Molecular Epidemiology ; trends

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumor of the gastrointestinal tract. GISTs have characteristic by a specific histological and immunohistochemical pattern. Malignant biological behaviors should be paid more attention in treatment. At present, operation is still the most important treatment method for GISTs. For patients with primary, localized GISTs, surgery represents the only chance of cure. The principle of surgery is complete resection of visible and microscopic lesions. Special care needs to be taken to avoid capsule rupture and intra-abdominal spillage, which increase the risk of recurrence. Positive resection margins may result in a higher risk of local and peritoneal relapse. Every effort should be taken to achieve negative margins. Although wide margins have not been shown to be beneficial, an en bloc resection is still recommended, when GISTs are densely adherent to adjacent organs. As GISTs rarely metastasize to lymph nodes, lymphadenectomy is not routinely indicated. While laparoscopic resection of GISTs is technically possible, it should only be undertaken when it will not increase the chance of tumor rupture. The success of imatinib in the treatment of recurrent and metastatic GISTs have prompted investigation into the adjuvant treatment for the significant risk of recurrence of GISTs and neo-adjuvant treatment for unresectable cases. Combined complete surgical resection and molecular therapy are the new therapy model which will improve therapeutic effect.
Gastrointestinal Stromal Tumors ; surgery ; Humans

Objective To investigate the clinical effect of biological agents etanercept combined with methotrexate in the treat-ment of refractory rheumatoid arthritis .Methods 30 cases of refractory rheumatoid arthritis treated in January 2010 to January 2012 were selected and randomly divided into the two groups ,15 cases in each group .The control group was treated with oral meth-otrexate(MTX) 15 mg per week ,and the combined treatment group was treated with the biological agent etanercept 12 .5-25 .0 mg by subcutaneous injection ,twice per week ,combined with M TX15 mg per week .3 months were taken as a course of treatment .Re-sults The effective rates of ACR20 ,ACR50 and ACR70 in the combined treatment group were 73 .3% ,46 .7% and 26 .7% respec-tively ,which were significantly higher than those in the control group (P<0 .01) .4 cases in the combined treatment group appeared gastrointestinal discomfort .Conclusion Biological agent etanercept combined with M TX in the treatment of refractory rheumatoid arthritis has better clinical curative effect .

Objective:To transfer full-length human mdrlcDNA into K562 cells and assess the feasibility and safety in vitro.Methods:PA317 cells were transducted via a virus vector,pHaMDR1/A,containing full-length human mdr1cDNA by calcium phosphate precipitation.The K562 cells were infected with the virus supernatant.The transfection rate was determined by using CFU selection,FACS and SP immunohistochemical methods respectively.The foreign Pgp function was tested by MTT assay and DNR exclusion with FACS analysis .The cellular cycle and the expression of bcl-2 and c-myc gene were detected by using CFU sclcction,FACS and SP immunohistochemical mcthods respcctively.The forcign Pgp function was tested by MTT assay and DNR exclusion with FACS analysis.The cellular cycle and the expression of bcl-2 and c-myc gene were detected by using PI via FCM and SP stain respectively.These data were analyzed with statistic graph and T-test for match pairs.Results:①The highest transfection rate of K562/MDR6-18 cells were 34%,even up to 84% after colchicine selection.②The exogenous Pgp expression of K562/MDR6-18 cells lasted for more than 4 months with a slow decrease after 10 generations.③The exogenous Pgp got an exclusive pump function.④K562/MDR6-18 cells appeared 1.46-2.22 times cross multidrug resistance phenotype.⑤K562/MDR6-18 cellular proliferation showed a mild,short,restored change.There was no abnormal apoptosis or proliferation.Conclusions:It implies a feasible,attractive and safe way that mdr1 gene transfers into target cells to get exogenous effective MDR.They also provide the basic protocol for using mdr1 gene modifying bone marrow transplantation against the myelosuppressive effects of anticancer drugs.

Objective:To explore the stratege of teratoma treatment in individual patient.Methods:53 cases(40 benign and 13 malignant) with teratoma were admitted from January 2001 to October 2003.Benign teratomas were treated with individual operation process in order to resect the whole tumor and to keep the function of the organ.In malignant teratoma chemotherapy was given before operation,then,tumor resection,and individual chemotherapy after operation.Results:40 benign cases treated with operation were all successful without complications except 3 newborn babies with low serum albumin and delayed wound healing.In 13 malignant cases,5 abdicated chemotherapy and 8 succeeded continuously with individual chemotherapy postoperation.Until now:initial lose to follow -up 5 examples,midway lose to follow -up 2 examples,PR3,CR3.Conclusion:It's important that the individual treatment of teratoma,especially individual chemotherapy against malignant teratoma can improve quality of life and increase cure rate in children with tumor.

OBJECTIVETo study clinical results of reduction and fixation under arthroscopy for the treatment of osteochondrotical lesion in the knee.

METHODSFrom December 2012 to December 2013, 4 patients with the knee joint osteochondritis lesion and free bone fragments were treated with arthroscopy to detect the stripped cartilage, and then the cartilages were reduced with small incision and fixed by cartilage nail. There were 3 males and 1 female, with age of 15, 15, 20 and 27 years old. The durations of the disease were 1 d, 5 d, 1 month and 1 year. All the patients had swelling and effusion in the knee joint, and the floating patellar test was positive. CT examination showed bone defects and loose bodies. The Lysholm, VAS, and Tegner scale were used to evaluate the knee joint functions before and after operation.

RESULTSAll the patients underwent successful surgery. Postoperative CT showed good location of the cartilage without loss of reduced bone and cartilage. All the patients were followed up, and the duration ranged from 10 to 13 months, with a mean of 12 months. In one patient, arthroscopy examination was conducted for a second time to examine the connection of the fracture part to the surrounding cartilage, and it showed that the internal fixator was not absorbed. The Lysholm, VAS and Tegner scale of all patients were better than those before operation.

CONCLUSIONTreatment of osteochondritis lesion with the fixation of absorbable cartilage nails may reconstruct the integrity of articular surface and recover the stability of joints, and it is an effective treatment method.

Adolescent ; Adult ; Arthroscopy ; methods ; Female ; Humans ; Knee Joint ; surgery ; Male ; Osteochondritis Dissecans ; etiology ; physiopathology ; surgery ; Tomography, X-Ray Computed ; Visual Analog Scale

Acupuncture Therapy ; Anal Canal ; pathology ; Female ; Humans ; Intervertebral Disc Displacement ; complications ; Middle Aged ; Pain ; etiology ; Rectal Diseases ; etiology ; pathology ; therapy

It is significant for theory and application to study on marine microbial exopolysaccharides with differential structures and activities endowed by the specific marine environment.The recent progress of the research on the structures and bioactivities of marine microbial ex- opolysaccharides was reviewed,and the prospect of the research and development of the marine microbial exopolysaecharides was also expec- ted.

Objective:The purpose of this paper is to introduce a method of using compensate angles to eliminate rotation set-up errors without six-degree of freedom couch. Methods: To detect six-degree of freedom set-up errors, cone-beam computed tomography (CBCT) scans were acquired. These set-up errors were defined as a matrix to transform from accelerator coordinate system to patient coordinate system. Two independent vectors were defined to describe angles of gantry, collimator and couch in accelerator machine. Transformation of vectors were determined by transformation matrix and re-calculated back to the machine angles. Results:It was found that compensate angles can fully corrected the rotation angles in set-up with limited time consuming. It is feasible to implement compensate angles in routinely radiation procedure. Conclusion:With this method, it is possible to implement the complete corrections of set-up errors in radiotherapy without six-degree of freedom couch and it is convenient in operation as well.

Biliary atresia(BA) is a destructive inflammatory obliterative cholangiopathy of neonates affecting both intrahepatic and extrahepatic bile ducts.BA is more common in east Asia.Genetic susceptibility,viral infections,and immune dysregulation may be related to BA,but immune dysregulation may play a key hole in the pathogenesis of BA.A current view of the pathogenesis of BA is that it may involve both a primary perinatal hepatobiliary viral infection and a secondary generation of an autoimmune-mediated bile duct epithelial injury.The etiology of BA is unknown,but there is evidence for the involvement of immunologic dysregulation mechanisms,which will be discussed in this review.