Objective To evaluate the clinical diagnosis and treatment of gastrointestinal stromal tumors (GISTs). Methods The clinical data of patients with GISTs admitted into surgical department from July 2000 to Oct 2005 were retrospectively analyzed. Rusults Twenty-three patients received operation. Twenty-one patients underwent complete tumor resection, two did laparotomy only. Among the patients 7 cases were benign ,6 potential malignant, and 10 malignant . All patients were followed-up from 10 to 72 months. Three of the patients had local recurrence and metastasis, and 5 patients died. Conclusion It was difficult the diagnosis of GISTs because of the lack of clinical feature. Endoscopy and imaging examination are main methods to detect GISTs. Final diagnosis should be based on pathology. Surgical rection is the main treatment.

Objective:To investigate the clinlic therapeutic effect of sigmoid orthotopic neobladder after radical cystectomy in the treatment of invasive bladder cancer.Methods:1 6 patients with invasive bladder cancer (all males;age range from 53 to 75 years)were admitted and underwent radical cystectomy and sigmoid orthotopic neobladder.Results:Sixteen patients were hospitalized for 37 to 62 d,with an average of 51 d.All patients were followed up for a mean of 26 months (range from 5 months to 6 years).The serum creatinine (Cr)and blood urea nitrogen (BUN)levels were both in the normal range and there was no acidosis in all the cases. No case had unilateral ureteral urine reflux during cystography. Of the 16 patients 14 cases (87.5%) achieved continence during daytime;6 cases (37.5%) were incontinent at night, but all of them could control urination by being woken up at night.The capacity of the neobladder was 245 to 380 mL with an average of 316 mL and the maximal pressure of the neobladder during filling was 28 to 57 cm H2 O (1 cm H2 O =0.098 kPa)with an average of 39 cm H2 O.Conclusion:As an operation the sigmoid orthotopic neobladder can be performed easily without serious postoperative complications and has more reliable results. This operation may be generally applied in clinical practice.

Objective To develop SPE - HPLC method for the assay of paeonol in Liuwei Dihuang Pill (LDP). Methods Separation was performed on a Hypersil ODS(2) column (250 mm?4. 6 mm, 5?m) . The mobile phase consist of methanol - 2 % acetic acid (55 :45, v/v) . The flow rate was 1 mL/min. The UV detection was set at 275 nm. Results Paeonol had a good linear relation in the range of 0. 03998 ~ 0. 7996 ug, the average recovery of honeyed bolus of LDP was 102. 9 % and the RSD was 1.2%; the average recovery of concentrated bolus of LDP was 101. 5 % and the RSD was 1.8%. Conclusion The method is simple, sensitive and rapid and it can be used to determine the paeonol content of LDP.

Objective To investigate the resistant status and to type the phenotype and plasmid profiles of prevalent gonococcal strains. Methods A total of 98 gonococcal strains isolated from 1998 to 1999 in Zhanjiang was identified systemically. The susceptibilities of 98 strains of gonococci to penicillin,tetracycline and ciprofloxacin were detected by agar dilution method. The β － lactamase production was tested by iodometric method. The plasmids were extracted by alkaline lysis technique. Results The prevalence of gonococcal strains resistant to penicillin, tetracycline and ciprofloxacin were 22.44％ ,45.94％ and 55.12％ ,respectively. There were 6 positive strains for β － lactamase, accounting for 6.12％ (6/98). The most common phenotypes were susceptiblePT、 CMRNGT、 CMRNGPT and TRNG, accounting for 43.86％ ,23.46％ ,10.20％ and 10.20％ ,respectively. The detection rate of plasmids were 91.84％ .Among them, the percentages of 42.5 kb,39.5 kb,7.4 kb and 4.2 kb plasmids accounted for 11.22％ ,41.82％ ,59.16％ and 67.32％ ,respectively.There were 12 types of plasmid profiles(PP), the predominant types were 7.4kb＋ 4.2kb and 39.5kb＋ 7.4kb＋ 4.2kb, accounting for 21.42％ and 17.34％ ,respectively. Conclusion The gonococcal strains resistant to ciprofloxacin are very high in Zhanjiang. The phenotype and plasmid profiles of the strains have characteristic distribution.

AIM:To investigate the effect of perifosine, an inhibitor of protein kinase B ( PKB/Akt) , on the cell cycle, apoptosis and autophagy in human brain glioma U251 cells, and to determine the relationship between perifos-ine-induced autophagy and apoptosis of glioma.METHODS:The cell growth inhibition was determined by MTT assay. The cell cycle distribution of U251 cells was examined by flow cytometry.The cell apoptosis was analyzed by Annexin V-FITC apoptosis detection kit.The protein expression of P21, P27, cyclin B1, caspase-9 and PARP was examined by Wes-tern blot analysis.The distribution and expression of LC3-Ⅱ, an autophagy marker, was observed to determine the effect of perifosine-induced autophagy.RESULTS:Perifosine inhibited the cell viability in a dose-dependent manner.In perifos-ine-treated U251 cells, the cell cycle was arrested in G2 phase and the expression of cyclin B1 was inhibited.Perifosine in-duced apoptosis of U251 cells through activation of caspase-9 cleavage, PARP cleavage and survivin inhibition.In addi-tion, suppression of autophagy by chloroquin, an inhibitor of autophagy, increased the number of apoptotic cells.CON-CLUSION:Perifosine inhibits cell proliferation and triggers apoptosis and autophagy in human U251 cells.Blocking auto-phagy magnifies perifosine-induced glioma cell apoptosis.

Objective:To construct the rat models of orthotopic bladder cancer induced by N-methyl-nitrosourea (MNU),and to evaluate the value of magnetic resonance imaging (MRI)in the noninvasive diagnosis of the bladder cancer model.Methods:Sixty femail SD rats were divided into experiment group (n=45)and control group (n=15).The rats experiment group were induced with MNU (2 mg per rat)by intravesical administration every other week,for 4 times.Meantime,the rats in control group were treated with normal saline (0.2 mL per rat)by intravesical administration.At the end of the 14th week,all rats were examined by MRI and the pathological changes of bladder tissue were detected.Results:In experiment group,43 rats were alived and 2 rats were died at the end of the 14th week;the survial rate was 95.6% and the death rate was 4.4%;the abnormal signals were found in each of 43 rats by MRI which manifested as bladder tumor, and the same results were identified by pathology;the tumor formation rate was 100%.In control group,14 rats were alived and 1 rat was died at the end of the 14th week;the survival rate was 93.3%,and the death rate was 6.7%;there was no abnormal signal in the MRI examination and no bladder cancer in the pathological examination;the tumor formation rate was 0.The tumor formation rates of bladder cancer of the rats in two groups had significant difference (P <0.05),and the death rate had no significant difference (P >0.05).Conclusion:The method to establish the rat models of orthotopic bladder cancer induced by MNU is simple and reliable;the results of MRI are consistent with the pathological results and MRI examination is a reliable diagnostic method concerning this model.

Objective:To explore the expressions of endogenous hydrogen sulfide (H2 S)and its synthases cystathionine beta synthase (CBS)and cystathionine gamma lyase (CSE)in the cell lines of normal bladder and bladder cancer,and to clarify their mechanism in the development of bladder cancer.Methods:The bladder cancer cell lines (5637,T24,UM-UC-3,EJ)and human bladder epithelial cell line SV-HUC-1 were selected.The expressions of CBS and CSE in bladder cancer and normal cell lines were analyzed by Western blotting assay and the productivities of H2 S in cell lines were detected by sensitive sulphur electrode assay.The EJ cells were selected based on the previous experimental results and divided into groups as follows:① 10 μmol· L-1 NaHS group, 50 μmol·L-1 NaHS group,100 μmol·L-1 NaHS group and control group.After drug treatment,the cell survival rate was measured by MTT assay at 24 and 48 h.② 5 μg·L-1 cisplatin group,cisplatin (5 μg·L-1 )+ NaHS (100 μmol·L-1 )group and control group.After medicine treatment,the cell survival rate was measured by MTT assay and the cell apoptotic rate was detected by flow cytometry at 48 h. Results:Compared with the normal bladder cells (SV-HUC-1),the expression levels of CBS and CSE and the productivity of H2 S in the bladder cancer cell lines (5637,T24,UM-UC-3 and EJ)were increased obviously (P <0.05 or P <0.01).Compared with control group,exogenous H2 S promoted the cell proliferation of EJ cells.The cell survival rates were increased with the increase of drug dose (P <0.05),which showed a dose-dependent effect.The cell survival rates were increased with the prolongation of time (P <0.05),which showed a time-dependent effect.After medicine treatment,compared with cisplatin group,the cell viability in cisplatin+NaHS group was increased (P <0.05)and the apoptotic rate was decreased (P <0.05).Conclusion:Endogenous H2 S and its synthases CBS and CSE have an increased expression level in bladder cancer cell lines compared with the normal bladder cells.H2 S can enhance the proliferation of bladder cancer cells and decrease the apoptosis induced by cisplatin.

Objective To develop an ideal substitution material for bladder defect ,which can reduce serious complications of urinary intestinal diversion ,we establish experimental rabbit model of reconstruction the new bladder by ileal seromuscular with transplantation of autologous peritoneum .This animal research provides the basical ground for the experimental model and further clinical application of replacement bladder .Methods Randomly ,seven experimental female rabbits were chosen ,and their body weight was 4 .0-5 .0 kg .By intravenous anesthesia ,the bladder substitute operation was carried out (to transplant the peritoneum to an ileum segment which mucosa had been removed .These flaps were used to mend and reconstruct the bladder by composite cys‐toplasty) .Animals were euthanized at 4 ,8 weeks for routine pathology and immunohistochemistry .Results Seven rabbits under‐went reconstruction ,but three were lost to complications .The length of ileum was 4 .0 cm ,and the area of substitute peritoneum was 4 .0 cm × 2 .5 cm .Voiding behaviour was normal ,and urine was clear in the remainder .At autopsy ,reconstructed bladders were healthy .Pathological examination showed that the technique was successful in creating seromuscular segments with no epithelial remnants .When applied surgically ,the seromuscular flaps with peritoneum survived at 4 weeks and the peritoneum was substituted by transitional epithelium at 8 weeks .Conclusion In this experimental rabbit model ,reconstruction bladder by autologous peritone‐um and seromuscular segment is an ideal approach for which can prevent regrowth by ileal epithelial cells and overcome the compli‐cations of conventional enterocystoplasty .Voiding behaviour is normal in the remainder .This animal study provides the basical ground for the large experimental model and further clinical application of the new enterocysplasty .

Objective To investigate the association between the apolipoprotein E (apoE) gene polymorphism and the dose for warfarin individual maintenance. Methods The genotypes of 249 patients with warfarin treatment in maintenance doses were determined by PCR/DHPLC assay. The doses for warfarin maintenance were compared among patients with different genotypes. Results In the total of 249 patients, the frequencies of 2/ε2, ε2/ε3, ε2/ε4, ε3/ε3, ε3/ε4, ε4/ε4 genotype were 1.20%, 15.66%, 1.80%, 72.29%, 9.24%, 0.80%, respectively; the allele frequencies of ε2, ε3, ε4 were 9.44%, 84.74%, 5.82%, respectively. The warfarin dose of group ε2 (ε2/ε2, ε2/ε3) was (3.24±1.36) mg/d, slightly higher than that of group ε3 (ε3/ε3, 2.91±1.14 mg/d) or group ε4 [ε4/ε4, ε3/ε4, (2.98±1.05) mg/d], but the difference of the warfarin doses among the 3 groups did not reach statistical significance (F=1.848,P＞0.05). Conclusion ApoE polymorphism may be not a major genetic factor that influences the individual dose for warfarin maintenance.

Objective To investigate the value of femoral neck fracture(FNF) typing by digital subtraction angiography(DSA) in prognostic prediction of the fracture healing. Methods From June 2005 to June 2008,45 patients were admitted to our hospital for treatment of single femoral neck fracture.They were 26 males and 19 females,aged from 26 to 60 years(average,45.4 years).Their fractures were all typed according to DSA results.Type Ⅰ ( 15 patients) were DSA pictures which showed 3 to 6 supporting band vascular images crossing the fracture line.Type Ⅱ(14 patients) were DSA pictures which showed one to 2 supporting band vascular images crossing the fracture line.Type Ⅲ(16 patients) were DSA pictures which showed no supporting band vascular images crossing the fracture line.All cases underwent close reduction and internal fixation with cannulated screws under C-arm fluoroscopy.The prognoses of all the patients were evaluated according to their symptoms and imaging examinations in terms of avascular necrosis of femoral head (ANFH) and fracture healing. Results All the patients obtained an average follow-up of 36.7 months (from 24 to 60 months).In patients of DSA type Ⅰ,the ANFH rate and nonunion rate were respectively 0 and 13.3％ (2/15).In patients of DSA type Ⅱ,the ANFH rate and nonunion rate were respectively 7.1％ (1/14) and7.1％(1/14).In patients of DSA type Ⅲ,the ANFH rate and nonunion rate were respectively 100％ (16/16) and 0.The ANFH rate following FNF treatment was negatively related to age and the vascular number showed by DSA.The nonunion ratewas positively related to age but not significantly associated with the vascular number showed by DSA. Conclusion DSA has a significant value in predicting the prognosis for patients with femoral neck fracture.