The clinical data of 22 cases with gastrointestinal stromal tumors were retrospectively analized.The main clinical manifestations were gastrointestinal bleeding (14/22),abdominal discomfort (5/22) and abdominal lump (3/22),stomach was the most common site of the tumor (14/22).All 22 cases underwent surgical treatment and pathological examination confirmed that 12 cases were benign.Immunohistochemical results showed that 68% cases were negative in solubility acid protein-100 (S-100),and the positive rates of tyrosine-protein kinase acceptor 117 (CD117),hemopoietic stem cell antigen 34 (CD34) and negative rate of smooth muscle actin (SMA) were all 73%.Eighteen cases were followed up for 1-5 years after operation,among them 3 died.The survival was closely related to the size,the pathological characteristics and the recurrance of the tumor as demonstrated by multivariate Cox regression analysis.Since gastrointestinal stromal tumor has no specific clinical manifestations,preoperative diagnosis is difficulty,so surgical resection and subsequent pathological examination is used for confirmation of diagnosis,as well as treatment of the disease.

Objective To discuss the diagnosis and surgical treatment of insulinoma. Methods The clinical data of 32 patients with insulinoma were analyzed retrospectively. Of the 32 patients, 19 patients were performed with simple tumor enucleation, 10 patients with pancreatic body and tail resection, 3 patients with pancreaticoduodenectomy. Results In this study, 20 cases were diagnosed and localized the tumor by type-B abdominal ultrasonic and enhanced spiral CT before operation and 12 cases by intraoperative type-B ultrasonic. Within all patients,9 tumors located in the head of pancreas, 15 tumors in the neck , 8 tumors in the tail. The clinical symptoms in 32 cases disappeared after operation with 2 cases followed by pancreatic leakage. Of all 32 cases with insulinoma,28 tumors were diagnosed as benign and the other 4 as malignant. Conclusions The mainly clinical manifestation of insulinoma is typical whipple triad. Preoperative qualitative diagnosis is practicable according to the clinical symptom and laboratory examination. Combined imaging examinations might be helpful in improving the positive test rates. Intraoperation exploration and ultrasonography are the chief methods for the tumor localization. Site, size, number and depth of the tumor are the key points determining the surgical method style.

Objective: To investigate the role of expression of Caspase-9 in megalosplenia of cirrhotic portal hypertension. Methods: Using SP immunohistochemistry method to examine theexpression of Caspase-9 in the specimens of 50 cases of megalosplenia with cirrhotic portal hypertension and 15 cases of traumatic spleen of normal man. Results: The Caspase-9 positive rates in the traumatic spleen and megaloplenia were 26.7% and 76.0%, respectively. There was a significant difference between the groups(P