Gastrointestinal stromal tumor( GIST)is the most common gastrointestinal mesenchymal neoplasm and accounts approximately 18% of all mesenchymal neoplasms and 1% of all gastrointestinal neoplasms. Morbidity of GIST is about 1-2 per hundred thousand per year. The recurrence rate 5 years after complete resection of malignant GIST is up to 50%,and the median survival of metastatic GIST is only 9 months. Nowadays,endoscopic ultrasonography(EUS)is the first choice management for upper digestive tract GIST with diameter ≤2 cm,however,because of its high degree malignancy,surgical resection is the choice for GIST with diameter > 2 cm,and adjuvant or neoadjuvant chemotherapy with tyrosine kinase inhibitors can be used in case with high risks and difficulties in surgical removal. This article reviewed the advances in study on treatment of GIST.

Objective To summarize the experience of using CT and MRI to diagnose the renal collecting duct carcinoma.Methods From February 2005 to January 2012,10 cases with renal collecting duct carcinoma,confirmed by pathology,were reviewed retrospectively.The data contained 6 men and 4 women,whose age ranged from 21 to 62 years (mean age 48 years).The flank pain was complained by 7 cases,waist discomfort was complained by 3 cases.In urine laboratory test,positive urine erythrocytes (++++) were found in 6 cases.In 10 cases,7 cases accepted CT examination and 3 cases accepted MRI examination.The growth pattern,lesion location,dynamic enhanced scan phase of the tumor and the way of spreading and metastasis were analyzed based on those CT and MRI images.Results The lesions were located in the left kidney in 6 cases,located in the right kidney in 4 cases.The size of tumors ranged from 4.4 cm×5.8 cm to 7.2 cm× 7.4 cm (mean size 5.7 cm× 6.4 cm).The mass,located in the center of renal parenchyma with irregular shape,showed infiltrative growth pattern.The shape of kidney was normal,whereas the border line between cortex and medulla was indistinct.The tumor involved the renal cortex and medulla in 4cases and involved the renal cortex,medulla,pelvis simultaneously in 6 cases.Among 7 patients who accepted the CT scanning,the solid mass was revealed in 6 cases.On CT plain scanning,the masses demonstrated slightly low or equal density within flaky or patchy low-density necrosis.Two cases showed small punctate calcification within the mass.One case was solid and cystic mass,which the cystic part of the mass showed irregular shape of the liquid-density.Among 3 patients accepted MRI scanning,all masses showed solid characters.The substantial part showed slightly hypointense on T1WI and low signal intensity on T2WI.The necrotic foci demonstrated low signal intensity on T1WI and high signal on T2WI.Dynamic enhanced scan revealed mild to moderate enhanced in the substantive part.The density of signal was lower than the renal cortex and slightly higher than the renal medulla in corticomedullary phase.It enhanced continuously in parenchymal phase,but still lower than the renal parenchyma.It enhanced continuously in the delayed phase,while the cystic or necrotic lesions were not observed the enhancement.Renal artery was surrounded by the mass in 2 cases.Tumor embolus was found in the renal vein in 2 cases,9 cases were noticed with renal hilum and paraortic hyperlymphonodus.The thoracic and lumbar spinal metastasis was found in 1 case and adrenal metastasis was found in another case.All patients underwent radical nephrectomy,that pathological diagnosis was renal collecting duct carcinoma.Conclusions The CT and MRI imaging characteristics of renal collecting duct carcinoma can be described as the mass located in the center of renal parenchyma with the infiltrative growth pattern.In MRI image,it demonstrates low signal intensity on T2WI.And a mild continuously enhanced can be observed on dynamic enhanced scanning.Moreover,the tumor often involves renal hilum,perirenal fat capsule,paraortic lymph node,and shows the tendency of distant metastasis.

Objective To assess whether 5-HTR1A C( - 1019) G and GNβ3 C825T gene polymorphisms are associated with post-stroke depression (PSD) and explore the genetic mechanism of the pathogenesis of post-stroke depression. Methods All 159 patients with first stroke were divided into the PSD group and the control group according to HAMD scores. Their genotypes were determined with polymerase chain reaction and allele-specific restriction enzyme analysis. Results The frequency of 5-HTR1A (-1019) GG genotype(8/53,15. 1% ), G allele (44/106,41.5%)and GNβ3 825T allele(68/106,64. 2% ) were significantly higher in the post-stroke depression group than in the controls (5/106,4.7% ;35/212, 16. 5%; 113/212, 53.3%; ×2 = 23.204, 23. 655, 3. 392, all P ＜ 0. 05 ). Combined genotype analysis showed that individuals with both 5-HTR1A ( - 1019) G and GNβ3 825T allele ( OR =4. 980,95% CI 2. 429-10. 210,P =0. 000) had a higher risk than those with 5-HTR1 A (-1019) G allele ( OR = 3. 589,95% CI 2. 113-6. 096, P = 0. 000) or GNβ3 825T allele ( OR = 0. 638,95% CI 0.395-1. 031 ,P =0. 042) only for post-stroke depression. Conclusion The 5-HTR1A C( - 1019)G and GNβ3 C825T polymorphisms are predisposing genes of post-stroke depression. Our data also suggest a significant interaction between the 5-HTR1A ( - 1019)G allele and GNβ3 825T allele in post-stroke depression.

BACKGROUND: Osteogenesis-related molecules were detected in osteosarcoma tissues, which have closely association with the occurrence, development and prognosis of osteosarcoma. OBJECTIVE: To study the expression of bone morphogenetic protein 7 (BMP-7), vascular endothelial growth factor (VEGF) and core binding factor ?1 (RUNX2) in osteosarcoma cell Lines MG63. DESIGN, TIME AND SETTING: A molecular biology observation was performed at the Central Laboratory of Changhai Hospital between March 2007 and November 2007. MATERIALS: Osteosarcoma cell line MG63 was purchased from Institute of Biochemistry and cell biology, ISBS, CSA. METHODS: Cell line MG63 was counted with blood cell counting, inoculated in 100 mL culture flask with density of 1?104/cm2, stimulated at 37 ℃ with 5% CO2 air and saturated humidity. Then adherent cultured with DMEM containing 10% fetal bovine serum. When the cells reached 70%-80% confluency, the cells were digested with 0.25% pancreatic enzyme for 5 minutes, followed by terminating the digestion with adding DMEM containing 10% fetal bovine serum, and passaged at a ratio of 1:3. MAIN OUTCOME MEASURES: The expressions of BMP-7, VEGF and RUNX2 in MG63 were detected by RT-PCR and immunohistochemistry. RESULTS: BMP-7, VEGF and RUNX2 were positive expressed in MG63. CONCLUSION: The expression of BMP-7, VEGF and RUNX2 in MG63 was confirmed by gene and protein levels, which suggested that osteogenesis-related molecules may play important roles in the development of osteosarcoma.

Objective To study the mechanism of cisapride in the treatment of gastricelectric dysrhythmia. Methods Cisarpride was gavage fed to rats in which gastricelectric dysrhythmia hed been reproduced. The cholinergic and nitriergic nerves in myenteric plexus of gastric antrum were examined with histochemical staining methods and whole mount preparation technique. The levels of cAMP and cGMP in the antral smooth muscle were measured by radioimmunoassay. Results Gastricelectric dysrhythmia in the model group was ameliorated after the treatment with cisapride(P

The quantitative parameters based on dynamic contrast-enhanced MRI (DCE-MRI)scan,simulate the distribution of contrast inside and outside of the blood vessels through a variety of tracer kinetic models.The DCE-MRI perfusion parameters now are widely applied in clinical management of uterine tumors,to analyze the microcirculation characteristics in tumor and to guide the diagnosis,tumor grading and efficacy evaluation.

Objective To investigate the findings and prognosis of head MRI and brain parenchymal lesions in patients with intracranial venous sinus thrombosis. Methods The clinical manifestations and imaging data of 41 patients with intracranial venous sinus thrombosis were analyzed retrospectively. According to the head MRI,the patients were divided into a brain parenchymal lesion positive group (n = 21)and a negative group (n =20). The clinical manifestations and the difference of the affected venous sinus in patients of both groups were analyzed. Results The proportion of dehydration,epilepsy,motor disorders,and psychiatric symptoms in the positive group were 28.6% (n =6)vs. 0% (n =0),57. 1% (n =12)vs. 15. 0%(n = 3),47. 6% (n = 10)vs. 5. 0% (n = 1),and 33. 3% (n = 7)vs. 5. 0% (n = 1),respectively. There were significant differences (all P < 0. 05). The proportion of the occurrence of superior sagittal sinus thrombosis in the positive group was lower than that in the negative group (47. 6% [n = 10]vs. 80. 0%[n = 16];P = 0. 031). At discharge,the proportion of complete recovery (modified Rankin score 0 -1)in the positive group was lower than that in the negative group (71. 4% [n = 15]vs. 100% [n = 20];P =0. 032). Conclusion Compare with the clinical symptoms of the positive patients,the patients with intracranial venous sinus thrombosis and those with negative brain parenchymal lesions are relatively minor,their prognoses are better,and the thrombi are more involved in superior sagittal sinus.

Objective To evaluate the clinical value of 3.0T magnetic resonance imaging (MRI) diffusion weighted imaging (DWI) on evaluation effect of neoadjuvant chemotherapy in advanced gastric cancer. Methods 3.0 T MRI DWI examination was performed in 42 cases of advanced gastric cancer diagnosed by gastroscopy and pathology, including 32 patients were examined with DWI both before and after chemotherapy. Lymph nodes of gastric cancer lesions and display ability of stomach were measured, and the area of the apparent diffusion coefficient (ADC) values in normal stomach and tumors were compared. ADC values were compared in the same patients before and after neoadjuvant chemotherapy and analyzed along with postoperative pathological examinations. Results In a total of 40 patients who received 74 DWI examinations, ADC values in tumor and lymph nodes were significantly higher than those in normal tissue. The ADC value in tumors was (1.348 ±0.278) ×10-3 mm2/s, and in 12 cases of stomach lymph node enlargement was (1.329±0.188) ×10-3 mm2/s. However, the average ADC value of normal stomach was (2.081± 0.189) ×10-3 mm2/s with significantly lower DWI than that of the former (P< 0.001). After chemotherapy, the ADC value in tumors was increased, which was (1.572 ±0.261) ×10-3 mm2/s (P< 0.001). After neoadjuvant chemotherapy, 16 patients received gastric cancer radical prostatectomy, and postoperative pathological TRG ratings of tumor were decreased with different extent. Tumor cell density (TCD) before treatment with an average of 4.45 ×10-5 / px2, which was downgraduated to 2.48 ×10-5 / px2 after chemotherapy and surgery. Negatively correlation between TCD values and ADC values were observed. Conclusion MRI DWI examination can effectively detect advanced stomach cancer and the associated lymph node enlargement. Comparison of tumor morphology and ADC values in advanced gastric cancer before and after neoadjuvant chemotherapy has clinical value in prognosis.

Objective This study was designed to explore the influence about apoptosis of STI571 on NB4.Methods After NB4 cells were treated with STI571 in different concentration(0.5,1.0,5.0umol/L)at indicated time(24h,48h,72h)(1)morphological observation:To determine cell morphology by light microscope.(2)MTT assay:Inhibition of proliferation was measured with a colorimetric 3-(4,5-dimethylthiazol-2-yl)-2,5-dipheny tetrazolium bromide(MYa3 assay.(3)Flow cytometric analysis:The expression of survivin and smac were measured on NB4 by FCM.Results Morphological observation showed characteristic apoptosis changes.MTT assay showed that STI at (0.5,1.0,5.0 μmol/L) range for 24 h,48 h and 72 h can markedly inhibit the proliferation of NB4 cells in a dose-dependent manner as well as a time-dependent manner(P＜0.05).FCM showed the expression of survivin decrease and smac increase.Conclusion STI571 In Vitro inhibits proliferation of NB4.

Objective To investigate the therapeutic effect of lengthening and rotational osteotomy of the fibula for lateral malleolar malunion. Methods Twenty-three patients who had suffering from the traumatic arthritis of ankle were due to lateral malleolar malunion treated with lengthening and rotational osteotomy from October 2005 to July 2008. Special radiographs were use to fully detect the extent of shortening and rotation of the fibula. The Lengthening and rotational osteotomy could be conducted with a special compression/distraction device and bone graft. The function of the ankles was evaluated by the American Orthopedic Foot Ankle Society (AOFAS) scoring system. Serial radiographs of the ankle were made to assess the bone healing and changes of posttraumatic osteoarthritis. Results Seventeen of 23 patients were followed up, with a mean 29.1 months (12-45 months). All the fractures were healed. The mean bone healing time was 13.3 weeks (11-16 weeks) and the mean time of total weight-bearing was 12.1 weeks (11-15 weeks). The ankle function score had improved from 29 (21-47) preoperatively to 81 (56-91)12 months after the operation. There was 5 in excellent, 8 in good, 3 in mild, 1 in poor, and the rate of good outcomes was 76.5%. After the operation, 1 patient had a skin necrosis around the wound which healed by conservative treatment. A slightly aggravated degeneration of the ankle joint was seen in 2 patients who responded to conservative managements. No failure of the internal fixation was noted in this group. Conclusion The outcomes demonstrate that reconstructive lengthening osteotomy is well worthwhile when there is absent or minimal osteoarthritic change, regardless the time from the original injury. Lengthening of the fibula is an important step in the treatment of the painful ankle when the fibula become shorter after injury, even when degenerative changes of the joint are already present. The lengthening of the fibula could lead to a good outcome in ankle with lateral malleolar malunion.