Objective To evaluate the results of surgical treatment for duodenal gastrointestinal stromal tumor (GIST).Methods Between January 2000 and January 2013,33 patients underwent surgical resection of duodenal GIST in Peking University Cancer Hospital,including local resection and pancreatoduodenectomy.Clinical data,surgical outcome and prognosis were reviewed.Results The median survival time is 94 months (range:55-132 months).The 1,3,5-year survival rates are 97％,89％ and 80％,respectively.The 5 year survival rate of patients after pancreatoduodenectomy and local resection is 78％ and 83％,respectively (P =0.091).It shows that tumor size and mitotic count and Fletcher classification influence overall survival.Conclusions When fulfiling proper safe margins,local resection is a reliable and curative option for most duodenal GISTs.

Objective To explore the diet features of diarrhea predominant irritable bowel syndrome (IBS-D) with small intestinal bacterial overgrowth (SIBO).Methods IBS-D patients were enrolled in outpatient department of Peking University Third Hospital from March 2015 to April 2016.Healthy volunteers were recruited as controls (HC).All the subjects completed screening examinations,clinical and food investigation,and lactulose methane and hydrogen breath test (LMHBT).The high fat diet is defined as the daily total calories supplying from fat is more than 50％.Results Eighty-eight IBS-D patients and 32 HC were finally enrolled.The positive rate of LMHBT in IBS-D was significantly higher than that of HC [39.8％ (35/88) vs 12.5％ (4/28),P=0.005].The 28 HC with negative LMHBT were enrolled in the follow-up analysis.(1) The BMI of IBS-P (IBS-D with positive LMHBT) was significantly lower than IBS-N (IBS-D with negative LMHBT) [(21.57 ±0.54) vs (23.30 ±0.53) kg/m2,P=0.032].IBS-D patients with SIBO had higher scores of abdominal pain assess.(2) The proportion of dietary protein and carbohydrate in IBS-D was significantly higher than that of HC (14.39％ vs 12.22％,P =0.001;53.94％ vs 46.25％,P =0.003,respectively).The proportion of diet fat was significantly higher in IBS-P than IBS-N[(47.19 ± 2.62) ％ vs (40.74 ± 1.66) ％,P =0.038].(3) The baseline of breath methane in IBS-P was significantly higher than that of in IBS-N [(8.69 ± 0.39) × 10-6 vs (6.39 ± 0.47) × 10-6,P =0.002].IBS-D patients with high fat diet had higher LMHBT positive rate than that of non-high fat diet patients[54.2％ (13/24) vs 17.2％ (11/64),P =0.001].Breath methane peak value was positively correlated with the fat proportion of diet (r =0.413,P =0.022).Conclusions About 39.8％ IBS-D patients diagnosed by Rome 11Ⅲ are combined with SIBO.SIBO may affect IBS-D patients' nutritional status.High fat diet might be one of the risk factors for IBS-D with SIBO.Proper diet structure might reduce the prevalence of IBS-D,especially for IBS-D with SIBO.

Objective To investigate the influence of ultrasonic cleaning time and disinfecting frequency on physical property of Ni-Ti root canal files in order to understand the safety and feasibility of ultrasonic cleaning and high temperature and high pressure disinfection for Ni-Ti root canal files.Methods The Ni-Ti root canal files used in this study were ProTaper,Mtwo and Hero642,5 files were selected from each kind.After the ultrasonic cleaning and high temperature high pressure disinfection the files underwent breaking test,the breaking time was recorded.Unclean and non-sterile Ni-Ti root canal files were set as control.Results After different time of ultrasonic cleaning,ProTaper and Mtwo showed no difference in breaking time,but the result was opposite in Hero642.After different times of disinfection,Mtwo showed no difference in breaking time,but significant difference was seen in the other two kinds.Conclusions Ultrasonic cleaning time has no significant influence on physical property of ProTaper and Mtwo Ni- Ti root canal files,but the influence was significant for Hero642.Disinfection frequency had no significant influence on physical property of ProTaper and Hero642 Ni-Ti root canal files,but the influence was significant for Mtwo Ni-Ti root canal files.

Objective To study the correlation between rotavirus nonstructural protein 1(NSP1) and species restriction of the virus and explore the role of NSP1 in the species restriction.Methods NSP1 C-terminal sequences,its whole amino acid sequences from UniProt Database,and its 3' noncoding sequences from GenBank were collected,and intraspecies and interspecies sequence alignment and phylogenetic tree analysis were performed by DNAStar(Lasergene)7.1.Results The diversity of NSP1 between species and rotavirus species restriction hosted a high degree of consistency.NSP1 C-terminal sequence,NSP1 gene 3' noncoding sequence and NSP1 whole sequence shared a high intraspecies identity,which was higher than the identity between species(P

Objective To analyze the findings of recurrent/residual caner after thyroidectomy for thyroid cancer in both ultrasonography (US) and contrast-enhanced CT (CECT),and to assess the diagnostic value of combination of these two modalities.Methods Forty-six patients with recurrence/ residue of thyroid cancer underwent both high-frequency US and CECT examinations and were enrolled in this study.The imaging features on US and CECT were reviewed and diagnostic accuracies for local residual lesions and cervical lymph node metastasis were evaluated according to pathological results.Results In 46 patients,the average period between thyroidectomy and diagnosis of recurrent/residual cancer was (14.6 ± 12.1) months(range,7 days-10 years).Twenty patients had local recurrent tumors at the surgical bed and the average size of tumors was 2.1 cm(range,0.5-4.6 cm).On US finding,the recurrent/residual tumors were hypoechoic in 60 ％ of cases,had microcalcification in 40 ％.Cervical lymph node metastasis were found in 40 patients,and 75％ of them were located in zone V[.The smallest size of abnormal lymph node which can be detected by US was 3 mm.In cases of lymph node metastasis,12 cases (30％) became cystic,10 (25 ％) presented microcalcifications,and 5 (12.5 ％) showed microcalcifications and cystic change within a lymph node.Microcalcifications,cystic change and hyperechoic appearance within a lymph node suggested malignant.The detection rate of US and CECT in the local recurrent/residual cancer were 90％ and 90％,respectively.The detection rate of cervical lymph nodes metastasis were 80 ％ and 72.5 ％,respectively.The diagnostic accuracy of US and CECT in local recurrence,cervical lymph node metastasis and both were 65％,67.5％ and 65.2％ vs 75％,55％ and 65.2％,respectively (P ＞ 0.05 for all comparisons).the diagnostic accuracy of combination of US and CECT were increased to 86.4％,77.5％ and 91.3％,respectively.US combined with CECT significantly improved the diagnostic capability compared with US or CECT alone(P ＜0.05).Conclusions US should be used as the first choice of imaging examination for post-thyroidectomy of thyroid cancer.US combined with CECT could further increase the diagnostic accuracy in recurrent/residual thyroid cancer.

Objective To detect the methylation status of the promoter of BNIP3 gene in gastric cancer cell lines MKN1,and to explore the mecha?nism of DNA methylation regulating the expression of BNIP3 in gastric cancer cells. Methods The methylation status of BNIP3 promoter was de?tected by bisulfate sequencing PCR. Reverse transcription PCR was used to evaluate BNIP3 mRNA expression. MKN1 cells were treated with 5?Aza?2′?deoxycytidine(5?Aza?CdR),and after the treatment,the methylation status and BNIP3 mRNA expression were observed. Chromatin immuno?precipitation(ChIP)was used to determine the combination of BNIP3 with DNA methyltransferase 1(DNMT1). Results The promoter DNA of BNIP3 in MKN1 cells was in state of hypermethylation. Compared to the control group,methylation status and mRNA expression of BNIP3 in the drug treatment group(the 5?Aza?CdR concentration was 10μmol/L)were reversed,which showed statistical differences(P<0.05). 5?Aza?CdR inhibited the combination of BNIP3 with DNMT1. Conclusion CpG island methylation regulates BNIP3 gene expression in MKN1 cells. DNA methylation is related with the binding between the promoter of BNIP3 and DNMT1.

Objective To investigate the safety and efficacy of reducing pulmonary arterial pressure in patients with congeni‐tal heart disease(CHD) complicated with pulmonary hypertension(PAH) .Methods From September 2014 to January 2015 in our hospital ,34 patients with CHD complicated with PAH were selected ,all of them were treated with endothelin receptor antagonist , bosentan ,on the basis of conventional therapy .The hemodynamics observation ,cardiac function detection and six‐minute walking distance test(6 MWD)were performed after pulmonary artery pressure reducing therapy .Results After treatment ,the pulmonary vascular resistance (PVR) ,arterial oxygen saturation(SaO2 ) ,Qp/Qs and right cardiac output(CO) in these patients was (218 .30 ± 91 .25)dyn · s-1 · cm -5 ,(95 .16 ± 7 .84)% ,(1 .10 ± 0 .27) and (5 .20 ± 1 .36) L/min ,respectively ,which were better than those be‐fore treatment(P<0 .05) .There was no statistically significant difference in the pulmonary artery systolic pressure(sPAP) ,pulmo‐nary artery diastolic pressure pulse AI(dPAP) ,mean pulmonary arterial pressure(MPAP) ,heart rate(HR) and central venous pres‐sure(CVP) before and after the treatment(P>0 .05) .There was no statistically significant difference in the right ventricular diame‐ter(RVD) ,left ventricular ejection fraction(LVEF) ,three tricuspid regurgitation velocity(VP) ,three tricuspid valve transvalvular pressure difference(PGTV) ,left ventricular diastolic volume (LVEDV) and left ventricular diastolic diameter(LVEDD) before and after the treatment(P>0 .05) .After 3 months and 6 months of treatment ,6 MWD was (378 .09 ± 40 .12) and (423 .07 ± 35 .32) m respectively ,both of which were higher than those before treatment ,the differences were statistically significant (P<0 .05) .Conclu‐sion The application of bosentan therapy is safe and effective for patients with CHD complicated with PAH ,which could improve pulmonary hemodynamics and 6 MWD .

Objective To observe the changes in red cell distribution width (RDW)and plasma N -terminal pro -brain natriuretic peptide(NT -proBNP)in children with chronic heart failure due to congenital heart disease (CHD),and to investigate their correlations with cardiac function.Methods Eighty -four children with chronic heart failure and pneumonia secondary to CHD who were hospitalized in Wuhan Health Care Center for Women and Children from January to December 201 4 were enrolled.According to the modified Ross scoring system,they were divided into 3 subgroups:mild,moderate and severe heart failure subgroups.Forty -five children with pneumonia who were hospitali-zed during the same period were randomly selected as the control group.Then the levels of RDW and plasma NT -proBNP were compared in each group,and the correlation between RDW and NT -proBNP was analyzed.Results The levels of RDW and plasma NT -proBNP in children with heart failure caused by CHD were significantly higher than those of the control group[(1 5.6 ±2.2)% vs (1 3.7 ±1 .5)%,(3 252.9 ±1 061 .5)ng/L vs (67.4 ±1 7.9)ng/L, t =5.51 8,7.838,all P <0.01 ].NT -proBNP levels were gradually increased along with increasing heart failure grade, and there were statistically significant differences[(1 71 8.3 ±456.2)ng/L vs (3 371 .4 ±834.2)ng/L vs (4 681 .2 ± 1 21 4.8)ng/L,F =1 5.961 ,P <0.01 ].RDW levels also increased gradually,while there were no statistically signifi-cant differences[(1 5.2 ±1 .5)% vs (1 5.7 ±2.0)% vs (1 6.0 ±2.8)%,F =2.246,P >0.05].There was no signifi-cant correlation between RDMand NT -proBNP (r =0.1 34,P >0.05).Conclusions For children with CHD,higher RDW and NT -proBNP levels can aid in the diagnosis of chronic heart failure,and NT -proBNP level is associated with the severity of heart failure,yet it is still unclear whether RDW level can reflect the severity of heart failure.

Objective To explore the feasibility of transauricular arterial access for hepatic artery catheterization in rabbits.Methods Thirty healthy New Zealand White rabbits were randomly divided into 5 groups ( n =6 in each group):transauricular vein injection group , transarterial infusion group , transarterial lipiodol group , transarterial gelfoam group and transhepatic puncture group .Every rabbit was prescribed elemene (20 mg/kg) via different access in 6 minutes. All the rabbits of hepatic artery catheterization were divided into two groups according to their serial number :transauricular arterial access group (odd, n=9) and transfemoral arterial access group (even, n=9).The arterial access could be changed each other due to the failure of one technique .The catheterization time , success rate and survival rate were compared between the two groups .Venous blood collection via auricular vein or jugular vein for pharmacokinetics was performed in each rabbit .Results Technical success rates of hepatic artery catheterization were 0% ( 0/9 ) and 88.9%( 16/18 ) for transauricular and transfemoral arterial access , respectively . The time duration of transauricular and transfemoral access groups was 28.4 ±13.6 and 33.9 ±19.6 minutes, respectively (P>0.05).The survival rates of the transauricular and transfemoral access groups were 100%(9/9) and 88.9%(16/18), respectively.Blood samples were collected via auricular vein in 4 and jugular vein in 23 rabbits.Conclusions Hepatic artery catheterization via transauricular arterial access is technically not feasible , while transfemoral access is simple and suitable in rabbits .Blood collection via the jugular vein may be a more reliable and valuable method for pharmacokinetic studies in rabbits .

Objective To evaluate the left ventricular rotation and twist in the cardiac allograft by speckle tracking echocardiography.Methods Twenty-six heart transplant recipients underwent echocardiographic studies at 1st,3rd,6th and 12th month after heart transplantation.Twenty-six healthy subjects served as controls.Parasternal basal and apical short-axis images of left ventricle were recorded and then were analyzed using EchoPAC software.The curves of basal and apical rotation and left ventricular twist were obtained,Peak values of basal and apical rotation and left ventricular twist were measured and then statistically analyzed.Results There were no significant differences in left ventricular ejection fraction (LVEF) and fractional shortening (LVFS) between heart transplant recipients and controls (P ＞0.05).The left ventricular twist,apical rotation were significantly lower in heart transplant recipients at 1 st,3rd,6th and 12th month after surgery than those in controls (P ＜0.05) ;while basal rotation in heart transplant recipients had no significant difference when compared with controls (P ＞0.05).The left ventricular twist,apical and basal rotation in heart transplant recipients among 1 st,3rd,6th and 12th month after surgery had no significant difference (P ＞ 0.05).Conclusions Although the LVEF and LVFS of cardiac allograft seemed normal,the left ventricular twist,apical rotation were still significantly lower in heart transplant recipients than those in controls.Speckle tracking echocardiography can be used for accurate assessment of left ventricular twist in heart transplant recipients.