Objective:To investigate the clinical and pathologic morphological features,immunohistochemical speciality of the gastrointestinal stromal tumors(GISTs) and their histogenesis,treatment and prognosis as well.Methods:The morphologic characteristics of GISTs were studied in 51 cases using light microscopy.The expression of c-kit(CDll7),CD34,vimentin,actin,S-100 were detected in all the cases with SP immunohistochemistry staining.Results:Among 51 cases of GISTs,40 were spindle cell type,4 epithelioid cell type and 17 mixturetype.Almost all of the stromal tumors were strongly positive for vimentin(99%),48 out of 51 tumors positive for CD117 (c-kit)(95.0 %) and 41 positive for CD34(78.5%).Some cases also expressed actin,S-100.Conclusion:GISTs are the most frequent mesenchymal tumor seen in the gastrointestinal tract.Under light microscope,the morphology of stromal tumors looks sometimes like that of a leiomyoma and Schwannoma.Application of immunohistochemical markers (particularly CD117 and CD34)is considered necessary for the differential diagnosis.GISTs may originate from the pluripotential stem cell of the interstium.

Objective:To study the expression and clinical significance of MRP and LRP in carcinoma of large intestine.Methods:Immunohistochemistry is used to examine the MRP and LRP expression in 60 cases of large intestine carcinoma and 10 cases of normal large intestine tissues.Results:The positive expression rates of MRP and LRP in the 60 cases of large intestine carcinoma are 68.3% and 70% respectively and are all significantly higher than those in normal large intestine tissues ( P 0.05).Conclusion:MRP and LRP are both highly expressed in large intestine carcinoma and play an important role in the primary multidrug resistence(MDR) of large intestine carcinoma.

Objective To explore the feasibility of laparoscopy-assisted total mesorectal excision(TME) for anterior resection of rectal cancer.Methods The clinical records of 42 patients with rectal cancer who underwentlaparoscopic TME from April 2006 to July 2008 were analyzed retrospectively.Results All the laparoscopic TME with anal sphincter preservation operations were successful;no case was converted to open procedure.The distal end of rectum was anastomosed by a reusable linear stapler.The average operative time was 195 min(170-230 min) and the operative blood loss 15 mL(10-30 mL).The time for bowel functionrecovery was 32 hours.One patient had postoperative dysuria,and one had intraoperative subcutaneousemphysema.No anastomotic leakage or infection of incisional wound occurred.Conclusions Laparoscopy-assisted anterior resection for rectal cancer is safe and feasible.

GRP78,as endoplasmic reticulum resident chaperone,is highly induced by a variety of tumor microenvironmental stresses,such as hypoxia and glucose deprivation.GRP78 is implicated in tumor cell proliferation,apoptosis,invasion,metastasis and angiogenesis.Recent evidence indicates that GRP78 levels is correlated with pathological grade,stage and prognosis for the majority of solid tumors.In addition,GRP78 plays an important role in drug tolerance and knockdown of GRP78 has been shown to sensitize malignant cells.GRP78 could not only be a good biomarker to predict cancer progression and chemo-responsiveness,but also an appealing target for the development of a more selective chemotherapy.

Radiation-induced brain injury is a neurological injury caused by radiation therapy of head and neck tumors. The pathogenesis is still unclear. It is hypothesized that immune cells play an important role in radiation-induced brain injury. The excessive activation of microglia in the central nervous system and the migration of peripheral immune cells into the brain collectively promote the incidence and development of radiation-induced brain injury. In this article, the immunological mechanism underlying the radiation-induced brain injury was reviewed.

Case based learning/problem-based learning ( CBL/PBL ) is a new teaching method based on traditional medical education methods.In order to conquer the deficiency of traditional education methods in autonomous study motivation and ability of knowledge integration, CBL/PBL has been introduced into vascular surgery teaching procedure since 2006.The quality and effort of CBL/PBL compared with lecture-based learning ( LBL ) were evaluated and scored. The outcome of this teaching innovation shows CBL can arouse students' desire in autonomous study and enhance their ability in clinical analysis.But, its superiority is difficult to develop in the current medical education system.

[ABSTRACT]OBJECTIVEThe purpose of the study is to put forward some ideas and suggestions for the future research of allergic rhinitis.METHODSThe experimental animal species, strains, methods of replicating animal model and the judging standard of allergic rhinitis in China from January 1998 to December 2014 were reviewed and analyzed.RESULTSThe experimental animal species, strains, methods of replicating animal model and the judging standard of allergic rhinitis used in 137 articles were different.CONCLUSIONOnly standardized and unified experimental animal model can ensure the implementation of scientific research successfully and the reliability of the experimental results.

Objective To investigate the characteristics and clinical significance of ocular vestibular evoked myogenic potential (oVEMP) and caloric test in Meniere disease (MD) at different hearing stages.Methods Fifty-five patients(52.8±15.8 years old) with MD were divided into stage 1(9 cases,48.8±13.8 years old), stage 2(9 cases,46.0±16.3 years old), stage 3(23 cases,50.3±13.5 years old) and stage 4(cases 14, 53.5±16.2 years) respectively according to the pure tone audiometry.They were evaluated by oVEMP and caloric test.Results The abnormal rates of oVEMP were 55.6%, 66.7%, 78.3%, 78.6%,and caloric tests were 22.2%, 33.3%, 78.3%,and 85.7% respectively in stage 1, 2, 3, and 4 MD patients.The amplitudes of oVEMP in stage of 1, 2, 3, and 4 MD patients were 4.3±4.0 μV,3.5±2.3 μV,2.5±2.4 μV,and 1.3±0.5 μV,respectively.Conclusion The abnormal rates of oVEMP and caloric tests in MD patients increased with the degree of hearing impairment and the amplitudes of oVEMP were decreased, suggesting that utricle and horizontal semicircular canal injuries were aggravated.

Objective To study the pre-existing intimal hyperplasia and the expression of nuclear factor-κB (NF-κB) and vascular cell adhesion molecule 1 (VCAM-1) in great saphenous vein(GSV) among the patients with diabetes mellitus undergoing coronary artery bypass grafting(CABG).Methods Segments of GSV were collected from 20 patients with diabetes mellitus and 22 patients without diabetes mellitus undergoing CABG.Morphometric analysis was performed after hematoxylin-eosin (HE) staining and Masson staining by microscopic computer analysis.Immunohistochemistry staining was used to examine the expression of NF-κB and VCAM-1 in intima.Results Pre-existing intimal hyperplasia was more common and server in GSV of the patients with diabetes mellitus.The expression of NF-κB and VCAM-1 were significantly higher in intima of GSV in patients with diabetes mellitus than patients without diabetes mellitus.The expression of VCAM-1 was positively related to NFκB in intima of GSV.Conclusion The pre-existing intimal hyperplasia and the expression of NF-κB and VCAM-1 were more common and server in GSV of the patients with diabetes mellitus than patients without diabetes mellitus.This can partially explain the poor prognosis of patients with diabetes mellitus after CABG.

Objective To analyze the CT and clinical features of acute pancreatitis(AP) patients with perirenal space(PRS) invasion.Methods CT images and renal function tests(serum urea,creatine) changes of 64 AP patients were retrospectively studied. PRS invasion by inflammation on CT scan and the relation between PRS invasion and renal function changes were analyzed. Results 81% patients had PRS invasion in which 52% were grade B, 25% were grade C. CT features of the PRS invasion varied from mild inflammatory changes to fluid collection or phlegmonous.The PRS invasion was detected in 35 of 52 patients with mild pancreatitis and all severe pancreatitis. Renal function abnormity was 47%, only 3% patients had abnormal renal function in patients without PRS invasion compared to 44% patients with PRS invasion. PRS invasion in patients with abnormal renal function attenuated on CT scan after the pancreatitis was controlled. Conclusions The CT clearly reveals the features of PRS in acute pancreatitis patients. The attenuation of PRS invasion in acute pancreatitis patients on CT parallels renal function recover.