARF was significantly correlated with serosal invasion and Dukes stage. The expression of Mdm2 was significantly correlated with histologic grade, lymph node metastasis and Dukes stage (P<0. 05). (3) In colorectal carcinoma, the expression of Bmi-1 and Mdm2 was negatively correlated with p14ARF, respectively (P<0. 05). Conclusions Abnormal expression of Bmi-1, p14ARF and Mdm2 is involved in the occurrence, development and metastasis of colorectal carcinoma, which could be as the reference factors in judgement of biological behavior and provide a new target for clinical treatment.

Objective To study the relationship between liver fibrosis degree and widths of portal vein(TPV) and spleen vein(SPV).Method Liver specimens from 151 patients with chronic viral hepatitis were divided into 4 groups from S 1 to S 4 according to the liver fibrosis degree.The diameters of TPV and SPV were measured by ultrasonic B.Results The diameters of TPV and SPV of groups S 1,S 2,S 3 and S 4 were (11 89?1 39)mm and (5 78?1 33)mm,(12 22?1 19)mm and (6 25?1 28)mm,(12 43?1 26)mm and (7 03?1 54)mm,(13 07?1 23)mm and (8 0?1 80)mm,respectively.The differences of diameter of TPV between group S 4 and group S 1,S 2 were significant(all P

Objective To explore the relationship between acid pocket and acid reflux in gastroesophageal reflux disease (GERD).Methods From March 2011 to January 2012,29 patients with GERD were enrolled and nine healthy individuals were set as control.All objects of this study accepted esophageal manometry test,acid pocket test,test of the occurrence time of acid pocket and ambulatory 24 hours pH monitoring.The t-test was performed for comparison between two groups.The relationship between the incidence of GERD and acid pocket was analyzed by Logistic regression analysis.Pearson correlation analysis was used for correlation analysis.Results The percentage of acid pocket in GERD group and control group was 58.6％ (17/29) and 5/9,respectively,and the difference was not statistically significantly (P＞0.05).The duration time of acid pocket was (56.3±44.7) minutes in GERD group which was longer than that of control group ((16.0±8.2) minutes) and the difference was statistically significant (t=1.970,P＜0.01).There was no statistical significance in the average pH value of acid pocket between GERD group with acid pocket (2.8 ± 1.3) and that of control group with acid pocket (1.9±0.5,P＞0.05).The duration time of acid pocket was correlated with the longest reflux time in GERD group with acid pocket (r=0.550,P＜0.01).The peak velocity of esophageal motility in GERD group ((3.3±0.6) cm/s) was lower than that of control group ((5.0±4.1) cm/s) and the difference was statistically significant (t=-1.354,P＜0.05).The peak velocity of esophageal motility in GERD group with acid pocket ((3.2±0.6) cm/s) was lower than that of control group with acid pocket ((7.2± 6.3) cm/s) and the difference was statistically significant (t=-2.693,P＜0.05).Conclusions The duration time of acid pocket in GERD is correlated with the time of acid reflux.Esophageal dysmotility may be related with the pathogenesis of GERD and the occurrence of acid pocket.

Objective To identify and investigate the cause of the unacceptable bacteria level inside the lumen of fiberendoscope during monitoring so as to increase the pass rate of its cleaning and disinfection. Methods A failure mode effect analysis of the cause was done and the workflow was thereafter improved. Meanwhile, pre and post bacteriological monitor was applied to the fiberendoscope lumen samples. Results The number of scrubbing times while manual cleaning affected the monitoring results. The scrubbing times was amended and the pass rate increased from 84.15% to 98.65%. The results were significantly different The failure mode risk index of endoscope cleaning and disinfection was calculated, and the highest two items were: The number of scrubbing times the operators execute RPN=640, the method of lumen cleaning RPN=480. These were the key factors of qualification of monitoring. Conclusions After the amendment, no less than 5 times' scrubbing was required and the bacteriological monitoring method was used to analyze the effects,thereafter the pass rate of lumen bacteria monitoring can be increased significantly.

Purpose To investigate the expression of the protein of CD151 and MT1-MMP in adenocarcinoma of esophagogastric junc-tion tissues and to explore their relationship with the invasiveness and metastasis of the tumor. Methods CD151 and MT1-MMP pro-tein were detected by immunohistochemical staining respectively in 15 cases of paraneoplastic normal gastric mucosa tissue, 40 cases dysplasia and 172 cases of adenocarcinoma of esophagogastric junction tissues. Results All of the expression level of CD151 and MT1-MMP protein were increasing according to the order of normal-dysplsia-carcinoma. The expression rate of CD151 was 6. 67%, 20. 0% and 78. 3%, while the rate of MT1-MMP with 13. 3%, 22. 5% and 79. 1% in the normal, dysplasia and carcinoma subgroup. The expression rate of each protein were significant difference among the three goroups (P<0. 05). In the adenocarcinoma of esopha-gogastric junction tissues, the expression of them in the subgroup of poorly-differentiated with serosa invasion and lymph nodes metasta-sis was significantly higher than the other subgroup of well-differentiated with non serosa invasion or lymph nodes metastasis ( P <0. 05 ) . There was a positive correlation between the expression of CD151 and MT1-MMP protein in adenocarcinoma of esophagogastric junction tissues ( P<0. 05 ) . Conclusions CD151 and MT1-MMP assuredly and highly express in the adenocarcinoma of esopha-gogastric junction tissues and they have close relationships, which could involved in the invasiveness and metastasis synergistically in this tumor.

Objective? To explore the effects of enhanced recovery after surgery (ERAS) intervention on functional rehabilitation among patients with anterior cruciate ligament (ACL) reconstruction under arthroscope. Methods? From January 2013 to April 2016, we selected 120 patients with ACL reconstruction under arthroscope in Department of Orthopedics in West China Hospital of Sichuan University by convenience sampling. All of the patients were divided into two groups according to the admission time including control group (n=60, traditional rehabilitation) and observation group (n=60, ERAS intervention). We compared the ankle swelling, effusion and the knee flexion as well as knee rehabilitation effect of patients in two groups with the Judet score and the Lysholn score after surgery. Results? The early ankle swelling of patients in observation group was more obvious than that in control group, and there were 12 cases with joint puncture drainage after surgery in observation group and 5 cases in control group with no statistical difference (χ2=3.358, P=0.067). There were 6 cases with knee functional disorder after surgery in control group reaching the excellent knee function after manual release. The excellent rates of knee function activity in observation group were respectively 83.33% and 96.67% three and six months after surgery superior than those (58.33% and 83.33%) in control group with statistical differences (χ2=9.076, 5.926; P＜0.05). The excellent rates of scores of knee function in observation group were respectively 80.00%, 91.67% three and six months after surgery higher than those (56.67% and 78.33%) in control group with statistical differences (χ2=7.548, 4.183;P＜ 0.05). Conclusions? The application of ERAS intervention in ACL reconstruction under arthroscope can effectively improve early function and scope of activity of knee, however the complications may occur, such as ankle swelling and effusion.

Patients with non-small cell lung cancer (NSCLC) are treated in a variety of ways. In addition to radiotherapy, chemotherapy and targeted therapy, breakthroughs have been made in immune checkpoint inhibitors, in particular, programmed cell death 1 (PD-1) and its ligand (PD-L1) inhibitors have achieved survival benefits for NSCLC patients, and some of them have been approved as first-line drugs by the US Food and Drug Administration. Currently, commonly used PD-L1 inhibitors are atezolizumab, durvalumab and avelumab. Combination therapies include combination with chemotherapy, anti-vascular endothelial growth factor drugs, molecular targeted therapy and immunotherapy.

Purpose To evaluate the feasibility of droplet digital PCR(ddPCR)for gene fusion detection of neurotrophic receptor kinase(NTRK).Methods A total of 830 cases of primary colorectal adenocarcinoma(CRAC)and 560 cases of gastric adenocarcinoma(GAC)were retrospectively studied.Im-munohistochemistry(IHC)and fluorescence in situ hybridization(FISH)were used to detect pan-TRK protein expression and NTRK1/2/3 gene fracture in formalin-fixed paraffin-embedded(FFPE)tumor tissues,respectively.FISH or IHC positive sam-ples were further detected by next generation sequencing and ddPCR.Results All FFPE samples were tested successfully by IHC and FISH methods.A total of 26 samples with NTRK gene breaks or pan-TRK expression were detected by IHC,among these 26 cases,21 FISH were positive and 18 IHC positive.A total of 14 cases of NTRK fusion and 2 cases of amplification were detected by DNA sequencing.A total of 3 cases carrying NTRK gene fusion were detected by RNA sequencing,and the results of ddPCR were completely consistent with RNA sequen-cing.Conclusion ddPCR can effectively distinguish false posi-tive CRAC and GAC cases harboring NTRK fusion detected by FISH and DNA sequencing,which can be used as the effective method for screening NTRK gene fusion.

OBJECTIVETo summarize the treatment status of gastric gastrointestinal stromal tumor (GIST) in Shandong province,by analyzing the clinicopathological features and prognostic factors.

METHODSClinicopathological and follow-up data of 1 165 patients with gastric GIST between January 2000 and December 2013 from 23 tertiary referral hospitals in Shandong Province were collected to establish a database. The risk stratification of all cases was performed according to the National Institutes of Health(NIH) criteria proposed in 2008. Kaplan-Meier method was used to calculate the survival rate. Log-rank test and Cox regression model were used for univariate and multivariate prognostic analyses.

RESULTSAmong 1 165 cases of gastric GIST, 557 were male and 608 were female. The median age of onset was 60 (range 15-89) years. Primary tumors were located in the gastric fundus and cardia in 623 cases(53.5%), gastric body in 346 cases(29.7%), gastric antrum in 196 cases(16.8%). All the cases underwent resection of tumors, including endoscopic resection (n=106), local resection (n=589), subtotal gastrectomy(n=399), and total gastrectomy(n=72). Based on the NIH risk stratification, there were 256 cases (22.0%) at very low risk, 435 (37.3%) at low risk, 251 cases (21.5%) at intermediate risk, and 223 cases (19.1%) at high risk. A total of 1 116 cases(95.8%) were followed up and the median follow-up period was 40 (range, 1-60) months. During the period, 337 patients relapsed and the median time to recurrence was 34 (range 1-60) months. The 1-, 3-, and 5-year survival rates were 98.6%, 86.1% and 73.4%, respectively. The 5-year survival rates of patients at very low, low, intermediate, and high risk were 93.1%, 85.8%, 63.0% and 42.3% respectively, with a statistically significant difference (P=0.000). Multivariate analysis showed that primary tumor site (RR=0.580, 95%CI:0.402-0.835), tumor size (RR=0.450, 95%CI:0.266-0.760), intraoperative tumor rupture(RR=0.557, 95%CI:0.336-0.924), risk classification (RR=0.309, 95%CI:0.164-0.580) and the use of imatinib after surgery (RR=1.993, 95%CI:1.350-2.922) were independent prognostic factors.

CONCLUSIONSThe choice of surgical procedure for gastric GIST patients should be based on tumor size. All the routine procedures including endoscopic resection, local excision, subtotal gastrectomy and total gastrectomy can obtain satisfactory curative outcomes. NIH classification has a high value for the prediction of prognosis. Primary tumor site, tumor size, intraoperative tumor rupture, risk stratification and postoperative use of imatinib are independent prognostic factors in gastric GIST patients.