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 To analyze the morphologic characteristics of the single infarct in the territory of perforating arteries which arise from the middle cerebral artery (MCA),and further to investigate the association between the type of cerebral infarction and the isolated stenotic disease of the ipsilateral MCA.Methods Fifty-five patients with acute ischemic stroke who were admitted to the Department of Neurology,Peking Union Medical College Hospital,Beijing,China during January 1,2005 and December 31,2006 were identified.All of the patients had a single acute infarction in the territory of the MCA perforating arteries revealed on diffusion weighted imaging (DWI).Transcranial Doppler (TCD) and magnetic resonance angiography (MRA) were performed for all patients.Patients with stenesis >50% of proximal internal carotid artery and potential cardiac sources of embolism were excluded from the study.Patients were classified into 2 groups according to the presence of the atberosclerotic stenosis of the ipsilateral MCA: patients with or without MCA stenosis.Size of the lesions was measured including the diameter,area and volume.The infarcts with a diameter less than 2 cm were classified as lacunar infarcts; those bigger than 2 cm were classified as the striatocapsular infarcts.The infarcts on DWI was seen in basal ganglia,the body of lateral ventricle and beth.The concomitance of subcortical multiple small old infarcts or leucoariosis on T2>WI-MRI between the two groups was assessed.Results Among these 55 patients,14 (25.5%) had stenosis of the ipsilateral MCA and 41 (74.5%) had a normal MCA.In the group of MCA stenosis,71.4% patients were lacunar infarcts; 67.3% patients were also lacunar infarcts in the normal MCA group.There was no significant difference between the two groups (χ2=0.147,P=0.701).No significant difference in the diameter,area and vo|ume of the infarcts was found between the two groups.The basal ganglia,the body of lateral ventricle and both of these places involvement accounted for 31.7% ,17.1%,51.2% in the normal MCA group; 35.7%,28.6%,35.7% in the stenotic MCA group.No significant difference was found (χ2=1.272,P=0.529).Twenty-three (56.1%) patients had concomitant of small old subcortical multiple infarcts or leucoariosis in the normal MCA group and 3 (21.4%) in the MCA stenosis group,and there was a significant difference between the two groups(χ2=5.033,P=0.025).Conclusions A series of pathologic mechanisms are supposed to cause the single infarction in the territory of MCA perforating arteries.Stenosis of MCA is an underlying cause in addition to perforating artery diseases.There is no significant difference in the size,volume or distribution of the lesions between the two groups.The concomitant of subcortical multiple small old infarcts or leucoariosis may demonstrate the perforating artery disease.

The endosopic imaging was simulated using SketchUp software, and the preliminary definitions of the visual relative quantity space (VRQS), visual absolute quantity space (VAQS), and visual space scale unit (length) VSSU (VSUL) were made to discuss characters of them; With the elevation angle or the distance of the endoscope entering the nasal cavity changed, the law and the cause of the spatial directions in the visual field of the endoscope were analyzed by the theory of VRQS, VAQS, and VSSU (VSUL). The perspective law in the 0° VRQS is: With the distance to the visual point nearer, the length of the VSSU in the view of the endoscope is longer. If the distance of the endoscope entering the model is increased only, the position of the spatial direction in the view of the endoscope shows the repeatable and substituted characteristics. If the elevation angle of the endoscope is changed only, the spatial directions in the view are changed. The change of the spatial directions in the view could be explained by the theory of VRQS, VAQS, and VSSU (VSUL). The change of the elevation angle of the endoscope can caused the change of the spatial directions in the view. The spatial directions in the view of the endoscope have the repeatable and substituted characteristics; the theory of VRQS, VAQS, and VSSU (VSUL) can completely explained the changes of the spatial directions, which provides a good basis for the operations and the further research.