Gastrointestinal stromal tumor(GIST) is the most common mesenchymal malignancy of the GI tract. The mainstay of treatment is surgery. For patients in whom complete resection is not possible, or in patients with metastatic or recurrent disease, they are unresponsive to standard chemotherapy and to radiotherapy. There has been no effective systemic treatment for unresectable GIST or metastatic disease. Gain-of-function mutations of the KIT proto-oncogene occur in up to 90% of GIST, allowing constitutive activation of tyrosine kinase (i.e. auto-phosphorylation of tyrosine residues independent of ligand-receptor binding), leading to aberrant cell division and tumour growth. Imatinib selectively inhibits the tyrosine kinase activity associated with KIT, which forms the rationale for evaluating its effects in GIST. Herein, we review recent developments in treatment for GIST and implication for optimal treatment in these patients.

Tumor recurrence and metastasis are the major cause for cancer patient death. Aberrant glycosylation is one of the important mechanisms of malignant tumor metastasis. The glycoprotein CD24, which could be a ligand for P-selectin on the surface of activated endothelial cells and platelets, appears to be a new diagnostic marker of tumors and possibly participates in tumor metastasis with unknown pathway. ?1,3 Fucosyltransferase Ⅶ (FucT-Ⅶ) is one of the fucosyltransferases which catalyze the transfer of a fucosyl residue from GDP-?-L-fucose to a sugar acceptor, usually galactose in the sugar chains of glycoproteins or glycolipids. The elevated expression of sialyl Lewis (SLeX), the only carbohydrate product of ?1,3 FucT-Ⅶ , predicts an ominous prognosis and high risk of recurrence and regulates the function of CD24. It is possible that ?1,3 FucT-Ⅶ may enhance the glycosylation of CD24 and thus promote the tumor metastasis.

ObjectiveTo discuss the clinical diagnosis, treatment and genetic diagnosis of congenital chloride diarrhea (CCD), a rare autosomal recessive disease.Methods One month old boy with persistent diarrhea, hypochloremia, hyponatremia, hypokalemia and metabolic alkalosis, his stool electrolyte testing, clinical treatment and follow-up, as well as his and his parents’ SLC26A3 gene mutation analysis were retrospectively analyzed.Results The fecal electrolyte testing showed that the levels of Cl- and K+ were increased and the level of Cl- was much higher than the sum of Na+ and K+. After replacement therapy with NaCl and KCl, the blood electrolyte recovered to normal. Follow-up 4 years, the boy had a normal growth and development. Mutation analysis onSLC26A3 gene showed there was a homozygous mutation of 239G>A and both his father and mother carried the same heterozygous mutation. This mutation was ifrst discovered in China.Conclusions The sequencing analysis ofSLC26A3 mutation may help to diagnosis CCD.

Objective:To observe the therapeutic effect of aspirin combined clopidogrel on unstable angina pectoris (UAP) .Methods :A total of 396 UAP patients hospitalized in our hospital from Jun 2010 to Aug 2013 were en-rolled ,randomly and equally divided into combined medication group (received combined therapy of aspirin and clo-pidogrel based on routine treatment ) and aspirin group (only received aspirin based on routine treatment ) according to number table method .Attack frequency and duration of angina pectoris ,and clinical therapeutic effect were ob-served and compared between two groups before and after treatment .Results:Compared with before treatment , there were significant reductions in attack frequency [combined medication group :(4.1 ± 1.2) times/d vs .(1.8 ± 0.6) times/d ,aspirin group :(4.0 ± 1.4) times/d vs .(2.5 ± 3.1) times/d ,P<0.05 or <0.01] and duration of an-gina pectoris [combined medication group : (23.2 ± 4.7) min vs .(3.3 ± 2.6) min ,aspirin group : (24.9 ± 2.4) min vs .(7.3 ± 1.6) min , P<0.01 both] in both groups after treatment ;compared with aspirin group after treat-ment ,there were more significant reductions in attack frequency and duration of angina pectoris in combined medi-cation group ( t = 5.36 ,6.03 respectively , P< 0.05 both );total effective rate of combined medication group (98.48% ) was significantly higher than that of aspirin group (85.35% ) ,χ2 =22.98 , P=0.002 .Conclusion:Com-bined therapy of aspirin and clopidogrel possesses more significant therapeutic effect on patients with unstable angina pectoris , and it is safe ,which worth extending and application in clinic .

Objective To construct and identify recombinant vaccine Bifwlobacterium bifidum(Bb)pGEX-Sj14-3-3 of Schistosoma japonicum(Sj). Methods Total RNA was extracted from adult Sj, antigen encoding gene Sj14-3-3 was amplified by RT-PCR and cloned into Escherichia coli (E. coli)-Bb shuttle expression vector pGEX-1λT to construct recombinant plasmid pGEX-Sj14-3-3. The recombinant plasmid was transformed into E. coli BL21 (DE3).The plasmid was extracted and identified by using BamH I and EcoR I. Then pGEX-Sjl4-3-3 was electroporated into Bb to construct recombinant Bb (pGEX-Sj14-3-3) vaccine. The extracted plasmid of the recombinant Bb (pGEX-Sj14-3-3) vaccine was identified by PCR, and the size of the products was compared with Sj14-3-3 gene of adult worms.Results Sj14-3-3 of 399 bp in length was amplified by RT-PCR. The products were digested by BamH I and EcoR I , and the fragments length of plasmid pGEX-Sj14-3-3 vector was 4947 bp, and of Sj 14-3-3 gene was 399 bp.The product of 399 bp Sj14-3-3 gene was also amplified by PCR from template of the extracted plasmid of the recombinant Bb(pGEX-Sj14-3-3 ) vaccine. The size of the product obtained was just the same as expected.Conclusion The recombinant Bb(pGEX-Sj14-3-3) vaccine of Sj is successfully constructed.

Objective To investigate the effects of recombinant vaccine Bifidobacterium bifidum (Bb) pGEX-Sj14-3-3 on splenocyte apoptosis in BALB/c mice.Methods Ninety-six BALB/c mice were randomly divided into two groups according to their body mass:per os group (PO) and intranasal immunization group (IN),with 48 mice in each group.All mice were orally and intranasally immunized with recombinant vaccine Bb(pGEX-Sj14-3-3).Four mice in each group were sacrificed on weeks 0,2,4,6,8,10,12,14,16,18,20 and 22,respectively,after immunization,and splenocytes were separated and cultured with or without ConA stimulation.The apoptotic rates of splenocytes were detected by flow cytometry.Results It showed that apoptotic level of splenocytes in both groups remarkably increased after 2-4 weeks without ConA stimulation (PO:0.069 ± 0.005,0.076 ± 0.010; IN:0.037 ± 0.002,0.075 ± 0.002),and the value reached the peak on the 4th week,and the differences were statistically significant compared with that of week 0(all P ＜ 0.05).Apoptotic level of splenocytes in both groups with ConA stimulation increased after 2-6 weeks(PO:0.089± 0.006,0.098 ± 0.010,0.060±0.007; IN:0.054 ± 0.001,0.093 ± 0.003,0.058 ± 0.012),and the value also reached the peak after 4 week,respectively.The differences were statistically significant compared with that of week 0 (all P ＜ 0.05).Apoptotic level of splenocytes in each group with ConA stimulation was significantly higher than that without ConA stimulation.Conclusion It is suspected that the recombinant vaccine Bb(pGEX-Sj14-3-3) may inhibit apoptosis of splenocytes in mice immunized orally or intranasally.

ObjectiveTo study the dynamic changes of IgG,IgG subclasses,IgE and IgA in sera of BALB/c mice immunized with recombinant Bifidobacterium bifidum (Bb) pGEX-Sj14-3-3 vaccine of Schistosoma japonicum.MethodsNinty six BALB/c mice were randomly divided into two groups:oral immunization group and intranasal immunization group,48 mice in each group.Mice were orally and intranasally immunized with recombinant Bb(pGEX-Sj14-3-3) vaccine,respectively.Four mice from each group were sacrificed,respectively,on weeks 0,2,4,6,8,10,12,14,16,18,20 and 22 after immunization and their sera from the eyeballs were collected.The levels of IgG,IgG subclasses,IgE and IgA were assayed with routine Enzyme-linked immunosorbent assay(ELISA).ResultsThe titers of IgG,IgG1,IgG2a,IgG2b,IgG3,IgE and IgA in both groups increased during the 2 - 22th,2 - 14th,2 - 22th,2 - 22th,2 - 20th,2 - 22th,2 - 22th weeks,respectively.The values reached the highest level on weeks 8,6,6,4,8,10 and 6,respectively,in the oral group,and the values were (0.065 ±0.001,0.021 ± 0.002,0.011 ± 0.001,0.015 ± 0.003,0.014 ± 0.002,0.011 ± 0.001,0.013 ± 0.002),respectively,as compared with the values on week 0(0.032 ± 0.001,0.015 ± 0.002,0.005 ± 0.002,0.005 ± 0.001,0.006 ± 0.001,0.006 ± 0.001,0.005 ± 0.001 ),the differences were statistically significant(P ＜ 0.05 or ＜ 0.01 ) except that of IgG1 and IgG2b.In the intranasal group these values reached the highest levels on weeks 4,6,4,4,8,10 and 8,respectively,and the values were (0.064± 0.003,0.022 ± 0.002,0.012 ± 0.003,0.019 ± 0.001,0.013 ± 0.001,0.015 ± 0.001,0.014 ± 0.003),respectively,as compared with the value on week 0,the differences were statistically significant(P ＜ 0.05 or ＜ 0.01 ) except that of IgG1 and IgA.ConclusionsTypes Th1 and Th2 mixed type immune responses can be induced in mice by immunization with the recombinant Bb(pGEX-Sj14-3-3) vaccine by early period of immunization (2th - 10th week).

Adult ; Epiglottis ; Humans ; Laryngeal Neoplasms ; pathology ; surgery ; Male ; Neoplasm Recurrence, Local ; Sarcoma, Synovial ; pathology ; surgery

Objective To investigate the characteristics of early changes in serum IL-17 and IFN-γ levels in elderly patients with acute myocardial infarction (AMI).Methods 70 hospitalized elderly patients with AMI and 35 healthy people were selected.Serum level of interleukin-17 (IL 17) and interferon-γ (IFN-γ) were assayed by enzyme linked immunosorbent assay (ELISA).Results Serum levels of IL17 and IFN-γ showed increasing trends in elderly patients with AMI as compared with that in control group,but there were no significant differences between the two group [(35.73 30.28) pg/ml vs.(28.70±17.12) pg/ml,(15.29±14.64) pg/ml vs.(11.38±10.10) pg/ml,t=0.144 and 0.138,P=0.365 and 0.377].There were correlations between serum IL-17 and IFN γ levels in patients with AMI and controls(r=0.936 and 0.989,both P=0.00).Serum levels of IL-17 or IFN-γhad no significant differences between AMI patients with well and poor prognosis [(35.43± 34.36) ng/L vs.(36.11±30.16) ng/L,(13.90±13.98) ng/L vs.(15.99±14.14) ng/L,U=0.266 and 0.166,P=0.687 and 0.668].Conclusions Serum IL-17 level has an increasing trend in AMI patients within 24h,but has no statistical significant.Serum IL 17 level has a significantly positively correlation with serum IFN γ level in the elderly,but serum levels of IL-17 or IFN γ have no significant correlations with short term prognosis in elderly patients with AMI.

Objective:To explore influence of rehabilitation exercise on daily living capacity in aged patients with chronic heart failure (CHF) .Methods :A total of 60 aged CHF patients were randomly and equally divided into rou‐tine treatment group (received routine CHF treatment and nursingcare ) and rehabilitation exercise group (received rehabilitation exercise based on routine treatmentgroup ) .Brain natriuretic peptide (BNP) level ,left ventricular e‐jection fraction (LVEF) ,daily living capacity and 6min walking distance (6MWD) were measured and evaluated in both groups at hospitalization and six weeks after treatment .Results:After six‐month treatment ,BNP level signifi‐cantly reduced and LVEF significantly rose in both groups ,and there were significant rise in 6MWD and daily living score in rehabilitation exercise group ,P<0.05 or <0.01 ;compared with routine treatment group ,there was signif‐icant reduction in BNP level [ (525.3 ± 113.2) pg/ml vs .(252.2 ± 114.5) pg/ml] ,and significant rise in LVEF [ (43.46 ± 9.12)% vs .(47.24 ± 8.46)% ] ,6MWD [ (286.6 ± 46.2) mm vs .(582.5 ± 55.3) mm] and daily living score [ (65.12 ± 17.6) scores vs .(82 ± 14.8) scores] in rehabilitation exercise group , P<0.05 or <0.01. Conclu‐sion:Rehabilitation exercise can significantly improve heart function ,raise daily living capacity in aged patients with chronic heart disease .