Objective To explore the surgical treatment experience of primary giant gastrointestinal stromal tumors(GIST)(with isolated lesions with a maximum diameter＞10 cm).Methods A retrospective analysis was conducted on the clinical and pathological data of 67 patients with primary giant GIST admitted from January 2018 to December 2024.Among them,35 cases underwent surgical operations after preoperative neoadjuvant therapy(25 effective cases and 10 ineffective cases)(neoadjuvant therapy group).Due to the initial diagnosis assessment expecting radical(R0)resection(13 cases),or preoperative complications(12 cases),or difficulty in obtaining a pathological diagnosis through puncture biopsy(7 cases),32 cases underwent direct surgery without neoadjuvant therapy(direct surgery group).Compare the general information,tumor condition,surgical condition,postoperative recovery,postoperative pathology,postoperative adjuvant therapy,and recurrence between two groups.Results Comparative analysis revealed that there was no statistically significant difference(P＞0.05)between the neoadjuvant therapy group and the direct surgery group in terms of gender,age,primary tumor location,initial maximum diameter,growth type,localized or locally advanced stage,and postoperative follow-up time.The maximum diameters of the tumors before surgery in the neoadjuvant therapy group and the direct surgery group were(12.4±7.1)cm and(18.2±5.0)cm respectively,and the operation times were(125.4±30.6)minutes and(153.0±31.7)minutes respectively.The intraoperative blood loss was(228.3±76.4)ml and(300.3±67.2)ml,respectively.The postoperative hospital stay was(9.1±2.6)days and(11.1±3.2)days,respectively.There was a statistically significant difference between the two groups(P＜0.05).The proportion of laparoscopic surgery in the neoadjuvant therapy group was 17.1％,which was higher than that in the direct surgery group(0),and the difference was statistically significant(P＜0.05).There was no statistically significant difference between the two groups in terms of the proportion of tumor rupture,combined organ resection,postoperative complications and postoperative recurrence(P＞0.05).Conclusion Primary giant gastrointestinal stromal tumors can mostly be reduced in size and progression through neoadjuvant therapy,improving the chances of minimally invasive surgery.However,there is also a risk of tumor progression during neoadjuvant therapy leading to increased surgical difficulty or even loss of curative surgical opportunities.

Objective To explore the surgical treatment experience of primary giant gastrointestinal stromal tumors(GIST)(with isolated lesions with a maximum diameter＞10 cm).Methods A retrospective analysis was conducted on the clinical and pathological data of 67 patients with primary giant GIST admitted from January 2018 to December 2024.Among them,35 cases underwent surgical operations after preoperative neoadjuvant therapy(25 effective cases and 10 ineffective cases)(neoadjuvant therapy group).Due to the initial diagnosis assessment expecting radical(R0)resection(13 cases),or preoperative complications(12 cases),or difficulty in obtaining a pathological diagnosis through puncture biopsy(7 cases),32 cases underwent direct surgery without neoadjuvant therapy(direct surgery group).Compare the general information,tumor condition,surgical condition,postoperative recovery,postoperative pathology,postoperative adjuvant therapy,and recurrence between two groups.Results Comparative analysis revealed that there was no statistically significant difference(P＞0.05)between the neoadjuvant therapy group and the direct surgery group in terms of gender,age,primary tumor location,initial maximum diameter,growth type,localized or locally advanced stage,and postoperative follow-up time.The maximum diameters of the tumors before surgery in the neoadjuvant therapy group and the direct surgery group were(12.4±7.1)cm and(18.2±5.0)cm respectively,and the operation times were(125.4±30.6)minutes and(153.0±31.7)minutes respectively.The intraoperative blood loss was(228.3±76.4)ml and(300.3±67.2)ml,respectively.The postoperative hospital stay was(9.1±2.6)days and(11.1±3.2)days,respectively.There was a statistically significant difference between the two groups(P＜0.05).The proportion of laparoscopic surgery in the neoadjuvant therapy group was 17.1％,which was higher than that in the direct surgery group(0),and the difference was statistically significant(P＜0.05).There was no statistically significant difference between the two groups in terms of the proportion of tumor rupture,combined organ resection,postoperative complications and postoperative recurrence(P＞0.05).Conclusion Primary giant gastrointestinal stromal tumors can mostly be reduced in size and progression through neoadjuvant therapy,improving the chances of minimally invasive surgery.However,there is also a risk of tumor progression during neoadjuvant therapy leading to increased surgical difficulty or even loss of curative surgical opportunities.

Chemotherapy based on cisplatin or its combination therapy is a common cancer treatment method.However,the non-specific side effects of cisplatin,poor pharmacokinetic properties of small molecule drugs,and susceptibility to drug resistance greatly limit the clinical application of cisplatin as first-line anti-tumor drug.With the development of nanocarrier technology,liposomes have become an ideal carrier for delivering cisplatin drugs due to their excellent properties of targeting,reducing toxicity,and enhancing efficacy.This paper reviews the status of cisplatin liposome both domestically and internationally which have entered clinical trials,including L-NDDP,SPI-077?,Lipoplatin?,LiPlaCis,SLIT and 1LC,etc.Currently,only Lipoplatin? and ILC are showing good potential in cancer therapy.Although cisplatin liposome has made some progress in reducing systemic toxicity and improving treatment efficiency in clinical research,there is still potential for further improvement in tumor targeting and reducing side effects.In the future,more low-toxicity and efficient cisplatin liposomes can be developed through formulation technologies such as co-delivery liposome,stimuli-responsive liposome and targeting liposome.

Objective To investigate the use of crime scene investigation umbrellas to solve the problem that it is difficult to show the luminol test for bloodstains in strong light environment.Methods Three objects:red bricks,soil and black cloth were selected,samples with different concentrations of blood and different retention times were,prepared,luminol tests were performed on the same type of samples in a strong light environment,under the umbrella and in a dark room respectively,and photograghic evidence were obtained.Results It was found that bloodstains that could not be directly visualised by luminol test in the strong light environment could achieve better effects in the dark environment formed by the umbrella,and showed unsignificant difference from the results in the dark room.Conclusion Using the umbrella to create a relatively dark environment in strong daylight can easily and quickly perform the luminol test for bloodstains,providing an effective way to discover and extract blood stains in on-site investigations.

Objective To explore the relationship between the expression levels of microRNA-155(miR-155)and suppressor of cytokine signaling 1(SOCS1)in the colonic mucosal tissue of patients with ulcerative co-litis(UC)and the severity of the disease.Methods A total of 130 UC patients admitted to the Second Affiliated Hospital of Hebei North University from September 2021 to June 2023 were selected.According to the modified Mayo score system,the patients were assigned into an active stage group(n=85)and a remission stage group(n=45).According to the modified Truelove and Witts classification criteria,the UC patients at the active stage were as-signed into a mild group(n=35),a moderate group(n=30),and a severe group(n=20).A total of 90 healthy individuals who underwent colonoscopy for physical examination or those who had normal colonoscopy re-sults after single polypectomy and excluded other diseases were selected as the control group.The colonic mucosal tissues of UC patients with obvious lesions and the colonic mucosal tissue 20 cm away from the anus of the control group were collected.The levels of miR-155 and SOCS1 mRNA in tissues were determined by fluorescence quanti-tative PCR,and the expression of SOCS1 protein in tissues was determined by immunohistochemistry.The corre-lations of the levels of miR-155 and SOCS1 mRNA in the colonic mucosal tissue with the modified Mayo score of UC patients were analyzed.The values of the levels of miR-155 and SOCS1 mRNA in predicting the occurrence of severe illness in the UC patients at the active stage were evaluated.Results Compared with the control group and the remission stage group,the active stage group showed up-regulated expression level of miR-155,down-regula-ted level of SOCS1 mRNA,and decreased positive rate of SOCS1 protein in the colonic mucosal tissue(all P＜0.001).The expression level of miR-155 and modified Mayo score in colonic mucosal tissues of UC patients at the active stage increased,while the mRNA level of SOCS1 was down-regulated as the disease evolved from being mild to severe(all P＜0.001).The modified Mayo score was positively correlated with the miR-155 level and neg-ative correlated with the mRNA level of SOCS1 in colonic mucosal tissues of UC patients(all P＜0.001).The high miR-155 level(OR=2.762,95％CI=1.284-5.944,P=0.009),low mRNA level of SOCS1(OR=2.617,95％CI=1.302-5.258,P=0.007),and modified Mayo score≥ 12 points(OR=3.232,95％CI=1.450-7.204,P=0.004)were all risk factors for severe disease in the UC patients at the active stage.The ar-ea under curve of miR-155 combined with SOCS1 mRNA in predicting severe illness in the UC patients at the ac-tive stage was 0.920.Conclusions The expression levels of miR-155 and SOCS1 mRNA were correlated with the disease severity in the UC patients at the active stage.The combination of the two indicators demonstrates good performance in predicting the occurrence of severe illness in UC patients at the active stage.

Background Lead exposure induces microglial cell death, of which the mechanism is unclear. Ferroptosis is a new death form and its role in microglia death has not been reported. Objective To investigate the role of ferroptosis in microglia following lead exposure in order to provide a theoretical basis for the mechanism of lead neurotoxicity. Methods Microglial cell line BV-2 cells were co-cultured with 0, 10, 20 and 40 μmol·L⁻¹ lead acetate for 24 h. The 40 μmol·L⁻¹ lead acetate group with iron chelator (DFO) was named the 40+DFO group. Changes in BV-2 cell morphology after lead exposure were observed under an inverted microscope; tissue iron kit and glutathione kit were used to detect intracellular iron and glutathione (GSH) respectively; flow cytometry was applied to detect lipid reactive oxygen species (lipid ROS) immunofluorescence intensity. Western blotting and qPCR were adopted to detect the expressions of glutathione peroxidase 4 (GPX4), solute carrier family 7 member 11 (SLC7A11), transferrin receptor 1 (TFR-1), divalent metal transporter 1 (DMT1), ferroportin 1 (FPN1) protein and mRNA. Results Compared with the control group, the number of BV-2 cells decreased with increasing doses of lead and the cells showed a large, round amoeboid shape. The intracellular levels of iron of BV-2 cells were (1.08±0.04), (1.29±0.03), and (1.72±0.10) mg·g⁻¹ (calculated by protein, thereafter) in the 10, 20, and 40 μmol·L⁻¹ lead acetate groups, respectively, significantly higher than that in the control group (P<0.05), and the intracellular level of iron in the 40+DFO group, (1.34±0.10) mg·g⁻¹, was lower than that in the 40 μmol·L⁻¹ lead acetate group, (1.72±0.03) mg·g⁻¹ (P<0.05). Compared with the control group, the TFR-1 and DMT1 protein and mRNA expressions were increased in BV-2 cells in the 10, 20, 40 μmol·L⁻¹ lead acetate groups (P<0.05), especially in the 40 μmol·L⁻¹ lead acetate group; the FPN1 protein expression did not change significantly, but the FPN1 mRNA expressions in BV-2 cells in the 10, 20, 40 μmol·L⁻¹ lead acetate groups were significantly decreased (P<0.05). Compared with the control group, the intracellular GSH level decreased and the lipid ROS content increased in all three lead acetate groups; compared with the 40 μmol·L⁻¹ lead acetate group, the GSH level increased by 12.30% and the lipid ROS content decreased by 13.00% in the 40+DFO group (P<0.05). The expressions of GPX4 protein were reduced to 50.00%, 35.00%, and 17.00% of that of the control group in the 10, 20, and 40 μmol·L⁻¹ lead acetate groups respectively, while the expressions of GPX4 mRNA were also significantly reduced; the expressions of SLC7A11 protein and mRNA in the 20 and 40 μmol·L⁻¹ lead acetate groups were lower than that in the control group, with the most significant decrease in the 40 μmol·L⁻¹ lead acetate group (P<0.05). Conclusion Lead exposure could induce ferroptosis in BV-2 cells, in which iron transport imbalance and oxidative damage might be involved.

Objective To investigate the expressions and the significance among the three markers TGF β1,Survivin and Caspase-3 in intrahepatic bile duct tissues in patients with intrahepatic bile duct stones.Method Total of 130 paraffin section of intrahepatic bile duct tissue were collected at Department of Pathology,The 904th Hospital of Joint Logistic Support Force of PLA from 2013 to 2018.Total of 50 patients with intrahepatic bile duct stones complicated with bile duct strictures (the stenosis group),40 patients with intrahepatic bile duct stones with chronic inflammation (the inflammation group),and 40 patients with normal liver tissues (the normal control group) were included in this study.The expressions of TGF β1,Survivin and Caspase-3 in liver tissues were detected by immunohistochemistry and compared among the 3 groups to find their correlations with the clinicopathological features of the disease of the patients.Results TGF β1 was expressed in 72.0％ of the patients in the stenosis group,37.5％ in the inflammatory group,and 15.0％ in the normal control group.The differences among the groups were significant (P ＜ 0.05);Survivin was expressed in 78.0％ of the patients in the stenosis group,47.5％ in the inflammatory group,and 25.0％ in the normal control group.The differences among the groups were significant (P ＜ 0.05);Caspase-3 was expressed in 10.0％ of the patients in the stenosis group,42.5％ in the inflammatory group,and 75.0％ in the normal control group.The differences among the groups were significant (P ＜ 0.05).Within the stenosis group,TGF β1 was negatively correlated with Caspase-3 (r =-0.882,P ＜ 0.05),and positively correlated with Survivin (r =0.889,P ＜ 0.05).Survivin and Caspase-3 were also negatively correlated (r=-0.923,P＜0.05).Conclusion Abnormal expressions of TGF β1,Survivin and Caspase-3 were involved in the formation of intrahepatic bile duct stones associated with bile duct strictures.

Objective:To investigate the expressions of TGF-β1,survivin and caspase-3 in hepatolithiasis-associated intrahepatic cholangiocarcinoma(ICC)tissue and their clinical significance.Methods:The expressions of TGF-β1,survivin and caspase-3 in intrahepatic bile duct specimens from 52 patients with intrahepatic stones and concomitant ICC(tumor group)and 30 patients with intrahepatic stones and chronic inflammation(inflammation group)as well as 30 specimens of normal intrahepatic bile duct were determined by immunohistochemical staining.The relations of the three factors with the clinicopathologic characteristics and prognosis of ICC patients were analyzed.Results:In tumor group,inflammation group and normal group,the positive expression rates TGF-β1 and survivin presented a successively decreasing order,while the positive expression rates of caspase-3 showed a successively increasing order(all P<0.05);in ICC tissue,the expressions of TGF-β1 and survivin showed a positive correlation(r=0.917,P<0.01),and both had a negative correlation with that of caspase-3(r=-0.890,P<0.01;r=-0.894,P<0.01).the results of univariate and multivariate analyses showed that TGF-β1,survivin and caspase-3 were independent influential factors for the prognosis of patients with hepatolithiasis-associated ICC(all P<0.05);the survival rates of patients with positive TGF-β1 or survivin expression were significantly reduced compared with respective negative ones(χ2=13.192,P=0.001;χ2=10.536,P=0.002),and the survival rate of patients with positive caspase-3 expression was significantly higher than those with its negative expression(χ2=5.469,P=0.023).Conclusion:The expressions of TGF-β1,survivin and caspase-3 are abnormal in hepatolithiasis-associated ICC tissue,and they may probably be jointly involved in the occurrence and development of this condition.

Objective:To investigate the expressions of TGF-β1,survivin and caspase-3 in hepatolithiasis-associated intrahepatic cholangiocarcinoma(ICC)tissue and their clinical significance.Methods:The expressions of TGF-β1,survivin and caspase-3 in intrahepatic bile duct specimens from 52 patients with intrahepatic stones and concomitant ICC(tumor group)and 30 patients with intrahepatic stones and chronic inflammation(inflammation group)as well as 30 specimens of normal intrahepatic bile duct were determined by immunohistochemical staining.The relations of the three factors with the clinicopathologic characteristics and prognosis of ICC patients were analyzed.Results:In tumor group,inflammation group and normal group,the positive expression rates TGF-β1 and survivin presented a successively decreasing order,while the positive expression rates of caspase-3 showed a successively increasing order(all P<0.05);in ICC tissue,the expressions of TGF-β1 and survivin showed a positive correlation(r=0.917,P<0.01),and both had a negative correlation with that of caspase-3(r=-0.890,P<0.01;r=-0.894,P<0.01).the results of univariate and multivariate analyses showed that TGF-β1,survivin and caspase-3 were independent influential factors for the prognosis of patients with hepatolithiasis-associated ICC(all P<0.05);the survival rates of patients with positive TGF-β1 or survivin expression were significantly reduced compared with respective negative ones(χ2=13.192,P=0.001;χ2=10.536,P=0.002),and the survival rate of patients with positive caspase-3 expression was significantly higher than those with its negative expression(χ2=5.469,P=0.023).Conclusion:The expressions of TGF-β1,survivin and caspase-3 are abnormal in hepatolithiasis-associated ICC tissue,and they may probably be jointly involved in the occurrence and development of this condition.

Professor , as the famous and veteran physician of TCM, has practiced TCM for more than 50 years, and had unique experience for the treatment of encephalopathy. Professor applied the theory of skin to guide the treatment of shoulder-hand syndrome after stroke. On the basis of the ancient acupuncture method of , combined with modern acupuncture method and new materials, with characteristics of shoulder-hand syndrome after stroke at different time points, he proposed to use floating needling and acupoint catgut embedding to treat patients with stageⅠ, and to use picking therapy and penetration needle to treat patients with stageⅡ, and to use fire needles, penetration needle and acupoint catgut embedding to treat patients with stageⅢ, combined with conventional acupuncture and rehabilitation treatment. As a result, the superior efficacy was achieved.