Objective To investigate the specific CT findings of gastrointestinal stromal tumors (GIST).Methods The CT imaging of 12 cases of GISTs confirmed operatively and pathologically were reviewed and analyzed.The gross pathologic findings of the tumors were compared with the manifestations of CT study.Results Two of the GIST were from the stomach,2 from the duodenum,4 from jejunum,and 1 from the junction of jejunum and ileum,ileum,rectum and mesenterium respectively.5 of 8 cases with GIST from intestine had history of hemafecia or positive of fecal occult blood test.9 of the 12 GISTs were malignant,1 of them was potentially malignant,1 was not sure to be malignant or benign.CT studies of 11 of the 12 tumors showed as exogenous mass of 3-20 cm,only 1 with less than 5 cm and 8 of them with over 5 cm.in the max diameter the tumors were cystic-solid with inhomogenous attenuation.The solid potion of tumors enhanced moderately to markedly after the contrast media administered.Ulcer was seen in the tumors of 2 cases,and the diameter of both of them were over 12 cm.Punctate calcification was seen in 1 GIST.Conclusion CT findings of GIST were specific to a certainty.CT study is helpful for locating the tumor and observation of the relationship of the tumor and surrounding structures.

A method based on solid phase extraction-liquid chromatography-tandem mass spectrometry for the simultaneous determination of 76 veterinary drugs in foodstuffs of animal origin was presented. The residues derived from pork, shrimp, milk, liver and egg were extracted by acetonitrile combined with citrate buffer containing magnesium cation. The extracts were distilled and redissolved with citrate buffer followed by a further cleanup procedure using polymer connected with cation exchange SPE column. The residues retained in column were rinsed with methanol and mixture of methanol and ammonium hydroxide(95∶ 5, V/V). Sample matrix-matched calibration was used to determine the residue contents by external standard. The method provided a LOQ of 0.5 μg/kg(β-agonist and triphenylmethane), 1.0 μg/kg(benzodiazepine and nitroimdazole), 5.0 μg/kg(benzimidazole) and 20.0 μg/kg(sulfanilamide), linear relationship more than 0.907 and a recovery ranged from 59.4% to 115.3% with a RSD between 2.6% and 27.3% in sample matrix. The practical inspection using the method offered two positive samples for ractopamine and diazepam with a residual concentration of 0.92 and 6.5 μg/kg.

OBJECTIVETo investigate the result of hip arthroplasty for failed internal fixation of femoral neck fractures.

METHODSFrom June 2007 to January 2014, 29 cases who underwent hip arthroplasty for failed of internal fixation of femoral neck fractures were reviewed. There were 12 males and 17 females. The mean age was 60.3 years (ranged 43 to 83 years) at the time of the fracture. Left hip was in 16 cases, right hip was in 13 cases. The average interval from fracture to arthroplasty was 23.3 months (ranged, 3 to 48 months).

RESULTSAll of 29 cases were performed total hip arthroplasty. There were 20 cases of cementless cup,7 cases of cementless cup with bone graft, 2 cases of cemented cup with bone graft; 13 cases of cementless stem, 16 cases of cemented stem. There were no complications occurred such as intraoperative fracture of the greater trochanter. The average operative time was (115 ± 38) minutes,the mean intraoperative blood loss was (420 ± 175) ml, the average postoperative drainage volume (240 ± 119) ml, intraoperative blood transfusion was (200 ± 220) ml, intraoperative fluid volume was (2,200 ± 400) ml, the average postoperative blood transfusion was (300 ± 200) ml. There was 1 case get postoperative dislocation. All patients were followed up for 14.7 months in average (ranged, 5 to 24 months). There was no revision for mechanical failure. Harris Hip Score significantly was improved from 51.1 ± 7.5 before the conversion to 88.5 ± 6.4 points at the final follow-up.

CONCLUSIONThe effect of the hip replacement for patients with failed internal fixation of femoral neck fractures was confirmed. This method can shorten the time on the bed and reduce the complications. It benefits the patients earlier functional recovery, but it must control operation indication. The long term efficacy is necessary to further observation.

Adult ; Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Hip ; methods ; Female ; Femoral Neck Fractures ; surgery ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Treatment Failure

Objective To explore the clinical features and the gene mutations in MECP 2 duplication syndrome. Methods The clinical data of a child with developmental retardation and hypophrenia accompanied with respiratory tract infection was analyzed retrospectively. Microarray analysis technique was used to detect the genes in the patient and his family. The pertinent literature was reviewed. Results A 1-year and 7-month old boy was found to have hypotonia, developmental delay, and recurrent respiratory tract infections after birth. Microarray analysis showed a duplication of 441.88kb in Xq28 area and diagnosis of MECP2 duplication syndrome was confirmed. His grandmother, mother, and two aunts were found duplication of 441.73-441.88kb in Xq28 area, all of whom were MECP2’s female carrier. Conclusions The improvement of chromosome chip technology inspection is helpful to the early diagnosis of MECP2 duplication syndrome.

Objective To study the curative efficacy of Ningmitai capsule unite amsulosin hydrochloride sustained realeased capsules treatment ofⅢ type B prostatitis and its effects on level of the prostate fluid of interleukin-10(IL-10), tumor necrosis factor alpha, prostaglandin E2.Methods 104 patients withⅢtype B prostatitis who received therapy from December 2015 to October 2016 in our hospital were selected as research objects, according to the treatment were divided into observation group and control group , the observation group was treated with Ningmitai capsules unite Tamsulosin hydrochloride sustained realeased capsules while the control group was treated with Tamsulosin hydrochloride sustained realeased capsules.Comparison curative effect ,before and after the treatment of chronic inflammatory prostate integral index, maximum urinary flow rate, average urine flow rate;Analysis before and after treatment prostate fluid of interleukin-10, tumor necrosis factor alpha, prostaglandin E2 level and WBC count.Results After treatment, the observation group total effective rate was 90.4%, significantly higher than the control group (P<0.05);After treatment, the observation group in the prostatic fluid IL-10, the TNF-α, PGE-2, the WBC levels were significantly lower than the control group (P<0.05),and after the treatment,chronic inflammatory prostate integral index of observation group was obviously lower than the control group, the maximum urinary flow rate, average urine flow rate is significantly higher than the control group (P<0.05).Conclusion Ningmitai capsules unite amsulosin hydrochloride sustained realeased capsules treatment Ⅲ type B prostatitis has significantly clinical curative effect, can pass down the prostate fluid of IL-10, the TNF alpha, PGE-2 levels, relieve the clinical symptoms.

Objective:To assess the effectiveness of free vascularized bone flap transfer for treatment of advanced osteoradionecrosis of the mandible (ORNM). Methods:We reviewed 53 patients who were treated for ORNM by radical resection and reconstruction with free vascularized bone flaps in our institute between January 2003 and January 2015. Results:Among the 53 vascularized bone flap patients, 48 (90.57%) had fibula osteocutaneous and 5 (9.43%) had deep circumflex iliac artery (DCIA). Postoperative complications occurred in 5 (10.42%) of the 48 fibula osteocutaneous patients (4 cases of vein thrombosis and 1 case of arterial crisis). In three of these patients, flap was salvaged back to normal in a timely manner by vascular exploratory surgery. However, pectoralis major myocutaneous flap was conducted as a second procedure for the other two patients. Meanwhile, complications occurred in 2 (40%) of the 5 DCIA transfer patients (1 case of vein thrombosis and 1 case of arterial crisis). None of these two flaps was salvaged back. Necrosis transfer bone was finally removed. No obvious donor site complications were noted. The mean follow-up time was 28 months. Our results showed that 88.57%of the patients with ORNM were stable, 85.71%of the patients can open their mouth at 2-3 figures, 85.72%of the patients can eat soft or semi-liquid food, and 80%patients can speak clearly and can be understood by others around them. No significant difference was found in mouth opening and face type of the patients with or without the intact condyle. However, the temporomandibular joint area discomfort of the patients with intact condyle was obviously less than that of patients with removed condyle. Conclusion:Radical resection, followed by vascularized bone flaps, especially fibula osteocutaneous, is still the best way to treat ORNM, as long as the indications are chosen appropriately, intraoperative work is conducted properly, and postoperative complications are controlled.

Objective To track the effects of hyperbaric oxygen (HBO) therapy on neonatal rats with hypoxic-ischernic brain damage (HIBD).MethodsA total of 126 healthy,seven-day-old SD rats were used to model the HIBD and then randomly divided into seven groups of 18:a sham group,a hypoxic-ischemic (HI) group,a 6 h HBO group,a 24 h HBO group,a 48 h HBO group,a 72 h HBO group and a 1 week HBO group.One hour of HBO treatment at 2 atmospheres absolute pressure was administered once daily for a week to the rats in the latter 5groups,starting at 6,24,48,72 hours and 1 week post the HIBD modeling,while no HBO was administered to the sham and HI groups.The effects were assessed in terms of histological changes ( the neuron density and the percentage of neuron apoptosis in the CA1 region of the hippocampus) and nitric oxide (NO),malondialdehyde (MDA) and superoxygen dismustase (SOD) concentrations after 15 days.ResultsIn the 6 h HBO,24 h HBO,48 h HBO and 72 h HBO groups,average neuron density in the CA1 region was significantly higher than in the HI group.But in the 1 week HBO group the average density was not significantly different than in the HI group.In the 6 h HBO,24 h HBO,48 h HBO and 72 h HBO groups the average percentage of neuron cell apoptosis in the CA1 area of the hippocampus was significantly lower than in the HI group,but the 1 week HBO group again showed no significant difference.There were significant differences in average NO,MDA or SOD levels among the 6 h HBO,24 h HBO,48 h HBO,72 h HBO and HI groups,but the 1 week HBO group showed no significantly higher average levels than the HI group.ConclusionsThe optimal therapeutic window for using HBO to protect against HIBD is within the first week.The best effect can be obtained in the first 6 hours,but after 1 week HBO no longer has a significant effect.The earlier the HBO is administered,the better the effect obtained.

Objective:To introduce recent progress on diagnosis and treatment of benign symmetric lipomatosis(BSL).Method:Detailed clinical data of 6 patients with BSL were reviewed and analyzed.We present a summary of the clinical symptoms,physical sign,diagnosis and therapeutic methods of BSL. And related literatures were discussed together.Result:All of 6 patients have excessive subcutaneous fat deposit predominantly around neck.One patients had upper extremity localizations. Six patients had the complication of left ventricular diastolic function changes,glucose intolerance or diabetes mellitus, chronic hepatopathy, hyperuricemia and sleep apnea syndrome in one or more. One patients with several symptoms occur simultaneously, another one female patient was accompanied by all symptoms but chronic hepatopathy. Five male patient were alcohol abusers. Tatal neck lipentomy and abstinence from alcohol were performed on 5 patients. One patient refused treatment.During a follow-up of 3 months to 4 years, one patients was relapsed again,and no recurrence was seen in another 4 patients. All pathological results were nonencapsulated fat. Conclusion:BSL is a lipodystrophy caused by diffuse fatty tissue, symmetry deposition in the neck and shoulder subcutaneous fascia space or deep fascial space .The highest incidence favors to middle-aged man who is alcoholist. Chronic alcohol addiction and typical clinical symptoms help to diagnosis BSL. Lipectomy represents a successful procedure in treating BSL.

Objective To investigate the clinical features of infective endocarditis(IE)in senile patients.Methods The clinical data of 166IE patients were retrospectively studied,including 37senile cases and 129middle aged and young patients finally diagnosed as IE and treated in the hospital the authors served from Jan.1999to Jan.2009.Analysis and comparison between the two groups were done on original heart diseases,clinical manifestations,laboratory examination,imaging features,treatment,prognosis and outcome.Results Among the primary heart diseases,degenerative heart valve disease(62.1%,23/37)and coronary heart disease(24.3%,9/37)were more common in senile patients,among them the body temperature of febrile cases was usually below 38.5℃ (75.7%,28/37),and the cardiac murmurs could be heard usually in aortic valve area(51.4%,19/37).The incidence of embolization was lower in senile group(13.5%,5/ 39)than in middle aged and young group(31.8%,41/129)with significant difference(P0.05)was found in operative mortality between the two groups.Conclusions The outcome is worse in senile patients with infective IE than in middle aged and young cases.Early diagnosis for senile IE patients was difficult because of atypical clinical features and lower positive rate of blood culture.Echocardiography may play a pivotal role in the diagnosis of senile infective IE.Surgical operation may be a reasonable option for the senile IE patients with operative indication.

Objective To observe the expression of synaptotagmin I(syt I)protein in the prefrontal cortex of adult-onset hypothyroidism rats and the effects of replicated therapy in different doses of thyroid hormone on the syt I protein.Methods All 44 aduh male Sprague-Dawley rats were divided into 4 groups randomly according to their body mass:hypothyroidism group,routine dosage thyroxine treatment group,high dosage thyroxine treatment group and control group.The adult male Sprague-Dawley rats were replicated to the adult-onset hypothyroidism and treatment models with propyhhiouracil(PTU).The levels of serum T3,T4 were assayed by the radioimmunoassay method and the level of the syt I protein in the molecular layer,external granular layer,external pyramidal layer,internal granular layer and internal pyramidal layer in prefrontal cortex was analyzed by immunohistochemistry.Results In the hypothyroidism group,the levels of serum T3 and T4[(0.34±0.04),(43.01±2.95)nmol/L]were significantly lower than those in the control group[(0.65±0.15), (55.20±3.56)nmol/L, F value: 6.026,5.940,4.503,P<0.05 or <0.01 ], the levels of the syt I protein in the molecular layer(0.018±0.010), external granular layer (0.020±0.007), external pyramidal layer(0.013±0.008), internal granular layer(0.011±0.005), internal pyramidal layer(0.024±0.013) of prefrontal lobe were significantly lower compared to the control group[(0.028±0.010,0.031 ± 0.010,0.028 ± 0.010,0.022 ± 0.008,0.038 ± 0.013), F value: 5.697,8.965,14.668,13.597,6.807,P<0.05 or <0.01 ]. In the routine dosage of the thyroxine treatment group, the levels of serum T3,T4 [(0.63 ±0.05), (55.04 ± 3.77)nmol/L] were not significantly different compared to the control group(F value: 3.162,0.367,all P>0.05), and the level of the syt I protein in the molecular layer, external granular layer, external pyramidal layer, internal granular layer and internal pyramidal layer in prefrontal cortex showed a significant improvement of the syt I protein(0.027 ± 0.013,0.025 ± 0.009,0.022 ± 0.008,0.020 ± 0.010,0.033 ± 0.010), which were similar to that of the control group(F value: 0.094,2.208,2.467,0.350,0.693, all P>0.05). In the high dosage thyroxine thyroid hormone treatment group, the levels of serum T3 and T4[ (1.11 ± 0.10), (96.68 ± 6.42)nmoL/L] were higher than the control group(F value: 6.291,12.031, all P<0.01), the expression of the syt I protein(0.028 ± 0.008,0.031 ±0.011,0.026 ± 0.012,0.023 ± 0.011,0.038 ± 0.010) were not significantly different compare to the control group (F value: 0.001,0.019,0.111,0.061,0.001, all P>0.05). Conclusions The expression of the syt I protein in the prefrontal cortex of adult-onset hypothyroidism can be decreased, which can be reversed by routine dosage of thyroxine treatment.