Background and purpose:Literature report of treatment and prognosis in gastrointestinal stromal tumors(GIST) with hepatic metastasis and recur rent metastasis was rare, This study was to discuss the clinicopathological characteristics and the situation of treatment and prognosis in GIST with hepatic metastasis and recurrent again metastasis. Methods:We reviewed two cases of GIST with hepatic metastasis reported from our hospital, and comprehensively analysed the related literature. Results:Two cases of GIST with hepatic metastasis in our hospital were analysed: one case of primary intestinel tumor,13 years after the treatment of the patient was diagnosed with hepatic metastasis. After operation, the patient accepts imatinib mesylate therapy for 400 mg per day and gave up one and a half month later because of serious side reactions. 1 year 10 months later, the patient was diagnosed with liver, kidney, peritoneum and diaphragm metastasis again, after excised lesions the patient continued to accept Imatinib therapy, and persisted takes about 8 months until now. The primary tumor of recowd case came from greater omentum, 2.5 years later after primary tumor excised hepatic metastasis occured, after operation the patient accepted Imatinib therapy for 400 mg per day, until now 15 months. Two cases followed respectively until now was 2.5 and 1.5 years, without recurrence or metastasis again, all are surviving. Conclusions:The patients of GIST with hepatic metastasis and recurrence again, by suitably lengthened Imatinib therapy cycle after the excision of the lesions, it is still to be possible to obtain the good curative effect .

Objective To investigate the dynamic changes and clinical significanes of TNF?α,IL?1,IL?10 and HMGB?1 in patients with tuberculosis. Methods Fifty?nine patients with active tuberculosis were enrolled in this study. The patients received the standard chemotherapy and the curative effect of the patient was evaluat ed according to the outcome classification in our country. The peripheral blood serum from the patients during the treatment and 12 healthy volunteers were collected. The concentrations of serum TNF?α,IL?1,IL?10 and HMGB?1 were detected by ELISA tests. Results Significant decreases of the concentrations of serum TNF?α,IL?1 and HMGB?1 were shown in patients from the initial treatment,to retreatment and extra?pulmonary tuberculosis (P<0.01),and the serum IL?10 was increased significantly (P<0.01) along with the chemotherapy and improvement of the disease. At the beginning of the treatment ,the levels of 4 kinds of inflammatory factors had no significant differences between the completed and uncompleted treatment patients (P>0.05). At the end of the treatment , the levels of serum TNF?α,IL?1 and HMGB?1 of the uncompleted treatment group were significantly higher than the normal levels (P<0.01) ,but the level of IL?10 was significantly lower than the normal level (P<0.01). Conclusion The dynamic testing of the inflammatory cytokines contributes to evaluation and judgement of the curative effect and the condition of patients with the active tuberculosis.

Objective To study the expression and regulation of pro‐inflammatory cytokinesTNF‐α,IL‐1 ,IL‐6 in mononucle‐ar macrophages stimulated with staphylococcal protein A (SpA) .Methods THP‐1 was incubated with PMA and induced into mononuclear macrophages .Then the macrophages were incubated with varying concentrations of SpA under different time points . The effect of SpA on macrophage proliferation was measured by MTT method .The levels of inflammatory cytokines ,TNF‐α,IL‐1 and IL‐6 from the cultured cell media were measured by ELISA respectively .The levels of mRNA expression corresponding to TNF‐α,IL‐1 and IL‐6 were detected by RT‐PCR from the macrophages stimulated with SpA .All statistical analyses were performed by SPSS17 .0 software .Results The MTT result indicated that SpA had a positive effect on the proliferation of THP‐1 cells in a dosage depended manner .The addition of SpA could enhance the mRNA expression of TNF‐α,IL‐1 and IL‐6 in the stimulated mac‐rophages .It also showed a specific dose‐effect and time‐effect correlation .The macrophages secreted inflammatory cytokines and its corresponding mRNA reached its peak levels at 12 h post stimulation .Compared with the control group ,the expression and release of TNF‐α,IL‐1 and IL‐6 in macrophages from the experimental group was increased with statistical significance(P<0 .01) .Conclu‐sion SpA can promote the secretion and expression of early pro‐inflammatory cytokines ,such as TNF‐α,IL‐1 and IL‐6 in macro‐phages .Therefore ,SpA plays a very important role in the initiation and development of the staphylococcus aureus sepsis .

Objective To investigate the incidence and CT imaging features of abdominal splenosis with a previous splenectomy.Methods 94 consecutive patients with a history of splenectomy underwent abdominal contrast CT examination between April 2010 and December 2012 and were recruited for this study.These patients were devided into two groups according to the reason for which splenectomy was performed.Descriptive statistics were calculated for clinical incidence of abdominal splenosis,and subsequently CT imaging features and diagnosis of abdominal splenosis were discussed.Results In this series,29 cases (30.85％) with abdominal splenosis were found in 94 patients.Abdominal splenosis was found in all of 20 cases with more than one year history of posttraumatic splenectomy,and in 17.31％ (9 of 52) of cases with more than one year history of non-traumatic splenectomy (P ＜ 0.05).There were 60 nodules found on CT examinations in these 29 cases.All nodules were 50 mm or smaller.All nodules appeared of homogeneous soft-tissue density on plain CT scan.The nodules showed significant enhancement during arterial phase on postcontrast CT scan,with continuous significant homogeneous enhancement during portal venous phase.Conclusions Abdominal splenosis following posttraumatic splenectomy are more common than previously suggested.Knowledge of typical CT imaging appearances and the history of splenectomy may prevent mistaking as tumors.

Objective To evaluate the correlation between ultrasonography and histopathology in acute lung injury of rats.Methods Twenty male Wistar rats were randomly divided into control group (4 rats) and experimental group (16 rats),in the experimental group acute lung injury models were step-by-step induced by oleic acid (OA) and sequentially by OA and lipopolysaccharide (LPS).After the end of each step of models,ultrasound examination was applied,and the rats were sacrificed to take the lung specimens to be observed.The ultrasonography and pathological results were analyzed,and the numbers of alveolar were counted under microscope (200 times).Results With the aggravation of acute lung injury,the sonographic findings showed unclear or disappeared pleural line,close-set of B-lines,and pulmonary consolidation with air bronchogram.For control group,the ultrasonographic score was 0.25 ± 0.50,lung injury pathological score was 0.50 ± 0.58,and the numbers of alveolar were 25 ± 3.For OA group,the ultrasonographic score was 2.86-± 1.35,lung injury pathological score was 6.28-± 0.76,and the numbers of alveolar were 10-± 2.For OA + LPS group,the ultrasonographic score was 5.83-± 2.32,lung injury pathological score was 9.83 ± 0.98,and the numbers of alveolar were 6-± 2.All 3 groups were significant different on ultrasonographic score,pathological score and alveolar counts (P ＜ 0.01).Conclusions The ultrasonography image of acute lung injury of rats were positively correlated with its histopathological alteration.The ultrasonography can effectively evaluate the degree of acute lung injury of rats.

Objective:To assess the correlation of high mobility group box 1 (HMGB-1) with Organoleptic rating(OR),dental plaque index(PLI) and halitosis with chronic periodontitis.Methods:Serum samples from 20 halitosis patients,20 chronic periodontitis patients with oral malodor and 8 healthy controls were collected.The level of HMGB-1 in the serum was detected by ELISA.The OR and PLI were estimated by organoleptic method and periodontal examination respectively.The data were analyzed with SPSS 17.0.Results:The levels of HMGB1 in the serum from 2 groups of patients was significantly higher than that of the controls(P ＜0.01).The level of HMGB-1 in the patients of halitosis with chronic periodontitis was significantly higher than that of the halitosis patients(P ＜ 0.01).There was no statistical difference of OR between the 2 groups of patients(P ＞ 0.05).The PLI of the chronic periodontitis patients with oral malodor was significantly higher than that of halitosis patients (P ＜ 0.01).The correlation of HMGB1 with OR and PLI of 2 groups of patients were positively correlated(P ＜ 0.05 and 0.01 respectively),the OR of halitosis patients showed no relevant(P ＞0.05).Conclusion:HMGB-1 may be one of the important factors that result in chronic periodontal inflammation and stubborn bad breath.

OBJECTIVETo evaluate the relationship between CT findings and immunohistochemical types of gastrointestinal stromal tumors (GIST).

METHODSCT imaging and clinicopathological data of 85 patients with GIST were analyzed retrospectively. The CT findings of GIST including lesion location, size, contour, boundary, tumor growth pattern, degree of enhancement, necrosis and calcification, were summarized and compared with the immunohistochemical types of the GIST.

RESULTSOf the 85 patients, smooth muscle differentiation was in 26 cases (30.6%), neural differentiation in 20 (23.5%) , both smooth muscle and neural differentiation in 10 (11.8%) and no obvious differentiation in 29 (34.1%) cases. GISTs occurred in the duodenum were more frequently seen in muscle type than in any other types, GIST with smooth muscle differentiation had higher prevalence of huge mass (larger than 10 cm), distinctive enhancement and extensive necrosis than other types (P < 0.05). There was no significant difference in the relationships of immunohistochemical types with tumor contour, boundary, growth pattern and calcification among the four groups of GIST (P > 0.05).

CONCLUSIONSCT scan is the most important and effective method for diagnosis of GIST. Analyzing CT signs has some potential value in judgmet of immunohistochemical types of GIST.

Diagnosis, Differential ; Gastrointestinal Stromal Tumors ; diagnosis ; metabolism ; Humans ; Immunohistochemistry ; Retrospective Studies ; Tomography, X-Ray Computed

Objective To investigate the clinical significance of dynamic detecting the levels of TNF-α, HMBG-1,TF and vWF in the peripheral blood from the patients with sepsis. Method The serum and plasma were collected from 39 patients with sepsis onset 24,48,72 and 120 h,and 15 health volunteers. The levels of TNF-α,HMBG-1,TF in serum and vWF in plasma were detected with ELISA.The septic patients were divided in-to death and survival groups.The relations were compared between the changes of the levels of TNF-α,HMBG-1, TF and vWF from septic patient peripheral blood with the illness severity.Results The levels of TNF-α,HMBG-1, TF and vWF in serums from different time point septic patient were significantly higher than health group(P <0.01).The peak time was 24 h for TNF-α,48 h for HMBG-1,TF and vWF,and the 24 h was lowest.By the mul-tivariate Logistic regression analysis,the death groups were significantly higher than survival groups(P < 0.05 &0.01).By ROC curve analysis,the 4 inflammatory factors have obvious judgment value from 72 and 120 h curves. Conclusion Firstly,the inflammatory immune response in the septic patient was excessive activated. Then the levels of detected inflammatory factors have a trend toward increased with the extension of the course and there may be a peak point. Moreover,the levels of detected inflammatory factors have a positively correlated with the course of the disease.Lastly,by dynamic detecting the changes of the levels of TNF-α,HMBG-1,TF and vWF in serum from septic patient,it can be served as a comprehensive evaluation index of the patient condition,treatment effect and prognostic judgment.