Objective To study the half quantitative diagnostic method of the high-risk gastrointestinal stromal tumors (GISTs) with analyzing the characteristic of high-risk and lower risk GISTs with multi-slice spiral CT (MSCT). Methods CT findings of 46 patients with 51 GIST lesions were retrospectively analyzed. The location, size, shape, boundary, growth pattern and other specialties of the tumors in high-risk and lower risk GISTs were studied, moreover statistical analysis was conducted, logistic regression equation was obtained. Results Significant difference was found in tumors' location, size, shape, boundary and distant metastasis between the two types of GISTs. There were obvious correlation between the risk level and tumors' size and boundary which could be used to build the diagnostic equation of high-risk GISTs. Conclusion The equation ln [P/(1-P)]=-2.612X_3+0.371X_5 (X_3:tumors' boundary, X_5:tumors' size) is valuable in the diagnosis of high-risk GISTs.

Adult ; Carcinosarcoma ; pathology ; Female ; Heart Neoplasms ; pathology ; Humans ; Lung Neoplasms ; pathology ; Myocardium ; pathology

Objective To investigate association of the DTNBP1 gene polymorphisms with paranoid schizophrenia in Chinese Han populations by a two-stage study.Methods In the discovery stage, 11 SNPs in DTNBP1 were tested in 532 patients with paranoid schizophrenia and 488 controls by Sanger sequencing.In the validation sample (1 111 cases and 1 435 controls), Taqman genotyping method was used to genotype SNP rs4715986.Results In the discovery stage, SNP rs4715986 showed disease association (χ2=11.02, P<0.01) with paranoid schizophrenia for analysis of 532 patients and 488 controls;such an association survived a correction with 10 000 permutations (corrected P<0.05).In the validation sample (1 111 cases and 1 435 controls), we confirmed the genotypic association (χ2=9.292, P=0.01) of rs4715986 with paranoid schizophrenia.Conclusions The present results suggest that the DTNBP1 gene may be mainly involved in the development of paranoid schizophrenia in the Chinese Han population.

Objective To study the expression of P63 in 76 patients with thymic epithelial tumors (TET, including thymomas and thymic carcinomas) and its role in pathological diagnosis of TET based on World Health Organization classification. Methods Immunohistochemistry (SP method) was used to detect P63 expression in 76 different subtypes of TET tissues. The initial diagnostic results, further diagnosis results and diagnostic results considering P63 expression were analyzed and compared. Results The further diagnosis results identified 9 cases of misdiagnosis (mainly AB and B subtypes) and 3 uncertain cases. Different degrees of P63 expression (located in the nuclei) was observed in 72 cases, and different subtypes had different expression patterns. The diagnostic results considering P63 expression were more accurate than those not considering P63 expression (TET, P = 0. 017 and thymoma, P = 0. 032, respectively). Detection of P63 expression helped to confirm the diagnosis of the 3 uncertain cases according to the further diagnosis results. Conclusion Considering that P63 expression can help to better differentiate the subtypes of thymoma, it should be used as a routine marker for clinical diagnosis, especially for AB and B subtype thymoma.

Objective To evaluate the diagnostic value of endoscopic ultrasound guided fine needle aspiration (EUS-FNA) in combination with flow cytometry (FCM) in lymphoma.Methods From January 2011 to December 2011,the cases of suspicious lymphoma with EUS-FNA examination at Shanghai Ruijin Hospital were retrospectively analyzed.The final diagnosis was according to pathological diagnosis of specimen from the surgery and follow up results.The sensitivity,specificity and accuracy of EUS-FNA combined with FCM in lymphoma diagnosis were initially analyzed.Results A total of 14 suspicious lymphoma patients were collected,eight cases were diagnosed as lymphoma by pathological examination of specimen from the surgery or.tissue from aspiration,four cases were non-lymphoma lesions and two cases still had no final diagnosis.The sensitivity and specificity of FCM alone in lymphoma diagnosis were 4/8 and 4/4 respectively.Six cases of lymphoma were detected by EUS-FNA with FCM.The sensitivity,specificity and accuracy of EUS FNA combined with FCM were 6/8,6/6 and 10/12 respectively.Conclusion EUS-FNA combined with FCM has better diagnostic value in lymphoma,especially for gastrointestinal lymphoma and those surrounding deep lesions.

Objective Based on the traditional Chinese medical knowledge service and sharing system, to explore the application of famous doctor Yu Ying'ao's regulating the liver method. Methods The medical records of Yu Ying'ao from the outpatient department of Chinese Academy of Sciences were used as the data source. The traditional Chinese medical knowledge service and information sharing system(V1.1.5) was applied to construct database. The regulating liver core combination of drugs, drug application mode, and combined treatment of diseases and syndromes were determined by analysis methods of frequency and association rules. Results The use of regulating liver method was often used in the treatment of irregular menstruation, cirrhosis, pain and other diseases. Differentiation of liver qi stagnation, blood stasis, liver stagnation and spleen deficiency, liver and kidney deficiency were the main TCM syndromes. Treatment included Tongluo, nourishing Yin treatment. The core drugs were Bupleurum and Rhizoma Cyperi. Conclusions The use of traditional Chinese medical service and knowledge sharing system could explore the clinical diagnosis and medication rules of regulating liver methods.

Objective To study the value of EUS-FNA cytology and fluid carcinoembryonic antigen (CEA) for differential diagnosis of malignant and benign pancreatic cystic lesions.Methods Data of 27 patients who underwent EUS-FNA were reviewed.According to Youden exponent,the optimal cut-off points for cyst fluid CEA were determined by receiver operating characteristic (ROC) curve.Compared with surgical pathology,the accuracy,sensitivity,specificity,positive predictive value (PPV) and negative predictive value (NPV) of the EUS imaging,cytology as well as cyst fluid CEA were determined.Results Of the 27 cases,14 were diagnosed as benign lesions,13 were diagnosed as malignant or premalignant lesions.The accuracy,sensitivity,specificity,PPV and NPV of EUS imaging were 77.8％ (21/27),69.2％(9/13),85.7％ (12/14),81.8％ (9/11) and 75.0％ (12/16).The accuracy,sensitivity,specificity,PPV and NPV of EUS-FNA cytology were 85.2％ (23/27),76.9％ (10/13),92.9％ (13/14),90.9％ (10/11),and 81.3％ (13/16).The corresponding values of fluid carcinoembryonic antigen under the ROCderived ideal cut-off were 74.1％ (20/27),84.6％ (11/13),64.3％ (9/14),68.8％ (11/16) and 81.8％ (9/11) (CEA ＞ 22.24 ng/ml).Conclusion EUS-FNA cytology is highly accurate and specific for differential diagnosis of malignant and benign pancreatic cystic lesions.Cyst fluid CEA shows better sensitivity.EUS-FNA cytology and cyst fluid CEA analysis can basically meet the requirement of differentiating the benign and (pre)malignant pancreatic cystic lesions.

Objective To evaluate the effects of reserved jejunal feeding tube during postoperative chemotherapy of gastric cancer. Methods Forty-two patients with gastric cancer underwent radical gastrectomy and going to adjuvant chemotherapy,conventional placed jejunal feeding tube. All of the patients weredivided into group A and group B randomly by pathological staging and tumor site, group A reserved jejunal feeding tube and received enteral nutrition through the tube during chemotherapy, and group B non-reservedjejunal feeding tube and been given daily diet,compared nutrition and immune indicators of two groups beforeand after chemotherapy ,compared the rate of vomiting,and observed complications long-term reserved jejunal feeding tube. Results In post-chemotherapy,nutrition and immune indicators of group A were betterthan those of group B, the difference was statistically significant (P＜0.05) ,the rate of vomiting in group Awas significantly lower than that of in group B (X2= 9.75, P＜0.01 ), no serious complieations occurred forlong-term reserved jejunal feeding tube. Conclusions Reserved jejunal feeding tube and received enteralnutrition through the tube during postoperative chemotherapy of gastric cancer can significantly improve the nutritional and immune status. It is safe and reliable, worth promoting.

Objective To explore the effect of wash pipe frequency on complications of double-lumen power peripherally inserted central catheter (PICC) connected to infusion pump during continuous chemotherapy. Methods A total of 160 patients with malignant lymphoma whose PICC connected to infusion pump were divided into 4 groups by random digits table method with 40 cases each: flushing and sealing the tube once every 4 hours(group A), every 8 hours(group B), every 12 hours(group C) and every 24 hours (group D). The incidence of blocking pipe and phlebitis were observed. Results The incidence of blocking pipe were 0,2.5%(1/40) , 27.5%(11/40), 42.5%(17/40) in group A, B, C, D, the differences among them were significant, χ2= 30.870, P<0.01. There was no significant difference in the incidence of phlebitis among 4 groups, P>0.05. Conclusions Flushing and sealing the tube of PICC connected to infusion pump once every 8 hours during continuous chemotherapy seems to be appropriate and worthy of being applied clinically due to its low blocking pipe incidence, and low incidence of phlebitis.

AIM:To observe the effects and mechanisms of hydroxyethylstarch (HES) 130/0.4 on no-reflow phenomenon after myocardial ischemia-reperfusion in rats.METHODS: SD rats were randomly divided into 4 groups:sham operation group , ischemia-reperfusion ( IR, treated with normal saline ) group, normal saline ischemia-reperfusion (NS-IR, treated with NS) group and HES ischemia-reperfusion (HES-IR, treated with HES) group.Myocardial infarct size and no-reflow range were determined by staining methods , and the activities of myocardial enzymes ( CK-MB, cTnI and MPO) were measured .Meanwhile , cardiac microvascular endothelial cells of the rat were cultured and divided into 4 groups:control group, hypoxia/reoxygenation (H/R) group, NS-H/R group and HES-H/R group.Acute ischemia reper-fusion models were simulated , and the concentration of calcium ions was measured .The relative cell activity was evaluated by CCK-8 assay, and the apoptotic rate was detected by flow cytometry .RESULTS:In HES-IR group, the myocardial in-farct size, the no-reflow zone, CK-MB, cTnI and MPO activity were all significantly lower than those in IR group ( P<0.05).In microvascular endothelial cells , the concentration of calcium ions and the apoptotic rate in HES-H/R group were significantly decreased, while the relative cell activity increased compared with H/R group (P<0.05).CONCLUSION:HES reduces no-reflow in acute myocardial ischemia-reperfusion .The mechanism may be involved in the inhibition of both the infiltration of neutrophils and the calcium overload of endothelial cells .