Sunitinib malate (SU11248 ,Sutent) is an orally available small-molecule multitargeted tyrosine kinase inhibitor that has potent anti-angiogenic and antitumour activities.In 2006 sunitinib was approved by FDA for imatinib intolerant gastrointestinal stromal tumors (GIST) patients or imatinib resistant GIST patients.This article review the molecular-based mechanism,the mechanism of resistance,the biomarker,the clinical trials and the adverse effects of sunitinib in the treatment of imatinib-resistant GIST.

With advancements in the field of cancer stem cells,the hypothesis that colon cancer originates from stem cells has not only been introduced but also receives substantial supports by separating a subpopulation of colon cancer cells through primitive cells markers.Unlike most non-tumourigenasis colon cancer cells,these tumor-initiating cells have many specific characters both in vitro and in vivo.An improved understanding of drug resistance based on cancer stem cells and molecular pathways that regulate proliferation and differentiation of gastrointestinal cancer stem cells could doubtless translate into new therapeutic strategies.

BACKGROUND:Currently thoracolumbar fixation techniques have its advantages and disadvantages, it is necessary to explore a new internal fixation to fix the spine effectively and conveniently.
OBJECTIVE:To establish thoracolumbar (T12-L2) three-dimensional finite element model and observe the effect of anteroposterior integration fixation by posterolateral nail-stick system on thoracolumbar stability.
METHODBased on the CT scan data of normal human T12-L2 segments, we used Geomagic 11.0, Ug 7.0, Hypermesh 10.0, Abaqus 6.9.1 software to establish a three-dimensional finite element model of T12-L2 segments. Subsequently we established nail-stick system posterior fixation, anterior fixation, posterolateral anteroposterior integration fixation model. T12 segment was given 500 N preload and 7.5 N·m torque, to simulate thoracolumbar flexion, extension, lateral bending and rotation. The average rigidity of fixed segments under different conditions were observed.
RESULTS AND CONCLUSION:Three fixation models showed a higher average rigidity than normal model under different conditions. The average rigidity in anteroposterior integration fixation by posterolateral nail-stick system was increased by 13%, 28%, 11%, 17%and 9%, compared with simple posterior fixation under the conditions such as anterior flexion, lateral bending and lateral rotation, respectively. Under the posterior extension, the average rigidity was reduced by 6%than the posterior fixation. Compared with the anterior fixation, the average rigidity in anteroposterior integration fixation by posterolateral nail-stick system was reduced by 15%, 10%, and 14%under the conditions of anterior flexion and lateral bending. While the average rigidity was higher than anterior flexion under the posterior extension and lateral rotation, increasing 5%, 12%and 2%. The anteroposterior integration fixation by posterolateral nail-stick system can improve the stability of fixed segments, and the stability is higher than anterior fixation at posterior extension and lateral rotation, while higher than posterior fixation in anterior flexion, lateral bending and lateral rotation. So it is a potential fixation method.

Objective To investigate the causes and prevention of bile duct injury during laparoscopic cholecystectomy (LC). Methods Clinical data of 16 cases of bile duct injury during LC between January 2004 and November 2013 (9 cases from Songqiao Central Hospital and 7 cases from Northern Jiangsu People ’ s Hospital ) were analyzed retrospectively .The bile duct injury was found intraoperatively in 10 cases, 4 of which were given common bile duct repaired with T tube drainage , 1 of which was given common bile duct anastomosisd with T tube drainage , 1 of which was given Roux-en-Y anastomosis , and 4 of which were given suturing of leakage at the gallbladder bed .The bile duct injury was found postoperatively in 6 cases, 3 of which were given peritoneal drainage , 2 of which were given reoperation of bile duct repaire with T tube drainage , and 1 of which underwent percutaneous gallbladder drainage guided by B ultrasonography . Results The hospitalization stay was 12-23 days, with an average of 16.3 days.All the patients were cured after treatment .Among the 16 cases of bile duct injury , the T tube was removed 3 months later in 6 cases of common bile duct repaired with T tube drainage , and the T tube removed 6 months later in 1 case of common bile duct anastomosis with T tube drainage.No complications or dysfunctions occurred in postoperative follow-up ranging from 3 months to 8 years. Conclusions We should pay more attention to causes of bile duct injury in laparoscopic cholecystectomy , especially indications for emergency cases .The relationship among the common hepatic duct , common bile duct , and cystic duct should be carefully identified .A timely conversion to open surgery is needed if necessary .

Objective To investigate the expression and correlation of microRNA‐335(miR‐335) and ROCK1 in osteosarco‐ma tissue and osteosarcoma cell lines MG‐63 and U2‐OS .Methods Eighteen paired tissue specimens of osteosarcoma and matched normal tissue were chosen clinically .Two osteosarcoma cell lines MG‐63 and U2‐OS were chosen as experimental group while the human osteoblast cell line hFOB 1 .19 as control group ,Quantitative real‐time PCR were used to evaluate the different expression of miR‐335 and ROCK1 mRNA in osteosarcoma tissue and cell lines;miR‐335 mimic was transfected into MG‐63 and U2‐OS ,while Quantitative real‐time PCR and Western blot were used to evaluate the effect of over‐expressed miR‐335 on ROCK1 mRNA and protein level .Results The result of real‐time PCR indicated a special lower expression of miR‐335 but higher ROCK1 ,and the cor‐relation between miR‐335 and ROCK1 was negative .Western blot showed that miR‐335 could decrease ROCK1 protein expression . miR‐335 mRNA showed a hyper‐expression while lower ROCK1 mRNA and protein after transfection of miR‐335 mimic .Conclusion The expression of miR‐335 and ROCK1 shows a negative correlation in both tissue and cell level;over‐expression of miR‐335 can decrease ROCK1 expression .

Background and purpose:MicroRNAs are endogenous small RNAs and involved in target gene regulation in post-transcription level. As a tumor suppressor, microRNA-335 (miR-335) was participated in the occurrence and progression in many types of human tumors. This study aimed at investigating whether miR-335 can regulate cell migration and invasion by negative targeting Rho associated coiled-coil forming protein kinase (ROCK1) in human osteosarcoma cell line MG-63.Methods:The speciifc binding ability of miR-335 to ROCK1 3’-untranslated region (UTR) was theoretically predicted and detected by the luciferase reporter gene assay. Western blot and real-time PCR were used to evaluate the effect of miR-335 on the expression of ROCK1 at protein and mRNA levels. Cell migration and invasion assays were performed by transwell chambers in MG-63 cells intervened by over-expression of miR-335 and knockdown of ROCK1.Results:Luciferase reporter gene assay showed that miR-335 could target ROCK1 3’-UTR. Lower miR-335 but higher ROCK1 was expressed in MG-63 cells. The results of Western blot showed that ROCK1 protein expression was decreased by transfection of miR-335 mimic or siROCK1. Transwell chambers results showed decreased cells invading through the substrate membrane after over-expression of miR-335 or knockdown ofROCK1 gene.Conclusion:miR-335 inhibits the migration and invasion ability of MG-63 human osteosarcoma cell line, which may through targeting ROCK1 3’-UTR and subsequent down-regulating ROCK1 expression.

Objective To explore the role of endotoxin during hepatic ischemia reperfusion (HIR) in rats. Methods Wister rats were randomly divided into endotoxin, HIR and HIR plus endotoxin (HIRE) groups. In the HIR group, hepatic reperfusion was performed after 60 minutes of ischemia by interruption of the arterial and portal venous blood supply to the left lobes and middle lobes of the rat liver. In the HIRE group, LPS(1.0mg/kg) was injected via the dorsum vein of rat penis after ischemia and reperfusion. In the endotoxin group, LPS (1.0mg/kg) was injected via the dorsum vein of penis in the rats without ischemia and reperfusion. The NF-?B activities in the liver tissue of the rats were determined with EMSA. TNF-? expression levels in the liver tissue of the were measured with immunohistochemical staining. Serum ALT levels of the rats were also measured. Results NF-?B activity increased after reperfusion and remained high 12h after reperfusion in HIRE group compared with endotoxin group and HIR group. Both TNF-? expression levels and serum ALT levels increased markedly after reperfusion in HIRE group. Conclusion Endotoxin during HIR could induce hepatic injury. Endotoxin induced liver injury possibly by activating NF-?B followed by the subsequent expression of proinflammatory mediators in the liver tissue.

0.05;q=8.055,P0.05;q=9.163,P

[Objective]To observe the effect of opposing needling accompanying continual static stretch(CSS) on high-spasticity poststroke.[Methods]80 patients with high spasticity poststroke were randomly divided into four groups.A group:treated with opposing needling accompanying CSS;B group:treated with opposing needling;C group:treated with CSS;D group:acupoints selected from anti-spasm muscle.The therapeutic effect of the four methods was evaluated on proving spasm degree and motor function.[Results]Four methods had effect on high muscle tension in patients poststroke.The marks of Ashworth scale and Fugl-Meyer scale of the four groups had remarkable difference(P

Objective To sum up the experience of donor hepatectomy in living-related liver transplantation.Methods From 1997 to 2001, donor hepatectomy was performed on 3 cases of left lateral segmentectomy at Xijing Hospital, Xi'an. Two living-related liver transplantations and one living-related auxiliary partial orthotopic liver transplantation were carried out. The surgical technique of donor operations consisted of mobilization of the liver lobe, hilar dissection, transection of the liver using ultrasonic dissector without inflow or outflow vascular occlusion. Results The donor operation took 5.0?h to 6.5?h. The blood loss was 200?ml to 400?ml. No complication occurred in all donors. The function of the donor liver in all donors were normal. Conclusions Donor hepatectomy of left lateral segment can be a safe operation provided. Good surgical technique and appropriate preservation are key points to success of the liver transplantation.