Objective To evaluate the clinical diagnosis and treatment of gastrointestinal stromal tumors (GISTs). Methods The clinical data of patients with GISTs admitted into surgical department from July 2000 to Oct 2005 were retrospectively analyzed. Rusults Twenty-three patients received operation. Twenty-one patients underwent complete tumor resection, two did laparotomy only. Among the patients 7 cases were benign ,6 potential malignant, and 10 malignant . All patients were followed-up from 10 to 72 months. Three of the patients had local recurrence and metastasis, and 5 patients died. Conclusion It was difficult the diagnosis of GISTs because of the lack of clinical feature. Endoscopy and imaging examination are main methods to detect GISTs. Final diagnosis should be based on pathology. Surgical rection is the main treatment.

Objective To investigate the efficacy and optimal dose of adrenocorticotropic hormone(ACTH) in treatment of infantile spasms (IS).Methods Sixty patients with IS were randomly divided into group A (ACTH 20 IU/d,n =20),group B (ACTH 40 IU/d,n =20) and group C (Depakine syrup,n =20) in a prospective randomized study.Patients in group A and group B were given ACTH in the dose of 20 IU/d and 40 IU/d for 2 weeks,respectively.After 2 weeks of treatment,ACTH administration was replaced by oral prednisone if the seizure frequency decreased by 50.0％ or less.Patients showing incomplete control of epilepsy(seizure frequency reduction less than 50.0％) or failing to respond to treatment were continuously treated with the original amount of ACTH for another 2 weeks,then ACTH was replaced by oral prednisone.Patients in group C were treated with the combination regimen of oral clonazepam and Depakine syrup routinely.All participants were followed up by 0.5-3.0 years.The differences in clinical efficacy,changes in electroencephalogram(EEG) and adverse reactions in 3 groups were compared and analyzed.Results Mter 4 weeks of treatment,the total effective rates (TER) and EEG remission rate (ERR) in group A [TER:75.0％ (15/20 cases),ERR:40.0％ (8/20 cases)] and group B [TER:70.0％ (14/20 cases),ARE:45.0％ (9/20 cases)] were significantly higher than those in group C [TER:30.0％ (6/20 cases),ERR:10.0％ (2/20 cases)] (x2 =10.011,6.624,all P ＜ 0.05),respectively,while no significant difference was found between group A and group B as for seizure control,hypsarrhythmia EEG resolution,and cognitive function restoration (x2 =0.125,0.000,t =1.95,all P ＞ 0.05).During follow-up study,the TER and ERR in group A [TER:30.0％ (16/20 cases),ERR:35.3 ％ (6/17 cases)] and group B [TER:30.0％ (6/20 cases),ARE:37.5％ (6/16 cases)] were also significantly higher than those in group C [TER:5.0％ (1/20 cases),ARE:5.9％ (1/17 cases)] (x2 =4.329,6.455,all P ＜ 0.05),respectively.The incidence of adverse reactions in group A was lower than that in group B (x2 =3.956,P ＜ 0.05).Conclusions ACTH proves to be an effective drug for the treatment of IS.Administration of ACTH in the dose of 20 IU/d for 2 weeks seems to be an optimal treatment recipe with remarkable efficacy with fewer adverse effects and may be worthy of clinical trials in a larger cohort.

Objective To investigate the long-term efficacy of transendocardial injection of vascular endothelial growth factor (VEGF) into ischemic porcine myocardium.Methods Thirty pigs were divided into two groups:control group and treatment group (15 each).A angioplasty balloon was used to occlude the left anterior descending coronary arteries of the animals to reproduce a porcine myocardial ischemic model.Blank plasmid (control group) or constructed pIRES2-EGFP-hVEGF165 eukaryotic expression plasmid (treatment group) was directly injected into the ischemic myocardium through an transendocardial injection catheter of NOGA system,respectively.Before and one year after injection,left ventricular electromechanical mapping (LVEMM) was used to detect local linear shortening (LLS) and unipolar potential (UpV);M-mode local wall motion,cycle variation of integrated backscatter (CVIB) and left ventricular ejection fraction (LVEF) were detected by ultrasonagraphy.One year later,the animals were sacrificed for the observation of the capillary formation in myocardial tissue with immunohistochemical staining.Results One year after injection,as compared with that of control group,local linear shortening (LLS) showed a significant increase (P0.05),and ultrasonagraphy showed better heart function in the treatment group (P

Objective To analyze the genotype distribution of human papillomavirus( HPV) strains and their epidemiological characteristics in cervixes of Chinese females. Methods Pertinent litera-tures published during 2004 to 2013 were screened from PubMed,China National Knowledge Infrastructure (CNKI)and Wanfang database for data analysis. Results There were 245 studies screened out for the me-ta-analysis. A total of 661 658 cases met the inclusion criteria,ranging from 16 to 87 years old. All prov-inces and territories of China were covered by the data. The overall rate of HPV infection in cervix was 25. 0% among Chinese females. The predominant high risk genotype of human papillomavirus strains was HPV16,followed by HPV52,HPV58,HPV18,HPV33 and HPV31. HPV52 and HPV58 genotypes were more prevalent than HPV18 genotype. HPV35 and HPV45 genotypes were less popular. Conclusion The study suggested that the HPV infection showed obvious regional differences in genotypes. The genotype dis-tribution of HPV infection in China was different from that in other regions of the world. There were differ-ences with genotype distribution of HPV strains among seven geographic regions of China.

Objective To explore the value of serum SC5b-9, anti-C1q antibody, C3 and C4 levels in the assessment of lupus activity. Methods The enzyme linked immunosorbent assay (ELISA) was used to measure SC5b-9 and anti-C1q antibody, rate nepheiometry was used to detect the serum level of C3 and C4 in sera of 62 SLE patients, 35 patients with other rheumatic diseases (including rheumatoid arthritis, ankylosing spondylitis, primary Sjogren' s syndrome, mixed connective tissue disease, dermatomyositis, polymyositis, systemic sclerosis and vasculitis) and 35 healthy controls. And the correlation between above-mentioned parameters and lupus clinical manifestations, disease activity and histological type of lupus nephritis were analyzed. Results In SLE patients, the levels of SC5b-9 and anti-C1q antibody were significantly higher than those in patients with other rheumatic diseases and healthy controls (P<0.05). The titers of SC5b-9 and anti-C1q antibody negatively correlated with C3 and C4 (P<0.05), and positively correlated with SLEDAI (P<0.05). The sensitivity and specificity of the combination of these three measurements for SLE was 95.37% and 98.46 respectively. SC5b-9 and anti-C1q antibody were associated with the presence of proliferative glomerulonephritis (P <0.05). Conclusion Taking the evaluation of all these three measurements simultaneously is valuable for the diagnosis of lupus flare. SC5b-9 and anti-C1q antibody may play major roles in the immunopathogenesis of lupus nephritis.

Objective To evaluate the immunogenicity of group A and C meningococcal polysaccharides conjugates using different proteins as carriers. Methods Heat-labile enterotoxin B subunit (LTB)pentamer form was expressed in E. coli. The target protein was identified and purified by cation-exchange chromatography. Then biological activity of rLTB was tested using GM1-ELISA. GCMP was conjugated to rLTB with the chemical method (ADH). Furthermore, the mice were immunized with GAMp-TT/GCMP-TT conjugates and GAMP-TT/GCMP-rLTB conjugates via peritoneal. Finally the anti-polysaccharide antibody was detected. Results The GAMP-TT/GCMP-rLTB conjugate elicits remarkably higher serum antibodies in mice than GAMP-TT/GCMP-TT conjugate. Conclusion These results indicated that polysaccharide conjugates using different proteins as carriers were superior to those using only one protein as carrier.

Objective To explore the effect of the gene silencing of phosphatidic acid-preferring phospholipase A1 (PA-PLA1) on insulin secretion in mouse insulin-secreting cell line MIN6. Methods The siRNA expression vector of mouse PA-PLA1 gene targeting was constructed using mouse PA-PLA1 mRNA sequence available in GenBank, and MIN6 cells were transfected with the vector. Fluorescence quantitative PCR and Western-blotwere applied to screen efficient RNAi-vector. After transfection with obtained efficient RNAi-vectors for 48 hours, glucose-stimulated insulin secretion experiments were conducted, and the changes of insulin secretion were examined. Results Four siRNA expression vectors of mouse PA-PLA1 gene targeting were confirmed to be successfully constructed by the analyses of enzyme cleavage and sequencing. The results of fluorescence quantitative PCR and Western blot analyses indicated that the siRNA expression vectorpGPU6-PA-PLA1-1885was the most effective RNAi-vector in the four vectors. The expression levels of the PA-PLA1 mRNA and protein of the MIN6 cells transfectedwith pGPU6-PA-PLA1-1885 decreased to 46.3% and 33.9% of that of the control, respectively, and meanwhile the insulin secretion levels of the cells decreased to 65.0% of that of the control (P < 0.05). Conclusion The gene silencing of phosphatidic acid-preferring phospholipase A1 might decrease insulin secretion in MIN6 cells.

Objective To investigate the prevalence of nutritional risk and malnutrition,and the application of nutrition support in hospitalized patients with surgically treated gynecologic malignant tumors.Methods 237 hospitalized patients with malignant tumors receiving surgery in Department of Gynecology of Beijing Hospital from January 1 to December 31,2013 were continuously sampled.Nutritional Risk Screening 2002 (NRS 2002) was performed in the morning the day after admission.NRS 2002 score ≥ 3 was considered indicating nutritional risk.Malnutrition was judged in accordance with NRS 2002.The application of postoperative nutrition support was recorded.Results The nutritional risk screening was applicable in all the patients (100％).The prevalence of malnutrition was 5.1％ (12/237) in the whole study population,9.2％ in the elderly (≥65 years),significantly higher than that in the patients ＜ 65 years (2.7％) (P =0.034).The nutritional risk rate was 21.1％ (50/237),which was 29.9％ in the patients ≥ 65 years and significantly lower in the patients ＜ 65 years (16.0％) (P =0.014).The nutritional risk rate in the patients with ovarian and endometrial cancers was higher the rate in those patients with vaginal and vulvar cancer was lower.47 patients (19.8％)received postoperative nutrition support,all being parenteral nutrition,including total parenteral nutrition in 13 patients (5.5％) and single transfusion (providing two or more than two amongs glucose,fat emulsion,andi amino acids) in 34 (14.3％).Tube feeding was not applied in all the patients.33 cases (66％) in the 50 patients with nutritional risk were supported by parenteral nutrition,while 14 cases (7.5％) in the 187 patients without nutritional risk were supported by parenteral nutrition.Conclusions There is nutritional risk in the patients with gynecology malignant tumors,the rate of which is higher in elderly patents (≥ 65 years) than in the patients of other age groups.Therefore,attention must be paid to ensure adequate postoperative nutrition support in the elderly patients.

Objective To compare the traumatic indicators of complete video-assisted thoracoscopic surgery (c-VATS) with traditional open surgery (TOS) for lung cancer patients, and further explore the minimal invasiveness of c-VATS. Methods From January 2010 to February 2013, 45 cases with complete video-assisted thoracoscopic surgery (c-VATS gurop) and 42 cases with traditional open surgery (TOS group) were compared in operation time, intraoperative blood loss, duration of chest drainage, the perioperative cytokine and immune cells (CRP,WBC,N,L),pain score and shoulder function score. Results There was no significant difference between groups in sex, age, pathological type, stage,operating time and the perioperative cytokine and immune cells (CRP, WBC, N, L) ( >0.05);Compared with TOS group, c-VATS group intraoperative blood loss was significantly reduced [(167.4±68.5) mL vs (288.6±84.0) mL, =0.000];Drainage time of TOS group was significantly longer than that of c-VATS group [(4.64±2.10) days vs (3.20±1.20) days, =0.000];The postoperative pain measurements in c-VATS group were less than that in TOS group, but the difference between groups was not significant on postoperative 1 day ( =0.542) and significant on postoperative 3 day,7 day,30 day ( = 0.034, 0.000, 0.000) . Patients activities of daily living scores at postoperative 7 day and 30 day in c-VATS group were significantly better than those in TOS group, with statistically significant differences ( =0.000,0.000) . Conclusion Whether the short-term effect or the long-term results,the VATS lung resection is better than the traditional open surgery. c-VATS resection of lung cancer is more invasive.

Objective To explore the expression of P53 and mettl-9 gene in colon cancer tissues and inflammation tissues and normal adjacent tissues and study its relationship with colon cancer.Methods The morphologic situation of histiocyte after H.E.stained was observed.The real-time fluorescent quantitative PCR was applied to detect the gene expression of P53 and METFL-9.Results The expression of P53 gene in inflammation tissues was significantly higher than that in cancer tissues and adjacent tissues(P ＜0.05).The expression of P53 gene in cancer tissues was significantly lower than adjacent tissues and infiammation tissues.METTL-9 gene expression in inflammation tissues was significantly lower than cancer tissues and adjacent tissues(P ＜0.05).In cancer tissues,P53 gene and METFL-9 gene were negative related.Conclusions The mutations of P53 gene played an important role in the course of colon cancer,its downstream gene METTL-9 was highly expressed in colon cancer,and the 9-methyl-converting enzyme which produced by transcription and translation might lead gene hypermethylation in the colon cancer,and thereby promoted the development of colon cancer.