Molecular targeted agents changed the therapeutic pattern on gastrointestinal stromal tumor (GIST).Imatinib of 400 mg/d is recommended to be the first line therapy for metastatic GIST.Escalation of imatinib dose or sunitinib could improve the overall survival of patients when the treatment with standard dose of imatinib failed.In addition,new targeted agents showed potential anti-tumor efficacy.Imatinib adjuvant therapy could improve the recurrence-free survival of GIST patients with median or high risk after complete tumor resection.Preoperative treatment with imatinib raises tumor resection rate,but whether it could provide survival benefit has not been proved.C-kit/PDGFRα gene mutation can predict the efficacy of imatinib and sunitinib,and it is helpful to screen out the GIST patients to receive imatinib adjuvant therapy.

Fibrin related markers include several proteins and fragments developed in the conversion of fibrinogen to cross-linked fibrin and following degradation.FDP played as a more important role than conventional global coagulation test before application of D-dimer in clinical settings,moreover,combination of FDP and D-dimer improve the diagnostic of DIC greatly,and D-dimer has become an effective tool excluding venous thromboembolism besides the imaging.Whether basic or clinical research on soluble fibrin monomers and complexes were focused in an early stage,however,limited by diversity of analytes and nonstandardization,no full application was come into being.It is worthwhile to note that fibrin related markers release into plasma sequentially from initialization of fibrinogen activation to fibrinolysis.Thus,the combination of these index is useful to understand patient's condition (such as DIC),prognosis of VTE recurrence,and prophylaxes of post-operation thrombosis.

OBJECTIVE:To investigate the clinical efficacy and safety of high-dose valaciclovir combined with acupuncture in the treatment of herpes zoster. METHODS:194 patients with herpes zoster were divided into control group and observation group according to random number table method,with 97 cases in each group. Control group was given acupuncture treatment;observa-tion group was additionally given Valaciclovir hydrochlordide tablet 0.3 g,bid,based on control group. Both group received treat-ment for 10 d. Clinical efficacy and the time of clinical symptoms improvement were observed in 2 groups as well as VAS score and substance P level before and after treatment. The occurrence of postherpetic neuralgia and ADR were also observed in 2 groups. RESULTS:Total effective rate of observation group was 97.9%,which was significantly higher than 90.7% of control group,with statistical significance(P<0.05). The analgesic time,stopping herpes time,lesion scabby time,lesion disappeared time of observa-tion group were significantly shorter than those of control group,with statistical significance(P<0.05). There was no statistical sig-nificance in VAS score and substance P level between 2 groups before treatment(P>0.05);those of 2 groups were decreased sig-nificantly after treatment,and the observation group was lower than the control group,with statistical significance(P<0.05). The incidence of postherpetic neuralgia in observation group was 14.4%,which was significantly lower than 28.9% of control group, with significant difference (P<0.05). There was no statistical significance in the incidence of ADR between 2 groups (P>0.05). CONCLUSIONS:High-dose valacyclovir combined with acupuncture can effectively treat herpes zoster,with advantages of analge-sic effect,rapid lesions recovery,low rate of postherpetic neuralgia with good safety.

The current tensive patient-patient relationship provides an unfavorable condition for the development of hospitals and the improvement of people's health level.Thus,it's necessary to harmonize the physician-patient relationship.To achieve this goal,hospital management should be enhanced;the concept of services rectified;the regulations and rules perfected,the attitudes towards services improved,the quality of services meliorated.Therefore,the overall development of the hospital will be further promoted with the help of advanced culture.

Objective To investigate CT features of brain in carbon monoxide poisoning.Methods CT features of brain in 18 cases of carbon monoxide poisoning were retrospective analysed.Results Bilateral symmetric low density areas within the globus pallidus and low attenuation of white matter were common features,the former was characteristic and amounted to 56 percent of all cases.Abnormality of cerebral cortex,hippocampus and cerebellum might be detected.Conclusion Brain CT is valuable to confirm the diagnosis of carbon monoxide poisoning/

BACKGROUND:Basic fibroblast growth factor can promote angiogenesis and connective tissue regeneration, but it can be degraded rapidly in vivo. Fibrin glue as a carrier can play a slow-release effect against the rapid degradation of basic fibroblast growth factor, so as to better play the biological role of basic fibroblast growth factor. But at present, the concrete application of them is stil in the research stage. OBJECTIVE:To review the research progress of the application of basic fibroblast growth factor and fibrin glue in orthopedics. METHODS:The recent literature concerning the application of basic fibroblast growth factor and fibrin glue in orthopedics was extensively reviewed by the first author through a computer-based retrieval of CNKI and Medline databases (2000-2014). RESULTS AND CONCLUSION:Finaly 64 articles were included in result analysis. Basic fibroblast growth factor can promote wound healing and tissue repair with the fibrin glue used as a carrier, but most studies are stil in the experimental stage and its clinical application needs further study.

OBJECTIVE To establish the distribution and the drug resistance of the pathogens of lower respiratory tract infections in a comprehensive intensive care unit(ICU).METHODS The bacterial culturing and the tests on the antibiotic from the deep phlegm in an ICU of the hospital from 2004 to 2005 were retrospectively analyzed.RESULTS Totally 408 phlegm samples were tested and 216 of them had bacteria,the positive rate was 52.94%.From them were isolated 240 strains of bacteria(among them 12 samples with 2 kinds of bacteria).The strains of Gram-negative bacteria were 172 and the positive rate was 71.7%,there were 35 strains of Gram-positive cocci with the positive rate of 14.6%.And there were 33 strains of fungi,the positive rate was 13.7%.Acinetobacter baumannii occupied the first place.The lowest drug resistance rate of the Gram-negatives was to SCF(0.0%),IMP(17.8%),and LEV((20.0%)).All Gram-positive cocci were sensitive to vancomycin,no vancomycin resistant.Staphylococcus were found.Candida albicans was sensitive to all tested drugs.CONCLUSIONS The isolation rate of A.baumannii is significant higher than reported before and its drug resistance is heavier.It indicated the importance of monitoring bacterial distribution and drug resistance dynamics.

Objective To investigate the causes of biliary tract complications after liver transplantation, and to put forward effective measures of prevention, diagnosis and treatment. Methods The literatures of recent years were reviewed and summarized. Results The causes of biliary tract complications after liver transplantation are very complex, and there are no standard preventive measures. Treatment differs according to causes. Conclusion One of the most important causes leading to biliary complications is preservative and ischemic injury. Poorly operative techniques and blood supply to biliary tract are also disastrous. Improving T tube placement can reduce the incidence of biliary complications related with T tube. To prevent biliary complications, it is crucial to completely wash the biliary tract, avoid damaging the blood supply to donor biliary tract and manage perfect biliary mucosa-to-mucosa anastomosis without tension. T tube cholangiography combined with noninvasive MRCP enables accurate depiction of the biliary tree and diagnosis of biliary complications. Doppler ultrosonography should be routinely applied postoperatively. Timely application of interventional radiological technique is a valuable nonoperative procedure for treatment of biliary complications. Meanwhile, biliary sludge or cholestasis and mixed infections of biliary tract should be handled actively and properly.

Aluminum ; urine ; Humans ; Metallurgy ; Occupational Exposure ; analysis ; Reproducibility of Results ; Spectrophotometry ; methods

BACKGROUND:Many diabetic patients get microcirculation disturbance due to abnormal hemorheology In a long-term angiopathy,which finally induces severe complications.OBJECTTVE:TO observe the influence of Yishen decoction on hemorheology in patients with diabetes mellitus and diabetic nephropathy and compare with the healthy controls.DESIGN:Controlled observational experimentSETFING:First Clinical Medical College,Harbin Medical University.PARTICIPANTS:Seventy-six inpatients with diabetes mellitus were enrolled at Department of Integrated Traditional and Westem Medicine,First Clinical Medical College,Harbin Medical University from January 1998 to December 2000 as diabetes mellitus group.Sixty-five inpatients with diabetic nephropathy were selected at the same hospital from January 1994 to February 2001 as diabetic nephropathy group.130 healthy subjects,who did body examination,were selected at the same hospital in 1993 as control group,including 98 males and 32 females,with an average age of(42±12)years.All subjects in the three groups knew the program and agreed to participate in the experimont.METHODS:The patients received conventional treatment combined with Yishen decoction containing herba epimedii,herba leonuri,astragalus mongholicus,each 20 g,barbary wolfberry fruit,solomonseal rhizome,gold theragran,dioscorea root,rhubarb,each 15 g,cowherb seed 25 g,as well as sanguisuge 0.8 g(taken medicine after mixing with water).These Chinese herbs were decocted at a simmer(200 mL),taken in the morning and evening respectively for 4 weeks.2 mL venous blood was collected from fasting subjects in the case groups.Hemorheology was measured before and after treatment in the case groups,whereas in body examination in the control group MAIN OUTCOME MEASURES:Hemorheological indexes.RESULTS:A total of 76 subjects with diabetes mellitus,65 subjects with diabetic nephropathy and 130 healthy subjects were involved in the result analysis.①Whole blood viscosity,plasma viscosity and plasma fibrinogen levels were obviouslv higher in the subjects of the diabetes mellitus group compared with the control group before treatment(P＜0.05-0.01). These changes were more significant in subjects of the diabetic nephropathy group(P＜0.01).Hematocrit and erythrocyte sedimentation equation K value were obviously higher in the diabetic nephropathy group than the control group(P＜0.01)Whole blood viscosity level,hematocrit and erythrocyte sedimentation equation K value were markedly hiaher in the diabetic nephropathy group than the diabetes mellitus group before treatment(P＜0 05-0.01). ②Whole blood viscosity and plasma viscosity levels,hematocrit and erythrocyte sedimentation equation K value were remarkably decreased in the case groups and most recovered to normal(P＞0.05).CONCLUSION: Yishen decoction can ameliorate the hemorheology of diabetes mellitus and diabetic nephropathy patients.