Taselisib moderates neuropathic pain through PI3K/AKT signaling pathway in a rat model of chronic constriction injury.

BACKGROUND: Neuropathic pain is a chronic condition commonly caused by inflammation-induced disturbances or lesions of somatosensory functions in the nervous system. The aim of this study was to investigate the effects and mechanisms of Taselisib on chronic constriction injury (CCI)-induced neuropathic pain in rats. METHODS: The rats were divided into four groups: sham group, sham + Taselisib (10 mg/kg orally once a day) group, CCI group, and CCI + Taselisib (10 mg/kg orally once a day) group. Pain behavioral tests, recorded by measuring paw withdrawal threshold (PWT) and thermal withdrawal latency (TWL), were conducted on days 0, 3, 7, 14, and 21 after surgery. After testing, the animals were euthanized and spinal dorsal horns were collected. Pro-inflammatory cytokines were quantified using ELISA and qRT-PCR. PI3K/pAKT signaling was assessed using Western blot and immunofluorescence. RESULTS: PWT and TWL were significantly reduced after CCI surgery, but were successfully increased by Taselisib treatment. Taselisib treatment notably suppressed the upregulation of pro-inflammatory cytokines, including IL-6, IL-1ß, and TNF-⍺. Taselisib treatment significantly reduced the elevated phosphorylation of AKT and PI3K induced by CCI. CONCLUSION: Taselisib can alleviate neuropathic pain by inhibiting the pro-inflammatory response, potentially through the PI3K/AKT signaling pathway.

A COVID-19 medical image classification algorithm based on Transformer.

Coronavirus 2019 (COVID-19) is a new acute respiratory disease that has spread rapidly throughout the world. This paper proposes a novel deep learning network based on ResNet-50 merged transformer named RMT-Net. On the backbone of ResNet-50, it uses Transformer to capture long-distance feature information, adopts convolutional neural networks and depth-wise convolution to obtain local features, reduce the computational cost and acceleration the detection process. The RMT-Net includes four stage blocks to realize the feature extraction of different receptive fields. In the first three stages, the global self-attention method is adopted to capture the important feature information and construct the relationship between tokens. In the fourth stage, the residual blocks are used to extract the details of feature. Finally, a global average pooling layer and a fully connected layer perform classification tasks. Training, verification and testing are carried out on self-built datasets. The RMT-Net model is compared with ResNet-50, VGGNet-16, i-CapsNet and MGMADS-3. The experimental results show that the RMT-Net model has a Test_ acc of 97.65% on the X-ray image dataset, 99.12% on the CT image dataset, which both higher than the other four models. The size of RMT-Net model is only 38.5 M, and the detection speed of X-ray image and CT image is 5.46 ms and 4.12 ms per image, respectively. It is proved that the model can detect and classify COVID-19 with higher accuracy and efficiency.

Access and benefit-sharing of the pathogenic microorganisms such as SARS-CoV-2.

With the outbreak of coronavirus disease 2019 (COVID-19), it is essential to share pathogens and their data information safely, transparently, and timely. At the same time, it is also worth exploring how to share the benefits of using the provided pathogenic microorganisms fairly and equitably. There are some mechanisms for the management and sharing of pathogenic microbial resources in the world, such as the World Health Organization (WHO), the United States, the Europe, and China. This paper studies these mechanisms and puts forward "PICC" principles, including public welfare principle, interests principle, classified principle, and category principle, to strengthen cooperation, improve efficiency, and maintain biosafety.

A multi-scale gated multi-head attention depthwise separable CNN model for recognizing COVID-19.

Coronavirus 2019 (COVID-19) is a new acute respiratory disease that has spread rapidly throughout the world. In this paper, a lightweight convolutional neural network (CNN) model named multi-scale gated multi-head attention depthwise separable CNN (MGMADS-CNN) is proposed, which is based on attention mechanism and depthwise separable convolution. A multi-scale gated multi-head attention mechanism is designed to extract effective feature information from the COVID-19 X-ray and CT images for classification. Moreover, the depthwise separable convolution layers are adopted as MGMADS-CNN's backbone to reduce the model size and parameters. The LeNet-5, AlexNet, GoogLeNet, ResNet, VGGNet-16, and three MGMADS-CNN models are trained, validated and tested with tenfold cross-validation on X-ray and CT images. The results show that MGMADS-CNN with three attention layers (MGMADS-3) has achieved accuracy of 96.75% on X-ray images and 98.25% on CT images. The specificity and sensitivity are 98.06% and 96.6% on X-ray images, and 98.17% and 98.05% on CT images. The size of MGMADS-3 model is only 43.6 M bytes. In addition, the detection speed of MGMADS-3 on X-ray images and CT images are 6.09 ms and 4.23 ms for per image, respectively. It is proved that the MGMADS-3 can detect and classify COVID-19 faster with higher accuracy and efficiency.

Discussion on the Application of Supercritical Carbon Dioxide Technology for Sterilization of Medical Devices / 中国医疗器械杂志

Traditional medical device sterilization processes are mature, but there are constraints when using on medical devices by new materials. With increasing environmental concerns, using of ethylene oxide sterilization has been limited by global environmental protection administrations. Exploring new sterilization methods for medical devices is urgently needed. This paper reviews the supercritical carbon dioxide sterilization technology by arranging the exploratory work of industry researchers. In the paper, we introduce the theory of supercritical carbon dioxide sterilization technology, microbial inactivation ability, material influence research and sterilization equipment. Then we discuss the concerns and possibilities of the technology applied to the medical device industry basing on the good manufacturing practices.

The effect of PM2.5 on oncogene expression in HBE cells / 中华劳动卫生职业病杂志

Objective@#To study the effect of particulate matter 2.5 (PM2.5) on oncogene expression in human bronchial epithelial (HBE) cells.@*Methods@#HBE cells were selected as the study subjects, and PM2.5 treatment group (10 μg/ml and 50 μg/ml) , negative control group and positive control group (10 μmol/L Cr6+) were set. CCK8 assay was used to test the IC50 value of PM2.5. HBE cells were treated with PM2.5 for 24 h at 10 μg/ml and 50 μg/ml, additionally, cells were treated with blank as negative control, 10 μmol/L Cr6+ as a positive control for 24 h. After the treatment, mRNA expression of oncogenes including c-myc, c-fos, k-ras and p53 were detected by fluorescent quantitative RT-PCR, the protein expression of oncogenes were detected with western blot.@*Results@#The IC50 value of PM2.5 in HBE cells is 70.12 μg/ml. The qRT-PCR data showed that compared with the control group, the expression level of c-myc gene increased by respectively 500.1%、780.7%、305.3% after exposure to 10、50 μg/ml PM2.5 and positive control group; c-fos gene increased respectively 34.0%、76.7%、131.3% after exposure to 10、50 μg/ml PM2.5 and positive control group; k-ras gene increased respectively 50.3%、107.0%、49.7% after exposure to 10、50 μg/ml PM2.5 and positive control group; p53 gene decreased by 28.3%、28.7%、59.7% after exposure to 10、50 μg/ml PM2.5 and positive control group. The western blot results showed that compared with the control group, c-myc protein increased respectively 29.7%、77.3% after exposure to 50 μg/ml PM2.5 and positive control group; c-fos protein increased respectively 200.3%、137.0% after exposure to 50 μg/ml PM2.5 and positive control group; k-ras protein increased respectively 106.3%、130.3%、116.7% after exposure to 10、50 μg/ml PM2.5 and positive control group; p53 protein decreased by 43.7%、53.3%、52.1% after exposure to 10、50 μg/ml PM2.5 and positive control group.@*Conclusion@#PM2.5 could promote the expression of oncogenes in HBE cells, the carcinogenicity of haze might be related to promotion of oncogenes expression induced by PM2.5.

Metal elements analysis and risk assessment of carcinogenicity on PM2.5 samples collected from Shenzhen and Taiyuan / 中华疾病控制杂志

Objective To conduct metal elements analysis and risk assessment of carcinogenicity on Particulate Matter 2.5 ( PM2.5) collected from Shenzhen and Taiyuan. Methods PM2.5 samples were collected in Shenzhen and Taiyuan from 2017 to 2018. Ten heavy metal elements in PM2.5 samples were detected by inductively coupled plasma mass spectrometry (ICP-MS). Health risk assessment was conducted using the recommended United States Environmental Protection Agency (EPA) model. Results Metal elements found in PM2.5 samples from Shenzhen included (in decreasing order of concentration) Al, Pb, Mn, Cr, Cu, V, As, Ni, Cd and Co. Their levels were 1 807.67, 31.02, 30.63, 17.37, 17.32, 11.59, 6.98, 4.76, 2.24, 2.20 ng/m3, respectively. Metal elements in PM2.5 samples from Taiyuan included Al, Mn, Pb, Cr, Cu, As, Ni, V, Cd and Co. Their levels were 2 817.64, 91.04, 63.33, 26.56, 24.69, 11.82, 10.39, 4.46, 3.42, 1.01 ng/m3, respectively. There were significant differences among Pb, Mn, As, Ni levels between Shenzhen and Taiyuan (all P1.00×10-4), then followed by As, Ni and Cd (1.00×10-6-1.00×10-4). Pb had the lowest risk (<1.00×10-6). Conclusion Some of the metal elements in PM2.5 samples collected from Shenzhen and Taiyuan have carcinogenicity risk. Further researches and measures for prevention and control should be considered.

Correlation between serum iodine level and thyroid cancer / 中国现代普通外科进展

Objective:To explore the correlation between serum iodine level and thyroid cancer.Methods:100 patients with thyroid cancer and 100 healthy controls (control group) were recruited in this study.Headspace gas chromatography was employed to detected serum iodine level.The clinical data were collected to analyze its association with different factors.Results:The high peak age of thyroid cancer patients was from 40 to 59.Mortality of thyroid cancer in female was significantly higher than that in male.Compared with control group,serum iodine,free thyroxine(FT4),triiodothyronine(T3),thyroglobulin antibody(TG-AB)levels were increased significantly.Besides,as the serum iodine level increased,the percentages of benign thyroid cancer declined while the percentages of malignant thyroid cancer increased,which has statistical significance(P＜0.05).Conclusion:Higher serum iodine level seems to be an inducing factor of malignant thyroid cancer,and serum iodine level has a certain reference value for identification of benign/malignant thyroid cancer.

[Observation on comprehensive control strategy for schistosomiasis with emphasis on infectious source control in Poyang Lake areas from 2009 to 2014].

OBJECTIVE: To evaluate the long-term effect of the comprehensive control strategy for schistosomiasis with emphasis on infectious source control in marshland-type endemic areas of Poyang Lake. METHODS: Three heavy endemic villages with schistosomiasis in the lake areas were selected as pilots for the comprehensive control strategy which included replacing bovine with tractors and forbidding grazing on marshlands. The data of schistosome infections of residents and Oncomelania hupensis snails were collected and analyzed statistically from 2009 to 2014. RESULTS: There were no patients with schistosomiasis through feces examinations in the 3 pilot villages. The average density of live snails in Niuzhou marshland showed a decline trend and the density was stable in Liulingwei marshland. There were no infected snails in the 2 marshlands, and no schistosome adult worms were found in the sentinel rats. CONCLUSION: The implantation of the comprehensive control strategy for schistosomiasis with emphasis on infectious source control can control the prevalence of schistosomiasis during a long period.

Opinion on the Industry Standard for Laparoscopic Trocar / 中国医疗器械杂志

There are some limits and irrationality in practical application of the clause 3.1, 3.2, 4.4.2, 4.5.2, 4.9.1 of YY 0672.1-2008 as the industry standard for laparoscopic trocar. This paper puts forward some opinion and advice.

Efficacy and safety of prolonged-release trazodone in major depressive disorder: a multicenter, randomized, double-blind, flexible-dose trial.

OBJECTIVE: To investigate the efficacy, safety, and clinical benefit of prolonged-release trazodone (Trittico) in the treatment of major depressive disorder (MDD). METHODS: In this study, 363 Chinese patients with MDD were randomized 1:1 to receive either prolonged-release trazodone (150-450 mg) or placebo treatment for 6 weeks. The primary efficacy measurement was the change of the 17-item Hamilton Depression Rating Scale (HAMD-17) total score from baseline to the end of the study. The secondary efficacy measurements were the response and remission rates, the Clinical Global Impression - Improvement of Illness (CGI-I) score at the end of the study, and the change of the HAMD-14 total score and quality of sleep [evaluated by the Pittsburgh Sleep Quality Index (PSQI) scale] during the study period. RESULTS: The mean maximum daily dose was 273.11 mg for the trazodone group and 290.92 mg for the placebo group. At the end of the study, there was a significant difference between the two groups in the HAMD-17 change score (trazodone vs. placebo: -11.07 vs. -8.29, p < 0.001). Trazodone showed advantages at 1 week of treatment, and the effect lasted until the end of the study (week 6). The response and remission rates of the trazodone group were significantly higher than those in the placebo group (response rate: 59.6 vs. 37.2%, p < 0.001; remission rate: 35.5 vs. 22.2%, p = 0.005). The majority of the adverse reactions of trazodone were mild to moderate, and the most frequent adverse reactions (≥5%) were dizziness, dry mouth, somnolence, and nausea. CONCLUSIONS: Prolonged-release trazodone was more effective than placebo in MDD and was well tolerated.

Increased prediction of right nonrecurrent laryngeal nerve in thyroid surgery using preoperative computed tomography with intraoperative neuromonitoring identification.

BACKGROUND: A nonrecurrent laryngeal nerve (NRLN) is a rare but potentially serious anatomical variant. Although the incidence is reported to be 0.3% to 1.3%, it carries a much higher risk of palsy during thyroid surgery. The objective of this study is to investigate the usefulness of computed tomography (CT) for preoperative identification and intraoperative neuromonitoring identification (IONM) of NRLN in thyroid cancer patients. METHODS: The preoperative neck CT scans from 1,574 patients who needed thyroid surgery were examined. Absence of the brachiocephalic artery (BCA) and the presence of arteria lusoria were defined as positive with NRLN. Systematic intraoperative neuromonitoring (IONM) was also carried out for these 1,574 patients to localize and identify NRLN. A negative electromyography (EMG) response from lower vagal stimulation but a positive EMG response from the upper position indicated the occurrence of an NRLN. RESULTS: Nine NRLN (0.57%) were intraoperatively identified out of the 1,574 patients, and no patient with a NRLN showed preoperative clinical symptoms related to NRLN. Prior to the operation, surgeons identified only seven suspected NRLN cases based on identification of arteria lusoria. But a review of CT scans revealed that all cases could be identified by vascular anomalies. All patients were successfully detected at an early stage of operation using intraoperative neuromonitoring (IONM). Postoperative vocal cord function was normal in all patients. CONCLUSIONS: CT of the neck is a reliable method for predicting NRLN before thyroid cancer surgery. However, some image features can be easily missed. Neurophysiology helps the surgeon to identify the NRLNs more precisely. Combining the two evaluation methods may decrease the incidence of nerve palsy, especially in cases of NRLN. Considering that CT is expensive, requires an X-ray, and achieves less information than ultrasound (US) concerning thyroid nodules, we suggest that applying US and IONM is more reasonable.

Evaluation of genechip for detecting isoniazid- and rifampicin-resistance of Mycobacterium tuberculosis in China: a Meta-analysis / 中华传染病杂志

Objective To evaluate the effect of genechip in detecting isoniazid-and rifampicinresistance of Mycobacterium tuberculosis (MTB) in China.Methods Studies of genechip in detecting MTB resistance to isoniazid and rifampicin in China,which were published from January 1995 to June 2013,were identified through searches of PubMed,Science Direct,CBMDISC,CNKI and Wanfang database.Meta-Disc1.4 software was used for all analyses.Results Totally 618 articles were identified.Fifteen articles published from 2004 to 2013 were finally included in the study.The pooled sensitivity and specificity of genechip in detecting MTB resistance to isoniazid was 0.79 (95 ％CI:0.77-0.81) and 0.94 (95％CI:0.93-0.95),respectively,with the area under curve (AUC) of 0.86.The pooled sensitivity and specificity of genechip in detecting MTB resistance to rifampin was 0.91 (95％CI:0.89-0.92) and 0.96 (95％CI:0.96-0.97),respectively,with the AUC of 0.97.The pooled sensitivity and specificity of genechip in detecting MTB resistance to multidrug was 0.75 (95％CI:0.72-0.78) and 0.97 (95％ CI:0.96-0.98),respectively.Conclusions The effect of genechip in detecting MTB resistance is moderate for isoniazid,while better for rifampin in China.More studies are needed to evaluate the effect of genechip in detecting multidrug resistance in MTB.

Influence of blastocysts morphological score on pregnancy outcomes in frozen-thawed blastocyst transfers: a retrospective study of 741 cycles / 华中科技大学学报（医学）（英德文版）

The influence of inner cell mass (ICM) and trophectoderm (TE) score on pregnancy outcomes in frozen-thawed blastocyst transfer cycles was analyzed. A retrospective analysis of 741 cycles of frozen-thawed blastosysts transfer was performed. All cycles were divided into four groups based on the number and morphological score of blastocysts: S-ICM B/TE B group (n=91), the single blastocyst transfer of ICM B and TE B; D-ICM B/TE B group (n=579), double blastocysts transfer of ICM B/TE B; D-ICM B/TE C group (n=35), double blastocysts transfer of ICM B/TE C; and D-ICM C/TE B group (n=36), double blastocysts transfer of TE B/ICM C. The pregnancy outcomes were compared among the four groups. As compared with D-ICM B/TE C group, the clinical pregnancy rate, implantation rate and multiple pregnancy rate were increased in D-ICM B/TE B group (74.96% vs. 57.14%, 57.43% vs. 37.14%, and 48.62% vs. 25%, respectively, P<0.05 for all). Clinical pregnancy rate and implantation rate in D-ICM B/TE B group were also higher than in D-ICM C/TE B group (74.96% vs. 50%, and 57.43% vs. 33.33%, both P<0.05). Multivariable Logistic regression analysis indicated that ICM score was a better predictive parameter for clinical pregnancy (OR=3.05, CI 1.70-5.46, P<0.001), while the trophectoderm score was a better one for early abortion (OR=0.074, CI 0.03-0.19, P<0.001). Clinical pregnancy rate and multiple pregnancy rate in S-ICM B/TE B group were significantly lower than those in D-ICM B/TE B group (46.15% vs. 74.96%, and 2.38% vs. 48.62%, both P<0.05), but there was no significant difference in the implantation rate between the two groups. It was suggested that the higher score of ICM and TE may be indicative of the better pregnancy outcomes. The ICM score is a better predictor of clinical pregnancy than TE, while TE score is a better one in predicting early abortion. Single ICM B/TE B blastocyst transfer in frozen-thawed cycles can also get satisfactory pregnancy outcomes.

Influence of blastocysts morphological score on pregnancy outcomes in frozen-thawed blastocyst transfers: a retrospective study of 741 cycles / 华中科技大学学报（医学）（英德文版）

The influence of inner cell mass (ICM) and trophectoderm (TE) score on pregnancy outcomes in frozen-thawed blastocyst transfer cycles was analyzed. A retrospective analysis of 741 cycles of frozen-thawed blastosysts transfer was performed. All cycles were divided into four groups based on the number and morphological score of blastocysts: S-ICM B/TE B group (n=91), the single blastocyst transfer of ICM B and TE B; D-ICM B/TE B group (n=579), double blastocysts transfer of ICM B/TE B; D-ICM B/TE C group (n=35), double blastocysts transfer of ICM B/TE C; and D-ICM C/TE B group (n=36), double blastocysts transfer of TE B/ICM C. The pregnancy outcomes were compared among the four groups. As compared with D-ICM B/TE C group, the clinical pregnancy rate, implantation rate and multiple pregnancy rate were increased in D-ICM B/TE B group (74.96% vs. 57.14%, 57.43% vs. 37.14%, and 48.62% vs. 25%, respectively, P<0.05 for all). Clinical pregnancy rate and implantation rate in D-ICM B/TE B group were also higher than in D-ICM C/TE B group (74.96% vs. 50%, and 57.43% vs. 33.33%, both P<0.05). Multivariable Logistic regression analysis indicated that ICM score was a better predictive parameter for clinical pregnancy (OR=3.05, CI 1.70-5.46, P<0.001), while the trophectoderm score was a better one for early abortion (OR=0.074, CI 0.03-0.19, P<0.001). Clinical pregnancy rate and multiple pregnancy rate in S-ICM B/TE B group were significantly lower than those in D-ICM B/TE B group (46.15% vs. 74.96%, and 2.38% vs. 48.62%, both P<0.05), but there was no significant difference in the implantation rate between the two groups. It was suggested that the higher score of ICM and TE may be indicative of the better pregnancy outcomes. The ICM score is a better predictor of clinical pregnancy than TE, while TE score is a better one in predicting early abortion. Single ICM B/TE B blastocyst transfer in frozen-thawed cycles can also get satisfactory pregnancy outcomes.

Collagen membrane alleviates peritendinous adhesion in the rat Achilles tendon injury model.

BACKGROUND: Tendon adhesion is one of the most common causes of disability following tendon surgery. Therefore, prevention of peritendinous adhesion after surgical repair of tendon is a major challenge. The aim of this study was to explore the possible application of a collagen membrane for the prevention or attenuation of peritendinous adhesions. METHODS: Sprague-Dawley (SD) rat Achilles tendon was cut and sutured by a modified Kessler's technique with or without the collagen membrane wrapped. Macroscopic, morphological and biomechanical evaluations were applied to examine the recovery of the injured tendon at 4 and 8 weeks after surgery. RESULTS: The surgery group wrapped by collagen membranes had a better outcome than the group with surgery repair only. In the collagen membrane-treated group, less adhesion appeared, stronger tensile strength was detected, and more tendon fibers and collagen I expression were observed morphologically. CONCLUSION: Wrapping the tendon with a collagen membrane may be an efficient approach for tendon repair and preventing tendon adhesion after its ruptures.

Collagen membrane alleviates peritendinous adhesion in the rat Achilles tendon injury model / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Tendon adhesion is one of the most common causes of disability following tendon surgery. Therefore, prevention of peritendinous adhesion after surgical repair of tendon is a major challenge. The aim of this study was to explore the possible application of a collagen membrane for the prevention or attenuation of peritendinous adhesions.</p><p><b>METHODS</b>Sprague-Dawley (SD) rat Achilles tendon was cut and sutured by a modified Kessler's technique with or without the collagen membrane wrapped. Macroscopic, morphological and biomechanical evaluations were applied to examine the recovery of the injured tendon at 4 and 8 weeks after surgery.</p><p><b>RESULTS</b>The surgery group wrapped by collagen membranes had a better outcome than the group with surgery repair only. In the collagen membrane-treated group, less adhesion appeared, stronger tensile strength was detected, and more tendon fibers and collagen I expression were observed morphologically.</p><p><b>CONCLUSION</b>Wrapping the tendon with a collagen membrane may be an efficient approach for tendon repair and preventing tendon adhesion after its ruptures.</p>

Clinicopathologic features of gastrointestinal stromal tumor with synchronous carcinoma / 中华病理学杂志

<p><b>OBJECTIVE</b>To evaluate the clinicopathologic features of gastrointestinal stromal tumor (GIST) with synchronous carcinoma and the treatment principle.</p><p><b>METHODS</b>Nineteen cases of GIST with synchronous carcinoma were collected from 113 cases of GIST from 2002 to 2008. The clinicopathologic features were studied and the expression of CD117, CD34, smooth muscle actin and S-100 protein were detected by immunohistochemistry using EliVision method. The expression of proliferation marker Ki-67 was also studied. GIST with synchronous carcinoma and those without carcinoma were compared.</p><p><b>RESULTS</b>Nineteen cases (16.8%) of GIST with synchronous carcinoma were found, including 11 males and 8 females (male to female ratio 1.38: 1.00). The age of the patients ranged from 43 to 66 years (median age 57 years). Five of 19 cases were located in the inferior segment of esophagus and 14 were in the gastric wall. The diameter ranged from 0.6 to 3.8 cm [mean (1.91 ± 0.92) cm]. Three of 19 cases showed low grade dysplasia, and there was no dysplasia in the remaining 16 cases. The number of mitosis ranged from 0 to 4/50 HPF [mean (0.74 ± 1.07)/50 HPF]. The Ki-67 proliferative index (number of Ki-67 positive cell/HPF) ranged from 0 to 7.72% [mean (2.51 ± 2.20)%]. The synchronous carcinomas included two esophageal carcinomas and 17 gastric cancers.In contrast, patients of GIST without carcinoma included 52 males and 42 females (male to female ratio 1.24: 1.00). The age of patients ranged from 43 to 71 years (median age 55 years). Seventy-nine of the 94 cases were located in the stomach, 10 were in the intestine and 5 were in the esophagus. The diameter ranged from 2.4 to 15.5 cm [mean (5.42 ± 6.17) cm].Seventy-nine of the 94 cases showed variable degrees of dysplasia, and 12 cases were of high malignant potential. The number of mitosis ranged from 0 to 53/50 HPF [average (3.78 ± 10.22)/50 HPF]. The Ki-67 proliferative index ranged from 0 to 37.54% [mean (6.78 ± 12.45)%]. Comparing these two groups, the male to female ratio of GIST with synchronous carcinoma was higher than that of GIST without carcinoma. The average diameter of GIST with synchronous carcinoma was smaller than of those without carcinoma. The number of mitosis and Ki-67 proliferative index of GIST with synchronous carcinoma were significantly lower than those without carcinoma (t' = 2.809, P < 0.05; t' = 3.095, P < 0.05, respectively).</p><p><b>CONCLUSIONS</b>Sixteen point eight percent of GIST may be associated with synchronous carcinoma. There are no special clinical symptoms in most of GIST with synchronous carcinoma, as these GIST are usually incidental findings. The Ki-67 proliferative index of GIST with synchronous carcinoma is significantly lower than that of GIST without synchronous carcinoma. Most GIST with synchronous carcinoma can be treated by the standard treatment for the accompanying carcinoma, and do not require specific additional treatments.</p>