Purpose To evaluate ultrasonography in diagnosis of high recurrence risk gastrointestinal stromal tumors (GIST) by retrospective studying the ultrasound (US) imaging features of GITS. Materials and Methods US features of 72 GIST cases confirmed histopathologically were retrospectively studied. The tumor size, shape, boundary, echogenicity and blood flow of GITS were observed and compared with the results of histopathology. Results Of all the 72 tumors, 34 were originated in the stomach, 14 in the intestine, 2 in the colon, 8 in the rectum, 9 in the mesentery, 1 in the posterior peritoneum, 1 in the omentum and 3 huge masses of non definite origin. There were 7 cases with very low recurrence risk, 14 cases with low risk, 11 cases with intermediate risk and 40 cases with high risk. High recurrence risk group showed no statistical difference in heterogeneous hypoechoes and blood flow (P>0.05), but showed significantly higher rates in following US features:size larger than 5.0 cm, irregular shape, obscure boundary and cyst-solid echogenecity (P<0.001), which showed the sensitivity of 95.0% (32/40), 72.5% (29/40), 25.0% (10/40), and 55.0% (22/40), respectively; and the specificity of 59.4% (19/32), 81.3% (26/32), 90.6% (29/32), and 87.5% (28/32), respectively. Conclusion US can serve as a mean of screening GIST. The recurrence risk can be evaluated based on the tumor size, shape, boundary and echogenecity to guide clinical decisions and prognosis evaluation.

Objective To investigate the immunoregulatory effects of immunonutrient ?-3 polyunsaturated fatty acid (PUFA) and its applications in organ transplantation. Methods Relevant literatures of recent years were reviewed. Results The immunoregulatory effects of ?-3 PUFA can inhibit proliferation and activation of the immunocompetent cells including T cell and B cell, reduce cytokine production, modulate immunologic response, improve graft function, pro-long survival, reduce episodes of rejection, and lessen adverse reactions of immunosuppressor.Conclusion ?-3 PUFA should have wide applications in organ transplantation due to its immunoregulatory effects. However, this research should be further studied.

Objective To investigate and analyze structure of risk perceived by people using HIV voluntary counseling and testing services and related factors.Method Two hundred and sixty eight VCT users were selected from 2 CDCs and 2 hospitals in Beijing and their perceived risks in the process of VCT were assessed by using self-administered question- naires.Factor analysis was performed to understand the relationship between different perceived risks,and risks perceived by different users were evaluated.Results Six factors were obtained from the factor analysis which included:fear of priva- cy disclosure,embarrassment,concern over the reliability of HIV tests,cost & time consumption,the tragic outcomes of HIV positive tests,and potential medical expenditures in the future.And the risks perceived by low and high income users were much higher than those perceived by middle income users.Conclusion There are clear structure of risks perceived by people using HIV voluntary counseling and testing,and people with different incomes have different levels of perceived risks.

Objective To study the expressions of MMP-2 and TIMP-2 in pancreatic carcinoma and their relationship with tumor invasion, local metastasis and prognosis of the carcinoma. Methods The expressions of MMP-2 and TIMP-2 were examined in 32 patients with pancreatic carcinomas by S-P immunohistochemical technique and the correlation with pathological tumor parameters were analyzed. Survival analysis was made by using the Kaplan-Meier method. Results The positive rates of MMP-2, TIMP-2 in 32 patients with pancreatic carcinoma were 56.25% and 75.00%, which were significantly higher than those of the controls(P＜0.05). Expressions of MMP-2 and TIMP-2 were independent of sex, age, histological grading and type, but well correlated with the lymph node metastasis and TNM clinical staging(Ⅰ and Ⅲ, Ⅱ and Ⅲ). There was a significant association between MMP-2, TIMP-2 and prognosis in pancreatic carcinoma. Conclusion MMP-2 and TIMP-2 might be useful markers for biological aggressiveness of this malignancy and might contribute to the invasive properties of pancreatic carcinoma, which can be used to evaluate the prognosis of patients.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Female ; Humans ; Immunophenotyping ; Leukemia ; diagnosis ; immunology ; therapy ; Male ; Middle Aged ; Neoplastic Stem Cells ; immunology ; Prognosis ; Treatment Outcome ; Young Adult

Objective:To prepare superparamagnetic iron oxide(SPIO) nanoparticles and to observe its acute toxicity on mice,so as to pave a way for further study on its long-term toxicity and on its role as a carrier in magnetic resonance gene imaging.Methods: The SPIO nanoparticle was obtained by means of co-precipitation,and its physical and chemical parameters were determined by transmission electron microscope,atomic force microscope,and 1.5 T super conduct MR,etc.According to the administration pathway and doses of SPIO,90 mice were divided into oral administration(with a total dose of 2 104.8 mg/kg and a volume of 40 ml/kg,n=30),intravenous injection(a total dose of 438.5 mg/kg and a volume of 25 ml/kg,n=30) and intraperitoneal injection(with a total dose 1 578.6 mg/kg and a volume of 30 ml/kg,n=30) groups.Another 10 mice in each group receiving the same dose of normal saline via the same pathway served as the controls(n=10).The general condition,the major serologic parameters,and the pathological changes of major organs were observed 14 d after administration in each group.Results: We have successfully prepared SPIO,and its core component was Fe3O4 crystal,with a size of 20-35 nm,a T2 relaxivity of 0.155?106 mol-1?sec-1,a specific saturated magnetization of 68.395 68 emu/g,and a retentivity of 21.463 74 Gs.There was no death of mice during the observation.There was no significant difference in serological parameters between mice of different groups and between each experiment group and their corresponding control group.No edema,degeneration and necrosis were seen in the liver,spleen,kidney,heart,and lungs by H-E staining and marrow by Wright staining;only a few blue particles were observed in the liver and spleen in the administration groups by Prussian blue staining,none observed in the control groups.Conclusion: SPIO prepared in the present study meets the requirement of MR imaging,with no acute toxicity to mice,and warrants further study for future MR gene imaging.

Objective To explore the therapeutic effect of infrabrow excision blepharoplasty combined with botulinum toxin A (BTXA) injection on periorbital rejuvenation.Methods A total of 146 females were involved in this study.The incision was designed,hiding at the lower edge of the brow.Eye orbicularis was folded,eyelid lift and some of the skin removed during operation,and simultaneously the shape of eyebrow was better adjusted.After suture cutting,BTXA was injected at the glabella and the lateral of canthus.Results All the 146 cases were followed up for 3 to 12 months.The blepharotosis symptom was improved effectively,the periocular wrinkles were alleviated obviously and no complications occurred in these patients.Conclusions Combining Infrabrow excision blepharoplasty with BTXA injection in periocular treatment is safe,convenient and effective.It is a good clinical approach to make periorbital rejuvenation.

Objective:To investigate the role of PUMA,a Bcl-2 family member,in oxaliplatin-induced apoptosis in colorectal cancer cells.Methods:In vitro,LoVo cells were treated with 1.2,2.4,4.8 ?mol/L oxaliplatin for 24 h and 4.8 ?mol/L oxaliplatin for 6,12,24 h,PUMA expression was assessed by Western blot analysis.The anti-sense PUMA plasmid was constructed by gene recombination.PUMA expression was suppressed by stable transfecting anti-sense PUMA plasmid into LoVo cells.The apoptosis was assessed by flow cytometry analysis(FCM) and proliferation rate was assessed by MTT assay.Results:Oxaliplatin induced PUMA expression in a time-and dose-dependent manner;stable cell lines expressing the anti-sense PUMA vector were established and named LoVo puma(-/-) cells;oxaliplatin-induced apoptosis was decreased by suppression of PUMA expression;the proliferation rate in LoVo puma(-/-) cells was higher than that in LoVo cells after oxaliplatin treated.Conclusion:Our data suggest that PUMA plays an important role in oxaliplatininduced apoptosis in LoVo cells and the sensitivity of LoVo cells to oxaliplatin was abrogated by suppression of PUMA expression.

Objective To explore the clinical therapeutic efficacy and value of endovascular embolization treatment for Hunt-Hess poor-grade intracranial aneurysms. Methods Eighty-seven patients with Hunt-Hess grade Ⅳ - Ⅴ intracranial aneurysrns were treated with endovascular embolization from May 2001 to February 2010,77 patients were grade Ⅳ and 10 patients were grade Ⅴ. Outcomes were assessed by using the Glasgow outcome scale (GOS). Results Follow-up time was from 3 months to 9 years. The therapeutic efficacy was as following according to GOS: 25 patients were grade Ⅰ , 5 patients were grade Ⅱ , 9 patients were grade Ⅲ , 12 patients were grade Ⅳ ,and 36 patients were grade Ⅴ. There were 55.17%(48/87) favorable outcome rate and 28.74% (25/87) mortality rate in all patients. There were 61.70%(29/47) favorable outcome rate and 25.53%(12/47) mortality rate in early stage treatment patients (diseased within 3 d), otherwise there were 47.50% (19/40) favorable outcome rate and 32.50%(13/40) mortality rate in medium and late stage treatment patients (diseased 3 d or later). There were no statistically significance in favorable outcome rate and mortality rate between them (P > 0.05). All the patients were embolized successfully ,technical complications occurred in 8 patients, 10 patients were found angiographic evidence of vasospasm. Conclusions Endovascular embolization is an effective method for treating Hunt-Hess poorgrade intracranial aneurysms. Early stage treatment is a feasible option because it can improve prognosis by reducing rebleeding and vasospasm.

Objective To discuss some problems about current learning objectives for the speciality of clinical medicine in China,including the concepts,the decision-making systems and value-orientation,and to provide the reference for stipulating the learning objectives in future. Methods The objectives of some Chinese medical universities were collected from their websites.Some medical educators were consulted about their feelings about these learning objectives,and also were asked to identify their own objectives. Results Medical educators failed to distinguish their own objectives,and there were four main problems in current learning objectives: generalization,similarity and lack of individuality,difficulty in guide the curricula and teaching,and setting up too high object. Conclusion The learning objectives in clinical medicine should reflect both specialty characteristic and university individuality,so they should be drawn up by teachers,students and educatirnal administrators,moreover their value orientation should be eligible standard,not excellence.