Objective To analyze CT features of gastrointestinal stromal tumors(GIST) and to evaluate its value in diagnosis of thedisease.Methods Both plain and enhanced CT findings in 32 cases with GIST pathologically-proved were retrospectively analyzed.Gastrointestinal air-barium double contrast radiography was performed in 15 patients . Results The tumors originated from the stomach (n=18),jejunum(n=4),ileum(n=3),esophagus(n=2),mesentery(n=2),ascending colon(n=1),rectum(n=1) and greater omentum(n=1).Of 32 GIST,12 were benign and 20 were malignant.In benign GIST ,the diameter of the tumor was less than 5cm,with clear margin and homogeneous density.In malignant GIST,the diameter of the tumor was more than 7 cm,the tumors were lobular in shape ,with necrosis within the tumor ,the tumor had large and deep ulcers,invasion of adjacent tissues and metastasis.The positive predictive value of CT for location of GTST was 96.9%(31/32),the positive predictive value of CT for differentiation of benign and malignant GIST was 93.8%(30/32).Conclusion CT is of great value in diagnosis of GIST.It can be considered as a supplement to X-ray barium meal examination and can provide useful informations for early diagnosis and for the evaluation of the treatment and prognosis.

BACKGROUND:The blood supply is essential for the repair of the meniscus after the suture of it in the injured knee joint. According to the condition of blood supply, the meniscus was divided into three zones by Arnoczk in 1982. The absolute vascularization zone, in which the distance to the combination part of meniscus and synovial membrane is inferior to 3mm, is called the red zone. The absolute devascularization zone, in which the above-mentioned distance is superior to 5 mm, is called the white zone.And the relative vascularization zone with the distance between 3 mm to 5mm is called red-white zone.OBJECTIVE: To observe and discuss the anatomical features of the blood supplyof the meniscus.DESIGN:Single sample observation.SETTING:Department of Orthopaedics, Huaxi Hospital of Sichuan University.PARTICIPANTS: The study was conducted in Huaxi Hospital of Sichuan University during the period from September 2000 to March 2001.Nineteen cases were collected, including 19 knees (38 menisci) from the subjects, 17 male and 2 female, whose age varied from 21 to 43 years old.All the samples were obtained in the amputation operation, the isolated limbs were without the change of re-transplantation and the voluntary donations from the non-minorities living in Sichuan.meniscus samples: 7 knees (14 menisci) were taken. After the femoral artery intubation and infusion of the heparinized normal saline, the vascular bed had no blood and then was infused with the normal saline and ink of 0.5 volume fraction and the infusion pressure was 13 kPa. The infused meniscus samples underwent the dehydration of gradient ethanol,the transparency of dimethylbenzene, and preservation with ilex pedunculosa, and then the blood supply of the menisci was observed and distribution of the meniscus section: 6 knees (12 menisci) with fresh and uninfused menisci were taken. The sections obtained at the sagittal plane,the coronal plane and the horizontal plane underwent hematoxylin-eosin staining. Then the tissues structure and blood supply of the meniscus samples were observed with light microscope. Another 6 knees (12meniscus) underwent the specific CD34 antibody immunohistochemical staining. Then the tissue structure and blood supply distribution of the meniscus samples were observed with the light microscope.in the devascularization zone of the meniscus.RESULTS: Nineteen cases with 38 menisci all went into the final result resourced from the medial and lateral genicular arteries and the middle genicular artery. The small vessels from them form the peripheral capillary vessel plexus and annular vessel meshwork in the synovium and joint capsule and then go into the menisci for the nutrition of the lateral The apparent lunar artery is sent by the vessel plexus around the meniscus into the body of the meniscus and arranges in the inferior,middle and superior layers and dominates 25%-30% of the zone around The vessels of the angular part of the semilunar plate cover the whole meniscus. The nutrition is supplied by the membranous synovium on the surface of the meniscus.Rich blood supply was observed in the anterior and posterior angular laminated blood supply in the body of the meniscus was newly devascularization zone of the meniscus is supplied from the joint synovial fluid is explicit.

Objective To report one stage treatment of chronic tibial defection in children. Methods 19 children with chronic tibial defection were treated in our department when their infection was at the stage of latency. First their focuses of infection were cleared away. Next a piece of fibula with vessel pedicles whose length was equal to that of the tibial defect was taken as the support to restore the length of the tibia. Then the external fixators were applied and a mixture of antibiotic and Lebone powder was used to fill the defect. Results In 15 cases the incision healed at one stage, slight infection occurred in 4 cases whose incisions healed after treatment of 3 to 4 weeks. Follow-ups of 0.5 to 1.5 years showed that no infection occurred again, bone defects healed well and limb function was satisfactory. Conclusion To treat chronic tibial defection in children at one stage, combined therapy should be applied. Grafting of fibula with vessel pedicles and Lebone under external fixators is a good one, because it can shorten the treatment time at no cost of satisfactory effects.

Objective To evaluate the value of the application of ultrasonic elastography and ultrasound contrast imaging on thyroid microcarcinoma(TMC). Methods The in-patients with thyroid lesions admitted in the Second People's Hospital of Foshan City from January 2013 to April 2014 were enrolled. Two-dimensional ultrasonography was used to screen the 162 solid thyroid nodules with a diameter ≤10 mm;they were examined by ultrasonic elastography and ultrasound contrast imaging respectively,and the result of pathological examination was regarded as the golden standard to compare the sensitivity and specificity between ultrasonic elastography and ultrasound contrast imaging for the diagnosis of TMC. Results The pathological results showed there were benign nodules 118 and malignant nodules 44 in number. The sensitivity,specificity,incidence of accuracy,positive predictive value and negative predictive value of the diagnosis of TMC by ultrasonic elasticity imaging,ultrasound imaging,and elasticity imaging combined with ultrasound imaging were much higher than those by two-dimensional ultrasonography〔sensitivity:88.64%(39/44),90.91%(40/44),95.45%(42/44)vs. 81.82%(36/44);specificity:91.53%(108/118),92.37%(109/118),95.76%(113/118)vs. 85.59%(101/118);accuracy:90.74%(147/162), 91.97%(149/162),93.26%(151/162)vs. 84.56(137/162);positive predictive value:79.59%(39/49),81.63%(40/49),83.67%(41/49)vs. 67.92%(36/53);negative predictive value:95.58%(108/113),96.46%(109/113), 97.35%(110/113)vs. 92.66%(101/109),all P<0.05〕. Conclusion For the diagnosis of TMC,both ultrasonic elastography and ultrasound contrast imaging have rather high value,and when they are combined together to be applied for the diagnosis,the result is the best.

Humans ; Lipodystrophy ; congenital

Programmed death-1 (PD-1) and its ligand 1 (PD-L1) play critical roles in the identification and elimination of tumor cells evading the host's immune system.Tumor model in mice which is given anti-PD-L1 monoclonal antibody shows obviously host anti-tumor response.Currently,immunotherapy drugs of PD-1/PD-L1 signaling pathways receive good effects in a variety of tumors failure of the traditional method,and with less adverse reaction,which provide valuable clinical experiences in advanced tumor immunotherapy.

Objective To explore protective effects of curcumin on lung injury in the early hepatic ischemia/reperfsion (reperfusion for 1 and 3 hour) inrats. Methods Wistarratswererandom]y divided into the fo]]owinggroups: GroupA (shamoperation), group B (control group) and group C (cureumin applied). Contents of superoxide dismutase (SOD), catalase (CAT), malondialdehyde (MDA), myeloperoxidase (MPO) in lung tissues were determined to evaluate the protective effect of eurcumin on lung injury in the injury of isehemia/ reperfusion. Results Curcumin relieved edema of diaphragmatic wall and exudation of blood cell and white cell in pulmonary alveoli. Curcumin increased the contents of SOD, CAT and decreased contents of MDA, MPO in lung tissue. Conclusion By repressing the generation of oxygen free radical and infiltration of polymorphonuclear leukocyte in lung tissue, curcumin can relieve lung injury in the early hepatic ischemia/repeffusion.

BACKGROUND:Bone morphogenetic protein-2 (BMP-2) is a key to bone formation and repair.However,it has some disadvantages such as easy to lose and degrade and difficult to sustain continuous effect.OBJECTIVE:To study the preparation and properties of silk fibroin/chitosan/nano-hydroxyapatite (SF/CS/nHA) scaffold loading BMP-2.METHODS:After silk degumming,dissolution and purification,2％ SF solution was obtained.BMP-2 was dissolved in 2％ CS solution,and then fully mixed with equal volume of SF solution and proper amount of nHA.At last,the SF/CS/nHA scaffold loading BMP-2 was prepared using freeze-drying method as experimental group.The SF/CS/nHA scaffold was soaked in the BMP-2 solution as control group.The scaffold porosity was measured by Archimedes method,the surface morphology of the scaffold was observed by scanning electron microscope,the compressive strength was measured by universal testing machine.Scaffolds in the two groups were soaked in PBS,and the release of BMP-2 was measured by ELISA method at different time points.RESULTS AND CONCLUSION:(1) The scaffolds in the two groups had irregular porous structure,interconnected pores and uneven pore wall.There was no significant difference between the two groups in mean pore diameter,porosity and maximum compressive strength.(2) On the 1st day,the release rate of BMP-2 was 4.63％ in the experimental group,and the release curve increased slowly.After 28 days,the release curve of BMP-2 was transferred to the plateau stage.But in the control group,the release rate of BMP-2 on the 1stday was 58.84％,and it was a significant initial burst release.The release curve increased rapidly,and was transferred to the platform stage on the 10th day.The release rate of BMP-2 release was significantly different between the two groups at days 1,2,4,10 (P ＜ 0.05).These results show that the SF/CS/nHA scaffold loading BMP-2 could sustainably and slowly release BMP-2.

BACKGROUND:Natural bone morphogenetic protein 2 disperses and degrades rapidly in vivo,reducing local concentration and therapeutic efficacy.Simply combining bone morphogenetic protein 2 with tissue engineering scaffolds could not stay in vivo for a long time,making it difficult to achieve good sustained and controlled release effects.OBJECTIVE:To prepare and test the biological properties and chondrogenic induction effect of collagen-binding domain-bone morphogenetic protein 2-collagen cartilage scaffold.METHODS:SD rat tail collagen was extracted and a collagen cartilage scaffold was prepared using a vacuum freeze-drying machine chemical crosslinking method.The plasmid expressing collagen-binding domain-bone morphogenetic protein 2 was constructed by rapid cloning C112 homologous recombination,constructed by genetic engineering,and introduced into E.coli,and then collagen-binding domain-bone morphogenetic protein 2 was isolated and purified.Natural bone morphogenetic protein 2 and collagen-binding domain-bone morphogenetic protein 2 were combined with collagen cartilage scaffolds,respectively,to detect the release level of bone morphogenetic protein 2 in the scaffolds.The biocompatibility of collagen-binding domain-bone morphogenetic protein 2-collagen cartilage scaffold was detected by CCK-8 assay and F-Actin staining.Bone marrow mesenchymal stem cells were implanted on two kinds of collagen cartilage scaffolds for chondrogenic induction,and their chondrogenic induction activity was tested.RESULTS AND CONCLUSION:(1)The binding rate of collagen-binding domain-bone morphogenetic protein 2 to collagen cartilage scaffolds was higher than that of natural bone morphogenetic protein 2(P<0.05).After being immersed in PBS for 7 days in vitro,the release of bone morphogenetic protein 2 in the collagen-binding domain bone morphogenetic protein 2-collagen cartilage scaffold was smaller than that in the natural bone morphogenetic protein 2-collagen cartilage scaffold(P<0.05).The results of the CCK-8 assay and F-Actin staining showed that the collagen-binding domain-bone morphogenetic protein 2-collagen cartilage scaffold had no obvious cytotoxicity and had good biocompatibility.(2)After 14 days of chondrogenic induction,ELISA detection demonstrated that the expressions of agglutincan and type Ⅱ collagen A1 in the collagen-binding domain-bone morphogenetic protein 2-collagen cartilage scaffold group were higher than those in the natural bone morphogenetic protein 2-collagen cartilage scaffold group(P<0.05).Under scanning electron microscopy,more bone marrow mesenchymal stem cells were observed on the inner wall of the pores of the two groups of scaffolds,and the cell morphology and size were the same,and the cells were closely arranged,without cell fragmentation or abnormal morphology.(3)The results indicate that the collagen-binding domain-bone morphogenetic protein 2-collagen cartilage scaffold has good biological properties and chondrogenic induction activity.

Objective:To study on the association between vasoactive-inotropic score(VIS) and mortality of total arch replacement in Stanford type A aortic dissection(TAAD) patients.Methods:Data of TAAD patients admitted from January 2018 to November 2018 were analyzed retrospectively. According to the inclusion and exclusion criteria, 187 patients were finally included in the analysis. 30-day mortality was calculated and the patients were divided into death group(18 cases) and non-death group(169 cases). The VIS at each time point and perioperative indexes of the two groups were compared. The value of VIS in predicting mortality was analyzed.Results:The 30-day mortality was 9.63%(18/187). The operation time, cardiopulmonary bypass time, ventilator assistance time, the incidence of tracheotomy and major postoperative complications in the death group were significantly higher than those in the non-death group( P<0.05). VIS of death group was significantly higher than that of non-death group( P<0.05). At each time point, the area under ROC curve(AUC) of VIS was greater than 0.500( P<0.05), among which AUC of ICU 48 h VIS was the largest(0.817), and the best cut-off point of ICU 48 h VIS was determined to be 9, sensitivity 61.1%, specificity 92.3%. Logistic regression analysis showed that ICU 48 h VIS was an independent risk factor for predicting the death of total arch replacement in TAAD patients( OR=1.465, 95% CI: 1.194-1.796, P<0.001). Conclusion:When ICU 48 h VIS≥9, the risk of death was increased in patients with total arch replacement of TAAD. VIS may be a useful reference index for predicting the mortality of total arch replacement in TAAD patients in the early postoperative period.