Objective To investigate the clinical characteristics of gastrointestinal stromal tumor (GIST) of the stomach and to analyze the corresponding prognostic factors. Methods We retrospectively reviewed the clinical data of 121 patients in our hospital from March 1996 to March 2008. Gender、age、tumor size and histological type were analyzed. Results For these 121 cases the median survival time is 73.2 months. The overall 1-、3-、and 5-year survival rates were 82%, 59% and 50% respectively. The tumor-free survival rates for 1-、3-、and 5-yeas were 65%, 46% and 33% respectively. Cox univariale analysis revealed that gender、tumor size、organ involvement and recurrence were factors impacting prognosis. Cox multivariate analysis revealed that gender、tumor size、organ involvement、recurrence were prognostic factors for gastric GIST. Conclusions Male sex、tumor size (> 10 cm) and involvement of organ were independent indicators for a poor prognosis in patients with primary malignant gastric GIST.

Objective To explore the effect and molecular mechanism of proteasome inhibitor in TNF-related apoptosis-inducing ligand (TRAIL)-induced apoptosis resistance on malignant lymphoma cells.Methods Raji cells were treated with TRAIL and proteasome inhibitor (PS-341) in vitro and the cell growth index was evaluated by MTT assay; cell cycle was analysed by flow cytometry; the protein and mRNA level of Bax were measured by Western blotting and real time RT-PCR. Results TRAIL inhibited proliferation of Raji cells at the concentration of 500 μg/L, but the inhibition rate was lower than that of the control cell:Hmy2.ciR.TRAIL arrested cell in G0/G1 phase. The Bax protein in Raji is degraded, but the Bax mRNA expression level does not change significantly .The effects of TRAIL was enhanced significantly 10 nmol/L PS-341 was added. Conclusion Raji cells are resistant in TRAIL-induced apoptosis. This effect may be related to the decrease of Bax protein. The Ubiquitin-proteasome pathway is involved in the degradation of Bax in TRAIL-treated Raji cells.

Objective:To discuss the clinical feature, diagnosis, and treatment course of pancreatic acinar cell carcinoma (ACC) to guide clinical practice and improve prognosis of patients. Methods:Clinical data of 15 patients with pathologically confirmed pancreatic acinar cell carcinoma between December 1994 and March 2014 in Tianjin Medical University Cancer Institute and Hospital were retro-spectively studied. Results:The patients include eight males and seven females with a median age of 44. Tumors in these patients appeared in different parts of the pancreas. Eight patients had tumor in the head, six in the body and tail, and one in the uncinate process. The tumor size ranged from 3 cm to 18 cm, with an average diameter of 6.67 cm. The patients presented less jaundice and the tumor markers remained constant, specifically, no increase was reported. Six patients had metastasis before their operation. Twelve patients received radical resection, while the other three received palliative treatment. The preoperative and intraoperative diagnoses were not exact. The final diagnosis depended on pathologic confirmation after surgery or puncture. The immunohistochemical results of trypsin and chymotrypsin were positive in the patients who were examined. The postoperative chemotherapy was usually based on gemcitabine. The average survival time was 20.6 months. Conclusion:Pancreatic acinar cell carcinoma has special clinical features, and clinicians tend to regard it as low-grade malignancy. The attitude towards ACC should be positive.

Objective To explore the value of urine formaldehyde test in the diagnosis of Alzheimer's disease (AD),and the influential factors of urine formaldehyde level in AD patients.Methods A total of 52 AD patients and 53 cognitively normal controls were recruited in a cohort study.All subjects were no less than 65 years old,and those with acute infection,or dysfunction in heart,liver or kidneys were excluded.The impact of age,gender,onset age,MMSE score,NPI score,MTA score,and ApoE ε4 gene on urine formaldehyde of AD patients were analyzed by multiple regression analysis.Results Urine formaldehyde level of AD group was statistically higher than that of cognitively normal control group ((13.27±4.16)μmol/L vs (10.76±4.47)μmol/L,t=2.99,P=0.15).Urine formaldehyde of AD patients was statistically negatively correlated with MMSE score (β=-0.35,P=0.03) and MTA score (β=-0.38,P=0.02).The impact of onset age,neuropsychiatric disorders and ApoE ε4 gene on urine formaldehyde of AD patients was not statistically significant(all P>0.05).Conclusion Urine formaldehyde level is worthwhile to be explored as a marker in AD diagnosis and severity assessment.

Objective To investigate the coagulation disorder status of patients with pancreatic cancer and to explore its role in tumor formation,progression and metastasis.Method The present study involved 114 patients with pancreatic cancer diagnosed by surgery or biopsy,and 40 healthy volunteers.For each individual,nine plasma coagulation parameters were tested using the STAGO Compact automated.Results The levels of plasma antithrombin Ⅲ (AT-Ⅲ) and protein C of the pancreatic cancer group were significantly reduced compared with the control group,while the levels of plasma PT,APTT,INR,FIB,F-Ⅷ,D-dimer (D-D) were significantly elevated.The level of plasma D-D increased with increase in clinical stage,while the level of AT-Ⅲ decreased.The level of plasma D-D became higher with worsening in histological grade.Conclusions Patients with pancreatic cancer were in a state of hypercoagulation,with reduced anticoagulation function and secondary hyperfibrinolysis.The level of Plasma D-D was significantly associated with the clinical stage,histological grade and distant metastasis.These together with AT-Ⅲ could be used as indicators to monitor patients with pancreatic cancer.

Spinal cord injury is a difficult medical problem and need to be solved urgently.Application of tissue engineering to repair spinal cord injury has gradually become a hot spot.It is important to prevent the development of scar tissue while inducing cells' regeneration by using scaffold.Nanotechnology has improved the performance of scaffold because of its superiority.Nanoscaffold has obvious advantages compared with the traditional scaffolds.New scaffold materials can be obtained by nanotechnology.Nanoscaffold can also serve as a good drug carrier,and it may have beneficial effects on biological behaviors of seed cells on its surface,such as differentiation,proliferation and migration,which may promote tissue regeneration and functional recovery and get good results in repairment of spinal cord injury.This article summarized the research progress in recent years in nano spinal cord engineering scaffolds in order to provide a reference for research in related fields.

Objective To study the clinicopathological characteristics and the prognostic factors in metastatic pancreatic tumor.Methods The clinical data of 32 patients with metastatic pancreatic tumors were retrospectively analyzed.The survival of the patients were evaluated with the KaplanMeier method.Univariate analysis was done by log-rank test.Results The primary foei of these32 patients included:9 lung cancer,6 renal cell carcinoma,5 gastric cancer,12 others.The median survival was 15.5 months in the radical surgery group (n 8),18 months in the cryosurgery group(n=3),8 months in the group with palliative bypass operation (n=9),6 months in the group with local radiotherapy (n=3),and 5 months in the group without treatment (n=9).Univariable analysis revealed the type of primary tumor,treatment of the primary tumor,interval between diagnosis of primary tumor and pancreatic metastases,localized pancreatic metastasis,and treatment of the metastatic pancreatic tumor were associated with prognosis.Conclusions Metastatic pancreatic tumors are rare.Long term survival can be achieved with pancreatic resection in a highly selected subset of patients according to the type of primary tumor.Therapeutic cryosurgery as a new minimally invasive,targeted and immunologic method needs to be further evaluated.

Objective To study the clinicopathological characteristics,diagnosis and treatment of patients with mucinous cystic neoplasms (MCNs) of the pancreas.Methods The clinical data of 42 patients with mucinous cystic neoplasms of pancreas were retrospectively analyzed.Chi-square test and independent sample t-test were used for statistical analysis.Results The mean age of the patients was 53.1 yeas (ranged from 29 to 78 y).There were 32 female (76.2％).The patients were divided into two groups according to symptoms (the symptomatic group and the asymptomatic group).There were significant differences in tumor size,tumor location,operation type,operation time and adhesions with the surrounding tissues between the 2 groups of patients.The patients were then divided into three groups according to pathological type.There were significant differences in age,tumor marker,tumor location,operation type,operation time,adhesions with the surrounding tissues,operative blood loss,and postoperative hospital stay among the 3 groups of patients.There was no tumour recurrence in the patients with cystadenoma.Patients with cystadenocarcinoma developed tumor recurrence at a mean of 16.4 months (range,0-50) and died of tumor recurrence even after radical surgery at a mean of 22.9 months (range,3-58).Conclusion MCNs were seen most commonly in middleaged women.The presence of symptoms was a sign of malignancy.Resection of the tumor in the early stage is the key in dealing with MCNs.

Objective To analyse the diagnosis and treatment options of serous cystadenoma of the pancreas.Method The clinical data of 57 patients operated in the Tianjin Medical University Cancer Institute & Hospital from August 1996 to December 2011 with pathologically confirmed serous cystadenoma of pancreas after the operation were retrospectively studied.Results There were 13 males (22.8％) and 44 females (77.2％).The median age was 56.8 years.The patients were asymptomatic in 31.6％.CT was accurate in the diagnosis in 70.6％.All patients received surgical resection,inluding pancreaticoduodenectomy (n =17,29.8％),distal pancreatectomy (n =38,66.7％),palliative resection (n=1),and tumor enucleation (n=1).Postoperative complications developed in 6 patients.Histopathologically,there were 50 cases of serous microcystic adenoma (87.7％) and 7 cases of serous oligocystic adenoma (12.3 ％).One of these patients had developed into serous cystadenocarcinoma.At a follow-up of 12 months to 15 years,one patient with serous cystadenocarcinoma died 13 months after the operation.The remaining patients were all alive.Statistical analysis was performed based on the postoperative histopathological type and tumor size.The mean postoperative hospital stay of the group of patients with serous microcystic adenoma were significantly longer than the patients with serous oligocystic adenoma [(17.39±7.61) d vs (19.43±0.98) d,P=0.002].The incidence of patients with clinical symptoms was higher in the group of patients with tumor size ≥4 cm when compared with the patients with tumour size ＜4 cm.There was no significant difference on the other parameters.Conclusions Pancreatic serous cystadenoma is a rare pancreatic tumor,and it often happens in elderly women.Indications for surgical resection included symptomatic tumours,tumor diameter more than 4 cm,malignant biological behavior,malignancy could not be ruled out,and potentially malignant tumors.For asymptomatic patients and tumor size less than 4 cm,surgical resection should also be considered if the tumour progresses on follow-up.

Objective To study sevoflurane and propofol for abdominal surgery in elderly patients with general anesthe-sia on postoperative cognitive function. Methods A total of 146 elderly patients with abdominal surgery were randomly divided into group A and group B, each of 73 cases, respectively, used sevoflurane and propofol anesthesia maintained. Results Set of recovery time, extubation time in group A were significantly less than group B (P<0.05). Group A and group B after 2 h, 6 h, 12 h MMSE were significantly lower than the preoperative (P<0.05), after 24 h, 48 h normal cognitive status, after 2 h, 6 h, 12 h MMSE in group B were significantly higher than those in group A(P<0.05). A group and B group before and after surgery 2 h, 24 h after serum S100βprotein, IL-2 levels after 2h before surgery were sig-nificantly higher than preoperative (P<0.05), 24 h after the fall, group B after 2 h serum S100β protein, IL-2 levels were significantly lower than group A (P<0.05). Conclusion Sevoflurane and propofol for abdominal surgery under general anesthesia in elderly patients with varying degrees of reversibility may cause postoperative cognitive dysfunc-tion, can be quickly restored, the degree of dysfunction induced by sevoflurane cognitive heavier, postoperative cogni-tive dysfunction and serum S100βprotein, IL-2 increases related.