The clinical data of 22 cases with gastrointestinal stromal tumors were retrospectively analized.The main clinical manifestations were gastrointestinal bleeding (14/22),abdominal discomfort (5/22) and abdominal lump (3/22),stomach was the most common site of the tumor (14/22).All 22 cases underwent surgical treatment and pathological examination confirmed that 12 cases were benign.Immunohistochemical results showed that 68% cases were negative in solubility acid protein-100 (S-100),and the positive rates of tyrosine-protein kinase acceptor 117 (CD117),hemopoietic stem cell antigen 34 (CD34) and negative rate of smooth muscle actin (SMA) were all 73%.Eighteen cases were followed up for 1-5 years after operation,among them 3 died.The survival was closely related to the size,the pathological characteristics and the recurrance of the tumor as demonstrated by multivariate Cox regression analysis.Since gastrointestinal stromal tumor has no specific clinical manifestations,preoperative diagnosis is difficulty,so surgical resection and subsequent pathological examination is used for confirmation of diagnosis,as well as treatment of the disease.

ObjectiveTo investigate the association of angiotensin converting enzyme(ACE) gene polymorphism and its serum levels with cerebral infarction, and further to explore its possible mechanism. MethodsEighty-four patients with cerebral infarction(cerebral infarction group) and 74 healthy controls(healthy control group) underwent the determination of ACE gene insertion/deletion polymorphism by polymerase chain reaction(PCR) and agarose gel electrophoresis(AGE). The serum levels of ACE were measured simultaneously. The difference in distribution of ACE gene polymorphism was compared between cerebral infarction group and ealthy control group. ResultsThe frequency of DD genotype in cerebral infarction group was significantly higher than that of healthy control group(50% vs 28% ,P<0.01); so was the frequency of D allele(64% vs 46% ,P<0.05). ACE gene polymorphism was associated with the serum level of ACE. A significant difference in serum ACE level was observed among three ACE genotypes. The highest serum ACE level or activity was in deletion homozygote(genotype DD), followed by heterzygote(genotype ID) and insertion homozygote(genotype Ⅱ)(P<0.01). ConclusionThe polyrnorphism of ACE gene and serum level of ACE are associated with cerebral infarction. The DD gene type of ACE and D allele may be the risk factor for cerebral infarction.

Acupuncture Therapy ; Cerebral Hemorrhage ; complications ; Cerebral Infarction ; etiology ; therapy ; Humans ; Male ; Middle Aged

砄bjective: To study the complications of interventional therapy in maxillofacial region. Methods : Retrospective analysis was conducted in 73 cases(96 times) treated with interventional therapy in maxillofacial region. Intraarterial angiography, drug infusion and embolization were conducted in 71 cases of maxillofacial tumor and 2 cases of injury by Seldinger method. Results: Complications with clinical significance occurred were observed in 6 cases (6.2%): allergic reaction to angiographic agent in 2 cases, necrosis of skin in 1, local pain in 1, facial paralysis in 1 and death because of brain damage in 1. 5 cases were cured. Conclusion: The most serious complication in maxillofacial interventional therapy is nerve injury, which may result in death . Certain measures should taken to prevent or reduce the reaction.

Objective To discuss the diagnosis and surgical treatment of insulinoma. Methods The clinical data of 32 patients with insulinoma were analyzed retrospectively. Of the 32 patients, 19 patients were performed with simple tumor enucleation, 10 patients with pancreatic body and tail resection, 3 patients with pancreaticoduodenectomy. Results In this study, 20 cases were diagnosed and localized the tumor by type-B abdominal ultrasonic and enhanced spiral CT before operation and 12 cases by intraoperative type-B ultrasonic. Within all patients,9 tumors located in the head of pancreas, 15 tumors in the neck , 8 tumors in the tail. The clinical symptoms in 32 cases disappeared after operation with 2 cases followed by pancreatic leakage. Of all 32 cases with insulinoma,28 tumors were diagnosed as benign and the other 4 as malignant. Conclusions The mainly clinical manifestation of insulinoma is typical whipple triad. Preoperative qualitative diagnosis is practicable according to the clinical symptom and laboratory examination. Combined imaging examinations might be helpful in improving the positive test rates. Intraoperation exploration and ultrasonography are the chief methods for the tumor localization. Site, size, number and depth of the tumor are the key points determining the surgical method style.

Objective To evaluate the mitochondrial function of chondrocytes in Kashin-Beck disease (KBD) patients and its correlation with age.Methods Mitochondrial function was evaluated by analyzing the activities of respiratory chain enzyme complexes and citrate synthase (CS),intracellular adenosine triphosphate (ATP)contents, changes in mitochondrial membrane potential (ΔΨm),as well as the intracellular reactive oxygen species (ROS) contents.Correlation of mitodhondrial function and age was analyzed with linear regression.Results Activities of complexes Ⅱ (P = 0.001 ),Ⅲ (P = 0.005 )and Ⅳ (P = 0.005 )were reduced in KBD articular chondrocytes compared with cells from normal controls.However,the mitochondrial mass was increased in KBD samples. Cultured KBD chondrocytes had reduced cellular ATP level (P = 0.001 )and mitochondrial membrane potential (P =0.001),but increased citrate synthase activity (P =0.04)and intracellular ROS level (P <0.001).We found no correlation between mitochondrial function and donor age either in normal or in KBD chondrocytes. Conclusion Mitochondrial function is altered in articular chondrocytes of KBD,and no correlation was found between mitochondrial function and donor age.

BACKGROUND: Anterior cervical decompression and fusion has been widely used in the treatment of multi-level cervical spondylotic myelopathy, but accompanied with lots of complications.OBJECTIVE: To investigate the efficacy of zero-profile interboby fixation system for multi-level cervical spondylotic myelopathy.METHODS: Seventy-one patients with multi-level cervical spondylotic myelopathy were randomly divided into two groups, and the patients in group A accepted zero-profile interboby fixation system, and group B accepted cage interboby fixation system. The Japanese Orthopaedic Association score, fusion rate, as well as the incidence of dysphagia and esophageal fistula were detected to compare the efficacy between two groups.RESULTS AND CONCLUSION: (1) All cases were followed-up for 3-34 months, average of 17.5 months. The excellent and good rate at the last follow-up showed no significant difference between two groups. (2) The final fusion rate did not differ significantly between two groups, but the fusion rate in the group A was significantly higher than that in the group B at 6 and 9 months postoperatively (P < 0.05). (3) There was one patient with mild dysphagia in the group A (3％), three mild, five medium, and two severe dysphagia in the group B (29％), which showed significant difference between two groups (P < 0.05). No internal fixation loosening occurred in the group A, but three cases in the group B. The blood loss, operation time and radiology times in the group A were significantly lower than those in the group B (P < 0.05). (4) These results suggest that the effect of these two surgical methods in promoting functional recovery of spinal cord and final fusion rate show no significant differences; however, the zero-profile interboby fixation system exhibits better postoperative stability and interim fusion rate, with lower incidence of dysphagia.

Objective To observe the clinical efficacy of Na Zhi method (midnight-noon ebb-flow method) plus electroacupuncture in treating poststroke uninhibited neurogenic bladder.Method A total of 120 patients with uninhibited neurogenic bladder due to cerebrovascular diseases were randomized into a treatment group and a control group, 60 cases in each group. The treatment group was intervened by Na Zhi method plus electroacupuncture; the control group was intervened by electroacupuncture. The intervention was conducted once a day, 30 min each time, for a total of 2 weeks. The daily voiding frequency index and maximum cystometric capacity (MCC) in the two groups were measured before and after the intervention, and the clinical efficacies were compared.Result The total effective rate and markedly effective rate were respectively 98.2% and 89.5% in the treatment group versus 93.1% and 72.4% in the control group. There was a significant difference in comparing the markedly effective rate between the two groups (P<0.05). There was no significant difference in comparing the daily voiding frequency index between the two groups before the intervention (P>0.05); the daily voiding frequency index was significantly changed after the intervention in both groups (P<0.01), and the daily voiding frequency index of the treatment group was significantly different from that of the control group after the intervention (P<0.05). There was no significant difference in comparing the MCC before the intervention between the two groups (P>0.05); the MCC was significantly changed after the intervention in both groups (P<0.01); the MCC of the treatment group was significantly different from that of the control group after the intervention (P<0.05).Conclusion Electroacupuncture can produce a significant efficacy in treating uninhibitedneurogenic bladder, while it can produce a more significant efficacy when combined withNa Zhi method.

Objective: To review the effect of the treatment of maxillofacial and cervical tumor with external cervical atery intervention technique(ECAI). Methods: 92 cases of maxillofacial and cervical tumor were treated with ECAI. Therapeutic embolization was conducted in 30 cases, arteroy perfusion in 42 and opacification in 20. The patients were cared psycologically befor operation, monitored carefully in operation, especially for contrast medium responsing, antitumor drug responsing,embolisming responsing, etc. Results: Permanent embolization was achieved in 5 cases of hemangioma, bleeding was reduced by 75% in 25 cases treated with subsidiary embolization, local and general condition was improved in 32 patients with malignant tumor by perfusion of antitumor drug. Accuration of angiography was achieved in 93% of the cases. Complications were found in 7 cases and cured after treatment but in 1 who died of cerebrovascular disease. Conclusion: Perioperative monitoring is important to eliminate complications of ECAI.

Objective:To explore the abnormalities of efficiency in resting state functional brain network in patients with paranoid schizophrenia and the correlations between efficiencies and clinical symptoms.Methods:A total of 73 patients with schizophrenia (SZ group) met with the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-Ⅳ) criteria for schizophrenia and 70 healthy controls (HC group) were included .All subjects were checked by using functional magnetic resonance imaging (fMRI), and positive and negative syndrome scale(PANSS) were used to assess the symptoms.Abnormalities of global and local efficiency of brain regions in brain functional network were analyzed by graph theory.Pearson correlation was used to analyze the correlation between the abnormal global efficiency and local efficiency of brain regions of SZ group and PANSS.SPSS 20.0 software was used for dependent-sample t-test, ANOVA test and Pearson correlation analysis. Results:Compared with the HC group, SZ group showed increased global efficiency in bilateral thalamus(left: 0.26±0.06, 0.28±0.04, t=2.03, P=0.044.right: 0.26±0.06, 0.28±0.05, t=2.08, P=0.040), right orbital part of middle frontal gyrus(0.21±0.04, 0.23±0.05, t=2.25, P=0.026), cerebellar lobule Ⅸ(0.19±0.06, 0.21±0.05, t=2.56, P=0.011) and vermis Ⅲ(0.15±0.08, 0.19±0.07, t=3.27, P=0.001), while decreased global efficiency in bilateral parahippocampal gyrus(left: 0.25±0.05, 0.22±0.05, t=-3.34, P=0.001.right: 0.27±0.04, 0.23±0.05, t=-4.96, P=0.000), superior occipital gyrus(left: 0.27±0.03, 0.26±0.03, t=-2.70, P=0.008.right: 0.27±0.02, 0.26±0.03, t=-2.73, P=0.007), superior parietal gyrus(left: 0.27±0.03, 0.26±0.05, t=-2.63, P=0.010.right: 0.27±0.03, 0.25±0.05, t=-2.76, P=0.007), paracentral lobule(left: 0.28±0.03, 0.26±0.07, t=-2.47, P=0.015.right: 0.28±0.04, 0.25±0.07, t=-3.06, P=0.003), left precental gyrus(0.28±0.04, 0.27±0.04, t=-1.98, P=0.049), left cuneus(0.26±0.04, 0.25±0.04, t=-2.08, P=0.039), left lingual gyrus(0.29±0.03, 0.28±0.03, t=-2.28, P=0.024), left middle occipital gyrus(0.29±0.03, 0.28±0.03; t=-2.74, P=0.007), left middle temporal gyrus(0.28±0.03, 0.26±0.03, t=-2.73, P=0.007), temporal pole in left middle temporal gyrus(0.20±0.06, 0.18±0.06, t=-2.59, P=0.011) and right hippocampus(0.27±0.04, 0.26±0.06, t=-2.05, P=0.042).Compared with the HC group, SZ group showed increased local efficiency in bilateral caudate nucleus(left: 0.33±0.06, 0.35±0.05, t=2.54, P=0.012.right: 0.33±0.07, 0.35±0.04, t=2.77, P=0.007) and left superior occipital gyrus(0.39±0.03, 0.40±0.02, t=2.17, P=0.031), while decreased local efficiency in bilateral parahippocampal gyrus(left: 0.35±0.04, 0.32±0.07, t=-3.16, P=0.002.right: 0.34±0.04, 0.32±0.07, t=-2.91, P=0.004), left supplementary motor area(0.36±0.02, 0.35±0.05, t=-2.01, P=0.047), left inferior parietal but supramarginal and angular gyrus(0.35±0.03, 0.34±0.05, t=-2.65, P=0.009), left cerebellar crus Ⅱ(0.37±0.03, 0.36±0.04, t=-2.01, P=0.046), lobule ⅦB(0.37±0.03, 0.35±0.07, t=-1.98, P=0.049), right posterior cingulate gyrus(0.36±0.04, 0.34±0.07, t=-2.07, P=0.041), right superior parietal gyrus(0.37±0.03, 0.36±0.05, t=-2.19, P=0.031), right precuneus(0.36±0.02, 0.35±0.04, t=-2.36, P=0.020), right paracentral lobule(0.37±0.02, 0.36±0.06, t=-2.07, P=0.041) and right temporal pole in middle temporal gyrus(0.33±0.08, 0.30±0.09, t=-2.09, P=0.038).The global efficiency of bilateral paracentral lobule and left temporal pole in middle temporal gyrus in SZ group were negatively correlated with the negative scale scores( r=-0.25, -0.25, -0.26, all P<0.05).The global efficiency of right hippocampus in SZ group was positively correlated with total scores of PANSS( r=0.23, P=0.049).The global efficiency of left middle temporal gyrus in SZ group was negatively correlated with total scores of PANSS( r=-0.23, P=0.049).The local efficiency of right paracentral lobule in SZ group was negatively correlated with the positive scale scores( r=-0.24, P=0.038). Conclusion:The brain networks of patients with first-episode paranoid schizophrenia may have regional dysfunction in the transmission efficiency and fault-tolerant ability of resting state brain functional network, and the abnormalities of efficiency may be associated with the severity of psychiatric symptoms in several brain regions.