Gastrointestinal stromal tumor (GIST) may be defined as mesenchymal tumors of the gastrointestinal tract,and the application of the tyrosine kinase inhibitor imatinib mesylate has changed the treatment style of the tumor.The surgical treatment is the only choice for the GIST patients before imatinib era,but now the individualized treatment combined with target therapy,surgery and laparoscope surery becomes the mainstay.The paper focus on the new development of preoperative biopsy,laparoscope surery,imatinib neoadjuvant and imatinib therapeutic effect evaluation in recent years.

Background and purpose:Blood vessel metastasis often occurs after the operation of rectal cancer of stage Ⅱ and Ⅲ,angiogenesis is an important step of the procedure.Cycloxygenase-2(COX-2) and vascular endothelial growth factor(VEGF-C) are correlated to angiogenesis. The purpose of this study is to investigate the expressions of Cycloxygenase 2(COX-2) and vascular endothelial growth factor(VEGF-C) in rectal cancer of stage Ⅱ and Ⅲ,to explore the relationships between them and the tumor biological characteristics,tumor angiogenesis.Methods:The expressions of COX-2,VEGF-C and the microvessel density(MVD) were detected by immunohistochemical staining.Results:①The positive rates of COX-2 and VEGF-C expression in rectal cancer were 72.5%,higher than those in peritumoral normal tissue(P

Gastrointestinal stromal tumor (GIST) is the most common gastrointestinal mesenchymal tumors, mainly due to the onset of the proto-oncogene receptor tyrosine kinase, or platelet-derived growth factor receptor gene activating mutations. Molecular targeted therapy drug of imatinib mesylate inhibit KIT, platelet-derived growth factor receptor aloha (PDGFRA) gene tyrosine kinase activity, which is effective in patients with advanced GIST. However, a growing number of studies have found the presence of imatinib mesylate in primary and secondary drug resistance in the treatment of GIST process. With the in-depth study of the physiological function and mechanism of action of non-coding RNA in recent years, making it gradually realized extensive regulation of non-coding RNA gene expression, which occurs in tumor development, invasion and metastasis, drug resistance and other processes plays an important role. Non-coding RNA has the potential to explore GIST pathogenesis and resistance mechanisms to provide new ideas and direction.

0.05),but the rectal administration showed a quicker response in pain-relieving than the oral administration of Morphine Sulfate Controlled-release tablets(P

OBJECTIVE:To investigate the utilization of narcotic analgesics in patients with cancerous pain in our hospital. METHODS:The consumption of Morphine and Pethidine in our hospital in 2004～2007 was analyzed statistically. RESULTS:The consumption quantity of Morphine sulfate controlled-release tablets has been on the rise from 2004 to 2007,while that of Morphine Hydrochloride Injection experienced little change and that of Pethidine Hydrochloride Injection showed a downward trend. CONCLUSION:The structure for the use of narcotic analgesics in our hospital tends to be reasonable,which is basically in line with the Guiding Principle of Pain Relief Ladder for Cancer Pain.

In this paper, the specific male sequeuce in paraffin section of various tissues with autolys is ofdifferent degrees was detected by polymerase chain reaction(PCR).The results shewed that PCR could be used for identifying sex in the tissues with low degrees ofautolysis; its positive rate was lower in high degrees with disappearance of nuclaic member and cell ou-tline,and often gave false negative results when the autolysis degree was high.

Objective To assess the clinical value of 131I-metaiodobenzylguanidine (MIBG) scintigraphy in pheochromocytoma. Methods A total of 430 patients with clinically suspected pheochromocytoma underwent 131I-MIBG whole body scintigraphy, 326 among them underwent B-ultrasound, 400 for CT and 77 for MR examination respectively. While 178 among them were diagnosed with pathology and the others were diagnosed clinically. Results Of all the patients, 108 were diagnosed pheochromocytoma, including 89 131I-MIBG scan positive and 19 negative. The sensitivity, specificity and accuracy of 131I-MIBG were 82.41%, 100% and 95.70%, respectively. 131I-MIBG scan detected 90.00% of unilateral adrenal, 45.45% of bilateral adrenal, 85.71% of ectopic and 66.67% of malignant lesions, respectively. The proportion of patients with positive 131I-MIBG scan increased from 20.69% in all patients to 35.15% in patients with clinical symptoms and positive conventional imaging (at least one of B-ultrasonography, CT or MR was positive) and 64.58% in those with clinical symptoms, positive conventional imaging, and elevated 24 h urinary catacholamines. In 59 patients with adrenal incidentaloma, 8 were scan-positive and all had confirmed pheochromocytoma, while 2 of scan-negative patients also had confirmed pheochromocytoma. Conclusion 131I-MIBG scintigraphy is the first choice for the diagnosis of both adrenal and extra-adrenal pheochromocytoma. However, it is inappropriate to take this method as the initial screening approach.

Objective To investigate the clinical application of retrograde autologous priming (RAP)in congenital heart disease surgery by cardiopulmonary bypass.Methods Twenty congenital heart disease patients undergoing heart operation by cardiopulmonary bypass were randomly divided into two groups,group control (n=10)and group RAP (n=10).Group control was received the regular priming method,whereas group RAP with RAP technique.The hematologic parameters were measured before CPB,15 minutes following CPB,1 h and 24 h after CPB.The priming volume, transfusion requirements,ventilator time and ICU stay time were recorded.Results All patients were healed completely without death and transfusing complications.The priming volume in group RAP was significantly lower than that in group control (P<0.01).The levels of hemoglobin and hemato-crit in group RAP at 15 min following CPB and 1 h after CPB were significantly higher compared to group control (P<0.05).Lactate in group RAP at 1 h and 24 h after CPB were significantly lower than those in group control (P<0.05).The transfusion requirements in group RAP were significantly decreased than group control (P<0.05).Conclusion In congenital heart disease surgery by cardiop-ulmonary bypass,RAP technique can effectively decrease priming volume,hemodilution and transfu-sion requirements,improve tissue perfusion and pulmonary function.

ObjectiveTo assess the diagnostic value of preoperative lymphoscintigraphy for lateral lymph node metastasis in low rectal cancer. MethodsFrom May 1999 to March 2001, pelvic and lower abdominal lymphoscintigraphy with 99mTc sulfur colloid was performed on 32 patients with proven colorectal cancer one day prior to operation. Among these patients were 27 rectal cancers, 3 sigmoid cancers and 2 colon cancers. Fifteen cases of rectal cancer with the tumor located at or below the peritoneal reflection received extended lymphadenectomy with lateral dissection (D3 lymphadenectomy). The result of lymphoscintigrams was correlated with histologic lateral node examination. Results The image ratio of pararectal nodes, obturator nodes, and internal iliac aorti lymph trains was 69%, 91%, and 100% respectively. In 15 patients receiving D3 lymphadenectomy, 10 had negative lymphoscintigrams whereas 5 had positive image, and the lateral pathology positive rate was 13%(2/15). Analysis of these results revealed the sensitivity (100%), specificity (77%) and accuracy (80%) of this diagnostic method. ConclusionPelvic and lower abdominal lymphoscintigraphy with 99mTc sulfur colloid could demonstrate the lateral lymph node drainage of low rectal cancer, and the correlation with postoperative histologic lateral node examination was high enough to enable surgeons to adopt an individualized surgical approach.