Objective Analyzed 32 cases of gastrointestinal stromal tumors(GIST) patients,to analysis the clinical and pathological characteristics of gastrointestinal stromal tumors of the stomach and explore associated prognostic factors.Methods Thirty-two GIST patients confirmed pathologically were included from May,2007 to April,2013.Their clinical records were retrospectively analyzed.Results Of the 32 GIST patients,the overall survival (OS) is 85.3％ for the second year.The progression free survival (PFS) is 79.2％ for the second year,respectively.Univariate survival analysis showed that OS and PFS have significant association with tumor size,metastasis,mitotic index and NIH risk group.Conclusions Metastasis and NIH risk group both are potential prognostic factor for gastric GIST.

Objective To observe the clinical effect of orally montelukast combined with doxofylline in older bronchial asthma.Methods A total of 87 stationary phase older bronchial asthma patients were divided into trial group (44 cases) and control group (43 cases).Trial group was given orally montelukast 10 mg 1 time/d,doxofylline 0.2 g,2 times/d.Control group was given inhaled fluticasone 250 μ g,2 times/d,a total of 3 months.The forced expiratory volume in one second (FEV1),peak expiratory flow rate (PEFR),one second rate (FEV1/FVC),asthma control test (ACT) score and the adverse reaction were compared between the 2 groups.Results There were no significant differences in FEV1,PEFR,FEV1/FVC before treatment between the 2 groups (P ＞ 0.05),they were significantly improved after treatment [trial group:(2.20 ± 3.21)L vs.(1.68 ± 0.71) L,(3.97 ± 0.32) L/s vs.(3.27 ± 0.32) L/s,(76.18 ± 1.02)％ vs.(63.91 ± 1.40)％,control group:(2.24 ±0.75) L vs.(1.71 ± 1.58) L,(4.06 ±0.34) L/s vs.(3.29 ±0.28) L/s,(77.85 ±0.67)％ vs.(62.37 ± 1.29)％],there were statistical differences (P ＜ 0.05).But there were no statistical differences after treatment between the 2 groups (P＞ 0.05).According ACT score,total effective rate in trial group was 90.9％ (40/44),in control group was 95.3％(41/43),there was no statistical difference (P ＞ 0.05).The rates of adverse reaction in trial group and control group were 4.5％(2/44) and 7.0％(3/43),there was no statistical difference (P ＞ 0.05).Conclusions The curative effect of orally montelukast combined with doxofylline in older bronchial asthma closes to the classic solution of inhalation fluticasone,which is easily accepted by older patients,and safety.It provides another option for older bronchial asthma patients.

ObjectiveTo investigate the efficacy of aerosol inhalation of Pulmicort Respules combined with urbason in treating severe bronchial asthma.MethodsThe clinical data of 40 cases aith severe bronchial asthma treated in our hospital were analyzed retrospectively,among which 20 cases underwent Pulmicort Respules combined with urbason(Tset Group),20 cases underwent urbason( Control Group).ResultsCompared with the control group,the blood gas analysis in test group had statistically significant difference before treatment (P ＜ 0.05 ).Compared with the control group,the clinical effect and the blood gas analysis in test group had no statistically significant difference after treatment(P ＞ 0.05 ).Compared with the control group,the complications in test group had statistically significant difference( P ＜ 0.05),the complications in test group was less than the control group.ConclusionAerosol inhalation of Pulmicort Respules can reduce the amount of urbason and lower the incidence d complications.The combination treatment of this two drugs can achieve the same clinical results alike the clinical effect of large doses of methy lprednisolone.

ObjectiveTo analyze the application effects of two dimensional Duplex imaging and Site- Rite 5 ultrasound guided instrument during PICC insertion. Methods60 cases underwent color ultrasound- guided PICC were divided into the control group and the experimental group,they used the SiteRite 5 ultrasonic guided instrument and two dimensional Duplex imaging for PICC respectively.The success rate of vessel puncture,success rate of one- time insertion,accuracy in vessel selection and the rate of local tissue damage between the two groups were compared. ResultsThe experimental group had a higher success rate in the vessel selection and also with a higher rate of local tissue damage,but success rate of vessel puncture,success rate of one- time insertion were lower than the control group.However,there were no significant differences. ConclusionsFor the hospitals which can't purchase the Site- Rite 5 ultrasound guidance instrument for PICC,the two dimensional Duplex guidance can he attempted for PICC.It can achieve a higher success rate of insertion,especial in patients with bad condition of the peripheral vessels,so that this technology can be developed rapidly and widely.

Objective To investigate the effects of ginsenoside(GS) on the expression of phosphorylated extracellular signal-regulated kinase(ERK) and cytokines in THP-1 induced by ?-amyloid(A?)_(1-40). Methods Human monocyte THP-1 cell line was used as a model of microglia.The expression of phosphorylated ERK was measured by Western blotting.The concentration of cytokine interleukin(IL)-1,IL-8 and tumor necrosis factor-?(TNF-?) was determined by radioimmunoassay in supernatant of THP-1 cells.Results The expression of phosphorylated ERK was enhanced and the concentration of cytokine IL-1,IL-8 and TNF-? was significantly increased in THP-1 cells stimulated by A?_(1-40) as compared with that of control group.Preincubation of THP-1 monocytes with ginsenoside(GS) for 30 min reduced the(expression)(of)(phosphorylated)(ERK)(and)(decreased)(the)(levels)(of)(cytokine)(IL-1,)(IL-8) (and)(TNF-?)(significantly)(in)(THP-1)(cells)(induced by) A?_(1-40).Conclusion Ginsenoside inhibites phosphorylation of ERK and reduces the content of cytokines in THP1 monocytes induced by A?,it may provide a novel therapy for alzheimer's disease.

With the development of transportation and construction, due to the increasing incidence of spinal cord injury, patients mainly rely on family caregivers.The paper reviewed the type of care burden and the influencing factors, and nursing intervention mode to decrease the caregivers' burden of spinal cord injury patients. We wish to provide suggestions for building nursing intervention model of Chinese spinal cord injury caregivers .

OBJECTIVE: To establish an HPLC-ELSD method for the determination of glucose in levofloxacin mesylate/glucose injection(LMGI).METHODS: The samples were determined by HPLC-ELSD on shim-pack VP-ODS column using ammonium acetate solution(adjusted to pH4.0 with acetic acid glacial)-acetonitrile(gradient elution) as the mobile phase at a flow rate of 0.7 mL?min-1.The injection volume was 10 ?L.The ELSD conditions were as follows: pressure of N2=35 PSI;drift temperature=80 ℃;spray temperature=48 ℃;attenuation Gain=10.RESULTS: The linear range of glucose was 49～148 ?g(r=0.999 8) and the average recovery rate was 100.18%(RSD=0.61%).CONCLUSIONS: The method is accurate,specific and applicable for the determination of glucose in LMGI.

Diabetic macular edema (DME) is a common complication of diabetes that can lead to severely impaired visual acuity.Its pathogenesis is complex,which is closely related to the destruction of blood-retinal barrier,and there are many cytokines involved in its formation,but the exact mechanism is not yet fully clear.Recent researches suggested that some typical pathological characterizations of retina can be used as criteria for evaluating its occurrence,and it is known that a variety of risk factors participated in the pathological process,such as glucose,blood pressure,blood lipids,which are well-known and can be closely correlated with its development through impacting the systemic and retinal vascular functions by complex mechanisms and leading to endothelial dysfunction.While other systemic risk factors,such as diabetic nephropathy which leads to changes in osmotic balance,anemia which increases cytokines caused by ischemia and hypoxia,excessive body weight which leads to vascular damage through fat factor,smoking that produces blood vessel damage by promoting oxidative stress on the body and various hypoglycemic drugs,will influence the development of macular edema on different levels.So conducting a comprehensive and newest understanding of this disease and its risk factors are conducive to better prevention efforts for diabetes patients.This review mainly summarizes the latest researches on definition,classification,pathologic characterization and risk factors of DME.

To study the effect of postural change on intraocular pressure ( lOP ) fluctuation in open angle glaucoma patients after trabeculectomy, and to discuss the value of this investigation on prognosis.METHODS:Fifty-one cases (62 eyes) of primary open angle glaucoma were selected as the research object. Perkins ophthalmotonometer was used to test lOP at the time when patient seat ( first seat ) . The patients were asked to lie supine for 25min, detected lOP, and the patients seated again (final seat), sustaining for 15min, detected lOP. According to whether the lOP range was more than 5mmHg, they were divided into high volatility fluctuation group and low volatility fluctuation group. We recorded their visual field progression ( with AGlS score) , HPA staging, in order to evaluate the correlation of lOP range with them. Reviews were made 3mo a time, and lasted for 1a, in order to evaluate the relation between lOP range and AGlS scores.RESULTS: The lOP of first seat was 18. 1+2. 2mmHg. There was no significant difference in the same position (P>0. 05 ). The lOP range was 4. 1 ± 1. 5mmHg. Low volatility fluctuation group was more likely to have low AGlS score and to be early vision HPA ( P<0. 001, P<0. 05 ) . There were significantly positive correlation between lOP range and AGlS (r=0. 412, P<0. 001); With time increasing, the number of patients whose visual field progression was increased, and the lOP was also raised. At any time the two were positively correlated (P<0. 01).CONCLUSlON:Visual field progression is related to the degree of lOP fluctuation in open angle glaucoma patients after trabeculectomy, so we can predict the prognosis of patients simply by detect lOP fluctuation. This is good to adjust the lOP control scheme.

Expression of the T-type Ca2 + channels has been reported in numerous types of tumors due to their unique activation/inactivation properties. In some cancer cells, the expression of T-type Ca2+ channels is proliferation state dependent. T-type channel blockers or interfering the α1 subunit of this channel via siRNA decrease proliferation of these cells. Since T-type Ca2+ channels are not expressed in epithelial cells, selective T-type Ca2 + channel blockers maybe serve as a potential therapeutic approach in the treatment of certain types of cancers.