Objective To explore the features of clinicopathology,gastroscopy,endoscopic ultrasonography (EUS) and immunohistochemistry of esophageal mesenchymal tumors (EMT).Methods The clinical data of 98 cases of EMT patients who underwent endoscopic biopsy,endoscopic treatment or surgery and were diagnosed according to pathological and immunohistochemistry examination were collected.The clinicopathologic characteristics,endoscopy,EUS and immunohistochemistry of these cases were retrospectively analyzed,and differentiated from other submucosal tumor.Results Among the 98 cases of EMT,there were 77 leiomyomas (LM),15 gastrointestinal stromal tumors (GIST),four lipomas,one leiomyoblastoma and one schwannoma.The age of GIST group were older than that of LM group,and most were male patients predominated in these two groups.Dysphagia was the most common symptom of EMT.Gastrointestinal bleeding was rare,which was different from other gastrointestinal mesenchymal tumors.Under endoscopy,the appearances of EMT were similar,as submucosal protuberant lesions.One esophageal GIST was extraluminal lesion.Under EUS,LM,GIST and schwannoma showed low echo images originated from the muscularis propria or muscularis mucosa.Lipomas showed high echo images originated from submucosa.Pathological examination indicated that main cell type of LM and schwannoma was spindle cell,part of GIST was epitheloid cell type.The expressions of CD117 and CD34 were high in GIST,the expressions of SMA and Desmin were high in LM.S-100 was expressed in schwannoma.Other submucosal tumors,such as esophageal cyst,esophageal tuberculosis,esophageal carcinosarcoma,and some esophageal squamous carcinoma were easily misdiagnosed as EMT.Conclusions Esophageal LM is the most common EMT,followed by GIST.EUS is helpful in EMT diagnosis,however it can not accurately distinguish GIST,LM or schwannoma.

Objective To study the reconstructive treatment of the different types of neurofibroma and neurofibromatosis in different locations. Methods 37 patients with neurobibroma or neurofibromatosis were reviewed, including 8 cases with simple suture after excision, 9 cases with skin grafting in situ, 12 cases with skin flap grafting. The main points of the treating methods for different types of neurofibroma and neurofibromatosis were discussed, and the chief clinical manifestations, therapeutic principle and notices of the operation were then summarized.Results These 37 patients, including 25 cases of neurofibroma, 11 cases of neurofibromatosis typeⅠ and 1 case of neurofibromatosis type Ⅱ, were satisfied with the results after reconstructive operation. Conclusion The methods of reconstructive operation of neurofibroma and neurofibromatosis, such as simple suture after excision, skin grafting in situ, skin flap grafting, the use of skin soft tissue expansion, microskin grafting and so on, must be selected according to the different type and location of the neurofibroma and neurofibromatosis. The reconstructive operation must guarantee the best recovery of the visage and the function on the basis of the most degree of tumor excision.

Objective To explore the differences and similarities of clinical characteristics,pathological features, treatment and prognosis between primary gastric lymphoma(PGL)and primary intestinal lymphoma (PIL). Methods The clinical characteristics, pathological features, therapeutic results, the detection of Helicobacter pylori (Hp) and prognosis of 48 PGL cases and 15 PIL cases were retrospectively analyzed. Results There was no statistical significance in age, gender, abdominal pain, gastrointestinal bleeding, B symptoms, clinical stage, mortality between PGL and PIL groups (P>0. 05). However, there were significant differences in the pathological type, acute abdomen emergency surgery between these two groups (P<0. 05). There was 12 Hp positive cases in mucosalassociated lymphoid tissue (MALT) lymphoma of PGL group (12/19), and 5 Hp positive cases in diffuse large B-cell lymphoma (DLBCL) (5/20). There was significant difference in Hp detection rate of these two pathological types. Hp was not found in PIL group. The Cox multivariate analysis indicated that stage Ⅲ-Ⅳ was the independent adverse factors affecting PGL prognosis (P<0. 05).Conclusions Mainly histological types are DLBCL and MALT lymphoma in PGL, and DLBCL in PIL.PIL predispose to T-cell lymphoma compared with PGL. MALT lymphoma is rare in PIL group. The mainly clinical stage is Ⅲ-Ⅳ both in PGL group and PIL group. Emergency surgery is often needed in PIL because of intussusception or perforation. The prognosis of PGL is correlated with the stage and the prognosis of PIL are correlated with the stage, B symptoms and T cell phenotype.

Objective To investigate the regulation and the mechanism of Melatonin in calcium overload of pancreatic acinar cell in acute necrotizing pancreatitis (ANP). Methods Fifty-four Sprague-Dawley (SD) rats were equally divided into three groups:sham-operation group (SO group),ANP group (created with retrograde cholangiopancreatography injection of sodium taurocholate) and MT group (ANP model made after intra-peritoneal injection MT for 30 mins).Rats were sacrificed at 1,4 and 8hours after operation and pancreas tissues were underwent pathological examination.The free calcium concentration of pancreas tissues was determined by fluorescence minitoring method; and the expression of CaMK Ⅱ in pancreas tissues at mRNA and protein level was tested by real-time PCR and Western Blot.Results Pancreatic pathological injury in ANP groups was progressively severe as time extended,which was obviously ameliorated in MT group compared with ANP group (the t value of compared pathological score at 1,4 and 8 hour was:-7.95,-9.72 and -7.69,all P=0.00).Compared at same time point,the free Ca2+ concentration of pancreas tissues in ANP group was significantly higher than that of SO group (the t value of 1,4 and 8 hour was 13.09,18.58 and 16.56,all P=0.00).It was a little bit higher in MT group compared with that of SO group,however was significantly lower than that of ANP group (the t value of 1,4 and 8 hour was -10.03,-11.75 and -11.02,all P =0.00).Compared with SO group,the expression of CaMK Ⅱ at mRNA and protein level significantly increased in ANP group; MT significantly inhibited its expression.Conclusions The expression of CaMK Ⅱ may be inhibited by MT interfere,and then lower the calcium overload in pancreatic acinar cell,which play a role in pancreas tissue protection.

OBJECTIVE：To establish the content determination method of betaine in Lycium barbarum ，and to optimize the extraction method. METHODS ：HPLC method was used to determine the content of betaine in L. barbarum . The determination was performed on Waters Spherisorb NH 2 column with mobile phase consisted of acetonitrile- 0.01 mol/L monopotassiun phosphate aqueous solution （75∶25，V/V）at the flow rate was 0.7 mL/min. The detection wavelength was 195 nm，and column temperature was 30 ℃. The sample size was 10 μL. Using the content of betaine as index，on the basis of single factor tests ，L（9 34）orthogonal test design were used to select the methanol volume fraction ，extraction time and solid-liquid ratio of betaine in L. barbarum by ultrasonic extraction. The contents of betaine in 10 batches L. barbarum were determined ，and compared with the results of TLC included in 2015 edition of Chinese Pharmacopeia . RESULTS ：The linear range of betaine was 2.035-2 035.04 μg/mL（R2＝0.999 3）. The limits of detection and quantification were 0.410 μ g/mL and 2.051 μ g/mL，respectively. The average recovery were 97.41％-98.86％（RSDs were 0.8％-1.4％，n＝3）. RSDs of precision ，reproducibility and stability （24 h）tests were not higher than 1.2％. The optimal extraction method included solid-liquid ration of 1∶30（g/mL），ultrasonic extraction with methanol for 45 min. The average content of betaine in the extract from the three validation tests was 2.30％（RSD＝0.43％，n＝3）. The contents of betaine in 10 batches L. barbarum were 1.91％ -2.55％ ，which was no significantly different from the results of TLC （1.88％-2.60％）（RE were －1.92％-2.79％）. CONCLUSIONS ：The content determination method of betaine in L. barbarum was established successfully ，and the extract ion process was optinized.