Sunitinib malate (SU11248 ,Sutent) is an orally available small-molecule multitargeted tyrosine kinase inhibitor that has potent anti-angiogenic and antitumour activities.In 2006 sunitinib was approved by FDA for imatinib intolerant gastrointestinal stromal tumors (GIST) patients or imatinib resistant GIST patients.This article review the molecular-based mechanism,the mechanism of resistance,the biomarker,the clinical trials and the adverse effects of sunitinib in the treatment of imatinib-resistant GIST.

Various hypotheses have been put forward to explain the pathogenesis of hemorrhoidal diseases. However, the etiology and mechanisms of hemorrhoids are far from clear, and as a consequence the present therapeutic objective is just to relieve or abolish the symptoms of hemorrhoids. In this review, the recent research advances on the pathophysiological characteristics that are closely associated with hemorrhoids are analyzed and discussed, which include constipation, high anal resting pressure, anal mucosa damage, aging of the anal cushion supporting tissue, blood and vessel alterations, obstruction of microcirculation and biochemical changes.

With advancements in the field of cancer stem cells,the hypothesis that colon cancer originates from stem cells has not only been introduced but also receives substantial supports by separating a subpopulation of colon cancer cells through primitive cells markers.Unlike most non-tumourigenasis colon cancer cells,these tumor-initiating cells have many specific characters both in vitro and in vivo.An improved understanding of drug resistance based on cancer stem cells and molecular pathways that regulate proliferation and differentiation of gastrointestinal cancer stem cells could doubtless translate into new therapeutic strategies.

Objective; To elucidate the mechanism of the role of ER-a in fat metabolism by regulating the expression of ER-a in SD rats marrow mesenchymal stem cells during differentiating into adipocytes in vitro. Methods ;SD rats marrow mesenchymal stem cells were separated and cultivated. The ER-a was transfected into the rBMSCs in group one. Tamoxifen Citrate was used to restrain the expression of ER-a in group two, the group without any treatment was used as control. Western blot was used to identify the difference of ER-a expression among different groups and Oil-Red-0 staining was employed to identify the adipocytes in vitro. Results; There was significant difference between the number of lipids and different groups (P <0. 01) ,the number of lipid droplet changed concomitantly with ER-a: Low-expression ER-a group > Control group > High-expression ER-a group. Conclusion; ER-a in SD rats marrow mesenchymal stem cells may restrain the adipocyte differentiation.

Objective To know about the status quo and influencing factors of undergraduate nurses' psychological empowerment at present,and provide a theoretical basis for nursing administrators so as to take measures to raise the level of psychological empowerment of undergraduate nurses.Methods General information questionnaire for nurses,Psychological Empowerment Scale were used to survey 207 undergraduate nurses in 3 first class teaching hospital of Dalian City.Results Undergraduate nurses' psychological empowerment score was (43.890±6.515) points,four dimensions whose scores from high to low were self-efficacy,job significance,autonomy and job impact.There was statistical difference in terms of ages,working length,working positions,professional titles,working purposes and training opportunities.Among them,working position and working purpose were the most important influencing factors of psychological empowerment.Conclusions Psychological empowerment of undergraduate nurses needs to be improved,managers should pay attention to the role of psychological empowerment,and actively cultivate and correctly guide undergraduate nurses in order to stimulate their potential in work,and finally,promote the sustainable development of a solid nursing career.

Objective To analyze nursing intervention and digoxin treatment of elderly heart failure patients taking digoxin drug compliance reasons. Methods Select Red Cross Hospital of Hangzhou on March 21, 2015 to March 21, 2016, 110 cases of senile heart failure patients as the research object, take the envelope random grouping scheme, divided into normal group and experimental group two groups, each group are occupying 55 cases. Among them to digoxin therapy on conventional therapy alone, in the experimental group were markedly drug treatment and corresponding nursing intervention, compared two groups of patients' medication compliance and quality of life score. Results the patients in the experimental group were 98.18% and 81.82% respectively, and the comparison groups were significantly different(P<0.05). The experimental group after treatment the patient's quality of life score of each dimension (physical function, psychological state, the doctor-patient relationship, independence, social relations, the personal faith and the general quality of life) were significantly better than the conventional group(P<0.05). Conclusion For elderly patients with heart failure to take scientific and reasonable method for nursing to improve the adherence of digoxin drugs, improve the quality of life, is worth popularizing practice.

Acute myeloid leukemia (AML) originates from rare leukemia stem cells (LSC).Because these chemotherapy-resistant LSC are thought to underlie disease relapse,effective therapeutic strategies specifically targeting these cells may be beneficial.With the increasing knowledge regarding the LSC,several major directions in targeted therapies with regard to LSC are being investigated.These include targeting cell surface molecules,signal pathways,and microenvironment of LSC.Since eliminating LSC-should provide an efficient,potentially curative treatment option for leukemia patients,this article reviews the recent progress of LSC targeting in AML therapy.

OBJECTIVE: To sum up the advantages and disadvantages as well as application prospects of several kinds of new devices in airway management, including the laryngeal mask airway (LMA), esophageal-tracheal combitubes (ETC),fribreoptic stylet laryngoscope (FOS), video Macintosh intubating laryngoscope system (VMS) and GlideScope(R) videolaryngoscope(GSVL).DATA SOURCES: Using the terms "airway management", we searched Medline for airway management device-related articles, which were published during January 1990 to February 2006 in English.STUDY SELECTION: The materials were firstly selected. Successful rate of intubation, intubation-related complications and incidence in studying tracheal intubation with LMA, ETC, FOS, VMS and GSVL were chosen. Inclusive .criteria: ① Randomized and controlled study of adult cases. ② Clinical studies or case report. ③ Including the studies of general airway or difficult airway. Exclusive criteria: ① Study of intubation in children. ② Repetitive study.DATA EXTRACTION: Eighty-six articles about tracheal intubation with LMA, ETC, FOS, VMS and GSVL were chosen, among which, 36 were included in this study, and 50 were excluded due to study on intubation in children or repetitive study.DATA SYNTHESIS: Correct placement does not affect vocal cord movement, so patients may vocalize while an LMA is in place. Its successful rate is over 90%. Its most attractive advantages are increased speed and ease of placement by both inexperienced personal and experienced anesthesiologists, low frequency of cough and low incidence. The esophageal tracheal combrtube is a supraglottic airway device that functions as an effective alternative to ventilization via mask and tracheal intubation in both the esophageal and tracheal position. It is successful when emergency occurs, but it is only suitable for adults. The flexibility of FOS allows for intubation of patients, without the need for head and neck manipulation. The main disadvantages of FOS are their limited field of view and the high cost of purchase and maintenance. Observation and manipulation in using VMS can be performed in one axis. GSVL provides a clear view of larynx on the monitor instead of directly viewed by the operator.CONCLUSION: These new devices of airway management can relatively decrease the intubation difficulty, increase the successful rate and lead to lower complication incidence. The skills of these new airway management devices should be included in the modern anesthesia residency program.

It is a consensus to place stent after cutting bile duct in the hepatobiliary surgery in the past.However,as the development of bile physiological research and surgical technique,especially the raise of medical concepts of rapid recovery,the negative effects which are caused by the placement of stent have been taken seriously gradually.Up to now,whether the stent should be placed after the bile duct is cut has no definite answer yet.

This artical introduces the cutter develop t for basi hospitals to carry out the vitreous resection.It is characterized by simple structure,easy to use and carry,complete fuctions and it is satified with results.