ObjectiveTo explore the clinical significance of lymph node metastasis in gastrointestinal stromal tumor (GIST).Methods A literature search to identify studies relating to GIST cases reported between January 1998 and December 2010 was conducted.The associations between lymph node metastasis and GIST clinicopathological features, gene expression, GIST stage, and GIST prognosis were evaluated.Results 6063 literatures were screened and only 16 GIST patients (median age of 49.25 years,10females) with lymph node metastasis were enrolled in this study.Among them,12 tumors were located in the stomach, 3 in the small intestine, and 1 in the esophagus.Morphologically, 13 specimens were mainly characterized by spindle cells.Gene analysis was examined in 7 cases.Conclusions Lymph node metastasis in GIST might more frequently found in the stomach, tumor stage of high grade, and cellular morphology of spindle-shaped.Gene mutation may have a relationship with lymph node metastasis.However, its clinical significance remains unclear.

ObjectivesTo compare clinical outcomes and safety of 5-Fu or capecitabine combined with oxaliplatin therapy for metastatic colorectal cancer. MethodsLiterature search were performed by key words,such as metastatic colorectal cancer,capecitabine,oxaliplatin,5-Fu on all randomized controlled trails reported on 5-Fu or capecitabine combined with oxaliplatin therapy for metastatic colorectal cancer before Jun.2011.Two authors drew the details of trail design,characteristics of patients,outcomes and so on from the studies included. Data analysis was performed by RevMan 4.2. ResultsAccording to the same screening criteria,6 clinical studies were included in this Meta-analysis. Sample volume in this Meta-analysis was 2189 colorectal cancer cases.The baseline characteristics of 5-Fu group were similar to those of capecitabine group.The short-term outcome such as response rate,RR was 0.92 [95 ％CI(0.82,1.02),P=0.12], and the long-term outcome such as median overall survival, median progression-free survival and the WMD was -0.19 [95 ％CI(-0.73,0.35),P=0.49],-1.91 [95 ％CI(-2.53,0.16),P=0.08],respectively,two groups weresimilar. In the comparison of Ⅲ-Ⅳ grade toxicity between the two groups, the incidences of neutropenic in 5-Fu group were higher than those in capecitabine group,and the RR was 0.24 [95 ％CI(0.11,0.55), P=0.0007]. However, the incidence of wand-foot symptoms in 5-Fu group was lower than those in capecitabine group, the RR was 2.83 [95％CI (1.66,4.82), P=0.0001]. ConclusionBoth 5-Fu and capecitabine were similarly effective in the therapy of metastatic colorectal cancer. And the Ⅲ-Ⅳ grade toxicity such as neutropenic was easier to happen in 5-Fu group,while the incidence of hand-foot symptoms was on the other hand.

Objective To evaluate the levels of LDH in cerebrospinal fluid in patients with different types of central nervous sys‐tem diseases .Methods Cerebrospinal fluid LDH were detected by rate assay in control group and disease group(including patients with acute leukemia ,lymphoma ,brain neoplasms and meningitis) .Results In ptients with acute leukemia ,the cerebrospinal fluid LDH level of central nervous system leukemia(CNSL) group was (28 .68 ± 9 .29)U/L ,which was higher than that of non CNSL group ,and the difference were significance(P<0 .05) .In lymphoma patients ,cerebrospinal fluid LDH level of brain metastasis pa‐tients was (125 .20 ± 115 .24)U/L ,which was higher than that of lymphoma patients without brain metastasis ,the difference was significant(P<0 .05) .In patients with brain neoplasms ,cerebrospinal fluid LDH level of meningeal carcinomatosis group was (77 . 37 ± 128 .15)U/L ,which was higher than that of primary brain neoplasms group ,the difference was significant(P<0 .05) .In pa‐tients with meningitis ,cerebrospinal fluid LDH level of tuberculous meningitis group and purulent meningitis group patients were (54 .48 ± 84 .60U/L) and (43 .54 ± 32 .05)U/L respectively ,which were higher than those of viral meningitis group patients ,and the differences were significant (P<0 .05) .Conclusion LDH in cerebrospinal fluid can be used in early diagnosis of CNSL ,brain metastsisly of mphoma ,meningeal carcinomatosis and differential diagnosis of meningitis .

Objective To explore the CT, MRI?PET features of Heroin Spongiform Leukoencephalopathy (HSLE).Methods CT and MRI of 29 patients, and PET of 4 patients were analysed.Results 1.CT and MRI showed extensive and symmetric lesions in white matters of bilateral cerebellum,posterior crus of internal capsule and parieto occipital region;2.Cerebral CT showed hypodense areas, MRI showed corresponding areas with decreased signal intensity on T1 weighted images and increased signal intensity on T2 weighted images, no edema, FLAIR and enhancing scan showed no destruction of brain blood barrier, PET imaging showed hypometabolism or non metabolism changes in corresponding areas; 3. PET imaging showed non metabolism areas in untreated patients' posterior limb of internal capsule, parietooccipital lobes and cerebellum, and the metabolism in corresponding areas of improved patients was low obviously; 4.PET imaging showed hypometabolism in grey matter of untreated and improved patients, and the metabolism in the grey matter remarkable improved patient was normal.Conclusion CT and MRI changes of HSLE sufferers almost limited in brain white matters, PET imaging showed hypometabolism or non metabolism changes in corresponding areas, the metabolism improvement in grey and white matters was very important to the improvement of HSLE sufferers, PET was more appropriate than MRI to the prognoses of HSLE sufferers.

OBJECTIVE:To study the pharmacokinetics and pharmacodynamics of single dose of intramuscularly injected methotrexate(MTX)in the treatment of ectopic pregnancy so as to provide theoretical bases for the choice dosage regimen.METHODS:Serum concentration of MTX in 8 cases with ectopic pregnancy were determined by fluorescence polarization immunoassay after injected i.m with single dose MTX(50mg/m2);The ?-HCG was monitored both before and after treatment and the lump sizes of the ectopic pregnancy were determined by B ultrasound.RESULTS:The pharmacokinetics of single dose of intramuscularly injected MTX conformed to two-compartment open model;Cmax occurred at 1.9h after drug taking with 2.31 ?mol/L;The time for the recovery of ?-HCG to normal was(24.8?10)days,the patency rate of oviducts of those who demanding procreation was 75%.CONCLUSION:Injection intramuscularly with single dose of MTX 50mg/m2 is effective in the treatment of ectopic pregnancy.

Objective To evaluate the influence of the placement of instant hand disinfectant in compliance and qualified rate of hand hygiene of clinicians.Methods Hand hygiene compliance of clinicians in departments of gyne-cology,obstetrics,and general surgery were observed after the placement of instant hand disinfectant at the door-way of wards,hand specimens were taken to check hand hygiene effectiveness.Results Before and after placement of instant hand disinfectant at the doorway of wards of above departments,hand hygiene behaviors of 300 person-times were observed.Hand hygiene compliance rate among clinicians in department of gynecology,obstetrics,and general surgery increased from 32.33% to 74.33%,33.67% to 85.67%,and 26.33% to 64.00%,respectively(all P <0.001).Each department selected 98 hand hygiene specimens,the qualified rate was 98.98%,100.00% and 94.90% respectively.Conclusion The placement of instant hand disinfectant at the doorway of each ward can effec-tively improve clinicians’hand hygiene compliance and hand hygiene effectiveness.

Objective:To evaluate p53,c erbB 2,p21 and nm23 oncoprotein expression in diagnosis and treatment of gastric cancer.Methods:The expression of p53,c erbB 2,p21 and nm23 oncoproteins was detected with immunohistochemical method in 63 surgically resected specimens and its endoscopic biopsy specimens of gastric cancer.Results:The positive rates of p53,c erbB 2,p21 and nm23 oncoprotein expression were 37 6%～46 2%,34 6%～56 8%,37 8%～61 5%,70 3%～30 8% respectively.Oncoprotein expression was not observed in non tumor endoscopic biopsy specimens.The expression of c erbB 2,p21 was correlated with grade of tumor differentiation and the expression of p21,nm23 oncoproteins was correlated with the depth of tumor invasion and clinical different stage,namely tumor metastasis.Positive rates of p53,c erbB 2,p21 and nm23 oncoproteins between biopsy and resected specimens was of coincidence.Conclusion:Determination of p53,c erbB 2,p21 and nm23 oncoprotein expression was might be useful in diagnosis and treatment of gastric cancer,differentiating benign and malignant tumor and clinical stages,of gastric cancer. [

Objective To evaluate the effects on trabeculectomy combined with implantation of anterior lens capsule.Design Radomized,controlled experimental study.Participants 36 experimental albino rabbits.Methods 36 albino rabbits were divided into 3 groups randomly.The rabbit and human anterior lens capsules were implanted under the scleral flap in trabeculectomy in group A and group B respectively,while only trabeculectomy in control group.The average follow-up period was 12 months.Main Outcome Mea- sures Intraocular pressures(IOP),filtering bleb,complications.Results The postoperative IOP of the experimental groups decreased sig- nificantly as compared with preoperative IOP at 12 week postoperatively.Retention of reflective filtering bleb in experimental groups was longer than that in contral group(5.12?0.43week,5.05?0.59week,2.74?0.32week,P＜0.05).The passage of humor outflow kept open in ex- perimental groups and became closed in control group at 12 week postoperatively.Anterior lens capsule wasn't attacked by T or B lym- phocyte seen with electron microscope.Conclusions Implantation of anterior lens capsule may help to postpone filtering bleb scarring in the trabeculectomy.This study provides experimental basis for the clinical practice.

Objective to investigate the effect of berberine on the expression of AQP4 and neuronal injury after focal cerebral ischemia in diabetic rats. Methods Male SD rats were randomly divided into four groups:control(sham surgery),middle cerebral artery occlusion and reperfusion (MCAO/R),MCAO/R treated with vehicle(DMSO),MCAO/R treated with berberine. the transient focal ischemia/reperfusion was induced by in-troducing silicone-coated monofilament nylon suture from the right external carotid artery into the origin of the middle cerebral artery,which was re-moved after 60 min. In group treated with berberine,the rats were injected with berberine before and after suffered from cerebral ischemia. Similarly, in group vehicle,the animals received DMSO vehicle at the same time. the score of neurological behavior was evaluated 24 h after reperfusion. Mean-while,the rats were sacrificed for Nissl staining. to estimate cerebral edema,the wet-dry ratio was measured. the expression of AQP4 in the border of the infarct region in different groups was observed by Western blot. Results Compared with the model group,berberine improved neurological deficits(P < 0.05). Berberine treatment inhibited the neuronal deformation shown by Nissl staining(P < 0.05). Berberine significantly decreased the wet-dry ratio and reduced the expression of AQP4(P < 0.05). Conclusion these results suggested that berberine could induce neuroprotection against ischemic injury by inhibiting the expression of AQP4 in diabetic rats.

AIM:To explore the relationship and molecular mechanism between microRNA-21(miR-21) and Schwann cells ( SC) following peripheral nerve injury.METHODS: The mRNA expression of miR-21 and phosphatase and tensin homologue deleted on chromosome ten ( PTEN) in animal model were detected by real-time PCR.The over-ex-pression of miR-21 and inhibition of miR-21 expression in the Schwann cells according to transfection of lentiviral vectors were performed, the nonspecific miRNA was used as a negative control ( NC) .The cell apoptosis was measured by flow cy-tometry.The mRNA expression of miR-21 and PTEN in the cells was detected by real-time PCR.The protein expression of PTEN and cleaved caspase-3 was determined by Western blot.RESULTS: The level of miR-21 was significantly higher and the mRNA level of PTEN was significantly lower in the model of nerve injury than those in control group.miR-21 over-expression decreased the number of apoptotic Schwann cells compared with NC-SC.The mRNA expression of PTEN was down-regulated by over-expression of miR-21.The protein expression of PTEN and cleaved caspase-3 was down-regulated by over-expression of miR-21 (P<0.05).CONCLUSION: miR-21 may play an important role in the peripheral nerve injury through inhibiting apoptosis of Schwann cells by down-regulating the expression of PTEN.