Objective To study the clinicalpathological characteristics,surgical treatment andprognosis of the gastrointestinal stromal tumor(GIST).Methods The clinical data of 160 cases of pathologically confirmed GIST were retrospectively reviewed.Clinical features,pathological characteristics andimmune markers were studied by multiple factor analysis.Results There were no intraoperative or deathsin 140 patients who underwent radical resection.Univariate analysis of survival revealed significant differences in the main tumor pathological characteristics,including mitotic figure and metastasis and Fletcher'sclassification(P <0.05).Immunohistochemical results showed that the positive rates of KIA and CD133were 97.6% and 81.3% respectively,and their influences to survival prognosis were of statistical significance(P <0.05).A total of 145(90.6%)patients finished the follow up and 53 cases of them had multiple liver metastasis.These patients received imatinib mesylate(400 mg/d)and the efficacy was significant(P <0.05).Multivariate regression analysis showed that Fletcher's classification and imatinib mesylatewere the independent risk factors affecting prognosis.Conclusion Fletcher's classification is an effectivemethod for evaluating the prognosis of GIST.Radical resection and imatinib mesylate can reach a remarkable curative effect in treating original and metastatic lesions of the GIST patients.

Objective To investigate the protective effects of propofol in clinical relevant concentration on TNF-induced apoptosis in endothelial cells derived from human umbilical vein (HUVECs) .Methods The third and fourth passages of the cultured endothelial cells were divided into 5 groups. 0, 12.5, 25, 50 or 100 ?mol/L propofol was added to the cultured cells respectively and the cells were incubated for 30 min. Then TNF-? was added to the cultured cells (the final concentration of TNF-? was 2000 U.ml-1 ) which was incubated for 24h. Apoptosis was detected by using "terminal deoxynucleotidyl transferase (tdt )-mediated deoxyuridine triphosphate (dUTP )-biotin nick end-labelling" (TUNED . Morphologic changes were examined by means of electron microscope.Results Apoptosis expression was very high in control group (no propofol was added) . The process can be inhibited by pre-treatment with propofol (P

Objective To evaluate the feasibility of the joint method containing salvia tetramethylpyrazine,trimetazidine,alprostadil in the treatment of unstable angina.Methods 70 unstable angina patients met the inclusion criteria were randomly divided into the observation group of 35 cases and the control group of 35 cases.The control group was given trimetazidine 20mg,tid,and alprostadil 100mg,1 qd.The observation group were given salvia tetramethylpyrazine 10ml on the basis of the control group,qd.Two groups were treated for 14d.The frequency and duration of angina attack was observed.The ECG was monitored.Clinical efficacy differences was compared before and after treatment.Results The total effective rate of the observation group was 100％.The effective rate were 86％.The control group were respectively 91％ and 60％.The total effective rate of observation group was significantly higher than the control group(x2 =6.838,P ＜ 0.05).The effective rate of observation group was significantly higher than the control group (x2 =5.851,P ＜ 0.0 5).The angina frequency,angina duration,stroke output quantity (SV),eiectionfraction(EF) of the observation group and the control group after treatment improved significantly than before treatment,after the treatment the angina frequency,angina duration,stroke output quantity (SV),ejection fraction (EF) of the observation group and the control group were respectively (2.69 ± 0.46) time/min vs (6.46 ± 0.62) time/min,(3.26 ± 0.32) min vs (5.54 ± 0.42) min,(49.7 ± 3.4) ml vs (43.2 ± 2.8) ml,(69.2 ± 5.9) ％ vs (55.3 ±4.8) ％,the angina frequency,angina duration of the observation group was significantly lower than the control group,and the stroke output quantity(SV),ejection fraction(EF) of the observation group were significantly higher than the control group(all P ＜ 0.05).Condusion The joint method containing salvia tetramethylpyrazine,trimetazidine,alprostadil have exact clinical efficacy,reduce the time of angina attack frequency and duration,effectively improve myocardial blood supply,improve heart function,which is worthy of clinical use.

Objective To evaluate the diagnostic value and technique advantage of 16-slice CT angiography(16SCTA) in aortic dissection.Methods 39 cases of aortic dissection underwent 16SCTA.The data were reconstructed by multiplanar reconstruction(MPR),curved planar reconstruction(CPR),volume rendering(VR),maximum intensity projection(MIP),virtual endoscopy(VE),and generally analyzed in combination with original axial images.Results According to DeBakey's classification,DeBakey's type Ⅰ in 5 cases,type Ⅱ in one case and type Ⅲ in 33 cases were founed in the 39 cases.16SCTA clearly showed that including the ture and false lumen(39 cases,100%),intimal flaps(39 cases,100%),intimal tear(25 cases,64.1%),and thrombus inside the false lumen(17 cases,43.6%).Conclusion 16SCTA may be as the first choice method in diagnosis of aoric dissection,and which is considered as having great value.

OBJECTIVE: To perform morphometric analysis of bilateral cochleae in all subjects based on computed 3-dimensional reconstruction tomographic data and assist the surgeon in diagnosing the inner ear abnormality or surgical strategies. METHOD: Two hundred normal developed cochleae from 100 patients were divided into 5 groups according to age. Morphometric analysis of bilateral cochleae was performed in all subjects by 3D reconstructions and 2D multiplanar reformation. The length and width of the cochlear base, the length within the cochlear base, the height of the cochlea, the angle between the first and second turn of the cochlea, and the cochlear orientation within the cranial base were measured and compared in different age, sex and bilateral groups. RESULT: The length of the cochlear base was (8.56 +/- 0.52)mm, the width was (6.63 +/- 0.56)mm, the length within the cochlear base was (7.33 +/- 10.56)mm, the height of the cochlea was (3.76 +/- 0.28)mm, and the angle between the first and second turn of the cochlea was (15.82 +/- 2.78)degrees. All index above did not change significantly in different aging, sex or side (P > 0. 05). Variability in the angle between the first and second turn of the cochlea was considerable, and a smaller angle (from the midsagittal line) was showed in the older age groups than the younger groups (P < 0.05). CONCLUSION 3D and 2D volume rendering enables us to evaluate the features of cochlear morphology and orientation that may assist the surgeon in diagnosing the inner ear abnormality or surgical strategies.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Cochlea ; diagnostic imaging ; Humans ; Imaging, Three-Dimensional ; Infant ; Middle Aged ; Reference Values ; Tomography, X-Ray Computed ; methods ; Young Adult

sed by pelvic fracture or other conditions.

Objective To investigate whether thalidomide inhibits the over expression of type I collagen in pulmonary fibrosis rats via inhibiting the JNK signaling pathway,thereby reducing bleomycin induced pulmonary interstitial fibrosis in rats.Methods 90 healthy male SD rats were randomly divided into normal control group (group N),model group (group M),thalidomide group (group T),SP600125 group (group SP) and thalidomide+SP600125 group (group T+SP).The pulmonary fibrosis models were prepared via intratracheal injection of 5mg/kg bleomycin,and rats in groups were given corresponding drugs from the first day after preparing model.Rats were randomly sacrificed at 7,14 and 28 days after treatment.The degree of pulmonary alveolitis and fibrosis was evaluated by H&E and trichrome masson stainings.The level of hydroxyproline in the lung tissue was detected by applying alkaline hydrolysis technique,and expression levels of p-JNK and type I collagen were tested by Western bloting for protein expression and real-time polymerase chain reaction (RT-PCR) for mRNA expression.Results In group M,alveolitis was the most serious on day 7; a marked pulmonary fibrosis formed on day 28; the level of hydroxyproline also peaked on day 28,and the contents of p-JNK and type I collagen were higher than in group N(F=277.87,472.51,both P＜ 0.01).Group T,SP and T+SP showed mild alveolitis and fibrosis at all time points,and their levels of hydroxyproline,p-JNK and type I collagen were remarkably decreased as compared with group M (F=14.77,61.59,101.73,all P＜0.01;F=10.33、79.12、57.48,all P＜0.01).No significant difference in p JNK was found between group SP and group T+SP.Conclusions Thalidomide may inhibit the over expression of type I collagen in pulmonary fibrosis rats via inhibiting the JNK signaling pathway,thereby reducing bleomycin induced pulmonary interstitial fibrosis in rats.

ObjectiveTo establish a enzyme-linked immunosorbent assay (ELISA) method for detecting the β-amyloid peptide 42 ( Aβ42 ) and explore its clinical meaning for diagnosis and treatment in the early stages of the alzheimer disease ( AD).Methods Using the Aβ42 single chain variable fragment constructed by phage antibody library display system as coat antibody,associated with the Aβ42 polyclonal antibody acquired by Aβ42 immunized rabbit and HRP labeled goat anti rabbit IgG to establish ELISA method for detecting the Aβ42 in peripheral blood.The method was used it to test the Aβ42 in 120 vascular dementia VD) or cerebral vessel infarction patients and 120 AD patients and 120 controls.The methodology performance were evaluated.ResultsThe inter and intra coefficient of variable (CV) of this self-established ELISA method was 3.6％ and 3.5％,6.8％ and 7.1％ respectively.The recovery rate was 97.2％ -103.1％.The linear range was 0.050 - 2 μg,/L.Its reactivity decreased ＜ 12％ when it was put in both 37 ℃ for 6 days and 4 ℃ for 6 months.Compared with the Belgium INNOTEST reagent by testing 90 samples simultaneously,the results of self-established method was (0.207 ± 0.039 ) μg/L,the results of INNOTEST was (0.206± 0.038 ) μg/L; the regression equation was Y =1.011X - 0.003,R2 =0.979,P ＜0.01.The Aβ42 in blood of AD group was (0.247 ± 0.032 ) μg/L,VD or cerebral vessel infarction group was (0.173 ±0.028) μg/L,control group was (0.172 ±0.032) μg/L.The Aβ42 in AD group was higher than that in the VD or cerebral vessel infarction group and control group (q =18.867,18.907respectively,P ＜ 0.01 ).The cut off value was 0.212 μg/L decided by the receiver operating characteristic (ROC) curve.The reference interval was 0 -0.212 μg/L.The sensitivity of this ELISA method was 86.7％(104/120) and specificity was 90.8％ (218/240).ConclusionsThe ELISA method for detecting Aβ42 in peripheral blood established by the study is sensitive and specific and has good precision and stability.It could provide a new effective criterion and support for the early diagnosis and treatment of the AD patients.

0.05).The infiltration of tumor to the muscularis mucosa or serosa layers was significantly correlated with the risk of GISTs(?~2=4.87,P

Objective To evaluate the clinical application of endoscopic thyroidectomy(ESTC) via the approach of areola of breast.Methods The clinical data of 46 cases of endoscopic thyroidectomy via the breast areola approach from October 2004 to November 2006 were retrospectively analyzed.Results The operation was successfulmy completed endoscopically in 44 cases,including 18 cases of unilateral partial thyroidectomy,26 cases of bilateral partial thyroidectomy,and 2 cases were converted to open operation for thyroid cancer neck dissection.The operation time of ESTC was 80~160minutes(mean 110min),and the intraoperative blood loss was 25~45ml,(mean,33?9.5ml).Pathological findings showed 25 cases of thyroid adenoma,16 cases of nodular goiter,and 3 cases of Graves disease.The length of postoperative hospital stay was 3~6day(mean4.5d).Complications occurred in 2 cases,including 1case of bleeding from left puncture tract,and 1 case of temporary hoarseness.Conclusions Endoscopic thyroidectomy via breast areola approach is a technically feasible and safe procedure,and has the advantage of minimal trauma,and with excellent cosmetic outcomes.